четверг, 4 октября 2012 г.


Byline: Christopher G. Wren

As a state employee, I appreciate the excellent health insurance benefits offered by my employer. They served as a significant incentive to enter state service, and they remain a significant incentive for continuing in state service.

At the same time, I understand the frustration of my fellow citizens and taxpayers, who often resent state employees for their access to this benefit. I remember the irritation I felt when, during a hiatus from state employment, my wife and I had difficulty finding good and affordable health insurance coverage.

But unlike many others in similar situations, I did not begrudge state employees their good fortune. Rather, I wondered why the state did not routinely make its employee group health insurance plans available to everyone in Wisconsin - to the people who ultimately paid the bill.

I still wonder that.

The time has come for the state to make its employee group health insurance plans available to all Wisconsin residents and businesses. Various proposals have surfaced recently to broaden the availability by allowing businesses to form insurance-buying pools or consortiums, allowing specific groups (such as farmers) to buy into the group health insurance plans. These proposals, however, seem inevitably to add unnecessary layers of negotiation and red tape.

Wisconsin already has an existing insurance pool. Instead of restricting access to state employees only, the plans should be opened to anyone in Wisconsin. The state could specify that as a condition of participating as an insurer for state employees, the insurer would have to make the plan available - same policy terms, same premiums - to any employer or individual in Wisconsin. Employers and individuals would purchase their coverage directly from the insurer.

This arrangement would have several beneficial effects:

With the state acting as the negotiator and standard-setter, the public would see its interests aligned with, not in conflict with, the state's. The lower the premiums negotiated by the state, the lower the premiums the public would pay for the same coverage.

Instead of complaining about the generosity of state employees' health insurance benefits while private-sector employers steadily reduce their employees' coverage, private-sector employees might begin asking why their employers aren't buying into the state's plans or offering comparable coverage. Making the state's group health insurance plans universally available might help stanch the race to the bottom in health insurance coverage.

Extending the state's group health insurance plans to the general public should foster competition among existing private sector plans, presumably yielding better benefit packages, or premiums that better reflect the cost/benefit characteristics of those plans.

Extending the state's group health insurance plans to the general public would make coverage universally available without creating new public or private sector bureaucracies. The Department of Employee Trust Funds would continue its role as negotiator.

Extending the state's employee group health insurance program to the general public makes sense as a matter of sound policy. The state has an opportunity to do something it already does well - negotiate high-quality, cost-effective health insurance coverage - and make the benefits of those efforts available to everyone at little or no additional cost to taxpayers.

Moreover, with competition widely regarded as the best way to get the best price, putting state plans and private sector plans in direct competition ought to reduce health insurance premiums overall, or at least significantly reduce the rate of increase.

Ideally, every employer would emulate the state and offer all employees high-quality, employer-paid health insurance. Wisconsin, however, lives far from this ideal, with pressures growing to retreat further from it. If the state really wants to make employer-paid health insurance a priority, however, it could take a second step in addition to expanding access: create a 'super deduction' for employer-paid health insurance.

A super deduction - allowing an employer to value the insurance premiums at, say, 105 percent or 110 percent of cost when calculating business expenses for tax purposes - would send the message that the state considers health insurance a preferred fringe benefit.

* By taking these steps toward affordable, high-quality health insurance coverage for everyone, Wisconsin has an opportunity to remind itself - and the nation - of its progressive tradition of government working for the benefit of all citizens.