How does America feel about healthcare?

Gallop recently released interesting polling data related to healthcare.

The first chart Gallop provided shows that historically most people believe the federal government has a responsibility to “make sure all Americans have healthcare coverage”. These numbers dropped with the signature ACA (“Obamacare”) legislation, due to smear campaigns or the law itself we cannot conclude. However, the percent of people who believe the federal government should ensure coverage is again on the rise.

galloppoll

Further down on the page linked above (first table), Gallop gives the numbers for how worried people are about the “availability and affordability” of healthcare. Interestingly, the percentage of people who are worried a “great deal” has trended downward from 2001.

In the following table, Gallop asked how satisfied people are with the “availability of affordable healthcare”. The percentage of “very dissatisfied” people (47%) peaked in 2006/2008 and has gone down ever since, by over 10 percentage points in some years (33% in 2013/2015).

These numbers are interesting, considering the rhetoric we hear from Washington DC. There is much more data on the page, so please take a look if you’re interested!

WA state bills for single-payer healthcare

Two bills have been introduced to the WA state House and Senate introducing a state-funded single-payer healthcare system.

These bills will establish a healthcare trust that will cover every resident in Washington state. Residency is explicitly defined and those who would move to Washington primarily for healthcare would not be covered. The care includes, but is not limited to, everything covered under the “Essential Health Benefits” of the ACA (ambulance, out-patient and in-patient visits, emergency care, etc.), with a focus on preventative care. The coverage would be secondary to state/federal insurance plans, which I take to mean Medicare and Medicaid, or any other optional work-funded or personal insurance plans. No providers will be excluded from receiving payment from the trust (though the text does not indicate whether providers will be forced to accept patients insured through the trust). Long-term care (nursing home) coverage would not start immediately, and when it does start, a co-pay would be required from those with an income of over 150% of the federal poverty level.

The trust will be governed by a board consisting of 9 paid members, who will be reconsidered every 6 years. Both parties in the House and Senate will submit a list of 5 people they would like on the board. The governor chooses the board members, but must pick 1 person from each list. The board members must be healthcare professionals (both on the financial and administration side; the bills do not mention practitioners), business professional, and/or understand the needs of diverse populations. The board will appoint 3 unpaid committees: a financial committee, a citizen’s committee, and a professional committee. The board will manage the money in conjunction with the financial committee and develop standards of care and determine needs in conjunction with the citizen’s and business committees. Administrative costs are not to exceed 11% of the total trust amount.

The funding mechanism of trust isn’t established in the bill, and instead, the financial committee will work with the board to determine the best way to fund the trust. Suggested funding mechanisms include employer taxes, premiums for Washington residents with incomes over 200% of the federal poverty level, and/or shuffling other current tax revenues around.

A tax cut of about a trillion dollars

Republicans promised to repeal both sources of financing for the law. But they couldn’t make the numbers add up if they eliminated all the financing sources in Obamacare, so they left the spending cuts in place, and instead focused on repealing the part that Republicans in Washington hate the most: taxes on the rich. So the bill is built on a tax cut of about a trillion dollars over a decade that benefits the rich almost exclusively:

WA04 Insurance Tax Cuts #1

http://nymag.com/daily/intelligencer/2017/03/7-charts-explain-the-horrors-of-trumpcare.html