Walking for health care

Carl E. Feather

Sep. 4, 2008 (McClatchy-Tribune Regional News delivered by Newstex) -- By CARL E. FEATHER

Lifestyle Editor

No one is forcing or paying Dave Pavlick to put on a 30-pound backpack and spend 23 days walking across eastern Ohio to raise awareness of the Single-Payer Action Network of Ohio (SPAN).

Indeed, Pavlick, whose full-time job is international representative for Region 2B of the United Auto Workers, could have spent his vacation at a resort rather than walking from Cleveland to Marietta and back to raise awareness of SPAN's mission of health care for all.

Even more ironic is the fact that Pavlick, a conservative Lutheran and Marine who worked 26 years for a sheriff's department before starting a second career with the UAW, does not have to worry about health insurance. His employer provides excellent coverage for him and his wife.

Why then is this 55-year-old Cleveland resident walking up to 20 miles a day on his vacation?

"We are commanded to love each other as ourselves," Pavlick said Wednesday afternoon as he rested at a picnic table in Dorset's Township Park. "I have good insurance, but how can I accept that when there are so many people who do without (insurance)?"

SPAN is a grassroots effort to force Ohio's lawmakers to act upon the Health Care for All Ohioans Act (HCFAOA), which would provde a single-payer system for all health care in the state. H.B. 186 and S.B. 168 propose this system but are held up in committee.

The organization needs 120,000 signatures to force the legislature to pass, amend or reject the measure within four months. If rejected, the measure can go to the ballot with another 120,000 signatures collected within 90 days.

If enacted the law would boot the health insurance companies out of Ohio and replace them with a state-run health care system. Pavlick says it would leave the delivery of services intact -- the state would not run the hospitals or hire the doctors, but it would act as the only payer for their services.

A public fund would provide comprehenisve medical, dental and vision care for every Ohio resident. A state board would set parameters for that care, such as length-of-residency requirements.

Patients who are under the Social Security earnings cap would spend nothing out of pocket; those with incomes above it would pay their Social Security taxation rate to the state to support the health care plan. All businesses operating in the state would be subject to a gross receipts tax of up to 3 percent and a payroll tax of 3.85 percent would also be paid by employers.

Pavlick says there is already enough money in the system to provide this kind of coverage; it just needs to shifted from supporting the 1,500 private insurance companies and HMOs that operate in Ohio to providing actual health care. He says up to 30 percent of the premiums paid by patients and/or employers goes to the insurance companies. That figure, plus the fact 11 percent of Ohioans don't have insurance, moves Pavlick to action.

"I've always been a little bit of a Don Quixote. It's just wrong what is going on now, insurance companies getting up to 30 cents of every dollar we spend," he says.

According to literature produced by the Ohio Association of Health Plans, an industry group comprised of major insurers, 5 cents of every health care dollar goes for customer services and 9 cents for administrative costs. Kelly McGivern, president and CEO of the Columbus-based organization, says those are national figures and she does not have percentages specific to Ohio. Nevertheless, she says administrative costs are a catch-all that includes disease management programs, case management and consumer outreach, as well as fees and taxes.

The OAHP states that more than 15,000 Ohioans are employed by Ohio's health plans, which pay an average wage of $52,604. The plans are responsible for $1.5 billion in wages for other insurance-related jobs, which pay an average wage of $42,312.

Pavlick says SPAN recognizes that these good-paying jobs would be lost in the state if a single-payer system were enacted, and the legislation has a provision for retraining and unemployment assistance for up to two years during the transition period. But SPAN also projects an increased need for health care providers that could open up new job opportunities in the state.

He says a single-payer system would stimulate economic growth because employers would not have the burden of providing health insurance. It would also stimulate new business starts as entrepreneurs would not the huge financial burden of providing health care for themselves and families while starting up a business.

McGivern predicts the economic effect would be opposite -- taxes would have to double to support the program and the increased burden would fall upon businesses that are already struggling in an economically depressed state. She says cost controls would be necessary to contain the program and would drive providers out of state. Further, the prospect of free insurance would attract a flood of migration from outside while industries would shun the state because of the tax burden.

But Pavlick says Americans aren't flocking to Canada because of free health care there, and when it costs GM $1,000 more to produce a car in the United States than it does in Canada because of health insurance costs, a state with a single-payer plan could look very attractive to industry.

"The reality of it is, businesses will be flocking to Ohio because it is an economic development tool," Pavlick says.

The nation is already closer to this system than most want to admit, says Pavlick. Of the $72 billion spent on health care in Ohio, about half is already government-sponsored Medicare and Medicaid. The single-payer plan draws upon the cost efficiencies of those plans, about 5 percent versus up to 30 percent for private insurance, he says.

He says other industrialized countries have proven that a single-payer system is an efficient way of providing health care for all citizens. Further, citizens in those countries receive care superior to that in the United States.

Pavlick, who walked across the western part of the state two years ago, recalls meeting up with a motorist on the Lincoln Highway. The man, who was driving an 18-year-old van, stopped to tell him he appreciated what he was doing because he was between jobs and without insurance. His kids were covered by Medicaid, but as the bread winner of the family, he couldn't get insurance to treat a chronic health issue.

"It's totally insane the way we do it in this country," Pavlick says.

In another example of the insanity, Pavlick points out that if a death row inmate in Ohio attempts suicide "we'll do whatever it takes to nurse him back to life so we can kill him" but the system won't provide insurance for the young person trying to re-establish his life after serving a sentence.

State Rep. Deborah Newcomb says she is aware of the proposed bills but has not heard any testimony on them and is reserving opinion until she's heard both sides.

"You have to keep an open mind and hear both sides of the issue ... it is something that needs to be discussed," she says.

Pavlick says neither one of the Presidential candidates have successfully addressed the health care crisis.

"Most of what they are offering are ways to get more health insurance," Pavlick says. "Our plan offers a way to get health care. That's the difference."

Online:

spanohio.org; oahp.org

Newstex ID: KRTB-0322-27899143