The Milwaukee Post

March 17, 2017 • Milwaukee County Post • 7 OPINION By JOHN TORINUS In their rush to repeal and replace Obamacare, Paul Ryan's Republicans in the House essentially punted. They had seven years while vehemently opposing the Affordable Care Act, which played out as the Unaffordable Care Act, to craft an elegant plan for governing the health care industry — nearly one-fifth of the U.S. economy. Instead they made least- wurst sausage. Speaker Ryan, R-Wis, knows a lot about health care economics, so President Donald Trump (not so much) has made him the head sausage maker. There are a lot of ingredients in his politically expedient House plan, none of them very bold. They kept politically popular elements of the plan: coverage of young adults on parents' plans and pre-existing conditions, both of which drive up insurance costs. They got rid of a politically unpopular ele- ment of ACA, the individual mandate, which will drive costs up as young health people leave the insurance pools. They kicked the Medicaid expansion issue down the road. They substituted tax credits for the Obamacare subsidies, but they are kissing cousins of one another. The legitimate worry on the part of some House Republicans, including Rep. Glenn Grothman, R-Wis, is that the credits were set so high that private employers will dump their health plans and put their employees onto the insurance market for single policies. It costs around $6,000 to provide care for an average American employed in the pri- vate sector. With the average tax credit set at about $3,000, the temptation for employ- ers to get out of health care will be high. Time will tell how many employers actually bail on the health care benefit. But if they do bail in large numbers, it is not a good thing for the country, because the pri- vate payers are the real reformers who are bringing down health costs. Insurance companies are not reformers; they are middle men. Note: Rising health costs are the real elephant in the room. They continue to inflate at double the general inflation rate in the country. There is also a huge risk, because some 150 million Americans now get their health care through their employers' plans. What if the private markets don't work well, if health care insurers don't step up? Unfortunately, private companies, who pay every dollar for the nation's health care bill, either through their own health plans or through taxes at the company or employee level, have not been major participants in the national discourse on health care. Most of the political debate has been about insurance reform, but since pri- vate companies mostly self-insure, so they are not in the game of insurance policies any more. What else will be lost if employers bail? Private employers have increasingly set up medical homes for their people. They have become very serious about proactive pri- mary care that keeps their workforces healthy and out of expensive and danger- ous hospitals. IBM, for example, requires medical homes in any health plan they contract for. Costs drop 20 percent to 30 percent with proactive primary care, as Quad/Graphics of Wisconsin has proved for 26 years. Private payers have learned that incen- tives and disincentives have to be right for every consumer of care. That means high deductibles and co-insurance, offset by some kind of savings plan. Health savings accounts, a Republican invention, work fine for people paying taxes, because they are triply tax-advantaged. But they don't work well for roughly half of the popula- tion that doesn't pay taxes. That uneven playing field needs to get fixed. The Republicans have missed an oppor- tunity to establish real transparency on the price of care. Prices vary 400 percent in the present busted business model. There is a silver bullet for Ryan. He could amend the bill to mandate that health plans offer bundled prices. That means one, fixed price for any standard procedure. Bingo: instant clarity. Anyone can understand $26,000 for a joint replacement or $3,000 for a colonoscopy. No one can understand today's inscrutable medical bills. Ryan and the GOP could have learned many lessons from private employers. He could still solve many more of the issues facing American health care. He and, by extension, Trump, will not get much applause for booting a long punt. (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.) By BRIAN HUBER Conley News Service WAUKESHA — After chewing the fat, attorneys for steakhouses in both Milwaukee and Delafield involved in a dispute have filed a stipulation and order that resolves the need for an injunction hearing that had been scheduled in the case. BW Holdings, LLC, doing business as Ward's House of Prime, last month filed a lawsuit and sought an injunction against PrimeOne LLC, whose owners operated Ward's House of Prime in Delafield via an agreement with Ward. The first Ward's House of Prime, owned by Brian Ward, is located at 540 E. Mason St. in Milwaukee. The pleadings said the parties jointly owned and operated Ward's House of Prime on Wells Street in Delafield until Creative Directions, LLC, run by David and Meghan Martin, on Feb. 23 "suddenly and unilaterally changed the restaurant's name to PrimeOne, disclaimed plaintiff's ownership interest in the restaurant and barred plaintiff from association with or entering the restaurant." Beyond that, Ward's House of Prime alleged PrimeOne continued to operate under Ward's liquor and food licenses, used Ward's secret recipes, cooking meth- ods and other proprietary aspects of its restaurant system, and cut off Ward's access to his email, website and social media accounts. An injunction hearing set for last week was taken off the calendar when Ward's attorney Joe Newbold said the sides reached an agreement resolving most of the immediate issues. The stipulation filed in court this week said the defendants have turned over access and control of the House of Prime email accounts and will cede administra- tive access to the website immediately. Ward's is authorized to delete social media accounts for the Delafield location, and the PrimeOne defendants are to use "best efforts" to scrub reviews of the Delafield restaurant from Internet sites like Yelp and Trip Advisor. The PrimeOne defendants also must remove any reference to Ward's House of Prime or Brian Ward from the licenses for the Delafield restaurant, and must also stop accepting Ward's House of Prime gift cards after a mutually satisfactory notice is sent to all customers. Ward's retains a customer list, minus customers added to it by PrimeOne, the stipulation said. In addition, each side must enter into a non-disparagement agreement. And finally, David Martin must show what steps he has taken to change recipes used for food served at the Delafield restaurant from Ward's recipes to new ones used at PrimeOne. The stipulation said the parties agreed to the arrangement in principle on March 3 and have already begun to complete sev- eral of the components of it. Tom Lyons, attorney for PrimeOne, declined to comment Tuesday. Newbold said via email, "We are pleased with the results of the litigation so far, but we have no further comment at this time as the parties are in the process of entering into a non-disparagement agreement." A scheduling conference in the case was set for May 15. Email: bhuber@conleynet.com BUSINESS But stipulation doesn't end underlying litigation Torinus Faced with tough call, GOP punts Legal tender: Milwaukee, Delafield steakhouse parties embroiled in lawsuit reach agreement

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