The Milwaukee Post

February 1, 2019 • Milwaukee County Post • 7 BUSINESS / OPINION Area reports 2.7 percent without jobs in December Exploring how the Albrecht way is helping the uninsured and the underinsured Milwaukee W-O-W unemployment rate drops again By John Torinus Down at the ground level, here at the Albrecht Free Clinic in West Bend, it is bla- tantly obvious that our political leaders need to do some fresh thinking on the deliv- ery of care for Americans who are unin- sured or underinsured. The clinic treats hundreds of people who can't afford care elsewhere, including peo- ple on Medicaid. Patients in Washington County who are living at less than 200 per- cent of the federal poverty level are eligible. Here are the major rubs: ■ It's the high costs of care that are the underlying issue for driving up premiums by at least 5 percent per year and often more on state exchanges. ■ The uninsured rate in the country jumped to 13.7 percent in the fourth quar- ter, up from a low of 10.9 percent in 2016. ■ Dentists in the county and some doc- tors will not treat people eligible for Medicaid, because Medicaid payments are not enough to cover the basic cost of care, much less make a buck. So, the clinic has stepped up. It has been in operation for 22 years for medical care and added dental services about three years ago. The clinic can only operate because of donations and because doctors, dentists and their staffs typically donate four to eight hours a month of their time. It has recruited 56 medical volunteers, 26 dental volunteers and 47 nonmedical. It saw more than 450 patients in 2018 for medical issues and more than 300 for den- tistry. Obviously, if the cost and price structure of medical care were less outrageous, there would not be that kind of demand for free care. Meanwhile, over in Madison, Gov. Tony Evers has focused on expanding Medicaid with mostly federal dollars, knowing that the Republican legislative leaders Speaker Robin Vos and Senate Majority Leader Scott Fitzgerald will not go along. The gov- ernor is also sending confusing messages about how to remove the state from lawsuit to torpedo Obamacare, with Vos and Fitzgerald standing pat. It's the same partisan debate that has been going on since Obamacare passed in 2011. The thinking of this timid trio is in a rut. What's missing at their level is the kind of problem-solving that is going on at the Albrecht Free Clinic. Why don't Evers, Vos and Fitzgerald pull in the smartest innovators for delivery of care — there are many in Wisconsin — and come up with a better model? For example, we know from QuadMed and other on-site or near-site providers in Wisconsin that proac- tive primary care sharply reduces costs by keeping employees out of expensive hospi- tals. Why not build a medical home into every health plan? We know that Medicare is better man- aged than Medicaid, so why would Evers not ask for a federal waiver to use the Medicare platform to deliver care to the poor? Better yet, use Medicare Advantage that almost 40 percent of Medicare recipients have switched to. It offers more choices of serv- ices because of competition among health insurers. We know that fixed, bundled prices (no more than $3,000 for a colonoscopy or $30,000 for a joint replacement) save 40 per- cent or more on elective procedures. Why not build bundled prices at top quality hos- pitals into the pricing structures of public health plans? That's what Walmart does for its employees. Why not promote lean disciplines in the medical-industrial complex, as has been done in several hospital systems in the state? These are the same disciplines that have made American manufacturers com- petitive with suppliers from low-labor-cost countries. I have said many times that fixing the disaster on the economic side of U.S. health care is more about management science than political science. It's about problem- solving. An example at the local level is what Dr. Robert Gibson, AFC volunteer medical director, is doing to stem the opioid crisis in Washington County. "For patients without insurance who can't afford a month Vivitrol injection that costs up to $1,000, the clinic has been able to help," he said to describe his Medically Assisted Treatment program. Dr. Thomas Albiero, the volunteer AFC dental director, is finding ways and funds for 30 people who need dentures at $1,000 apiece. "We love to see patients smiling again and having the confidence to attain or keep gainful employment," he said. To break out of their rigid partisan mindset, Evers, Vos and Fitzgerald should make a joint trip to the Albrecht Free Clinic, where problems are being solved, not debated for political gain. (John Torinus is chairman of the board of Serigraph Inc. in West Bend and blogs regularly at www.johntorinus.com. His col- umn runs occasionally in the Post.) MILWAUKEE — The unemployment rates for metro Milwaukee took another dip in December coming in at 2.7 percent, down slightly from the 2.9 percent rate in November and 2.8 percent for December 2017, according to data released Jan. 22. The Department of Workforce Development said that preliminary December unemployment rates for Wisconsin's 12 metro areas declined or stayed the same when com- pared with December 2017. The metro area with the greatest decrease during that time was Wausau at 0.2 percent. For municipalities, the December unemployment rates declined or stayed the same in 26 of Wisconsin's 32 largest cities. The DWD said unem- ployment rates ranged from a low of 1.9 percent in Fitchburg, Madison and Sun Prairie to a high of 3.8 percent in Racine. Milwaukee was one of nine Wisconsin cities that tied or set a record for their lowest unemployment rate on record. It was joined by Wausau, Racine, Janesville and Beloit. Milwaukee's unemploy- ment rate for December was 3.3 percent, compared with 3.7 percent in November and 3.5 percent last December. Brookfield's unemploy- ment rate for December was 2.2 percent, compared with 2.4 percent last December, while Menomonee Falls was also at 2.2 percent last month and 2.3 percent in December 2017. New Berlin came in at 2.4 percent in December and 2.3 percent last December. Waukesha reported an unemployment rate of 2.3 percent for December, the same as last December, and West Bend was 2.4 percent in December, compared to 2.3 percent last December. Wauwatosa also saw a slight increase in December, rising to 2.4 per- cent compared with December 2017 when it was 2.3 percent. Oak Creek also remained the same year over year at 2.3 percent. When taking a look at counties, the DWD said pre- liminary unemployment rates for December 2018 declined or stayed the same in 52 of Wisconsin's 72 counties over-theyear. The largest over-the-year decline occurred in Florence County (0.8 per- cent). Dane County had the state's lowest unemploy- ment rate in December (1.9 percent). Three Wisconsin coun- ties, Rock, Racine and Milwaukee, tied their record low unemployment rates. Milwaukee County had a rate of 3 percent in December, compared with 3.3 percent for November and 3.1 for December 2017. Waukesha County's rate was 2.3 percent in December, the same as November, and 0.1 less than December 2017 when it was 2.4 percent. The unemployment rate for Washington County was 2.2 percent for December, the same as December 2017, and 0.1 percent lower than November. The rate for Ozaukee County was 2.1 percent last month, 2.3 per- cent in November and 2.1 percent last December. West Bend free clinic could be example for state Torinus

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