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The wrong health debate PDF Print E-mail
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Written by Ozaukee Press   
Wednesday, 26 July 2017 19:41

Congress could have avoided the antipathy of the American people over its increasingly farcical attempt to repeal the Affordable Care Act if it was having the right health care debate.
    The wrong debate, underway now mostly behind closed doors, is about how to pay for health care—or more accurately, how to limit what government pays for health care for its citizens.
    The right debate would be about how to bring American health care up to the standard set by other well-endowed nations. It is an embarrassment, with tragic overtones, that this country that leads the world in so many ways is a straggler when it comes to the health of its people.
    The U.S. ranks 42nd among all countries in human longevity, according to the World Factbook compiled by the Central Intelligence Agency.
    The rate of infant mortality in the U.S. is worse than that of any industrialized country. American babies are twice as likely to die in their first year as babies in a number of European countries.
    American women are far more likely to die in childbirth than women in other developed nations, according the World Health Organization.
    The countries that lead the U.S. in health have in common that care is provided through national health systems paid for by taxpayers.
    The U.S. doesn’t need comparisons with other countries to see how national health care works in keeping people healthier. Its own limited version of so-called single-payer health coverage—Medicare—demonstrates it.
     After Americans qualify for Medicare at age 65, life expectancy improves to near that of European nations.
    Medicaid, another limited form of national health coverage, has proved successful in keeping Americans too poor to afford health insurance healthier. Yet one of the proposals in the ACA repeal effort is to reduce federal Medicaid spending by $772 billion over the next decade.
    Those seeking to weaken federal Medicaid say the states will fill the gap. Not only is there no assurance, or even likelihood, of that happening, some states are hostile to the very concept of Medicaid. Wisconsin, unfortunately, is an example.
    Here Gov. Scott Walker is pushing to require people applying for Medicaid to undergo drug testing—urinate in a cup to qualify for health care.
    In an op-ed piece in last week’s Ozaukee Press that should be read by the members of Congress now mired in the wrong health debate, John Torinus of West Bend wrote, “Every health plan, whether funded by a company, by the government or through an insurance policy, should provide proactive primary care.”
    Torinus is a nationally recognized expert on corporate health insurance programs, but his point that providing the means to staying healthy is the key to a healthier populace and more affordable health care applies to government programs as much as to those provided by employers.
    Universal proactive primary care is a fundamental feature of the world’s most effective national health programs. In the U.S., it is a luxury many cannot afford. Until Congress has the right health debate, that won’t change.

 
Better health care is the key to solving the ‘repeal and replace’ problem PDF Print E-mail
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Written by JOHN TORINUS   
Wednesday, 19 July 2017 18:49

   The Republican Party has driven its “repeal and replace” legislation into a box canyon. It isn’t selling with the American people. But there is a way out.
    I have talked with many of the great innovators in the delivery of health care over the last decade, and they have come up with a far better business model.
    Based on those insights, I am offering this speech to House Speaker Paul Ryan free of charge:
    My fellow Americans:
    The debate over U.S. health care has carried us way off track. We have spent far too much time on insurance reform and not enough time on real reform of the delivery and cost of care.
    I look to my own state of Wisconsin for innovations. The following breakthroughs have been tested and proven to work in my state and elsewhere.
    n Provide primary care for every family or individual. Some call it a medical home. Many company plans already offer this huge benefit. They do it because it’s the right thing to do, and because it saves big money by helping them avoid the hospital. QuadGraphics created its first medical home here in 1990 and has saved more than 20% in health insurance costs. Every health plan, whether funded by a company, by the government or through an insurance policy, should provide proactive primary care.
    n Set single price for most procedures. Car repair shops give you an estimate, and they must call back if the price is going beyond what they quoted. Clinics and hospitals must do the same. I know they can do it, because companies in my back yard are contracting for “bundled prices.” They are saving as much as 50% on elective of care.
    n Do you cringe when you enter a hospital, fearful of either an infection, a medical accident or an astronomical bill? I know my family does. There is a fix. It’s called lean health care, the same kind of disciplines that car companies have applied to sharply improve the quality of their vehicles. Several Wisconsin hospitals have led the charge to lean practices, and they have driven out waste, sharply lowered costs and eliminated defects, such as infections that can prove lethal.
    Premiums will come down if people stay healthy through proactive primary care. It’s the underlying costs that matter.
    We will need to create insurance pools for people with catastrophic issues. A tax on each insurance policy, whether the insured is on an employer plan or individual policy, will fund the high-risk pools.
    We will ask employers to continue to offer coverage. By and large, they have done a great job with their plans.
    And we should scrap Medicaid for people who can’t afford care in favor of a model based on Medicare Advantage, a far better managed program.
    Both parties should see a lot to like in these proven best practices. Let’s hammer out a bipartisan plan that works for all. Only bipartisan legislation will stand the test of time.
    Torinus, of West Bend, writes about health care and political issues on his blog at johntorinus.com.

 
Blues Factory affront invites opposing views PDF Print E-mail
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Written by Ozaukee Press   
Wednesday, 12 July 2017 16:34

If the would-be developer of the Blues Factory thought erecting a prominent sign on land owned by the people of Port Washington at the edge of the north slip marina promoting the entertainment complex would increase support for the controversial project, he miscalculated.
    Gertjan van den Broek’s sign is being taken as an in-your-face affront to the many citizens of Port Washington who have expressed their opposition to the development on the principled grounds that it would block public water views and detract from the beauty of the lakefront.
    Energizing the opposition, the sign quickly attracted an anti-Blues Factory placard and printed messages that corrected the false impression left by the developer’s sign that the Blues Factory was a “done deal.”
    City officials learned the identity of the Port Washington resident who stapled the messages to the sign from an Ozaukee Press news story, and on Thursday two police officers made an after-dark visit to her home to deliver a warning against posting comments on the sign.
    By attempting to silence this citizen, the city is crossing a line into the risky territory of interfering with constitutionally protected free speech. If a developer can put up a self-promoting sign on public land, citizens should have the right to post contrary messages.
    It would, in fact, be a public service for someone to place a sign next to van den Broek’s, preferably with the same 8 by 4-foot dimensions, that would supply information missing from the Blues Factory sign, including these points:
    n In a yearslong battle, large numbers of Port Washington residents have expressed their opposition to the development with signatures on petitions, appearances at city government meetings, social media comments, letters to the editor and, in the most explicit display of public contempt for the development so far, by ousting with landslide votes two aldermen who supported the project.
    n City officials’ rationale for the Blues Factory—that it would be a “catalytic” development needed to encourage downtown investment—is not credible. Developers are tripping over one another to build in the marina district and the city is accommodating them. The development surge has only made the proposed Blues Factory site more valuable as an island of public open space on the water in what will be a very densely developed area.
    n The Blues Factory did not appear as a spontaneous reaction to market demand, but was forced on the community by officials hellbent on developing the marina land in a torturous process that is still going on. City efforts to market the land resulted in only one tenuous offer, that from a Madison-area man who conceived the idea of a blues music-themed attraction but abandoned it for lack of financing. The city has been keeping the development on life support in the hope it can persuade local developer van den Broek to resuscitate it.
    n The Blues Factory is far from a fait accompli. In spite of generous developer incentives and taxpayer subsidies, numerous deadlines for the sale of the site have come and gone. After a missed April deadline, van den Broek has been given until early next year to buy the land while the city shores up the harbor wall to support the Blues Factory building at taxpayer expense.
    Another sign on the site could further clarify the issues. The developer’s sign features an idealized rendition of the Blues Factory building from an angle that minimizes its height, overall size and visual impact. A realistic sign would show a front view of the building and its massive facade facing Washington Street.
    In an insult to the ambience of Port’s handsomely designed heart-of-the-city marina, the Blues Factory building is designed to resemble the Wisconsin Chair Co. manufacturing building that occupied the site before it was torn down as a lakefront blight.
    Were it possible, the sign featuring the picture of the brick monolith would be actual size—two stories high and stretching the full width of the site. It would shut off the views admired daily by residents and visitors of the marina and the lake beyond.
    The gigantic billboard would thus be an accurate preview of the aesthetic damage that would be done by the Blues Factory.

 
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