Health Care

WPC's Center for Health Care develops patient-centered solutions to reduce costs and improve the availability and quality of health care for businesses and individuals, providing the only detailed, independent critique of health care issues available in the Northwest.

What's New

The Impact of National Health Care Reform on Washington State

January 1, 2010 in Publications

U.S. House and Senate Democrats have passed two sweeping 2,000 page bills that would fundamentally and dramatically change our health care. There are significant differences between the two bills, but the more moderate Senate bill has the best chance of passing through the conference committee and being signed by the President. Both bills passed on a strict party-line vote, with essentially no support from minority Republicans.

What will this far-reaching legislation mean for Washington state?

Cigarette Taxes to Increase in 2010?

December 28, 2009 in Blog

As the legislature gears up for session in January and with the state facing a multi-billion dollar deficit (yet again), now is the time to pay close attention to trends the legislature may take. Perusing this pre-filed bill page can be useful.

One of the bills introduced today is House Bill 2493, an act "relating to the taxation of cigarettes and other tobacco products." Sponsored by Representative Cody, the bill, if passed, would raise cigarette taxes yet again. Currently, the state charges $2.025 per pack for cigarettes. 

Reading through the bill, it looks like the taxes would amount to $1 per pack more if the legislature and the governor sign off on the bill. That's about a 50% tax increa!
se for smokers. 

If the goal is to eradicate smoking, then the tax should be hiked even more. If the goal is to raise money for education programs, health care centers, water quality, and programs to stop youth violence, then a 50% increase in taxes will most likely move people towards purchasing tobacco from non-sanctioned sellers (aka the black market). The state says it already loses over $200 million in tax revenue per year to illegal sales of untaxed cigarettes. 

If policymakers are looking for a quick buck to help shore up the $2.6 billion budget deficit, this isn't the way. If, however, policymakers want more people to live up to what is sure to be their 2010 New Year's resolution, then raise the tax even more. My hope is that whatever our elected officials end up doing, they are honest about their motivations behind the tax hike.

Public Option by Another Name

December 11, 2009 in Blog

The latest "compromise" in the Senate debate on health care reform is the expansion of Medicare to anyone 55 - 64 years of age and the potential expansion of Medicaid to anyone who makes less than 150% of the federal poverty level (FPL). These measures would take the place of the "public option" passed in the House bill.

This is like something right out of Alice in Wonderland, where up is down and in is out.

Medicare is a public option, where everyone over the age of 64 is essentially required to join and where all participants are locked into a government run and controlled health care program. It is estimated that 3-5 million people would be eligible for the proposed Medicare buy-in. These new enrollees would be people without current health insurance and would be high utilizers of health care.

At present, Medicare has an unfunded liability of $89 trillion according to the CMS trustees. Adding millions more people to the program will not bend the cost curve of health care down unless significant rationing takes place. For the first three years there will be a buy-in for the 55 - 64 year olds to defray costs, yet after 2013 the federal government would simply wrap all participants into the standard Medicare plan.

Likewise, Medicaid is a government controlled health care program for the poor, where states share the cost with the federal government - in other words, tax payers from all over the country. Medicaid is also one of the largest budget items for virtually every state and is a main cause of the huge financial deficit states are facing.

Expanding Medicare and Medicaid is simply a bold move to place more of the American public in government controlled health insurance programs without calling it a "public option".

Americans Watch Nervously as Congress Debates Giant Health Care Bill

December 1, 2009 in Publications

The U.S. House of Representative has passed a 1,910 page health care bill essentially along party lines. The Senate is now considering its own 2,074 page bill, again along party lines.

Are the Uninsured Really Treated Differently After Major Trauma?

November 17, 2009 in Blog

The Archives of Surgery recently a published a peer reviewed paper concluding that people without health insurance were more likely to die after major trauma than people with health insurance. The study looked at trauma deaths as recorded in the national trauma registry from 2002 through 2006 and included a total of almost 700,000 patients.

Overall mortality in the insured group was 4.7% with a breakdown of 3.3% for commercial insurance, 2.9% for managed care, 3.7% for Medicaid and as expected in the higher age range, 6.7% for Medicare. The uninsured had a 5.7% overall mortality rate.

The study was very well controlled for matching age, race, severity of trauma, and type of trauma (blunt vs penetrating). The authors concluded that having health insurance determines the likelihood of survival after major trauma.

The one glaring difference between the insured and uninsured groups was the incidence of penetrating injuries. The commercially insured and managed care groups had a 6% and 9% rate respectively with seniors in Medicare at 4%. The uninsured had a 24% rate. Most penetrating injuries are gun shot wounds and it can be argued that the chance of surviving a gun shot injury is much less than surviving blunt trauma which is usually in the form of an auto accident or a fall.

The implication of the paper is that providers treat patients in an emergency setting differently based on their insurance status. This is disingenuous and is absolutely insulting to the medical profession.

Small businesses rank top policy priorities

November 13, 2009 in Blog

Small business owners, legislators, and policymakers from all over Washington gathered in SeaTac this past Tuesday to discuss the state's business climate at WPC's 2009 Statewide Small Business Conference. During several interactive issue breakout sessions, business owners suggested and discussed solutions to improve the climate for small businesses in Washington. This was the fourth statewide small business conference hosted by WPC since 2003.

Real Cost of Baucus Bill - $2 Trillion

October 9, 2009 in Blog

The Congressional Budget Office (CBO) scored the Senate Financial Committee health care reform bill this week. Never mind the fact the bill is only a summary and is not in legislative language, which made the CBO disclaim the cost of an actual final bill.

Total cost is reported at $829 billion with $81 billion in savings over the first ten years. Unfortunately, as published in a Micheal Cannon report for CATO, the cost would be closer to $2 trillion over the first ten years. So why the difference?

First, the CBO omitted $75 billion in new federal spending and $33 billion in unfunded mandates on state governments. Second, the nonpartisan CBO assumed Congress would allow the "sustainable growth rate" cuts in Medicare provider reimbursement starting in 2012. Congress has never let this happen. And finally, the CBO omitted the cost of the individual and employer mandates which represent 60% of the cost of Massachusetts' health care reform.

Therefore, to do the math: $829b + $75b + $33b = $937 billion (which is 40% of some number).

40% x N = $937 billion    N = $937 billion divided by 0.4 = $2.34 trillion.

So the Baucus bill is not budget neutral, let alone a deficit reducer. Instead, it is a colossal budget breaker that has the potential of bankrupting this country in just the first decade of application.

The President's Vision for Health Care Reform

October 1, 2009 in Publications

President Obama recently addressed a joint session of Congress and the American public. As always, his speech was forceful and well-delivered with just the appropriate amount of emotion.

New Policy Note Addresses Spokane's Community Bill of Rights Proposal

September 28, 2009 in Blog

Washington Policy Center today released a Policy Note that dives into Spokane's Proposition 4 -- the Community Bill of Rights. Voters inside Spokane city limits will vote on whether to amend the city's charter to include several new or expanded "rights" for citizens.

These rights include:

  • Residents have the right to a locally-based economy,
  • Residents have the right to affordable preventative health care,
  • Residents have the right to affordable and safe housing,
  • Residents have the right to affordable and renewable energy,
  • The natural environment has the right to exist and flourish,
  • Residents have the right to determine the future of their neighborhoods, 
  • Workers have the right to be paid the prevailing wage, and the right to work as apprentices, on certain construction projects,
  • Workers have the right to employer neutrality when unionizing, and the right to constitutional protections within the workplace.

The Policy Note points out:

  • The Community Bill of Rights will expand government entitlement programs, not individual rights,
  • Taxpayers could be on the hook to pay for proposed programs that have no funding mechanism in place,
  • The broad policy agenda is not affordable under the city's current budget,
  • The measure will likely face scrutiny in courts under the state's "single subject law."

The Policy Note also highlights potential costs associated with some of the measure's mandates, such as mandating affordable, renewable energy and the potential cost of insuring affordable, preventative care for Spokane citizens.

Finally, we also point out that many of the rights enumerated in the Community Bill of Rights proposal contradict each other, such as heightened environmental regulations increasing the cost of affordable housing, which would also be required for the city to provide. The Community Bill of Rights would also strip businesses from possessing any legal rights if a citizen were to file claim against a business in violation of the rights laid out in this proposal.

Chilling Views of Health Care Advisors Driving Reform Plans

September 17, 2009 in Publications

Everyone agrees the key to improving health care is to get control of unsustainable rising costs. This can be done either through greater market competition and more choices for consumers, or through restricting choice and imposing ever-tighter government controls. The thousands of pages of legislation now under consideration in Washington, D.C. show Congress and the Administration are opting for the second approach. A look at who is advising the White House on health care should cause all Americans to be very worried about our health care future.