http://leahvukmir.com/site/Viewer.aspx?iid=1160&mname=ArticleGroup In the News en-us 60 The candidates fighting to represent the 5th District in the state Senate live a little more than two miles from each other in Wauwatosa, but their ideological views lie far apart...That means their Tosa neighbors will have a big decision when casting their ballots in November - a decision that could have significant partisan and policy ramifications in an election being closely watched throughout the state.  more Wed, 25 Aug 2010 22:54:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=28933&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=28933&mname=Article With the news from Harley Davidson last week that they need to find $54 million in cuts to their costs, the debate renewed over just how bad Wisconsin’s taxes are for business. Attention is now focused on combined reporting, the corporate tax increase passed as part of the budget reconciliation bill and the last state budget. Of the $54 million, Harley Davidson is facing $22.5 million in increased taxes as a result of the new combined reporting requirement...State Representative Leah Vukmir has called for a special session to put an end to the combined reporting requirement so Wisconsin businesses can once again be competitive and thrive. It would certainly beat the fire drill method of helping businesses in the state now. more Tue, 04 May 2010 00:29:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=27355&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=27355&mname=Article State Rep. Leah Vukmir (R-Wauwatosa) today called for a special session of the legislature to repeal the state's combined reporting tax. ... "Shortly after this tax was passed in 2009, Harley Davidson was forced to pay the state an additional $22.5 million in taxes and lay off another 400 employees," Vukmir said... "The legislature must act now to eliminate this job-killing tax or we run the risk of permanently losing even more jobs and a company that made Milwaukee famous." more Thu, 29 Apr 2010 00:12:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=27317&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=27317&mname=Article Legislation allowing the state Superintendent to intervene in failing school districts heads to the Governor. The bill given final approval in the Assembly Thursday night would allow the Superintendent to step in and help fix troubled public schools... State Representative Leah Vukmir (R-Wauwatosa) was among Republicans who claim the measure won’t do enough to fix failing schools. She says it actually complicates problems even further by adding another layer of bureaucracy to the process. more Fri, 23 Apr 2010 00:27:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=27242&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=27242&mname=Article To balance the state budget in 2007, Democratic Gov. Doyle and the Legislature pulled $200 million from the Injured Patients and Families Compensation Fund, which is used to pay medical malpractice victims...At the time, Democrats controlled the Senate and Republicans controlled the Assembly..."This is a bipartisan failure," said Rep. Leah Vukmir, who voted against that budget. "This is fiscally . . . unsound and nothing more than a gimmick." more Tue, 30 Mar 2010 23:28:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=26878&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=26878&mname=Article It was on Black Friday two years ago that state Rep. Leah Vukmir proposed doing away with the law, replacing it with one she said protects small business, while still allowing Wisconsin consumers to find bargains without have to cross the border. “We have Wisconsin consumers crossing state lines contributing to other state's economies, namely Illinois and Minnesota,” Vukmir said. more Fri, 20 Nov 2009 01:46:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=25069&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=25069&mname=Article Sat, 31 Oct 2009 01:39:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=24768&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=24768&mname=Article Assembly GOP Unveils Jobs Agenda September 16, 2009 By Bob Hague, Wisconsin Radio Network Republicans in the state Assembly want a focus on jobs during the fall legislative session. “About six months ago, Assembly Republicans and Senate Republicans decided to go and ask the people of Wisconsin what we could do to help job creation,” said Assembly Minority Leader Jeff Fitzgerald. Members of the Wisconsin Jobs Now Task Force traveled the state. “Time and time again,” said Fitzgerald, task force members heard that taxes and regulations are hampering the state’s ability to compete economically and attract and retain jobs. Recommendations made to the task force have been incorporated in a number of legislative proposals. State Representative Mary Williams of Medford said the state Jobs Tax Credit enacted as part of the budget, needs to start immediately. It’s currently set to go into effect in 2010, with credits to businesses in 2012. “The problem with that is, I have had the two highest unemployment counties in the state,” said Williams. “We need the jobs now. Providing funding two years from now doesn’t help the people in business now.” Williams said she’ll propose a bill to push up the start date for the tax credit. Representative Kitty Rhoades said Assembly Republicans would require the Dept. of Commerce to report to the legislature’s Joint Committee on Finance detailing its business retention methods, a plan identifying businesses seeking to expand or relocate, and to develop a Rapid Response Team for relocation or expansion. “Sometimes, when you need help from the state, you need it quick,” said Rhoades, noting that her proposal was in every version of the state budget until Governor Jim Doyle vetoed it. Representative Rich Zipperer of Pewaukee said Assembly Republicans would restore legislative accountability, by banning the Department of Revenue’s ability to unilaterally impose new taxes, such as the combined reporting for corporate taxes, which he said has already cost the state jobs. “Places like Harley Davidson . . . were directly hit by this tax, and some folks were laid off as the result of it,” Zipperer said. Representative Jeff Stone said Wisconsin needs allow small businesses to claim a bigger deduction for new equipment purchases, in line with what the federal government allows. “We are now at a competitive disadvantage with other states,” said Stone. “We currently only allow $25,000 of that type of expense, this would raise that to $50,000.” A provision in the state budget, providing employers and shareholders with incentives to invest in state businesses, needs to go into effect now, according to Representative Pat Strachota of West Bend. “Unfortunately, the start date was pushed out to 2011,” said Strachota. “We need every tool we can get right now, to jump start our economy.” Representative Leah Vukmir of Wauwatosa said the GOP will push to allow Wisconsin employers to purchase health insurance plans from out-of-state, something they can’t do now. Other proposals from the GOP will include a 2011 sunset on the controversial phone line tax, the increase in capitol gains taxes and combined reporting for corporate taxes. “Obviously, I think we need to look at setting priorities for the state of Wisconsin,” said Fitzgerald. “We have to become more competitive, the way other states are.”  AUDIO: Assembly Republicans press conference (18:20 MP3) VIDEO: Watch the press conference on Wisconsin Eye Wed, 16 Sep 2009 00:34:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=24270&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=24270&mname=Article Sullivan Comes Out as Early Backer of Lawton September 16, 2009 By Patrick Marley of the Milwaukee Journal Sentinel  State Sen. Jim Sullivan (D-Wauwatosa) has come out in support of Lt. Gov. Barbara Lawton for governor at a time when most Democrats are staying on the sidelines. "Barbara Lawton has my full support for governor," Sullivan said in a statement released by the campaign. "Lt. Gov. Lawton worked hard to create jobs in the state by bringing in a new industry and helping small businesses get access to the capital they need." Most Democratic legislators haven't said who they are endorsing because the full field of candidates isn't known. Lawton launched her campaign after Democratic Gov. Jim Doyle announced he wouldn't seek a third term. Other Democrats haven't said yet what they'll do. U.S. Rep. Ron Kind of La Crosse is considering a run, while some Democrats are encouraging Milwaukee Mayor Tom Barrett to get in the race. Sullivan is facing what is expected to be a tough re-election campaign next year because of a challenge by state Rep. Leah Vukmir (R-Wauwatosa). Wed, 16 Sep 2009 00:09:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=24269&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=24269&mname=Article Milwaukee Democrats speak out against mayoral takeover of MPS September 9, 2009 By Erin Richards of the Milwaukee Journal Sentinel U.S. Rep. Gwen Moore, state Democratic lawmakers from Milwaukee and a host of labor and civil rights leaders joined forces Tuesday to speak out against Milwaukee Mayor Tom Barrett's proposal for the mayor to control the Milwaukee Public Schools system. But because there's no proposed legislation yet in Madison to change state law and transfer power over MPS from the School Board to the mayor, critics such as Moore and several state legislators - Sen. Spencer Coggs, Rep. Fred Kessler, Rep. Barbara Toles and Rep. Annette Polly Williams - were left with few new arguments to make against the plan. "We've seen nothing in the Assembly, and nothing in the Senate; there's currently nothing on the table" on which to comment, Coggs said during a news conference at the Milwaukee office of Moore, a Democrat. Critics argue that a shift to mayoral control would take away citizens' right to choose their School Board members. They also contend that a change in governance won't help Wisconsin position itself any better in the competition to win more federal school stimulus money, as Gov. Jim Doyle has suggested. Barrett and Doyle last week that the change is necessary because of the stimulus issue and to tackle the state's racial achievement gap. Doyle said the public would have a more forceful voice in mayoral elections than in those for School Board, and the change to mayoral control would mean that schools would be at the top of the political agenda in any mayoral election. Rep. Tamara Grigsby (D-Milwaukee) added another layer of criticism Tuesday, saying Doyle and Barrett have not developed a plan for changing the school system's governance since they announced three weeks ago that they wanted the mayor to head the school system and be the direct boss of the next superintendent. "It would be best for takeover supporters to either come forth with a detailed plan for education reform or reconsider the viability of taking over MPS," Grigsby said in a statement. While Democratic members of the Assembly and Senate have spoken against the proposal in recent weeks, little has been heard from Republican lawmakers in Madison. Rep. Leah Vukmir (R-Wauwatosa), one of the first state Republicans to talk on the record about the issue, said in a telephone interview Tuesday that she did not think there was broad support or enthusiasm in the Legislature for a "Milwaukee takeover." "I can't speak for the Senate, but I don't think it will make it through the house," Vukmir said. Vukmir said she might favor a mayoral takeover if she believed that Barrett was a strong leader who could follow through with drastic changes. "If I thought Mayor Barrett was a passionate reformer, I'd be in favor of this," Vukmir said. "But I don't think he is." At an informational hearing in Madison about the issue Tuesday, School Board President Michael Bonds told lawmakers on the Assembly Committee on Education Reform about the board's progress on efforts to increase accountability and transparency, as well as improve academics within the district. Bonds said the public is being misled about the federal "Race to the Top" stimulus funds because there's nothing in the federal guidelines that requires changes to MPS' governance structure. "The 'Race to the Top' is a statewide application . . . yet Milwaukee is the only school district that's being asked to change its governance structure," Bonds said. Stacy Forster of the Journal Sentinel staff contributed to this report from Madison. Watch the TMJ-4 Coverage Here: MPS Fight Goes To Madison Watch the Assembly Education Reform Hearing on WisconsinEye Fox-6 Coverage: Tue, 08 Sep 2009 22:23:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=24049&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=24049&mname=Article Vukmir named Legislator of Year  July 21, 2009 By Stefanie Scott, WauwatosaNow State Rep. Leah Vukmir, R-Wauwatosa, was honored Friday by her peers as Legislator of the Year at the 36th annual American Legislative Exchange Council meeting in Atlanta. The award goes to council members who have distinguished themselves by advancing, introducing and/or enacting policies based on the fundamental Jeffersonian principles of free markets, limited government, federalism and individual liberty, according to a news release issued today by the council. Vukmir has served the 14th Assembly District since 2002, and she sits on the Health and Health Care Reform Committee, on which she worked in 2007 to stop a government-run health care proposal in Wisconsin. The American Legislative Exchange Council is a national, nonpartisan organization of state legislators. Tue, 21 Jul 2009 15:34:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=23816&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=23816&mname=Article Republicans Eye State Seats July 2, 2009 By Paul Sloth Racine Journal Times With the budget finished and the ink from Gov. Jim Doyle’s pen dry, state party leaders on both sides of the aisle say they’re planning their next moves leading up to the 2010 election. Republican Party leaders hope to capitalize on dissatisfaction over the budget written and passed by Democrats who hold slim majorities in both houses of the Legislature. They’re eyeing key seats around the state, including a seat in Racine County, where they think they can win in 2010. Summer, experts say, is the time party leaders start looking for candidates to run for seats that might be in play. Joe Heim, a professor of political science at the University of Wisconsin-La Crosse, said 2010 could be a Republican year, following two straight elections where Democrats gained control of both houses of the Legislature. The issue Republicans might win with in the next election? The 2009-11 budget Doyle just signed into law. “There is a reason why every Republican voted against it. It wasn’t just partisanship. I think they felt that this was the kind of budget they could run against,” Heim said. “There is a lot for the average voter not to like in this budget.” Republicans need to take two seats to regain control of the Senate, which the party lost control of in 2006. Democrats hold an 18-15 majority. With at least one state representative, Leah Vukmir in Wauwatosa, announcing her plan to challenge Sen. Jim Sullivan, the Republican Party of Wisconsin has started looking for other seats to target. One of those seats is the 21st Senate seat currently held by John Lehman, a Racine Democrat. “I think we’re going to have a very good race in that Senate district and we have a good shot at winning it,” said Mark Jefferson, executive director of the state Republican party. “We have a lot of good opportunities on offense taking Democratic seats than we do on defense.” The seat is one of four that Democrats targeted in 2006, when Lehman beat Racine County Executive William McReynolds for the open seat. All four seats will be back in play in 2010, Jefferson said. The seat, once held by George Petak, is a volatile one, Jefferson said. Petak was the first Wisconsin lawmaker to be removed from office in a recall election. Rep. Robin Vos, R-Caledonia, who might be considered a possible choice to run against Lehman, said he has no plans to run for Senate. While he wasn’t ready to name any potential candidates, Jefferson said he also expected Republicans to recruit someone to challenge Rep. Cory Mason, D-Racine. Mason beat Racine County Board Supervisor Van Wanggaard in 2006 to claim the seat Lehman vacated to run for Senate. “The sands have shifted so hard and so fast in the past several months. If the Democrats don’t shift direction, they will have a very tough time,” Jefferson said. “We’re going to have to work doubly hard, but when you have public opinion on your side you can accomplish a lot of things.” Bill Kraus, a veteran Republican strategist in Wisconsin, said the Republican Party’s problems are “deeper than the superficial discontent about the Doyle budget.” While the budget had its faults, according to Kraus, he doesn’t know if it’s a strong enough issue for Republicans to run on in 2010. “I think they’ll make runs at people, but I don’t think they have a persuasive case,” said Kraus, a long-time political campaigner. “If they’re going to do something they’ve got to have something to say.” Democrats are also starting to think about areas where they will focus their attention in the next election. While the 21st Senate seat has been a volatile one, and one Republicans are eyeing, no party has been in a better position to retain the seat than Democrats are with Lehman, said Jason Stephany, executive director of the Democratic Party of Wisconsin. Stephany, a Racine native, doesn’t believe voters will look at the budget as a reason to vote Democrats out of office. “I think that the budget package that we put through, it certainly has its challenges, but it does protect Wisconsin’s priorities,” Stephany said. “I feel confident that our Democratic incumbents have a record that they can defend, especially in the face of a Republican Party that sat on the sidelines and did nothing,” Heim doesn’t necessarily agree. Could the budget come back to haunt Democrats? “It’s very possible. Unless the economy doesn’t turn around, this is a difficult budget to run on,” Heim said Thu, 02 Jul 2009 21:43:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=22815&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=22815&mname=Article Bills Would Require More Open State Budget Process June 26, 2009 By Karen Madden, The Wisconsin Rapids Daily Tribune When Wisconsin gets its biennial budget in place, the majority of state residents won't know much about how the final version was created. The state requires county and municipal governments to hold their meetings in the open, and Wood County Board Chairman Lance Pliml said he wants the state to follow its own rules. "The openness of government leads to more honesty and better government," he said. It also would help if local officials could have better knowledge of what direction the state budget is going, Pliml said. The last state budget process wasn't finished until late in the year, leaving local governments unable to finalize their own budgets. Although Wisconsin has strong open record laws, in many cases the Legislature is exempt from the rules. Rep. Dean Kaufert, R-Neenah, who has been in state office for 18 years, is one of a few legislators trying to change things. "I don't like what I'm seeing," Kaufert said. "What I'm seeing is more secrecy and cutting the public out." Kaufert is co-sponsor of Assembly Bill 143, which would delete the current open meeting exemption for a partisan caucus. "I think we need to open them up and let a little sunshine in," Kaufert said, Rep. Leah Vukmir, R-Wauwatosa, opposes Kaufert's bill, but is co-sponsor of Assembly Bill 168, which would require every "earmark" to have its author's name attached. It also would mandate a 24-hour advance notice on all budget motions, live video streaming of Joint Finance Committee meetings and the recording of all votes. "Right now, you know the vote was 12-4, but you don't know who voted how," she said. Both bills have bipartisan support, although their sponsors aren't optimistic the legislation will pass anytime soon. Rep. Marlin Schneider, D-Wisconsin Rapids, doesn't think there is a big problem with openness at the state level. Media coverage of the state legislative process has fallen off in recent years, and there are many open meetings that aren't attended, he said. "The Madison press corps is not what it once was," he said. The Democrats reported who authored all earmarks that came out of their partisan caucus, something the Republicans didn't do, Schneider said. Although Schneider doesn't have a problem with requiring earmark authors to be identified and some of the other items in Vukmir's bill, he wants to know the cost of such measures before supporting them. Schneider said he has never had a problem letting the public know his position on issues. However, he is concerned that requiring partisan caucuses to be open to the public would inhibit debate. "There are occasions when legislators need some private time to debate issues that might otherwise not be addressed or would be addressed in a less frank manner," Schneider said. "We just had a knock-down, drag-out fight about school choice in our caucus." While those might be issues that should be talked about in public, having the caucuses open would make legislators more vulnerable to pressure from special interest groups, Schneider said. Vukmir agrees with Schneider about the importance of allowing some closed door discussions. To avoid public discussion, some legislators could decide to meet in small groups behind closed doors on controversial decisions, making things even less public, Vukmir said. "That's a very dangerous situation or path to go down," she said. "You run the risk of making the process even more secretive." Vukmir worries a public frustrated with the current situation, especially after a budget process like they're currently seeing, will take more extreme measures. "People are already saying, 'enough is enough,'" she said. Fri, 26 Jun 2009 10:45:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=22743&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=22743&mname=Article Vukmir to Challenge Sullivan for 5th District Senate Seat June 25, 2009 WauwatosaNow.com State Rep. Leah Vukmir, R-Wauwatosa, announced this morning that she will run for the state's 5th District Senate seat. Creating jobs and providing core services in an efficient way are her top priorities, she said. "Wisconsin has lost 130,000 jobs in the last year," she said in a news release from the Friends of Leah Vukmir. "We need a senator who cares about getting people back to work instead of figuring out how to squeeze more tax revenue from our families and employers." Vukmir, who was first elected to the state Assembly in 2002, made the announcement at Gilles Frozen Custard. The 5th Senate District includes portions of the cities of Milwaukee, Wauwatosa, West Allis and Brookfield and the villages of West Milwaukee and Elm Grove. Democrat Jim Sullivan is the current 5th District senator. Thu, 25 Jun 2009 11:59:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=22746&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=22746&mname=Article State Republicans To Push For Majority Leah Vukmir Plans To Run In District 5 June 25, 2009 WISN News Announcing her candidacy in front Gilles' custard, the kind of small business she says she'll work to help, Vukmir set her sights on the Senate seat held by Wauwatoswa Democrat Jim Sullivan. It's considered a toss-up district and a seat the Republicans believe they can win. A shift of two seats in the next election would put republicans in the majority... Vukmir said this race in the 5th district will focus on what happens in the current budget and the ones to follow. “I don't believe that my running will change the outcome of this budget,” Vukmir said. “I'm running to change the outcome of future budgets." more >> Thu, 25 Jun 2009 11:22:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=22745&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=22745&mname=Article Who Did What? Shhh. It's a Secret June 20, 2009 Editorial: The Milwaukee Journal Sentinel The state Legislature should not be immune from the open meeting laws it imposes on other units of government. In fact, since this is where the state budget is birthed, there is a particular responsibility when it comes to transparency. "In recognition of the fact that a representative government is dependent upon an informed electorate, it is declared to be the public policy of this state that all persons are entitled to the greatest possible information regarding the affairs of government and the official acts of those officers and employees who represent them. . . . The denial of public access generally is contrary to the public interest, and only in an exceptional case may access be denied." That's what Chapter 19.31 of the state statutes says about the importance of open government in Wisconsin. And for the most part, from Superior to Kenosha and Platteville to Marinette, municipal and county officials adhere to the intent of the statute, although there's often some argument over details. The one glaring exception to that adherence is the state Legislature, which has exempted key bodies from the law governing open meetings and does far too much of its critical work behind closed doors, out of the public eye. Two bills that have been introduced in the Legislature would provide major steps toward reforming the process. Both deserve passage. Sadly, it's unlikely that either will be approved any time soon. Both have been more or less buried in committee. That could change if enough pressure were put on lawmakers by citizens who want to see change. And who knows? The current budget mess may provide enough incentive for citizens to contact their lawmakers and urge reform to allow a little more daylight into the process. We hope so. In the state budget bills currently before the Assembly and Senate, there are earmarks and other provisions that were inserted without public discussion, whose authors are unknown and whose effects on public policy could be significant. Meetings take place into the dead of night; deals are made and decisions are reached in secret and in the wee hours of the morning when - our guess - legislators often are too fatigued to think straight. Milwaukee County Executive Scott Walker - who served in the Legislature and is now, with every other local official in the state, on the receiving end of legislators' secret-late-night policy decisions - says the secret meetings are bad for two reasons. First, because the public doesn't get to see what their representatives are doing. Second, because that lack of public scrutiny and the late hours combine to produce bad law. Measures that legislators wouldn't dream of introducing in public are secretly inserted with no accountability. He's right on both counts. The shape of the two budget bills was mainly determined in party caucus sessions that can be off-limits to the public and their representatives in the media. And reconciling the two budget bills - which contain several key differences from each other - also could very well be done in private this week. That's not the way the public's business is supposed to be done in Wisconsin, and it's not the way business is done by other governmental bodies in the state. Peter Fox of the Wisconsin Newspaper Association argues that if local governments such as the Milwaukee Common Council or the Lomira Village Board operated in the same secrecy as the Legislature does, "those members would be facing prosecution. There is a dual standard of open government in Wisconsin." He also argued that there is a widening gap between the open government intent of state statutes and the control that the state's political parties would like to exercise over legislation. One of the reform measures that could change business as usual was introduced by Rep. Cory Mason (D-Racine) in March. Assembly Bill 143 would end the exemption that allows party caucuses to be held in secret. In a March 17 op-ed, Mason described the process: "On days the Legislature is in session, both parties in both houses split into groups to discuss the day's calendar. It is in these meetings that most of the real legislative debate occurs. Members suss out their positions, cajole people to a certain view and reach a general consensus. We employ shuttle diplomacy, devise strategy and argue passionately for our respective positions. In other words, it's where the action happens. In and of itself, this is a useful exercise. It lets members pose questions to each other, discuss possible amendments and ensures that legislators are better informed before they create new public policy. "The objectionable part, in my view, is that we close these meetings to public view." And he added: "I continue to believe that transparency is the best policy. If a democracy is to have the trust and confidence of its citizens, the deliberations of its elected representatives must be open to the public." Mason is not alone: Reps. Dean Kaufert (R-Neenah), Gordon Hintz (D-Oshkosh), Jeffrey Wood (I-Chippewa Falls) and Terese Berceau (D-Madison) have signed on to the bill; Sen. Alan Lasee (R-De Pere) is the co-sponsor in the Senate. The other reform measure has been introduced by Reps. Leah Vukmir (R-Wauwatosa) and Rich Zipperer (R-Pewaukee). It would require disclosure of who made motions or suggested earmarks during Joint Finance Committee meetings, would require 48-hour notice of earmarks, would require that Joint Finance Committee executive sessions relating to the budget bill be available in real time for public viewing on the Legislature's Web site and would tighten rules for lobbyists. Vukmir, who does not support Mason's bill, told us last week that she thinks her and Zipperer's bill would do enough to "alleviate a lot of the problems we're seeing right now. This would bring the amount of transparency you need and would be more honest for taxpayers." We agree that the bill is a great step forward, but the state would be better off if both measures became law. And if it doesn't happen in the current session, supporters need to keep hammering away until reform happens. Sat, 20 Jun 2009 23:08:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=22693&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=22693&mname=Article Democrats Vote for Student Cap in Milwaukee's School-choice Program June 11, 2009 By Patrick Marley, Steven Walters and Stacy Forster of the Milwaukee Journal Sentinel Democrats who control the state Assembly voted Thursday to cap participation in Milwaukee's parental choice program at 19,500 students for the next two years - about the same number of students who now attend private schools at state expense. If it becomes law, the change would reverse a 2006 compromise that would have allowed participation to grow to 22,500. The 19,500 cap was added to the state budget, which the full Assembly was scheduled to debate at 10 a.m. Friday, by state Rep. Fred Kessler (D-Milwaukee). It was one of the final decisions made by the 52 Democrats, who ended four days of closed-door caucus meetings that resulted in dozens of proposed changes to the 2010-'11 budget. Assembly Speaker Mike Sheridan (D-Janesville) said Democrats will have enough votes to pass the budget Friday. "When you look at the document, it's well-balanced, and I think we did a lot of good things," Sheridan said. An opponent of the choice program, Kessler said it would be the first major reduction in the number of choice students - a number that had been expected to grow next year. The two-year budget includes $2 billion in tax and fee increases, cuts aid to local governments and schools and would force 6% across-the-board spending cuts by state agencies. But choice supporters said the cap would be fought in both the Assembly and Senate. "This is not a done deal," said Howard Fuller, the former Milwaukee Public Schools superintendent who now leads the Institute for the Transformation of Learning at Marquette University. Fuller said "a significant number" of Milwaukee-area legislators will fight the 19,500 cap when it is debated by the Assembly and Senate. Choice supporter George Mitchell called the cap a "bad move" that would throw students out of the choice program and create a "near-term state of chaos" in the program. Kessler called the cap reasonable, however. "I wanted something that was choice neutral, but at the same time, cap the burden that Milwaukee property taxpayers would have to pay," Kessler said. Now, Milwaukee taxpayers pay 45% of the choice costs, but their share will drop to 41.6% next year and 38.4% in the following year. Rep. Pedro Colón (D-Milwaukee) also got approval for a choice-related amendment that he said would not require more widespread bilingual programs in choice schools. Thursday's change would "severely" reduce the requirement for bilingual programs added by the Joint Finance Committee, Colón said. But Rep. Leah Vukmir (R-Wauwatosa) said she was frustrated by the amendments and called both measures part of an effort by some Milwaukee Democrats to gut the choice program. "We have successful schools in the choice program where kids are learning, kids are succeeding and achieving their dreams and we're going to kill it," Vukmir said. "The people who represent these children can't even stand up for them." Kessler said he did not have an agreement with Democratic Gov. Jim Doyle, who signed the 2006 compromise into law, to accept the 19,500 limit. But Kessler said the Senate may accept the 19,500 limit. "I have a feeling I'm in pretty good shape in the Senate," Kessler said. The 19,500 cap would expire on June 30, 2011. After that, Kessler said, "I think we have to battle again" over limits in the choice program. The 19,500 limit was not part of a compromise approved by the Legislature's Joint Finance Committee that would require private schools in the program to give standardized tests and report the results, employ teachers who have at least bachelor's degrees and meet the same minimum hours of instruction as public schools. In earlier decisions Thursday: Regional transit authority: A proposed 1% sales tax in Milwaukee County to subsidize the county bus system and other public programs was reduced to 0.65%. Most of the Milwaukee County sales tax increase - 0.5% - would go toward funding county buses, and advocates said that would ease the strain on property tax bills. The remaining 0.15% would be distributed to municipalities to help play for police and public safety programs. If approved, the change would allow the County Board to raise the sales tax from 5.6% to 6.25%. They also voted to allow transit authorities in the Chippewa Valley, the Fox Valley and Dane County that would be funded with a 0.5% sales tax. Commuter rail: Assembly Democrats also voted to increase the fee on rental cars to up to $18 to pay for a commuter rail line in southeastern Wisconsin and buses in Racine and Kenosha counties. The current fee for rental cars is $2; the Finance Committee recommended raising it to $16. The rail line would run from Milwaukee to the Illinois border, where it would link to Chicago's Metra train line. Rep. Cory Mason (D-Racine) and Rep. Peter Barca (D-Kenosha) said they pushed the changes to the transit authorities for Milwaukee County and southeastern Wisconsin after consulting with federal authorities on how to capture rail subsidies. Critics have said the rail line wouldn't get federal help unless it included funding from a sales tax, but Mason and Sen. John Lehman (D-Racine) have resisted sales taxes in their districts. Oil company tax: Democrats approved taxing oil companies to help pay for roads, but said the companies could pass on up to 4 cents per gallon to drivers. Doyle had wanted a provision that would bar passing the tax onto consumers, but Assembly Democrats said they didn't think that was possible because of constitutional protections on commerce. Assembly Republican Leader Jeff Fitzgerald (R-Horicon) said the minority would offer dozens of amendments as well; few, if any, are expected to be adopted. No Republicans are expected to vote for the budget because of its increases in taxes and spending. When the budget passes the Assembly, it will go to the Senate, which is also controlled by Democrats. The Senate is expected to take up the bill next week, and lawmakers hope to put it on Democratic Gov. Jim Doyle's desk by the end of the month. The budget plan closes a record $6.6 billion shortfall by mid-2011. Sat, 13 Jun 2009 16:03:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=22649&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=22649&mname=Article Hiding Out in Madison The Joint Finance Committee rewrites the state's new budget mostly behind closed doors - an outrageous way to conduct the people's business. Why all the secrecy? May 28, 2009 Editorial: Milwaukee Journal Sentinel For those who like to compare making laws to making sausage, we've got news for you: We really would like to see how it's made. But the Legislature exempts itself from the state Open Meetings Law to go into closed-door sessions, where the real business of the state is hashed out. The powerful Joint Finance Committee is notorious for this tactic. On Wednesday, the budget-writing committee met for hours in private, never convening publicly. At 10 p.m., a co-chairman emerged to promise that the committee would reconvene in public at noon Thursday. It didn't. Such backroom deal-making is the enemy of accountability, and it has spawned an overstuffed document that squeezes many of the most controversial items into one package for a single vote with almost no public debate. How is this good government? The committee is dominated 12-4 by the Democrats, who must bear responsibility for this fiasco. But the act of hiding from the public is nothing new. When Republicans controlled the Legislature, they were just as eager to do the work of the state away from the prying eyes of press and public. "If a majority of a local government body, a school board, a village board, met like this . . . they would be violating the state Open Meetings Law," said Peter D. Fox, executive director of the Wisconsin Newspaper Association. There are a couple of new attempts to put an end to these secret societies. Rep. Cory Mason (D-Racine), a member of the Joint Finance Committee, along with colleagues Dean Kaufert (R-Neenah), Gordon Hintz (D-Oshkosh), Jeffrey Wood (I-Chippewa Falls) and Terese Berceau (D-Madison) have introduced Assembly Bill 143 to end the exemption that allows party caucuses to be held in secret. State Sen. Alan Lasee (R-De Pere) is the co-sponsor in the Senate. State Reps. Leah Vukmir (R-Wauwatosa) and Rich Zipperer (R-Pewaukee) are authors of a bill that would require disclosure of who made motions or suggested earmarks during Joint Finance Committee meetings. These are both good ideas. The Legislature should do its work - all of its work - in public. Let's see how they're stuffing this sausage and with what. Fri, 29 May 2009 11:24:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=22453&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=22453&mname=Article Smaller, Better School Districts April 4, 2009 By Ted Kanavas for the Milwaukee Journal Sentinel Milwaukee Public Schools has failed. It has failed parents, it has failed the community, it has failed Wisconsin taxpayers, and we have failed to meet our moral obligation to educate our children. Here's the thing: We know it's a failure, and for one reason or another, year after year, politicians do nothing but use MPS as a pawn. Critics cite MPS as the result of all that is wrong with our educational system, a financial drain, the black eye on Wisconsin's education scorecard, an adult jobs program for teachers, administrators and bureaucrats. Supporters of the district argue that MPS struggles because class sizes are too large, it doesn't have enough teachers or money, or that the students have different social needs and backgrounds than the rest of the state. Both sides use MPS to make an argument and make their agendas, but in the end teachers continue to get raises in salary or benefits, board members get re-elected, taxpayers statewide get the tab and children pay the price. It's a seemingly endless cycle, and it's our job to break it. People have been playing this game for generations, and we're all losing. The failure of Milwaukee Public Schools can no longer be seen as a Milwaukee problem to the rest of Wisconsin. It's time for a game-changer. It's time for action. It's time to tell the children of Milwaukee that failure is unacceptable. I learned by serving on a local school board that public education works best when the entire community takes ownership of its schools; when parents and teachers and principals and school board members all work together. In Milwaukee, an expansive and ineffective bureaucracy stands in the way of this type of harmony. This is what I am going to do about it. My plan is to abolish MPS. I want to break the district into eight new, independent school districts and end the era of one superintendent for 200 plus schools. Each district will have its own identity and its own newly elected school board. The only thing the districts will share are the common goals of empowering parents by localizing control of education and focusing on preparing children for careers or college. My legislation asks the Legislature to stand up and acknowledge that we are failing Milwaukee's school children. It sets in place a process of orderly transition to new districts and district leadership by specific dates, and it protects the existing Milwaukee Parental Choice Program. What it does not do is complicate matters by legislating details about where district borders would be drawn. It does not fire teachers or dictate where they will report to work. It does not pre-select new school board members or necessitate any current administrative employees lose their jobs. It wouldn't raise taxes or make budgeting decisions that should be left to parents and board members. Milwaukee and Wisconsin are socially and politically complex. This complexity has a tendency to slow progress and resist change even when change is desperately needed. Passage of this bill will be a test of how complex and diverse groups can come together to make real change for the betterment of Milwaukee's children and the betterment of our entire state. It won't be easy, but it's our obligation. State Sen. Ted Kanavas (R-Brookfield) and State Rep. Leah Vukmir (R-Wauwatosa) have introduced a bill to dissolve MPS and form eight new, independent school districts. LV: Find out more... Sun, 05 Apr 2009 11:48:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=21775&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=21775&mname=Article School-Voucher Movement Loses Ground After Democratic Gains March 25, 2009 By Robert Tomsho, The Wall Street Journal The school-voucher movement is under assault, as opponents have cut federal funding and states move to impose new restrictions on a form of school choice that has been a cornerstone of the conservative agenda for education overhaul. Vouchers -- which give students public money to pay private-school tuition -- have grown since a 2002 Supreme Court decision upheld their use in religious schools. About 61,700 students use them in the current school year, up 9% from last year, according to the Alliance for School Choice, a voucher advocate. But earlier this month, Congress voted to stop funding a voucher program for the District of Columbia. Two other prominent voucher programs -- in Milwaukee and Cleveland -- are facing statehouse efforts to impose rules that could prompt some private schools to stop taking voucher students. Pressure is mounting from other corners as well. President Barack Obama has said he opposes vouchers, and the stimulus bill he signed in February bars its funds from being used to provide financial aid to students attending private schools. On Wednesday, the Arizona Supreme Court ruled that two state voucher programs, benefiting foster children and disabled students, violated Arizona's state constitution... ...In Wisconsin, Gov. Jim Doyle, a Democrat, recently proposed new regulations for the Milwaukee Parental Choice Program, or MPCP, the first modern-era voucher program, which launched in 1990. Among other things, he wants participating private schools, many church-affiliated, to adhere to state open-records laws, administer the state achievement test and pay fees to hire a state auditor to monitor their own programs. In recent years, Wisconsin Republicans sympathetic to the voucher cause were able to block such proposals because they controlled the lower house of the state legislature. In the November election, they lost that majority to the Democrats.... read the rest (subscription) Wed, 25 Mar 2009 21:27:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=21550&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=21550&mname=Article More Progress on Legislative Pay March 21, 2009 A Wisconsin State Journal editorial The list of state lawmakers returning all of their 5.3 percent pay raise continues to grow. Rep. Leah Vukmir, R-Wauwatosa, confirmed this week she is returning the $2,530 annual pay hike Wisconsin's 132 lawmakers started receiving in their Feb. 1 paychecks. That brings to 16 the number of lawmakers who are showing self-sacrifice and leading by example in the face of a massive state budget deficit and terrible economy. They're not just returning their pay raise. Because of state rules limiting how and when legislative pay can change, they're also agreeing to pay taxes on the raise they just surrendered. Another state lawmaker, Rep. Gary Hebl, D-Sun Prairie, almost got it right. In a press release, Hebl indicated he's giving most of his $2,530 annual raise back to state coffers. But the precise amount is unclear. "To return the raise, Hebl authorized a monthly payroll deduction for the net, take-home pay raise to the state's general program revenue fund," a press release stated. Asked for more clarity, Hebl responded in an e-mail: "What the government is not retaining in taxes (e.g. Social Security taxes) I am returning to the state in full." OK. But how much of the $2,530 will the state then be getting back? The Legislature could have rescinded its raise without creating any tax liabilities last year after the economy tanked and a giant budget deficit was apparent. That's what the State Journal urged last fall. Instead, legislative leaders allowed their 5.3 percent raise to become enshrined on the first of the year. That's when a new two-year legislative session began. And the state constitution doesn't allow lawmakers to change their pay during the same session in which they are serving. Officially, they can only change future compensation. An overwhelming majority of the Assembly and a strong majority of the Senate signed on to a letter this week opposing a 2 percent pay raise for lawmakers set to take effect in two years. Promising to eventually show some personal sacrifice is better than doing nothing at all. Yet 16 state lawmakers -- including Vukmir --are sacrificing all of their raise now, regardless of any related tax burden. Now that's leadership Wisconsin could use more of. LEADING BY EXAMPLE The 16 state lawmakers who are returning all of their 5.3 percent pay raise to state coffers: Sen. Alberta Darling, R-River Hills Sen. Jon Erpenbach, D-Waunakee Sen. Ted Kanavas, R-Brookfield Sen. Dan Kapanke, R-La Crosse Sen. Joe Leibham, R-Sheboygan Sen. Dale Schultz, R-Richland Center Rep. Ed Brooks, R-Reedsburg Rep. Brett Davis, R-Oregon Assembly Minority Leader Jeff Fitzgerald, R-Horicon Rep. Steve Hilgenberg, D-Dodgeville Rep. Dan Knodl, R-Germantown Rep. Margaret Krusick, D-Milwaukee Rep. Phil Montgomery, R-Green Bay Rep. Keith Ripp, R-Lodi Rep. Leah Vukmir, R-Wauwatosa Rep. Bob Ziegelbauer, D-Manitowoc LV: We also introduced AJR 32, a resolution that would amend the Wisconsin Constitution by deleting the prohibition against decreasing legislative compensation during the term. Sat, 21 Mar 2009 14:16:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=21478&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=21478&mname=Article Repeal of Minimum Markup Law for Gas is Warranted March 20, 2009 Editorial: The Sheboygan Press We're happy to see that Wisconsin Attorney General J.B. Van Hollen won't appeal a federal judge's decision calling the state's minimum markup law unconstitutional. Now, the Legislature must follow suit and remove this archaic law from the books. First passed in 1939, the Unfair Sales Act requires retailers to mark up the price of gas 6 percent over certain costs or 9.18 percent above the average wholesale price, whichever is greater. The law was designed to protect the small, so-called mom-and-pop, service stations from the larger operations by preventing them from selling gasoline below cost to force out the little guy. The Wisconsin Petroleum Marketers and Convenience Store Association contends that the ruling against the Unfair Sales Act has "the effect of shutting down independent retailers" because the major retailers could drive them out of business with below-cost prices. Once the independents are gone, the association says, the big retailers will raise the price and consumers will pay more. The idea of protecting the small, independent station is a good one — but there already is a federal law against predatory pricing that covers the same circumstances. And, Wisconsin has its own version of the Sherman Antitrust Act that makes predatory pricing illegal, so the scenario seen by the marketers group isn't likely. Also, two Wisconsin lawmakers, Rep. Leah Vukmir and Rep. Bill Kramer, are proposing further legislation that would deal with potential and actual predatory pricing to protect the independent retailers. Getting rid of the minimum markup law in its present form would benefit consumers, according to the Federal Trade Commission. In 2003, the FTC said the law actually discourages competition on the price of gas and inflates cost for Wisconsin consumers. Several other studies have come to the same conclusion, including the Wisconsin Policy Research Institute. The markup law, these studies concluded, protected the competitors by guaranteeing them a profit margin and did nothing to benefit the consumer with lower prices. With federal and state antitrust laws protecting the retailer, a separate law requiring a minimum markup on the price of gas is no longer needed. LV: Read about The Competitive Marketplace Act Fri, 20 Mar 2009 09:47:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=21430&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=21430&mname=Article Van Hollen Won’t Challenge Minimum Markup Ruling Area leaders optimistic full repeal is on its way March 11, 2009 By Joe Petrie and the Associated Press, Waukesha Freeman Attorney General J.B. Van Hollen says he won’t appeal a federal judge’s decision striking down Wisconsin’s minimum markup on gasoline. State Rep. Bill Kramer, R-Waukesha, who along with Rep. Leah Vukmir, R-Wauwatosa, and Sen. Tim Carpenter, D-Milwaukee, has been pushing for a full repeal of the minimum markup law, said the decision is a big victory for Wisconsin consumers. “It doesn’t get us that much closer to passing the bill, but it strikes down part of the law as unconstitutional and I believe the entire law is unconstitutional,” said Kramer. “It creates a situation of state-imposed collusion and creates a state-sanctioned cartel.” Even if the bill isn’t passed in the state Legislature, Kramer said the law could disappear gradually because the ruling has left it open to a “whole slew” of lawsuits from other industries. The 1939 law prohibits retailers from selling products for less than they paid. Gas stations must tack on 6 percent over what they paid or 9.18 percent over the average wholesale price of gas, whichever is higher. U.S. District Judge Rudolph T. Randa ruled in February that the law violates federal antitrust statutes. Van Hollen says an appeal wouldn’t be wise. Matt Hauser, president of the Wisconsin Petroleum Marketers and Convenience Store Association, said he’s extremely disappointed by Van Hollen’s decision because it will allow large gas stations to sell at lower prices than smaller stores, which will hurt competition. The organization, which represents about 2,000 convenience stores, will make a motion to intervene as a party in the case, Hauser said. “Without competition you really lose,” said Hauser. “You lose on choice and you lose on price.” He declined further comment because it’s still a pending legal matter. Vukmir said the bill she’s working on will make sure the marketplace remains competitive without the law and, because it could soon be completely struck down legally, it makes it more important than ever to get it passed. “This bill not only repeals the minimum markup law, but it also puts in place a lot of protections to small mom and pop operations concerned about a competitive marketplace,” she said. “It gives more sustainability in a more chaotic environment where only part of the law is struck down.” LV: Read our Letter to Attorney General Van Hollen regarding an appeal. Wed, 11 Mar 2009 10:15:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=21237&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=21237&mname=Article Federal Judge Rules Minimum Markup Law Unconstitutional Court enjoins state from enforcing statute February 17, 2009 By Richard Moore, Investigative Reporter for the Lakeland Times A federal district judge found Wisconsin's minimum markup law for gasoline to be unconstitutional Wednesday, saying it violated federal anti-trust prohibitions on the restraint of trade between states. As long as the ruling by chief federal district judge Rudolph T. Randa of the Eastern District of Wisconsin stands, the state cannot enforce the law, formally known as the Unfair Sales Act, which requires retailers to sell gas at a price at least 6 percent higher than what they paid for it, or 9.18 percent higher than the average terminal wholesale price posted closest to them. The state Department of Agriculture, Trade and Consumer Protection had initiated an enforcement process against Flying J Inc., which operates gas stations in Black River Falls and Oak Creek, for violating the statute; Flying J sued the state to halt any action. Wednesday's decision had an immediate impact. While gas prices were generally rising through the weekend, Flying J in Oak Creek was selling gas as of Sunday afternoon for $1.85 a gallon for regular unleaded, according to wisconsingasprices.com. That was the lowest reported gas price in the state, the average of which stood at $2.02. The arguments on both sides were similar to those made in another case against Flying J filed earlier by one of its competitors; in that case, a federal magistrate judge also found for Flying J and declared the law unconstitutional. However, because the state was not a party to that litigation, enforcement was not affected as it is now. As of late Friday, attorney general J.B. Van Hollen said he had not decided whether to appeal the case. Gov. Jim Doyle applauded the court's decision, however, as did several other Democrats, including State Sen. Tim Carpenter of Milwaukee. "I have fought to eliminate this unfair and outdated rule that forces Wisconsin consumers to pay more for gasoline than our neighbors," Carpenter said. Carpenter was the lead Senate author of a bill last year to repeal the minimum markup, but the legislation never made it to a public hearing. On the Assembly side, two GOP lawmakers said Friday they would renew their push to have the entire Unfair Sales Act repealed. "It is our opinion that it is now imperative to pass the . . . Competitive Marketplace Act, repeal of the entire Unfair Sales Act, setting up a statutory framework that mirrors federal antitrust policy," said state Reps. Bill Kramer of Waukesha and Leah Vukmir of Wauwatosa in a statement. "This would free prescription drugs, and a host of other goods, from the strictures of state law." Supporters of repeal have failed primarily because several Democratic legislative leaders support the law, including Assembly Speaker Mike Sheridan of Janesville and Senate Majority Leader Russ Decker of Weston. In addition, repeal will be opposed by such groups as the Wisconsin Petroleum Marketers & Convenience Store Association, which on Friday asked the attorney general to appeal Thursday's decision. "The Wisconsin Legislature has reviewed the law every session since 1998 and 10 previous court cases have upheld the constitutionality of the law," the group said in a statement. "Time after time they found value in a law that promotes competition and protects consumers. States with similar laws have more retail establishments, which leads to a more competitive marketplace. And that's always good for consumers." The ruling In his decision, Randa observed that the minimum markup had been enacted in the 1930s, when gasoline sold for a mere 18 cents a gallon. The purpose of the legislation was to cover a proportionate portion of the cost of doing business and, in so doing, protect mom-and-pop retailers from predatory pricing by larger companies. The Legislature amended the statute in 1997, putting the current markup percentages in place. At the time, the judge observed, regular gasoline sold for an average retail price of $1.03, giving retailers a built-in markup of 8 or 9 cents a gallon. The Legislature had not adjusted the percentages since, Randa continued, despite changes in technology, economic conditions, and rising prices in the oil and gas industries. By May 2007, gas was retailing in the Midwest for $3.32 cents a gallon, and, by May 2008, Flying J's competitors were selling regular gasoline for $4.19 per gallon. "Applying Wisconsin's 9.18 percent minimum markup and assuming that the retailer purchases at 'average terminal price' under the statute, a gallon of gasoline that retails at $3.98 per gallon has a built-in markup price of approximately $.33 per gallon," Randa wrote. "While gasoline and diesel prices increased between 300 percent and 360 percent from 1998 through 2008, during the same 10 years inflation has been approximately 33 percent." Not only that, Randa stated, but Flying J, because of its efficiencies, could sell fuel with substantially less markup than the law required and still make a reasonable profit. Though Flying J prevailed in the earlier magistrate's decision, the state of Wisconsin continued to require the company to file motor fuel reports to the state under the Unfair Sales Act, and, as a result, sent an enforcement letter to the company on Oct. 12, 2007; Flying J filed suit to enjoin the state from pursing any actual enforcement. The Sherman Act In the final analysis, Randa concluded, the Unfair Sales Act violated the federal antitrust statute called the Sherman Act, which provides that "[e]very contract, combination in the form of trust or otherwise, or conspiracy, in restraint of trade or commerce among the several States, or with foreign nations, is declared to be illegal." And that's exactly what the Unfair Sales Act was doing, Randa stated. "To illustrate, the Act allows motor fuel retailers to match (but not undercut) their competitors' prices," Randa wrote. "It forbids retailers from selling motor vehicle fuel below cost, which is based on the average posted terminal price plus a minimum markup of 9.18 percent. In addition, the state's evidence confirms that retailers must hold their posted prices for at least 24 hours. The minimum markup percentage creates a range in which competitors may engage in collusive parallel pricing, which is exacerbated as the wholesale price of gasoline fluctuates. Therefore, the Act is a per se restraint of trade because it authorizes and enforces a parallel (or horizontal) pricing policy." Mandatory industrywide resale price fixing is virtually certain to reduce brand competition because it prevents manufacturers and wholesalers from allowing or requiring retail price competition, he wrote in citing another case. Of course, Randa notes, the state argues that the law does not violate the Sherman Act because there is no "concerted action" among retailers to fix prices. In effect, the state argued, the Legislature fixed prices for them. "Rather, the State attempts to characterize the restraint of trade as nothing more than a 'unilateral act' of its Legislature," Randa states, citing a case that concludes that "a restraint imposed unilaterally by government does not become concerted-action within the meaning of the statute simply because it has a coercive effect upon parties who must obey the law. The ordinary relationship between the government and those who must obey its regulatory commands whether they wish to or not is not enough to establish a conspiracy." Randa did not buy that point of view. There were precedential exceptions to that conclusion, he wrote, especially in cases where nonmarket mechanisms merely enforce private marketing decisions and in which private actors are thus granted "a degree of private regulatory power." "When a state 'compels retailers to follow a parallel price policy, it demands private conduct which the Sherman Act forbids,'" he wrote. Cost and exemption In making his decision, the judge cited two studies submitted by Flying J, both of which concluded that the Unfair Sales Act restricted competition and harmed consumers by leading to higher gas prices. One was a Federal Trade Commission study; the other, a Wisconsin Policy Research Institute report. "According to the FTC," Randa wrote, "'the Act aims to protect individual competitors, not competition, thereby discouraging pro-competitive price-cutting. Moreover, the Act defines 'cost' in a way that lacks a firm economic foundation and likely leads to significantly higher prices.'" The FTC report concluded that the markup was unnecessary "both because scholarly studies and court decisions indicate that anticompetitive below-cost pricing happens infrequently, and because the federal antitrust laws already prohibit below-cost pricing." Similarly, Randa observed, the Wisconsin Policy Research Institute had analyzed data that suggested the law worked to keep gasoline prices higher than they would be otherwise. "The Institute concluded that the Act 'benefits retail gas station owners at the expense of consumers and should be repealed,'" Randa stated. "The State fails to contradict or undermine this evidence. In other words, the State confusingly argues in favor of a rule of reason but then fails to argue why the Act is a reasonable restraint." Still, Randa pointed out, the U.S. Supreme Court has held that the Sherman Act does not apply in some instances to the anticompetitive conduct of a state acting through its Legislature. "Therefore," he wrote, "even though the Unfair Sales Act conflicts with the Sherman Act, it may be saved . . . under the doctrine of 'antitrust immunity.'" To qualify, there's a two-part test, Randa cautioned. "First, the challenged restraint must be 'clearly articulated and affirmatively expressed as state policy,'" he wrote. "Second, the policy must be 'actively supervised' by the State itself." While it's obvious the first standard is met, Randa stated, he said the current law simply does not satisfy the second part of the equation. "As an initial matter, the State argues that the Unfair Sales Act meets the active supervision requirement because it does not delegate any degree of control over the markup percentage to private parties," Randa stated. "The State seizes on a [case law footnote] where the Court observed that a 'simple minimum markup statute requiring retailers to charge 112 percent of their actual wholesale cost may satisfy the active supervision requirement, and so be exempt from the antitrust laws under Parker.'" But Randa said that determination did not apply to the facts in this case. "While it is true that the Unfair Sales Act's markup percentage is fixed, the markup is not based on actual costs," he stated. "Instead, it is based on the 'average posted terminal price' without regard to actual costs. As the Court explained (in the other case), the statute at issue . . . was not a 'simple minimum markup statute because it impose[d] a markup on the posted bottle price, a price that may greatly exceed what the retailer actually paid for the liquor.' The same is true here. The 'average posted terminal price' may be significantly higher than the actual cost to a particular retailer." Therefore, Randa stated, some type of state supervision is required, both with regard to the markup percentage and the "average posted terminal price." And, to determine whether a pricing restraint is actively supervised, he stated, courts examine whether the state establishes or reviews prices, or monitors market conditions, or in any way reexamines the program. The state does none of that, Randa said. "The Unfair Sales Act's markup percentage was changed by the Wisconsin Legislature only one time, from 6 percent to 9.18 percent in 1997," he wrote. "More glaring, there is no program or effort to determine whether the 'average posted terminal price' bears a close (or any) relationship to the actual price paid by retailers." And while the state does take enforcement actions to ensure compliance with the law, that's not enough, the judge stated. "These efforts do nothing to ensure the reasonableness of gas prices in Wisconsin," Randa wrote. "In other words, enforcement matters little when the Act being enforced creates a horizontal pricing mechanism." In addition, Randa rejected the state's assertion that the whole matter was a policy argument best left to the state Legislature. "To the contrary, the legislative enactments of the State of Wisconsin must comply with federal law," Randa wrote. "Failure to comply simply results in preemption under the Supremacy Clause. Stated another way, the State of Wisconsin has displaced competition among [gasoline] retailers without substituting an adequate system of regulation. This the State cannot do, no matter the rationale." Randa's decision enjoins the state from enforcing the motor vehicle fuel provisions of the Unfair Sales Act. The injunction and ruling apply only to the motor vehicle fuel provisions of the Act, which does include other items. Tue, 17 Feb 2009 15:45:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=21005&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=21005&mname=Article Bring Truth To Budgets Davis Proposes Plan to end State's 'Credit Card' Spending February 16, 2009 By Brian Gray, The Monroe Times Rep. Brett Davis, R-Oregon, has joined three Republican colleagues to improve state accounting methods and allow more public scrutiny of the state budget. Davis plans to introduce the measure this week as the Legislature begins to work on the 2009-10 budget. The plan, the Truth in Budgeting Act, calls for the state to stop putting off some budget issues until future biennial budgets. Davis said that for the past 20 years the state has pushed out bills until future budgets, which makes the state look like it's in better financial shape than it really is. "It's paying for it later," Davis said. "Like putting things on a credit card. The bills still need to be paid." Davis said if the state adopts the measure, there will be tough choices for the Legislature but it will have long-term benefits for the state. He said that when the economy recovers the state will be in a better financial situation. "Just like families all across the state, state government needs to tighten its belt and make responsible decisions regarding the upcoming budget process," Davis said. "We need to stop putting spending on the state's credit card and need a plan to eliminate the deficit." The Truth in Budgeting Act also requires the state to make sure funds from the federal stimulus funds are used responsibly. Davis said the economic situation creates a sense of "urgency" to make sure any federal money given to the state is used to create jobs. The proposal also includes two bills to increase public knowledge of how tax dollars are spent. The Government Checkbook Disclosure Act would create an easily accessible state database and Web site that is fully interactive and searchable. The database will disclose all state expenditures over $25, from supplies to salaries and contracts. Other states have similar laws and programming and software can be shared to reduce the cost to Wisconsin taxpayers. The second bill, known as the Earmark Transparency Act, requires a report listing all earmarks be made public at least 48 hours before any votes are cast. "By approving this package of legislation, we can finally put Wisconsin on the fiscal road to recovery," Davis noted. "As we work hard to create jobs and get our economy back on track, I believe we owe it to the taxpayers to adopt these common sense measures that will improve our state's accounting practices and increase government transparency." Davis was joined by Reps. Leah Vukmir, R-Wauwatosa, Bill Kramer R-Waukesha, and Rich Zipperer, R-Pewaukee, in announcing the package of legislation. Davis said he hopes Democrats, who control both the Assembly and the Senate, will join him in support of the bill. "I think good budgeting practices should be bipartisan." he said. Mon, 16 Feb 2009 19:39:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=20898&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=20898&mname=Article Legislative Raises Come in Midst of Budget Shortfall Lawmakers can’t refuse pay increases February 14, 2009 By Joe Potente, Kenosha News As the state begins to tackle a $5.7 billion budget shortfall, the Kenosha area’s entire legislative delegation recently received 5.3 percent pay increases. They weren’t alone; all but 10 of the Legislature’s 132 representatives and senators are keeping the raises that took effect last month. With the pay increase, their salary jumps to $49,943 per year, plus per diems that average about $11,000 per lawmaker. Declining the increases isn’t as simple as it sounds, they said. “I wish, to be honest with you, that we could vote not to take it,” said Rep. Samantha Kerkman, R-Randall. They can’t. The Legislature’s pay is never voted upon by the full Legislature itself. Instead, it is established by an eight-member committee that approves compensation plans for all non-represented state employees. What’s more, a state constitutional provision prohibits public officers from changing their compensation during a term office, meaning that lawmakers cannot legally turn down a raise. They can write a check for the difference back to the state, as 10 legislators from elsewhere in the state opted to do recently. But they would still pay income taxes on the wages they returned to state coffers. And that is where the rub is for at least three Kenosha-area lawmakers. Kerkman, Thomas Lothian, R-Williams Bay, and John Steinbrink, D-Pleasant Prairie, all cited tax ramifications in justifying their respective decisions to hold onto this year’s pay increase. “They should do it so that if a legislator wants to turn it down, there isn’t a tax consequence,” said Steinbrink, who added he plans to donate this year’s increase amount to local charities. All three said they returned past increases, only to find themselves paying higher taxes in spite of it. Kerkman called it “a difficult accounting issue.” Kerkman said she is cosponsoring a constitutional amendment authored by Rep. Leah Vukmir, R-Wauwatosa, which would strike the words “or diminished” from the article prohibiting public officers’ compensation from being increased or diminished during a term of office. The amendment would have the practical effect of allowing lawmakers to refuse raises without tax implications. “It is very difficult times,” Kerkman said, of the state’s present fiscal outlook. “I wish that we could go back and just not have it come into our paychecks at all.” More important issues Rep. Peter Barca, D-Kenosha, will take the raise. Re-elected to the Assembly in November after a 15-year absence, the new pay rate took effect the day he was sworn into office last month. Barca said he had considered the salary change. For those who were around before the pay change and oppose it now, Barca said the proposed amendment sounded like an act of grandstanding. Barca said he believes the Legislature should instead focus on larger issues, such as jobs and the economy. “It seems to me that there’s a simple solution,” Barca said. “If you want to turn back some of your pay, turn back what you think is responsible. If you want to donate to charities, donate to charities.” Sens. Robert Wirch, D-Pleasant Prairie, and Neal Kedzie, R-Elkhorn, are also taking the pay increase. Kedzie could not be reached for comment Friday. Wirch, like Kerkman and Lothian, noted his office’s frugality. All said they have frequently returned unused office budget funds to the state’s coffers. Kerkman said she does not claim interdistrict mileage reimbursements, for which she is entitled to thousands of dollars per year. “I’ll tell you, we’ve slashed our travel budget, meaning I don’t go to conferences anymore — like the local people go,” Wirch said. The lawmakers also noted that with salaries just shy of $50,000 per year, they are paid less than many longer-tenured members of their office staffs. Legislators could vote Mike McCabe, executive director of the nonpartisan watchdog group Wisconsin Democracy Campaign, said he would prefer to see a system where the legislators vote on their own pay increases. “I think it’s one of those issues where it would be the best to have more accountability and to have a situation where if they’re going to raise their pay, they have to stand behind it and vote for it,” McCabe said. Countered Lothian: “It would embarass a lot of people. So I suppose I’d say they’ve got a system that supposedly works. When it’s good times and they give them a raise, they don’t say anything.” Barca said he believed it made sense for lawmaker pay increases to be voted upon in the same fashion as all other nonrepresented positions. The Joint Committee on Employment Relations approved the recent raise in 2007, long before the current term and before the state’s ledgers reddened to their current hue. “We should look at the system that creates this,” Steinbrink said. “Some things were done at a time when the economics were better, and now we’re looking at a totally different time.” LV: Read the CoSponosrship Memo and Resolution Sat, 14 Feb 2009 11:06:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=20864&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=20864&mname=Article GOP Calls for Budgeting Reforms February 10, 2009 By Andrew Beckett, Wisconsin Radio Network With Wisconsin facing a deficit of at least $5.7 billion, Assembly Republicans say changes are needed in how the state budget is developed. Assembly Republicans unveiled a package of bills Tuesday that call for an overhaul of the state budget process. State Representative Leah Vukmir (R-Wauwatosa) says one goal is to end the frequent reliance on one-time revenue sources to balance the budget. Other proposed changes include full disclosure of earmark spending and requiring agencies to use zero-balance budgeting. A proposal from State Rep. Bill Kramer (R-Waukesha) would require the state to create a public database of where taxpayer money goes. Kramer says the public website would list all state expenditures over $25. Lawmakers say the changes will require the state to budget more responsibly. AUDIO: Andrew Beckett reports (MP3 1:01) Wed, 11 Feb 2009 21:49:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=20788&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=20788&mname=Article State Republicans Seek to Balance Spending by 2015 GOP representatives introduce three bills aimed at fiscal health February 11,. 2009 The Rachel Vesco, Badger Herald To increase government transparency and accountability, four Assembly Republicans announced the proposal of a package of bills to change the way the state budget is handled. Reps. Bill Kramer, R-Waukesha, Rich Zipperer, R-Pewaukee, Leah Vukmir, R-Wauwatosa, and Brett Davis, R-Oregon, introduced the proposals at a press conference Tuesday morning. According to the state representatives, the bills will help guarantee the state’s long-term fiscal health by relying on honest budgeting practices and eliminating the need for one-time funding sources to address the state’s budget shortfalls. The first bill introduced was the Truth in Budgeting Act, which would require the state to achieve a balanced budget by the 2015-16 biennium. The proposal would also require that once every 10 years, each government agency prepares its budget using the principles of zero-based budgeting, justifying each component on cost and need. “The challenges we are now confronting [are] that we have run out of one-time money and budget tricks,” Vukmir said. “This is the first step towards finally balancing the state budget, moving us towards a truly balanced budget.” The bill is currently being circulated for co-sponsorship. The second bill, The Government Checkbook Disclosure Act, would create a searchable online database of state government expenditures over $25, right down to a copy of the check, according to Kramer. “I think it will show what that government spends its money on, both good and bad,” Kramer said. Kramer added while a similar service is provided by the state fiscal bureau, the database would make the information simpler for citizens. The database would be modeled off a similar program designed by the federal government. According to Kramer, since the federal program has been so successful, the government is making the software available to all states, greatly reducing any costs associated with the program. The final bill, The Earmark Transparency Act, was introduced by Zipperer to help raise public awareness about earmarks included in bills. The proposal would require an earmark transparency report to be filed before the Legislature votes on any proposal and would include information on the location of the earmark and the legislator who introduced it, Zipperer said. The proposal would also prohibit conference committees from putting “airdrops” into the budget during the final stages of legislation. Airdrops are earmarks put in by the committees that were not approved earlier during the budget process. Assembly Speaker Mike Sheridan, D-Janesville, believes many of the reforms have been discussed before and will likely be considered, spokesperson Rebekah Sweeney said. However, Sweeney is cautious of the negative effects they might have on the federal stimulus money the state is expected to receive. “At this point, we don’t want to set up a roadblock for the stimulus money,” Sweeney said. “We want to get things up and running.” Wed, 11 Feb 2009 02:04:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=20795&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=20795&mname=Article Assembly Republicans Want a Plan to Cut Deficit Before Accepting Federal Stimulus Money February 10, 2009 By Mark Pitsch, Wisconsin State Journal Some Republicans want to block the state from spending federal economic stimulus money unless Gov. Jim Doyle comes up with a plan to reduce the structural imbalance in the state budget. The idea is one of several proposals Assembly Republicans plan to propose today that they say will curtail years of sloppy state budgeting practices by lawmakers in both parties. Some worry any federal stimulus money will be used to help solve the state’s $5.7 billion budget shortfall through the end of the next two-year budget in June 2011 but leave the state worse off financially in future years. "We need to begin this process of putting Wisconsin on the road to honest budgeting," said Rep. Leah Vukmir, R-Wauwatosa. About $1.7 billion of the state’s shortfall is considered a "structural deficit," the gap between revenues and spending commitments already approved for the coming budget. The state would get at least $4.3 billion from the House version of the federal stimulus bill, while an early version of the Senate bill would deliver at least $3.1 billion. The Senate has scheduled a final vote today, and any differences in the legislation will have to be worked out. It’s unclear what reception the GOP proposals will get from the Democrats who control the Legislature. Rep. Mark Pocan, D-Madison, co-chairman of the Legislature’s budget committee, said the GOP proposal would set up a "roadblock" to spending the federal stimulus money. "A lot of us are pretty committed to being in a more responsible place in the future," he said of state budgeting. "But I’m not going to say we’re not going to take federal money for education or health care until we come up with some plan." Doyle spokesman Lee Sensenbrenner declined to comment on the proposals. The proposals to be introduced today by Assembly Republicans Vukmir, Brett Davis of Oregon, Rich Zipperer of Pewaukee and Bill Kramer of Waukesha also would: • Require the governor to prepare the 2011-13 budget using generally accepted accounting principles, a set of budgeting guidelines that more accurately reflects the state’s financial health than the cash accounting method typically used. • Require at least 20 percent of state agencies in 2011-13 and every budget cycle thereafter prepare their budget requests using "zero-based budgeting" rather than on the cost to continue current services. • Disclose the cost, beneficiaries and legislative districts of pet projects inserted in the state budget. A similar bill passed the Assembly by voice vote last legislative session. • Create a searchable online database of state expenditures. A similar bill passed the Assembly last year. LV: Read the Truth In Budgeting Act Tue, 10 Feb 2009 20:09:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=20778&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=20778&mname=Article Some Lawmakers Received More Than $10,000 in Per Diems February 6, 2009 By Steven Walters of the Journal Sentinel Madison - Nineteen of Wisconsin's 132 legislators claimed daily expense stipends that totaled more than $10,000 in 2008 and two of them - Rep. Marlin Schneider (D-Wisconsin Rapids) and former Rep. Terry Musser (R-Black River Falls) - collected $13,464 each. Legislators who live outside Dane County can claim $88 per day when on official business in Madison; legislators from Dane County can claim $44 per day. Expense payments are separate from their salaries, which were about $47,000 last year and $49,000 this year. Assembly per-diem expense payments ranged from $13,464 for Schneider and Musser to $440 for Rep. Mark Gundrum (R-New Berlin), who spent most of 2008 on active duty with a military unit in Iraq. Senate per-diem payments ranged from $12,760 for Senate Majority Leader Russ Decker (D-Weston) to $2,288 for Sen. Joe Leibham (R-Sheboygan). LV: The Journal article does not provide a list of local legislators, so I thought I would: In 2008, I claimed 39 per diem days for a total of $1,716. I typically only claim a per diem for the days that I was in Madison to take a vote or attend a committee hearing. Occasionally, I will include days where I am working on legislation or doing constituent work, but even then, I try to limit the number of days claimed. When I became chair of the Health and Health Care Reform Committee in 2007, I chose to use the lower Dane County rate of $44 because I knew the workload and the number of days I would spend in Madison would be greater. Per Diem’s are intended to offset the meal and lodging expenses incurred by legislators who are required, because of their job, to be away from home for official business. It is up to each legislator to determine what is reasonable. There are no requirements to claim per diem days and there is no verification system. View the 2008 Assembly Per Diem Ranking Report View the 2008 Senate Per Diem Ranking Report Fri, 06 Feb 2009 23:49:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=20752&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=20752&mname=Article Obama, Daschle Seek Big-Gov't Health Care Overhaul January 29, 2009 By Jeff Emmanuel, Heartland Institute Health Care News In public appearances since being selected by President-elect Barack Obama to head up the U.S. Department of Health and Human Services, Tom Daschle has reiterated his and Obama’s commitment to overhauling the U.S. health care system to give the federal government a stronger regulatory and decision-making role. Daschle, a former Democratic U.S. Senator from South Dakota and Senate Majority Leader in the early 2000s, has served as a distinguished fellow with the Center for American Progress, a Democratic think tank, since being ousted from the Senate in 2004 by Republican John Thune. Daschle wrote a book on health care reform (Critical: What We Can Do About the Health Care Crisis, Thomas Dunne Books), released in February 2008. “The president-elect made health care reform one of his top priorities of his campaign, and I am here to tell you that his commitment to changing the health care system remains strong and focused,” said Daschle in a December 5 address at the 2008 Colorado Health Care Summit, hosted by Sen. Ken Salazar (D-CO). Pushing for National Health Care Many experts say Daschle’s selection is a signal the Obama administration is serious about increasing federal government control of the health care system. “This is a sign that President Obama is serious about pushing for national health care,” said Michael Tanner, a senior fellow with the Cato Institute. “If proponents of a market-based solution to the health care crisis hoped they could avoid this fight, they were wrong—and if they don’t get ready quickly, they will lose it.” “Barack Obama’s choice for secretary of HHS signals a plan to resurrect big-government health care,” said Twila Brase, president of the Citizens’ Council on Health Care. “Daschle has publicly called for the federal government to direct the practice of medicine, putting all private medical decisions under federal control.” FedHealth Proposal Controversial Daschle has said he hopes to implement a Federal Health Board, called FedHealth, loosely modeled after Britain’s National Institute for Clinical Evidence, a decision-making body that has been under fire in recent months for refusing to allow coverage of some life-extending drugs under the National Health System. Stuart Butler, vice president for domestic policy at The Heritage Foundation, said Daschle “wants a Board that really doesn’t have to listen to Americans, and will have the power to determine what health care we get and what we will be denied.” Butler, a 30-year resident of Great Britain, warned against adopting the British model, where “regulating access to treatments based on the decisions of faceless health bureaucrats is the norm.” “The Daschle Board might be better described as the Supreme Court of Health,” Butler added, “and, given the powers he imagines for it, selections to it will be about as free from politics as nominations for a Supreme Court justice.” “Who would be appointed to this board?”asked James Gelfand, senior manager of health policy for the U.S. Chamber of Commerce. “Let’s be realistic—is it going to be the brilliant health care minds we hope, or is it more likely to be a bunch of retired Senators, representatives from interest groups with little policy depth, and academics with no real-world health care experience? Should we be comfortable with a group of that nature making these decisions with no legislative debate?” States Concerned Too Some state legislators have expressed concern about the signal the Daschle pick sends about the future of state health care. “Candidate Obama used broad generalities to describe how his health care plan would preserve private insurance and allow us to choose our own doctors,” said Wisconsin state Rep. Leah Vukmir (R-Wauwatosa). “In reality, though, Obama and Daschle are about to create the Fannie Mae of health care. They are about to give us rationed health care we can’t believe in.” “While Tom Daschle has a long history of interest in health care, his likely approach is worrisome,” said Iowa state Rep. Linda Upmeyer (R-Garner). “This country can ill-afford a massive SCHIP [State Children’s Health Insurance Program] increase right now, and expanding entitlements is not the answer. “Further,” added Upmeyer, “his desire for a National Health System that moves health care decisions further away from patients and providers, creates more bureaucracy, and models itself after a failed system does not seem like positive health care reform.” Some Optimism Some experts, recalling Daschle’s promotion of consumer-driven health care elements in the Senate, preferred to view the incoming Health and Human Services secretary with guarded optimism. “Tom Daschle was one of the first sponsors of Medical Savings Account legislation when they were introduced in the early 1990s,” said Greg Scandlen, director of Consumers for Health Care Choices at The Heartland Institute. “His views have likely changed since then, but I am hoping we can work with him to increase consumer choice in health care.” Fri, 30 Jan 2009 12:17:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=20627&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=20627&mname=Article More Relying on State Health Care Programs Growing enrollment poses funding challenges January 29, 2009 By Stacy Forster of the Journal Sentinel Madison - Enrollment in state health care programs such as BadgerCare Plus has increased by about 238,000 people - or 35% - in the past six years and is expected to rise as the economy continues to struggle. Medicaid programs provide some level of health care to about 1 in 6 Wisconsin residents. The state-federal program provides care to low-income families with children younger than 21, and to people who are elderly, or disabled and impoverished. It is one of the biggest programs in state government. Enrollment reached 926,600 people last month, up from 688,500 in January 2003, when Democratic Gov. Jim Doyle took office. How to fund the $5 billion-a-year program - which faces a deficit of about $1.4 billion through the next two-year budget - is one of the biggest long-term questions looming for the state. Other states are facing similar shortfalls as tax revenue has fallen because of the economic crisis. State leaders will likely get help for this budget from the federal stimulus package being developed in Washington. Still, Doyle said Thursday that the two-year spending plan he is expected to present Feb. 10 will include administrative cuts to the Medicaid program. He added that he is committed to maintaining eligibility and protecting health care for children. One of the hallmarks of the last budget was BadgerCare Plus, a restructuring of programs for low-income families that made it easier for eligible parents and children to enroll. In a statement last week, Doyle said he would look at "creative solutions and serious cuts" across state government to continue providing health coverage, especially for children. State officials would be expected, however, to run the program more efficiently, Doyle said. "The benefits of keeping BadgerCare whole far outweigh the costs of not covering children and families," Doyle's statement said. Medicaid enrollment will likely tick higher in 2009. Each increase of 1 percentage point in the national unemployment rate is expected to increase Medicaid enrollment by 1 million people, according to the Urban Institute, a policy research institute in Washington. About two-thirds of the Medicaid budget goes to providing care for seniors and people with disabilities. State Health Services Secretary Karen Timberlake said Wisconsin hasn't yet seen more people enroll in BadgerCare Plus because of the economy. But Sen. Bob Jauch (D-Poplar) said that as benefits run out for those who have lost their jobs, more people will apply. Rep. Leah Vukmir (R-Wauwatosa) said she was concerned that as Medicaid enrollment grows, participants won't get the same quality of care. Sen. Alberta Darling (R-River Hills) said the state needs to do a better job of coordinating care to save money and warned against further expansions. Jauch said the state could be worse off by not spending the money on preventive health care that BadgerCare Plus provides to families. "We can't ignore it," he said of the need for affordable health care. "If we do, we pay for it another way." He and others suggested that people without insurance would seek costly care in hospital emergency rooms. Reasons for rise Officials at the state Department of Health Services cited a number of factors for the increase in enrollment and eligibility for programs: Fewer employers offer health care benefits to employees, contributing to an overall increase in the number of families and children in Medicaid and BadgerCare Plus. Simplifying enrollment for BadgerCare Plus. About 100,000 people signed up for the program last year; two-thirds of them were children. The bulk of new participants were signed up through an effort targeting people who were eligible for BadgerCare Plus but not previously enrolled. Higher enrollment in narrower programs such as SeniorCare, a prescription drug plan for residents 65 and older, implemented in September 2002, and the family planning waiver, which provides reproductive care for women ages 15 to 44, which started in January 2003. State officials said they were also trying to make it easier to apply for Medicaid and BadgerCare Plus by offering online applications and removing the stigma of receiving help through the programs.When looking at the increase in enrollment, Timberlake said, it's most meaningful to look at the 1 in 10 Wisconsin residents in BadgerCare Plus. For those without access to employer-sponsored insurance, she said, "BadgerCare Plus plays an important role." Other states have tightened Medicaid eligibility in recent years, but that hasn't happened in Wisconsin. "The fact that we have a healthy state with strong health coverage is a plus," said Rep. Mark Pocan (D-Madison), co-chairman of the Legislature's Joint Finance Committee. Indeed, state officials want to expand BadgerCare Plus to cover about 40,000 childless adults. "I don't see us having the money to do any more than that," Jauch said. The federal stimulus package could go a long way toward filling the Medicaid budget hole, especially as the economy sputters. Wisconsin is likely to receive about $1 billion for Medicaid, according to U.S. Rep. Tammy Baldwin, a Madison Democrat. A proposed assessment on hospital revenue would cover the BadgerCare expansion to childless adults. Patrick Marley in Madison, and Larry Sandler and Guy Boulton in Milwaukee, all of the Journal Sentinel staff, contributed to this report. Thu, 29 Jan 2009 12:26:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=20628&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=20628&mname=Article Small Businesses Hope for Health-care Help December 6, 2008 By Jason Stein, Wisconsin State Journal Small businesses struggling to provide health insurance to employees could soon see a state proposal to help them, but it might come with a tradeoff: Getting help may mean having to get their insurance through a state-organized marketplace. The BadgerChoice plan being considered by Gov. Jim Doyle might include a mandate that potentially tens of thousands of small state businesses with insurance for hundreds of thousands of employees start buying those private plans through an online state portal. The possible requirement, which would also give many more options to employees with coverage, would not force small businesses to offer coverage if they choose not to. The Democratic administration is negotiating tricky territory as it decides whether and how to restructure Wisconsin's insurance market for small businesses, including the recession and the state's $5.4 billion budget hole. "We're still very much in the design phase," Rea Holmes, executive assistant at the state Department of Health Services, said of the proposal. "It's going to be a consumer-driven marketplace where you can harness the buying power of small businesses to lower health-care costs." Holmes said that her agency was still fleshing out all the details of the plan but that Secretary Karen Timberlake was leaning toward the possible mandate to ensure the broad participation needed from businesses for a successful program. Republican lawmakers said they would oppose such a requirement, but several business owners or groups said they were open to the idea as long it came with better, more affordable coverage. Some Democrats have said they would prefer a plan requiring universal coverage — a much more sweeping mandate than Doyle's — but others, especially those in the Assembly, have praised the governor's approach. Doyle unveiled the BadgerChoice concept in his state of the state speech last January, saying that helping small businesses of 50 employees or fewer was the key to addressing the state's uninsured population. Businesses with more than 50 employees largely already offer health coverage and wouldn't be affected by the plan. Holmes said the health department would have a full proposal ready in time for Doyle to decide whether to include it in his budget, normally released in mid-February. Doyle spokesman Lee Sensenbrenner declined to speculate on whether the governor would do so, however, saying the governor saw promise in the program but also recognized "his main challenge is dealing with the budget" shortfall. Holmes said the administration would also monitor whether Congress and President-elect Barack Obama pass a national health plan that would lessen the need for BadgerChoice. 'Tougher and tougher' Businessman Gary Waldhart is just hoping someone does something. Waldhart, president of the cell phone and electronics business AMS in Fitchburg, has watched health-care expenses for his full-time work force of about 30 rise by as much 10 percent a year, in spite of steady cuts in the benefits. Last year, Waldhart made the difficult decision to scale back his firm's share of long-term employees' insurance premiums from 100 percent to 75 percent. "It's been tougher and tougher. It keeps going up," Waldhart said, calling health care his fastest-growing cost. Waldhart said he's willing to consider Doyle's plan, including the state mandate on how he buys health insurance, if it delivers results. "If they were to offer something and say we must go into that, I would hope that they could do better than what we're doing today as a small business," Waldhart said. "It must be a benefit to the employer." Rep. Leah Vukmir, R-Wauwatosa, wasn't open to the idea. Vukmir, a nurse and the outgoing chairwoman of the Assembly health committee, criticized the plan's possible mandate and focus on insurance reform rather than on the costs of medical care itself. "It doesn't get to the root of the problem" of rising costs, Vukmir said. Small business pool For small business, the problem is huge. In 2006, only 44 percent of small businesses in Wisconsin provided health insurance to their employees, compared to 98 percent of large businesses, according to a federal health survey. Doyle's proposal would attempt to shrink that disparity by pooling small businesses together to better share their buying power and risks. The concept is modeled after the "Commonwealth Connector" program used in Massachusetts. The Wisconsin model would help small businesses and employees connect with health insurance through a Web site and telephone system that would offer a range of competing private plans. Businesses would decide how much to contribute toward workers' premiums and their employees would then choose a plan that suited their needs and pocketbook, Holmes said. The plan could include a state subsidy of up to $100 million to help hold down the premiums, administration officials said last year. But that was before the state hit its current severe budget trouble, which makes it harder to pay for a large subsidy now, although it could be phased in as part of later budgets. More insurance options About 28,000 Wisconsin small businesses offer health insurance, and about 390,000 employees and their family members receive it, according to the state health department. Agency spokeswoman Stephanie Smiley acknowledged those businesses could be covered by the possible mandate but said it's "premature for us to make assumptions." Holmes said that if BadgerChoice were voluntary, it might not attract enough businesses with younger, lower-cost employees to be viable. She noted that participating employees would have more insurance options to choose from under the proposal, and would be able to keep that insurance if they changed jobs from one small employer to another. The Wisconsin Association of Health Plans agrees with Doyle's focus on small businesses and wants to see more details, senior executive officer Phil Dougherty said. The health insurers group worries that a plan to charge premiums based on the profile of all employees insured in a pool, not just those of a single business, could end up hurting more businesses than it helps, he said. Wayne Corey, executive director of Wisconsin Independent Businesses, said reaction from members of his small business lobby was generally favorable, though he said more details were needed. Peter Hanson, a lobbyist with the Wisconsin Restaurant Association, agreed. "A lot of our members feel like they've been priced right out of the market and they want some kind of health care reform," Hanson said. "The elements of BadgerChoice that we've seen so far, we like." Sat, 06 Dec 2008 01:01:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=20133&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=20133&mname=Article Milwaukee Journal Sentinel Candidate Questionnaire 14th Assembly District Posted: Oct. 14, 2008 "Vukmir, first elected to the Assembly in 2002 and chairwoman of the Assembly Committee on Health and Health Care Reform, has carved out valuable experience that serves her district well" The Milwaukee Journal Sentinel sent a questionnaire to candidates for the state assembly. Their answers will be used by the editorial board when it decides which candidates to endorse for the Nov. 4 election. Q. Wisconsin is facing a $800 million deficit in the next biennium, not including longer term spending commitments. How should the state Legislature fix this? What role should fee or tax increases play in this? What fees? Which taxes? What role should spending cuts play? What would you cut? Leah Vukmir: The citizens in Wisconsin are already facing some of the highest taxes in the nation. We cannot increase taxes to close this gap. The legislature adopted significant fee increases in the last budget and there is very little justification for raising them again in this budget. We must focus on spending cuts. We can begin by putting in place a statewide hiring and wage freeze. In addition, we need to call on every agency to implement rolling furloughs for non-essential state employees. In every agency and department, we must temporarily stop or permanently end grants and programs that have questionable value. For example, we should eliminate all ethanol subsidies, and our economic development grant programs. We spend nearly $200 million on business subsidies that, according to the Audit Bureau, have produced little in the way of tangible results or job creation. We should reform SeniorCare and encourage enrollment into Medicare Part D. This would make Wisconsin the payer of last resort, rather than the primary payer. This could save Wisconsin $75 million. We must put in place a meaningful freeze on state employee travel and it must include the University System. This could save $30 million over the budget. We should also offer incentives to state employees to enroll in Consumer Driven Health Plans. Such a move would save a minimum of $300 million. The challenges facing state government are no different from those facing businesses and families. Businesses are making these same decisions and making their operations leaner and more efficient. Families are cutting back on their spending and finding ways to stretch their dollar. Government must do the same - we cannot simply turn to taxes and fees. We need to make government work better for less money and now is the time to do it. Q. Nationally, states have enacted legislation to address illegal immigration. Do you believe state government has a role here? If so, in what way? Leah Vukmir: State government has an obligation to enforce the law. Every agency and program must verify that a person is here legally before dispensing public assistance or enrolling the person into a government program (with exceptions for emergency medical care). The state should also prohibit municipalities from establishing "sanctuary" cities and instead require them to enforce federal immigration law, particularly when dealing with illegal immigrants who are breaking state and local laws. Wisconsin's taxpayers, particularly when faced with budget challenges, should not be expected to provide benefits and services to citizens who are here illegally. These added costs make it difficult to serve our own citizens who are in need. States that have encouraged and supported illegal immigrants are facing extreme budget challenges because of their choices. I do not want to see this happen in Wisconsin. We must enforce the law. Q. For elections for candidates for the State Supreme Court, would you support legislation that would require outside spending groups to register with the Government Accountability Board and be subject to disclosure of their donors and regulation of the funds during specified periods before elections? Your views please on full public financing for Supreme Court candidates who qualify and who agree to spending limits? Leah Vukmir: These groups are already required to register with the GAB. Issue advocacy groups should not be required to disclose their donors nor should the GAB attempt to regulate their funding. Issue advocacy and political speech is a valuable part of our democracy and it should not be infringed upon or limited by government. Such a system would only serve to silence free speech. I do not support public financing in any form, nor do I support any attempts to change the way we choose Supreme Court Justices. It is impossible to take politics out of the system, particularly when justices choose to become activists who advance a political agenda in their opinions rather than carefully considering the meaning and purpose of the law. If we want to take the politics out of the Supreme Court then we need justices who will strictly interpret the law and not work as political activists. Once we do that, we will not need to worry about the amount of money that is spent on campaigns. Q. Would you favor public financing and similar campaign finance rules for candidates for state legislative office? Leah Vukmir: No. The taxpayers should not be force to pay for political campaigns, nor should a state board regulate political speech. I do support more transparency and an improved system of disclosure. Voters should be able to quickly and easily find out who is giving money to a candidate. This system should be tied into a better lobbying transparency database and, in the case of the legislature, should disclose budget earmarks and recorded votes. The GAB has already begun updating the financial disclosure system and it is a good first step, but we need to do more to connect the financial disclosure system to lobbying and voting records. Q. Among the state's school districts, Milwaukee Public Schools arguably has the most serious challenges. What fixes can state government apply to MPS specifically? Would you favor dissolving the district and starting over? What would you replace it with? Leah Vukmir: I support breaking MPS into smaller, community-based districts. The system is simply too big for parents to make a difference. I believe in the parents and I believe in more local control. The only way for these schools to become better is by putting the parents back in charge of their schools and this approach, with locally elected school boards, would go a long way towards accomplishing that. Having these smaller districts aggressively competing for students under our open enrollment system would foster significant improvements. Q. Would you favor expanding Milwaukee school choice in Milwaukee, raising the ceiling on the number of students eligible? Would you expand the program to other districts in the state? Why? Leah Vukmir: I support eliminating the enrollment cap and expanding the income eligibility limits in the Milwaukee School Choice Program. I would support expanding the choice program to other districts, however I believe such expansions must be made thoughtfully and carefully. We should begin by offering vouchers in districts where there are a large number of private schools for parents to choose from, such as Racine and Madison. I support providing every parent in the state with these choices but I believe that such an expansion should be done gradually and in a way that encourages and supports improvements in the public schools at the same time. Q. Currently, Milwaukee taxpayers pay a premium for choice schools. State taxpayers pick up 79% of the cost of public school students but only 55% of the cost of voucher students, with city property taxpayers making up the difference. Would you support legislation that would have the state pick up a larger share for voucher students? Leah Vukmir: While this is true, it must be pointed out that the cost of a voucher student is about half as much as a public school student. This funding differential is the unfortunate result of politics. The opponents of school choice have attempted to use this as a sort of "poison pill" to kill the program. The school choice opponents believe that having the state pick up a larger share of the voucher cost will eliminate support for the program from out-state legislators because their district's share of state education funds will be reduced. The formula has also prevented many Milwaukee area legislators from supporting any expansion of the program. I would support changing the formula so that students in the choice program cost Milwaukee's property taxpayers no more than an MPS student, however, I would not support making this change outside of a broader package of compromises that protects and improves the Milwaukee School Choice Program. I have been involved in too many legislative battles to protect this program. Unilaterally offering this funding change without obtaining tangible protections and reforms would not be a responsible legislative decision. Q. Healthy Wisconsin, a proposal to provide universal health care for the state's residents, failed in the state Assembly but passed in the state Senate last year. Should the state resurrect such a proposal? Why or why not? If not, what can the state do about health care? Leah Vukmir: Healthy Wisconsin did not fail in the Assembly. Not one State Representative was willing to bring Healthy Wisconsin to the floor for a vote. As the chair of the Assembly Committee on Health and Health Care Reform, I have worked hard to inform the citizens of Wisconsin about the flaws and dangers of this plan. The more that people understand, the less they like it. Despite the claims of its supporters, Healthy Wisconsin is a government takeover of the health care system in Wisconsin. The program relies on a government board that would determine guidelines for appropriate medical care, restrict medical technology investments and impose a 14.5% payroll tax on every worker in Wisconsin. The program relies on a one-time savings by eliminating private insurance but the cost projections show that Healthy Wisconsin would do little to control annual cost increases. In fact, the projections show that costs would increase 2 to 3 times faster than wages meaning that the payroll tax rate would have to increase by as much to keep pace. The other choice would be to ration care. Real health care reform must focus on cost, quality and access. Healthy Wisconsin only addresses access in the short-term. The costs will force rationing or a reduction in quality. Our reforms work to put the patient and their doctor in charge of their health care decisions. My focus is on providing more extensive price and coverage transparency, consumer-driven health care, increasing competition among providers and insurers and making health insurance more portable and affordable. We all agree that we need to make significant reforms, we just don't agree on which solutions will work best. The Senate Democrats believe that government is the answer, I believe government helped create the problems facing health care. I am very passionate about this issue and I have a great deal more that I could say about it, but the space here is limited. For more information and a very detailed answer to this question, please read my WPRI article: www.leahvukmir.com/Health_Care_Articles.aspx Q. What is your position on a regional transit system for southeastern Wisconsin that would integrate the various bus systems and include commuter rail components such as the proposed Kenosha-Racine-Milwaukee commuter line? If you favor such a system, how would you finance it? Or do you feel each community is best suited to assess and finance its own system with perhaps some transit aid from the state? Leah Vukmir: I support individual efforts between counties and municipalities to work on solutions that improve bus routes, but there is no reason to rely on a regional transit authority for this. I have many concerns about the KRM rail proposal. First, I am not sure that the ridership projections justify the costs or that these projections are even accurate. Second, I believe the voters in each of these counties should have the opportunity to vote on the proposal. Third, I am very concerned about providing another unelected board (the RTA) with taxing authority. As we go into the budget process, we are facing significant challenges paying for the programs we already have. Our transportation fund has been raided to pay for other programs and now we are forced to make difficult decisions about currently scheduled transportation projects. Now is not the time for the state to take on such a program. I believe we need to approach the upcoming budget with a focus on taking care of core government programs and priorities. Now is not the time to add new spending. With all of this in mind, my vote is no on the RTA and no on KRM. The taxpayers can't afford our spending levels now - and they certainly don't need us to increase their burden. Q. What is your position on implementing recommendations of the governor's task force on global warming? Should the state set its own standards for greenhouse gas emissions or should it leave such standards up to the federal government or should there be no such restrictions and standards? Leah Vukmir: From the time that the Governor established the task force to the time the group issued its final recommendations, the term "global warming" has been replaced by "climate change" because the scientific evidence for global warming is questionable. We should all be focused on finding ways to reduce pollution and improve the quality of our air and water. I don't think you will find much disagreement about that. Should we transition to clean coal, nuclear energy, natural gas and alternative sources of energy? Yes. Should Wisconsin set its own higher standards for emissions, vehicle mileage? The answer is - absolutely not. If there is evidence that "climate change" is manmade, and the science is not clear on this point, then we need to address it in a far larger scope than just the state of Wisconsin. Wisconsin on its own accord will not significantly impact the global climate no matter what type of restrictions we place on industry or individuals. The decisions we make as a state should be based on actual science and should be made with a full appreciation of how these changes will impact jobs and our economy. Simply imagining that creating "green jobs" will grow our economy does not make it a fact. Throwing taxpayer subsidies at politically favored industries at a time when we cannot pay for the promises and programs the legislature has already made is fiscally irresponsible. We made this mistake with corn-based ethanol and it has had disastrous consequences on our nation's food supply and the cost of food. Q. Municipalities complain of a disconnect between state mandates and state revenue sharing. Is there a gap and would you close it? Leah Vukmir: Closing the gap for most municipal leaders means more state money. The state has essentially frozen the level of shared revenue for a decade while passing on additional responsibilities to local government. Unfortunately, the state cannot afford to pay its bills now and an increase in shared revenue in this budget is very unlikely. Further, most of the communities that I represent are net contributors towards revenue sharing. That is, if a municipality in my district receives an additional dollar in shared revenue, that dollar cost the taxpayers in that municipality at least a $1.25 under the formula. What we need to do is avoid passing on more costs to local governments. Others have proposed eliminating exemptions on certain personal property arguing that it makes businesses "pay their fair share." These exemptions encourage business investment that creates jobs and keeps employers in Wisconsin. The exemptions should remain in place; in fact, we should begin a broader plan to phase out the use tax entirely. It is counterproductive to our job creation efforts. Q. What should Wisconsin do to curb the increasing problem of invasive species in the Great Lakes and the surrounding regions? For example, should Wisconsin set its own regulations for ballast water discharge or should it wait for the federal government to set such regulations? Should Wisconsin communities just outside the natural basin of the Great Lakes have access to lake water if they abide by the terms of the Great Lakes Compact? Should the state impose any additional rules on such diversions, such as extra payments or agreements to limit development? Leah Vukmir: I would support an effort whereby the Great Lakes states work together to develop a common set of standards for ballast water discharge and a joint federal-state enforcement mechanism. The state could develop its own rules, however it is unlikely to be as effective because our rules only apply to the waters under our jurisdiction and it will not stop the migration of invasive species from other parts of the Great Lakes. Illinois may not be willing to sign on to such an agreement because of their bustling port traffic, however working with other states we would be able to restrict traffic through the St. Lawrence Seaway and prohibit traffic from the Illinois Waterway from entering Wisconsin, Michigan and Indiana waters. I support diversions outside of the basin that comply with the recently enacted Great Lakes Water Compact. I do not support the imposition of "additional rules, payments and restrictions" on communities that purchase water from communities inside the basin. This issue is a matter of perspective and I would phrase the question this way. "Should the state allow one municipality to extort money from the citizens of another community and control the economic development of another community simply because the other community's water has been determined to be dangerous by the Environmental Protection Agency?" This is precisely what Milwaukee is threatening to do to its neighbors and I do not support it. It does serve as an object lesson about the realities of regional cooperation however. Q. What is the most important issue in your district and how would you, as a legislator, address it? Leah Vukmir: The number one issue that I have been hearing about from the voters in my district is the economy. We need to protect our business climate and do everything we can to protect jobs. This begins with the upcoming state budget. There will be a push to increase taxes on business or perhaps even increase the sales tax to balance the budget. These tax increases will kill our economy and make it even harder for Wisconsin to avoid a deep recession in 2009-2010. I will continue to work on health care reforms that empower individuals to take more control of their health care dollars. I will also work on several education reform proposals. The next session will need to focus on state spending. I believe that doing so and preventing increases in taxes and fees is the most important priority and the best way for us to protect our economy. Wed, 15 Oct 2008 00:17:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=19221&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=19221&mname=Article BadgerCare Plus health program projected to cost another $25 million this year September 22, 2008 By Jason Stein, Wisconsin State Journal An expansion of health care for children and families that Gov. Jim Doyle's administration said would not cost taxpayers more money is projected to cost another $25 million this year. Advocates for low-income families say the BadgerCare Plus program is still a bargain that gives tens of thousands of children and parents access to good health care. But Republican lawmakers, who have been skeptical of the cost claims all along, said they weren't happy with the new expected price tag. News of the added cost comes as the state faces a tight budget and the Democratic governor's administration seeks to move forward with an expansion of the state's Medicaid health program for poor families to cover childless adults. "It's troubling because this was supposed to cost nothing," said Rep. Leah Vukmir, R-Wauwatosa, chairwoman of the Assembly Health Committee. "The program has opened up to far more people than was anticipated." The state has added 85,400 children and parents to its Medicaid rolls — more than three times the number originally projected by state officials — since BadgerCare Plus was rolled out in mid-January. The program essentially makes Medicaid coverage available to more parents and all uninsured children in Wisconsin, except those whose parents already have access to adequate coverage through an employer. The expansion is aimed at reaching more uninsured families partly by raising income limits. But Stephanie Smiley, a spokeswoman for the state Department of Health Services, said 85 percent of the children and parents enrolled through BadgerCare Plus were people who qualified for state coverage all along, but who are now receiving it because of efforts to simplify Medicaid programs. "Thanks to these efforts, far more poor children and their parents now have health-care coverage," Smiley said. "Preventive care helps reduce health-care costs in the long run." Exceeded budget In addition to the $25 million in projected cost overruns for the year ending in June 2009, BadgerCare Plus also exceeded its budget for the previous year, Smiley said, though she could not say by how much. Medicaid director Jason Helgerson said the health department did its best beforehand to do the complicated projection of how many people would sign up for BadgerCare Plus, estimating that 26,000 would do so by June 2009. The Doyle administration said the state's share of the cost to cover those enrollees could be more than paid through increased use of HMO-style managed care organizations, other administrative savings and monthly premiums or other charges to enrollees. $88 million deficit Smiley said state officials were working to correct a projected deficit of $88 million as of June 30 in taxpayer dollars in the state's overall Medicaid fund — an expected shortfall of about 4 percent. The state could save an estimated $8 million by taking steps to reduce prescription drug bills, use more managed care and delay Medicaid payments by the state until after the federal government puts in place a higher reimbursement rate for the state's costs, Smiley said. "We are doing a whole bunch of things to try to control costs," Helgerson said. Rep. Kitty Rhoades, R-Hudson, co-chairwoman of the Legislature's budget committee, said in a time of economic troubles the state needs to be careful about "expanding programs we can barely afford now." Still a bargain Jon Peacock, research director for the Wisconsin Council on Children and Families, said the BadgerCare Plus program was still a good deal, given that it insured 85,000 more people. "It's actually remarkable that the net cost is only $25 million given how many more people we're serving," Peacock said. "This program's still a bargain." Peacock said the health department's early cost estimates appeared optimistic to him. "I thought there was a pretty fair chance that it would have a net cost," Peacock said of BadgerCare Plus. "I was surprised that the (agency's cost) numbers weren't higher initially." BADGERCARE PLUS COSTS The news: A state health program for families will cost a projected $25 million more than originally expected this year. The response: Critics point out that Gov. Jim Doyle said the program wouldn't cost taxpayers. But supporters pointed out the program is costing more because it's serving three times more people than expected. Mon, 22 Sep 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=18447&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=18447&mname=Article Health care fix a joint effort Valley experts say employers can help promote lifestyle September 11, 2008 By Larry Avila Appleton Post-Crescent business editor APPLETON — Coercing employees to change their lifestyles could be a pill that cures health care cost woes. Ask Mary Felton, vice president of human resources for Neenah-based Tidi Products, a health care products company. Part of her job is finding cost-effective health insurance for the company's 225 workers and this year, her efforts to get employees to kick bad habits will pay off. Tidi Products is expected to see significant savings in insurance costs thanks in part to commitments from workers adopting healthier lifestyles. "We're making employees more accountable for their lifestyle choices," said Felton, who was among five presenters Wednesday at the Value Driven Health Care Forum presented by the Fox Cities Chamber of Commerce & Industry. The program was organized to showcase successful efforts of providers and businesses to reduce health care costs. The company replaced about 70 percent of vending machine food with healthier choices and keeps fruit baskets for employees in its building. Tidi also has a health coach and nurse practitioner on site to work with staff, Felton said. For every dollar spent on the health team, the company estimates it gets a $1.84 return. Jay Fulkerson, regional market leader for UnitedHealthcare, which provides health insurance for about 1 million people in Wisconsin, said businesses should consider taking health risk assessments. "Companies do need to be part of the solution," he said. "Health providers can't get lean enough. We can't do enough to educate on the benefits of wellness, but we do have to get people healthier." Dr. John Toussaint, president and chief executive officer of the ThedaCare Center for Healthcare Value, a medical provider thinktank, said providers should help themselves reduce health care costs. Before his current position, Toussaint was at ThedaCare, operator of Appleton Medical Center and Theda Clark Medical Center in Neenah, implementing lean manufacturing or efficiency principals into its patient care . By streamlining — and working to continuously improve — operations, ThedaCare has saved $27 million the past three years, Toussaint said. "We've seen a 5 percent improvement in productivity," he said. For certain cases, he said length of stay at the hospital has been reduced by 20 percent, costing patients and insurance companies less. Right now, though, Toussaint said the health systems aren't set up to reward providers for cutting costs. In fact, the opposite is true. "Our reward for providing better quality at a lower cost is $2,000 less per case from Medicare," he said. If nothing changes, health costs only will get higher, said Dan Neufelder, president and CEO of Menasha-based Affinity, which operates St. Elizabeth Hospital in Appleton. He said in 2006, the nation's health care costs represented about 16 percent of the country's total gross domestic product and by 2035, it would reach 31 percent. Neufelder said if individuals were forced to cover more of their health costs, they would become better health careconsumers. "It does create wiser choices," he said. State Rep. Leah Vukmir, R-Wauwatosa, chairman of the Assembly Committee on Health and Health Care reform, was supportive of private industry addressing rising health care costs but also said government should be an active player. "Solutions that come from the private sector is the best situation," she said. "Government can help by getting out of the way." Thu, 11 Sep 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13373&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13373&mname=Article Surge in Individual Health Insurance Policy Market: Time for the States To Step Up There have been several articles coming across the wire about the increased activity in the insurance market for individual policies. Diane Levick from the Hartford Courant gives a good report on the dynamics. She spends a lot of the article talking about the problem of pre-existing medical conditions when seeking an individual policy, which would be a concern of many. What I found the most gratifying was her mention of Health Savings Accounts and the fact that she doesn't spur them as "insurance for rich people." I didn't realize how much this label frustrates me until after I had read the fair representation in this article. The end of the article implicitly plugs consumer education. "Take that application you're asked to fill out very seriously" because policies can be rescinded, state Healthcare Advocate Kevin Lembo warns. Also, individual policies may be quite different than employer plans, and "cheaper is not always better," Lembo said. "Make sure you make an educated decision based on provider networks, cost-sharing, and not just on premium." Bravo. Anticipating that the surge will grow, and that many consumers will depend more on the individual markets in the future, the laboratories in the states need to start taking their position of insurance regulation more seriously, by allowing the markets to be more flexible to meet the needs of consumers. For too long, state insurance regulation has been the toy of Big Public Health, special interest advocates, and, quite frankly, legislators attempting to look good on paper. But, there are exceptions: Rep. Vukmir from Wisconsin proposed a piece of legislation this spring that would allow people with low income to purchase policies that have fewer mandates. Look at a PDF of the legislation at this link: Download 07-38221.pdf Florida passed something similar, but the legislation became a lot more broad than the original bill. Thu, 21 Aug 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13374&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13374&mname=Article Poll shows Obama leads McCain on education issues By AMY HETZNER - Milwaukee Journal Sentinel A new poll on the public’s perception of education indicates that more think Democratic presidential candidate Barack Obama would be better for public schools than think rival John McCain would, even on the traditionally Republican issue of parental choice. William Bushaw, executive director of Phi Delta Kappa International, called Obama’s lead over McCain one of the most significant findings of the poll that his educator organization has conducted for 40 years with poll-giant Gallup Inc. “When you drill down even deeper and ask Americans who would do better in the four specific areas — closing the achievement gap, promoting parental choice, supporting research and funding education — in all four cases, Senator Obama received a much more favorable rating than Senator McCain,” Bushaw said. While President Bush ran neck-and-neck in previous polls with Democratic candidates Al Gore and John Kerry on the question of whom respondents would vote for solely based on a desire to strengthen public schools, Obama was favored 46% to 29% over McCain on the same question this year, according to the poll. People also found Obama much more likely than McCain to close the achievement gap between white and minority students, by a factor of 59% to 18%. Obama’s weakest showing was on the issue of promoting parental choice. But even there he beat the poll’s 3 percentage point margin of error, with 43% saying he would be better vs. 32% for McCain. “That surprised me,” said former Milwaukee Public Schools Superintendent Howard Fuller, a voucher proponent who said he is supporting Obama. “I mean, it’s interesting to hear that. It’s a bit of a surprise to me.” The differences are striking given that neither candidate has said much about education, Bushaw said. That leads some to think McCain, the presumptive Republican nominee, might be able to make up ground. State Rep. Leah Vukmir (R-Wauwatosa) pointed to the poll’s finding of growing support for allowing students to attend private schools at the public expense. The share of respondents who favored this idea increased to 44% in 2008 from 39% the year before. McCain has come out in support of such voucher programs. Obama has not, though some have seized on a statement he made to the Journal Sentinel editorial board in February as leaving the door open to private-school vouchers if they can be shown to work. “I just think that, in general, the public simply doesn’t know where the candidates stand,” Vukmir said. “Hopefully the McCain campaign will capitalize on this.” The PDK/Gallup poll of 1,002 adults was completed in early July before McCain had thoroughly outlined his educational platform, said Michael Petrilli, vice president of the Thomas B. Fordham Institute. That’s important because, unlike Obama, McCain has not had much involvement in education issues from which the public could form an opinion, said Petrilli, a former U.S. Education Department official under Bush. And, he noted, the poll question on parental choice can be interpreted broadly to include charter schools and public school choice, both of which Obama favors. “I think that it is fair to say Barack Obama is a strong supporter of choice,” Petrilli said. The impression that Obama would be better than McCain on the issue of choice also is likely driven by his past as a community organizer, said Joe Williams, executive director of New York-based Democrats for Education Reform. Obama’s background can be seen as giving him a better understanding of the issues confronting families, he said. Although the Democratic Party historically has been viewed more favorably on education issues than the GOP, that’s not true when it comes to choice, Williams said. “We’re generally seen as the party that’s standing in the way of choices,” he said. “But that’s changing.” Thu, 21 Aug 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13375&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13375&mname=Article Health Care Referendum Headed to Ballot By LaToya Dennis WUWM, Milwaukee Health care reform could again become a hot button political issue in Wisconsin. Last year, Senate Democrats approved a plan called Healthy Wisconsin. It would have provided universal coverage for residents. The measure died in the Republican-controlled Assembly. Now, as WUWM's LaToya Dennis reports, a state advocacy group is hoping Wisconsin residents can push the agenda. The group Citizen Action Wisconsin has been collecting signatures across the state from residents who want the legislature to improve the health care system. Spokesman Robert Kraig says it must be affordable, accessible and of high quality. His organization’s goal is to get advisory referendums on ballots come November, demanding that lawmakers act by the end of 2009. “Health care premiums have doubled since 2,000, which is a shocking number if you think about it. And the Legislature has not been able to take concrete action. We and hundreds of citizen activists that are working on this across the state are convinced that if the public is given the ability to speak with a clear voice by having advisory referendums this fall, that a message can be sent to the state assembly,” Kraig says. That’s exactly what Democratic state Senator John Erpenbach is hoping. “Well I think it’s a great idea. I think I know what the outcomes of the referendums will be. I think pretty much everybody does. This is tied into legislators who don’t think health care is that much of a priority or health insurance is that much of a priority. I think voters in Wisconsin will be pretty loud on this one,” Erpenbach says. Erpenbach predicts residents would vote overwhelmingly in favor of the referendum calling for health care reform. Republican state Representative Leah Vukmir agrees that it’s time for changes to be made to the health care system. But she’s quick to note that the bills on the table last legislative session like Healthy Wisconsin don’t get at the core of the problem. “We all agree that health care costs are out of control. Their plan doesn’t address the cost of health care. All it does is take the current amount of money that we spend on health care premiums, spread it around to a payroll tax on employers and employees, and then magically assume that we’re going to continue to have the quality of health care that we’ve all come know in our state,” Vukmir says. Vukmir says if people were forced to pay for health care using a personal health savings account they wouldn’t abuse the system. She says part of the reason health care is so expensive is because it’s overused. Thousands of residents in several communities have signed petitions wanting to weigh in on the matter on the November ballot. The latest two are Oak Creek and South Milwaukee. Wed, 13 Aug 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13390&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13390&mname=Article FOR IMMEDIATE RELEASE, July 28, 2008: Americans for Prosperity Applauds Wisconsin State Representative Leah Vukmir -Signs No Climate Tax Pledge- Contact: Mark Block (414) 475-2975 or Phil Kerpen (202) 349-5880 MILWAUKEE -The Wisconsin chapter of the free-market grassroots group Americans for Prosperity (AFP-WI) today applauded Wisconsin State Representative Leah Vukmir (WI-14) for signing the group’s “No Climate Tax Pledge.” By doing so, Vukmir pledges to “oppose legislation relating to climate change that includes a net increase in state revenue.” “The one thing elected officials should be able to agree on is that global warming shouldn’t be used as an excuse to hike taxes on citizens and businesses,” said AFP-WI State Director Mark Block. “We encourage all of Wisconsin ’s elected officials and candidates for elected office to sign the pledge.” Proposed cap-and-trade legislation on the federal level, introduced by Sens. Joe Lieberman (I-CT) and John Warner (R-VA), is scored by the Congressional Budget Office as a net revenue increase of $1.2 trillion within just the first 7 years the bill is in effect. “Using the guise of climate change to transfer dollars from hard-working citizens to bureaucratic big government is unacceptable,” said Block. “Regardless of their stance on global warming, this should be common ground for all of our elected officials at all levels of government.” Wisconsin stands to lose up to 34,000 jobs by 2020 and a reduction in gross state product of up to $3.7 billion per year, in the same period. Additionally, gas and electricity prices would soar over 21 percent and 31 percent respectively, according to a study by the American Council on Capital Formation. The pledge is available online at www.NoClimateTax.com. AFP does not endorse candidates. All elected officials and candidates are encouraged to sign the pledge and go on the record in opposition to using the climate change issue to increase taxes and grow the size of government. Americans for Prosperity (AFP) is the nation’s premier grassroots organization committed to advancing every individual’s right to economic freedom and opportunity. AFP believes reducing the size and scope of government is the best safeguard to ensuring individual productivity and prosperity for all Americans. AFP educates and engages citizens in support of restraining state and federal government growth, and returning government to its constitutional limits. For more information, visit www.americansforprosperity.org. # # # Mon, 28 Jul 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13395&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13395&mname=Article Minimum Markup Law Under Fire Study: Law Has Bigger Effect On Gas Cost As Wholesale Price Rises By Jason Stein, Wisconsin State Journal As gas prices have soared, so has the effect of a Depression-era state law that mandates gas stations mark up the price at the pump, a new study by a conservative research group argues. The state law requires filling stations to raise the wholesale price of gas by 9.2 percent. That was one thing 10 years ago when the wholesale price of gas was 64 cents a gallon; the effect is far greater when the price is $3.29 a gallon like it is now, the Wisconsin Policy Research Institute said. "Consumers should be irate," said Christian Schneider, the report's author. "It shouldn't be the government's job to make sure that they're paying more for gas." The study was harshly criticized by those who see the law as a needed defense for mom-and-pop filling stations against big business, even though the full markup is often not imposed. It comes as state lawmakers renew a call to repeal the controversial minimum markup law. The 1939 law is meant to ensure competition and help consumers by preventing big gas sellers, then the Standard Oil Co. and today giant retailers such as Wal-Mart, from driving smaller stations out of business with low prices only to jack them up later. With retail gas prices hitting more than $4 a gallon earlier this month, the markup law calls for upping the wholesale price of gas by as much as 30 cents a gallon, a more than 400 percent increase from the 5.9 cents a gallon mandated in January 1998, the study found. That's nearly equal to the 32.9 cents per gallon the state charges in gas taxes. After allowing for what gas stations would normally charge to make a profit without the law, the markup could add up to 8 cents a gallon, or $278 million a year, in extra costs for state motorists at recent gas prices, the study estimates. Full markup not common A representative of the state's small gas stations ridiculed that claim, saying that in practice gas stations don't usually impose the full markup. That's because a clause in the law allows retailers to lower their price to meet those of a competitor, including those across state lines where gas taxes are lower, said Matt Hauser, president of the Wisconsin Petroleum Marketers and Convenience Stores Association. "That (study) assumes that every gallon of gas sold in Wisconsin includes a 9 percent markup," Hauser said. "That's just not happening." In Madison, the average price of gas was near its peak on July 17 at $4.08 per gallon, Hauser said. Assuming a $3.42 wholesale price and allowing for state and federal taxes, the average markup for stations that day was about 15 cents - half of what they could have received under the markup law - and actual profits were just pennies on the gallon, he said. In the long run, the law keeps prices lower by ensuring competition, Hauser said, citing a 2001 study done for his group. Even though the full markup isn't common, he said, the law provides a recourse for gas stations that see their prices severely undercut by a competitor. "Mom-and-pop stations are alive and well here," he said. "The big retailers know that once they push them out, they're not coming back." Andy Reschovsky, a UW-Madison economist, agreed that repealing the law probably would hurt some smaller retailers. But that's only because it likely has kept prices artificially higher than they otherwise would be, he said. The government doesn't set minimum profits on a bag of groceries or a hamburger and fries at a fast-food restaurant, Reschovsky said. "Why is it different for gasoline?" Call for change Wisconsin is one of 18 states with laws barring retailers from selling gasoline below their cost. The law has survived a number of challenges from both Republicans and Democrats in recent years. On Tuesday, state GOP Reps. Leah Vukmir, of Wauwatosa, and Bill Kramer, of Waukesha, urged Democratic Gov. Jim Doyle to call a special session to repeal the markup law. Doyle, who also supports repealing the law, said Wednesday he wouldn't call lawmakers back into session if "the votes aren't there." Doyle said eliminating what he sees as an antiquated law would help drivers but won't eliminate the unwelcome reality of $4-a-gallon gas. "It would help on the margins but not in a major way," he said. Pam Moen, spokeswoman for AAA Wisconsin, said that was reason enough to dispense with the law. "It's doing more harm than good," Moen said. But Ed Francois, of Belleville, doesn't see it that way. His business, Francois Oil, runs 12 gas stations in Dane and surrounding counties and supplies other independent stores with fuel. A strong advocate of the law, Francois said the markup law is the only thing that allows him to be able to continue serving his customers. "It's protecting a guy like me against Wal-Mart," Francois said. "With this law off the books, I will be history. It will take five years but it will happen." Read the report http://www.wpri.org/Reports/Volume21/Vol21No6/Vol21No6p1.html PRO Wisconsin's minimum markup law ensures competition by barring large retailers from undercutting mom-and-pop filling stations only to raise their prices later. Few stations impose the full markup anyway. CON The law artificially inflates prices. The state also doesn't set a price floor for other goods; why should it require retailers to raise gas prices? Thu, 24 Jul 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13428&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13428&mname=Article Wisconsin’s markup law adds 8 cents to gallon of gas, study says By Stacy Forster and Patrick Marley Milwaukee Journal Sentinel Madison - A Depression-era state law adds about 8 cents for every gallon of gasoline purchased in Wisconsin, costing the state's drivers as much as $278 million more a year, according to a report to be released today. The 1939 Unfair Sales Act mandates a minimum markup on certain products, including gas, to protect against predatory pricing that could force smaller operations out of business. The report by the Wisconsin Policy Research Institute, a Thiensville think tank generally associated with conservative policies, said that as the wholesale price of gasoline increases, so does the impact of the minimum markup law. The law requires a 9.18% markup, which would be 30.2 cents a gallon when the wholesale price of gas is $3.29. Without the law, retailers would mark up gas about 22 cents a gallon as their share of the sale, according to the report. So the law means gas here costs 8 cents higher than it otherwise would. "The fact that minimum markup climbs at the same rate that wholesale gas climbs is a double whammy for consumers," said Christian Schneider, senior fellow at the institute. Supporters of the law argue that the report is flawed because it assumes gas stations always charge 9.18% above wholesale. The law allows them to mark gas up less than that to meet competitors' prices. The report calls for the repeal of the law, or, at minimum, for the Legislature to cap the per-gallon markup at 21 cents a gallon, where it was a year ago. "Rather than government continuing to skew the market and funnel profits to gas stations, they can provide citizens with instant relief," the report says. Democratic Gov. Jim Doyle has long opposed the law and called for its repeal, but despite efforts by pockets of lawmakers, the Legislature hasn't moved to get rid of it. When it was originally passed, the law set the floor on the price of gas at 6% above actual costs. The law was amended in 1998 and the floor was set at 9.18% above the average terminal cost in most cases. The average price of regular gas in Wisconsin is now $3.985, according to AAA's Daily Fuel Gauge Report. That includes 32.9 cents for the state gas tax and 18.4 cents for the federal gas tax. Matt Hauser, president of the Wisconsin Petroleum Marketers & Convenience Store Association, said retailers are lucky to make 2 or 3 cents a gallon. Credit card fees can eat up as much as 12 cents a gallon, he noted. He said the law saves drivers tens of millions of dollars a year because it prevents large businesses from driving small companies out of business by temporarily selling gas at a loss and then raising prices. "The act serves as a great way to show when predatory pricing occurs," he said. U.S. Magistrate Judge William Callahan last year held that the law is unconstitutional, but his ruling did not strike down the law because the state was not a party to the case, in which one gas station accused another of predatory pricing. Bill goes nowhere State Reps. Bill Kramer (R-Waukesha) and Leah Vukmir (R-Wauwatosa) introduced a bill this session to repeal the minimum markup law and replace it with a new law that would have limited the Legislature's ability to set prices. The bill didn't get a committee hearing and died at the end of the session. The pair this week asked Doyle to call a special session of the Legislature to repeal the law. Doyle said he appreciates bipartisan support for a repeal, but without legislative leaders pledging it would pass, he's not planning to call a special session. "If the legislative leaders came and said they actually want this called and that they have votes to get it passed, I'd be glad to do it, but I'm not going to do it to have nothing happen," Doyle said. Senate Majority Leader Russ Decker (D-Weston) and Assembly Speaker Mike Huebsch (R-West Salem) in the past have supported the law. Doyle said he thought repealing the law would help "on the margins" but that more would need to be done to lower gas prices. "These gas price problems are all over the United States - it's not like Wisconsin is some island," Doyle said. The issue is also getting renewed attention this campaign season as voters' wallets are hard hit by rising gas prices. Kramer said he's knocked on 6,000 constituent doors recently and the No. 1 issue he hears about is gas prices. "We're hoping there's enough of a groundswell we can get it moving," Kramer said. State Senate candidate Chad Fradette, a Republican running against Sen. Dave Hansen (D-Green Bay), has made it a central issue in that race. "I don't think it's fair when government tells (gas station owners) how to conduct business," Fradette said. Hansen said he supports leaving the law in place to protect small businesses. "You're looking at a small piece of the pie," Hansen said. Stone offers alternative Rep. Jeff Stone (R-Greendale) suggested lawmakers could replace the law with one that requires larger companies to maintain uniform prices across the state or regions of the state. That would prevent them from going into small markets with an eye toward driving mom-and-pop shops out of business. "Gasoline . . . is not truly a competitive market," he said. "There's not that many players. The potential for large players to dominate is extremely strong." Wed, 23 Jul 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13381&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13381&mname=Article Study attacks gasoline minimum markup law By JASON STEIN 608-252-6129 Wisconsin State Journal As gas prices have soared, so has the effect of a Depression-era state law that mandates gas stations mark up the price at the pump, a new study by a conservative research group argues. The state law requires filling stations to raise the wholesale price of gas by 9.2 percent. That was one thing 10 years ago when the wholesale price of gas was 64 cents a gallon; the effect is far greater when the price is $3.29 a gallon like it is now, the Wisconsin Policy Research Institute said. "Consumers should be irate," said Christian Schneider, the report's author. "It shouldn't be the government's job to make sure that they're paying more for gas." The study was harshly criticized by those who see the law as a needed defense for mom-and-pop filling stations against big business, even though the full markup is often not imposed. It comes as state lawmakers renew a call to repeal the controversial minimum markup law. The 1939 law is meant to ensure competition and help consumers by preventing big gas sellers, then the Standard Oil Co. and today giant retailers such as Wal-Mart, from driving smaller stations out of business with low prices only to jack them up later. With retail gas prices hitting more than $4 a gallon earlier this month, the markup law calls for upping the wholesale price of gas by as much as 30 cents a gallon, a more than 400 percent increase from the 5.9 cents a gallon mandated in January 1998, the study found. That's nearly equal to the 32.9 cents per gallon the state charges in gas taxes. After allowing for what gas stations would normally charge to make a profit without the law, the markup could add up to 8 cents a gallon, or $278 million a year, in extra costs for state motorists at recent gas prices, the study estimates. Full markup not common A representative of the state's small gas stations ridiculed that claim, saying that in practice gas stations don't usually impose the full markup. That's because a clause in the law allows retailers to lower their price to meet those of a competitor, including those across state lines where gas taxes are lower, said Matt Hauser, president of the Wisconsin Petroleum Marketers and Convenience Stores Association. "That (study) assumes that every gallon of gas sold in Wisconsin includes a 9 percent markup," Hauser said. "That's just not happening." In Madison, the average price of gas was near its peak on July 17 at $4.08 per gallon, Hauser said. Assuming a $3.42 wholesale price and allowing for state and federal taxes, the average markup for stations that day was about 15 cents — half of what they could have received under the markup law — and actual profits were just pennies on the gallon, he said. In the long run, the law keeps prices lower by ensuring competition, Hauser said, citing a 2001 study done for his group. Even though the full markup isn't common, he said, the law provides a recourse for gas stations that see their prices severely undercut by a competitor. "Mom-and-pop stations are alive and well here," he said. "The big retailers know that once they push them out, they're not coming back." Andy Reschovsky, a UW-Madison economist, agreed that repealing the law probably would hurt some smaller retailers. But that's only because it likely has kept prices artificially higher than they otherwise would be, he said. The government doesn't set minimum profits on a bag of groceries or a hamburger and fries at a fast-food restaurant, Reschovsky said. "Why is it different for gasoline?" Call for change Wisconsin is one of 18 states with laws barring retailers from selling gasoline below their cost. The law has survived a number of challenges from both Republicans and Democrats in recent years. On Tuesday, state GOP Reps. Leah Vukmir, of Wauwatosa, and Bill Kramer, of Waukesha, urged Democratic Gov. Jim Doyle to call a special session to repeal the markup law. Doyle, who also supports repealing the law, said Wednesday he wouldn't call lawmakers back into session if "the votes aren't there." Doyle said eliminating what he sees as an antiquated law would help drivers but won't eliminate the unwelcome reality of $4-a-gallon gas. "It would help on the margins but not in a major way," he said. Pam Moen, spokeswoman for AAA Wisconsin, said that was reason enough to dispense with the law. "It's doing more harm than good," Moen said. But Ed Francois, of Belleville, doesn't see it that way. His business, Francois Oil, runs 12 gas stations in Dane and surrounding counties and supplies other independent stores with fuel. A strong advocate of the law, Francois said the markup law is the only thing that allows him to be able to continue serving his customers. "It's protecting a guy like me against Wal-Mart," Francois said. "With this law off the books, I will be history. It will take five years but it will happen." Wed, 23 Jul 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13382&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13382&mname=Article Rx: Unleash forces of a free market Charlie Mathews Manitowoc Herald Times Reporter "I want to thank Leah for helping to derail the socialized medicine train in Wisconsin," Michael Fredrich, Manitowoc Custom Molding president and forum moderator, said of state Sen. Leah Vukmir, R-Wauwatosa. "Unlike the proponents of Healthy Wisconsin, I don't believe the problems of health care can be solved with a government takeover," Vukmir told an audience of about 75 people at the Wisconsin Maritime Museum. Sponsored by Wisconsin Manufacturers & Commerce, Americans for Prosperity, and National Federation of Independent Business-Wisconsin, other speakers included Steve Moore, senior economics writer with The Wall Street Journal; Gerald Frye, president of Pewaukee-based Benefit Services Group; and George Lightbourn, executive vice president of the Wisconsin Policy Research Institute. Frye said Healthy Wisconsin's $15.2 billion price tag, financed by payroll taxes, would make Wisconsin a less desirable state in which to do business. "Wisconsin also would become a health-care magnet, providing coverage to all Wisconsin residents, including illegal aliens," Frye said. He contended the plan would result in health care rationing and lower quality. State Sen. Jon Erpenbach, a Healthy Wisconsin supporter, released a statement Thursday accusing plan opponents of using "scare tactics to defend the status quo ... "By using the buying power of the people of Wisconsin to negotiate drug prices, streamlining administration, discouraging inappropriate emergency room visits, and encouraging healthy lifestyles and preventive care, Healthy Wisconsin will save an estimated $1.3 billion per year," Erpenbach stated. Lightbourn couldn't disagree more. He said Healthy Wisconsin supporters are engaged in an "elegant deception." "Once something like this has been adopted, there is no going back," Lightbourn said. "The health-care system, with the level of care and comfort we have today, would be in jeopardy." The four speakers acknowledged the need for health-care reform but advocated free-market solutions. "We have a variety of proposals aimed at shaking up the system through real competition ... focusing on high health-care costs," Vukmir said of state Republican initiatives. "People need to have the freedom to shop for insurance products that meet their needs," Vukmir said. "You can buy car or life insurance from other states, but not health insurance. That would bring an enormous amount of competition into the mix." She said current state mandates stifle competition. The legislator said true health-care reform would create a "paradigm shift, putting individuals, not the government in charge of their health care." Vukmir said the changes she advocates would lower cost, improve quality, and spur innovation by health-care providers. Moore said Wisconsin would be making a major mistake if Healthy Wisconsin became law, increasing, he said, employers' cost of doing business. "You can't tax the businesses that would move out of state," he said. Fri, 20 Jun 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13378&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13378&mname=Article Event criticizes Healthy Wisconsin Emily Banks Eau Claire Leader-Telegram staff A crowd of local residents and a handful of state politicians gathered Thursday to hear the argument against government-organized health care. The majority of the evening's speakers, which included Rep. Leah Vukmir, R-Wauwatosa, and a Wall Street Journal writer, focused on not raising taxes and squashing Healthy Wisconsin. The event was organized by Americans for Prosperity, an anti-tax increase group, and drew about 130 people. Despite the subject matter being against Healthy Wisconsin, a bill that would provide health care for all Wisconsin residents and was supported mainly by Democrats, Sen. Pat Kreitlow and Rep. Jeff Smith, both local Democratic representatives, attended the event. Vukmir said if health care were a free market, competition would cause prices to drop. Making people more informed about the costs of health care would help them make better decisions - like not going to the emergency room for a hangnail, she said. Instead of the government establishing health care, it should "inject competition" into the sector. Another speaker, insurance executive Gerald Frye, said Wisconsin would become a "health care magnet" if Healthy Wisconsin passed in the state Assembly. The state Senate has already passed it. The bill would provide coverage to all Wisconsin residents, including illegal immigrants, pregnant women, domestic partners and dependent children - all of which Frye was against. Kreitlow didn't agree and called Frye's words "ugly fear-mongering we reject in this state," in an interview. He said he attended the event, where many attendees wore Republican Party pins, to monitor what the bill's opponents are saying so he can "correct the record and point out that this is a group that has not and cannot propose a plan of their own because they do not want things to change." Kreitlow said much of what the speakers said at the event was misinformation. And when Vukmir told the crowd it bothers her when people give misinformation, Kreitlow said he wanted to tell her he agrees. Thu, 19 Jun 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13377&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13377&mname=Article Update: Assembly narrowly approves budget repair bill By Wheeler News Service Wisconsin lawmakers have approved their prescription for curing the state budget, something the governor has already said he won't take. The Assembly voted 51-46 yesterday in favor of a plan to wipe out a revenue shortfall of just over $526 million, sending it to Gov. Jim Doyle. It does not include the hospital tax Doyle wanted. It does push millions in state school aid into the next budget and it refinances the state's future payments from the tobacco lawsuit settlement to grab an extra $200 million now. Doyle opposes both, and he promises to use his line-item veto power extensively. Rep. Leah Vukmir, R-Wauwatosa, scolded her colleagues for not having the backbone to cut spending. Rep Frank Boyle, D-Superior, said the measure will come back to bite the state in the future. Leaders of both houses said the package is far from perfect, but it's the only one they can pass in a split Legislature - an Assembly run by Republicans, and a Senate ruled by Democrats. Only 32 of the 52 Assembly Republicans voted yes, and 19 Democrats joined them. Rep. Ann Hraychuck, D-Balsam, and Rep. Barb Gronemus, D-Whitehall were the only two area lawmakers to vote against the measure. Thu, 15 May 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13439&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13439&mname=Article The budget repair bill has earned final approval in the state Assembly By Andrew Beckett . - Wisconsin Radio Network (WRN) Lawmakers approved the measure Wednesday on a 51-46 vote. It had already passed the Senate earlier this week. Assembly Speaker Mike Huebsch (R-West Salem) says changes were needed to close a $527 million hole in the current state budget. The Speaker says Wisconsin and its residents are facing tough financial times, and action was needed to address the problems from the budget shortfall. The bill faced harsh criticism from both Democrats and Republicans. State Representative Leah Vukmir (R-Wauwatosa) was among those who argued that lawmakers should be focusing on overspending, rather than just pushing off the current problems to the next budget cycle. Madison Democrat Spencer Black attacked a plan to re-finance $209 million in tobacco settlement funds. He argued it could result in major fiscal problems down the road, if the settlement money falls short. The bill now heads to the Governor, who could use his veto pen to make changes. AUDIO: Andrew Beckett reports (MP3 1:10) Wed, 14 May 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13380&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13380&mname=Article State budget passes test, heads to Doyle By Scott Bauer - Associated Press MADISON - Gov. Jim Doyle now gets his chance to change a bill intended to fix the state's $527 million budget shortfall. The budget bill cleared the Republican-controlled Assembly on Wednesday, the day after it passed the Democratic-led Senate. Doyle is expected to issue his vetoes within days. He's already said he's unhappy with major parts of the plan, including a $125 million delay in school aid payments and a $209 million refinancing of tobacco bonds. "The governor does not believe you solve a budget gap by pushing off school aid payments, and he believes the Legislature went too far in taking money from the tobacco settlement fund," said Doyle spokeswoman Jessica Erickson. The plan that passed the Legislature also takes back $22 million set aside to comply with a federal law to make driver's licenses more secure, taps $97 million from reserves and imposes $15 million more in taxes on some businesses. Doyle has said he would prefer to help balance the budget by taking more money from the state's transportation fund, to be replaced with additional borrowing. He also proposed $111 million in cuts to state spending, while the plan that passed cuts just $69 million. The Assembly passed the budget 51-46, with one vote more than the 50 needed. A roll call vote was delayed due to a technical glitch resulting in the vote not being recorded properly. Legislative leaders and staff of the clerk's office examined an image taken from the WisconsinEye television broadcast of the vote board to re-create the tally and record it in a roll call format. Thirty-two Republicans and 19 Democrats voted in favor of it, compared with 19 Republicans and 27 Democrats against. In the Senate, the vote ran along party lines except for one Democrat who joined Republicans opposed to it. The budget plan was attacked by lawmakers on both sides in the Assembly. "We need to start over," said Rep. Leah Vukmir, R-Wauwatosa. "We need to get serious and we need to address our fiscal problems right now." Vukmir said she hoped Doyle would veto the entire bill. Rep. Spencer Black, D-Madison, also took issue with the proposal, especially a plan to refinance and sell tobacco bonds to get $209 million. All the deal does is push off the state's financial problems into the future, he said. Even those who put the deal together said it had problems, but they defended it as the best agreement they could reach. "Frankly, if any of these were good ideas, we would have done them already," said Assembly Speaker Mike Huebsch, R-West Salem. "All of us would prefer changes." Lawmakers missed opportunities to make the deal better by imposing a new tax on hospitals to generate more federal money or paying for a new commuter rail line connecting Kenosha, Racine and Milwaukee, said Minority Leader Jim Kreuser, D-Kenosha. The budget shortfall is blamed primarily on a faltering economy. Even with the changes being made under the bill, state government is projected to be $1.7 billion short of meeting its expenses by July 1, 2011. That problem will have to be fixed in the next budget that Doyle releases in February. Wed, 14 May 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13379&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13379&mname=Article Great Lakes compact passes Measure awaits Doyle's signature; Assembly narrowly OKs budget-repair bill May 14, 2008 By Stacy Forster and Patrick Marley Journal Sentinel Madison - Both houses of the Legislature overwhelmingly approved the Great Lakes compact Wednesday, sending it to Gov. Jim Doyle and putting pressure on the states that have not yet ratified it. The Assembly also narrowly approved the budget-repair bill passed by the Senate Tuesday. That package now heads to Doyle, who has said he will rewrite it with vetoes. Lawmakers praised passage of the compact as a historic step for Wisconsin - as well as the other seven Great Lakes states. They said it would protect a resource critical to the state's culture and economic development and give thirsty communities in southeastern Wisconsin a path for tapping Great Lakes water. The compact is an agreement by eight Great Lakes states and two Canadian provinces to protect the lakes from large-scale water diversions and promote water conservation. It passed the state Senate 32-1 and the Assembly 96-1. Sen. Mary Lazich (R-New Berlin) and Rep. Sheryl Albers (R-Reedsburg) were the only legislators to oppose it. It now heads to the desk of Doyle, who has pledged to sign it. "Wisconsin has been blessed with one of the world's most incredible natural resources," Doyle said in a statement. "In a world where water is becoming more precious, the Great Lakes help Wisconsin businesses grow and attract new businesses to our state." Concern that states to the west and south will look to divert water from the Great Lakes has added urgency to efforts to protect them. "The waters of the Great Lakes do not belong to Wisconsin, they do not belong to Michigan, they do not belong to New York," said Sen. Mark Miller (D-Monona), who helped craft the legislation. "They do not belong to any state. They belong to all of us. They are a shared resource." A majority of the Great Lakes states have now approved the compact; Wisconsin joins Minnesota, Illinois, Indiana and New York in passing it. Once it is ratified in the remaining states - Michigan, Ohio and Pennsylvania - it must be ratified by Congress. The Wisconsin Senate first voted on the compact in March, but the Assembly objected to certain provisions and didn't act on it before the regular legislative session ended. After negotiations between Doyle's staff and legislative leaders yielded a deal, Doyle last month called a special session of the Legislature. Rep. Scott Gunderson (R-Waterford), who worked with Miller on the bill, noted there were doubts that he and Assembly Republicans would pass a compact but said it was necessary to address concerns before adopting the compact. "We've got something that will protect the Great Lakes for generations to come," Gunderson said. "Sometimes you've just got to sit back, take a breath, do our work and communicate, and when we do that we come up with historic legislation as we have before us today." Although there were some changes made to plans for implementing it, the compact's original language was untouched, including the element to which some objected - that one of the eight governors could stand in the way of any future water diversion to a community entirely outside the Great Lakes basin. Local diversions possible The clearing of a path to Great Lakes water is important for communities such as New Berlin and Waukesha. The compact blocks diversions outside the basin but grants exceptions to communities and counties that straddle the Great Lakes basin dividing line if treated wastewater is returned to the lakes. Communities denied diversions that otherwise meet criteria in the compact may appeal and sue. Passage of the compact earned praise from local leaders and conservation groups throughout the state. Waukesha Mayor Larry Nelson said the legislation provides clear guidelines for communities such as Waukesha. "We need a new water supply, and Lake Michigan would be the most sustainable choice," Nelson said. "This legislation will allow us to pursue that option." Jodi Habush Sinykin, a lawyer from Midwest Environmental Advocates, said the deal was "a strong, protective compact." Anne Sayers, program director for the Wisconsin League of Conservation Voters, said passage of the compact was critical because other states are looking anywhere they can to solve their water problems. "The fact that we have 20% of the world's fresh water sitting in the Great Lakes has not gone unnoticed by other thirsty states," she said. Passage in Wisconsin puts pressure on the remaining statesto move the compact forward. "It will create a domino effect, and other states will follow suit," Miller said. Sharon Cook, water conservation program director for the Alliance for the Great Lakes, said Wisconsin's ability to pass a bill despite some of the challenges the state faced sends a message to others it can be done. Albers and Lazich said there were too many unanswered questions about the effect of the compact, prompting their "no" votes. "The broadness of the document, the lack of definition of what's going to happen in the future, gives me pause," Lazich said. Budget bill In other action, the Assembly approved 51-46 a package to repair the state budget. Nineteen Democrats joined 32 Republicans to push the bill through the GOP-controlled house. Members of both parties bashed the deal on the Assembly floor, calling it irresponsible for refinancing the state's tobacco settlement payments, relying on what they called accounting tricks and not making tougher budget cuts. "If we cannot find the resolve to actually cut spending in an economic downturn, we will never be able to do so," said Rep. Leah Vukmir (R-Wauwatosa). "This is horrible policy - policy that is going to come back to bite you in the future," said Rep. Frank Boyle (D-Superior). Leaders from both parties said the deal was flawed but that it was the only one they could get through a split Legislature. Doyle has said he dislikes major aspects of the bill and will rewrite it with his powerful veto pen. Lawmakers passed a two-year budget in October, but adjustments are needed because tax collections are now expected to be $652 million lower than first projected. Journal Sentinel reporters Darryl Enriquez in Waukesha and Dan Egan in Milwaukee contributed to this report. Wed, 14 May 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13394&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13394&mname=Article Smoking ban passes Assembly committee By Andrew Beckett, WRN Legislation creating a statewide smoking ban advances out of an Assembly Committee. The bill was passed by the Assembly Public Health Committee Tuesday on a 6-3 bi-partisan vote. State Representative "Doc" Hines (R-Oxford), who chairs the panel, says it's about the public health and the health of the citizens of the state of Wisconsin. The proposal would ban smoking in all public places by January 1, 2009. The committee rejected an amendment that would have extended the deadline for taverns to go smoke free until 2011. State Representative Spencer Black (D-Madison) says it protects the health of customers and those who work in bars and restaurants. He says it's not right to force employees to work in environments that can harm them. The vote comes as the Governor joins with Tour de France champion Lance Armstrong to push for a statewide smoking ban. Wauwatosa Republican Leah Vukmir was among members voting against the bill. Vukmir says the bill denies business owners the right to decide what goes on in their establishments. The bill now heads to the Assembly floor, but it's uncertain if it will get a vote before the end of the session. AUDIO: Andrew Beckett reports (MP3 1:07) Tue, 04 Mar 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13441&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13441&mname=Article Cyclist Lance Armstrong stumps to stub out smoking in Wisconsin as state Assembly committee OKs plan by Scott Bauer (AP) MADISON, Wis. (AP) - Cycling champion Lance Armstrong planned Tuesday appearances to urge Wisconsin to pass a comprehensive state smoking ban, while opponents continued to hold out for exemptions that would protect taverns for at least a couple of years. Armstrong's noon rally in Madison, followed by a news conference at a bar in the Milwaukee suburb of Shorewood, comes as lawmakers plan to end their work for the year in a matter of days. While there's still time for a ban to pass, proponents have not been able to reach a deal with the powerful Tavern League lobby. Tavern owners want to allow smoking to continue in their establishments until at least 2011, while it would be banned in other places starting in January. The American Cancer Society in Wisconsin and other supporters of the ban argue there is no reason to delay the ban for bars and it should start at the same time for everyone. Gov. Jim Doyle has made passing the ban one of his top priorities and asked Armstrong to help galvanize public support for the ban. Since retiring from racing, the seven-time Tour de France winner has been a vocal advocate for increasing cancer funding. He successfully lobbied the Texas Legislature and campaigned for a $3 billion bond issue for cancer research that voters approved last year. Supporters of the smoking ban saw some progress Tuesday when the Assembly Public Health Committee voted 6-3 for a bill that would enact the ban for everyone in January. But without a compromise with bar owners, the bill is unlikely to be brought up for a vote in the Republican-controlled Assembly. "All the media attention and bringing Lance Armstrong here hasn't changed my mind," said Rep. Leah Vukmir, R-Wauwatosa, one of the three members of the Assembly committee who voted against the bill. Acknowledging Armstrong's "Live Strong" motto, Vukmir said, "I prefer to live free." The issue isn't about personal freedom, it's about protecting employees who don't want to work in a smoke-filled environment, said Rep. Spencer Black, D-Madison. The bill is also awaiting debate in the Senate. Majority Leader Russ Decker, D-Weston, has not brought it up for a vote while negotiations have failed to yield a deal. The last scheduled day of the legislative session is March 13. Anything not passed by then will be on hold until at least 2009. Tue, 04 Mar 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13440&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13440&mname=Article Candidates should get tough on health costs By John Torinus, Journal Sentinel After four years of hand-to-hand combat with the beast of health cost inflation, it has become my everlasting contention that business leaders, health care executives and presidential candidates have no real position on the subject if they don't have an aggressive posture on the costs. Why doesn't one of the presidential candidates get to the heart of the issue and say, "It's the costs, stupid!" That plain, Harry Truman-like truth could be followed by the corollary, "It's the incentives, stupid!" and the equally important, "It's management, stupid!" Instead, the debate is off track on the subjects of who pays and who's not covered. Those two questions have become a major issue only since costs have run wild on us. They are serious issues, but they are not the root cause of the economic ills surrounding health care. Now, it would be vapid to say, "It's the costs, stupid!" if the hyperinflation surrounding health care costs were inevitable. But as reforms in the private sector have demonstrated, the costs are not unfixable. It takes good ideas to solve big problems and fortunately new inflation-killers have been discovered by cutting-edge reforms: Consumer-driven health plans work. The combination of high deductibles, co-insurance and personal health accounts provided by employers, puts the patient in the equation as a consumer. Consumers move their business if they don't like a vendor's quality, service and price. My company, Serigraph Inc., went consumer-driven in 2004. Despite a horrendous year for accidents and cancers in 2007, we averaged about a 4% increase in costs over those four years. Bucyrus International went to a consumer-driven health plan last year and is reporting its costs have gone down. Yes, down. KI and Bellin Health in Green Bay employ consumer-driven health plans and are far below the state average for costs. Humana, an early adopter of consumer-driven plans with its own employees in 2002, has held its increases to less than 5% a year. It reports the same kind of results for its customer base with consumer-driven plans. Most of the major health systems in Wisconsin have consumer-driven health plans for their own employees. Shouldn't that tell us something? Lean disciplines work. Every leader in politics, business and health care should spend a day at ThedaCare in Appleton. Under the leadership of CEO John Toussaint, a physician, ThedaCare's work force of 5,500 collaborates in team problem-solving to eliminate all forms of waste. For six years under lean measures, they have driven out millions of defects and errors, thousands of hours of waiting time and millions of dollars in costs.Result? Its prices are far below those we suffer in the Milwaukee area, and its customer satisfaction scores have soared. It's the same saga that took lean pioneer Toyota to the top of the automotive industry. Serigraph offers cash incentives to its workers to go to ThedaCare and equivalent high-value health care providers. Transparency is taking root. Humana and United Healthcare have systems in place to reveal real prices. Anthem Blue Cross & Blue Shield is rolling out its model in Wisconsin this year, and it is partnering with Zagat Survey to put ratings of doctors, hospitals and clinics online. State Rep. Leah Vukmir (R-Wauwatosa) is calling for an estimate of sticker prices for a procedure costing over $500. State Sen. Jim Sullivan (D-Wauwatosa) would require disclosure for major procedures of actual payments under Medicare and Medicaid pricing, as well as average payments to third-party payers. A compromise of some sort will emerge. In short, the transparency trend is irreversible. Technology is starting to reduce costs. Medical technology has often raised costs in the past, but now is starting to cut them. Electronic medical records are eliminating mountains of paper and the accompanying errors. Electronic intensive care units catch potential health failures before they happen. Some drugs eliminate the need for invasive surgeries. In short, technology doesn't have to drive costs and prices up. Prevention, wellness, disease management are taking root. Executives in business and medicine are getting serious about keeping people healthy and out of the hospital. The payoffs will be enormous because the 10% of the people with health failures cause more than half the country's costs.In the end, it's all about rigorous management. The CEOs of this country should offer an apology for letting this mess happen. They are finally engaging because they have learned that hyperinflation in medicine is a threat to the economy that can't be delegated. Sat, 23 Feb 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13442&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13442&mname=Article Will Washington state take Wisconsin's health care sloppy seconds? RedState - Jeff Emanuel At the beginning of this legislative session, State Senator Karen Keiser (D-Kent) introduced legislation that would radically increase government control of health care in the state of Washington. The legislation was based almost entirely on a plan that had been considered – and rejected – a year before by a state halfway across the country. Thanks to the efforts of pro-market legislators like Wisconsin State Rep. Leah Vukmir (R-Wauwatosa), who spent a great deal of time, resources, and political capital educating their fellow representatives, and the state’s voters, about what a poor policy decision it would be to enact the expensive and inefficient program, the 2007 attempt at government-run health care was removed from the state budget it had been inserted into, and was scrapped entirely. Though Wisconsin managed to avert the debacle that the “Healthy Wisconsin” program would have caused in the state’s health care market, the program’s authors did not give up on their dream of subsuming the health care and health insurance markets entirely into a government-run framework. Instead, remaining true to government’s penchant for rehabilitating failed ideas and policies and presenting them – unchanged, but under slightly new names – as new solutions, they simply exported their idea to Washington, where Sen. Keiser was happy to adopt them and to present them as a "solution" to Washington’s health care woes. Read on for more. Keiser did not attempt to hide the fact that her proposal was the exact replica of a horribly failed measure from another state – instead, she flaunted that fact, by actually having Wisconsin State Senator Jon Erpenbach (D-Middleton), primary sponsor of the failed Healthy Wisconsin program, appear in the Washington State Senate with her when she introduced her legislation. Keiser’s bill, SB 6221 (also known as the “Washington Health Partnership”), would, of course, be as bad for the state of Washington as its original form would have been for Wisconsin. Volumes could be written on just why this is, but the simplest explanation can simply be made by dealing with the issue of cost. The Washington Health Partnership is expected by its proponents to cost, at the beginning, around $15 billion per year – most of which would be funded by an increased payroll tax, the rate of which would be set by a board established to oversee the program. The payroll tax rate necessary to raise the $15 billion needed to initially fund the program has been estimated at no less than 14 percent – a significant increase in Washingtonians’ tax burden. In fact, the $15 billion in additional tax revenue needed to get the Washington Health Partnership off the ground represents more in tax revenue than the state currently takes in through sales, income, and corporate taxes combined. As Michael Tanner, the Cato Institute’s director of health and welfare studies, explained during his October 2, 2007 testimony to the Wisconsin Assembly Committee on Health and Health Care Reform (when the Badger State was considering the exact same proposal), the payroll tax would theoretically be “split, with the employee paying four percent and the employer paying 10.5 percent. “But, while it might be politically appealing to claim that business will bear the new tax burden, nearly all economists would see it quite differently. The amount of compensation that a worker receives is a function of his or her productivity. The employer is generally indifferent to the composition of that compensation. It can be in the form of wages, benefits, or taxes. What matters is the total cost of hiring that worker. Mandating an increase in the cost of hiring a worker by adding a new payroll tax does nothing to increase that worker’s productivity. Employers will therefore seek ways to offset the added cost by raising prices (the most unlikely solution in a competitive market), lowering wages, reducing future wage increases, reducing other benefits (such as pensions), reducing hiring, laying off current workers, or outsourcing. In the end, one way or another, workers will bear the full cost.” Further, small businesses – the life’s blood of America’s state and national economies – will be hardest hit by the severe payroll tax increase. Most small businesses pay less than ten percent payroll tax, and few provide health insurance. Therefore, these businesses will see their tax burdens per worker skyrocket without any corresponding savings that would come from no longer having to provide employee health plans. In order to relieve themselves of this added hardship, businesses can – and will – leave the state as a result of the Washington Health Partnership’s passage. Given that Washington’s tax burden is already significantly worse than its neighboring states, the increased weight of the Washington Health Partnership is an almost certain recipe for slowed economic growth and lost jobs. The non-partisan Tax Foundation currently ranks Washington 16th in the nation in terms of state and local tax burden (rankings go from 1=highest tax burden to 50=least tax burden). By comparison, Idaho ranks 35th, Oregon 37th, and Montana 41st. Washington state has been enjoying moderate job growth in recent months and years. Passing a bill like SB 6221 would do much to reverse that trend, and would severely damage the state’s economy – not to mention the state’s health insurance and care market. Even if businesses do not relocate to escape the increase in their payroll costs, the national rate of health care inflation is too far ahead of projected wage and revenue increases for the Washington Health Partnership to avoid running a sever deficit within the next few years. Further, with its health care-by-geographical-area framework, Sen. Keiser’s retread proposal would not only eliminate consumers’ ability to choose their providers, but would, in Tanner’s words, “set up a perverse set of incentives that will encourage healthy and insured residents to move out of state, while also encouraging uninsured and sick from out of state to relocate to, or at least take jobs,” in Washington. This would significantly strain the health facilities in the state’s border areas, acting as a magnet for those to whom it alone extends coverage, such as undocumented immigrants and extends low-income pregnant women. This outcome would increase program costs exponentially, while also creating several other problems for Washington state. Beyond these issues, the Washington Health Partnership would create a situation in which health care is rationed and prices are inflated due to the outlawing of competition. Rather than cause serious damage to the health care market and to the state’s economy as a whole, Washington should seek common sense reform to help solve the health care crisis. Opening up the market to greater competition, decreasing the number of procedures and operations whose coverage is mandated by law from the current total of 23 – including “port wine stain” birthmark removal – would do a great deal to alleviate the current biggest problem with health insurance: its affordability. Further, the state should amend its insurance laws to allow the sale of any health insurance plan approved for sale by any state – something which is not allowed by most states, but which would work wonders in bringing down health insurance costs through the tried-and-true method of simple competition. Regardless where Washington goes from here, further regulation of its health care market will only serve to exacerbate the state’s problems. Instead of repackaging recently failed attempts to legislate an area of the market that is already suffering from over-regulation, the state legislature of Washington should seek out real reform – reform that would decrease government involvement, increase consumer choice, and work to the benefit of the market as a whole. Disclosure: Jeff Emanuel is Research Fellow for Health Care policy at The Heartland Institute and is managing editor of Health Care News. Wed, 06 Feb 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13376&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13376&mname=Article The right to buy a cure By Patrick McIlheran Journal Sentinel - Right On Blog Interesting, that a couple of lawmakers are proposing to enshrine in Wisconsin's constitution the right to buy health insurance. What they're really doing, say west suburban Republicans Leah Vukmir and Ted Kanavas, is throwing a spike into the kind of compulsory plan Democrats were proposing with Healthy Wisconsin, wherein everyone would have to get health insurance through a state-run "market" and all the plans would be state-designed. You'd apparently still have to pay for such a thing via taxes, but at least you could opt out of government control. At first this struck me as fairly symbolic at best. On reconsideration, it's not such a small thing. Here's why: While Healthy Wisconsin contends its really "managed competition," no details are certain until they're law. And there are plenty of people who would prefer details much more like Canada's system -- a single-payer plan, in which the state simply handles all the money. One remarkable feature of Canada's system is that private insurance is generally banned: Everyone has to be on the government system -- and that alone, at least in theory. Britain, with a single-payer plan, isn't quite like that. Everyone pays, extortionately, but people can buy private insurance so they can actually be treated instead of lying for days on a gurney in a hallway. Canada? No go, and there a great deal of sentiment that allowing people to buy private insurance would "privatize" care or allow a "two-tier" system to emerge -- similar to the kinds of complaints one hears now from single-payer advocates here. Anyhow, some Canadians -- the ones in Quebec -- can buy health care on their own if the government doesn't satisfy. But it took a Supreme Court decision to get them that ability. And that decision didn't apply to other provinces, where people are still stuck (pdf) with one option, a government system that's beloved by everyone except for the people who actually have to use it. Something about waiting 42 weeks on average to get treatment for a bad hip must make them grumpy. So Canadians outside Quebec are having to sue to be able to buy health care. In light of that, the amendment from Vukmir and Kanavas takes on some meaning beyond the politics of it. Tue, 05 Feb 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13385&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13385&mname=Article Legislators push amendment to protect private health insurance By Stacy Forster Journal Sentinel - All Politics Blog Madison -- Senate Democrats made a big splash last summer with their universal health care reform plan. But a pair of state lawmakers want to protect residents from government health care plans and their right to have private insurance. Rep. Leah Vukmir (R-Wauwatosa) and Sen. Ted Kanavas (R-Brookfield) are asking fellow members to co-sponsor an amendment to the Wisconsin Constitution that would explicitly give people the right to enter into private contracts with health care providers and to purchase health care coverage. "The Legislature may not require any person to participate in any state-sponsored health care system or plan," the language reads. Vukmir and Kanavas said those rights are fundamental liberties, but are under attack in Wisconsin. "The state should not have the power or authority to compel its citizens to participate in a state-sponsored health care system," they wrote. The amendment would need to pass both houses of the Legislature in two consecutive sessions before it could go to voters. You can read the text of the resolution in the attachment below. Attachment: Resolution.pdf Mon, 04 Feb 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13386&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13386&mname=Article Doyle's idea: Equalized insurance Plan would form health coverage marketplace for small businesses By Guy, Boulton, Journal Sentinel Health coverage for Debbie Wicker and her husband costs $18,500 a year and continues to rise. Her employer, Enterforce, faced a 19% increase in premiums this year if it remained with the same health plan. "People say it's a problem," said Wicker, vice president of operations and strategy for the company, which employs 15 people in Waukesha. "I don't think people realize the extent of the problem." Among the proposals in Gov. Jim Doyle's "state of the state" address last month was an idea that could help small businesses such as Enterforce while bringing sweeping changes to the health insurance market. The proposal hinges on prohibiting health insurance companies from setting rates for small businesses based on the health of their employees. That could lower costs for businesses with older workers or workers with medical problems, while increasing costs for those with healthy, younger employees. But it could protect small businesses - those with 50 or fewer workers - from sharp increases in health insurance rates if an employee racks up large medical bills. Borrowing a page from Massachusetts' recent health care reform, Doyle also wants to set up a marketplace where small businesses could buy health insurance and their employees could pick the insurance company of their choice. To participate, health insurance companies would be required to provide information in a standard format, allowing true price comparisons for competing plans. The goal is to increase competition and potentially slow the rise in costs in a segment of the economy where fewer than half of all businesses offer health benefits to their employees. "This all comes down to an issue of fairness," Doyle said in a written statement. "Why should our farmers, our manufacturers and our service employees have to pay so much more for health care?" None of this is likely to happen until the summer of 2009 at the earliest, if at all. The governor will need to win the backing of the Legislature for a proposal that could face opposition from the insurance industry. The response from both so far has been cautious. Small businesses struggle Many small businesses, which on average bear higher costs than large employers, struggle to offer health benefits to their employees. James Ratchek of Jim's Auto Body in Burlington stopped providing health benefits four years ago. The cost at the time was $48,000 a year. "You can't afford to be in business and pay that kind of money out," said Ratchek. His employees thought they could do better buying their own insurance, and Ratchek gave them raises to offset the cost. Now they want him to provide benefits again, so he's shopping for health insurance once more. He may not like what he finds. Toolcraft Co., a machine shop in Germantown, has seen its health insurance costs increase 42% over the past two years. "It's pretty staggering," said Kathy Rogers, president of the company, which employs about 35 people. She understands well the unpredictability that small businesses face when it comes to insurance rates. "It doesn't take more than one employee to have an issue," Rogers said. Doyle's proposal, called BadgerChoice, would change that - but at a price. Roughly 10 states have similar regulations prohibiting health insurance companies from setting rates for small businesses based on the health of their employees. But the proposal in all likelihood will have some unintended consequences. "This is a tricky regulatory issue," said William Custer, director of the Center for Health Services Research at Georgia State University. Insurers would be forced to compete on price alone, not their ability to predict who could have high medical expenses. But that could hurt smaller insurance companies because they can't spread the increased risk among as many people as their larger competitors. "Companies with smaller market share are more likely to leave the market," Custer said. The benefit is that small businesses would no longer need to worry that they will be priced out of the market if one of their employees has a serious illness. "You don't have to look over your shoulder that, if your co-worker gets cancer, you are going to lose your insurance," said Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology who is advising the state. To Lynn Mahuta, co-owner and chief executive of Mahuta Tool Corp. in Germantown, the tradeoffs would be worth it. "On first glance, this looks like it could help us small employers," she said. Mahuta Tool, which employs 22 people, has hired some older workers. "These are good productive employees," Mahuta said. But how they could affect the company's health insurance rates is a concern. "Every year we are in business," she said, "our group is not as young as it once was." Some say rates would rise Rep. Leah Vukmir (R-Wauwatosa), chairwoman of the Assembly's Committee on Health and Health Care Reform, said she's interested in working with Doyle to find some common ground on market-based solutions, especially for small businesses. But she has concerns about the proposed change in how the state regulates the insurance market for small businesses. "It would be government rate-setting, and historically that usually ends up driving up cost," Vukmir said. Insurance companies, such as Humana and Anthem Blue Cross and Blue Shield, also are wary. Dan Schwartzer, executive vice president of the Wisconsin Association of Health Underwriters, which represents insurance brokers, said the proposed regulatory change would raise rates for the majority of businesses. And Bill Smith, state director of the National Federation on Independent Business, contends that the proposed change would only shift costs. Regulatory change would be needed, though, to set up the insurance marketplace proposed by the governor. The state would solicit bids from health insurers who wanted to participate. The marketplace would be broken into different tiers based on the cost and type of plan. But the information would need to be presented in a standard format. "The hope is you are setting up a marketplace where there can be much more effective shopping," said Gruber, who was involved in designing Massachusetts' sweeping health care reform. Employers would pick the tier for the type of health plan they want to offer their employees. But within that tier, employees could pick the insurance company of their choice. One employee could opt for a Blue Cross plan, for instance, while another could pick a similar plan from UnitedHealthcare. "That's the sort of choice that people in small business don't have today," Gruber said. The standardization could hold considerable appeal to small businesses. "I would welcome an apples-to-apples comparison," said Wicker of Enterforce in Waukesha, a company that manages vendors for Harley-Davidson, We Energies and Actuant. To get quotes from different insurance companies today, she said, each employee would have to fill out a 20-page form. Then there's also the challenge of comparing the competing plans. "Pages and pages of what one covers and what another one covers," Wicker said. "Just unbelievable." The governor's proposal could ease that chore. It also could give small businesses some of the same advantages that large businesses have in providing health benefits. "When Doyle said it is a fairness issue - that's what I really agree with," Wicker said. Stacy Forster of the Journal Sentinel staff contributed to this report. Mon, 04 Feb 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13438&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13438&mname=Article Arizona Health Care Bill Supports Personal Choice (Chicago, Illinois - February 4, 2008) The new year has brought a number of proposals in state legislatures to mandate health insurance and legislate coverage and premiums. Many of these pushes for "universal health care" have involved efforts to amend state constitutions to require increased government interference in the health care market. A fledgling ballot initiative in Arizona is bucking that trend. Instead of amending the constitution to require further government involvement in health care, Arizonans may have a chance to vote this November on a constitutional amendment solidifying their right to make their own health care decisions free of government interference. The effort is being spearheaded by the group Medical Choices for Arizona. Experts contacted by The Heartland Institute offered the following comments about the measure. You may quote from this statement or contact the experts directly at the phone numbers and email addresses provided below. -------------------------------------------------------------------------------- "The fact that private health care is under such a threat that we need a ballot initiative is sad, but in a nation that seems hell-bent on adopting the failed, socialist health care systems of Canada and Europe, explicitly protecting individuals' ability to make health care decisions free of government control is nothing less than the protection of the basic human right to life." Paul J. Gessing President Rio Grande Foundation P.O. Box 40336 Albuquerque, NM 87196 pguessing@riograndefoundation.org 505/264-6090 -------------------------------------------------------------------------------- "In the original U.S. Constitution, the people did not delegate the ability to choose their health care to the government. Nevertheless, governments at all levels in the U.S. have strayed well beyond their competence in this regard. "In such a state of affairs, this is an outstanding and necessary initiative. The tide of government-provided or government-mandated health care is swelling and the people of Arizona, and every state, would benefit from imposing an explicit constitutional limit on their government's power to interfere with their health choices." John R. Graham Director, Health Care Studies Pacific Research Institute 755 Sansome Street #450 San Francisco, CA 94111 jgraham@pacificresearch.org 415/955-6104 -------------------------------------------------------------------------------- "The 'Medical Choice for Arizona' initiative is a common-sense proposal to assure citizens that they will be able to control their own health care and health insurance arrangements without being forced into a state-sponsored system. Americans do have choices today, but we often take them for granted. "In Canada, with its government-run health system, it is generally illegal to purchase health care directly or to buy private health insurance. As we move toward a debate over the future of our health system in America, initiatives like Arizona's could build a firewall to assure people that they can continue to have freedom of choice and control over their health care destiny." Grace-Marie Turner President Galen Institute galen@galen.org 703-299-8900 -------------------------------------------------------------------------------- "It is unfortunate that this basic, fundamental right is under attack and that such an amendment is even necessary. This defense of personal liberty should be presented to the voters in every state. I applaud Arizonans for leading the way." Leah Vukmir State Representative State of Wisconsin Rep.Vukmir@legis.wisconsin.gov 608/266-9180 -------------------------------------------------------------------------------- For more information about The Heartland Institute, please contact Harriette Johnson, media relations manager, at hjohnson@heartland.org or 312/377-4000. Mon, 04 Feb 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=18443&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=18443&mname=Article Repeal Of Minimum Markup Law Unlikely High Gas Prices Not Enough To Lead To Repeal Of Depression-era Law Wisconsin State Journal :: CAPITAL REGION BUSINESS JOURNAL The governor calls it a relic of the 1930s, the Federal Trade Commission says it likely harms consumers and restricts competition, and a judge recently ruled it violated antitrust laws. But - like it or not - Wisconsin's minimum markup law likely isn't going anywhere anytime soon. Though some lawmakers have upped the efforts to end Wisconsin's Unfair Sales Act, a coalition of legislators and interest groups remain firmly entrenched in their determination to keep the 1930s-era law in place. Their main argument is that it protects independent retailers in small markets from being driven out of business by a large, national chain that swoops into town. They fear those big retailers can cut its prices unfairly and drive everyone else out of business, leaving a monopoly for itself. "Bless their hearts, we don't trust the Wal-Marts of the world, and we're not going to anytime soon because we have seen what they have done to the moms and pops, especially in the smaller markets," said Wayne Corey, executive director of the Wisconsin Independent Businesses Inc., which represents small retailers. Lawmakers have tried off and on for years to repeal the law that generally prohibits merchandise from being sold at less than cost with a 9.18 percent markup on alcohol, tobacco and motor vehicle fuel. HIGHER PRICES FOR CONSUMERS At the request of a state lawmaker, the Federal Trade Commission weighed in on the law five years ago, finding that it can ultimately lead to higher prices for consumers, duplicates protections against predatory pricing already found in federal laws and discourages competitive pricing. This fall, a federal magistrate ruled that the law as it applies to gasoline prices violated federal antitrust statutes because Wisconsin officials had failed to properly monitor it. U.S. Magistrate Judge William Callahan noted the law was last adjusted in 1998, when the required markup was changed from 6 percent to 9.18 percent, and gas was going for about a buck a gallon. "Given that a markup of 9 cents per gallon was deemed an accurate estimate of the "costs of doing business" in 1998, it seems curious that a markup of 25 to 30 cents per gallon, which is approximately 200 percent greater than the markup in 1998, is an accurate estimate of the "costs of doing business in 2007," Callahan wrote in the opinion. But the state was not a party to the suit that prompted Callahan's ruling, and he did not issue an injunction ordering Wisconsin officials to cease enforcing the law. Thus, it remains in effect. REPEATS CALL FOR REPEAL Gov. Jim Doyle again stated his opposition to the law following Callahan's ruling and repeated his call for lawmakers to repeal it. He did the same thing following a spike in gas prices in the wake of Hurricane Katrina. But that call didn't get much traction. Former state Sen. Dave Zien, R-Eau Claire, unsuccessfully sought to push through legislation in 2006 that would have repealed the minimum markup on gasoline. A bipartisan group of lawmakers used a procedural vote to nix the bill, which also had bipartisan support. Now, state Rep. Sheldon Wasserman, D-Milwaukee, is pushing legislation that would exempt prescription drugs from the law. In announcing the bill, Wasserman noted that he's supported efforts to end the law in the past, but the chances of the Legislature approving a repeal were "slim." Still, Republican state Rep. Leah Vukmir of Wauwatosa said she hopes the time is right to move forward with a new approach. Along with state Rep. Bill Kramer, R-Waukesha, she has introduced legislation that would repeal the minimum markup law while beefing up state prohibitions on predatory pricing and monopolistic practices. Violating those prohibitions could result in a felony under the bill. PREDATORY PRICING HURTS "No longer will you be able to use the argument that the small mom and pops will be hurt by the Wal-Marts of the world," Vukmir said. "It really can't be said enough that under the current law, consumers are hurt. But real predatory pricing hurts consumers and retailers. We don't want that, either." But any efforts to repeal the law now face uphill battles in both houses of the Legislature. Senate Majority Leader Russ Decker, D-Weston, supports the law, as does Assembly Speaker Mike Huebsch, R-West Salem. It doesn't hurt that Kwik Trip, which supports the law as well, is headquartered in Huebsch's district. With both legislative leaders behind the law, that makes the chances of any changes going through slim. The law also has a broad coalition behind it. When Zien introduced his bill to lift the minimum markup from gasoline, the groups that registered their opposition to the proposal included the Wisconsin Petroleum Marketers & Convenience Store Association Inc., the Wisconsin Farm Bureau Federation, the Tavern League of Wisconsin and even the Outdoor Advertising Association of Wisconsin. Corey, of the Wisconsin Independent Businesses, said his organization has long backed the law because many of the small companies it represents fear being undercut by a national chain. He said that fear was much more intense about a decade ago when Wal-Mart first became a player on the Wisconsin scene. But it's still a very real threat for a good chunk of the organization's constituents. "We have always held the belief that the big guys will do predatory pricing if they get the chance and do harm to the little guys," Corey said. Fri, 01 Feb 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13430&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13430&mname=Article Insurance Plan Praised, But Will It Fly? Doyle's Proposal May Be Resisted By Health Insurance Companies As Well As Both Parties. By Jason Stein, Wisconsin State Journal Gov. Jim Doyle's new health-care proposal holds out an enticing promise - individuals and small businesses would no longer have to fear skyrocketing insurance costs because of a catastrophic disease they can't control. "A horrible illness or accident could happen to any one of us," Doyle said in announcing the program in his State of the State speech Wednesday. "The purpose of health insurance is that we all share the risk." But the up to $100 million plan, called BadgerChoice, hinges on getting insurance companies to charge everyone the same rate regardless of their risk factors or past medical claims. That could have the negative side effect of discouraging healthy individuals from buying insurance, leaving a pool of sicker, costlier consumers, critics said. Doyle's plan drew praise Thursday from policy experts and representatives of small business and the insurance industry for focusing on the smaller companies that most struggle to offer insurance to workers. But the plan is still short on details and it will likely be more than a year before it is even introduced in the Legislature. Even then, parts of the plan could face resistance from business and insurance groups as well as Republican and Democratic lawmakers pursuing their own health-care proposals. Also Thursday, the Legislature's budget director said the state could face a budget shortfall of up to $400 million by June 2009, which could lead to deep cuts in state spending and threaten future programs like BadgerChoice. Governor's plan Doyle's proposal applies to businesses with 50 or fewer employees. It would: Create a Web site and toll-free phone number so workers can easily compare and purchase insurance from among a number of plans. This virtual marketplace, similar to one being used in Massachusetts, would allow workers and businesses to pool their purchasing power and give employees more choices than the one or two plans smaller employers typically are able to offer. Provide a subsidy of up to $100 million to lower costs. That subsidy might come in the form of tax credits to workers or businesses, an insurance program to handle catastrophic health costs, or something else. Require all small businesses to allow their employees to pay for their health insurance costs using pretax dollars. The administration predicts that could save workers $130 million a year in federal taxes. Doyle's plan appealed to Randy Meffert, of Waunakee, who has struggled to keep up with sharp increases in health-care costs for the 46 employees of his gasoline and home heating oil distribution company. "We really appreciate that the governor is focusing on this critical issue," Meffert said. "I'm for anything that will take down costs in insurance." State subsidy Bill Smith, state director of the National Federation of Independent Business, said his group liked the Web site idea and the choices it would offer the employees of small businesses. But he is skeptical of the merits of a costly state subsidy and the so called "community rating system" mandate. Under that system, insurers might be able to vary their rates by a consumer's age or region of the state but not by their medical history and claims. At least 10 states have adopted such laws, according to the Kaiser Family Foundation, a nonpartisan group that researches health-care policy. Such a rating system "usually ends up driving up costs," said Rep. Leah Vukmir, R-Wauwatosa, chairwoman of the Assembly health committee. "The healthier ones are going to look for cheaper insurance and that leaves the sick ones in there." Massachusetts Institute of Technology economist Jonathan Gruber, a consultant to the state on BadgerChoice, said Doyle's proposal would help stabilize insurance prices for small businesses by protecting them against a big increase if one employee gets sick. But he acknowledged that, without a state subsidy, Doyle's proposal could slightly increase the number of uninsured people in the state because healthier individuals might see higher costs and more pressure to go without insurance. "If you want to fix things for the sick people, you potentially make it more difficult for the healthy people" to buy insurance, Gruber said. That's why the proposed state subsidy is key, since it would help drive down costs for everyone in the pool, Gruber said. A December study for the state by the Urban Institute found that a $100 million subsidy such as the one Doyle could propose for BadgerChoice would lead to health coverage for about 5,850 more state residents. Potential challenges Doyle's proposal could face as many challenges in the Democratic-controlled Senate as in the Republican Assembly. The author of a sweeping $15 billion universal health-care plan endorsed by Senate Democrats in the state was cool to Doyle's more incremental plan. "It's good it's on the table but I think (Doyle's) in a position to be much more bold than's he being on health care," said Sen. Jon Erpenbach, D-Middleton. Sen. Kathleen Vinehout, D-Alma, a supporter of Doyle's plan, said she wasn't sure whether Senate Democrats would abandon their larger plan for the governor's. "We went further than that but I'm grateful that he went as far as he did. BADGERCHOICE PROPOSAL THE PLAN: Gov. Jim Doyle proposed an up to $100 million plan to hold down health-care costs for small businesses. THE DELAY: Full details of the plan won't come until mid-summer, with any approval likely taking until at least 2009. THE REASON: Many major initiatives - including past Doyle health proposals - take more than a year from the time they are proposed until the time lawmakers take final action. Fri, 25 Jan 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13427&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13427&mname=Article Doyle unveils plans to grow state’s economyBizTimes Daily - Small Business Times In his State of the State Address last night, Gov. Jim Doyle unveiled his plans to grow Wisconsin’s economy. Doyle said the state faces challenges, including revenue shortfalls, and must cut state spending, work to boost state businesses and reform health care. His plan includes a $100 million annual subsidy to reduce health care costs. Doyle’s plans also include tax credits to help high-tech firms and manufacturers, incentives for renewable energy and an increase in the minimum wage to $7.25 an hour. “America’s economy is in deep turmoil and this will be a year of great challenge for us,” Governor Doyle said. “Our changing world brings serious economic challenges along with new opportunity to grow this state. Not only must we seize this opportunity, Wisconsin can lead the way. Global markets will go up and down, but it has never been more important to invest in long term economic growth for Wisconsin.” However, Doyle must convince the Legislature to support his proposals. Early indications are he may receive more support for some of his proposals, especially spending cuts and tax credits for businesses, from Republicans who control the state Assembly than members of his own Democratic party that control the state Senate. State Rep. Leah Vukmir, R-Wauwatosa, who spoke at the Northern Trust Economic Trends program this morning, presented by Small Business Times and attended by more than 500 business executives at the Italian Community Center, expressed support for some of Doyle’s initiatives. “I was actually happy with much of what Governor Doyle had to say last night,” Vukmir said. “He acknowledged we will need to work together to address state spending. If we do have a recession we will have to make significant cuts in spending.” Vukmir said she would like to see even more tax cuts than Doyle is proposing. “We must focus on broad tax relief that protects jobs,” she said. Doyle’s Grow Wisconsin also received favorable reviews from Tim Sheehy, president of the Metropolitan Milwaukee Association of Commerce (MMAC). “Grow Wisconsin wisely deploys the state’s resources to support the kind of industries and entrepreneurial activity that have a multiplier effect throughout our economy,” said Sheehy. “We appreciate Governor Doyle moving these items off business’ wish list and onto the legislature’s work list. I hope that lawmakers of both parties respond quickly and positively to these important proposals.” Thu, 24 Jan 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13443&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13443&mname=Article Wisconsin moving toward consolidated drug purchases By Stacy Forster Journal Sentinel - All Politics Blog Madison -- With concerns mounting over the precarious state budget, lawmakers have a series of concerns about a program to consolidate drug purchases for people enrolled in Medicaid managed care plans. The program was put into the budget at the last minute as a way to cut spending; it is expected to save the state $25 million over the two-year budget. It goes into effect on Feb. 1. Rep. Leah Vukmir (R-Wauwatosa), chairwoman of the Assembly's Committee on Health and Health Care Reform, invited Jason Helgerson, the state's Medicaid director, to address concerns. Among them are fears that patients could lose access to necessary prescription drugs, and that the program won't achieve the expected savings. "We all know it is very hard to control costs today, particularly in our Medicaid program," Vukmir said at the committee meeting. Helgerson said if the program isn't successful at achieving the necessary savings, the state Department of Health and Family Services will find other ways to do it. Also, state officials will be watching to be sure that the cost of medical treatments for Medicaid patients doesn't increase because people aren't taking the right drugs. Helgerson also said that 90% of prescriptions for people in Medicaid managed care programs use drugs that are included on the state's drug list. For those who need a drug that's not, a physician can sign a form authorizing access to the drug. Those on mental health treatment drugs will be "grandfathered for life" and continue to receive stabilizing medications. Patients have until April 2 to get prior approval for any drugs not covered. Medicaid participants can find more information here, and health care providers can find more details here. Tue, 22 Jan 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13387&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13387&mname=Article Health Mandate Left Out of Wisconsin Budget By: Liz Klimas Health Care News The Wisconsin legislature approved the state's final budget on October 23--and did not include a controversial, near-universal health insurance mandate that would have forced every resident to purchase health insurance. The state Senate passed the individual health insurance mandate as a standalone bill on June 26, less than 24 hours after its introduction. The measure would have levied taxes of 10.5 percent per employee on all business owners and 4 percent on all employees to subsidize insurance for low-income people. This would have resulted in a $15.2 billion payroll tax increase--the largest in Wisconsin's history. The final budget was accepted by Gov. Jim Doyle (D) October 26 as the second-latest in state history--114 days late. The $57.2 million budget will cover the next two years. Mark Block, associate state director for the Americans for Prosperity Foundation--a Washington, DC group advocating fiscal conservatism--said the health plan was "ill-conceived" to begin with, and he's pleased it was not included in the budget. "It was introduced on Monday and passed Tuesday with no public hearing on it," Block said. "Not only would it have been the largest tax hike in Wisconsin's history, but it would also put us in third behind Sweden and France [concerning government involvement in health care]. Plus, the legislation itself had many shortcomings." Subsidizing Illegal Aliens One of those shortcomings, Block noted, was the fact the state would subsidize insurance for illegal immigrants. The final budget will expand BadgerCare--the state-subsidized health care plan for families below 185 percent of the federal poverty level--to BadgerCare Plus, which will cover all children under 18 regardless of their family's income and pregnant women with household incomes below 300 percent of the federal poverty level. The budget did not include Doyle's proposal to provide health care to childless adults earning less than 200 percent of the poverty level. "It was left out because, first, [Wisconsin] needed to pass a budget," Block said, noting Republicans would not pass anything as long that provision was included. "Also, once people are educated on the facts of Healthy Wisconsin, they are appalled that the legislature would even consider putting such a burden on taxpayers." The Healthy Wisconsin Authority would have been a state agency with massive, legislative-like powers--able to establish insurance co-payments, accept and evaluate bids from insurance companies, decide medical standards for treatment, and set payroll taxes. State Rep. Leah Vukmir (R-Wauwatosa) said advocates of the universal plan began having problems when taxpayers started hearing about it. Consumers Want Competition A survey of 500 Wisconsin residents--conducted August 5-6 by Call Research, a national research firm, and released August 21--revealed 47 percent of the 500 respondents statewide felt the health care system should be reformed. Of those, 64 percent felt "the best way to reform the current private health care system is to cut costs and provide more choices by increasing competition among private insurance companies and by requiring private health care providers to be more transparent with their actual costs." Fifty-four percent disapproved of including the universal insurance mandate in the budget. "Government-run health care will take us down the wrong road," Vukmir said. "The larger message is we have to bring in competition to lower health care costs. "We need to bring it down to level one--the transaction level," Vukmir noted. "Right now everything is occurring at upper levels, and individuals have very little say and input." Coming Back Block predicted the mandate would reappear as a standalone bill by the end of 2007. "I think it will be reintroduced soon," Block said. "The next step for us is quite simple. Continue educating by hosting seminars and meeting with legislators and media on what we feel are the major downfalls of Healthy Wisconsin." Sen. John Erpenbach (D-Middleton), a primary architect of the Democrats' health care plan, declined to comment for this article. Tue, 01 Jan 2008 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13404&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13404&mname=Article Health Care For All Kids State Opening Medicaid To More People To Increase Coverage For Uninsured. By Jason Stein, Wisconsin State Journal Russ and Bobbie Peterson's adoption of granddaughter Alexia in November was supposed to be joyous. Instead, the couple discovered that 5-year-old Alexia, who has needed repeated treatments for a blood infection, would lose her Medicaid health coverage because her new legal parents' modest income was too high. "I had a panic attack," Bobbie Peterson said. "I worried so bad I couldn't believe it." In just weeks, the Petersons may have an answer. On Feb. 1, Wisconsin will start toward an ambitious health-care goal - ensuring all children in the state have access to coverage. The state already has one of the lowest percentages of uninsured children in the nation, and the new proposal could make the state even more of a leader. To do it, the state is opening up Medicaid health coverage to families such as the Petersons with incomes higher than the existing limits. Just as important, advocates say, the state is also simplifying existing Medicaid programs to cut red tape that has kept eligible families from signing up. The result, called BadgerCare Plus, will be the biggest overhaul yet of the state's Medicaid programs, which have provided health coverage to needy families since 1967. There are 510,000 - about 1 in 10 Wisconsin residents - already in the system. The changes range from making wider use of cheaper HMO-style care to using the Internet and local partners such as schools to sign up eligible but uninsured children. But challenges also remain, from finding enough health-management organizations, or HMOs, to cover the expected additional patients as well as ensuring the plan doesn't lead to a drop in the use of private insurance. At the forefront Wisconsin is taking a step-by-step approach to covering its uninsured, rather than the more sweeping universal health-care plans being pursued in states such as Massachusetts, said Jennifer Tolbert, principal policy analyst in Washington, D.C., at the Kaiser Family Foundation's Commission on Medicaid and the Uninsured. "Certainly (BadgerCare Plus) places Wisconsin at the forefront of a handful of states that are dramatically expanding coverage for children," Tolbert said. In 2006, an estimated 98,000 children in Wisconsin went through all or part of the year without health insurance, including 4,000 in Dane County, according to the state Department of Health and Family Services. State officials expect the BadgerCare Plus changes taking effect in February will provide coverage for about 26,000 more children and adults by June 2009. BadgerCare Plus was championed by Gov. Jim Doyle and passed by lawmakers as part of the state budget in October. Federal officials overseeing Medicaid signed off on the program changes on Nov. 27. "The extension of health insurance so that every child in the state will have access puts Wisconsin well ahead of almost every other state and it gives kids a chance to grow up healthy," Doyle said. The program will essentially offer Medicaid coverage to all uninsured children in Wisconsin, eliminating the previous income ceiling of $38,200 a year for a family of four. Families with employer-funded insurance coverage generally wouldn't be eligible. A family of four making $41,300 or more will have to pay a premium to cover a child under the program, ranging from $10 to $68.25 per child per month, depending on income. BadgerCare Plus will also raise income limits for parents and pregnant women under Medicaid as well as make it easier for farmers to qualify for coverage. Jason Helgerson, Medicaid director for the state Department of Health and Family Services, said the state will attempt to shift more Medicaid recipients to lower-cost HMOs as part of the program and will also for the first time try to make clients' health a condition for some payments to the HMOs. Children are less expensive than adults to cover and state officials hope to pay for this first round of BadgerCare Plus with $17.4 million gained from the HMO expansion and the streamlining of three existing Medicaid programs into one. A further expansion - to cover low-income childless adults - is scheduled to be rolled out in January 2009, pending federal approval and state funding. Some Republicans such as Rep. Leah Vukmir, R-Wauwatosa, say the state should help families purchase private insurance rather than expand government health care. Bobbie and Russ Peterson, who are both disabled and unable to work, have cared for Russ's granddaughter since her birth because Alexia's then-teenage mother wasn't able to raise her and the girl's father died, Bobbie Peterson said. The couple's roughly $40,000 annual income means Alexia doesn't qualify for BadgerCare under the current income limits, Bobbie Peterson said. The bacterial infection of Alexia's blood disqualifies her from obtaining private insurance. But starting in February and subject to the state's decision, Alexia will likely qualify for BadgerCare Plus if the couple pays a $68.25 monthly premium, said Erin McBride, a staff attorney for ABC for Health, a public-interest group in Madison that connects clients with health care. "We'd spend our last penny to know she's OK," Peterson said of Alexia. "Her life is more important to us than anything." But simply raising income limits on Medicaid won't help all of the state's uninsured children. That's because more than half of them live in families who already qualify for Medicaid, said Jon Peacock, research director at the Wisconsin Council on Children and Families. The state will try several ways to reach those families, including simplifying some requirements, using more Internet enrollment and working with schools and groups such as the Boys and Girls Club, Helgerson said. Finding HMOs Donna Friedsam, an associate director at the University of Wisconsin Population Health Institute, said a challenge will be finding enough HMOs to handle all the new clients the state wants to shift to managed care. Without enough HMOs, the state might not realize the cost savings it needs to fund the BadgerCare Plus expansion, she said. That would leave the state with a choice between scaling back benefits or finding the money somewhere else. In Dane County alone, the state health department said it is still trying to negotiate with HMOs to open some 7,200 slots for Medicaid recipients.\ \ Who will be covered? The state is moving to overhaul and expand its Medicaid health coverage for poor families starting Feb. 1. Here are some of the groups the new BadgerCare Plus program will cover: All children generally without insurance through their parents' employer, with premiums ranging from zero to $68.25 per child per month, depending on the parents' income. Pregnant women with family incomes of less than $61,950 for a family of four. Parents with income of less than $41,300 for a family of four. Young adults leaving the foster care program when they turn 18. More farm families because they will now meet income limits more easily. For more information on BadgerCare Plus, go to www.dhfs.state.wi.us/badgercareplus or call 800-362-3002. Preventing fraud Some insurers have voiced concerns that BadgerCare Plus will encourage some workers to drop employer health coverage in favor of Medicaid. To prevent that, the state generally would disqualify workers who have received employer health insurance in the last year, supporters of the program say. BadgerCare Plus by the numbers Estimated number of Wisconsin children who were uninsured for at least part of 2006: 98,000 In Dane County: 4,000 Of all Wisconsin children, percentage who were uninsured in 2006: 6 percent State's rank by percentage of insured children: 4th best in the nation Estimated number of additional children and adults to be insured: 26,000 Sources: Wisconsin Department of Health and Family Services; Urban Institute and Kaiser Commission on Medicaid and the Uninsured. Thu, 27 Dec 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13426&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13426&mname=Article Editorial: Minimally useful Let's rid Wisconsin of a Depression-era law that no longer serves a useful purpose. From the Journal Sentinel Wisconsin should kill, finally, its outdated and needless minimum markup law. A proposal by Reps. Bill Kramer (R-Waukesha) and Leah Vukmir (R-Wauwatosa) would do that and deserves a fair hearing in Madison. The law, which dates to 1939, sets a minimum markup of 9% for gasoline and bars retailers of all kinds from selling merchandise below cost. But it puts consumers here at a disadvantage. The Journal Sentinel's Doris Hajewski reported recently that Wal-Mart Stores Inc. has charged more for certain highly publicized sales items in Wisconsin than in border states (www.jsonline.com/689136). Hajewski found a laptop computer going for $348 in most other states selling for $428 here. She found a $99 Toshiba high-definition DVD player, advertised nationwide, that cost $185 in Wisconsin. Moreover, the law was found to violate federal antitrust laws recently by U.S. Magistrate Judge William Callahan. In that case, involving a Kenosha business group and a Utah company, Callahan ruled that the markup law violated federal legislation because the state has failed to monitor the system. It's time to put consumers out of its misery. Is the state's 68-year-old minimum markup law still needed? Why or why not? Send a letter to: Journal Sentinel editorial department Wed, 28 Nov 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13384&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13384&mname=Article Lawmakers Want To Disband Minimum Mark-Up Law Shoppers Look Forward To Savings WISN.COM Some Wisconsin lawmakers are trying to make sure shoppers get the best deals possible. Many lawmakers are calling for a repeal of Wisconsin’s controversial minimum mark-up law. The law prohibits almost everything in the state from being sold below cost. Some lawmakers say that this is leading shoppers to get a better sale price in other states. "We hear all kinds of stories of people who are leaving Wisconsin to go to neighboring states to make purchases because they're cheaper," said Rep. Leah Vukmir. On Friday, Vukmir and and Republican Rep. Bill [K]ramer unveiled a plan to get rid of the nearly 70-year-old minimum markup law. Some believe this law is important because it can help small businesses compete against giant corporations. But many consumers said they would rather pay the lower prices. “I think it would be a wonderful idea to repeal that law,” Judy Milbrath said. “I’m looking forward for a savings.” The issue could come up for vote early next year. Fri, 23 Nov 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13389&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13389&mname=Article Legislators propose health cost disclosure Bill would require information to be available to patients By Stacy Forster, Journal Sentinel Madison - On the biggest shopping weekend of the year, you'll know the price of the big-screen TV and the Wii you're about to buy - but you'll likely be in the dark about the cost of any health care you need. In Wisconsin and elsewhere nationally, lawmakers, consumer advocates and even some health care providers are pressing for more price transparency in health care. They say that will bring down the cost by introducing consumerism into the system and making providers compete on price. The push for information has intensified as more people enroll in high-deductible health plans and pay more out-of-pocket costs. Some providers, hospitals and insurance companies are already making cost information available. And the issue will be a key part of the Capitol debate in coming months about health care reform. Sen. Jim Sullivan (D-Wauwatosa) and Rep. Steve Wieckert (R-Appleton) this week introduced a bill requiring health care providers and insurance companies to make available information about the cost of procedures or services to patients who ask for it. "People should know how much medical procedures cost, period," Wieckert said. Under the bill, health care providers would have to make available cost information about their 50 most commonly performed services. They would have to be presented at three levels: The usual and customary charge for the service; the rate paid by government programs; and the average rate for health plans. Sullivan said the hope is that information is easy to understand so that patients can say, "I'm here for a sore knee, and what can I expect this is going to cost?" Requiring hospitals and other providers to supply prices for the most common procedures has become popular nationally, said Paul Keckley, executive director of the Deloitte Center for Health Solutions in Washington, D.C. It's not clear yet whether consumers are using the information that's been made available to them, he said. About a half-dozen states are leading the move toward transparency with comprehensive price reporting requirements, according to the National Conference of State Legislatures. Minnesota has requirements in place that are similar to what's being proposed in Wisconsin. Transparency has also been one of the proposed health care reforms offered by Republicans who control the Assembly. Rep. Leah Vukmir (R-Wauwatosa), chairwoman of the Assembly's Committee on Health and Health Care Reform, said she would introduce her own proposal in the coming weeks. "Merely taking the top 50 procedures out there, what if you have procedure 51?" Vukmir said. "How does that help you?" Doctors and other providers have concerns about how much information they would be able to provide to patients because of confidentiality agreements with insurance companies, said Carl Eisenberg, a Milwaukee pediatrician and chairman of the Wisconsin Medical Society's Council on Legislation. Also, he said, the cost of a procedure can vary from patient to patient. "If somebody were to call in and ask, 'What's the cost going to be for a child with a simple problem like an ear infection?' it's not going to be easy to give an exact answer," Eisenberg said. Sullivan said doctors, hospitals and insurance companies wouldn't be required to give precise prices. Price transparency was an element of the universal health care reform proposal Senate Democrats adopted in their version of the budget; it did not become law, but senators are expected to soon reintroduce it as separate legislation. Sen. Jon Erpenbach (D-Middleton), sponsor of the plan, said people shouldn't be insulated from price concerns but that the goal should be making health care more accessible and affordable. Providers and health plans already give consumers access to a growing trove of information - if they're willing to take the time to look for it. Those enrolled in a plan administered by Humana Inc., for example, can log on to a Web site that offers information about quality and cost estimates for dozens of procedures done in a doctor's office or at a hospital. Larry Rambo, chief executive officer for Humana's Great Lakes region, said cost information might best come from an insurance company because it can encompass the "episode of care," meaning all the costs that go into treatment. "If you're going in for knee surgery, you're going to get a bill from the hospital, you're going to get a bill from the surgeon, you're going to get a bill from the anesthesiologist and you're going to get a bill from the radiologist," Rambo said. Medical Associates Health Centers just added to its Web site a list of estimated fees for services. And the Wisconsin Hospital Association's Web site provides information on hospital charges for inpatient and common outpatient procedures. Each hospital also lists the average discount it gives to health plans. Fri, 23 Nov 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13432&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13432&mname=Article Proposal would replace gas law U.S. judge declared minimum markup unconstitutional By Doris Hajewski - Milwaukee Journal Sentinel A proposal from two Milwaukee-area legislators would repeal Wisconsin's minimum markup law and replace it with a new Competitive Marketplace Act. The so-called minimum markup law, formally named the Unfair Sales Act, sets a minimum markup of 9% for gasoline and forbids retailers of all types from selling merchandise below cost. "Getting it off the books and letting the marketplace work is our main goal," said Rep. Bill Kramer (R-Waukesha). Kramer and Rep. Leah Vukmir (R-Wauwatosa) are co-sponsors of the law. The Competitive Marketplace Act will be circulated for co-sponsorship starting today, Kramer said Wednesday. The proposed legislation will limit the Legislature's ability to set prices. The existing law, enacted in 1939, was held unconstitutional recently by U.S. Magistrate Judge William Callahan. The case before Callahan was brought by a Kenosha business group against a Utah company with two gas stations in Wisconsin, accusing them of predatory pricing. State didn't monitor system Callahan ruled that the markup law was unconstitutional because the state has failed to monitor the system. Wisconsin last adjusted the markup for gas in 1998, moving it from 6% to 9.18%. Despite the ruling, the law remains on the books and the state Department of Agriculture, Trade and Consumer Protection continues to enforce it. The law sometimes has resulted in higher prices for Wisconsin consumers. For example, Wal-Mart Stores Inc. has charged more for certain highly publicized sales items in Wisconsin than in neighboring states. Wal-Mart had different fliers for Wisconsin stores for a sale this month, charging $428 for a laptop computer that sold for $348 in most other states. The company did not respond to a question on whether today's Black Friday prices are higher in Wisconsin. Likely to be controversial Kramer said he and Vukmir plan to seek support for their bill for about a month before introducing it to the Assembly. But the proposal is likely to be controversial. The Wisconsin Petroleum Marketers & Convenience Store Association supports the law, saying it preserves competition. Sellers of tobacco and alcohol also have favored the minimum markup law. Thu, 22 Nov 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13388&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13388&mname=Article Hospital Tax May Be Revived It Was Cut From The State Budget By Jason Stein, Wisconsin State Journal Before the state's budget has even been signed, an effort is afoot to undo some of its key compromises. Sen. Roger Breske, D-Eland, said Thursday he is working on legislation to bring back a hospital tax that was dropped as part of the budget negotiations and then use the money generated to stop a controversial $200 million transfer from a fund for injured patients that is included in the budget. The budget, passed Tuesday by the Legislature, is expected to be signed by Gov. Jim Doyle today at a ceremony on the UW-Madison campus. Breske's announcement came just one day after Senate Democrats ousted their leader in part out of concern that they'd been too quick to compromise with the GOP-led Assembly on issues such as the hospital tax. The announcement also came just hours after a group representing the state's doctors said Thursday they would sue to block the transfer from the fund used to compensate patients and families of patients injured by medical malpractice. Breske, who voted for the budget but doesn't like the patients fund transfer, said the $418 million hospital tax would help bring in added federal money that could be used to increase reimbursements to hospitals for Medicaid treatment of the poor and to help the state do without part or all of the transfer. "Everyone supported the provision in the budget, including the Wisconsin Hospital Association," Breske said in a statement. "It's unfortunate that this opportunity had to be removed in order to get the budget done." Sen. Russ Decker, D-Schofield, the senate's new majority leader, has been a supporter of the hospital tax. Only minutes after taking over his new job Wednesday, he called a decision by Doyle and then-Majority Leader Judy Robson, D-Beloit, to jettison the hospital tax to reach a budget compromise with Republicans a "missed opportunity" and said he would like to revisit it. "I would hope we can still cross that bridge in time," Decker said. Breske's chief-of-staff, Sue Meinholz, said Decker hadn't asked Breske to draft the legislation but her office has discussed it with other senators. She expects the bill would be ready to introduce within the next month. Supporters say the hospital tax could reduce health-care costs for Wisconsin residents and businesses by hundreds of millions of dollars by making sure hospitals get paid for more of their actual costs for treating Medicaid patients. Opponents argue the tax could push those costs higher in the long run if lawmakers raid the tax money saved for other spending. Passing the tax will be difficult, with Assembly Speaker Mike Huebsch, R-West Salem, opposed to it. Rep. Leah Vukmir, R-Wauwatosa, the chairwoman of the Assembly health committee, said she also still opposes the "sick tax." Vukmir said Doyle proposed using $125 million of the tax money for something other than reimbursements for hospitals. They "can be intent on trying to bring it back. That still doesn't make it a good idea. It's still bad public policy," Vukmir said. Eric Borgerding, a lobbyist for the Wisconsin Hospital Association, said his group is "encouraged by some of the signals coming out of the Capitol" on bringing back the tax. The association initially opposed the proposal, then changed course after Doyle agreed to put a two-year sunset on the tax and make changes to better ensure that extra reimbursement payments would flow to hospitals. Hospitals are now paid only about 48 percent of the true cost of Medicaid care, a gap of about $550 million, and the reimbursement rates haven't increased in 12 years, Borgerding said. Meinholz said the Breske plan would be similar to a version of the hospital tax that was introduced by Doyle as part of a budget compromise and defeated in the Assembly last week. Meanwhile Thursday, Wisconsin Medical Society attorney Tom Pyper said the group will file a lawsuit as early as next week challenging the transfer from the state's patients compensation fund to pay for state health programs. The fund consists of money paid in premiums by doctors, hospitals and other health-care providers. Money from the fund is used to pay medical malpractice claims greater than $1 million. A $200 million transfer will make the fund unstable and result in an increase in the charges to doctors and hospitals to keep it solvent, Pyper said. The Legislative Audit Bureau seemed to support that position. It reported in March that a $175 million transfer, as Doyle originally proposed, would leave the fund with an accounting deficit that could require higher premiums. As of June 30, 2006, the fund had a net worth of $59.8 million, the highest year-end balance since it started in 1975. Its assets were $746.4 million, with $686.5 million in liabilities, including projected claims. The Doyle administration maintains the fund has more than enough reserves and the transfer is legal. Fri, 26 Oct 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13424&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13424&mname=Article State Budget Approved UW-Madison To Get Millions More; City Will Get Windfall By Mark Pitsch and Jason Stein, Wisconsin State Journal Nearly four months after its deadline, the Legislature on Tuesday evening approved the two-year, $57.2 billion state budget and sent it to Gov. Jim Doyle, who could sign it this week. The bill passed the GOP-led Assembly on a bipartisan 60-39 vote over the opposing votes of 10 Democrats and a majority of the 52 Republicans who control that house. The Democrat-led Senate passed the bill on an 18-15 party line vote. Effects from the bill will ripple through Madison, including millions of dollars more for UW-Madison, a $500,000 windfall for the city of Madison, new state jobs, a Hmong cultural center and even possible high-speed train service here from Milwaukee. Doyle spokesman Matt Canter said the Democratic governor expects to sign the bill within the "coming days." Doyle said Friday that he would make "if any, very few vetoes" to the bill. Assembly Speaker Mike Huebsch, R-West Salem, said the $57.2 billion budget eliminated a majority of the taxes proposed by Doyle and Senate Democrats. "We knew we were going to have our work cut out for us, but we did find middle ground," Huebsch said. "We said no to the notion that we can tax our way out of a spending problem." The budget compromise announced Friday by Doyle and lawmakers ended a dispute that has left Wisconsin with the most overdue budget in the nation. Tuesday's votes came only days before the latest budget passage on record in Wisconsin, set on Oct. 27, 1971. Senate Majority Leader Judy Robson, D-Beloit, said the budget "protected all the core values of Wisconsin," including health care for children, K-12 schools and public universities. Doyle praised the votes, saying the budget made those investments while holding taxes in line. "While we all had to make some difficult compromises, I believe the bill that passed tonight reflects our state's values, protects our priorities and invests in our people," Doyle said in a statement. "Good product" In the Assembly Tuesday, 29 Republicans and 10 Democrats voted against the bill, while 23 Republicans and 37 Democrats voted for it. Huebsch said he hadn't expected to win a majority of the Assembly's GOP lawmakers. "You know you've got a good product when neither side is happy," Huebsch said. The biggest budget dispute was the fight between the GOP-led Assembly and Doyle and Senate Democrats over how much to raise taxes to fund new spending on education, health care and state roads. The 1,633-page budget bill raises state spending by $3.56 billion, or 6.6 percent, over two years. The bill would provide health-care access to 98 percent of the state's residents, including all children, through an expansion of Medicaid. It will expand the Family Care program, which provides long-term care for the elderly and disabled outside of nursing homes and institutions, though there no plans to do so in Dane County. The bill will raise the state's cigarette tax by $1 to $1.77, which makes Wisconsin's tax the 11th highest in the nation. It would also take $200 million from a fund to compensate patients injured by medical malpractice and their families. But it leaves out taxes on oil companies and hospitals proposed by Doyle. The compromise approved Tuesday by the Legislature would raise taxes and fees by $763.3 million, closer to the $256.1 million increase sought by the Assembly than the $1.75 billion increase proposed by Doyle. But the $2.76 billion in new state borrowing approved in the bill Tuesday came much closer to the $3.17 billion in borrowing sought by Doyle than the $1.59 billion sought by the Assembly. The tax increases were too much for Rep. Leah Vukmir, R-Wauwatosa. "This budget simply isn't good enough. In fact, it's not good at all," she said. Madison area The bill will have a number of effects on the Madison area: An estimated $62 million increase for UW-Madison to cover rising salaries and utilities, growth in nursing and teaching programs, and a fund to retain talented professors. $253 million in building projects for UW-Madison, including replacing Union South and renovating the Union Theater wing. An increase of 488 state jobs, mostly at UW-Hospital and in the state corrections system. That brings the state to a total of 68,027 jobs, 65 fewer than the state had in 2003 when Doyle took office and cut state jobs to help deal with a huge budget shortfall. $2 million in state borrowing to help build a Hmong cultural center in Dane County. Up to $80 million in state borrowing to help start high-speed passenger train service between Madison and Milwaukee. The project still needs federal approval. A $4 million grant for a soybean crusher in Evansville. A more than $4 million increase over the next two years for special education and a program that reduces class sizes, according to Madison School District lobbyist Joe Quick. A $500,000 boost in state aid for the city of Madison from what was anticipated in Mayor Dave Cieslewicz's budget proposal. The City Council could either spend the money or reduce the mayor's proposed tax levy. Budget committee member Rep. Mark Pocan, D-Madison, said the budget would be good to the city. "There's a lot of pluses out there and really few negatives." Cieslewicz said Tuesday he would recommend spending half of the additional money on programs he wasn't able to cover in his budget, such as $33,000 for police promotions, and put the other half in a reserve fund. The Legislature included Doyle's proposed $53.6 million increase in special education funding, or about $1 million this year and $1.7 million next year for Madison schools. The state's share of the mandated program will increase slightly, to about 29 percent, which is still well below the 45 percent rate the state paid when revenue limits started, Quick said. Wed, 24 Oct 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13425&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13425&mname=Article Wisconsin has a budget Long-overdue fiscal plan has higher fees, taxes, and free booze By Stacy Forster, Patrick Marley and Steven Walters Madison - The Legislature passed a long-overdue budget late Tuesday, even as lawmakers discovered new provisions - including one allowing grocery stores to serve customers free samples of hard liquor. The little-noticed tidbit in the budget would allow grocers and liquor stores to serve up to 1 1/2 ounces of whiskey, gin and other liquors to customers each visit. The budget, 115 days overdue, was the second-latest spending plan the Legislature ever adopted. The Republican-controlled Assembly passed it, 60-39, with 23 Republicans joining 37 Democrats in favor. The Senate then quickly passed it 18-15, with all Democrats in favor and all Republicans opposed. The $57.2 billion budget now goes to Democratic Gov. Jim Doyle, who can strike out any part of it - but he has said he would use his veto sparingly. Doyle aide Matt Canter would not say whether the governor plans to veto the measure on liquor sampling. It's a controversial budget for several reasons: It boosts the cigarette tax by $1 a pack, costing smokers $378.5 million more by mid-2009. It includes a one-time $200 million transfer from the state fund that pays medical malpractice claims. It raises transportation-related fees by about $274 million. But Republicans got Doyle to drop tax increases on hospitals and oil companies and a fee boost for those who sell property. Doyle praised the budget, saying it continues two-thirds state funding of public schools, funds the University of Wisconsin System and extends health care to most families whose children are uninsured. "After a long process, Democrats and Republicans have come together to hold the line on taxes, streamline government and create real opportunity for Wisconsin families and businesses," Doyle said in a statement. Doyle could sign the budget into law as early as this week. If the budget compromise had not passed the Legislature soon, he had promised to order the first-ever shutdown of some non-emergency state services. The debate in the Assembly reflected the months of haggling that led to the final budget compromise, with many members saying they didn't like everything in it but would vote for it anyway. "This budget doesn't solve all of Wisconsin's problems," said Assembly Speaker Mike Huebsch (R-West Salem). "If there is a budget that comes to this floor and both sides are not happy, we've probably done our job." Rep. Phil Garthwaite (D-Dickeyville) said all members can identify some good things in the budget, and "I'm going to go to work on the bad things in this budget a soon as we walk out the door tonight, and I expect you to do the same thing." Tax increases had been a critical issue in the Assembly, where 27 members - mostly Republicans - had signed pledges not to raise taxes, complicating negotiations. Republicans claimed victory because many tax increases didn't make it in to the final package. Huebsch touted the budget as one that keeps government spending in line with taxpayers' ability to pay, but Rep. Leah Vukmir (R-Wauwatosa), a no-tax-increase pledge signer, disagreed. "This is not a Republican budget, it is a Democratic budget; and it's riddled with earmarks and favors and new spending that we simply cannot afford," she said. Senate Majority Leader Judy Robson (D-Beloit) called it a budget that "protects the priorities of the people of Wisconsin." Senate Republican leader Scott Fitzgerald (R-Juneau) said GOP pressure "whittled down" the tax increases Doyle proposed. "Republicans won on many different fronts," Fitzgerald said. As soon as Doyle signs the budget into law, it will end up in court. The Medical Society of Wisconsin has vowed to sue to void the $200 million transfer from the Wisconsin Injured Patients and Families Compensation Fund. Many who voted against the budget in the Assembly spoke out about the transfer, which they condemned as an irresponsible use of funds that are paid by doctors to cover malpractice awards. Rep. Sheldon Wasserman (D-Milwaukee), a physician, said the transfer was against the law and bad fiscal policy. "It makes no sense to use one-time funds to pay for ongoing services" and leave a hole to fill in the next budget, he said. Cheers! One budget item that came as a surprise to some would allow grocers and liquor stores to serve liquor samples between 11 a.m. and 7 p.m. The stores could serve one-half ounce samples at a time, with customers receiving up to three samples, or 1 ½ ounces of liquor. "What an interesting thing, and it all comes through a bill that has seen no light of day," said Rep. Samantha Kerkman (R-Randall). Kerkman wrote a bill earlier this year that would have allowed liquor sampling at wineries, grocery stores and liquor stores. She said her focus was on a winery in her district, and she was upset the budget provision did not allow wineries to distribute such samples. No lawmaker would admit to sponsoring the sampling provision. "The message we're sending is it's OK to go ahead and consume alcohol and go out and get in a car," said Kari Kinnard, Wisconsin executive director of Mothers Against Drunk Driving. But Dale Szyndrowski of the Distilled Spirits Council of the U.S. said the measure puts hard liquor on the same footing as beer and wine, which already can be offered as samples. He said about half the states allow liquor sampling. Legislative leaders approved the budget Monday with no changes, sending it to the full houses. The compromise budget the Legislature passed raises taxes and fees by $763.2 million through mid-2009, according to new summary. The Legislative Fiscal Bureau said the biggest increase - $410.9 million - would come from raising the 77-cent tax on a pack of cigarettes by $1 and also raising taxes on other tobacco items. The second-largest amount - $273.93 million - would result from raising transportation-related fees. Under the budget, the $55 annual vehicle registration fee would go to $75; registration fees would be raised by 30% on heavy trucks; and there would be a new $10 driver's license surcharge and identification verification fee. In addition, the base cost of titling a car would go from $28.50 to $45. With other fees already tacked onto titling, car buyers would pay a total of $69.50 for new titles. The budget would allow resident undergraduate tuition on four-year University of Wisconsin System campuses to rise by about 2% next year, although the final percentage will depend on pay raises given system employees. The tuition increase will cost students $52.2 million over the two years covered by the budget, the Fiscal Bureau reported. By passing the budget Tuesday, the Legislature avoided delivering the latest budget in Wisconsin history by four days. The latest budget was passed Oct. 27, 1971. Tue, 23 Oct 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13411&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13411&mname=Article State health care debate heated Sides square off over proposal By Guy Boulton Journal Sentinel Two sides in the debate over Healthy Wisconsin - the plan to provide health insurance to nearly everyone in the state - faced each other Wednesday in a session that soon made clear the ideological rift over the proposal. The discussion at the Milwaukee Press Club became an often heated debate about the government's role in reforming the health care system and in expanding coverage for the state's uninsured. A four-person panel consisted of Rep. Jon Richards (D-Milwaukee) and David Riemer, both key architects of the plan, and Rep. Leah Vukmir (R-Wauwatosa), chair of the Assembly Committee on Health and Health Care Reform, and Richard Blomquist, president of Blomquist Benefits LLC. The proposal essentially would remake the state's health care system. To proponents, Healthy Wisconsin would give people more choices in health plans, encourage competition among insurers and indirectly doctors and hospitals as well as lower overall costs. The plan would be paid for by a 10.5% tax on employers and a 4.5% tax on workers' wages under roughly $100,000. "It preserves what's good about our system, and makes that available to everybody," Richards said. To opponents, the proposal will lead to a massive expansion of state government, hurt small businesses and prove fiscally untenable. "This is a government-run health care plan," Vukmir said. "It is a top-down, government controlled takeover of the funding and financing of health care." Blomquist, who has run health plans, said the legislation is being debated in the wrong venue as part of the state budget. The plan also could subject doctors to price controls and may violate federal law. Some businesses would pay more, Riemer said. But he noted that some employers pay nothing toward the cost of their employees' health care, potentially shifting costs to other employers. "That's the price you pay for making sure everyone is covered," he said. "We've got to be honest about this." Devoid from the debate was the perspective of Arvid "Dick" Tillmar, a partner with Diversified Insurance Services and one of the first in his industry to encourage employers to focus on keeping employees healthy. "I've got to believe there's common ground," he said. Thu, 13 Sep 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13403&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13403&mname=Article WisBusiness: 'Healthy Wisconsin' plan debated at MMAC event By Patrick Fitzgerald WisBusiness.com Business leaders were largely skeptical of the “Healthy Wisconsin” care plan at today’s MMAC Blueprint Briefing in Milwaukee, which featured a panel debate over the controversial health care plan. As it stands, “Healthy Wisconsin” aims to provide health care coverage to state residents and employees, including coverage for mental health and substance abuse treatment. Proponents of the plan say it will be funded by assessments on employers, employees, the self-employed, and individuals without an earned income who meet specific residency and employment requirements. Stepping up to the plate for the Democrat-sponsored plan were State Rep. Jon Richards (D-Milwaukee), and former State Budget Director David Riemer, who maintained that the plan would remain on par with the state’s high-quality health care system. Riemer emphasized that “Healthy Wisconsin” is extraordinarily consumer driven in that “individuals get a choice every year among multiple health care plans. “They could join the lower cost plans that are competing in an intensely competitive private market, or if they wanted another choice, they could pay extra for the higher cost plans,” Riemer said. “Sounds a lot like a free market, doesn’t it?” “And that’s exactly what this is.” Riemer also cited a study by the Lewin Group in which they found businesses will pay $1,500 less per year per worker, and that the average insurance-providing employer will pay between 15 and 50 percent less in annual rates, projecting to save state businesses almost $700 million in its inaugural year. “This is not a government run program,” said Riemer. “Yet the government sets the playing field for this.” State Rep. Leah Vukmir (R-Wauwatosa), a staunch opponent of the plan, called the plan nothing short of government run health care. “It is a top-down government controlled takeover of the funding and financing of our health care,” Vukmir said. “There will be no mechanism for real competition.” “Healthy Wisconsin eyes a model of managed competition, and I have a hard time even putting those two words together.” Vukmir said the plan would create a climate carefully managed and monitored by the Healthy Wisconsin authority, taking the role of private insurance companies and leaving two types of plans: managed care or fee-for-service. “And the other choice that everyone will have is that they may choose to move to one of the 49 other states to receive health care,” Vukmir said. Vukmir further ripped into the plan by saying it leaves employers with no wiggle room during times of financial instability. “If your business is facing a serious competitive challenge and your health care costs are tied to your worker’s employment, under Healthy Wisconsin you can’t go back in and re-bid your health insurance,” Vukmir said. “Your only option is to reduce the number of hours and eliminate the jobs.” Jon Rauser, president of The Rauser Agency and the other panelist opposed to the plan, called Wisconsin’s health care dilemmas a “cost crisis, not an insurance crisis.” “We don’t need to send more money to Madison and to the provider community," said Rauser. “It is an already bloated system with an enormous amount of waste.” During the audience question and answer session that followed the panel debate, Riemer was asked if he thought that it is a legitimate concern that Wisconsin could become a welfare magnet. “I don’t think it will be a significant problem,” Riemer replied, eliciting laughs from several members of the audience. “It could be a possibility, but I don’t think its going to be a real problem.” Riemer felt “Healthy Wisconsin” would be added incentive for insurance-weary businesses to relocate within Wisconsin borders. “Employers in other states that are providing health insurance are finding it very costly to do so, and will find Wisconsin a very attractive place to be,” Riemer said. “They’re spending a lot of money on out-of-control health care costs, and they can move to Wisconsin and spend a lot less.” Despite Riemer’s optimistic picture for “Healthy Wisconsin,” Vukmir said the only way the plan will control health care costs is through managing competition. “This plan doesn’t reform, all it does is change who pays for our current health care,” said Vukmir, calling the plan a re-allocation of current health care dollars. “I often think Adam Smith might be turning over in his grave right now.” --Listen to audio of the debate: *Richards and Riemer on why "Healthy Wisconsin" works: http://www.wispolitics.com/1006/DW_C0074.wav *Vukmir on why "Healthy Wisconsin" will not work: http://www.wispolitics.com/1006/Vukmir.wav *Rauser on why "Healthy Wisconsin" will not work: http://www.wispolitics.com/1006/Rauser.wav *Question & answer session following the debate: http://www.wispolitics.com/1006/Q_and_A.wav Thu, 23 Aug 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13383&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13383&mname=Article Consumer control is the best course By Rep. Leah Vukmir Aquiet revolution is transforming the health care industry and challenging the status quo. Employers, fed up with the current system, are moving toward consumer-driven health care. They are empowering their employees to manage more of their health care dollars and decisions. Assembly Republicans are leading the way by promoting reforms that put individuals - not government - in charge of their health care. Unleashing an army of consumers with information and tools with which to make personal decisions about health care is the only way to lower health care costs, expand access and protect the high-quality health care we have come to expect in Wisconsin. Decades of government regulation and top-down reforms - such as managed care, which sought to control costs by limiting patient and physician choices - have failed. Employers are pressuring insurers to control costs. Insurers are working to leverage lower prices from providers. Providers are consolidating to form larger groups to resist those pressures. As a result, the system has become inefficient, expensive and less responsive. While individual health care providers may be responsive to a patient's needs, the system they work in is not. Consumers are insulated from plan options, cost and financial incentives for proper utilization. Having a third party pay nearly 85 cents out of every health care dollar has placed the consumer outside of the system and provides little inducement for individuals to consider costs. This lack of consumer pressure has allowed the health care industry to be immune from basic market forces. Government mandates and regulations have worked to limit choices and to stifle market reforms, not only for insurers but for providers. Putting consumers in charge of their own health care is a significant paradigm shift. Consumerism forces providers to compete. Competition improves quality, lowers costs and drives innovation. Consumers evaluate cost, quality and value in every segment of our economy - except in health care - because the consumer has never been in charge. A well-designed consumer-driven health care plan protects individuals from large out-of-pocket costs while providing them with incentives to find savings. Most plans provide essential preventative care and wellness incentives so individuals can directly benefit from reasoned choices. Offering health savings accounts allows consumers direct control over a larger portion of their health care dollars and empowers them to make choices about providers and care. Employers offering HSAs realize significant savings in premium costs, which allow them to offer insurance to more workers. Consumers also must have access to relevant and objective cost and quality information about hospitals and doctors. Wisconsin is a pioneer in promoting health care transparency. Consumers must be able to evaluate providers in the same way they research every other major purchasing decision they make. Opponents falsely claim that consumer-driven health care is only for the healthy, yet significant innovations are occurring in chronic disease management that are improving outcomes while lowering costs. At Marshfield Clinic and other places, focused, integrated health care teams are changing their approach to comprehensive care for illnesses such as diabetes and heart disease - significant cost drivers. Assembly Republicans' agenda also calls for reforming BadgerCare to empower low-income individuals to obtain their own coverage rather than suffer through the current managed care maze. Innovative, low-cost private insurance plans that transform recipients into consumers will expand access and improve care. Finding solutions to our health care problems requires less government - not another centralized authority that collects our money and allocates it on our behalf. Big government plans may temporarily address the issue of access, but they do nothing to control costs. The end result would be the loss of quality and personal freedom. That is a price none of us should be willing to pay. Rep. Leah Vukmir (R-Wauwatosa) chairs the Assembly Committee on Health and Health Care Reform. Sat, 11 Aug 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13407&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13407&mname=Article Dentists Urge 2-cent Tax On Soda The Capital Times When state Rep. Garey Bies was growing up poor in a large family, he was thankful for a program in Oshkosh that made it financially possible for him to see a dentist. That is why the Sister Bay Republican has authored AB 237, a bill that would impose a tax on soft drinks -- which dentists say increase risk of tooth decay -- to subsidize dental access for low-income people and to pay for dental education. The tax would actually be imposed on wholesale soft drinks and soft drink syrups and powders, but Bies said it would come out to about 2 cents per can for a consumer, hence the bill 's nickname: "Two Cents for Tooth Sense." The money deposited into a dental access trust fund would be used to enhance the reimbursement payment for dentists' services provided to recipients under the Medical Assistance program for the poor, and to fund grants from the Department of Health and Family Services for dental public health and dental education projects. The bill would ensure that 75 percent of dentists who care for Medicaid and BadgerCare patients would be reimbursed for the fair market value of their services, according to the Wisconsin Dental Association., "A lot of dentists can't afford to take on Medical Assistance patients because the reimbursement rate is far below their cost level. Some dentists donate their services, but if you can't make a go, you 're not in business very long," Bies said. The soft drink bill is opposed by lobbyists for trade groups including the Wisconsin Beverage Association, the Wisconsin Grocers Association and the Midwest Food Processors Association. "No one will argue that people need dental care and education. They also need vision care and obesity care. Should we tax certain products to pay for that type of help?" asked Brandon Scholz, president and chief executive of the Grocers Association. "Say people need reading glasses, should we impose a tax of 10 cents on each newspaper? How would your publisher like that? You would say that's not fair to us or our customers, and we view the soda tax the same way." Scholz added that if sugar causes tooth decay, why just pick on soda? How about ice cream or a bag of sugar? "Once they go down that road, they will tax everything else," he warned. "And all that money won't go for the program. It would be diverted elsewhere." The soft drink tax is also opposed by some legislators, including the chairwoman of the Assembly Committee on Health and Health Care Reform, where the bill has been referred by legislative leadership. "There are three different versions of budgets out there, and not one of them include 'Two Cents for Tooth Sense,'" said committee chairwoman Leah Vukmir, R-Wauwatosa. "We have a commitment to dealing with dental care and dental issues, but the idea of creating a special tax on soda, when we are saying no to gasoline and cigarette taxes, makes no sense." Gov. Jim Doyle 's original budget contained $8.8 million in additional dental care funds for the two-year budget period through the BadgerCare Plus expansion, and a 1 percent increase in the dentist reimbursement rate for 2008 and a 2 percent rise in 2009. He has also provided additional funds for community health centers that provide dental services. The Assembly version of the state budget includes $7 million in state and federal money to increase subsidies to dentists statewide in the second year of the two-year budget period. The Senate version has a two-year, $8.2 million pilot plan that provides much more Medicaid reimbursement for pediatric dental services in La Crosse, Brown and Racine counties. Bies and the Wisconsin Dental Association are pinning their hopes on the conference committee that is trying to resolve differences between the two legislative plans. But as of Thursday, the committee had not acted on that matter. Eva Dahl, an Onalaska dentist who is president of the Wisconsin Dental Association, said she is pleased that the plight of low-income people has finally reached the attention of lawmakers. The situation has reached crisis proportions, she said, with Medicaid patients in pain and missing work or school because of untreated tooth problems. "Our real thrust is to have the state live up to its promise of dental care for the underserved and needy. They are entitled but can't receive care because reimbursement rates are so low that the dentist is not taking a penny home. They are paid 30 to 40 cents on the dollar by the state, and the dental office costs 60 or 70 cents on the dollar to provide the service," Dahl said. The dental Medicaid budget in Wisconsin is just 0.8 percent of the total state Medicaid budget; in most states it's 2 to 5 percent, according to Dahl. She added that the American Academy of Pediatrics has recommended that 20 percent of all health care expenditures for children should be spent on dental care. The Assembly proposed to increase across-the-board reimbursement across the state to roughly 47 cents on the dollar, but that still doesn't reach the costs of a dentist's overhead, she said. Fri, 10 Aug 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13431&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13431&mname=Article Health plan is market driven Assembly GOP looks to consumer choice, tax-free accounts By Guy Boulton and Stacy Forster, Journal Sentinel Republicans in the state Assembly have an alternative to the sweeping overhaul of Wisconsin's health care system proposed by Senate Democrats: Let the free market do its job. The Assembly is putting its faith in market-based reforms, betting that informed consumers can make health care more efficient, control costs and make health insurance more affordable. The Republican-controlled Assembly's stance, in ideology and scale, is a sharp contrast to the Democrat-controlled Senate's wide-ranging proposal to provide health insurance to nearly everyone in the state. The Senate plan would remake - critics say "blow up" - the state's health care system in an effort to expand coverage and control costs. The Assembly proposals center on changes in the tax code that aim to make health insurance more affordable. The cornerstone of this approach is encouraging the adoption of health savings accounts, or HSAs, by exempting contributions from state taxes. That would lower the cost of health insurance by several hundred dollars a year for the typical family. HSAs, which are paired with high-deductible health plans, allow people to put aside money tax-free to pay for medical expenses. In Wisconsin, unlike most states, contributions are not currently deductible from state taxes. Proponents of health savings accounts acknowledge that they will do little to make health insurance more affordable for low-wage workers and people with pre-existing medical conditions. "HSAs do not solve all the problems in the health care system," said Michael Tanner, director of health and welfare studies at the Cato Institute, a research organization that backs market-based reforms. "HSAs are a tool, but they are not the magic bullet." The Assembly has taken a strong stance against tax increases, such as Gov. Jim Doyle's proposal to tax tobacco and hospitals and use some of the revenue to fund health care programs. It also has proposed some other minor reforms: It endorsed a bipartisan proposal to exempt all health insurance premiums from state taxes. It would create up to $5 million in tax credits for employers who set up wellness programs designed to help keep people healthy. It would provide a small increase in Medicaid payments for hospitals. It would offer incentives encouraging hospitals to install electronic health records. One issue the Assembly proposal does not take on is state mandates, which require insurance companies to provide coverage for certain medical conditions. Such mandates are often cited by advocates of market-based reforms as a factor in high insurance premiums. "To the extent we can peel those mandates away, the better off we'll be," said Rep. Leah Vukmir (R-Wauwatosa), chairwoman of the Assembly's Committee on Health and Health Care Reform. Yet the Assembly has not proposed removing any mandates. 286,000 uninsured In separate interviews, Vukmir and Rep. Kitty Rhoades (R-Hudson), co-chair of the Joint Finance Committee, noted that the percentage of the Wisconsin population without health insurance is relatively low compared with other states. An estimated 286,000 people in Wisconsin have been without insurance for more than a year. The two representatives also stressed that the Assembly's focus is on controlling costs. And they contend that HSAs can do that. The underlying idea is that when people are spending their own money - money they've set aside in a health savings account - they are more likely to shop for the best quality care at the lowest price. That in turn will increase competition in health care, driving down prices the same way it does in other markets. "If you call around and say, 'I'm going to call around and pay cash. How much would you charge me?' it's going to be different and lower than with the insurance company," Rhoades said. Many health care economists agree that HSAs can influence consumer behavior and lower health care spending - though to what degree is a source of much contention. Susan Marquis, a senior economist at Rand Corp., said research shows that high-deductible health plans yield a one-time reduction in costs of 4% to 15%. Marquis agrees that HSAs could enable employers to continue offering health benefits and help keep health insurance affordable for people who are now insured. But she said, "Our research shows it isn't going to bring the uninsured into the market." Rhoades and Vukmir dispute this. "If you're lowering health care costs in general, more employers are going to be able to offer health insurance to more people," Vukmir said. Vukmir also contended that people who previously were uninsured are buying policies with HSAs. America's Health Insurance Plans, an insurance trade group, says that 31% of the people who bought health insurance policies with HSAs previously were uninsured. Yet a significant number of people who buy any insurance policy previously were uninsured. The trade group says it doesn't have figures for how many people without insurance buy any individual policy. The Cato Institute noted in a policy brief that, without that point of reference, the trade group's figures don't "reveal whether HSAs are any more attractive to the uninsured than other types of coverage." Out-of-pocket costs For certain, high-deductible insurance policies paired with HSAs cost less. That could encourage some people, particularly those who are young and healthy, to buy health insurance. But as critics note, plans with high deductibles don't necessarily lower total health care costs for consumers, because they now have the expense of the higher deductible. "Even if you have a high-deductible plan, the premiums are still going to be quite a bit of money every month," said Sen. Jon Erpenbach (D-Middleton), a key architect of the Senate's reform proposal. "You have to rifle through that deductible before your insurance even kicks in." Policy analysts agree that high-deductible plans alone don't make health insurance affordable for low-wage workers and people with pre-existing medical conditions. Devon Herrick, a senior fellow at the National Center for Policy Analysis, a policy research group in Dallas credited with first pushing the idea of HSAs, said the tax-free accounts can expand coverage. But he acknowledges that health insurance would remain unaffordable for a family of three, for example, with an annual income of $35,000. "They probably would not be able to buy the HSA plan any more than the Cadillac plan," Herrick said. But Herrick contends that only a "slim, slim group" of people cannot afford health insurance - basically families with incomes of less than $40,000 to $50,000 a year. An estimated 30 million people nationally have been uninsured for a full year - though some probably could afford insurance but opt not to buy it. The uninsured are just one of the health care system's many problems. Rhoades and Vukmir say the Assembly's goal is to encourage competition, drawing on the power of markets to make the health care system more efficient, and, in turn, lower costs. Information and tools "It's really that simple: Create consumers with information and tools with which to make decisions about their health care," Vukmir said. Yet giving consumers the information and tools they need to make decisions isn't all that simple. A hospital now may charge a dozen different health plans a dozen different prices for the same procedure. Those prices are confidential by contract. And so far at least, hospitals have largely balked at disclosing their prices. As a result, almost no information is publicly available on prices. That's beginning to change. Many hospitals will give people estimates on the cost of a procedure under their health plan. And some health plans also are beginning to provide information on costs for specific procedures. In coming years, the Wisconsin Health Information Organization, a collaboration of hospitals, doctors, insurance companies and the state, could provide specific information on costs and quality. But that may be years away. Market response The Assembly did not propose any legislation that would speed the process. But Rhoades said this is not needed because the information will become public when more people ask for it. Herrick, the senior fellow at the National Center for Policy Analysis, agreed, noting that the market will respond when enough people start asking for information on prices. But he also acknowledged that it's hard for him to get prices with his own health plan. For now, the Wisconsin Legislature is debating two radically different approaches to health care reform as it negotiates the state budget. One house has embraced an all-encompassing reform. The other has put its faith in the marketplace. Both contend they will lower costs, expand coverage and make health care more efficient. Both have their skeptics. And even supporters of market-based reforms such as those backed by Assembly Republicans concede that HSAs alone are not enough. "We are going to have to find other ways to make insurance more affordable," said Tanner, of the Cato Institute. Sat, 04 Aug 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13437&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13437&mname=Article Vrakas backs plan that unions oppose Bill would let officials change health coverage By Scott Williams, Journal Sentinel Waukesha - Waukesha County Executive Dan Vrakas has thrown his support behind state legislation that would allow local governments to impose new health care coverage on unionized employees without union approval. And labor leaders in the county are not happy about it. "Employees have to have a say in their benefits - that's the whole point of having a union," said Liz Pantelis, president of a union that represents more than 400 county workers. Pantelis and other labor leaders oppose a bill in Madison that is designed to help Wisconsin municipalities, counties and school districts save money on employee health coverage by circumventing collective bargaining. Vrakas testified in favor of the legislation this week, saying that rising health care costs are pushing government and taxpayers to the brink. "We are simply going to bankrupt our state," he said. Authored by Rep. Leah Vukmir (R-Wauwatosa), the bill is pending before the Assembly Labor and Industry Committee, which held a public hearing on the proposal Wednesday. Leaders from several public employee unions turned out to oppose the measure. Among those voicing support were Vrakas and officials from the Kettle Moraine School District, the Wisconsin Alliance of Cities and the Waukesha County Chamber of Commerce. Brian Nemoir, a chamber board member who registered his group's support in writing, said private business backs the bill because lower health insurance costs for government could mean lower taxes. "We're the taxpayers," Nemoir said. "It's a real easy equation." Waukesha County spends about $13 million a year on employee health insurance - a figure that has doubled since 2000 - out of a county budget of $254 million. If the county wanted to change its health coverage to save money, under current state law, any change affecting unionized employees would have to be presented to labor unions and negotiated in contract bargaining, which often takes months or even years. The county has about 1,400 employees, two-thirds of whom are unionized. Under Vukmir's bill, a county, municipality or school district could "unilaterally change its employees' health care coverage plan provider without the consent of any affected employee in the collective bargaining unit." The bill requires that health coverage must remain "substantially similar" to whatever was provided before. Another local labor leader called the bill's terminology vague and disturbing. "That is one of the most troublesome ideas that has come across the table in some time," said Tiffany Insley-Grigg, a board member of the union that represents about 150 county correctional officers and police dispatchers. Both the correctional officers union and a bargaining unit for sheriff's deputies are scheduled to open contract negotiations with the county this year. Pantelis' group, which represents secretaries, janitors and clerks, is in negotiations to replace a contract that expired Dec. 31. Pantelis expressed doubt that the bill would ever become law, speculating that Gov. Jim Doyle would veto the proposal if it passed the Legislature. "I don't think it'll happen," she said. "But you never know." Union representatives said that Vrakas' support for the bill could cloud future contract talks. To read the bill, go to: www.legis.state.wi.us/2007/data/AB-110.pdf Thu, 31 May 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13436&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13436&mname=Article After convention, Republicans ready to fight again By Rep. Leah Vukmir (R-Wauwatosa) Journal Sentinel Backroom Blog Last weekend, Wisconsin Republicans gathered in Lake Geneva for their annual convention. Outsiders - primarily Democrats - would prefer to imagine that such a Republican gathering would be characterized by antipathy, depression, and despondency. After all, how could a group of party faithful be any other way given the trouncing their candidates took at every level of government and in almost every state? Wisconsin’s Republicans find themselves in a far different position since the convention a year ago. On the national level, we lost control of both houses of Congress. Here in Wisconsin, we lost control of the State Senate; our Assembly majority was whittled down by eight seats; we lost a congressional seat; we were unable to field a competitive candidate for U.S. Senate, and our candidate for governor was roundly defeated. Despite these resounding defeats, the Republican Party this weekend was united, focused and ready to fight again. The grassroots of our party know exactly why we lost last November. As Congressman Paul Ryan (R-Janesville) told the delegates, “a party that leads is a party that is true to itself. So lets be honest, the Democrats didn’t win the last election, the Republicans lost it. We did not walk our talk.” Ryan labeled the last several years of Republican governance as “the sin of hypocrisy.” Congressman F. James Sensenbrenner (R-Menomonee Falls) told the conventioneers, that part of our defeat was due to the mismanagement of the war, but just as important, he noted that, “we did not give the voters the reasons to vote Republican last year…we Republicans lost our brand identity.” Sensenbrenner reminded us why we are Republicans. We are the party that believes in lower taxes, limited government, a strong national defense, safe streets, quality education and the efficient delivery of government services. Instead, we had become the party of big spending and earmarks. Elected Republicans nationally and here in Wisconsin gradually drifted towards the political center. Republican leadership gave in to the belief that increasing their majorities required them to preserve government programs and increase government spending. The voters did not abandon our Republican agenda, but many of our Republican office holders did. The voters still believe in our conservative ideals, but we must once again become worthy of our message and the beliefs we profess to hold. We must stop committing the sin of hypocrisy and we must rebuild our brand. If we do, we will preserve our base and regain the trust of the independent voters. The delegates and our party leadership understand what needs to be done and they united this weekend to bring us back to our core principles. The party is strong and devoted to our platform. Our elected Republicans must share that commitment. One resolution, easily adopted by the delegates, called on elected Republicans to stand by the party’s conservative agenda. The resolution also urges the party to withhold support for candidates, including incumbents who do not consistently stay the course. Another topic of discussion among the party members was the shaky leadership Democrats are providing both nationally and here in Wisconsin. An AP poll released last week shows that the approval rating for the Democrat controlled Congress dropped five points in a month and is almost as low as thepPresident’s rating. The public does not seem to like the way the Democrats are handling the war either, nor do they appear to be having any great success with their domestic agenda. In Wisconsin, Gov. Jim Doyle made a dangerous tactical blunder by introducing a budget that increases spending by nearly 10% over two years with huge tax increases disguised as fees. This high-risk budget strategy may prove to be a fatal mistake for the Democratic wave that hit the state six-months ago. Most of the legislative races Republicans lost in Wisconsin were decided by a few hundred votes, some by a few dozen. These razor-thin margins of victory may not be sustainable for freshmen Democrats if they stand by their governor’s $3 billion tax increase ($1.75 billion in new state taxes and $1.25 billion in property tax increases). Had Doyle kept his election promises on taxes, it would have been very difficult for the Republicans to differentiate themselves from the Democrats next November. Instead, Doyle has given Republicans something to run on and Democrats something to run from. Republicans get this and they are feeling energized. The party leadership is planning and preparing for the battle. Off-year conventions are usually lackluster. However, from my perspective the level of optimism and the eagerness of the party leaders, the party faithful and the elected leadership to address and fix our mistakes gives me hope. The Lake Geneva convention may prove to be the event that brought Republicans together. Assembly Speaker Mike Huebsch (R-West Salem), said, “every movement has a moment… let this be ours… when we look back and talk about the Republican revolution in Wisconsin that happens in 2008, let us remember Mother's Day weekend in May in 2007, when the Republican Party was reborn.” Doyle’s tax increases will not be passed unless three Assembly Republicans vote for them in the final budget package. Mike Huebsch, told the delegates assembled at the convention, “we will stand in the way of Jim Doyle and his tax increases, you can count on that.” Gov. Doyle and the Democrats have given Wisconsin Republicans a real “Opportunity Budget”. Republicans must seize that opportunity. Tue, 15 May 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13406&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13406&mname=Article Parents, politicians spar over vaccine Some say it's too soon to mandate HPV shots By Kawanza Newson and Stacy Forster, Journal Sentinel For Terri Wichman, the decision to vaccinate her 17-year-old daughter against a virus that causes cervical cancer was simple. After seeing several commercials about human papillomavirus virus, or HPV, she spoke with her own physician and then had a frank discussion with her daughter about the importance of protection once she became sexually active. Wichman says, however, that she's not forcing her daughter to get the shot and feels that no one else should dictate her family's choice. "It's too slippery a slope," said the 46-year-old mother of three from Greendale. "I have a real problem with government getting involved in this." Lawmakers in at least 39 states have introduced measures to require the HPV vaccine, provide funding for it or educate residents about its availability, while 23 are considering bills specifically to mandate the vaccine for school entry, according to the National Conference of State Legislatures. In Wisconsin, state Sen. Lena Taylor (D-Milwaukee) is preparing legislation that would require the HPV vaccine for all young girls. But some lawmakers, physicians and parents say many educational and financial obstacles must be addressed before it can be taken seriously. They also argue the vaccine is too new and needs more time to be tested. A mandate requiring the vaccine for school enrollment isn't expected to pass during this two-year legislative session, although it has stirred debate. "Part of what I want to do is not find out where we're divided but figure out how we can move something forward for girls and women of Wisconsin," Taylor said. "This isn't about Republican or Democrat, it's not about male or female. . . . This is a deadly disease that crosses all barriers." HPV is the most common sexually transmitted disease, and the American Cancer Society estimates that the virus affects at least eight out of every 10 sexually active women. HPV is most common in young women who are in their late teens or early 20s. Gardasil, a three-shot series that costs $360, is recommended for 11- and 12-year-old girls, though it can be given to those as young as 9. The vaccine, manufactured by Merck & Co., protects against four types of HPV - two that are responsible for cervical cancer and two that cause genital warts. All four types are sexually transmitted. Last month, manufacturer GlaxoSmithKline filed for FDA approval of its HPV vaccine, Cervarix, which would protect young girls and women against two strains of the virus. Any legislation would include a provision allowing parents to opt out of the requirement for any reason, Taylor said. "This is a disease that's not on people's radar," said James H. Conway, a pediatrician with the University of Wisconsin School of Medicine and Public Health in Madison. He also is chairman of the committee on immunizations and infectious disease at the Wisconsin chapter of the American Academy of Pediatrics. "We can't get to the point where we're forcing people into doing something without educating them about why they're doing it, first," he said. Conway says the academy can't endorse school-based mandates for HPV until several questions have been answered, including how long the vaccine remains effective, whether there is a need for a booster shot and if the vaccine is safe in the long term. Furthermore, there is a need for an infrastructure that will guarantee vaccination of all children - insured and uninsured, he said. Personal objections Angela Morris, a mother of three from Watertown, won't be vaccinating her 10-year-old daughter and is against the idea of a mandate; her 15-year-old daughter is past the proposed mandate age. Morris has done her own research and doesn't believe the vaccine has been fully tested. "We need to do that good science that's going to give us the answers about whether this vaccine is going to be beneficial for our children, and for me it's not there yet," Morris said. "I don't want to rush in and give my child something, and I especially don't want to be mandated to do that." For Preston Mayes, also of Watertown and the father of a 10-year-old daughter and three sons, there are moral implications. He said he is trying to teach his daughter through the family's Christian faith that she shouldn't engage in high-risk behavior that might lead her to contract HPV. "As a parent, my feeling is it's unnecessary for the general health and well-being of the population," unlike a disease such as smallpox, which can become an epidemic, he said. Taylor is talking with health care providers and advocates, legislators and parents to build a public health strategy that provides education about cervical cancer and HPV, and offers greater access to the vaccine. She would like to see the state require girls to receive the vaccine to start sixth grade. Taylor said she hasn't developed the bill yet, in part because she wants to work through some of the concerns being raised. But even if the bill were to move through the state Senate this session, it wouldn't come up for a hearing in the Assembly, said Rep. Leah Vukmir (R-Wauwatosa), a nurse and chairwoman of the Committee on Health and Health Care Reform. "The speed at which we're moving from FDA approval to state mandate is unprecedented," Vukmir said. Medical providers should take time to see potential problems and side effects that weren't picked up in FDA testing, she said. Vukmir also said the decision whether to provide the vaccine to a young girl should rest with the health care provider and parents. Sat, 14 Apr 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13435&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13435&mname=Article State's drug plan to end U.S. rejects plea for SeniorCare By Steven Walters and Stacy Forster, Journal Sentinel Madison - Federal officials denied a request from Wisconsin officials to continue the state's popular SeniorCare prescription drug program Wednesday, giving Gov. Jim Doyle and legislators an expected nine months to find a way to help many of its 103,000 participants pay for their medications. Doyle and legislators assured those Wisconsin seniors that they want to find a way to continue to provide access to affordable prescription drugs. They noted, however, that many of the 103,000 now in SeniorCare must move to the controversial - and complicated - Medicare Part D plan by the end of the year, as officials design a new state program with some of SeniorCare's benefits for the poorest seniors. The replacement program "will not be as good" as SeniorCare, Doyle said. Enrolling in Medicare Part D means seniors will have to list their assets when they apply, pay higher premiums depending on the drugs they need, and face higher out-of-pocket costs because of the controversial "doughnut hole" - periods in which there are no benefits - in coverage under the federal program, officials said. Continuing SeniorCare with state tax funds would cost $320 million over the next two years - $200 million more than the governor has budgeted for the program, and a price Wisconsin cannot pay, Doyle said. Now, federal funds and drug-price rebates negotiated by the state pay 60% of the cost of SeniorCare. Doyle, legislators and representatives of aging groups said seniors should not panic but give their elected officials time to design a supplement for Medicare Part D. "The advice today is: Hold tight. SeniorCare isn't over today. People should go get their prescriptions filled," Doyle said. Helen Bixby, 87, of Muskego said she was "just sick" about the decision of federal officials to not allow SeniorCare to continue. She takes six drugs for heart-related ailments and needs a salve for cancer on her ear. Bixby said her income is $15,600, so she now pays a $500 annual deductible to qualify for SeniorCare. She said she has attended seminars on costs and benefits under Medicare Part D, and gone through piles of mail asking her to sign up for drug plans. But, she added, "There is nothing on the market like SeniorCare - it's not a benefit, it's a lifeline." Seniors are encouraged to seek out resources on the federal program, including through aging advocacy organizations in their counties, Doyle said. SeniorCare started in 2002, prior to the creation of Medicare Part D. Federal officials have said they want all states to participate in Part D. Wisconsin has been the only state with its own program. Federal officials told Doyle in a letter they could not determine whether SeniorCare saved money, in part because state officials didn't provide some details. "Because the state failed to submit critical information for us to evaluate, we have no basis to conclude that SeniorCare is budget neutral to the federal Medicaid program," wrote Leslie Norwalk, acting administrator of the federal Centers for Medicare & Medicaid Services. Responding, Doyle angrily accused Norwalk and other federal officials of ignoring data state officials sent to Washington proving that SeniorCare is cheaper than Medicare Part D. Members of Wisconsin's congressional delegation vowed to fight the decision. Attention shifted Wednesday to what the state can do to help transition. Gail Sumi, government affairs representative for AARP Wisconsin, said the state should work to ease the asset standards for low-income participants to receive a subsidy under Medicare Part D. To qualify for the subsidy under the federal program, annual incomes must be below $15,315 for individuals and $20,535 for married couples, and assets have to be less than $11,710 for individuals and $23,410 for married couples. The state should use money already budgeted for SeniorCare to find a way of helping the 43,000 lowest-income participants in SeniorCare, said Rep. Leah Vukmir (R-Wauwatosa), a nurse and chairwoman of the Assembly's Committee on Health and Health Care Reform. Vukmir encouraged SeniorCare participants to begin looking at prescription drug plans available through different insurers. For some, especially those with higher incomes who pay annual deductibles between $500 and $850, a Medicare Part D plan might turn out to be a cheaper option, she said. SeniorCare Q&A Q: What if I'm enrolled in SeniorCare now? A: The program will continue as is until the end of the year. In the coming weeks, state officials will work with federal authorities to develop a timetable for the transition. Wisconsin will also look at how to supplement the federal program to make it affordable to the most needy participants. Q: Who can I contact to register support for SeniorCare? A: AARP Wisconsin is encouraging residents to contact their state lawmakers to let them know how important the program is to enrollees; the state's legislative hotline is (800) 362-9472 and Gov. Jim Doyle's office number is (608) 266-1212. Q: Should I start looking at plans under Medicare Part D? A: AARP Wisconsin said it's premature for SeniorCare enrollees to start researching potential Medicare Part D insurance plans, but some lawmakers are encouraging residents to familiarize themselves with their options under the federal plan. Q: Where can I get more information about Medicare Part D? A: AARP's Web site has a section on Medicare Part D; find it at www.aarp.org/health/medicare/drug_coverage/medicarerx_coverage.html. AARP Wisconsin can be reached at (866) 448-3611 and the Coalition for Wisconsin Aging Groups is available at (800) 366-2990. Wed, 04 Apr 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13434&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13434&mname=Article Support Slipping For Cervical Cancer Bill Mandatory Vaccine Shots For Sixth-grade Girls Hits Medical And Legislative Opposition. By Mark Pitsch, Wisconsin State Journal In January, two Democratic senators announced bipartisan support for a proposed bill that would require all sixth-grade girls to be vaccinated against the virus that causes cervical cancer. But since then, social conservatives and medical groups have opposed the mandate, some Republican co-sponsors have withdrawn their support and the chairwoman of the Assembly health committee has declared the proposal dead on arrival in that chamber. "If the legislation comes before my committee, it's not going anywhere," said Rep. Leah Vukmir, R-Milwaukee, the Assembly health committee chairwoman. Sens. Lena Taylor, D-Milwaukee, and Robert Wirch, D-Pleasant Prairie, said they still plan on introducing the legislation, which would include an opt-out provision for parents who object. But Wirch admitted this week that the mandate will have a hard time being enacted. "There are significant obstacles in its path," Wirth said. Taylor said she's still trying to build support for the legislation among lawmakers, medical groups and others, and she planned to continue pushing for a mandate. She also said she didn't know when she would introduce the bill. "The desire is to try to find something that moves us toward making sure we embrace this vaccine to eliminate cervical cancer for the daughters of Wisconsin," Taylor said. Across the country, more than 20 state legislatures are debating whether to mandate the Gardasil cervical cancer vaccine for girls, according to the National Conference of State Legislatures. Some states are also weighing related legislation, including to require insurers to cover the cost of the vaccine, to educate parents or to use tax dollars to pay for the vaccine for poor or underinsured girls and women. A vaccine mandate bill died in Mississippi, one was withdrawn in Maryland and another passed in Virginia and is awaiting the governor's signature, the national legislature group said. In Texas, Republican Gov. Rick Perry this year issued an executive order requiring the vaccine for all sixth-grade girls. Perry's action sparked a national controversy over the vaccine after it was revealed that his former chief of staff was a lobbyist for Merck, the vaccine's manufacturer. Merck and Women in Government, a bipartisan group of female state lawmakers, were strongly pushing states to enact legislation mandating the cervical cancer vaccine in girls. But Merck announced last month that it would suspend lobbying. Neither Merck nor Women in Government are registered as lobbyists in Wisconsin. Vukmir said she has not talked to representatives from either organization, but said she has received information from the women's group on the cervical cancer vaccine. 9,700 new cases According to the Centers for Disease Control and Prevention and the American Cancer Society, there were 9,700 new cervical cancer cases in the United States last year and 3,700 cervical cancer deaths. Nearly all of the cases resulted from the human papillomavirus, a sexually transmitted disease that also causes genital warts. An estimated 20 million people are infected with the virus, and an estimated 80 percent of sexually active women will contract it by age 50, according to the CDC. Last summer a federal CDC panel recommended that all girls and women ages 11 to 26 be vaccinated. Gardasil is the first vaccine approved. It was the first vaccine ever approved to fight cervical cancer, and proponents say it has the potential to nearly eliminate the disease. Girls and women in Wisconsin can get the $360 vaccine, a series of three shots, if their doctor carries it. But some insurance providers or company health plans may not cover the cost, according to Phil Dougherty, a spokesman for the Wisconsin Association of Health Plans, which represents health maintenance organizations and other insurers. Because the CDC panel has recommended the vaccine, girls eligible for the state Vaccine for Children Program for low-income, underinsured and American Indians can get the vaccine for free, said Stephanie Marquis, a spokeswoman for the Department of Health and Family Services. Girls ages 9 to 18 are covered under the state program, and the federal government will pay for the vaccine, Marquis said. Dr. Jim Conway, a pediatrician and infectious disease specialist at UW-Madison, said it is important to vaccinate girls before they become sexually active because once the virus is contracted it remains in the body. A woman with the virus could show no outward signs of infection, such as genital warts, but still get cancer later in life, he said. Adolescents and young women who are infected are more susceptible to getting cancer than women who get infected later in life, he said. The vaccine is safe and federally approved studies are continuing, Conway said. But Conway, who is a consultant for Merck on other immunization issues and is immunization chairman for the Wisconsin chapter of the American Academy of Pediatrics, said questions remain about how many years the vaccine will be effective, how many supplemental shots a woman would need throughout her life, and who will pay for it. Some insurers have balked at paying for the vaccine, and some doctors aren't stocking it because of the high cost and uncertainty over whether they'll be able to cover their costs of making it available, he said. Those questions have led proponents of the vaccine -- such as the Wisconsin chapters of the American Cancer Society and the American Academy of Pediatrics, and the Wisconsin Academy of Family Physicians -- to oppose or remain neutral on legislation to mandate the vaccine. Meanwhile, social conservatives oppose mandating the vaccine because they say it could lead to premature sexual activity. "What we're telling kids is, look, we expect you'll be sexually active between 12 and 16," Julaine Appling, chief executive officer of the Family Research Institute of Wisconsin, said of a possible vaccine mandate. Appling said parents and physicians should decide whether a girl should be vaccinated. But Wirch and Taylor dismissed those concerns. "Why would social conservatives want to deny this vaccine to people if there's an opt-out provision?" Wirch said. Legislators withdraw Vukmir and other Republicans agree. Sen. Alberta Darling, R-River Hills, said she had expected to co-sponsor Taylor's legislation but decided against it after she learned it mandated the vaccine. Darling said she would support a public education campaign for parents about the vaccine, but that she's not sure legislation is needed for that. In her online newsletter for Jan. 20, Taylor also cited Republican Sens. Luther Olsen of Ripon and Dan Kapanke of La Crosse; Rep. Suzanne Jeskewitz, R-Menomonee Falls; and Rep. Tamara Grigsby, D-Milwaukee as co-sponsors. Kapanke said he also has concerns about the bill and is no longer a co-sponsor. Olsen, Jeskewitz and Grigsby didn't return several telephone calls seeking comment. Taylor has since removed their names, along with Kapanke's and Darling's, from the list of bill co-sponsors on her online newsletter. CERVICAL CANCER VACCINE Merck has developed a $360, three-shot vaccine that would prevent cervical cancer. THE ISSUE: Federal officials are recommending that girls and young women be vaccinated against cervical cancer, which is caused by a sexually transmitted virus. PROPONENTS SAY: The state should mandate the vaccine before girls become sexually active. OPPONENTS SAY: Requiring the vaccine could lead girls to engage in premature sexual activity. Others argue that it's unclear who would pay for the vaccine. To contact a lawmaker Phone: 266-9960 in Madison; 1-800-362-9472 toll-free Online: www.legis.state.wi.us Mon, 05 Mar 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13429&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13429&mname=Article Doyle seeks electronic health-data fund He wants $30 million to encourage use of records, reduce care costs, errors By Stacy Forster, Journal Sentinel Madison - Gov. Jim Doyle said Thursday that the state budget he would introduce next month would include $30 million to boost the use of electronic medical records to reduce medical errors and lower health care costs. "Health information today is often inaccurate, and unfortunately, it's often filled with errors," Doyle said at Dean Health System. "Patients, providers and health officials often have to make decisions with inadequate information." Rep. Leah Vukmir (R-Wauwatosa), chairwoman of the Assembly Committee on Health and Health Care Reform and a nurse, said speeding the use of electronic medical records was also part of Assembly Republicans' efforts to bring down the cost of health care. "Having worked in a variety of health care settings from emergency rooms to office settings, the savings here in time and money and human lives, it's huge," Vukmir said. Vukmir said Wisconsin should require that medical providers that want to do business with the state meet information technology standards. Such a requirement is in place for those who participate in federal health care programs, she said. Doyle said the $30 million would be a mix from general budget funds and the Injured Patients and Families Compensation Fund, which gets its money from fees collected from doctors and health care providers and pays malpractice awards. "I hope and I think everybody would agree this is an appropriate use of a very small portion of that fund to improve medical quality," Doyle said. Rep. Kitty Rhoades (R-Hudson), a co-chairman of the Legislature's budget-writing Joint Finance Committee, said there wasn't state money in the fund and that Doyle shouldn't tap it. "The fund is there for payments to insured patients and families," Rhoades said. A grant program with $20 million would be available for non-profit organizations that implement electronic health initiatives. There would also be $10 million in tax credits for businesses that put electronic health efforts in place. The key for health care providers is the cost of implementing an electronic record system, because it can be expensive for those starting from scratch, said Mark Grapentine, senior vice president of government relations for the Wisconsin Medical Society. "It makes it harder for the two- or three-doctor shops to do this," Grapentine said. Thu, 25 Jan 2007 00:00:00 CST http://leahvukmir.com/site/Viewer.aspx?iid=13433&mname=Article http://leahvukmir.com/site/Viewer.aspx?iid=13433&mname=Article