Thursday, July 5, 2007

5 Spot: Judi Hilman

[CW Extra] Judi Hilman is Utah Health Policy Project’s executive director. Her organization seeks sustainable health-care coverage for every Utahn. Are Hilman and her minions tilting at windmills? Or are they on the verge of ushering in a new era of health-care reform? Read her comments below and you can decide. (Excerpts of this interview appeared in City Weekly’s July 5 Five Spot column.)

What did you think of the Michael Moore film Sicko?
Overall, thumbs up. I think it’s definitely worth seeing, but it is a pretty devastating portrait of our health-care system, and whether that’s accurate or not, that type of portrait may not be helpful for when it comes to getting people focused on solutions. States all over, including Utah, are finally tackling the beast of our health-care crisis, so I wouldn’t want Moore’s reputation to slow down momentum on solution seeking.

Was there any moment in Sicko when you felt sicko?
Sicko but also catharsis. At the moment when the medical director from Humana got up in front of Congress and testified that she denied claims. I just broke down completely. I think what that confession showed us is there is an awareness of the problems with the current system, the cherry picking and the social Darwinism that goes along with the experience rating that we do. We finally have a critical mass that sees there is something horribly wrong with that. It’s not just the Michael Moores of the world that find that outrageous but the actual former medical director of Humana.

That sicko feeling is not especially new to me. What got me really sicko was the difference between U.S. and, say France in terms of our quality of life and ultimately family values.

Why does health care in our country languish behind other nation’s?
We have not seen health care as vital part of our social infrastructure. I think that what’s happening now in the U.S. is that we have more and more businesses saying, “Hey, we can’t compete.” I think that’s what in the end is what gets the U.S. to do something meaningful. I think we are on the brink. I think Utah is on the brink of meaningful reform. It’s not because of the tragic stories so much as businesses can no longer compete. They have to continually pay double-digit health-care costs.
Moore’s movie points to specific historical developments that moved each European country and Canada to financially sustainable coverage for all. I’m optimistic that the U.S. is next, starting with Massachusetts and the other earlier implementers. Utah is not far behind.

What does the Utah Health Cooperative (UHC) hope to accomplish?
Financially sustainable health-care coverage for every man, woman and child in Utah, whether through the UHC or the Exchange, which is a mechanism to facilitate efficient purchase of insurance.

Utah is trying to model the Massachusetts Connector Model in Utah. Utah solution seekers want to call it the Exchange. The idea being that right now some big pieces—making it truly affordable, doing community ratings so we are share risk appropriately—those are big pieces that are being seriously considered in the Exchange. If we get those big pieces, if they fit, that will be a very meaningful reform, and we will be happy to put all of our energies toward it.

We are hopeful about the Exchange, because so far at least at this concept stage, it will allow everyone covered on the Exchange to share risk—no more cherry picking! And it will be affordable.

What or who are the biggest obstacles in achieving your aims?
The concept that health care is a commodity. And the idea that authentic charity care could somehow make up for whatever the market lacks.

Is it possible for one state to offer universal health care?
Absolutely. Look at Massachusetts, Maine, Vermont, soon California, Illinois, now Wisconsin. Utah is next! All are learning as they go, but that’s how it starts.

If yes, won’t everyone want to move here?
What’s wrong with that? If we make coverage affordable and accessible, businesses will want to locate here … and everyone wins when this happens. Far as I can tell, our governor’s No. 1 priority is to bring businesses to Utah.

Do you ever feel threatened for speaking out on health-care reform?

No, not anymore. You would be surprised at how open political leaders are now to positive changes. We are at the table because everyone is relaxing about change and realizing we have to do something fast. In Utah, there is increased urgency to do something before the next presidential election. This is why solution framework for the Connector and for the Exchange is coming right out of the Heritage Foundation.

Do state legislators have a clue how increasingly out-of-reach affordable health care is becoming for the average family?
Yes, some of their own families are impacted. I can introduce you to at least six legislators who’ve had medical crises that they had trouble paying for. Now, whether this awareness translates into making sure coverage is affordable for low-income families: we have work to do here.

What can local residents do to see that universal health care is enacted in Utah?
Join the UHPP Health Matters alert list and consider endorsing our nine principles for health-care reform. Visit

Do you have any message for the CEOs of insurance companies?
I say: Please stay with this Exchange concept: what you might lose in any disruption to your business model you will gain in increased volume of business. (Jerre Wroble)

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