Curing health care

One of the regrettable realities of Olympia in the post-I-695 panic is that none of the state's other pressing business is being attended to. Even years like 2000 have only 60-day sessions, and that's hardly enough time in the normal course of events to deal with literally thousands of bills; things are even worse when legislators are preoccupied with how to keep massive chunks of government from being defunded.

As a consequence, important and urgent matters are being left to rot, and one of the most putrid at the moment is the state's crisis in health care and health insurance. Insurers have almost completely pulled out of the new individual insurance market; 700,000 Washingtonians are without health insurance and another million are badly underinsured. The only movement in Olympia is from the insurance industry itself; their "fix" is to make the post of insurance commissioner appointed rather than elected because its current occupant, Deborah Senn, has occasionally actually regulated the industry like the law says she should.

Into this vacuum, a single-payer initiative kicked off a signature-gathering campaign last week to get a solution to the health care crisis onto the November 2000 ballot. Health Care 2000 needs some 225,000 voter signatures statewide by July 7 to make it on the ballot. If they achieve that—and chances are good they will—they will face an uphill battle against the insurance industry giants like Regence that constitute the single greatest barrier to providing treatment to sick people in Washington state.

The Health Care 2000 initiative also faces an uphill battle because it's complicated—not surprising, given the complex nature of the mess that needs fixing. The initiative took two years to write, with initiative language based on recommendations for a single-sponsor system by the Gardner Commission—recommendations the Legislature chose to ignore. It changes the method of financing health care, establishing a public trust fund, the "Washington Health Security Trust," which patients, businesses, and other stakeholders would pay into. The trust fund would be dedicated and could not be used for other governmental purposes. All health providers and facilities would remain in the private sector; prescription drugs would also be covered. The HC 2000 proposal essentially provides for universal health care by creating "socialized" insurance, not socialized treatment.

Thus far, Health Care 2000 has done an impressive job of lining up support and creating what appears to be a workable system. HC 2000's board includes three past presidents of the Washington State Medical Association; a third of the board are doctors, along with current and former elected officials, business and labor figures, and community activists. HC 2000 executive director Cindi Laws says that while the WSMA itself is divided over the initiative, much of HC 2000's support comes from family practice and general physicians who are on the front lines and see the problems with the current system; opposition is concentrated among specialists and higher-income docs who are somewhat shielded from the inability of some people to get primary care.

Laws estimates that HC 2000 will need about $1 million to wage a successful petition drive and campaign—a drop in the bucket compared to what the other side will raise. With a reservoir of over 7,000 volunteer signature gatherers lined up, she has opted thus far to go the more difficult route of foregoing paid signature gatherers, though she doesn't rule it out if time runs short.

Fundraising is coming primarily from doctors and smaller donors. That's important because the limited history of single-payer initiatives in other states—particularly one in California in 1994—is that they get badly outspent by industry and then lose at the polls.

Laws' mantra is that the Health Care 2000 system is "simple, it's fair, and it's accountable; the current system is none of those." The failings of the current piecemeal system of financing health care in the US are well documented; we pay more for health care than any other industrialized country in the world and get less for our money, in large part because so many for-profit middlemen have inserted themselves into our health care delivery system. Presently, our health care system isn't designed to heal the sick or keep the well fit—it's designed to make money.

It's telling in all sorts of ways that the resulting crisis isn't being addressed by our elected lawmakers and that it's taking a citizen initiative to put some sort of a workable alternative on the table. The lack of affordable, accessible health care is causing people to die in our state; for any other issue, the loss of life involved would be a scandal. For health care, for some reason, it's not—yet. How alarmed people are about a health care system that's badly broken will go a long way towards determining whether we're up for a radical cure.

A draft of the initiative and information on signature gathering is available at or by calling 903-9723.

The return of tritium

Lost in the coverage of last week's emotional hearings in the Tri-Cities, in which Department of Energy officials listened to hundreds complain about health problems associated with working at Hanford, was a revelation that made headlines in Richland but was ignored here. It seems that soil samples taken at Hanford revealed a level of 8 million microcuries of the radioactive compound tritium (a "safe" level is considered to be about 20,000 microcuries.) Moreover, last year the level in the same area was 1.8 million—a fact the DOE kept secret for 14 months, choosing to do nothing about it until it got far worse.

Folks following Hanford follies may remember tritium—it's the compound the Fast Flux Test Facility was campaigning to produce two years ago in a dangerous and fraudulent privatization scheme to "cure cancer." Turns out they didn't need to make tritium after all; all they needed was a shovel.

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