Tom Palzewicz
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Healthcare Plan

Achieving Universal Healthcare for Every American

 

Recently, I visited a free healthcare clinic in my district. I asked their team what the long-term goals of the clinic were, and they said they wanted to be put out of business. This may seem like a strange response, but it makes sense. The only reason this clinic exists is to fulfill an underserved healthcare need in the community. People turn to this clinic because so many don’t have access to affordable healthcare, and often times, they do so after they are already very sick.

Too many of us don’t have insurance or simply cannot afford it. The costs of prescription medication, basic tests and visiting a doctor are simply too high for way too many American families. Meanwhile, our healthcare system is one of the most expensive in the world.

In 2016, we spent almost 18% of our GDP on healthcare, which is more than education, transportation, veteran’s benefits and energy combined. [1]

Since we spend so much on healthcare, shouldn’t we be the healthiest country in the world with the best patient outcomes? Unfortunately, this is not the case. In the US, we have a shorter average life expectancy [2] and higher infant mortality rate [3] than many other industrialized nations.

Simply put, we are paying more and getting less.

When the Affordable Care Act (i.e. Obamacare) first came into effect, the number of uninsured Americans decreased dramatically. But as we speak, the Trump Administration and Congress are chipping away at it every chance they get, meaning more Americans are seeing higher costs and losing coverage. [4]

In 2017, we had a nearly 34% increase in the number of uninsured Wisconsinites over 2016. [5]

This is unacceptable. 

When healthcare coverage becomes more scarce and more expensive, we all lose -- physically, morally and economically. A healthy country is a productive country. 

In my view, access to affordable, quality healthcare is a fundamental human right, not a privilege. 

Below is my five-point plan to improve healthcare in America, which will make us a stronger country and help more people achieve the American Dream.

1. WORKING TOWARDS TRUE UNIVERSAL COVERAGE

We are the only major industrialized nation without guaranteed access to healthcare for all of its citizens. For too long, powerful special interests have been able to effectively block any form of a universal plan from passing, despite more than 50% of our country supporting it. [6]

A system such as “Medicare For All” will lower costs and make healthcare more affordable for everyone. Currently, our healthcare expenses are bloated and inefficient. In 2016, our country spent roughly 8% of our total GDP on just the administrative costs of healthcare. [7]

Implementing true universal coverage will take a lot of work, and it won’t -- and shouldn’t -- happen overnight. We must recognize that hundreds of thousands of Americans work in the health insurance industry, and we need to have a transition plan for them. But, I believe we can get it done in a way that focuses on cost savings through streamlining and efficiency, while minimizing any potential negative impact to those companies operating within the current system.

I believe the first steps should be to increase eligibility for Medicare by allowing people to choose to enter at a younger age, such as 50 or 55, and to add a true public option to the healthcare exchanges for individual coverage. Then, we need to allow group purchase of plans on the exchanges, and cover all children in a universal, single-payer program. 

These reforms will lead to the inevitable transition to a single-payer program that significantly reduces or even eliminates the need for private health insurance, allowing health care decisions to be made for health reasons, rather than financial reasons.

Let’s be very clear -- this system will require a transition, and we’ll need to assist those whose jobs may be displaced in the process.  But in the end, this system would cost less than our current system, while covering everyone. Even the Koch Brothers have to acknowledge that, as a recent study they funded indicates. [8]

Until we’ve worked toward Medicare For All, we must stabilize the Affordable Care Act and structure the exchanges to ensure they offer great options to the American people. This starts with creating a public option for people to buy coverage. We must ensure that young and healthy people have every incentive to get coverage, and we must absolutely ensure that we continue to cover all preventative care without a copay. No one should ever be charged more because of their age, gender, or pre-existing condition.

2. REPRODUCTIVE HEALTH IS A RIGHT

For too long, politicians -- mostly wealthy men -- have been making decisions about women’s reproductive rights. This needs to end. Women must have a full and equal seat at the table and drive the direction and implementation of our reproductive health laws. 

I believe a woman has a constitutional right to choose abortion before viability. But even if you disagree, we should all be able to agree that women should be able to prevent themselves from getting pregnant if they choose. The reality is that anti-choice groups continue to attack not only the availability of abortion, but access to birth control. And their radical views on access to reproductive healthcare results in women finding it harder to access even things like pap smears and cancer screenings. 

Designing a reproductive health system that meets the needs of every woman will help improve infant mortality rates, ensure every woman who chooses to have children has a healthy pregnancy and childbirth, reduce unwanted pregnancies, decrease the number of women who die during childbirth, and help cut down the spread of sexually transmitted diseases, among many other benefits.

It’s my view that healthcare clinics and the women they support should not be burdened with unnecessary regulations that are clearly disguised as laws aimed at shutting down access to care. I oppose so-called “TRAP”[9] laws that attack the availability of legal care by using unjustifiable regulations like how wide corridors should be or insisting that doctors get credentialed at health facilities they don’t even work at. And, we absolutely need to continue to support the funding of crucial women’s health organizations like Planned Parenthood and others. These organizations not only provide pre- and post-pregnancy care, but often serve as the main form of primary care for many women in need.

3. IMPROVE PROACTIVE AND PREVENTATIVE CARE

The skyrocketing costs of our current healthcare system prevent most Americans from being proactive about their health. This leads to higher long-term costs, and for many, leads to putting off medical attention until it’s too late.

When you have to decide whether a trip to the doctor is more important than putting food on the table, it leads some to ignore symptoms and only seek treatment once they’re very sick. This, in turn, drives up the costs for not only those individuals, but throughout the system as a whole. [10]

We must create a system that prioritizes proactive and preventative health. People need to be able to see their doctor regularly, before they get sick. The passage of the Affordable Care Act included many important incentives for people to be more proactive with their health, such as ensuring that all health plans cover basic preventative care, like an annual check-up and birth control, with no co-pay.

But we can do more. We should design incentives in all health coverage programs that reward people for living a healthier day-to-day lifestyle. Many group health insurance plans provide rebates to insured people who participate in wellness programs, and we should make those types of incentives universal. 

Another step forward would be putting a renewed emphasis on health-related education within both our primary care system and our public education system. We need to train more nurses and primary-care providers. And we need to incentivize health care professionals choosing career paths to improve health outcomes, not just to make a lot of money, and to serve the poor and underserved populations such as the rural and urban poor. By ensuring there are enough providers to meet the need, we can create more access and give people a chance at preventing illness and disease instead of just treating it after it is done.


4. INVEST IN HEALTHCARE INFRASTRUCTURE

One of the most crucial elements to a properly functioning healthcare system is a strong infrastructure. If we don’t have access to high-quality emergency rooms, hospitals, labs and qualified doctors and nurses entering the workforce, then the whole system starts to crumble.

We long ago decided that when someone experiences a medical emergency, it’s our duty to treat them, no matter the cost. But our financing system makes no sense. First, the cost of care often is a burden on a patient who might have sought emergency care through no fault of their own, and often cannot afford to pay the resulting bills. Then, the costs they can’t cover often fall to nonprofit hospitals who can’t afford to take too many non-paying patients.

Investing in infrastructure that makes it easier and more cost-effective for people to seek preventative care will dramatically reduce expenses across the board. And investing in more facilities where people need them, serving the urban and rural poor, will lower overall costs.

As it stands now, the US is projected to have a shortage of physicians ranging from 40,000 - 105,000 [11] over the next decade. Our best and brightest used to seek careers in medicine, but now they’re increasingly turning to other professions. And it’s easy to understand why -- challenges like complicated insurance bureaucracy and lower pay for primary care providers lead many of our young people to pursue other careers with less red tape and more financial opportunity.

Our healthcare system must ensure every American has close geographic access to the physical facilities they need and the providers they need, and that our young people are excited and incentivized to once again pursue primary care as a profession.

We also need to examine how our licensing system reduces supply, and while ensuring quality and safety, think about opening up more opportunities for competition in the health labor market.

These steps will help make a universal solution more affordable, but more importantly, will lead to people living a healthier and more economically productive life, reducing costs for all of us and improving health outcomes for all of us. 


5. STRENGTHEN OUR EARNED BENEFIT PROGRAMS

We have an aging population. Every day, roughly 10,000 Baby Boomers turn 65. They’ve worked hard for decades to pay their fair share into earned benefit programs like Medicare and Social Security that they expect will be there to support them when it’s their turn. This must be protected.

Our veterans who have served our country honorably deserve access to high quality VA care. We must ensure that wait times are kept to a minimum and that VA hospitals are receiving the funding they need to keep our veterans in good health. They’ve risked everything for us, and we must ensure they’re taken care of. 

Recently, there have been attempts made to eliminate funding for CHIP (Children’s Health Insurance Program). This program covers over 9 million children in need. We cannot have a healthcare system that allows our elected officials to play politics with children’s lives. CHIP must continue to be funded as a top priority.

With the passing of Trump’s $1.5 trillion tax giveaway to the wealthiest in America, programs like Medicare and Medicaid are now at risk of being decimated as Congress seeks ways to pay for their giveaway to the ultra-rich. Until we have a true universal healthcare system, it’s imperative that we continue to expand Medicaid at the state level so that our most vulnerable citizens have access to the coverage they need. By expanding Medicaid, states will realize increases in revenue, reductions in costs, decreases in uncompensated care and increased coverage rates in rural areas, among many other benefits. 

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It comes down to this: we are the richest country in the world but we have a second-rate healthcare financing system. When every American has guaranteed access to affordable, quality healthcare, the resulting benefits to our economy are almost too big to fathom. 

So I’ll propose one more important concept - we must stop making health insurance coverage dependent on where you work and how well you are employed. If we decouple jobs from coverage, then people will be free to seek any job they want -- not forced to keep one they don’t like just to have health insurance. Additionally, entrepreneurship and job mobility would likely increase because people will be able to remove healthcare from their decision-making process.

We’d have parents no longer forced to choose between fixing their car or letting their child see the doctor. Without the extreme stress of worrying over how we’ll pay for our family’s healthcare, our combined productivity increase could pay for any cost of a universal healthcare system several times over. 

The American people want it, and once elected, you have my word that I’ll do everything in my power to get universal healthcare passed.

 

Footnotes

[1]https://jamanetwork.com/journals/jama/article-abstract/2674671
[2]http://fortune.com/2018/02/09/us-life-expectancy-dropped-again/
[3]http://time.com/5090112/infant-mortality-rate-usa/
[4]https://www.scmp.com/news/world/united-states-canada/article/2128555/32-million-americans-lost-health-insurance-donald
[5]https://news.gallup.com/poll/233597/uninsured-rate-rises-states-2017.aspx
[6]https://www.washingtonpost.com/news/the-fix/wp/2018/04/12/about-half-of-americans-support-single-payer-health-care/?noredirect=on&utm_term=.fc768df16244
[7]https://jamanetwork.com/journals/jama/article-abstract/2674671
[8]https://www.thenation.com/article/thanks-koch-brothers-proof-single-payer-saves-money/
[9]“Targeted Regulation of Abortion Providers”
[10]https://insight.kellogg.northwestern.edu/article/who-bears-the-cost-of-the-uninsured-nonprofit-hospitals
[11]https://news.aamc.org/press-releases/article/workforce_projections_03142017/