Reliable, affordable health care is a reachable objective

Debate in the other Washington has big consequences for our Washington

Wednesday, Sept. 30, 2009

By state Rep. John McCoy

Intense and all-too-often ferocious.

There’s no better way to describe our national health-care debate. In fact, the debate has become so intense and so all-too-often ferocious that it’s elbowed surreality TV stars and alien-abductions off the front page. Town-hall meetings, community forums, letters-to-the-editor columns, and, of course, Twitterdom and the blogosphere have never been so stampeded with citizen participation.

And that’s the way it should be. Wherever citizens stand on the issue, they have every right and every responsibility to participate and to speak their piece. Yes, I’d like to see more civility in this democratic process of ours. Sure, I’d like to see less showboating on the part of TV and radio uber-pundits more concerned with their wealth care than our nation’s health care. But I understand that regular people in the real world have strong feelings. It’s their money and, far more importantly, it’s their family’s well-being we’re talking about.

The bottom line for me is that reliable, affordable health care for citizens is a reachable objective. After all, how does a society become a society in the first place? I say you measure it by the way it meets people’s basic needs. And I say basic health care is a reliable, affordable, and reachable need.

Through the Basic Health Plan, through expanded Medicaid, and through programs called Apple Health for Kids and the Health Insurance Partnership, we have stretched Washington state strategies providing publically subsidized health coverage for folks who don’t have insurance – and many of them are working people.

In the 2009 legislative session, we approved statewide standards to:
* Bolster telemedicine for home health care – requiring that the state’s Medicaid program must cover and reimburse these services.
* Streamline health-care administration – requiring that the Washington Insurance Commissioner and state agencies work together to get a better and more efficient bang for our health-care buck.
* Improve primary medical care – requiring that agencies look at state- funded health-care-assistance programs and work with private health carriers and health-care providers to design, implement, and evaluate pilot projects for primary-care medical-home-reimbursement.
* Take aim at prescription-drug fraud – requiring that prescriptions not sent electronically must be written on tamper-resistant prescription pads in order to foil counterfeit prescriptions for narcotics and other dangerous drugs.
* Protect citizens against the MRSA infection (“methicillin-resistant staphylococcus aureus,” which is a serious bacterial infection that is highly difficult to treat) – requiring that every hospital in the state adopt a policy that includes:
(1) Testing intensive-care and at-risk patients for the infection.
(2) Developing procedures for arresting its spread if the infection is detected.
(3) Notifying patients who are sharing a room with an MSRA-positive patient.

But we as a country need to work toward national, long-term reform. There is only so much any state can do without a national commitment toward building health-care peace of mind for our neighborhoods and communities. You better believe this debate in the other Washington will have big consequences for our Washington.

According to a 2008 report from our Snohomish Health District, as many as 15 out of every hundred Snohomish County citizens between 18 and 64 have no health insurance. The report, which is available online at http://www.snohd.org/snoHealthStats/accessReport.htm#, says: “Access to timely and adequate health care plays an important role in preventing and treating disease.” That means it’s imperative for people to get their medical needs tended to today, and if at all possible, warded off today – not tomorrow in the emergency room. Further, the report says that 15 percent of the time citizens 65 to 74 years old were hospitalized in our county last year, their hospitalization could have been avoided – obviously a better physical outcome for them, and equally obviously a better fiscal outcome for the general public.

A lot of people who call this Washington their home work in jobs where you’re happy to get a paycheck every month and a pat on the back every now and then. Forget about “benefits,” such as health insurance. These are the American citizens who catch pneumonia whenever the “No new taxes, and while you’re at it, stay off my lawn!” crowd sneezes.

It’s unconscionable for a 21st-century society to stand idly by while citizens and families crash and burn. And as if that’s not enough, the economics of it are downright boneheaded for the rest of us. Folks who are thinking, AHey, this stuff doesn’t apply to me because I have a dependable job with good health insurance” should think again. These numbers hit home for all of us. What happens when an uninsured citizen finally ends up in the hospital for something that basic health care could have prevented early on? Take a wild guess who often winds up paying for it.

Then too these days, existing programs providing basic help for many deserving Washington people face cuts more severe than anything that’s been unleashed in years. The economic crisis left us with no choice in the 2009 session but to make significant cuts in health-care funding. Enrollment in the Basic Health Plan will have to drop from about 100,000 citizens in June 2008 down to about 65,000 by January 2010. And the new Health Insurance Partnership has yet to be funded. Just when we would have started kicking money in for premium subsidies for low-wage employees, the economic crisis hit. Our state has received a $34 million, five-year grant to launch the Health Insurance Partnership, however, and it should begin enrolling citizens by the end of next year.

People are absolutely right to look at the health-care debate and ask themselves:
* “What’s in it for me?”
* “How’s any change at the national level going to affect me?”
* “Where’s my health-care coverage going after the reformers get through with me?”

Now, you don’t need a Phi Beta Kappa lawyer to dissect and scrutinize every health-care proposal before Congress right now. As I understand it, the administration’s major goals are to:
* Reduce long-term growth of health-care costs for businesses and government.
* Assure affordable, quality health care for all citizens.
* Protect families from bankruptcy or debt because of health-care costs.
* Guarantee choice of doctors and health-care plans.
* Eliminate barriers to health-care coverage for citizens who have pre- existing medical conditions.

I noted some alarming numbers regarding the state of health-care access here in Snohomish County. Let’s throw some other local and national numbers into that troubling mix:
* Our county grew to more than 686,000 citizens from 1990 to 2007, and our population between 45 and 64 years old went up by 48 percent in those years.
* It’s estimated that, every day, 14,000 Americans lose their health-care coverage – and year in and year out, Americans who can get coverage must pay a lot more for it.
* The price for employer-sponsored health insurance has almost doubled since 2000, tripling the pace of wages.
* In 2008, the average premium for a family plan bought through an employer was just about what you’d make in a year at a full-time, minimum- wage job.
* Americans today pay more than ever for health insurance, but all too often actually get less coverage.
* The number of non-elderly Americans covered by employer-based health insurance fell from 66 percent to 61 percent between the years 2000 and 2007.
* An estimated 87 million people – one in every three Americans under the age of 65 – were uninsured at some point in 2007 and 2008, and more than 80 percent of those uninsured folks lived in working families.

Still another devastating, nightmarish number: A recent Harvard Medical School analysis found that every year in this country almost 45,000 uninsured people die because, in very large part, they simply don’t have a realistic opportunity to get the health care they need. Think about that for a second. Every 12 minutes some American citizen dies because in their country, our country – the only such country in the “first” world in this, the year 2009 – the big majority of folks must turn to the market for their health insurance, basically the same kind of “market” where they go for their breakfast cereal and their soda pop and their canned goods.

You don’t have to be a math whiz to see that right now, today, it’s time to stop the showboating on health care. You don’t have to be a fiscal mastermind to see that our nation’s health-care ship is sinking, and that it’s time for grown-up hands to steer the tiller toward genuine reform.

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Editor’s note: Washington State Rep. John McCoy, D-Tulalip, represents Snohomish County’s Everett, Marysville and Tulalip communities in the state Legislature. McCoy lives in Tulalip with his wife, Jeannie McCoy. He chairs the House Technology, Energy & Communications Committee, and he’s also a member of the House Financial Institutions & Insurance Committee, and the House Agriculture & Natural Resources Committee.