State Initiative Proposes Health Care Coverage for Everyone

By Susan Haworth

Dr. Stuart Bramhall

In 1993, Health Care 2000, a coalition of concerned medical professionals and citizens, began a plan to remedy what they saw as a health care crisis. Initiative 725 emerged--a ballot measure that would provide universal coverage to every state resident if passed.

According to the coalition, access to private health insurance is either so rare (unavailable in 31 of 39 state counties) or so unaffordable that more than 600,000 Washington residents are without health coverage or grossly underinsured. Those lucky enough to be covered by their employer's health plans fear losing their coverage due to cutbacks.

Under the current system, the economically privileged and employees of companies large enough to provide health benefits are entitled to health insurance. The unemployed, self-employed or those working in low-paying service sectors must fend for themselves. Many people have only catastrophic insurance, ineffective for preventing and treating chronic conditions.

The coalition believes the time is right for change. A voter study, conducted in January by an independent research firm, reported that 84 percent of voters interviewed believe the current health care system needs reform, up from 70 percent in a comparable 1997 survey. Skyrocketing premiums, reduced health benefits and lack of choice contribute to voters' lack of faith in the current health care system.

This is how the proposed system will work. Legal residents of Washington pay into a trust. Adults whose income is above 250 percent of the federal poverty level will be assessed a $75.00 monthly premium. Coverage will be automatic: no deductibles and no waiting periods for "preexisting conditions." Like current group insurance plans, employers may elect to pay premiums for their employees.

Proponents of Initiative 725 point to the added benefit of improved care under a new system. By de-privatizing health care, financial incentives to undertreat patients will be removed. Patients are guaranteed the right to choose their own providers and change providers if they're unhappy with treatment.

In addition, preventive health care would be funded by the trust. Because private insurers view their customer relationships as short-term, they have little incentive to provide preventive care. To control long-term costs, the state is obliged to endorse prevention.

Coalition members say employers will also benefit, asserting that businesses currently spend 12-15 percent of payroll on health insurance, compared with the 9.75 percent contribution rate assessed under their plan.

"The biggest challenge we have is educating consumers," says Dr. Stuart Bramhall, president of Health Care 2000. Bramhall believes that lack of information, coupled with a general distrust of government, contributes to skepticism about de-privatizing health care.

"Young people are the most negatively affected by our current system," claims Bramhall. She estimates only 10 percent of those between 20 and 30 currently have insurance. "We should all be concerned about the health, welfare and vitality of young adults," says Bramhall.

Insurance companies and the pharmaceutical industry have the most to lose from de-privatization. Citing weaknesses in the Canadian national health care system, drug companies have launched a recent television campaign to discredit efforts at providing universal health care. The advertisements depict Canadian citizens traveling to the U.S. to receive needed health care.

"These ads are misleading, suggesting that universal care means inadequate care," states Bramhall. "Not only do the ads fail to mention that the Canadian government reimburses all health care expenses both inside and outside of Canada, they imply that any universal system would fall prey to the same shortages. We have learned from the mistakes made in other countries."

Opponents of the proposed system claim the coalition has underestimated future costs, predicting the trust will soon be depleted of funds. "Not so," asserts Bramhall. "We were very scrupulous in our actuarial projections. We have, in fact, built a surplus into our system for long term care and dental care."

Pointing to two cost studies conducted by leading actuarial firms who studied utilization and applied these figures to growing populations, Bramhall explains, "When you realize that up to half of the money insurance companies collect in premiums goes toward administrative costs for advertising and marketing, our cost projections are sound."

Those most negatively affected by the current health care system (the indigent and young adults) tend to be low-frequency voters, voting only in presidential election years. Coalition members, therefore, are currently engaged in a statewide effort to collect enough signatures to bring the initiative to the ballot this election year.

Should the coalition amass the required 220,00 signatures by July, the system could be up and running by 2002 if voters approve it. But, what happens if the initiative does not get the requisite endorsements by this deadline?

"We'll just re-file and start a new petition," says Bramhall. Not without resignation, she adds, "Most progressive initiatives need several attempts before they are embraced by the public."

FOR MORE INFO

The full text of Initiative 725 is available at www.healthcare2k.org. The web site also includes information about how passage of the initiative will affect health care coverage in the state of Washington.

Or contact Health Care 2000 at (206) 323-3393 or e-mail: info@healthcare2k.org.

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