Haven't seen a lot of visible response so far to last week's status report from Washington's office of the insurance commissioner, which may be partly because on its face - the preceding description - it doesn't sound like hot stuff.
The content is, though, or should be. And for the politically-minded among us, there's some terrific resource material packed in toward the back.
The main thrust of the report ("Threatening the Health Security of Washington") ought to be disturbing, if not especially surprising (for those who've paid attention to the woes of the medical care system these days). Except maybe in the details.
Insurance Commissioner Mike Kreidler has pulled together a strong case for getting covered those who have no health insurance, and the very large additional number who are drastically underinsured. He means to take the case to the 2008 legislative session, and if he makes serious headway at all it could be the biggest single thing the legislature does this session, or maybe this term. Among the pieces:
Guaranteed coverage for all Washingtonians • All Washington residents would have a guaranteed benefit plan that provides catastrophic coverage for unexpected health emergencies and guaranteed access to basic preventive care such as immunizations, cancer screening, and annual check-ups. All residents would be able to purchase additional coverage for the more routine health care not included in the guaranteed benefit plan. Premiums would be more affordable due to the plan, and subsidies would be available, on a sliding-scale, to help individuals and families purchase additional coverage.
Managing risk instead of avoiding it – changing insurance company behavior • The costs for insuring all Washington residents – regardless of their health status –would be covered through combined pooling and better managing risk, rather than avoiding risk by making coverage unavailable and unaffordable for some.
Personal responsibility • All residents would contribute according to their means and be encouraged to live healthy lifestyles, in part through guaranteed access to preventive care.
Is something like this doable? It's no slam dunk. But Washington legislators may be influenced by the example south of the Columbia, where Oregon officials already are busy setting up a health system approved by that state's legislature earlier this year. Handled with great care (as it was in Oregon), something like this might happen.
The report points to the urgency. After a description of the problem of the uninsured (about 700,000 or so Washingtonians), there's this on the insured: "Despite digging deep into their savings, raiding their retirement accounts and running up credit card balances, 27 percent of underinsured residents said they were still in debt to doctors and hospitals. Forty nine percent of all U.S. residents, and 43 percent of residents with insurance said they were “somewhat” to “completely medical emergency over the coming year."
The problems have ballooned all over the system. Increasingly, hospitals are eating medical costs, and the operative word is "increasingly." In 1996, Washington hospitals wrote off $160,347,281 in "uncompensated care"; exactly a decade later, the figure was $493,143,147 - tripled. That ought to be a number to conjure with at the statehouse.
Politics watchers can also find some juicy chart data here.