The call for universal health care in Arizona has gone mainstream. The venerable Arizona Town Hall, meeting last week in Prescott, recommended a statewide program to ensure everyone in the state has access to basic health care.
The group of 150 community leaders also called for expanded efforts to enroll children in federally funded health insurance programs and beefed-up mental health coverage.
“I was just amazed. It’s a real sea change,” said Carol Ann Lockhart of Tempe, a longtime health care consultant. “People are saying it’s a messed up system. We’ve got to fix it,” Lockhart said. “And it needs to be fixed so everybody can get care.”
Rising health care premiums and shrinking employer-based coverage mean that, more and more, the 18 percent of Arizonans who are uninsured includes a growing middle class. About 45 percent are covered by their employers.
From hospital executives to business leaders and elected officials, Town Hall participants agreed a statewide health insurance system is the only way to cover more people and reduce skyrocketing costs.
Hospital board member and former high school principal Lanny Kope of Sierra Vista summed up the journey many have traveled.
“Ten years ago, I think I would’ve washed my mouth out with soap,” Kope said. “We may have to change the name from single payer to something else, but I really think we need to take a look at public-sector funding.”
A bill to create a universal health care system has been introduced the past two years in the Legislature but failed to get a hearing. Tucson Democratic Rep. Phil Lopes’ Arizona Health Plan would be funded through Medicare, Medicaid and employer contributions.
A measure to put mental health coverage on par with other services, brought before lawmakers for several years, stalled in committee this session.
Still alive is a proposal to allow the state to hire community groups to go into schools and enroll children already qualified for KidsCare or the Arizona Health Care Cost Containment System, the state’s version of Medicaid.
National studies show up to 70 percent of uninsured children may already be qualified for some kind of government health insurance. An estimated 250,000 Arizona children are uninsured, but roughly half of them could qualify.
The outreach effort would cost about $500,000 up front, plus another $4 million the first year to cover the state’s share of the newly insured children.
Nearly 20 percent of Arizonans are insured under AHCCCS and KidsCare and another 13 percent have Medicare, which covers seniors and the disabled.
Several hundred thousand also get health care through other government programs, including Tricare and the Department of Veteran’s Affairs for active duty and retired military, and the Indian Health Service.
Though participants agreed on the need for a universal plan, they differed on how to fund it. A key sticking point was whether insurance coverage should be guaranteed, regardless of health status. So-called guaranteed-issue markets are in place in six states.
A successful system would have to lure more of the “young invincibles” — young adults who can’t afford insurance now and gamble on staying healthy — and could include a “pay or play” provision like that in Massachusetts, where employers would have to offer health insurance or pay to opt out.
Sue Gerard, director of the Arizona Department of Health Services, reminded her panel that health care costs are one of the leading causes of bankruptcy. Single-payer systems in Canada and Europe, she said, not only save money but their health care outcomes are superior to the U.S.
Several others, however, took issue with that, arguing that care in Canada and Britain is fraught with delays.
“It’s inefficient and a god-awful nightmare to get services,” said Alan Kennedy, a former Phoenix city councilman.
But Scottsdale-based consultant Sharon Flanagan-Hyde, who co-authored the background report, said most of those criticisms are based on anecdotes, not studies. Long waits, she said, don’t indict the system but rather show areas where it’s underfunded or understaffed.
Gerard said government should administer a universal system, but predicted that it will never get through the Legislature.
“I really think the only way to go is single payer,” Gerard said. “It’ll end up being done by initiative.”
Two groups are working on universal health care initiatives for the 2008 ballot, including a Mesa man who’s behind Arizonans for Responsible Health Care and a group in Tucson, the Healthy Arizona Coalition.
“We have great health care if you can afford it,” said Glenn Ray, who ran unsuccessfully for the Senate in 2004.
Arizona Town Hall, started in 1962, meets twice yearly to educate civic leaders and jumpstart public policy debate. Recent topics have included growth and development, immigration, biotechnology and aging.
Who’s insured in Arizona
46% Employer-based coverage
16% Arizona Health Care Cost Containment System (Medicaid)
5% Individual insurance
1% Other public health care coverage
For information about Arizona Town Hall, call (602) 252-9600 or go online to www.aztownhall.org