Despite High Expectations, Washington’s Universal Health Care Work Group Falls Short

After much noise, some cautious optimism from healthcare organizations, and nearly two years of work, the Universal Health Care Work Group (UHCG) fell well short of the goal many of us hoped for: a recommendation to the legislature of a state-based single payer system. So why after input from hundreds of Washingtonians advocating for a publicly funded system (Option A, as named by the UHCG) and a clear demonstration by the UHCG’s report that Option A would save the most money while covering the most people(1), did the group not recommend Option A? Well, as usual, it comes down to who was at the table.

From the moment the group was announced, and the “stakeholders” were listed on the Healthcare Authority (HCA) site(2), I was suspicious the effort would result in anything more than a recommendation of bolstering “Cascade Care.” Cascade Care is Governor Inslee’s so called “public option” bill that I have written about previously. Despite it being called a public option, it is not a public option, as it is available only to people who buy insurance coverage through the exchange, which is less than 3% of the residents of the state(3). Further, it has the HCA contracting with those insurance companies(4) which is the opposite direction we need to go to guarantee that everyone has affordable healthcare coverage. Additionally, a public option is supposed to be a state-run insurance option that is available to everyone, which competes with private insurance companies. The goal of the public option is to offer more affordable coverage that will eventually eliminate the need for insurance companies altogether. I felt fairly certain that since some of the stakeholders would find a real public option untenable, that they would push for the faux public option as exemplified by Cascade Care. This is one instance where I hate to be right. It appears that Option C, a band aid solution like Cascade Care, is being framed by leaders in the legislature as the “pathway” to universal healthcare. Unfortunately, this patch work system will still leave many hundreds of thousands of Washingtonians uninsured or underinsured.

Due to the fact that some of the stakeholders of the group are affiliated with the very companies that would have their bottom lines adversely affected by a real public option or a non-profit, publicly funded system, the outlook for those systems being recommended at the end of the UHCG was slim to none from my perspective. Despite this, I attended a few meetings, gave public testimony, and encouraged dozens of others to do so as well. One cannot say that the organization I volunteer for, Whole Washington, didn’t do its very best to influence the outcome in the other direction: away from our tax dollars being siphoned into the pockets of insurance CEOs who make millions even while people are denied treatment and rationing insulin. Yet, clearly, our voices are not as loud as the voices of the insurance lobbyists. It didn’t make any difference the amount of public testimony or even the overwhelming proof by their own study that a publicly funded and administered system would be better, the outcome of this study group was predetermined due to the sinister motives of some stakeholders to ensure that no real reform ever happens.

I do not wish to belabor this point, nor focus on the wasted time and money of the UHCG. It is another example of insurance companies getting a seat at the table by feigning good faith. Wendell Potter, who was the Head of PR at Cigna, wrote about a similar situation in his book “Deadly Spin.” Insurance lobbyists, like Karen Ignangi, convinced President Obama that she and other lobbyists should have a seat at the table and would help the president by taking healthcare reform efforts seriously. Mr. Potter writes that at that moment “The president — having just been played like a Stradivarius by one of the best lobbyists to hit Washington — said, ‘Good. Thank you, Karen. That’s good news.’” Similarly to President Obama, our legislators and well-meaning healthcare organizations here in Washington were played. Mr. Potter goes on to say at the end of his book that “The cliché that if it sounds too good to be true, it probably is, is generally true: The oil company that wants to reduce dependence on oil … the health insurance company that wants to make you well … the tobacco company that wants to discourage smoking … the finance company that wants to help you make money. Count on it: Any for-profit company that claims to have no self-interest has nothing but.”

Now, I wouldn’t be an organizer if I ended this article without a solution. And the good news is that there is one! The Whole Washington Health Trust (SB 5204) was introduced this session by Senator Bob Hasegawa and 6 co-sponsors. It is an Option A solution to our present (and ongoing) healthcare crisis. This legislation would create the first ever universal healthcare system in the United States, covering vision, dental and prescriptions as well. We could say goodbye to deductibles and surprise billing. Lose your job due to unforeseen circumstances like COVID-19? No problem. You’re still covered. And you won’t be paying COBRA rates for the coverage either! So if you believe we need to join the rest of the developed world, saving lives and money, contact your representatives about the bill by calling 1–800–562–6000 and ask to leave a message. Or you can use the form on the WA Leg website here: https://app.leg.wa.gov/pbc/bill/5204. The time for transformational change is now, but it depends on people like you and me.

Georgia Davenport is the Field Director for Whole Washington and One Payer States. She is also the Stevens County Washington State Democratic Committee Member. She writes this article in her capacity as a healthcare advocate, not as a representative of those organizations.

(1)https://www.hca.wa.gov/assets/program/final-universal-health-care-work-group-legislative-report.pdf, page 86

(2) https://www.hca.wa.gov/assets/program/universal-health-care-workgroup-roster.pdf

(3)220,765 enrolled in Exchange plans out of 7.615 million Washingtonians.

(4)https://www.healthinsurance.org/washington-state-health-insurance-exchange/

Field Director, Whole Washington and One Payer States