Whack-a-mole is No Longer Working to Keep Healthcare Affordable
If it is Not Affordable, it is not Accessible
Thank you to all who traveled to Olympia to testify!
Thank you to the HCFA-WA members serving on the Work Group: Dennis Dellwo, Pete McGough, Kelly Powers, Ronnie Shur, Lynette Vehrs, and Sherry Weinberg
The theme of this second meeting was Problem Identification and Root Causes. The meeting kicked off with remarks from Sue Birch, the Director of Health Care Authority who urged us to weave in coverage, access, eligibility as well as transparency, true costs and potential innovations into our proposals.
I was asked to share my health care story, which you can watch at the 10:37 mark. I spoke to the fact that 40% of Americans cannot afford a $400 emergency1— they don’t have the cash, the savings, nor the credit. With high premiums, deductibles and co-pays — up to $2500 for an individual, and $7500 per year for a family of four on the Exchange– it is a crisis for many Washingtonians.
Whack-a-mole — keeping premiums down only to have co-pays go up over there — is not working anymore. My family’s premiums have more than doubled since 2012, the inception of the ACA and the Exchange. My family will be paying over $2300 per month including the cost of our daughter who is attending college out of state. This year, many Exchange plans had minuscule premium increases, but are offering 30% co-pays— even at the Gold and Silver level. So that would mean, roughly, that if it costs about $30,000 to deliver a baby — a family will have to pay $10,000.
I wish I had used the example of breast cancer. Treatment costs an average of $100,0002 — so that’s $33,000 a patient would be responsible for under these plans. Clearly, this is unsustainable and unaffordable for most Washingtonians whether they have employer insurance or are on the Exchange.
I shared the story of a mom who asked “How can we use money for health insurance that we literally cannot afford to use?
The facilitators presented an ambitious Work Plan for meeting the expectations of the budget proviso by November 2020. The fiscal analysts told us that they plan to analyze two approaches recommended by the Work Group, plus a variation of one of the recommendations.
After reviewing the work plan, we broke into breakout groups to work on defining the health care crisis and its root causes. We were given the following Draft Problem Statement to respond to:
“Universal health care means all Washington residents can access effective and appropriate preventative, curative, rehabilitative, and palliative health services. Currently, not all Washington residents have access to necessary health services. Health outcomes for many Washingtonians are worse, on average than comparative high-income countries, especially for people of color, people with incomes below the poverty level, and those living in certain zip codes. Rising health care costs adversely impact families, small business, and taxpayers.”
Each group was asked to refine the definition. My group suggested editing the problem statement to be: “Universal health care means all Washington residents can access effective, affordable, appropriate ….service delivered in a culturally appropriate manner.
Our group barely scratched the surface of our task. It would have been more efficient to have had time to ponder the statement prior to the meeting. We have asked to meet before the next meeting so that we can keep pace with the schedule.
As a result of the interruption, the online public comment period will be extended until 5 pm on Monday, December 30th.
- From the Executive Summary of the May 2019 Federal Reserve Report:
• Four in 10 adults, if faced with an unexpected expense of $400, would either not be able to cover it….
• Over one-fourth of adults skipped necessary medical care in 2017 due to being unable to afford the cost.
- Comparison of Treatment Costs for Breast Cancer, by Tumor Stage and Type of Service Helen Blumen, MD, MBA, Kathryn Fitch, RN, MEd, and Vincent Polkus, MSEM, MBA