LV Congressman Charlie Dent: How Will We Pay For Healthcare Reform?

During Monday's town hall in Nazareth with LV Congressman Charlie Dent, our health care crisis was a topic of animatd discussion. Congressman Dent's basic point is that none of the "reforms" currently under consideration account for the costs. He also lists some minor reforms that might make those costs more manageable.

"Well, I think everybody acknowledges that our health care system is in very serious [inaudible]. The question is, what type of reform do you want for this country? And I would say to you - we have to deal with the issue of health care costs. Simply creating a new health care entitlement does not address the cost issue. I want to be clear about that.
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"There was a very interesting article recently about healthcare costs in McAllen, Texas - down at the border - versus El Paso. Two demographically similar communities. Why McAllen's costs were so much higher than El Paso's gets into the issue of [inaudible] and the culture of the healthcare community and how that has contributed to cost.
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"We need to find ways to control costs. One thing I can do that can help costs is by dealing with a lot of lawsuits. We need medical liability reform in this country. We need it because it is broad enough to affect the costs of medicine because of the defensive medicine practiced. That is one thing I can specifically point to and say, 'We can help you get more money out of the courtroom and into the operating room.' That would be a big help.

"Two, we want to protect the doctor-patient relationship. That, I think, has to be the centerpiece of any reform. People want to protect that relationship.

"We need a strong prevention and wellness piece. I read an interesting piece - an article - by the guy that runs the Safeway Company. His health care costs for that company are flat while everybody else is going up double digits. Everybody should read that guy's piece. How he's able to manage this? He had series of prevention/wellness issues, everybody had skin in the game, he really worked with the employees and educated them and they became very good healthcare consumers. Bottom line is he has 83% satisfaction from employees. He's managed their costs far more effectively. We should be listening to people like this who definitely tried with thousands of employees.

"Third thing, you talked about the 45 to 50 million uninsured. I mentioned 10 million are not citizens; 10 million are eligible for current programs - Medicaid or SChip; half are under the age of 35. Why don't we use the tax code to help the under 35 population? They are the most insurable population in America, the younger population. They are the least expensive to insure. Let's give them favorable tax treatment just like we give to any company. They [corporations] get all kinds of deductions and exclusions and that's good - we should protect that. 165 million people have their healthcare through their employers. We should protect it. But for the guy who doesn't have health care through an employer, give him or her the same favorable tax treatment. I bet you would be able to get a lot of these folks into a catastrophic program, a healthcare coverage program. If your age is 22, that's what you need - catastrophic coverage. That's what you need more than anything else. This is over half the uninsured in America. ... Let's incentivize this.

"Comprehensive health care reform is a difficult task because it is so complicated. To get into issues of individual mandates versus employer mandates, or both, we just have to go up to Massachusetts to look at their little experiment to get some perspective as to what reform can look like if we're not careful.

"I support reform, but I want to make sure that whatever we do, we do it properly. Look at what's happening in Massachusetts. They created an individual mandate. basically, you have to have insurance. But they failed to deal with cost issues. So what happened is they also have a state plan up there, too, so a lot of people are on the state plan. The costs of the state plan are going up. They're hundreds of millions of dollars into the red. (I think this is their first year of operation if I'm not mistaken - it's the second). And they're running hundreds of millions of dollars into the red. So what happens when the costs of the program go up? Costs go up and taxpayers meet that cost in the middle so what does the state do? Well, it rations care. That's what happens. So,i am concerned that the debate in Washington has been centered around a public plan or a government plan. I have concerns about that. I'll be very honest. The pundits will say you have a government plan to keep the private plans honest ad there are thousands of private plans competing for business. The reality is that public plan or government plan will probably be heavily subsidized. We have some independent analysis ... that says if you use that government plan or public plan - call it whatever you want to call it - you will see about 120 million people transfer from private insurance into the government plan. That will happen. ... Costs will still go up and it kinda' leads to a back door single payer system that i think has some people concerned because Massachusetts - you don't have to go far - will not have the revenue to deal with the rising costs.

"So you have to deal with the costs issue. And that's real the conundrum. That's the issue. If we don't deal with the costs issue, we're not going to fix the problem."