Governor Doyle advised his audience last evening during the 'state of the state' message, that we were going to have to make some tough decisions and cut spending.
Then he proceeded to propose a new program called BadgerChoice that would have subsidies of $100 Million in the next budget cycle (beginning in 2009) and that would provide healthcare coverage for employees of firms under 50 employees. Republicans were quoted as saying that a lot could be done to stimulate the lagging economy with $100 Million, but the governor would apparently rather spend that money on this program.
He can find $100 Million for this but continues to veto the tax advantages of health savings accounts. Maybe the idea of consumers being able to make their own decisions is somehow unpalatable to him.
He wants to advance state-run healthcare at any cost and sees this as the opportune time in which to launch the effort...again. He would have the state design several plans of benefits, and employees would choose the one that best fit their needs. He would have insurers hamstrung to the point that they could not take health conditions into account. He would have all insurers in this marketplace use a device known as 'community rating'.
Community rating means that all people pay one of two things...they either pay too much because they're healthier or they pay too little because they're greater risks. No one pays the right premium. This causes something called 'adverse selection'. If this is a voluntary program, only those who have greater health risks will enroll in large numbers. Once that has begun to occur, insurers will seek to have the state raise premiums, or reduce benefits and will drop from the program if they cannot run the plans at a profit.
He wants to have the new 'marketplace' run without the employers and employees having the benefit of a licensed, trained and monitored health insurance agent available to handle the inevitable questions, education and problem resolution that is especially important in the small employer marketplace since, as the governor's administrator of the Division of Health Care Financing Jason Helgerson said, "Small businesses can't hire an HR Director". If that isn't the single most contradictory thing to come out of this, it has to be very near the top of that list. Small employers are the very area where a licensed insurance professional is needed, and virtually every small business person will attest to that.
It appears the governor is taking a page from the Commonwealth of Massachusetts where the "Connector" program was created. It serves as a clearinghouse, sets the plan design parameters, gets competing bids from insurers and works without agents except where one might be used to do the initial enrollment. The Connector has one significant difference, so far, and that is the mandate that everyone have coverage or face penalties assessed as part of the Massachusetts tax system. Even with the mandate requirement, insurers have already found themselves being hit with adverse selection as the result of the community rating scheme discussed above. The healthier people are flowing to the least expensive plans while the health risks are more interested in the higher benefit level programs.
This proposal is not only ill-timed given Wisconsin's obvious needs to reduce spending, novel concept that this is, but it is poorly thought. This is but another example of the fact that Democrats will not rest until Wisconsin runs health care for every citizen it can force into such a program. BadgerCare Plus is poised to launch on February 1st. That is a state-run health care program. It is what we used to think of as the children's health care program, BadgerCare, except that in Wisconsin we spent the majority of that funding to insure adults while some 40,000 children were never enrolled in the system. BadgerCare Plus doesn't try to hide its intent. Adults are openly accepted as of February 1st.
The 'nanny state' wants more and more of us wholly-dependent upon it for everything possible. We apparently should not have to take personal responsibility for our life style habits that account for more than half of all health care costs today.
We are living in an increasingly socialist state. We can change that if we choose when we go to the polling place. Or, we simply go another step down the 'slippery slope' to which we've grown nearer over the past decade.
Finally, if the governor were planning to stick with his promise to not run for another term, why would he continue to raise campaign dollars at such a rapid pace? The specter of another term after this one is indeed frightening. The only defense will be a Republican majority in both the Senate and Assembly.
