1 . Barron County Democrats pass health care resolution, seek co-sponsors
2 . Health Security America
3 . Text of health care resolution, original format
4 . Appendix: background on the resolution
5 . 100-word version of resolution
6 . Why to choose the Barron County Democratic Party Health Care Plan vs. a Single Payer Plan
7 . When our health care resolution becomes a reality, what happens to you
8 . Frequently Asked Questions
9 . Contact information

Fred Bannister has written a book, Health Security America, which mirrors this health care resolution and expands on it.
Please write to Dr. Bannister or call (715) 237-2597 for more information.

Featured on WHWC 88.3 FM Monday, April 4th, on the West Side program.

1. Barron County Democrats Pass Health Care Resolution, Seek Co-Sponsors

BARRON, February 17, 2005 -- In a strong show of support, the Barron County Democratic Party passed a new health care resolution Thursday evening at its monthly meeting. The resolution calls for affordable health insurance to be made available to all citizens through a Medicare-sponsored, completely self-funded insurance program, allowing insurance from birth to death and including free health insurance for children to 18 years of age. It will be subject to vote at the upcoming 7th Congressional District Convention at Ashland on April 30th. If passed in Ashland, the resolution has the potential to move on to the Wisconsin State and national Democratic conventions and be adopted as part of the party platform. The Barron County Democratic Party is reaching out to all potential co-sponsors.

The resolution comes in the wake of recent news that over 45 million Americans lack health insurance, and studies that show that the United States ranks second to last in life expectancy out of the 23 top industrialized countries. The U.S. spends over twice per person (US $5000 yr. 2001) as Japan and Sweden do, but has a life expectancy 5 and 3.5 years shorter. Despite claims of cost control, premiums charged by HMOs and managed care increase by double digits each year. Locally, health insurance premiums have increased 15%, on average, for 44 of Barron County's largest employers in the past year. One employer of 8 people had his insurance premium increased 34.1%. Such increases have made the costs of extending health insurance benefits and hiring new employees prohibitive. Many employers face either canceling health insurance benefits, or operating their businesses at a loss.

In addition to its negative economic and public health impact, the corporate-driven health care system weakens the doctor-patient bond, says Fred Bannister of Chetek, a retired physician with 40 years' experience in family practice. Speaking in a presentation at the Barron County Democratic Party's February meeting, Dr. Bannister maintained that while the "system is indeed broken, it can be fixed," and outlined some possible remedies included in the resolution based on the efficient, automated administrative models already in place and used by Medicare. "In this debate I have one un-debatable point," says Bannister. "When you are born in America you have the right to have access to affordable health insurance. This is not a privilege."

The full text of the health care resolution and supplemental information is available below. Party members encourage anyone interested in real health care reform and affordable, available health insurance to come to the party's next meeting on Thursday, March 17th, at 7:00 p.m. at the Rice Lake Library, 2 East Marshall St., Rice Lake.

2. Health Security America
May 2005

Health Security America is the name that delegates hope to attach by amendment to the health care resolution up for a vote at the Democratic Party of Wisconsin's convention next month. The resolution, advanced to the state convention by the Sixth Congressional District, is identical to the resolution written by Barron County Democrats.

DPW convenes June 10th and 11th, in Oshkosh.

3. Barron County Democratic Party Health Care Resolution
February 17, 2005

Whereas, the current United States health care system is crippled by
excessive cost, poor performance and inefficient administration; and

Whereas, the present health care system leaves 45 million citizens
uninsured--many of them children; and

Whereas, health care insurance policies many times are not transportable
from one area of the country to another or from one job to another; and

Whereas, the present health care system stifles competition among health
care providers keeping costs high; and

Whereas, the present health care system stifles patients' choice of
physicians; and

Whereas, the United States healthy life expectancy ranks 22 out of 23 top
industrialized countries, better only than the Czech Republic; and

Whereas, the United States in 2001 spent $5,000 for every citizen; Japan and
Sweden spent $2,000 and $2,200 per citizen with life expectancy revealing 69.3
years for the United States, 73.2 years for Sweden and 75 years for Japan1,
and

Whereas, one half of all personal bankruptcies are triggered by costly
illnesses and three out of four of these persons had health insurance
policies2; and

Whereas, group health insurance premiums for 44 of the largest employers in
Barron County increased about 15% in the past year3; and

Whereas, smaller businesses in Barron County are experiencing annual health
insurance premium increases as high as 34.1%, 4 forcing them to cancel
coverage or operate their business at a loss; and

Whereas, individual health insurance policies (for anyone other than young,
completely healthy individuals) are unaffordable or unavailable; and

Whereas, the only health insurance model that works is that of a very large,
diverse group like Medicare; and

Whereas, Medicare does not have a department to sell policies to the public
to include other than basic coverage to people over 65 years of age; and

Whereas, many Medicare providing hospitals have staff regulations that many
times do not allow all Medicare providers to work; and

Whereas, Medicare presently allows receiving insurance companies to have
limited provider lists and contracts.

Now therefore be it resolved, that the Barron County Democratic Party
request the 7th Congressional District, State, and National Conventions to
adopt the following health care plan in its platform:

1. All citizens shall be allowed the opportunity to participate from
birth to death in a government-sponsored but completely self-funding health
insurance program based on the highly efficient administrative model already
in place and used by Medicare.

2. All children will receive free medical care to 18 years of age.

Be it further resolved, new Medicare regulations will allow insurance
companies to buy and resell Medicare policies with fixed provider fees. The
only exception would be a six-month waiting period following the first year
open enrollment period.

Be it further resolved, new Medicare regulations will require free
competition among all licensed providers and no group will be able to impose
non-compete provisions in its contracts to deter this.

Be it further resolved, Medicare regulations will require participating
hospitals to have an "open staff" (anyone licensed to perform procedures by
Medicare will be allowed on the staff).

Be it further resolved, Medicare regulations will not allow restrictive
provider lists or physician contracts with insurance companies.

Document signed:

February 17, 2005, after passage by the Barron County Democratic Party.

Cecil Kippenhan,
Chairman

Judy Holloway,
Secretary

John Hunsinger,
Resolution Committeeman

Fred Bannister, M.D.,
Resolution Committeeman

John Banks,
Resolution Committeeman

4. Appendix

Backup information, Critique and References to some items referred to in the
Barron County Democratic Party Health Care Resolution of February 17, 2005.

The following web site contains a 15-page document with more in-depth
explanations on how the new Medicare regulations would affect the various
parties involved.

Med-OPS

The Whereas referring to the 34.1% increase in health care premium for
business is from our very own John Hunsinger--He would be more than happy to
give his experience.

The Whereas referring to the personal bankruptcies is from the Sunday, Feb.
6th Austin American, Austin TX. It refers to Dr. David Himmelstein, the lead
author of a Harvard study revealing the findings.

The Whereas referring to the life expectancy ratings and the cost per
citizen are both out of the recent book by John Abramson, M.D. Overdosed
America, pages 46-47. John is also on the Harvard faculty.

The Whereas referring to the 44 Barron County employers is from page 12,
Labor Market Conditions in Barron County, Gary Paul Green, University of
Wisconsin Extension, and Andrew Dane, Barron County UW Extension, January
12, 2005.

1.Whereas, the present US health care system

2. spends over twice per person ( US $5000 yr 2001) as Japan and Sweden for life expectancy 5 and 3.5 years less; and

3. still leaves 45 million people uninsured; and

4. stifles competition, portability, and patient’s choice.

5. Medicare, proven efficient, automated and already in place,

6. will provide the government a necessary, large diverse risk pool. (Potentially 275,000,000 persons)

7. Resolved, all citizens may participate from birth to death in Medicare,

8. that will be completely self-funded,

9. and provide free insurance to children through 18 years.

6. Why to choose the Barron County Democratic Party Health Care Plan vs. a Single Payer Plan

The proponents of both plans know that WE ARE IN CRISIS and, in fact, post the same or similar statistics justifying the need for immediate action.

Our country’s culture and history will influence whatever solution is used to remedy this Health Care Crisis.

Some thoughts:

• Our Health Care System has developed over the last 200 years.
  We still have a “Pull yourselves up by your own bootstraps” thinking.
  If we have affordable options before us, we expect people physically and mentally able to take responsibility to act on them.
• We all fear big government and most of all, an imposing one. The IRS is the best example of this. They have a job to do, but many would call the results of their work “Coordinated Chaos”. They impose regulations that change constantly and are poorly communicated, which leads to undue stress on the part of honest citizens.
• People want their personal lives to remain private. Health care decisions must remain with patients. This became even more evident as demonstrated by the results of the government’s intervention in the life of Terry Schiavo. Will the government honor this privacy in whatever part they play in health care?
• Americans perceive their doctor as just that –their own. They want to choose him/her and they want him/her to remain without interference their advisor, friend, and provider of health care. The right to choose is important and forced change by government regulation will not be accepted anymore than forced physician provider panels of HMO and Managed Care plans.
• Perhaps the ideal portrayal of a family doctor was captured by the famous Norman Rockwell painting of an elderly gray haired physician sitting by the bedside of a little girl taking the doll's pulse. How many patients today could say they have experienced that relationship?

After reviewing some of the above lets look at the differences of the Barron County Democratic Health Care Resolution (BCDHCR) and a plan called a Single Payer Plan. (For guidance on this we will refer to the “Wisconsin Universal Health Plan” (WUHP) (http://www.wisconsinhealth.org/wiplan.html)

Administration

BCDHCR will:

Fix the abuse of administration powers by allowing providers to administer their own practice (field). This is done by removing non-compete clauses, not allowing fixed physician provider panels and keeping hospital staffs open to all qualified to practice medicine. Competition will be free and unfettered. The Medicare fee structure will make this happen by imposing the fee schedule currently in effect at the time of this writing. There will be no money available for administration as is it is done now. Providers will have to take on this task. With the prohibition of non-compete employee contracts, closed provider panels, and closed hospital staffs, the ability of the provider to administer his business will be restored. These three very important clauses will be removed from the new paradigm of practice allowing the system to reform itself.

WUHP:

Administration will be done by a new huge government bureaucracy. Does the American populace trust this idea? I think not. The IRS is a perfect example. Medicare currently collects the money and dispenses it at a cost of 2-3% but does not administer the local clinic or independent physician’s Health Care business. WUHP would be imposing a bureaucracy that could be similar to the current system we have running large clinics, HMOs, Managed Care Plans-a new administration. This will disappear under the BCDHCR! Government bureaucracies tend to grow and grow. Any poll would agree with this.

Benefits Covered

WUHP defines the following to include all forms of health care:

• Hospital and clinic services; office visits and house calls
• Services of physicians, dentists, social workers, and other licensed professionals;
• Prescription drugs
• Health promotion and illness or injury prevention
• Long term care, including home and nursing home care, and community health centers;
• Mental health services, and alcohol and other drug rehabilitation services

BCDHCR:

Coverage will be decided by citizen panels. They will certainly take the premiums into consideration and they may include all of the WPUHP coverage, but it will not be imposed without citizens’ review. The government will not impose the coverage which may lead to high premiums. BCDHCR guarantees that the people will decide--not government administrators. In this plan, the government will act only as facilitator –the same role they take in Medicare or Social Security Administrations. Our government works well in this role.

Freedom of Choice of Providers:

Same for BCDHCR and WUHP

Provider Reimbursement:

BCDHCR:
Providers would be reimbursed by present Medicare Fee schedules and infrastructure. No new government department is needed. This is already a national program that is far more reaching than the WUHP.

WUHP: Fee schedules would be set up by a new government department (which does not come without significant cost to taxpayers).

This wheel need not be re-invented! Medicare already has a system in place.

Cost Controls:

BCDHCR:

Presently, the resolution calls for a Medicare fee schedule. This includes a 20% co-pay or $10 on a $50 bill for physician office calls. The Citizen Panel will have the final word on establishing a co-pay schedule, for incorporating some patient responsibility has proven to work in reducing patient abuse of the system. (Yes, abuse does exist!)

The BCDHR calls for free medical care for children birth to 18 years old. The Medicare Fee schedule would have to be changed to remove co-pays for children, birth to 18.

WUHP:

No bills are received for any service and you have access to the system anytime you desire. Where is the cost control?

How They Are Financed:

BCDHCR:
Premiums are set by Medicare. Rough estimates indicate there could be a 35-50% reduction in current premiums. Insurance companies will resell these policies in addition to any other options they choose to add at their own risk. The government does not need to develop another department to deal with the collection issue. Insurance companies already have these controls and departments in place. People still have the responsibility and the choice to buy the policy. Any advertising costs would be paid for by insurance companies.

WUHP:
This plan would be financed by government imposed payroll deduction and employer contribution estimated to be 7-9% of gross income.

Coverage:

For the answer to this we will refer to the 45 million without health insurance as it will be easier to understand how people will be covered under both plans.

Children are 24% of the 45 million uninsured population.

Under the BCDHCR all children are covered free.

Under the WUHP all children are covered free.

Employed people are 46% of the 45 million uninsured population.

BCDHCR:

This plan is an affordable, voluntary plan that will be available to all without regard to current health or disabilities. The present system of employee and employer contributions can exist as it currently functions, but there will be an affordable, voluntary, and reasonable plan available.

WUHP:

Everyone has access to the plan without concern for payment of premiums or billings.

Unemployed people are 9 % of the 45 million uninsured population.

BCDHCR:

Employees will be allowed to keep their policies after being laid off. Medical Assistance which now covers shelter, food and fuel would pick up the premiums when an unemployed person becomes unable to pay them. This would be much cheaper than paying for urgent care visits that occur as a result of uninsured patients waiting until a health care situation is critical before going to a doctor. It would be up to Medical Assistance to decide at what level of poverty they would pick up this premium. This would be the same for the Out of Labor Force population now judged to be 21% of the 45 million uninsured. (Out of Labor Force includes students over 18 (not on parents’ policy), homemakers, disabled, and early retirees.)

WUHP:

This plan covers everyone without any question.

In Summary

We have a terrible crisis in health care. The present system has parts that work very well. Example: Medicare operates with only a 2-3 % cost to handle billings and payments to providers.

The present system got out of hand by using corporate tools like non-compete contracts, fixed physician provider panels and closed hospital staffs (or perception of closed hospital staffs). Freeing the system of these tactics allows the system to function again as it should. Using the Medicare fee schedule as it is now being used would force the issue. There simply would not be room for the HMO and Managed Care Plans with all their inherent administrative faults--huge bloated bureaucracies, bloated salaries, and intimidation of providers, to mention only a few. Large clinics will also have decisions to make.

The American people have a 200 year history of health care and it has not always been in crisis; they do fear big government bureaucracies; and they are intent on having physician and other provider choice. Last but not least, they are insistent on keeping their personal lives private and resent interference by the government as represented by the recent Terri Schiavo drama, as well as other personal matters of life and death.

We have a two party political system. To get any major accepted change approved, it takes these two groups working together. There has to be major agreement on most provisions in both parties for this health care crisis to be resolved. If one party presents a plan with major conflicts with the basic precepts of the other, it simply will not pass. Give and take will have to be a part of any solution. There is no question in our mind that both parties want a solution that is inclusive, with quality and affordable care. The question thus becomes what is the most likely solution that all can live with to at least start on a resolution of our health care crisis.

The Barron County Democratic Party Health Care Resolution provides this solution by way of a REFORM – NOT A REVOLUTION.

The Barron County Democratic Party Health Care Resolution, given the chance, will put us on the road to solving our present terrible health care crisis. The Single Payer Plan for this time in our history is too drastic. It insists we turn our health over to the government. The American people are not yet ready for this and, indeed, another solution is available. The Barron County Democrats think we do have that solution and would appreciate your support.

Fred Bannister, M.D.
Barron County Democratic Party
Resolution Committee

• Free health insurance for children to 18 years of age.
• It allows insurance from birth to death
• It is a completely self-funded insurance program
  

8. Frequently Asked Questions About Our Resolution Authorizing Medicare To:

1. Offer Medicare Coverage from birth to death.
2. Give free Medicare insurance up to 18 years of Age
3. The program must be self-funded

1.Why such a sweeping change to the program?

We are in a crisis in America with runaway health care costs, performance of our health care system and availability of a voluntary, affordable insurance to all.

These are best symbolized by a study done by the Organization for Economic Co-Operation and Development. We ranked 22 out of 23 industrialized countries when comparing money spent per citizen on healthcare and life expectancy. In the 2001, Japan had a life expectancy of 75 while spending $2000 per citizen. We spent $5000 per citizen with a life expectancy of 69.5 years. Our country is accumulating deficit at an alarming rate and it can not go on much longer.

Recent studies done by Dr. David Himmelstein from the Harvard faculty showing one half of all personal bankruptcies are triggered by costly illnesses and three out of four of these persons had health insurance policies.

45 million Americans are without any health insurance.

A little “tweaking” of the system will not do it. Major change has to occur.

2. Why use government to fix the system?

The Medicare system is in place to best facilitate change. We don’t need to start over.
They will facilitate not order change. The people will do this. (addressed later paragraph)

3. How much will the premium be?

The premium will be determined actuarially and be very accurate due to the 275,000,000 people involved.

4.What if the premium is still out of line and no one can afford it?

Participants in the plan will have to take responsibility to see that this is affordable and Medicare staff will facilitate this by leading hearings around the country to determine just how this health care will be administered. Remember, this is the public group which will make the general policies, not the government. Through consensus and practical constraints, many limits will have to be set so that there is no waste and we can afford the plan. This is common sense, not rationing. Under no circumstances will any delay be allowed in treatment of a disease or condition that requires immediate intervention. Let us site some examples of how this would work.

Example one:
A person comes in 100 lbs over weight and his knees are degenerating to have knee replacement as an option. There is probably close to 50% chance that if this person lost this one hundred pounds he would be without pain and not require surgery. The hearing process might have determined by its rule making that until this person lost his excess weight no surgery would happen. This is tough love, but also, a very reasonable expectation of the other people who are paying premiums.

Example Two:
Person comes in with high blood pressure. Rules might well be in effect requiring the use of very cheap and very good generic meds before going to the $1-1.50 pills. Before this would happen he also would have to lose weight before moving on to expensive therapies. Is this rationing? Answer is no, this is common sense.

These sorts of examples will go on in almost every disease process. Remember this is the group which we all will be in that determines this not the government.

5. Who pays the premium?

The policy owner. You do! The government might still decide to finance all over 65 years as they do now. The states, counties might decide to pay policies for its disabled people as they do now. Corporations, individuals will act to their own benefit on determining if they will buy policies. The policies are available to all and it is voluntary.

6. Who will we buy the Medicare insurance policy from?

You will buy it from the insurance company of your choice. They will offer the simple policy that is the basis of Medicare but you may well decide you want a private room, or international coverage or any number of added options that the company might choose to add on to the basic plan. You will pay your money to the insurance company. They will have bought the basic Medicare policy in bulk from the Government at the premium set by the government. They will add on their fees for the added options if any and they will collect the premiums from the individual policy owner. The insurance company will only be responsible or at risk for the amount of the added options. Competition will keep this under control.

7. How will the physicians and other providers get paid?

This will be done electronically and will avoid all the insurance hassles that now prevail.
This is done by books published by AMA called CPT and UCD codes. This is all well worked out and functions very well.

8. Why all the open staff, non-compete regulation changes?

These are very necessary to keep the competition free and will avoid the patient complaints about not seeing his or her Dr. choice. No one insurance company or group should be allowed to corral patients only for their group. No one should come between the physician and the patient as happens now.

9. Contact

Barron County Democratic Party Resolution Committee

Send comments and questions to: fredb@citizens-tel.net