The Senate Republicans came out with an alternative health insurance plan yesterday. The intent of their plan is to a) not be left totally behind and b) stir up needless debate for the precise purpose of making sure nothing happens.

I'm going to publish the Pennsylvania Health Access Network Response in its entirety here, but you should also click "read more" to see an excerpt from what the Pennsylvania Medical Society released today as well (that's the biggest group of physicians).

Senate Republicans Unveil a Band-Aid
“We must care for people until we can figure out a solution.”

(Harrisburg, June 10, 2008) Plainly uncomfortable with their emerging role as the caucus that blocked affordable health insurance for 250,000 uninsured Pennsylvanians, Senate Republicans have at long last unveiled their non-solution to the problem of the uninsured.

The plan, as presented by senators Erickson, Corman, Donald White, and Wonderling at this morning’s press conference, is infused with humanitarian zeal. But its presentation also includes a note of pessimism.Dr. Zane Gates, a physician who serves as medical director of a free medical clinic in Altoona, articulated both sentiments: “We need 150 free clinics across Pennsylvania, which would serve 600,000 patients. We must find a way to care for people until we can figure out a solution to the health insurance problem” (emphasis added).

“Being uninsured is the 5th leading cause of death in America,” said Gates. “The incarcerated receive medical care, as I think they should. Why not also the working poor?”

The Senate plan would cobble together a patchwork of community health centers and free clinics to offer primary care to more uninsured Pennsylvanians. “Rather than open a pathway to the health system we have, their plan is to stitch together another one. But it would be filled with gaps and none of it would be available tomorrow. It would take time to put their new infrastructure in place,” said Tracy Lawless, Campaign Director for the Paraprofessional Healthcare Institute of Pennsylvania.

“Consider for a moment what the House-passed plan has that this plan doesn’t have,” said Marc Stier, Health Campaign Manager for the Service Employees International Union. “Hospital coverage, prescription coverage, access to specialists, access to sophisticated diagnostic care. They propose spending nearly as much as the House plan but would have little to show for it.”

The humanitarian part of the Senate Republican plan is $50 million to expand services of community-based health clinics, a plan that Senator Erickson said would serve 175,000 new patients. Erickson was plainly uncomfortable that his proposal did not provide access to specialists or sophisticated diagnostic tools and asked his guests to speak to the problem. The answers, which were hardly reassuring, focused on recruiting volunteers.

“If you are an uninsured Pennsylvanian, toward the end of your working years and needing access to medical care, this plan will be a big disappointment,” said John Dodds, executive director of the Philadelphia Unemployment Project. “Relatively few additional individuals will be insured as a result of the $100 million they want to spend.”

Sharon Ward, director of the Pennsylvania Budget and Policy Center in Harrisburg, noted the absence of any discussion by Senate Republicans of the availability of federal resources to expand health coverage. “Access to Basic Care, the House-passed plan, would draw down $400 million in federal funds annually. Uninsured Pennsylvanians need that help. But the plan announced today leaves that money on the table.”

Ward was complimentary about one aspect of the plan – the proposal to use $100 million annually from the surplus in the Health Care Provider Retention Account. “I welcome that commitment from the senators because it signifies agreement with the House and the Governor that a portion of the HCPRA surplus should be used to improve health access for the uninsured. That will be a huge help in the budget discussions that are going on behind the scenes. Now the only question is how to use that money in the most effective way possible.”

“The health insurance problem” Dr. Gates acknowledged was not being solved was nevertheless addressed by Senator White, who promised health insurance coverage for 20-year-olds whose parents have coverage and can afford to add them to their policies. He also promised support for the extension of COBRA requirements to small employers, thus offering former employees the option of purchasing their former coverage.

At one point in the press conference, senators Wonderling and Corman used the terms “archaic” and “retro-New Deal thinking” to describe government funding to help the uninsured buy private insurance.

“That’s where the press briefing took on the tone of a campaign event,” said Berry Friesen, public affairs manager for the Pennsylvania Health Access Network. “Just two years ago the Pennsylvania Senate unanimously approved a plan to use public resources to stimulate broader private coverage of children. Yet here they are, slamming virtually that same plan for uninsured adults as ‘archaic and lethargic’.

“We like free medical clinics, just as we like free food pantries,” said Friesen. “We’re just surprised the Senate Republicans put free clinics at the center of their plan. People want health insurance.”

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Excerpts from the Medical Society's own response to the GOP Plan:

The Pennsylvania Medical Society has received information on the plan, and is currently reviewing its details.

With that said, the Pennsylvania Medical Society thanks the Senate Republicans for opening new portals for a full discussion on the future of health care delivery in our state ... all cards are now on the table for everyone to review, discuss, and debate.

A quick review of the Senate Republican plan indicates that their model would involve the private sector, and the financial mechanisms appear positive in running the program. HealthNET PA also delinks Mcare and health insurance, allowing each to stand on its own merit and doesn't hold one hostage to the other from year to year.

Hold one hostage? They both draw from the same funding stream. It just seems like the Medical Society would like to give doctors a chance to draw even more from the cigarette tax's funding stream than they could if they had to share the money with the Uninsured.

The nice thing about the GOP plan is that they realized they couldn't get anything done on healthcare without dipping into cigarette tax money. Now that they have admitted that, the only question is how much of it we spend and on whom.
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Philadelphia Unemployment Project