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One part of the whole that thinks it is separate

by: Eric B.

Sun Jul 26, 2009 at 11:35:02 AM EDT


The media supporters of the Dillon health care plan launched a dunning offensive this morning in support of it.  The Freep says this:

House Speaker Andy Dillon's bold idea to put every public employee and retiree in Michigan under one health insurance plan may have real drawbacks, and may require serious alteration.

But the money on the table -- a potential $900 million in savings -- means everyone ought to be taking this seriously. And serious consideration means avoiding interest-group shenanigans and dealing with the realities of the state budget and of the plan itself.

The paper goes on to outline some of those facts, which includes big savings if fully implemented and that it would require substantial cuts in benefits by public service employees.  That is, nothing that hasn't already been said.  I wish that someone, somewhere would at least acknowledge what this means, which is building a future based on making things worse for people.  Again, it's not like public sector employees have usurped benefits overly generous when compared to private sector employees.  It's that private sector benefits have just simply gotten so crappy.

On a related note, there's this thing going on right now someplace else.  I think the city is Washington.  It's some kind of debate on comprehensive health care reform, something that could mean sweeping changes to how we health care as a nation, which means it's something that could invalidate the Dillon plan, or at least provide other options for the state to explore.  You would think that the fact that this is being currently debated at a higher level would give this state's political and media leadership some pause.  After all, it could change things dramatically and quickly.  The answer to that is no.

more...

Eric B. :: One part of the whole that thinks it is separate

Meanwhile, Nolan Finley has taken this opportunity to do what he really does best, which is trash the governor.  He does it by simply inventing things.

Nearly everyone except Granholm and the Michigan Education Association has enthusiastically saluted the proposal. So why is the governor so reticent?

This just simply isn't true.  L. Brooks Patterson said he was nervous about consolidating decision making at the state level, where he worries about how competently managed it can be.  Leon Drolet, who was said to support the plan, clarified in comments on this site that he has questions about it.  Other organizations said they wanted to take a closer look at it.  In short, a lot of people didn't enthusiastically support this plan, and for a lot of reasons.  I suppose the first of those is that it currently exists in a draft proposal circulating around the Internet, and not as anything concrete.

That's not all ... Finley also claims the governor has never supported any substantial reform, ignoring that two years ago she originally proposed a series of reforms in how local governments, ISDs, and school districts got money (the carrots and sticks proposal) and suggested we modernize what revenue we collect by adding services.  Major reforms, laughed off the stage at the time without serious consideration.

It's worth putting this in the context of time.  Right now, we have two months to balance the state budget for fiscal year 2009-2010.  This is the same position we were in two years ago.  In fact, if Skubick is correct (see post below), then the state Legislature still has no sense of urgency in balancing the budget.  And, one thing everyone agrees on regarding this proposal, it's that it won't help balance next fiscal year's budget very much.  That is, we're up against a budget deadline, and the state's political and media leadership thinks this is a good time to share that time with a major overhaul of public sector health benefits that would involve deep cuts to benefits and consolidating decision making in Lansing, and an overhaul that wouldn't do a great deal to balance next year's budget, at that.

We have further illumination on how this might shake out through recent history.  While the state Legislature actually managed to repeal the Single Business Tax and replace it with something that people thought a decent idea, that was followed up on with the budget crisis of 2007.  Therein, as we remember, the budget was balanced in a rush by creating a tax on services that was so unpopular the first order of business was to repeal it.  That was done, and it was replaced -- again in a rush -- with the surcharge on the Michigan Business Tax, which itself has become highly unpopular and confusing.  That is, history demands prudence on this, not rushing the thing through for the sake of saying that state government has enacted serious reform.

What is again galling about this, however, is that Michigan once again appears intent on charting its own course while things are taking place in a bigger picture.  This happened a few months ago, when this state's leadership defiantly insisted that coal was the way of the future ... even as cap-and-trade legislation started working its way through Congress and proposed coal projects started failing due to lack of investment dollars.  Now, we have a major health insurance overhaul proposed, with action demanded on it immediately, even as a larger health care debate is taking place.  That one guy we elected in November, I seem to remember, talked about it for almost an hour the other night.

That reform debate currently taking place not only has the potential to provide interesting alternatives to how the state insurs its employees (it would be great if we could strip health insurance from employment, as they do practically everywhere else) but also promises relief to Michigan employers who find themselves saddled under bigger costs offering benefits to workers.  In short, what happens in Washington could not only help government, but also employers in this state.

I'm not suggesting that we simply ditch new ideas and reforms.  Clearly, there exists the very real possibility that the great stupidity that tends to pervade Washington, as in Lansing, will derail substantive health care reform.  However, when you combine the potential for improvement for regular people (again, when wouldn't this be preferable to a policy based on making things worse for thousands on purpose?) while also looking at this through the prism of past failure to get things done a) in something less than a rush, and b) competently then it suggests that there is no special reason to rush this proposal through the state Legislature.  That is especially true when you recognize that it won't help balance next year's budget ... the budget that they're supposed to be working on right now and appear willing to be derailed away from by shiny new tangents.

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The Dillon Distraction (0.00 / 0)
While the traditional media coverage of the Dillon plan ignores what's going on in Washington with national health care reform, the reality is Dillon's proposal might not just reduce benefits for public workers. It could, possibly, might and maybe have the effect of reducing Michigan's ability to expand coverage and cut health care costs for other workers.  

Truth is, we don't know yet because national health insurance reform is still an unfinished work of policy and political art.  But the Dillon proposal would seem to run flat up against a centerpiece of both House and Senate national health insurance reform--the creation of large health coverage exchanges or pools, including a public one. Each state would have the option of creating their own pool under certain standards of care and other rules, including under a Senate proposal a rule allowing tiered benefits.

All of this, of course, is complicated stuff but the math is relatively simple.  The more and diverse people in the pool the better in terms of benefit costs.  That in theory is the underlying premise of the Dillon proposal.  But wait...even the Freep analysis of the Dillon plan says benefits would have to be reduced to achieve cost savings. The Dillon proposal just isn't big enough or broad enough to really address the cost issue without reducing benefits for workers.

But under national health insurance reform, that might not be the case. Costs could be reduced while benefits for workers are maintained. That's because the state could create a pool that didn't just include public employees but lots of others as well.  Maybe small business workers, students, etc etc. And if you had the ability to create a tiered benefit plan within this much larger pool couldn't you then possibly achieve cost savings for taxpayers and the insured while preserving benefits for public employees and avoiding the rush to the bottom in health coverage for all workers?

The point is that even assuming the best of intentions on Dillon's part, this isn't the time or the tool for dealing with health care insurance on a massive scale. It doesn't do much for FY2010 budget, if anything.  And it is taking place within the context of a much bigger picture that will likely reshuffle the health care insurance deck.

It's a distraction. Not only from budget solutions in Lansing, but from the much more important issue that should be occupying every progressive right now--getting national health insurance reform.  

 


The Freep had a story "analyzing" the plan's plusses and minuses... (0.00 / 0)
The plusses all had to do with Republicans supporting the plan; the negatives were that Democrats might torpedo it.

Your liberal media at work.

Among the Trees


[ Parent ]
dillon's intent (0.00 / 0)
i too want to see what the national plan is going to look like. dillon's idea is reckless simply because of the motive: quick political points as he jockeys for a place in the dem gov nomination table--and something thrown out there with little details of how some rather big obstacles would be overcome (see freep today).

this isn't going anywhere--and i think dillon knows it, BUT he can then say "well, i tried," which will still allow him to collect political capital.

pretty shrewd on his part.

but if anyone believes dillon gives a rat's ass about the state first and his political career second, i've got a bridge i want to sell you.  


A Nay Vote on Obama? (0.00 / 0)
The common feature with Dillon's and Brewer's plans (mandatory coverage in state) is that both make a tacit assumption that the Obama plan comes up short.  As Eric keeps pointing out, both plans would be rendered unnecessary were something like the Obama plan to pass.

Health care is as badly politicized as anything is why (0.00 / 0)
My impression based on actions taken rather than words spoken, looking in from outside, is that state government is so wrapped up in itself that -- institutionally -- it rarely gives thought to fitting itself into a bigger picture.

That's also the only reasonable explanation I can think of for why everyone would be jumping up and down praising the Dillon plan without seeing fit to acknowledge the larger health care reform debate taking place in Washington.

Among the Trees


[ Parent ]
Economies of Scale and the Dillon Plan (0.00 / 0)
Dillon suggests that many millions will be saved through "economies of scale." A 2006 study by by the National Association  of State Personnel Executives entitled State Government Employee Healthcare Benefits establishes 20,000 as the limit to economies of scale in healthcare policies. The state employee pool is already well beyond this point.

Read it here: http://www.naspe.net/associati...


what's been fun... (0.00 / 0)
it's been utterly hilarious watching the mackinac center get on board with centralized government plan. maybe they're moving to the left and there's hope for humanity after all.  


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