Just how lightweight is the campaign for Wisconsin governor between Democrat David Crowley and Republican Tom Tiffany?
They are essentially punting on the biggest affordability issue in the state and nation: Health costs are projected to rise by more than 9.5% in 2027. That can only be called hyper-inflation, especially since the pattern of large increases has been there for two decades.
Even though employers now absorb more than 80% of health plan costs, according to AON, a large consulting company, employees are expected to spend nearly $5300 on health care this year.
The increases are unsustainable for many families and small businesses. With that stark reality facing us all as the number one affordability issue, why are Tiffany and Crowley side-stepping it?
Tiffany is calling for more health care transparency on prices, but that strategy has been around for decades and hasn’t moved the needle on costs and prices. Health care prices are so complicated that the average consumer almost never checks on prices for treatment. Transparency simply hasn’t worked.
Similarly, Crowley has done no serious work or thinking on how health care costs might be reformed. He has called for a “public option” that would allow individuals and companies to buy into BadgerCare, the state’s version of Medicaid, the federal program to cover the poor. His sound bite is a non-starter. Why do I say that?
Medicaid is actually a combined federal and state program, with the feds picking up about 60% of the tab. Could Crowley convince the president and Congress to create such a public option here? Doubtful.
On point: President Trump and the Republican-controlled Congress are going the other way. They have been cutting subsidies for public health care. Tiffany was part of the Republican majority that just voted against extending Obamacare tax credits.
Further, Medicaid administration has been a mess. It is administered differently in each of the 50 states. Wisconsin would be an outlier with a public option.
Even more problematic are Medicaid prices. In Wisconsin, they run at 66 cents of the dollar spent by Medicare on standard medical procedures. Hospitals claim not to be able to stay alive with low Medicare prices, much less with much lower Medicaid prices.
Long and short, Crowley’s promise to open up BadgerCare is an empty concept.
Crowley should study Wisconsin history. When BadgerCare was created in 1999, it was opened up for the public option for three years until that program died, because it didn’t work.
Also lightweight: Tiffany won’t depart from the Republican Party line that calls for cuts in federal health care spending. The GOP has never had a workable health care strategy.
Crowley sounds good when he calls for accessible clinics, better addiction treatment access and expanded “mobile outreach.” But it’s more spending without cost controls.
So what would work?
There is a way forward for states. Indiana and Oregon have crafted innovative strategies that appear to be working. Indiana just passed a law that limits health care price increases to 200% of Medicare prices. Oregon is on the same track.
In effect, their health plans rely on Medicare clout, which has more purchasing power than any other entity in the country.
While hospitals would go bankrupt with Medicaid pricing, they should be able to stay viable with 200% of Medicare.
Note that, according to Rand Corporation, Wisconsin is more than 300% of Medicare for average price levels for private insurance treatments – the highest in the Midwest.
That said, a few hospitals have shown the way. They use the same lean disciplines that manufacturers have used to keep costs and prices under control.
Importantly, lean organizations aim to improve quality as their main objective. If you improve quality, such as reducing hospital infections, costs fall. One lower cost outcome, for example, is fewer readmissions to fix medical mistakes.
The political beauty of price caps based on Medicare is that they are easy for the public and politicians to understand and articulate. The word “caps” fits in headlines. Everyone on Medicare loves it.
At one time, Medicare had a price cap of $30,000 for a joint replacement, compared to double that or more at some hospitals. Hospitals can make good money at $30,000. Know that the Oklahoma Surgery Center’s bundled price is about $18,000 for a total hip replacement.
A big part of the cost problem is that Wisconsin is one of the most consolidated states for its health care corporations. Mergers have sharply reduced the number of healthcare systems in different parts of the state to oligopolies of two or three hospital corporations. Marketplace disciplines have disappeared. Mergers always result in higher prices.
It gets worse. Some of the hospital corporations own their own insurance companies (their customers) and collaborate on prices. In other economic sectors, such price fixing is illegal.
Our attorney general has done no trust-busting.
Long and short, a default to regulations, such a price caps, may be the only way out. The energy and telecommunication industry successfully operate under regulations overseen by a Public Service Commission (PSC). The PSC would also approve or disapprove of consolidations.
Our governor wannabes need to listen to Governor Mike Braun of Indiana. “Government has to intervene, because healthcare is run like an unregulated utility,” he told KFF (formerly known as the Kaiser Family Foundation) Health News June 22, 2026.
Crowley and Tiffany should be aware that two of the huge health systems that serve Wisconsin, Ascension and Atrium, operate in Indiana where price caps rule. And they survive there.
Wisconsin does not have to be a pioneer. Crowley and Tiffany can just follow the lead of other pioneer states, such as Indiana and Oregon.
Did you know the issue of healthcare cost is not on the agenda of the only confirmed gubernatorial debate between Crowley and Tiffany on Oct. 21? How can they be ducking the number one economic issue in Wisconsin and the country?
