Legislative Leaders Diverge on Policy Issues, but Agree Health Care is an Asset

Four of Wisconsin’s legislative leaders participated in a panel discussion at WHA Advocacy Day 2017. This is part one of a two-part series featuring that dialogue. The second article in this series wi

April 21, 2017

It is the most highly anticipated and popular session at WHA’s Advocacy Day, and this year the state legislators participating in the panel discussion moderated by WHA President/CEO Eric Borgerding did not disappoint the audience.

Legislators participating on the panel included: Senate Majority Leader Scott Fitzgerald (R-Juneau); Senate Minority Leader, Jennifer Shilling (D-La Crosse); Assembly Speaker Robin Vos (R-Rochester); and, Assembly Minority Leader Peter Barca (D-Kenosha).

Borgerding kicked the conversation off by asking Barca for his thoughts about the importance of hospitals and health systems to economic development.

"Health care is an important asset in our state. A WHA survey of 300 employers showed they ranked quality health care second in importance only to education," Barca said. "You are making our regions more economically vibrant. We need to do what we can to support your efforts and provide you with the tools to succeed."

Before answering his first question, Vos made a point of dispelling any notion that Wisconsin legislators do not "get along."

"We are fortunate to have four leaders who get along. While we don’t agree on all the public policy points, we know we have good people in our state, and we are lucky that our economy is doing better," according to Vos.

On the point of the importance of good quality health care to the state, Vos noted there is a budget surplus of "almost a half billion dollars."

"That is why in this budget we can make significant investments to improve our business environment. As a business owner, I need access to high-quality health care and a great education system…and it’s important that we fix transportation," Vos said. "This is a time to be proud that we have leaders who work together addressing problems that are really important that keep our economy growing."

Shilling noted she has good access to quality health care in all areas of her district and because of that, she is seeing employers and health systems partner to provide on-site clinics and wellness programs to employees.

"It’s a cost savings. They realize if their employees are healthy, they are more productive," she said. "As we recognize the important role that health care has on our economy, in many communities it is the nursing home, hospital and school district that are the largest employers. But, as we look at Medicaid and uncompensated care, we know we still have work to do."

Shilling said much of the work that has been done in the Legislature on the opioid problem, mental health and telemedicine has been on a bipartisan basis. "Urban and rural, Democrat and Republican, we have worked together on these issues," she said.

Fitzgerald said it is frustrating that so much of health care is driven by the federal system.

"We understand the importance of health care in every community we represent. For us, it is frustrating that so much of health care is driven by the federal government," he said. "We have to look for waivers to implement stuff related to Medicaid. I am hopeful that some of the action we are seeing in Washington results in more flexibility in the state. If there is any place to manage health care, anything that reaches out and touches a hospital, it should be handled at the state level. We have a bipartisan relationship to accomplish things. If a block grant came down, this is where we could do good with that."

Fitzgerald said he appreciates the community programs that hospitals sponsor because it moves them to a prevention model, and that is why "hospitals are so important to mid-sized and small communities."

Moving to the topic of workforce, Borgerding asked the panelists if there is a role for the state of Wisconsin to help meet the demand for health care professionals in hospitals and health systems.

Vos said this is a really critical topic not just for hospitals, but for all employers.

"If you draw a line from Eau Claire to Green Bay, the region north of that line is one of the oldest in the entire United States. That is why we focus so much effort to ensure we have great schools in Wisconsin; the entire community depends on that," Vos said. "We have done some things to encourage people to go into different career fields. We have the patient’s compensation fund to make sure doctors come here and to know we value their services. But it’s a real challenge. Health care is no different than other fields, except you are a 24/7 business, and you cannot stop a line or fill in with a substitute. We need to attract more people to our state and into better careers."

Shilling said career exposure is occurring at younger ages. Students need to know about the career opportunities available in their own town. She said a new rural legislative initiative should help.

"There is a rural health care package that offers incentives and targets some of our rural communities. It has matching grant programs for newly created clinicians and incentives such as loan forgiveness for professionals to practice in remote areas," according to Shilling. "If they practice in those rural areas, they are more likely to stay. I think working together in a bipartisan fashion will help us address these issues."

There are big picture issues to consider, according to Fitzgerald. It is a matter of once they have the right education, to attract and keep them in the community.

"If you open a facility, say with 100 jobs and offer a good wage, but there is not an infrastructure to support having restaurants and adequate housing, those kids won’t want to live in that size of a community," he said. "The hospital is the one place that brings professionals together and there is a real effort to attract physicians, nurses and other clinicians. If there is any place this hits hard, it is hospitals because you need all those professionals in one place."

Borgerding agreed the hospital really is a hub, and we must find ways to keep our kids here. The blueprint is in place, he said, which is graduate medical education (GME).

"We know if a Wisconsin student attends medical school here and completes a residency here, we have an 86 percent chance they will practice here," according to Borgerding. "The Rural Wisconsin Initiative is the exact model we want to follow with allied health professionals to create opportunities for them to stay in our communities and enter post grad training."

Barca is concerned about the shortage of mental health professionals and psychiatrists. He believes the state could do more to attract these professionals to Wisconsin.

"I think getting our education institutions to open more nursing slots is important, but we are asking people to have more post-graduate opportunities, too," Barca said. "We have an aging workforce. We have to do much better at keeping people here and attracting them to Wisconsin. We have to make sure that people want to stay here. We need to do better to support entrepreneurs…refinance their education debt… and in health care it means greater partnerships with WHA and the Medical Society."

This story originally appeared in the April 21, 2017 edition of WHA Newsletter