The Governor's Gift

By George Lightbourn

Health care poses a real dilemma to conservative politicians.  Every poll over the past few years shows that Wisconsin families are troubled about the state of health care.  While it might be tempting for conservatives to dismiss the prattle about universal health care from the Michael Moores of the world, the issue is not going away. 

Assembly Republicans, now hashing out a budget with Senate Democrats, know that how they address the health care issue will go a long way toward determining whether they retain the majority.

The health care issue was largely an academic discussion in Wisconsin - that is until the Senate Democrats unceremoniously dropped a universal health plan into the budget at the eleventh hour.  Senate Democrats threw subtlety out the window and pushed the health care pedal hard to the left.  Dubbed “Healthy Wisconsin,” their budget play unabashedly included a breathtaking tax increase and a big new government agency.  They went out of their way to jab a stick in the eye of businesses from Beloit to Superior.

The list of problems with the Senate Democrat plan is a long one.  However, will it be sufficient for Assembly Republicans to poke holes in the Democrats’ plan?  In the long run the answer is no.  Rightly or wrongly, the public expects their government to do something about the health care mess.  Killing the Democrats’ budget plan is not doing something.  Democrats in the Senate and the Assembly know this.  That low rumble you hear is the movement of Democrats out of Madison and into the hinterland to keep the discussion going through the summer and into the fall.  The longer it takes to reach a budget deal, the longer will be the period for discussing health care. 

Senate Democrats understand better than anybody that their plan stands scant chance of becoming law, but they want to leave a lasting impression of which party was willing to take action.  By inference they are also building a case that Wisconsin Republicans seem resigned to the status quo.  As the budget drags on, it could be a long, hot summer for Republicans.

But Assembly Republicans have a path out of this dilemma, and it has been delivered by Governor Doyle of all people.  But before getting into the budget strategy, let’s back up and review a few key points in the health care debate.  Over the past few years, free market thinking has begun to make serious inroads into health care.  Consumer-driven reforms, the most familiar of which included health savings accounts, are increasingly being adopted by businesses and individuals.  Free market reforms put the individual – not employers and not insurance companies – in charge of our health care.  By providing the individual with more information and incentives to wisely manage their own health care spending, it has been shown that we can effectively bring the same market forces to health care that have revolutionized nearly every aspect of the U.S. economy. 

However unlike universal health plans, consumer-driven solutions cannot be done with one swift law change.  The reforms will require time to implement and time for the health care market to adapt, much the same as when managed care revolutionized the industry in the 1980s.

So, let’s return to the gift from Governor Doyle.  His budget included an initiative called Badgercare Plus.  Badgercare, the brainchild of Tommy Thompson, was created to provide affordable health care to the working poor.  Governor Doyle, building  on the platform created by Tommy, sought to extend Badgercare insurance to an even wider swath of Wisconsin.  His proposal would ensure that 98% of Wisconsinites will have health insurance.  The idea is remarkably cost effective (especially compared with the $15.2 billion price tag of “Healthy Wisconsin) but does engender some risk since it requires concurrence of the federal government.

Were the Assembly Republicans to embrace the Governor’s Badgercare Plus, they would neutralize one of the key health care issues on the mind of Wisconsinites, the plight of the uninsured.  And just like that, the key selling point for universal health care would dissolve.  Early in the budget negotiation, Assembly Republicans should embrace the Governor’s Badgercare Plus idea.  Instantly they would undercut the rhetorical base of those riding the circuit espousing “Healthy Wisconsin” and rhetoric is about all that they have.

This move would also be smart strategy in the more important effort to build free market solutions.  By neutralizing the advocates of government run health care, it buys precious time, time for the private sector to continue their work on transforming Wisconsin’s health care marketplace to one that is consumer driven.  It would also ensure that Assembly Republicans avoid the temptation to fight so vigorously to kill the Democrats’ “Healthy Wisconsin” plan that they become advocates for the status quo.

True health care reform will entail unleashing consumer-driven capitalism on the Wisconsin health care market.  Over time there will be a constant policy tug between those that advocate a free market health care system versus those who see only a big government, universal care solution.  It will be imperative to elect legislators and a governor committed to consumer driven health care for Wisconsin.  As counterintuitive as it might appear, the first step is to acknowledge the strategic advantage provided by the Governor’s Badgercare Plus initiative.