WalkerCare Or WalkerDon'tCare?

On Tuesday, Scott Walker introduced his "plan" to reform Obamacare. By Sunday, during his appearance on This Week with George Stephanopoulos, he was furiously trying to defend it:

STEPHANOPOULOS: Let’s talk about health care. You put out a plan this week calling for the replacement of Obamacare with a series of tax credits for everyone that would be escalating over age. This is what one of your rivals, Governor Bobby Jindal, had to say about that.

(BEGIN VIDEO CLIP)

GOV. BOBBY JINDAL (R-LA), PRESIDENTIAL CANDIDATE: Scott Walker’s plan actually does create a new entitlement program. It actually does guarantee universal coverage through government subsidies for every American. One estimate this week says it would cost over $1 trillion, and he doesn’t tell us how he would pay for this plan.

(END VIDEO CLIP)

STEPHANOPOULOS: So how much will your plan cost? How are you going to pay for it?

WALKER: Well, he’s just wrong on that, and in fact conservative commentator after commentator from “The Wall Street Journal” to “The National Review” and plenty of others out there have said this is the best plan out there. In fact, it’s one of the only plans out there. They said it’s the best plan, it’s about freedom, it’s about giving patients and their families the freedom to control their own health care decision and to control their own money.

We repeal Obamacare immediately. On Day 1 we send a bill up to Congress, and on Day 1 we get rid of the special provisions for Congress, their families, their staff, and everyone else, to make sure they repeal it entirely, immediately. And then we give people a tax credit for those who don’t have health insurance from their employer. If you get it from your employer, it’s not going to be touched. If anything, your premiums are likely to go down because repealing Obamacare and putting in place our reforms will actually help lower health care costs, not raise them, as we saw under Obamacare.

But we give people a tax credit, it goes up by age. Because before Obamacare that’s what happened. Your health care costs go up over age, the credit goes up over age. We allow people to apply that to the health care plan they want, or not buy health care insurance if they don’t want. But we put the freedom back in the hands of the American people. And for us it’s a simple way to do it that’s cost neutral. It repeals all of the trillion dollars’ worth of tax increases that you see under Obamacare, gives us one of the biggest tax cuts we’ve had in the past 40-some years, one of the best pro-growth plans out there, and we do it by making sure we have a tax system that appropriately acknowledges some of the top tier health insurance plans and by giving Medicaid back to the states where there’s real reform. That makes it cost neutral.

Let's talk about WalkerCare, shall we?

First of all, Walker's "plan" consists is pretty damn flimsy and sketchy, as Jessie Opoien of Cap Times reports (emphasis mine):

Gov. Scott Walker on Tuesday unveiled his health care blueprint, the first policy paper of his presidential campaign.

"The Day One Patient Freedom Plan," announced by Walker at a machine parts manufacturer in Brooklyn Center, Minnesota, would provide tax credits based on age rather than income, allow people to shop for plans across state lines and restructure Medicaid and long-term care services.

"It’s all about freedom," Walker said Tuesday, speaking at Cass Screw Machine Products. "It’s putting freedom back in the hands of patients and families to make decisions about your health care and about your money."

Walker's 15-page plan — five of which are dedicated to campaign logos and three of which make the argument for repealing Obamacare — includes no cost estimates or projections of how many people would be covered, but Walker said Tuesday it would be "cost-neutral" and would amount to "a tax cut of about a trillion dollars."

Hmm, that's more than a little reminiscent of the "job plan" that Walker came out with in 2010. It was a 68 page document written in size 58 font. Maybe when it comes to these sorts of things, he has flashbacks to his grade school days when he tried to cut corners even then.

One of the biggest changes in WalkerCare would be to give tax breaks based on age instead of income and family size - y'know, the things that put the affordable in Affordable Health Care. He also wants to give young people the right to opt out of it - which also makes no sense:

One of the biggest ways it would differ from the current law is by providing tax credits to uninsured people based on their age instead of income, an idea that "doesn’t make any sense," according to University of Wisconsin-Stevens Point political science professor Ed Miller, because it gives tax credits to the wealthy.

Those credits could be used to buy insurance on the free market. Under Walker's plan, people 17 and younger would receive a credit worth $900, while those 50-64 would get a substantially larger credit worth $3,000. Further, anyone who signs up for a health savings account would receive up to a $1,000 refundable tax credit and annual limits on tax-free HSAs would also increase. Everyone in a given age group would be eligible for the same amount of credits regardless of how much money they make.

If the goal is to get lower-income people insured, Miller said that's the wrong way to go.

"The individuals who are low-income simply can’t afford it," he said.

Another big thing is that Walker is saying he would allow states to "innovate" ways to administer his plan. This is the same thing he said when he dropped the bomb known as Act 10 on Wisconsin. What he means is that he would drastically cut the funding the states receive from the federal government and leave it to them to figure out how to make up for the shortfall.

Perhaps it was the fact that Walker's WalkerCare is so sketchy that he was screening reporters' questions about it. He knows the plan is a failure from Day One and didn't want to take the chance of getting caught flat-footed yet again.

The only thing that is even remotely appropriate about WalkerCare is the location that Walker chose to introduce it - a company in Brooklyn Center, Minnesota called Cass Screw Machine Products.

There But For The Grace Of God Go We

In the beginning of May, my wife went to her primary physician. The appointment was to address some of the routine things that can happen to a person as they get older.

Or so we thought.

During the appointment, the doctor ordered X-rays of my wife's chest due to my wife having a lot of congestion.

The Friday before last, the doctor called and told us that the X-rays showed a spot on one of her lungs.

As the doctor gave us the name and number to an oncologist, my mind was reeling.  My wife had cancer twice in the mid-1990s, but had beat it both times.  She is also about the age my mother was when she was diagnosed with cancer.

We called the oncologist and got an appointment for the first thing Monday morning.  That was the longest weekend of my life as I tried to keep my imagination from getting carried away.

I'll spare the gentle reader the details of the whirlwind of scheduling appointments, more tests and more scans, and the nonverbal language of the oncologist giving the tell that she was already thinking of treatment options.

The big news was that the tumor was thankfully not cancer.

As I spent the weekend waiting for Monday and then spent the beginning of the week waiting as my wife was poked and prodded and dyed and had all sorts of tests and scans done, I did a lot of thinking.  What else is there to do in a hospital waiting area?

The most frequent thought I had was how glad I was to have a job with relatively decent benefits.  If not for the insurance, my wife might not have had the X-rays done, the spot might not have been found.  I silently thanked by union brothers and sisters who had fought so hard to get us these things and appreciated them all the more.

For without the insurance through my job, we might have had to go with Badger Care, like many of the poor, the working poor and Walmart employees (but I repeat myself).  But with the way that Scott Walker has been screwing up by the numbers with first Badger Care and now with Walkercare, odds are my wife wouldn't have any resources that way.

She might have been able to access free screenings, like those offered at Planned Parenthood, but Walker and his Teapubligoons went after them and made sure that they couldn't help the poor either.  After all, who would want to save a life or anything?

Another frequent thought was that of gratitude to the Milwaukee County Board, led by Supervisor Marina Dimitrijevic.  I realize that this might sound odd, but there is a very solid reason for it.

When the county was going through the crafting of the 2013 budget. one of the major issues that Milwaukee County Executive Emperor Chris Abele and the County Board were at odds was that regarding employee benefits.

Abele wanted to give workers a 3% raise, but completely eliminate the health savings account and raise employee contributions to 29%.  The Board restored the HSA and cut the contribution to 25%.  They also cut the raise to 1.5%.  It was the same amount of money either way, but the Board's method offered a greater potential of savings as well as balanced it a little better for the workers (although we took a hit either way - losing over another thousand in take home pay).

Because the Board's version won out at the end, I was able to focus on supporting my wife instead of trying to find money we don't have or finding a bankruptcy attorney or having to give up everything just get her the care she needed.

As I wrote above, we were most fortunate that the scare was just that - only a scare.  Even with the "Cadillac" insurance we have, if it had been anything more than a scare, it would have sent us over our own personal fiscal cliff.

Yet, even though we are one major illness from bankruptcy, we are one of the "lucky ones."

There are tens of thousands of Wisconsinites that are not receiving the necessary and proper health care and have nowhere to turn now.  And the only reason for this is the greed and malfeasance of Walker, his Teapubligoons in the legislature and their corporate overlords.

Until these wrongs are righted, I am rededicating myself to the fight, not just for health care, but for all the evils that Walker and his ilk have visited upon our once great state.  I hope that the gentle reader will remember what we are fighting for and once again pick up the fight as well.

I would also be remiss if I ended this without giving a large shout out of thanks to all of our family, friends and coworkers who gave us an overwhelming amount of emotional support during this scare.

Walker The Wishdoctor

Yet another nonpartisan, nonprofit group has come to the same conclusion - Walkercare won't work (emphasis mine):

A new national study from the RAND Corporation says states choosing
not to expand Medicaid under federal health care reform will leave millions of residents without health insurance and increase spending, at least in the short term, on the costs of treating uninsured residents.

Wisconsin is among the 14 states studied in the analysis, which examined the impacts of Medicaid expansion on insurance coverage, federal payments into the states and state spending on care for the uninsured.

“Our analysis shows it’s in the best economic interests of states to expand Medicaid under the terms of the federal Affordable Care Act,” said Carter Price, the study’s lead author and a mathematician at RAND, a nonprofit research organization.

The study says that if the 14 states decide not to expand Medicaid under the Affordable Care Act, as intended by their governors, those state governments collectively will spend $1 billion more on uncompensated care in 2016 than they would if Medicaid is expanded.

The study also says that failing to expand Medicaid could have more than financial consequences. The study estimates that an additional 19,000 deaths could occur annually if the 14 states studied do not expand Medicaid.

The article goes on to show just how badly Scott Walker and the Republicans have screwed this one up:

Citizen Action of Wisconsin has voiced opposition to this potential deal.

“By conceding that hospitals will be damaged by an increase in uncompensated care, such a deal would be an admission that Walker’s plan will cause tens of thousands people throughout Wisconsin to lose health coverage. This has been denied by the governor and his allies in the Legislature up to now,” said Robert Kraig, executive director of Citizen Action of Wisconsin. “It would be a stunningly callous and immoral act to compensate hospitals for impact of forcing people of health coverage, when it would be easy to prevent this tragic result in the first place by taking the federal health care dollars that are on the table.”

Women’s health advocacy groups have also voiced opposition to Walker’s decision on Medicaid. On Tuesday, the Wisconsin Alliance for Women’s Health (WAWH) will mark a Wisconsin Women’s Day of Action for Health Care Coverage supported by American Association of University Women–Wisconsin (AAUW), League of Women Voters of Wisconsin Education Network, Mid-Day Women’s Alliance, NARAL Pro-Choice Wisconsin, Planned Parenthood Advocates of Wisconsin, Reproductive Justice Collective, The Demeter Foundation, Wisconsin Women’s Network, the Women’s Fund of Greater Milwaukee and the Wisconsin Alliance for Women's Health.

“Women are the primary recipients of Medicaid services because they make up a larger portion of low-income and elderly populations, and are likely to be custodial parents,” said WAWH executive director Sara Finger. “For those committed to advancing Wisconsin women’s health and economic security, they must protect current BadgerCare coverage and improve Gov. Walker’s initial proposal.”

The Wisconsin Nurses Association also released a statement opposing Walker’s proposal, as executive director Gina Dennik-Champion said, “Nurses are deeply concerned about the approximately 88,500 patients that could lose access to Medicaid coverage. These patients would be put into a health insurance exchange that has yet to form and they would face expensive premiums, copays, and deductibles that would limit their access to quality, preventive health care services. This unnecessary barrier to health care will come with a significant cost to our hospitals, providers, and ultimately, Wisconsin taxpayers.”

But here is the real kicker of this. Walker already has first hand knowledge that not only would this work, but how it could work.

During his time as Milwaukee County Executive, up until the creation of Badger Care, Walker was responsible for seeing to the administration of a program called General Assistance Medical Program or GAMP for short. As I pointed out four years ago:

Wisconsin's General Assistance Medical Program (GAMP) provides health care coverage to indigent Milwaukee County residents who are not eligible for other forms of public coverage (such as Medicaid and the State Children's Health Insurance Program) and are not enrolled in private coverage. The county redesigned the GAMP program into a community-based primary care model in the late 1990s to achieve two interrelated goals: to provide increased primary care services, and to do so via community-based clinics. The new design was intended to improve effectiveness and efficiency of care. Prior to this, indigent patients relied on the emergency room of the county hospital, which created access barriers for enrollees and cost inefficiencies for the county. Under the redesigned model, GAMP enrollees select a participating clinic as their primary care provider, which is then responsible for providing and coordinating services. The clinic coordinates specialty care for the enrollee by working with specialists and hospitals that participate in the GAMP network. The program covered a total of 24,000 individuals in calendar year 2003, with some 10,000 to 12,000 individuals enrolled at any given time. All in all, GAMP estimated that it saved $4.2 million in 2000 (in comparison to the projected costs had the previous system remained in place). Administrators believe that inpatient and outpatient costs have been controlled largely through a Utilization Management program that ensures delivery of care in the appropriate settings and using appropriate resources.

Similar findings have been found with Obamacare.  Because having affordable assurance makes it easier for people to take care of themselves, it has drastically cut down on the much more expensive hospital stays.

The gentle reader is probably wondering why Walker would then go ahead and make such a bungle of the health care reforms if he already knew better.

The answer is really rather simple.

Walker is stupid.

Walker, despite his protestations to the contrary, is doing everything based on how it would affect his presidential campaign.

He's not about to do anything remotely resembling accepting Obamacare.  He's seen the way that the red meat Teapublicans tore up New Jersey Governor Chris Christie for doing what was in his state's best interest after last year's Frankenstorm.  He is trying to out-conservative all of his potential candidates.  Apparently, Walker napped for the three years of the 2009-12 GOP primary.

So instead of giving the slightest impression of cooperating with that Black Man in the White House, Walker somehow thinks it will help his aspirations by allowing people to deny needlessly and to raise the taxes on the living for that privilege.

Less services, more deaths, higher taxes.

That's not exactly a winning slogan, especially for a POTUS wannabe.

In fact, that's sounds pretty damn stupid.

With Walker's mishandling of health care reform for purely political reasons, he has shown himself to be a wish (he was gonna be president) doctor who should face charges for malfeasance as well as malpractice.