WCCF Health Care Coverage Newsletter
Jon Peacock
Wisconsin Budget Project of the WI Council on Children & Families

July 25, 2002 Wisconsin Budget Project - WCCF

In this issue of "Health Care Coverage":
1. Check Our Website for Gubernatorial Candidates' Positions
2. Cost Increases Blamed on "Lavish" Hospitals and Expanded Supply of Care
3. The Controversy Over Health Care Mandates
4. Welfare Sanctions Correlated with Increased Hospitalization
5. $19 Million Provided in New Round of Community Health Center Grants
6. Directory of WI Child Abuse Prevention Programs
7. KFF Offers Native American Health Policy Fellowships
8. Other Resources
9. Join WCCF
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1. CHECK OUR WEBSITE FOR GUBERNATORIAL CANDIDATES' POSITIONS

The WI Council on Children and Families distributed a questionnaire to all the candidates for Governor. WCCF received responses from 9 of the candidates, including all 4 Democrats, Governor McCallum, and one of the two other Republicans. At least 3 of the 11 questions posed to the candidates relate to health issues:

3. What would you do to protect young children from lead poisoning? Would you support a state requirement for lead screening of all children entering daycare and kindergarten? If not, why not?

4. How would you ensure that adequate funding exists for BadgerCare, Medicaid and Healthy Start?

5. What policy initiatives would you propose to protect children from firearm injury?

Another question (#9) asks the candidates for their specific ideas on solving the budget deficit in the next biennium.

You can find the responses, by candidate, on the WCCF website at: http://www.wccf.org/whatsnew/candidates.html

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2. COST INCREASES BLAMED ON "LAVISH" HOSPITALS AND EXPANDED SUPPLY OF CARE

Two different articles published in newspapers on Sunday (7/21) discuss rising health costs and reasons why market forces are not working to hold down those costs. An article in the New York Times, titled "Research Suggests More Health Care May Not Be Better," states: "A growing body of research is leading many medical experts to ask whether more is really better when it comes to health care. Some medical specialties and geographical areas are suffering from a glut of doctors and hospitals, these experts say. Supply seems to drive demand.

More hospitals in an area mean many more days spent in hospitals with no discernible improvements in health. More medical specialists mean many more specialist visits and procedures. "If there are twice as many physicians, patients will come in for twice as many visits," said Dr. John E.Wennberg of Dartmouth Medical School, where much of the new work is being done."

For the rest of the article, go to: http://www.nytimes.com/2002/07/21/health/21CARE.html (The NYT website requires one-time free registration.)

An article in the Journal Sentinel on the same day focuses on new and "lavish" hospitals in the Milwaukee area as significant cost drivers:

"Attempts to rein in soaring Milwaukee-area health care costs are destined to fail as long as hospitals compete for patients on glitz and not on price. That's the view of many health care experts, who say area hospitals' dominance has given them a free hand to charge health insurance companies higher rates for touted tinsel amenities that have little to do with quality care."

You can find the article at: http://www.jsonline.com/news/metro/jul02/60556.asp

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3. THE CONTROVERSY OVER HEALTH CARE MANDATES

Another factor that is sometimes cited as a significant contributor to rising health costs, particularly by the insurance industry, is the increased cost of mandated benefits. The issue was raised last week in the testimony of Nancy Wenzel, Executive Director of the WI Association of Health Plans, at the hearing of the Assembly Health Committee. Quoting from the association's press release:

"There are many factors contributing to the problem of rising health care costs, but perhaps none is more avoidable than the impact of government mandates," said Nancy J. Wenzel.... A recent national study conducted by PricewaterhouseCoopers for the American Assn. of Health Plans concluded that 15 percent of the cost increase from 2001 to 2002 is attributable to government-mandated benefits and other regulation...."

That press release might still be accessible on the Wheeler website at: http://thewheelerreport.com/releases/Jul02/0716hmomandates.PDF

An analysis of the pros and cons of mandated benefits can be found in a 4-page issue brief titled "Mandated Health Insurance Benefits: Tradeoffs Among Benefits, Coverage, and Costs?" The brief was written by the Center for Health and Public Policy Studies at the U. of California, Berkeley, for an upcoming meeting of the CA Health Policy Roundtable. It explores the debate over mandated benefits legislation, the evidence about the impact of mandates, and the status of mandated benefits in California and in other states. It can be found on the Kaiser Family Foundation's website: http://www.kff.org/content/2002/20020807a/

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4. WELFARE SANCTIONS CORRELATED WITH INCREASED HOSPITALIZATION

A study in the July 2002 issue of the Archives of Pediatrics and

Adolescent Medicine finds that infants and toddlers in families whose welfare

benefits were reduced or eliminated by 1996 welfare sanctions have higher rates of hospitalization and household food insecurity. The study, which was conducted by the Children's Sentinel Nutrition Assessment Program (C-SNAP), looked at data on children age 3 or younger in six cities (Baltimore, Boston, Little Rock, Los Angeles, Minneapolis and Washington, DC). Data was collected over three years on 2,718 children whose families reported currently receiving welfare, or having their benefits reduced or terminated since 1996.

The study found that among families whose welfare benefits have been terminated or reduced by sanctions:-- Infants and toddlers have approximately 30% higher risk of having past hospitalizations than children in families whose benefits have not been decreased. -- Infants and toddlers have 90% higher risk of being hospitalized at the time of an emergency room visit than those in families' whose benefits have not been decreased. -- The families have approximately 50% higher risk of being food insecure than similar families whose benefits have not been decreased.

To read this study, go to http://dcc2.bumc.bu.edu/csnappublic/Welfaresanctions.htm and click on "Report" (Sources: 7/15 Boston Medical Center Press Release, and CDF Health Information newsletter)

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5. $19 MILLION PROVIDED IN NEW ROUND OF COMMUNITY HEALTH CENTER GRANTS

Secretary Thompson recently announced a new round of grants to help community health centers, totaling $19 million. The 149 grants, which are part of the Consolidated Health Center Program, include 3 grants to centers in WI: -- HCH of Milwaukee, Inc. - $110,000 Mental Health/Substance Abuse Service Expansion Grant -- Westside Health Care Corporation of Milwaukee - $200,000 Oral Health/New Access Service Expansion Grant -- La Clinica De Los Campesinos of Waushara - $100,000 Oral Health/Expanded Access Service Expansion Grant http://newsroom.hrsa.gov/releases/2002releases/serviceexpansion.htm

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6. DIRECTORY OF WI CHILD ABUSE PREVENTION PROGRAMS

Prevent Child Abuse Wisconsin recently announced that the Partners in Prevention Directory of Child Abuse Prevention Programs is now available in both print and online forms. This directory was created to assist citizens across the state in becoming more aware of and better able to access local prevention resources. The intent of the directory is to help unify community groups working to prevent child abuse and neglect and create opportunities for programs and organizations to exchange ideas and resources.

Print copies of the directory are available to purchase for $15.00 plus shipping/handling. To purchase a directory call 1-800-CHILDREN or email, pcawi@preventchildabusewi.org. To view the directory on-line, go to www.preventchildabusewi.org and click on "resources," and then "The Child Abuse Prevention Directory."

Also be on the lookout for their website discussion forum that will be available in the near future. This tool will allow individuals concerned about child abuse and neglect to share information about programming andresources available.  (Source: Hayley Williamson, MSSW, Program Coordinator, Prevent Child Abuse WI, 608-256-3374 or 1-800-CHILDREN)

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7. KFF OFFERS NATIVE AMERICAN HEALTH POLICY FELLOWSHIPS

There is an August 15 deadline to apply to the Henry J. Kaiser Family Foundation for Native American Health Policy Fellowships. These funds are designed to give Native American health and welfare leaders an opportunity to learn more about national health and welfare policy issues that affect Native Americans and gain a better understanding of the national health policymaking process.

Fellowships run annually from January through December. Fellows, who are required to make a yearlong commitment to work in Washington, D.C., will have the opportunity to work full-time for one year in a Congressional or Executive Branch office to gain first-hand knowledge of policy issues. Candidates are responsible for identifying and securing placements with assistance from Kaiser staff.

For more info or an application, go to: http://www.kff.org/docs/topics/nafellow.html

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8. OTHER RESOURCES

-- "Underinsured in America: Is Health Coverage Adequate?" - This Kaiser Commission fact sheet examines the adequacy of health insurance coverage of the insured and focuses on the consequences and future policy challenges of what some experts have defined as "underinsurance." http://www.kff.org/content/2002/4060/

-- "Preliminary Summary: Medicaid Managed Care Final Regulations" - The National Health Law Program (NHeLP) has completed a preliminary summary of the final MA Managed Care regs published by the Centers for Medicaid & Medicare Services on June 14, 2002. http://www.healthlaw.org/pubs/prelim-analysis-2.pdf

-- Disability Resources-DHFS Email Newsletter Available - The State of WI has joined the National Organization on Disability Community Partnership Program (CPP). Scott Durren, DHFS rep to NOD, will be disseminating by email news from NOD on various topics. To join the list, email Scott at durresb@dhfs.state.wi.us

-- "Help Yourself to a Healthy Home: Protect Your Children's Health" - UW Extension has just published the new edition of this booklet that helps people identify and address potential health threats at home. It's a product of a joint initiative of HUD Cooperative State Education and Extension Service initiative called the Healthy Homes Partnership. The new booklet covers nine areas of concern: mold, carbon monoxide, asthma and allergies, lead poisoning, drinking water, pesticide use, indoor air quality, hazardous household products and home safety. You can also download the booklet from the Healthy Homes website at: http://www.uwex.edu/healthyhome

-- President's New Freedom Commission on Mental Health - On July 8 the Commission launched a web site that allows the public to monitor a comprehensive study of the United States' mental health system. The study will analyze private and public providers and make recommendations on how to improve the system-partly based on input that the site is encouraging consumers to submit regarding what they believe works and/or what needs improvement in the mental health system. Go to www.MentalHealthCommission.gov

-- "Protect Your Family's Health ... With Confidence" - HHS recently released this bilingual, Spanish/English Guide to Medicaid and CHIP Programs. For more information visit: http://www.hhs.gov/news/press/2002pres/20020723.html

-- "Medicare Home Health Agencies: Weaknesses in Federal and State Oversight Mask Potential Quality Issues" - A newly released GAO report on home health care. http://www.gao.gov/cgi-bin/getrpt?GAO-02-382

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9. JOIN WCCF!

If you like receiving these updates and appreciate all the other stuff we do here at WCCF, consider helping us continue doing it by becoming a member. You can sign up via the website at http://www.wccf.org/membership/index.html

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Jon Peacock
Wisconsin Budget Project of the WI Council on Children & Families 608-284-0580 ext. 307
http://www.wccf.org/budget.html