CADILLACS, PINTOS AND YUGOS

by Paul Gibbs

Healthy Utah finally got its committee hearing on Wednesday, March 4, in the Utah House Business and Labor Committee. This was a little bit like having Olympic figure skating judged bu plumbers. But this bizarre non-sewuiter was no mere chance: it was a committee stocked with far right-wingers like Rep. Jacob Anderegg, and one one where "Utah Cares" sponsor Jim Dunnigan would have a lot of imfluence. It was a hearing, but not a faor one, and despite extensive expert testimony and overwhelming evidence, Healthy Utah lost.

In presenting his "Utah Cares" plan, Dunnigan admitted that Utah's Primary Care Network (PCN), on which his plan heavily relies, is "not a Cadillac plan". In my testimony, I countered that it isn't even a Pinto plan. Later, Dunnigan compared his plan to a Yugo.

The problem with "Utah Cares" is that PCN provides unbelievably weak and liimited coverage. No specialty care. No behavioral health care. No hospital care (my friend Clare Richardson couldn't even get help with an ingrown toenail). Very limited ER and prescription drug coverage. It's only because of a motion by Rep. Edward Redd that it now includes Mental Health care (which raises the level of care from "patthetic" to "poor"). Perhaps Dunnigan's Yugo analogy is apt in the following ways:

1) It's "affordable," but it's not there when you need it. 
2) The Yugo came out of a Communist country that had no compunction about engaging in rationing, and PCN is rationing, plain and simple, no two ways about it. 

Some are encouraging those of us who support Healthy Utah not overlook the good because we want the perfect. That's wrong on two levels:

1. "Utah Cares" can and at very best be called "mediocre". It fits no reasonable definition of "good".
2. A huge number of of us who support Healthy Utah do so because we are accepting the "good" of "Healthy Utah" because we couldn't get the "perfect" of Medicaid expansion.

Compromise is a good thing. It's the way a democratic government works. But "Utah Cares" isn't the compromise. If Rep. Dunnigan is willing to work with Senator Brian Shiozawa on a compromise between Healthy Utah and his bill, maybe we can work up a compromise more like a  Toyota Camry: not the best, but solid and reliable. Until then, "Utah Cares" isn't a compromise, it's a defeat for everyone.

"BETTER THAN NOTHING"

by Paul Gibbs

As Healthy Utah now advances toward a committee hearing, it does so along with the latest incarnation of "Utah Cares", an alternative plan from Utah legislators. The name of that plan is inadvertently telling: its purpose is to send a message that these legislators aren't a bunch of heartless bureaucrats who don't care about people who are suffering. Sadly, the bill seems far more concerned with sending that message than actually helping people.

"Utah Cares", sponsored by House Majority Leader Jim Dunnigan, relies on a mix of traditional Medicaid and heavy reliance on Utah's Primary Care Network (PCN). Dunnigan himself has, on multiple occasions, referred to PCN as "better than nothing". Is that really what we plan to offer as a solution?  PCN covers primary care only, which means no specialty care, no urgent care, no mental health coverage, and only limited prescription drug coverage. In essence, "Utah Cares" has morphed from a Senate plan which only covered people after they got sick enough to a plan which only helps people until they get sick.

Dunnigan defends this (as Allen Christensen defended his SB 153) by saying it's a big step, that it expands some form of coverage to a lot of people who didn't have it.  That's a very skewed way of viewing the situation. It's not about how their plan compares to the status quo, it's about how it compares to the very effective alternative we have in place, and comparing Healthy Utah to "Utah Cares" is like comparing the Superman to Justin Bieber. Healthy Utah gives actual help to those in need, and brings a lot of tax money back to Utah and into our economy in the process. "Utah Cares" spends a lot of new money so we can pat ourselves on the back and say we tried.

WHO'S BULLYING WHOM?

by Paul Gibbs


The fight for Healthy Utah has taken perhaps its oddest turn yet over the past week: Despite the Utah Senate passing Healthy Utah by a vote of 17-11, and rejecting Sen. Allen Christensen's competing SB 153, Utah House Speaker Greg Hughes is refusing to bring Healthy Utah to a committee hearing in the House. While Hughes claims this is because there is no significant support for it in the House, Republicans such as Rep. Becky Edwards have expressed support and called for Speaker Hughes to bring the matter to a hearing. One source even quoted me a GOP House member claiming the possibility of enough votes to pass the bill with Democratic support, though I freely admit I have not been able to confirm this as more than rumor.

Perhaps oddest of all is Speaker Hughes' assertion that his attitude has been caused in no small part by a flyer sent to the constituents of House Majority Leader Jim Dunnigan, encouraging them to contact the Representative and tell him to support Healthy Utah. Hughes calls the flyer "bullying" and even made melodramatic references to "dark money" , but what's in the flyer that has him so outraged? There is no character assassination, no personal attacks. Hughes and Dunnigan claim they flyer says Dunnigan is trying to hurt Utah families,
but no such claim is made, only that failure to pass Healthy Utah hurts Utah families (a claim supported by evidence and a far cry from accusing Dunnigan of deliberately hurting anyone). Has Hughes shown similar outrage at the larger campaign conducted by the Florida based Foundation For Government accountability, which has been making accusations at least as damaging against Governor Gary Herbert? What makes Jim Dunnigan so special that criticizing his position warrants circling the wagons and keeping the public out of the legislative process?

While we live in a representative democracy which calls on legislators to act in our behalf, make no mistake, they represent the public. To kill a bill which poll after poll shows has the overwhelming support of the people of Utah without even allowing the people of Utah to know which representatives support it and which oppose it is outrageous.  And for people who are blocking healthcare access to over 100,000 people in need because one legislator apparently can't handle criticism to cry "bullying" is comically absurd.

In the meantime, while Hughes continues to assert that Healthy Utah is dead, Dunnigan now says he has a compromise plan (ignoring that Healthy Utah itself is the conservative compromise for Medicaid expansion, and the current Healthy Utah 2.0 is a compromised compromise). Dunnigan's plan costs rejects federal funding and costs more to cover fewer people. I'd like to be able to call this a unique approach, but it's what Healthy Utah opponents have been putting out there all along. It's all they can put out there because they do not have a plan which will do as much good and spend less money.

Healthy Utah opponents in our legislature have been playing the "bullying" card for months, accusing the federal government of bullying them by trying to make us take back our money and only giving in to some of their demands instead of all of them.  They continue to portray themselves as the little guy pushed around by the feds, but the little guy is the poor peopls of Utah being pushed around their own Representatives.  Healthy Utah has gotten more concessions from the federal government than any other state's proposed Medicaid expansion alternative (including putting the money into privatized insurance instead of just expanding the existing Medicaid program), yet they continue to accuse the federal government of being unreasonable. Where are the concessions made by our legislature? Our Governor and the federal government have fashioned a compromise which was passed by our own state Senate, but the House leadership refuses to even allow it a committee hearing becau
se one legislator had his ego bruised. Which group seems unreasonable here? Which seems like the real bullies?

If there really isn't enough support to pass Healthy Utah in the House, show us with public proceedings. Asking us to take it on blind face because one official said so is not how America or Utah works.