Provision of early health services has been shown to reduce costs over the long run. So, in short, the focus must be on therapeutic aspects of health care with (as far as the patient is concerned) secondary concern on money considerations. Fiscal matters will comprise an important concern of the Health Policy Board and the secretary of the State Department of Health Planning and Finance.         Mechanisms for monitoring, evaluating, and controlling costs are included in provisions of the Act.
      As noted in my column last month, carrying out the plan will result in reduced administrative costs, wait time for services, and red tape. All funds will be placed in the Health Trust Fund from which all payments to health care providers will be made. It will be somewhat like a family checking account in which all family income is deposited and from which authorized payments are made. The key part of the Act is the word "authorized." That means that payment and the processes used will be scrutinized and justified before payout occurs. The gatekeeper will follow legal regulations established by the Act, policies developed by the Health Policy Board, and procedures specified by the State Department of Health Planning and Finance.
      According to the Act, there will be no "premium, copayments, deductibles, and other forms of direct payment by patients ..." Also, the Health Trust Fund will receive " ... federal, state, and local moneys that fund ... health care services including medicare, medical assistance, health care services funded by a relief block grant, ... veterans medical benefits, ... federal block grants, alcohol and other drug abuse services, and services provided by local health departments.
      There will be " ... a tax on employers, based on the amount of wages that they pay, that generates, in the aggregate, revenues that are at least equal to amounts that employers contribute, as of the effective date of [the Act] for employee health care benefit costs, including worker's compensation attributable to health care for injured employees."
      Further, there will be " ... revenues from a graduated tax on individuals that generates, in the aggregate, revenues that are not greater than expenditures that individuals make as of July 1, 2008, for health care costs in which coverage under disability insurance is not obtained."
      To plan for future increased costs, there will be an indexing of revenues equal to anticipated growth of health care costs under the plan. An element not part of the design is one I think may grow in importance as time goes on. That is, how much and in what manner should retired people contribute to the cost of the Plan? Could Wisconsin ask the federal Social Security Administration to make special deductions for Wisconsinites and annually transmit the total to the Wisconsin Health Trust Fund? Is there some other way retired persons could contribute to the Plan?
      In Wisconsin, as elsewhere, the number and proportion to total population of the people in the group called aging or retired are growing. The so-called Baby Boomers are reaching retirement age in large numbers. Because health and health-related conditions improve, more people will live longer and will require increased amounts and varieties of prescription medications and health care. Therefore, the complexities of providing comprehensive health care and financing the expenditures must be dealt with before they become overwhelming.
      If you want to join the efforts of the Coalition for Wisconsin Health or if you have questions about the Wisconsin Health Security Act, contact Coalition for Wisconsin Health, 1202 Williamson Street, Madison, WI 53703.
      Well, that's enough about health care in Wisconsin. I'll get on to other topics after this. Health care is so important, and since Wisconsin introduced a bill in the Legislature, I just had to ramble on about it.
How can we afford health care for all?
by Paul Kusuda
     How can we afford health care for all? The better question is, 'How can we not afford health care for all?' During the past two months, my articles in Asian Wisconzine have been about the Wisconsin Health Security Act. They dealt with who it will cover, what health-related services will be provided, and how the program will be directed and evaluated. There will be minimal use of partisan politics, and the first priority will be provision of  health services to everyone. Emphasis will be placed on efficiency, effectiveness, cost controls, evaluation, and preventive health care.
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