Scott Walker's Health Care Hypocrisy
February 28, 2011 - 4:36pm ET
If Wisconsin Governor Scott Walker is so concerned about the price of public sector workers’ health care benefits, why isn’t he clamoring to cut underlying costs?
To justify the massive benefit cuts they are inflicting on teachers, janitors and nurses, Republican governors like Scott Walker in Wisconsin are claiming that the health care benefits enjoyed by public sector unions are “financially unsustainable” and “bankrupting the state.” It is ironic then, that while organized labor has been at the forefront of reforms that cut medical costs, Republican governors have actively fought cost-cutting measures, most notably in their stalwart opposition to stateside implementation of the Affordable Care Act.
Rather than working to find solutions that ease their budget deficits without fleecing middle class workers, Walker and his allies are throwing workers and their families over board. For proof, we need look no further than the king of union-busting himself, Gov. Scott Walker.
Exhibit A: One of Walker’s first moves as Governor was to order his Attorney General to file a lawsuit against the Affordable Care Act.
Exhibit B: Hidden in the now-infamous bill stripping public employees of their collective bargaining rights is a provision granting the governor executive authority to lop people off the Medicaid rolls and drastically increase premiums.
There you have it: Complaining about skyrocketing costs on the one hand, and enacting policies that do nothing to change the underlying problems. That’s because, for the most part, Republican governors couldn’t care less about exploding medical costs. They're interested in busting unions and eviscerating what remains of our social safety net.
Meanwhile, unions, who led the national fight for the Affordable Care Act, which will produce massive health care cost savings in the coming years, are now at the cutting-edge of local pilot projects aimed at further reducing costs. Atul Gawande, a doctor who has conducted incredibly revealing investigations of the country’s health care costs, recently profiled the achievements of a wildly successful pilot project that the Atlantic City, NJ casino workers’ union has undertaken. Tired of having to accept stagnant wages in order to maintain their increasingly expensive health care benefits, the union adopted an unconventional, comprehensive preventive care regimen. By providing patients with regular examinations it was able to identify a core group of 1,200 chronically ill plan members who were in and out of the hospital on a regular basis. Then it assigned teams of “health coaches” to work with these people on troubleshooting burgeoning medical issues before they flare up, taking the proper medicines, and adopting healthier lifestyles—better diets, better exercise, less tobacco, alcohol and drugs.
One year later, the results are amazing. Here's Gawande describing the findings of a third-party evaluation of the Atlanatic City union plan's cost-savings:
So the union’s health fund enlisted an independent economist to evaluate the clinic’s one-year results. According to the data, these workers made up a third of the local union’s costliest ten per cent of members. To determine if the clinic was really making a difference, the economist compared their costs over twelve months with those of a similar group of Las Vegas casino workers. The results, he cautioned, are still preliminary. The sample was small. One patient requiring a heart transplant could wipe away any savings overnight. Nonetheless, compared with the Las Vegas workers, the Atlantic City workers in Fernandopulle’s program experienced a twenty-five-per-cent drop in costs.
A 25 percent drop in costs?!
It turns out that a small number of people with horrific health problems are responsible for the vast majority of the union’s costs. It sounds cruel to think of human suffering as if it were a number on a ledger, but by identifying the neediest, most neglected patients, the casino workers’ union was able to improve people’s lives and ease the financial burden of all the workers in the union.
So if Scott Walker is as concerned about costs as he claims, let him be the first to try the casino workers’ union’s experiment on a statewide level. Then he can talk about benefit cuts.
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