Memo to: Sen. Elizabeth Warren.
Subject: Bring your presidential campaign to Lewiston, Idaho.
Why: Talk about a great opportunity to sell Medicare for all. You could not ask for a better set of facts.
Background: For almost two months, a for-profit hospital and a health insurance company have been holding about 15,000 people in this community hostage over how much those patients are going to fork over in higher premiums.
The hospital, St. Joseph Regional Medical Center, is owned by Lifepoint Health Inc., of Brentwood, Tenn.
The insurance company, Regence BlueShield of Idaho, is part of Cambia Health Solutions, based in Portland, Ore.
If they don’t end their very public squabble over reimbursement rates by Jan. 15, Regence customers will be considered out of network. That means patients can pay more to get treated at St. Joe’s — or go elsewhere.
The problem for them is “elsewhere” means traveling at least 35 miles away.
There is no other hospital in Lewiston or nearby Clarkston, Wash., that competes with St. Joe’s services such as maternity and oncology.
Message: What could fit your longstanding narrative of corporate greed and beleaguered consumers any better than this?
Both the hospital and the insurance company are engaged in advertising and direct mail campaigns designed to exhort the people caught in the middle to put pressure on the other side. Says the hospital: Regence is paying too little. Says the insurance company: What St. Joe’s wants is for customers to pay higher premiums.
It’s the kind of naked tactic you’d expect to see between a cable television provider and a network during one of their periodic disputes that blocks viewer access to the NFL season but not something as vital as health care.
Think of all the money that’s being spent on advertising, lawyers, administrators and negotiators. That’s coming out of health care dollars. According to Kaiser Family Foundation, 17 cents of every health insurance premium dollar goes into overhead. And you can argue that overhead involves keeping people away from their health care provider.
The remedy: Start with the bottom line. Again, according to Kaiser, the overhead on Medicare is about 2 percent. In a single-payer system, no hospital — for-profit or not — would have the leverage now being employed against Regence customers in Lewiston.
Under Medicare for all, you could promise them that the government would negotiate the reimbursement rates. You can’t force a hospital or any other provider to participate. Presumably, they could charge patients directly — in other words, operate on a cash basis — or launch a niche service not covered by Medicare such as cosmetic surgery. But as a practical matter, they’re going to accept Medicare’s reimbursements.
The politics: You’ve been taking hits by those who suggest a single-payer system is too radical, but how could Medicare for all be any worse than the situation unfolding for the people of Lewiston?
Nobody’s suggesting coming to Idaho will net you one vote in a state that’s in the bag for President Donald Trump. But Lewiston’s dilemma is more than a metaphor. It will resonate with voters in the rural communities of the small states that make up the first four presidential contests: the Iowa caucuses and the primaries in New Hampshire, South Carolina and Nevada.
Here’s the theme: If this can happen to Lewiston, Idaho, it can happen to you. Showing up in Lewiston with an entourage of national television and print reporters will hammer that message home. From there, it’s a straight path toward reams of television commercials in key states.
Need we remind you of a few salient facts:
l As health care goes, so goes the Democratic presidential nomination. Says Kaiser: This is the issue the largest bloc of Democratic voters — 24 percent — want to hear about. That’s double the slice of voters energized by climate change and six times the share of voters motivated by gun control.
l Althought support for Medicare for all is split among the general electorate, Democratic presidential voters support your idea by 77 percent.
l You’re behind. On health care, 29 percent of Democrats trust Sen. Bernie Sanders, compared to 21 percent for former Vice President Joe Biden and 19 percent for you.
Bernie has the kids — among the 18- to 34-year-old crowd, 47 percent trust Sanders on health care.
Biden has the seniors — 33 percent trust him.
Here’s a chance to grab the political spotlight. Don’t wait for Sanders or Biden to get to Lewiston first.
Warning: Keep your travel plans confidential. If Lifepoint Health Inc., and Cambia Health Solutions get wind of this, they’re likely to settle. — M.T.