Let's Act Now to Preserve Our Health Care

Our Health Care is at Risk in 2018

2018 is going to bring big risks in health care for all of us because the radical rightists in Congress want to cut or eliminate programs that we all depend on at some point in our lives. The radical rightists have deliberately created a crisis in the funding for Medicare and Medicaid by passing a tax cut primarily for the very rich. The tax cut will reduce the government’s revenue, and the radical rightists will use that reduction to claim that we cannot afford the programs on which we depend. 

We Must Provide Health Care for All Americans

The truth is that we can afford these programs, and, as claimed in a recent letter to the Post Crescent, we have a moral responsibility to provide health care for all Americans in a sustainable way.  Moreover, we should do so not merely from of a sense of charity but because, if we do not do so, most of us will soon be unable to afford the health care that we need.

Health Care Will Soon Be Unaffordable for Most Americans

“Wait a minute,” you may say. “Most Americans don’t depend on Medicare or Medicaid. Most Americans receive health insurance through their jobs, and they are not in danger of losing it.” That is true, but each year, the insurance costs more and covers less.  The employee’s share of the cost of health insurance is growing, and so are deductibles and co-pays. We have not yet reached a crisis point in employer-sponsored health insurance, but there is little doubt that we will reach a crisis soon. Health care is already unaffordable in the unsubsidized individual market, and cuts in Medicare may well come this year. Soon, health care will also be unaffordable for most Americans.

We Must Act Together

This is unacceptable, and we can do something about it. However, if we are to succeed, we must act as a community and not just as a scatter of individuals because the rising cost of health care has causes in the structure of health care delivery that an individual cannot address. No individual has the market power to bargain effectively with big insurance companies or monopolistic health care providers.  So, we must work together either through government programs or through cooperative action because if we do not, most of us will risk joining the hundreds of thousands of Americans who declare bankruptcy every year because they cannot pay for the health care that they receive.

In short, providing health care for all of us in a sustainable way is not a matter of charity. It is a matter of survival.

We Can Work in Our State and in Our Community

National action to make health care affordable for all Americans will not come soon because the radical rightists in Congress are uninterested in the well-being of the American people. However, in Wisconsin, there are currently two proposals to deal with the crisis in the affordability of health care. The first, proposed by Rep. Genrich of Green Bay is called “Badgercare-as-a-Public-Option,” (BPO) and it calls for making Badgercare available for purchase on Wisconsin’s health care exchanges. Under this proposal, an individual who would not be eligible to receive Badgercare for free would be allowed to buy into the program to provide health insurance for his/her family. The cost would be lower than the cost of insurance in the private market because Badgercare is big enough to negotiate lower rate with health care providers.

The second proposal, which comes from Fox Valley Health Care, would have the residents of the Fox Valley form a cooperative to bargain with health care providers to obtain health care locally at a reasonable cost. The cooperative would begin as a coalition of local governments that would join together to provide health care for their employees at a reasonable cost. It would be able to do so because, like Badgercare, the cooperative would be large enough to bargain with the health care providers.  Once the cooperative was up and running, it would be opened to individuals as a way to provide affordable health insurance for themselves and their families.

The advantages of BPO are that it brings the resources of the state to bear on the problem, and it addresses the needs of the whole state. However, BPO will be difficult to enact in a legislature dominated by Republicans, and in addition, it only addresses the problem of providing affordable coverage. It does not address the cost of health care directly, and if the cost is not addressed, BPO may become unsustainable. However, Badgercare has the bargaining power to force cost reductions in the future if the state has the political will to do so.

The advantages of a local health care cooperative are that it does not require legislative action and that it addresses the cost problem directly.  The disadvantages of a local cooperative are that it addresses the problem only in the Fox Valley and that it depends entirely on local resources. 

Let’s Get to Work!

Fortunately, the two ideas are not incompatible. We can support BPO at the state level while working to form a cooperative here in the Fox Valley. We should support both of these initiatives as strongly as we can because our healthcare is at risk in 2018. What are we waiting for?