Whole Washington: SB 5233
This is about situational awareness. This roughly means that we need to be aware of how policies interrelate. Our topic for this evening is how we keep rural health care viable. How we keep rural hospitals alive. Already, we may have complicated the question by writing about how the incentives driving private insurance and Medical Advantage threaten our rural hospitals. This is appropriate.
It is appropriate also to ask about how universal health insurance would affect rural hospitals. This week, for example, Senator Bob Hasegawa introduced SB 5233 in response to Whole Washington’s proposal for universal health. By this evening, SB 5233 has earned eleven co-sponsors. And Whole Washington plans a voter initiative if SB 5233 falls short.
The language of SB 5233 is directed to the consumer: “to provide stable coverage from time of birth and maintained as a legal guarantee to all residents”. How about the suppliers: the hospitals? The situational awareness part of this is to ask if universal health care would make a difference to rural health care providers as well as to rural health consumers.
Universal health care is not precisely our topic this evening. But it may play a role.
Myth Busting…The problem is not Medicare/Medicaid
Harold Miller calls out a myth about why rural hospitals are under threat: “A common myth about small rural hospitals is that almost all of their revenues come from Medicare or Medicaid, but the fact is, on average, more than half of the services at small rural hospitals are delivered to patients with private insurance” (underlining added).
Not good. Earlier this month I passed on the observation that Medicare Advantage plans made “expense recovery difficult for small hospitals.” The bad guy in this story is not just UnitedHealthcare and Medicare Advantage. It turns out that private insurance administrators are in the same business. Should we be surprised? UnitedHealth group, UnitedHealthcare’s family, is the largest writer of private health insurance.
Putting names on villains makes moral outrage easier. Before we get too engaged in painting UnitedHealth black, though, let us remember that UnitedHealth is just the most success of a class of actors in how we deliver health care in this country.
Shane and Harold have to work within this framework. Join them in learning how to win in health care delivery and some of the counter-tactics that we have some chance of influencing. Learn the details. Then, we can talk about changing the rules.
Don Schwerin, chair of the Washington State Democrats Ag & Rural Caucus.