Say Anything Blog

I’ve been calling my quote/unquote Representatives in Washington to try and find out where the Constitution allows the Congress to interfere with health care.  I note that the Tenth Amendment prohibits any activity not specifically permitted.  So if it’s not specifically permitted in the Constitution then by helping to push fourth any health care bill, my representatives are breaking their sworn vow to uphold the Constitution.

Well, I called Ander Crenshaw today to ask his staff this question.  (interesting side note:  Not one of the staffers seemed to be all that familiar with the Constitution.  Most had no idea what the 10th said.)

Here is the e-mail response from Ander (Note, please, that my question is still not answered.):

Dear Mr. Yantiss:

Thank you for contacting me to express your opinions regarding the state of our nation’s health care system. I appreciate you taking the time to share your thoughts with me on this important matter. The health care debate in America is unprecedented and the final outcome will affect all of us.  While I normally attempt to be informative, yet brief in my responses to your inquiries, this issue demands a detailed answer.

Our health care system is in dire need of reform. Today millions of Americans in our country are uninsured, unable to go to a doctor’s office for the most basic of care. Without any insurance, they have no choice but to flood our hospitals’ ER rooms, where waits are long and care is rushed. Hospitals, which by law must care for anyone that comes in their doors but with more patients than beds and profits only at the slimmest of margins, have no choice but to rush them through and push them out. With conditions like these, it is not surprising that fewer and fewer medical residents are choosing to become ER doctors. The stress is too high, the malpractice insurance too expensive, and the hours too long.

Furthermore, because doctors only get paid for the services they provide, those doctors who order the most services make the most money. There is no reward for doctors who keep their patients healthy. While some doctors admittedly order services to excess, others do it to as a form of defensive medicine to make sure they do all they can so they will not get sued by a lawyer looking to make a quick buck. The Department of Health and Human Services estimates that $126 billion a year is spent on unnecessary tests and procedures ordered to avoid legal liability.

Still others order unnecessary services to cover insufficient federal government reimbursements. Testifying before the Senate Finance Committee, Congressional Budget Office (CBO) Director Douglas Elmendorf noted that in 2006, Medicare and TRICARE physician reimbursement rates averaged 20% less than private insurance levels; for hospitals, the disparity was 30%.  We should not force doctors to order unnecessary services just so they can keep serving Medicare patients or avoid frivolous lawsuits that ruin their career. 

This lower reimbursement structure within the government-run plans has resulted in a rise in private health insurance premiums as physicians and hospitals shift their costs from public payers to private ones. A recent study by the consulting firm Milliman found a total of nearly $89 billion in cost-shifting from Medicare and Medicaid onto commercial payers. As a result, families with private health insurance spend nearly $1,800 more per year-$1,512 in higher premiums (paid by both employers and employees) and $276 in increased beneficiary cost-sharing-to cover the below-market reimbursement levels paid by Medicare and Medicaid.

In all, the inefficiencies in our system equate to Americans paying more for health care than any other country in the world-both per capita ($6,714) and as a percentage of GDP (16%). At $2.5 trillion, we will spend more on health care this year than the entire size of Great Britain’s economy. With millions uninsured, hospitals barely able to make a profit, doctors unrewarded for keeping people healthy, and consumers facing higher and higher costs, something must be done. We must increase coverage, decrease cost, and restore choice to our system.

I believe we need to cut the inefficiencies out of our health care delivery system by restoring free-market principles. As we bring more transparency and accountability to the system, true choice will breed competition which in turn will spur innovation and value. Specifically, I support reforms and initiatives that will cut costs and increase access by:

o   Erasing arbitrary rules that currently restrict consumers from purchasing across state lines.

o   Prohibiting insurers from discriminating against a consumer based on pre-existing conditions, one’s health history or future risk.

o   Making insurance plans portable so if you change jobs, you don’t have to change plans.

o   Mandating all insurance providers describe their plans with plain language so consumers know what they are getting.

o   Allowing small businesses, the self-employed, and others to band together and purchase health insurance at lower costs resulting in more coverage for more people.

o   Passing comprehensive medical liability reform that will prohibit frivolous lawsuits that cost our country $126 billion every year and allow doctors to freely provide the best care possible.

o   Offering immediate and substantial financial assistance, through new refundable and advanceable tax credits to the working poor.

o   Promoting prevention and wellness by giving employers and insurers greater flexibility to financially reward employees who seek to achieve or maintain a healthy weight, quit smoking, and manage chronic illnesses like diabetes.

o   Rewarding high-quality care, instead of encouraging health care providers to order more and unnecessary services.

These reforms do not raise taxes or the deficit by a single cent. When you introduce productive competition, increased consumer power, and efficiencies of scale into a market and eliminate billions of dollars of waste, you get lower prices and higher quality. Health care is too big of a problem to leave it in government hands and squash the vitality and innovation that has made our country so great. In the end, I stand on the side of quality versus mediocrity, affordability versus unsustainable debt, and freedom of care versus bureaucratic control.

This is NOT what Congressional Democrats put forth in their proposal.  They want a public, government-run health care plan that may be a good-faith effort, but will have tragic consequences on our system.  Their proposal will cost $1.2 trillion and increase our national debt by $239 billion over the next 10 years. “The way I would put it is that the [cost] curve is being raised,” said the CBO Director. That’s right; Democrats actually want to increase the cost of health care.

To pay for it, Democrats are taxing the very Americans who are the key to our economic recovery: small business owners. Since the mid-1990s, small businesses have created 60 to 80 percent of the net new jobs. House Democrats propose that if small businesses cannot afford to offer insurance, they should contribute as much as 8% of their payroll spending toward helping workers buy insurance on their own. The only problem is that small businesses often operate at the slimmest of profit margins-a third of all small businesses go out of business within the first two years. The Democrat plan would put small businesses in an impossible spot: provide health insurance and go out of business or do not offer health insurance and go out of business.

I am also strongly opposed to using taxpayer dollars to fund abortions, which is currently allowed in the Democrat-proposed health care plan. Many Americans do not want their hard-earned money to provide for abortion on demand. I will never vote for any bill that would result in the government forcing taxpayers to pay for the eradication of innocent, unborn lives.

I am also opposed to a public plan because it will inherently squash private plans. Any government plan that does not have to rely on making a profit to stay afloat and receives taxpayer subsidies inevitably means that it can undercut private plans, running them out of business. What’s more, employers, recognizing the billion-dollar savings, would drop their employees’ current coverage and force them into a government plan. According to the Lewin Group, a nonpartisan consulting firm, over 100 million Americans would lose their coverage. As costs skyrocket with more and more enrollees, government bureaucrats will have no choice but to ration care just as they have in efforts to control the Medicare and Medicaid systems that face $86 trillion in unfunded obligations. As care is rationed, experts expect hospitals’ revenue to drop 5 percent and physicians’ revenue 7 percent, not to mention millions of Americans who are denied the care they need.

Rest assured that I will keep your views and thoughts in mind as health care reform legislation is debated in Congress. Again, I want to thank you for taking the time to contact me. Please feel free to contact me if I can be of any further assistance on this matter or if you would like additional information on this topic or other issues facing Congress, please visit my website at http://crenshaw.house.gov.

Sincerely,

Ander Crenshaw

Member of Congress

Great…  I thought I could count on Ander to uphold the Constitution…  Looks like that’s a no…