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Commission takes first steps toward statewide access to health care |
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Written On: January/February 2007 |
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Written By: by Paul Schlienz |
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Will Washington state start thinking creatively on health care? A new report from the Washington State Blue Ribbon Commission on Heath Care Costs and Access gives hope to those who have pressed for market-oriented reforms instead of burdensome regulations and taxes on the business community.
"Our goal is to improve Washington’s health by increasing access to, enhancing the quality of and containing the costs associated with health care," said Sen. Pat Thibaudeau, D-Seattle, co-chair of the commission, which was created by a proviso in the governor’s 2006 budget.
The genesis of the report was in May 2006, when Gov. Chris Gregoire announced the formation of a blue-ribbon panel to find ways of providing accessible, affordable, quality health care for all residents of Washington. The commission was bipartisan, with two members of each of the four legislative caucuses (Speaker of the House Frank Chopp, D-Seattle; Rep. Eileen Cody, D-Seattle; Rep. John Serben, R-Spokane; Rep. Bill Hinkle, R-Cle Elum; Sen. Lisa Brown, D-Spokane, Sen. Linda Parlette, R-Wenatchee; and Sen. Alex Deccio, R-Yakima.) in addition to Insurance Commissioner Mike Kreidler, Secretary of Health Mary Selecky, Health Care Authority Director Steve Hill, the Department of Social and Health Services’ Doug Porter, and Labor and Industries’ Robert Malooly. Gov. Gregoire co-chaired the commission along with Thibaudeau.
Five-year plan
The commission’s final report, which was in draft form as this article went to press, proposes a five-year plan to improve access to health care. Significantly, the plan does not call for tax increases on business to achieve this objective.
The plan includes four main strategies and timetables. By July 1, 2010, the report calls for ensuring that all children have access to health care insurance coverage. This goal is to be achieved by linking children with a "medical home," identifying health improvement goals for children and linking innovative purchasing strategies to these goals. Parents would be encouraged to take more responsibility for their children’s health, and legislation would be introduced, in 2007, to give parents the option of buying into the State Children’s Health Insurance Program with any expansion tied to increased cost sharing by parents.
By July 1, 2012, the commission calls on the state to develop a health care system that uses evidence-based medicine, promotes prevention strategies and healthy lifestyles, better manages chronic illness, increases data transparency to give consumers and providers better information on health care costs and quality, and expands the use of health care information technology.
Also by July 1, 2012, the commission wants the state to provide affordable health insurance options. The commission’s strategy is to promote a marketplace that connects individuals and small businesses to affordable insurance plans, providing coverage to high cost individuals through affordable means, and targeting the young adult population.
Details are pending on this portion of the plan, since the final recommendations are dependent upon a series of studies that will not be released until February.
Finally, by July 1, 2012, the commission calls for a program to promote prevention and health promotion. This part of the plan calls for rewarding sound prevention policies in public and private health plans, strengthening the public health system, and initiating strategies to improve childhood nutrition and physical activity.
No 'pay-or-play'
"The report fits in well with many of our objectives," said AWB’s Mellani McAleenan. "The report is very broad because the commissioners want it to have bipartisan support. Often, the devil is in the details. The more specific you get, the more potential there is for controversy. Still, its goals match well with the business community’s concerns."
Co-chair Thibaudeau and Rep. Eileeen Cody—along with Insurance Commissioner Mike Kreidler—were supporters of the 2006 legislative session’s Health Care Responsibility Act, which would have taxed many businesses of over 50 employees that buy coverage with insufficient benefits or do not sponsor health care in order to pay for the state’s Basic Health Care Plan for their employees. Nevertheless, such a "pay-or-play" approach to health care does not appear to be on the table with this commission. Indeed, the bipartisan focus and desire for acceptance of the commission’s plans may explain why there has been no call for taxing businesses to pay for employee health care.
"What the commission has done is that it’s gotten us to a point where Democrats and Republicans are talking," said commission member Rep. Bill Hinkle. "This is just a first step. We need to make sure that we provide an environment where businesses will have some flexibility in their health care choices."
The commission has yet to propose any specific legislation to enact its goals. It remains unclear if the commission’s ideas will gain traction in the Legislature once they are fleshed out.
"The health care purchasers now have an opportunity to help us develop legislation," Hinkle added. "Everyone wants to look at their ideas. That’s a step in the right direction. We have to make sure that any actions for small business are not dependent on government funding."
Clearly, whatever happens to the commission’s plan, the health care issue is not going to go away any time soon. Some 595,000 people remain uninsured in Washington state. Of these, approximately 400,000 are low-income children, parents, and childless adults. There are also 50,000 small business employees who are uninsured. Half of the uninsured are between age 19 and 34.
"We have a responsibility to ensure that all Washingtonians have access to quality health care that fits within their budget," Gov. Gregoire commented. "The current system is not working for a large portion of our citizens."
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