MPTV Health Care Report January 2nd: What Surely Must Have Been Left on the Cutting Room Floor

Milwaukee Public Television aired a 27 minute report over the weekend entitled "Critical Condition: The Wisconsin Perspective". Featured were three individuals with serious health conditions. While it appeared all three were coping pretty well with the physical aspects of their illness (two cancers and MS), the focus of the show was the financial impact. I am so blessed to have good health but that is not the case with many friends, family members and clients so I do not want to trivialize how difficult dealing with illness can be. Having acknowledged that, the MPTV production - and so many others like it - repeatedly attributed the cost question to "affordable" health insurance.

For example, one of the featured individuals was working in California when her cancer was diagnosed. It wasn't clear to me her reasons for returning to Wisconsin but she did so without health insurance. Why didn't she have insurance? The report didn't ask that question but instead vilified health insurers for not wanting her as a customer with a 'pre-existing condition'. (Presumably it is also just wrong to deny someone homeowners insurance after the house is on fire.)

Maybe this particular featured patient returned to Wisconsin because our legislators have already provided at least two remedies for the uninsured; guaranteed issue of coverage for all small businesses (defined as having 2 to 50 employees) or our HIRSP Plan which stands for Health Insurance Risk Sharing Pool - again, a guaranteed issue policy for individuals who have been turned down by insurers.

And here is where what must have been left on the MPTV cutting room floor did the greatest disservice. Premiums for small group health insurance and the HIRSP Plan are strictly regulated by the state; they are "unaffordable" not because of insurers administrative costs and profits (combined, only 14% of the total premium) but because of the underlying delivery of health care. Not once in the 27 minute report were the costs of surgery, chemotherapy or miraculous life saving drugs revealed or discussed. Not once.

The cost of health insurance will not be reduced by tinkering with the size of pools or further regulating underwriting guidelines to guarantee access. MPTV should do its next health care feature dissecting the waste fraud and abuse in the delivery of health care, accounting for 86 cents of every premium dollar and where the real savings are to be found.