From HCFA-WA members Cris Currie, RN (ret), MA, former Rep. Denny Dellwo, Dan Schaffer, MD, and Lynette Vehrs, RN, MN:
To the Editor:
Imagine if everyone in Washington state could get truly affordable, high quality health care, when they needed it. Imagine if, like the U.S. Marines, we never left anyone behind. Imagine a standard rate for each procedure, known in advance. Imagine nobody ever going bankrupt again or needing a Go Fund Me account to pay their medical bills. Imagine seamless coverage, separate from employment and fractured networks of providers. Imagine standardized, administratively simple, and fair provider reimbursements.
Creating a pathway towards these goals was the task for members of the Washington State Universal Health Care Work Group, which wrapped up its assignment this month after delivering its report to the legislature. The group was established in 2019 and consisted of a broad range of stakeholders with expertise in health care financing and delivery (including two of us from Spokane), a few legislators, paid actuarial analysts, and administrators from the Washington Health Care Authority. Nine meetings were held over 18 months. Meeting materials, recordings, public comments, and reports are all available here.
So, what exactly was accomplished? In short, the report shows that universal health care in Washington is not only necessary, possible, and urgent, it also represents an economic life boat. It’s necessary and urgent because far too many people are still priced out of the care that they desperately need. After the pandemic caused the state’s uninsured rate to double, over 100,000 more residents enrolled in Apple Health, the state’s Medicaid program, further straining our tax base. But even so, about 8.7% of residents are still uninsured compared to 6.7% before the pandemic.
Study after study over the last 20 years, including two that specifically addressed Washington state, have shown that a single-payer, publicly administered, privately delivered universal system is the most cost efficient and sustainable solution available. The Work Group estimated that if such a program were instituted, Washingtonians would save roughly $2.5 billion in the first year. That number would rise to about $5.6 billion in subsequent years. Regardless of the exact numbers, this savings could completely erase the state shortfall caused by COVID!
But it’s not just dollars that matter here. When people can’t afford the medications or the physical and mental health treatments they need to lead normal lives, there are many kinds of hidden costs that add unnecessary strains and stresses to our society, lead many into drug addiction and crime, and drag down our productivity and happiness. It’s true that costs, including status quo costs, are often higher than predicted, and savings can be lower, but nobody is saying universal healthcare is strictly an economic issue. It is a moral issue as well. We need to make the shift to single-payer because it is the right thing to do for our people. It can even become a platform for redressing other fundamental societal inequities involving racism and the ever-widening gap between rich and poor. Nearly every other developed country in the world has reached these conclusions.
Despite the fact that about three-fourths of Work Group members and the vast majority of the nearly 300 public comments favored the single-payer model over any other approach, it won’t be easy to achieve. The report gave it low marks for feasibility, a largely subjective measure which can quickly change. However, the insurance industry has mounted a well-financed campaign to make it appear infeasible, and politicians still need to publicly admit that single-payer has no more in common with socialism than does the fire department. A single-payer health care system might be difficult, but it is definitely feasible.
Since the report failed to include a recommended funding mechanism, legislators will also need to gather more research to establish a simple payroll deduction and employer contribution plan that will leave workers with far more take-home pay and employers with far less administrative expense and hassle. There is tremendous support among healthcare providers, unions, business owners, consumer advocacy organizations, and even voters for state managed universal care, so the political will cannot be far behind. But just to make sure, it is still necessary to write to your state legislators and let them know how urgently this is needed. For more information go to www.healthcareforallwa.org where a free eBook is available called A Medicare for All Q & A.