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March FTAC Meeting: Our Advocacy is Paying Off!

By Consuelo Echeverria

Our advocacy is paying off! This was the first time we heard the members really engage in substantial discussion. The presentation of Whole Washington’s WA Health Trust triggered a substantial discussion on steps to universal health care, its feasibility, cost and essential benefits.  

The main take away was that while there was real progress in discussion, we need concrete proposals from the Finance Technical Advisory Committee (FTAC) starting with the actuarial analysis for the UHCC to implement.  While ERISA regulations, winning federal Medicare waivers, along with a lack of a state income tax are real barriers to true universal healthcare in Washington, a stepwise approach is feasible. The Whole Washington presentation proposes starting with a single, state-designed coverage plan that insurance companies will run, and slowly over time move to a single payer plan with no insurance company participation. 

Feasibility:

There seems to be an overarching belief that single payer universal health care is just not feasible. However, is our current for-profit healthcare system feasible?

Nationally 67% of bankruptcies are caused by medical debt. Over half of WA families delay or forego care altogether with almost a third rationing medicines like insulin, all due to costs. Furthermore, BIPOC and rural communities are unduly burdened in disease with disparities in health outcomes.

An Oct. 2022 presentation to the Health Care Cost Transparency Board, Dr. Sinanan and Jeb Shepard from the Washington State Medical Association highlighted the results of their 2022 survey which found that medical practices ranked administrative burden as the top priority. They stressed that time spent on insurance approvals, coding and billing, and practice management has resulted in less time spent with patients and increased practice and treatment costs as well as burn out.  

Finally, consolidation by for-profit entities, United Health, Aetna and Cigna masquerading as not-for-profits, along with venture capitalists, currently control a substantial portion of beds and physicians in Washington State. And, access to our medication is controlled through pharmacy benefit managers, many owned by for-profit entities.

Is this landscape feasible? In the face of all this, how can our current profit-driven health care system be considered feasible?

Cost:

Many Committee members said that consolidation from private entities and excess utilization are the drivers of cost with no mention of how a for-profit system drives up the cost of health care.

A fractured and repetitive system, including complex billing, coding and authorization procedures are a substantial burden for both doctors and patients. In fact, administrative overhead impacts the cost of healthcare both in Oregon and in Washington.

The 2022 Optimus Financial Report for the Oregon Health Care Authority found substantial savings of almost a billion dollars by just removing Insurance Margins.  In fact, approximately $1.4B can be saved when Oregon adopts their universal healthcare plan.

In our state, in 2020 the Universal Health Care Work Group found that $2.5 billion would be saved in the first year if WA adopted a single payer universal healthcare system. That report highlighted that most of those savings are found in the administrative simplification of a single insurance system. 

Essential benefits package.  

Committee members proposed an actuarial analysis using Cascade Care’s Gold, Silver and Bronze plans to show the relationship of prices and rates along with SEBB/PEBB as they cover a significant portion of those insured in WA state and we know they work. 

We expect that this actuarial analysis will be recommended to the UHCC in the next meeting as there is funding for such a study.

Join us as we track the next meeting of the UHCC on Wednesday, April 17 from 2-5 p.m.

We encourage you to:

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