Monday, August 6, 2018

High Wisconsin health care costs proving a big burden

There’s a new report out today from WalletHub, who is listing the “2018’s best & Worst States for Health Care.”

WalletHub worked with a number of health policy academics to determine how all 50 states and the District of Columbia fared when it came to health care services. Here’s what they came up with for Wisconsin.

Wisconsin ranking, WalletHub health care survey
Health Outcomes 9th
Health Care Access 13th
Health Care Costs 47th
Total Health Care Ranking 23rd

Source: WalletHub

47th out of 51 in costs! That seems like a big deal. How is that number determined?

Here’s what WalletHub says.
Cost – Total Points: 33.33
Cost of Medical Visit: Full Weight (~6.67 Points)
Cost of Dental Visit: Full Weight (~6.67 Points)
Average Monthly Insurance Premium: Full Weight (~6.67 Points)
Share of High Out-of-Pocket Medical Spending: Full Weight (~6.67 Points)
Note: This metric measures the percentage of the population aged 64 and younger with high out-of-pocket medical spending relative to their annual income.

Share of Adults with No Doctor Visits Due to Cost: Full Weight (~6.67 Points)
So it's basically 1/5 premiums, 2/5 the cost of the services rendered, and 2/5 out-of-pocket expenses and visits avoided due to costs.

Under these metrics, Wisconsin’s health care costs are by far the highest in the Midwest. In fact, 4 Midwest states are in the top 11 for lowest costs, and all Midwestern states outside of Wisconsin are in the top 20 for low costs. The high costs are the main reason why WalletHub ranks Wisconsin is 5th out of 7 Midwestern states for health care overall (only beating Illinois and Indiana. Minnesota is Number 1 in our region and 4th in the US).

It looks like Wisconsin has fallen from 21st to 23rd in these health care rankings vs where they were last year. What’s odd about it is that the state actually moved up in 2 of the 3 categories listed – Access (16th to 13th) and a notable increase in Outcomes (22nd to 9th).

But the cost element overrode those improvements, as Wisconsin fell from 25th to 47th for this year. It also was a main reason Ohio and Michigan passed Wisconsin in this survey (this is soothed a bit by Illinois falling behind us, due to the FIBs dropping from 29th to 31st in outcomes).

This is where I recall something that Citizen Action Wisconsin have harped over the 7 years that Scott Walker and the GOP Legislature have been in power in this state. The “regulators” of the insurance industry in Wisconsin have refused to step in and control how much insurance rates have gone up.

What Citizen Action said here in 2015 hasn’t really changed 3 years later.
As Citizen Action of Wisconsin has repeatedly pointed out, Governor Walker’s Office of the Commissioner of Insurance (OCI) has been exceptionally lax in its implementation of rate review. Since 2011, 46 Wisconsin insurance plans have increased their rates by more than 10%, yet OCI has not found a single rate increase excessive. This includes a 43% increase by Humana in 2013, a 37% increase by Unity Health Plan in 2014, and a 21% increase by WPS in 2014.

OCI has also failed to hold a single public hearing on a major insurance company rate increase. In 2012, the Walker Administration went as far as to request a waiver from the rate review provisions of the Affordable Care Act, which was denied.
States such as Minnesota have effectively used rate review to reduce the prices of health insurance plans.

“Thousands of Wisconsin consumers have seen excessive premium increases because of the Walker Administration’s refusal to police the health insurance industry,” said Robert Kraig, Executive Director of Citizen Action of Wisconsin. “It’s long over due for the Walker Administration to side with consumers across Wisconsin who need access to affordable health coverage that can never be taken away. A great first step would be to hold public hearings on the largest proposed premium increases.”
And why the Walker Administration didn't step up to stop those cost increases is obvious – It was a cynical attempt to claim that “Obamacare is failing” and turn Wisconsinites against the Democrats.

Note it took the combination of the Black man no longer being in the White House and the strong possibility of a Blue Wave in the midterms for Walker to try something to hold down what people may pay for health care. Even then, it’s in the form of a tax-funded bailout to insurance companies in the hope that they might play nice and keep a lid on premiums before the 2018 elections.

Wisconsin used to be a leader when it came to offering health care at a reasonable price, and keeping its citizens covered. We have slipped badly in both categories in recent years, and now we resemble a middling, red state where citizens and businesses are having to pay a lot more than our neighbors do for the same services.

The only way this cycle of non-competitiveness changes is if we change the leaders in power. Know this.

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