Republican Phil Roe has been spreading a health care message of his own during a holiday swing through the district, telling listeners he will “stand in front of the bus” to prevent a national, single-payer system.
Roe reiterated his themes at Resp-I-Care in Johnson City on Wednesday and again Monday at Holston Medical Group in Kingsport, and said Monday he expects the U.S. House of Representatives to begin the debate in earnest Tuesday.
The retired obstetrician has lashed out at early details of a plan he said is being promoted by President Barack Obama but promulgated in the Democrat-controlled House and Senate. In particular, he seemed to suggest that a “public option” coverage under consideration ultimately could lead to a single-payer system by driving private insurance corporations out of business.
“It’s a very complex plan, and they’re going to try to run it through between now and the August recess,” Roe told doctors, health care executives and others gathered at HMG Monday. He passed around the nearly 1,000-page, recently passed Waxman-Markey climate change bill as an example of the size of legislation that’s being passed during his first year, and said representatives had less than 12 hours to read it before voting.
“I predict the health care bill will be bigger, but that again we’ll get it without enough time to study it before voting,” Roe said. “In health care, we need to get it done right, not quick.”
While he warned of both rising costs and “rationed” care under the bill, Roe left no doubt he believes the American health care system needs change. He said a continued rise in the amount of its total income the United States spends on health care is unsustainable, and that “there are things we can learn” from single-payer and other systems such as Britain’s and Canada’s.
Roe said when he arrived in Congress in January he spent two hours each with about eight “think tanks” on both sides of the partisan divide, trying to parse details of a problem he thinks is much too complex to solve quickly. He said his four major principles for health care include:
• Access to at least some basic health coverage for all Americans with a basic insurance plan of some kind.
• Guaranteeing no one ends up in bankruptcy due to medical costs.
• Requiring each person or family, regardless of income, to bear at least a portion of the cost of care so that “everybody has some skin in the game.”
“If it’s free, it will get over-utilized,” Roe said.
• Reforming health insurance so that private insurance companies aren’t able to “cherry pick” who they will and won’t cover in order to wind up with a healthier, and thus cheaper to insure, risk pool.
The plan Democrats are pushing would go much further than that, Roe said. Including a government-run insurance plan to “compete” with private insurers, along with mandates to most businesses to provide insurance for employees, could eventually push private health insurance out of business, he said.
He pointed to the early years of TennCare as an example, when thousands of people with insurance available through employers opted into Tennessee’s version of Medicaid instead.
“It was a very generous, taxpayer-subsidized plan and a better plan than what those people had,” Roe said. “But when it came to paying the cost of the care it fell short, and those costs were shifted to the private insurers. That makes their costs go up, and it makes private health insurance more and more expensive.”
Roe said he anticipates a déjà vu experience, on a national scale, if all Americans have the option of a public plan.
“It will promise a lot,” Roe predicted. “It will be underfunded, as in every single government plan you have to fight them every step of the way to get a nickel, and these costs are going to go up and up on the private side. People will drop their insurance and you’ll end up with a single-payer system.”
Though Roe sits on the Education and Labor Committee, and that body is playing a role in shaping health care reform, he said his minority party status seems to have left his suggestions falling on deaf ears.
“I held up my hand in there when they were talking about the public option plan and said, ‘I’m just a country doctor from East Tennessee, but we’ve already tried that plan out in Tennessee — it was called TennCare, and it almost broke the state.’
“The best I could tell, any suggestion I made was not heard. We have a one-party situation right now.”
Roe also predicted that any reform plan coming out of the current Congress will be very expensive — early predictions out of the Congressional Budget Office peg the 10-year price of a House bill at $1 trillion and a Senate version at $1.6 trillion — yet still ultimately bring a rationing of care.
He said limits on mammograms in Britain have left breast cancer survival rates significantly lower there than in the United States due to what he deemed a bureaucratic rationing of care.
“There are things we can learn from the English system and the Canadian system, but one is not rationing care. Two is not pinching on research,” Roe said before stating the M.D. Anderson hospital in Houston spends more annually on cancer research than the entire nation of Canada.
Ultimately, Roe said, it is the people gathered to hear him discuss the issue — doctors, nurses, hospital administrators and others in the health care industry itself — who have the best knowledge base to lead America’s health care reform.
Ideas about everything from preventive care and recruitment of primary care doctors to innovative ways to improve private insurance are bubbling up from providers and others, as are concessions (private insurers have said they’ll enroll people with pre-existing medical conditions, for instance). Roe said majority Democrats would do well to heed the industry before ramming through a reform package.
“All I can tell you is, I’m going to get in front of the bus for you, and with every breath in my body I’m going to try to prevent government takeover of our health care system.”