to the floor.

>> What are the most important issues to voters?

The Marquette Law School poll consistently shows cost of living as number one.

Immigration.

Number two, and health care as the number three top issue.

There's a lot driving the cost of health care for consumers, including reduced subsidies, new rules and loss of generous plans.

But there's something else that makes Wisconsin a national outlier for how expensive health care is in this state.

We're joined now by Toni Lo Sasso, a health care economist with the La Follette School of Public Affairs.

And thanks very much for being here.

>> Great to be with you.

>> So how does Wisconsin compare cost wise for health care and attendant kind of premiums and out-of-pocket costs?

>> Yeah, it's a great question.

And it's one of the motivations for my work.

I, I, I am born and raised in Illinois, but I, and a lot of folks in Wisconsin like to dunk on Illinois for a lot of good reasons.

But one of the things I wanted to study is, well, how do health care prices compare between Wisconsin and Illinois?

And sure enough, kind of.

To my own surprise, Wisconsin is is dramatically more expensive when it comes to the cost of health care.

When we talk about hospital prices for health care services, 25% higher.

So than Illinois.

And, and so I think that that's a puzzle for me because it looks as if Wisconsin's actually a pretty.

At first glance, the insurance market looks pretty competitive.

The hospital market, if you take a statewide lens and look at it, it looks pretty competitive.

And so what I did most recently in a follow on study is to drill down into health care markets where people basically where people live and where they see care.

And then you see kind of a different story, a different pattern emerges.

And so here you see that actually hospital markets are quite consolidated.

So what we did in this most recent study is look at how consolidation has, has, has changed in the past 7 or 8 years.

And sure enough, it started out pretty consolidated and it only got more consolidated.

>> Are there any policy prescriptions for this?

>> Yeah, it's really hard.

I mean, there have been a number of mergers.

Some of them have had quite dramatic effects on concentration in specific markets.

I think the the Ascension merger, the merger that took place up in Wausau created basically a not a monopoly, but but a very consolidated, very concentrated market in the Wausau region.

And so and there have been a series of mergers, all of them to the best of my ability to discern, have not been challenged, were not challenged in any way.

So they've gone through.

So that means the FTC at the federal level, that means the state AG.

No, they've gone through so, so so on the one hand, in terms of what do you do now that you're in this situation?

You've got high prices, those prices, incidentally, they they transfer on to higher cost of health insurance.

They go directly into the cost that premiums, the costs that people pay in terms of their health insurance premiums.

So you kind of can't put the toothpaste back in the tube, so to speak.

But you know what I would say from a policy standpoint is you'd like to see people talk about encouraging investment and entry of new hospitals into the market.

It's hard to do, but that's that's a it's hard to it's much harder to unwind mergers.

That's just years of litigation.

>> Meanwhile, how do these costs for health care put a drag on wages in Wisconsin?

>> Yeah, I think that's that's something I, I liken it I like to describe it as, you know, the this increase in health insurance premiums is essentially a silent thief of workers wages.

And I think that's, you know, when you talk about affordability, when you talk about, you know, cost of living, when you've got this, this kind of sneaky drag on people's cash wages, that just amplifies this affordability crisis that we hear so much about.

>> Why does no one on the campaign trail kind of talk about this particular issue?

>> It's a great question.

I mean, people talk about health care generally, but when it comes down to the specifics and what do you do?

How do you how do you tackle this?

It it's challenging.

And I don't think it lends itself all that readily to soundbites.

I mean, the soundbite that you get is Medicare for all.

And that's not really a solution.

That's practical, especially at a state level.

I mean, it sounds like a great bumper sticker, but in terms of actually operationalizing that, nobody, nobody, nobody really wants to see their taxes go up 20, 30, 40% in order to pay for such a system.

So, so I think the solutions are local.

And, you know, I talk about it earlier, like investment.

I think keeping a close eye on any future mergers.

I also think my experience has been that folks in Wisconsin don't even they're not all that aware of how pricey this market is.

It's an outlier nationally.

I'm talking Wisconsin, but nationally it's an outlier.

>> Great.

All right.

Toni Lo Sasso, thank you so much.

>> You're welcome.

>> Prediction markets are continuing to grow in continuing to grow in