This morning I posted an op-ed at Human Events about health care in the next Congress.
It looks as if voters were more than ready to show how much they’re fed up with the Democratic Party’s idea of healthcare reform by investing their trust in Republicans to repair the medical malpractice that took place under President Obama. Now it’s imperative that we Republicans respond with more than talk.
Delivering the goods should start with oversight hearings into exactly what went so wrong and the repeal of everything after the enacting clause of the law that set ObamaCare in place. The individual mandate, employee mandate, abortion funding, the tangle of outsider/insider councils like the comparative effectiveness board, and the effective nationalization of health care under grants of authority to the Department of Health and Human Services: All of those have to go. I hope we can move a repeal bill through the House in the first 90 days.
Next, we need the thoughtful creation and passage of healthcare reforms that make sense. I particularly want to ban insurers from rescinding coverage when their policyholders get sick and need to use their insurance. And an updated Patients’ Right to Know Act makes sense so that patients can know the actual price and quality of the care when making their healthcare decisions. This proposal would provide ways to collect and publicly disclose pricing and risk-adjusted quality data. Never again should patients get a bill on which a box of Kleenex tissues is featured as a pricey “mucus recovery system.”
Purchasing health insurance across state lines is another reform that’s overdue. This bill actually passed out of committee when I was chairman. People living in a state with expensive health insurance are now locked into those plans and do not have an opportunity to choose lower-cost insurance available in other states. Only in the restrictive world of health insurance do we find that goods and services don’t flow from one state to another state without restriction. I can’t think of a good reason why Americans should not be allowed to buy insurance coverage outside the state in which they live if the plan they buy is approved by the state where it is offered.
Still another priority should be reversing the Obama administration’s effort to demolish the Medicare Advantage programs. The chief actuary of the Centers for Medicare and Medicaid Services estimates that half of all seniors who select a Medicare Advantage plan will lose that coverage under ObamaCare, cutting 7.4 million people off from their insurance. “You can keep insurance if you like it” was one Obama promise worth keeping, even if it takes Republicans to get it done.
On Medicare, we face an even more immediate problem. The latest extension of Medicare payment rates to doctors expires on December 1, 2010, effectively cutting their pay, followed by a second cut on January 1, 2011. In total, doctors face approximately a 26% reduction in their rates of payment from Medicare, giving some an enormous incentive to simply stop accepting Medicare patients altogether. It’s time to solve this problem permanently.
We should also rescind the ban on expanding or creating physician-owned hospitals. It is a strength of the American free-enterprise system that people may own their own businesses, and doctors should not be excluded from that right.
Competitive bidding for Medicare-bought equipment is another area deserving our attention. The Medicare Modernization Act of 2003 required bidding, which Medicare says will save an average of 32 percent on the money paid under the current fee schedule.
Finally, I propose the creation of a task force with governors on a bipartisan basis to hold hearings on the state-federal welfare program, Medicaid. As we already know from governors on both sides of the partisan aisle, the federal mandate forces states to spend money they don’t have.
Crossposted at Human Events
Moe Lane
PG DeFreese
Victoria Coates
Daniel Horowitz
Dan Spencer
Great proposals, so long as this language does not mandate unlimited coverage of pre-existing illnesses
Mike gamecock DeVine (Diary) Monday, November 8th at 1:06PM EST (link)You state: “I particularly want to ban insurers from rescinding coverage when their policyholders get sick and need to use their insurance.”
Fine, it would be a violation of basic contract law to do so, so long as the insured did not lie on the application.
Mandating that all pre-existing conditions be covered, no matter the circumstances, would eventually accomplish Obama’s goal of destroying the private insurance industry.
Does anyone in the GOP caucus have the guts to say this and level with the American people?
Mike DeVine’s Examiner.com, Charlotte Observer and The Minority Report columns
“One man with courage makes a majority.” – Andrew Jackson
The problem isn't 'rescission' it is renewal
scorpio0679 (Diary) Monday, November 8th at 1:57PM EST (link)My understanding is that the issue here is most insurance policies are sold as 1-year term policies, much in the way that car insurance is sold. When someone gets sick, they of course cover the treatment. However, they then refuse to renew the policy at the end of the policy term. Which means, of course, that the person is without insurance once they hit their caps.
The one thing that private insurance should take from the VA is the insurer should have an obligation to permanently cover a condition that arises during the insured’s coverage. Future insurers would not have the obligation, thus allowing the person who is sick to buy insurance elsewhere if they won’t renew.
In the military, it works like this: if someone gets injured or sick while deployed, once that person is discharged the VA must cover all care related to that condition. The condition is exempted from coverage by outside insurance companies, and they can’t jack up the rates because of it.
Does this make sense?
yes, agreed - nt
Mike gamecock DeVine (Diary) Monday, November 8th at 2:25PM EST (link)Mike DeVine’s Examiner.com, Charlotte Observer and The Minority Report columns
“One man with courage makes a majority.” – Andrew Jackson
No, they aren't...
hgstern Monday, November 8th at 3:14PM EST (link)and no, they can’t:
“most insurance policies are sold as 1-year term policies,… they then refuse to renew the policy at the end of the policy term.”
That’s not how they work, either in group or individual major med. At the end of the year, the rates are “adjusted” (i.e. “raised”), and alternate plan designs are offered. *Sometimes,* a specific plan design is “retired;” in that case, the insured is offered the chance to move, without additional underwriting, to a new, simialr plan.
*This* is an incredibly bad idea:
” the insurer should have an obligation to permanently cover a condition that arises during the insured’s coverage”
That’s called a “tail” in P&C circles, and it’s a deal-killer in healthinsurance. What happens, for instance, when the insured jumps to another carrier to save $5/month (or whatever), leaving the previous carrier on the hook for future claims but no future premiums?
Great opening shot, Congressman Barton
E Pluribus Unum (Diary) Monday, November 8th at 1:20PM EST (link)Repeal is the first order of business, but it is not good to not think toward the day when that is done.
These are good ideas at the minimum. Practical things that frankly do not sound all that sexy, but I think move the chains in the right direction.
People, stuff like this is among the reasons I am proud to call this guy MY CONGRESSMAN. He’s the upcoming Chairman of the Energy & Commerce Committee, and he’s an idea and policy guy, conservative and not “establishment”. Putting stuff out, almost ANY idea inre medical reforms, to be criticized and picked apart.
Does that sound like one of the “good old boy” network of establishment Republicans?
Kill the Terrorists
Protect the Borders
Punch the Hippies h/t IMAO
Just What the Doctor Ordered!!!
jtlfromfredmd Monday, November 8th at 1:37PM EST (link)You most assuredly have my support Congressman Barton.
The elephant in the room than nobody (Dems or Repubs)
usadying (Diary) Monday, November 8th at 2:32PM EST (link)will discuss is that the health care market is totally distorted by the government’s presence in the marketplace: Medicare and Medicaid. Their reimbursement rates to physicians and hospitals are so low that the providers must make up for it by charging higher rates to private insurance (you and me). If we had a free marketplace where the providers competed with each other and consumers could make intelligent decisions (now possible with the internet), it would go a long way to reducing health care costs. When we have low co-pays and pay $10 for a $500 prescription, there is no incentive for a patient to make prudent decisions.
We had a high deductible plan for 5 years. If a prescription drug was more than we could afford, I asked for something cheaper and asked the differences between the two. We decided on a cost/benefit basis, just like every other family decision we make.
Medicare and Medicaid are political hot potatoes, but we are reaching the edge of the cliff. It’s either bankruptcy (not possible) or print money (already happening). No politician is brave enough to bring it up.
Exactly!
hgstern Monday, November 8th at 3:17PM EST (link)MC and MA cause major ripples in the market, from reimbursements to approvals (Avastin, anyone?!).
You were fortunate, BTW, if your HDHP carrier let you actively shop for meds, and counted your non-PBM purchases towards your deductible. That seems to be the exception.
What do you mean "nobody" -- the Paul Ryan roadmap tackles this issue
JSobieski (Diary) Monday, November 8th at 4:38PM EST (link)head on. Voucherize Medicare and Medicaid, transform them into HSA accounts with private high deductible/low premium insurance.
My rules of the road for primary season.
Rule #1: Vote for YOUR first choice in the primaries
Rule #2: Vote for the R in the general.
Rule #3: Don’t let anyone convince you to violate Rule #1 or Rule #2
Rule #4: When in a center-right argument, reaffirm Rules #1-#3–it will help us all to get along better.
Rule #5: If you are using the language of the left, you probably aren’t furthering conservativism
Rule #6: The priority is issues first, candidates second, and supporters third. Nobody is bigger than the issues. Conversely, if you spend your time focusing on supporters, you are wasting everyone’s time.
STOP THE MADNESS!
A reduction in the rate of spending increases is NOT a cut!
In-state tuition for illegals is NOT amnesty!
Requiring someone to pay their medical bills is NOT an individual mandate!
Reducing tax rates is NOT a tax increase!
The biggest intrusion by gov't
1volunteer Monday, November 8th at 10:06PM EST (link)is the tax break given for employer-provided health insurance. It has wildly distorted the market by making employers rather than consumers the purchasers of insurance.
I favor lower taxes, but this break should be ended. The result would eventually be that employers stop paying employees’ medical bills, and more competition would be introduced into the market. Each consumer would make his own decisions on health care coverage. (Group coverage could still be available, perhaps with arrangements similar to credit unions.) Medical costs would drop.
President G. W. Bush recommended this change, but no one would pick it up. Senator McCain recommended it while campaigning for the presidency, and Obama attacked him for it in one of the debates. However, after taking office, Obama suggested dropping this tax break, but it went nowhere. Citizens seem to have no idea what a big difference this would make in the cost of medical care.
Repeal Some, but Maybe not all of the Egregious
jimbo51 (Diary) Monday, November 8th at 4:14PM EST (link)clauses. I have heard that the law does not contain a standard boilerplate clause that says that if one part of the law is found invalid or unconstitutional, than the rest is OK. It would be a real shame if we repealed a section that was subject to a valid court challenge of constitutionality, only to make our court case moot because we have removed it, thus leaving the remainder of the law constitutional. We’ve got an important and good legal case here. Let’s not let too much haste screw up a great opportunity to reign in the Commerce Clause. Be selective and smart in our repeal efforts. If we lose in court, then we can move forward to repeal the Individual Mandate and State Medicaid Expansion.
The mandate must go
californiagold Monday, November 8th at 6:09PM EST (link)ObamaCare would not have passed had it not been for the deal between democrats and the health insurance industry to include the mandate that forces all individuals to purchase insurance or pay a fine. Without the mandate, the health insurance lobby would have killed the bill, just as they did to Hillarycare in 1993.
The effort to repeal ObamaCare faces two challenges. One is the obvious political wall the democrats will build in an effort to keep the bill as is. And another challenge is the health insurance lobby – if republicans propose the elimination of the individual mandate, yet propose keeping preexisting conditions and unlimited lifetime max benefits as part of the required plans, the health insurance lobby won’t support repeal.
To cover all their bases, it has been reported that the health insurance lobby spent more on republicans than democrats this election cycle. That is a potential concern because it raises the possibility that some republicans might say in public that they support repeal, yet privately might be far more influenced to do whatever the health insurance lobby wants.