IN THIS ISSUE:
? FamiliesUSA Hears From Clinton, Reinhardt
? Overview of State Legislative Challenges
? Universal Health Proposals Not Dead Yet
? Maine’s Governor Baldacci Seeks Universal Coverage
? New Hampshire’s Governor Benson Wants MSAs for State Workers
? Former Governor Dean Wants to Ride Health Care to White House
? Squeezed Between COBRA and Pre-Ex in Florida
? Florida Businesses Make Health Care Top Priority
? Association Health Plans Get Senate Help
FamiliesUSA Hears From Clinton, Reinhardt
You will no doubt be pleased to know that Bill Clinton is alive and well and still thinking about health care. He and Uwe Reinhardt were among the high-powered speakers at a recent Families USA conference last month in Washington trying to inspire the Left to get back in gear on health reform.
Most of Uwe’s talk was throwing red meat to the lions. He went on at length about how contemptible the United States is, including this observation: ?So you are more class conscious than any country in the OECD. Class is everything. Family dynasties is everything in this country. So don’t tell me. This country is run by an elite. They run and own it all. And they run it.? During the Q&A he recovered from his hysteria, and actually had some worthwhile things to say. When asked about reimporting drugs from Canada, he said it wasn’t a very good idea: ?If the Canadians pay less, I think Canadian GDP per capita is about 60 percent or 70 percent of ours. The Canadians are poorer on average. Therefore you would expect them actually to pay less for drugs than we do. And the idea is to sell the drugs to South Africa at cost, at marginal cost, at no profit at all. So you will have ideally staggered prices by the – staggered by the ability of nations to pay for it.? And, when asked about Senate majority leader Bill Frist, he said, ?I’ve seen a lot of people snipe at Billy Frist, saying he became a senator to bail out HCA. I happen to know that’s absolutely not true. That is just dumb. He – this man has power. I think he has good will. I think you should work with that, rather than bat him down because he isn’t totally like Paul Wellstone.?
Mr. Clinton’s presentation was mostly a defense of his administration and a blast at the idea of tax cuts, including refundable tax credits to help people buy their own coverage. Much of his time was spent explaining how a tax cut in America is stealing from people in Africa and Latin America (don’t ask me, I just report it), after which he says he wants to ?propose a political truce here,? because, ?we’ve got to try to find a bipartisan solution.? He’s like that kid you knew in the seventh grade who would whack people in the back of the head and then ?propose a truce? when they turned around to hit him back. Of course, like that kid, the only reason Mr. Clinton wants a truce is because he’s afraid of being hit back. He says, ?I think it’s quite interesting that the worst congressional losses the Democrats suffered in the last 60 years were the midterms of Harry Truman and my first midterm, and both happened after we tried to fix health care.? He thinks it is interesting because, ?the experts said we had made a very moderate proposal,? until it was ?demonized? by the ?health insurance industry.?
But, as you might expect, Mr. Clinton also has what he fancies are Deep Thoughts. This year’s Deep Thought is that, ?the number one task of the world is to move from interdependence to an integrated community.? Integration, in his mind, means making ?a world with more partners and fewer terrorists,? and doing ?more work in organized ways through international institutions,? like the United Nations. (He adds, predictably, ?it’s important to let these inspectors do their work.?) We also need to set an example, he says, which is why, ?we will continue the process of the integration of America into a community of shared benefits, responsibilities and values.? I guess he has already revised the Declaration of Independence to a ?Declaration of Interdependence,? and soon a ?Declaration of Integrated Communities.?
SOURCE: The whole conference is available as a webcast from Kaiser Family Foundation. These presentations may be found at:
Overview of State Legislative Challenges
Before Mr. Clinton ?integrates? them out of existence, lets look at what the states are up to these days. We’ll start with an overview by Martha King of the National Conference of State Legislatures, who writes a summary of health issues facing the states in the January issue of State Legislatures. She lists some of the problems facing states and says, ?The bad news can overwhelm would-be reformers?? She adds that state legislators often don’t have the time to look at systemic reform and tend to work on the most immediate problems. Some of the most immediate problems include, ?Shoring up the private market,? which may include allowing mandate-free coverage, establishing MSAs and other forms of consumer-driven care, and creating high-risk pools. Other topics she addresses include prevention and disease management, helping the uninsured, and reinventing Medicaid. She also mentions a couple of states that are trying to do longer-range thinking, including Kansas, Mississippi, and Kentucky.
SOURCE: Contact Martha King at: NCSL, 7700 East First Place, Denver, CO 80230, Tel: 303-364-7700, Fax: 303-364-7800. The article does not appear to be available on-line.
Universal Health Proposals Not Dead Yet
Business Insurance has an article by Judy Greenwald that shows some ideas will never die. Despite losing by four to one in the recent elections in Oregon, the Single Payer folks have a zombie-like ability to rise from the dead. The article repeats some of the tired old slogans — ?the United States is the only industrialized nation in the world that does not guarantee health care to all its citizens.? (Yeah, and the Soviets ?guaranteed? everyone bread – they just didn’t say when.) The article looks at some of the activities going on in Oregon, California, Maryland, Illinois, and Maine.
Maine’s Governor Baldacci Seeks Universal Coverage
Speaking of Maine, there are a couple of articles describing the new governor’s efforts to create a universal health care system in the state. Governor John Baldacci has ?made health care his top priority,? according to one advocate, and the Democrat-controlled state legislature is chomping at the bit. The governor’s health policy person, Trish Riley, says, ?(Lawmakers) are ready to move now and we’re asking them if they can wait and work with us for a broader, more comprehensive bill.? She may have her hands full. Some legislators are fervent about a single-payer government-run program, and don’t want to wait. Meanwhile, Ms. Riley is heading up a governor’s Health Action Team that hopes to present legislation in April to be enacted by June. The Bangor Daily News article reports that recent federal legislation will influence the governor’s approach. Some 5,000 former employees of Great Northern Paper are eligible for the tax credit under the Trade Adjustment Assistance Act, which subsidizes 65% of health insurance costs, and the governor will want to take advantage of that, along with the potential $1 million to create a high-risk pool.
SOURCE: There are two articles, one by Josie Huang in the February 9 edition of the Maine Sunday Telegram. There is a fee for accessing the archives at: www.portland.com
The other is by Meg Haskell of the Bangor Daily News on February 12, 2003. Access to the archives is free but you have to log in. The article is at: www.bangornews.com
New Hampshire’s Governor Benson Wants MSAs for State Workers
Next door, New Hampshire also has a new governor, Craig Benson, who is proposing a medical savings account option for state employees. He described it as, ?a modern way to deal with benefits.? The bill is being sponsored by state representative Fran Wendelboe, who sponsored similar legislation before that passed the House but died in the Senate. A State Employees Union spokesman said ?The union would be very interested in listening to a proposal,? according to the article.
Former Governor Dean Wants to Ride Health Care to White House
And a former New England governor, Howard Dean of Vermont, is making health care a cornerstone of his campaign. The Boston Globe reports that Dean ?hopes that health care can do for him what it did for Bill Clinton a decade ago?? (uh, you mean lose control of Congress?) The article describes Dr. Dean’s approach as ?a political hybrid of tax credits and expanded Medicaid coverage? similar to Vermont’s Dr. Dynasaur program. Most of the article was skeptical, noting that translating a program that works in tiny, rural, and homogenous Vermont into a program for Texas and California is a reach. Plus, the program is largely subsidized by physicians, who accept very low fees to see a handful of children. That dynamic will change once you get into states with 25% uninsured.
SOURCE: The article ran in the Boston Globe on February 10, 2003, by Susan Milligan and Liz Kowalczyk. There is a fee for accessing the Globe’s archives.
Squeezed Between COBRA and Pre-Ex in Florida
Now let’s go all the way down to Florida where the Tampa Bay Business Journal has run a number of articles on that state’s health woes. We’ll start with an opinion piece by Steven Kibort, who was a successful consultant in Colorado until his firm was sold and he was laid off. He says his COBRA premium was $750/month, up from the $130/month he had been paying while employed. He, his wife and daughter bought a 16-unit motel in St. Petersburg, moved to Florida and started looking for coverage. The daughter had a pre-existing sphincter condition, and they could only get coverage that excluded colon or rectal disorders for her. Mr. Kibort says she is fine now, but he worries about what might happen in the future. Curiously, he does not report what he is paying for this coverage or whether he is putting aside the savings to pay for the girl’s future needs.
Florida Businesses Make Health Care Top Priority
In the same issue, Stacey Snow reports that, ?health care is top of the mind for small business owners?? For the past three years a state chamber survey found that ?finding qualified employees? was the number one concern of Florida’s employers. This year, affordable health insurance is number one. The article reports on a meeting of local business leaders with the state’s Speaker of the House during which they called for, ?easing the state’s insurance mandates, allowing small businesses to purchase basic coverage, and securing caps on non-economic damages in medical malpractice cases.? They also supported enabling Association Health Plans.
Association Health Plans Get Senate Help
Kent Hoover reports ?Momentum Grows for Association Health Plans? in several of the local business journals. The hook is a hearing chaired by Sen. Olympia Snowe (R-ME) in her new role as head of the Senate Small Business and Entrepreneurship Committee. The hearing heard from hard-pressed business owners and led Sen. Snowe to conclude, ?Let there be no doubt, there will be cost savings (if AHPs are enacted).? Also testifying in favor of AHPs were Secretary of Labor Elaine Chao and SBA Administrator Hector Barreto. The article says that Sen. Snowe has the moderate credentials to appeal to Democrats, and the AHP drive is also helped by the election to the Senate of Jim Talent (R-MO), an ardent proponent when he was in the House. Opposing are the Blue Cross Blue Shield Association and the state insurance commissioners.
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