You are viewing this article in the AnnArbor.com archives. For the latest breaking news and updates in Ann Arbor and the surrounding area, see MLive.com/ann-arbor
Posted on Wed, Aug 12, 2009 : 7 p.m.

Q&A: Response to your health care reform legislation questions from Congressman John Dingell

By Tina Reed

Not unlike the heated conversation that’s been happening around the nation, there was quite a bit of debate generated in response to a health care reform story posted earlier today.

The story was a question-and-answer about the potential local impacts that proposed health care legislation could have with Congressman John Dingell, D-Dearborn.

I emailed Dingell with some questions I’d received both on our Web site and in my email inbox. Here is a look at your questions and his replies from the email exchange.

Q: “Why isn’t tort reform being considered to reduce costs?”

A: “Tort reform and medical malpractice are issues that many care about. President Obama even brought it up during his speech to the American Medical Association earlier this summer. The Energy and Commerce Committee passed an amendment offered by Congressman Bart Gordon of Tennessee dealing with medical malpractice reform. The Gordon Amendment establishes a voluntary state grant program that allows states to institute either "certificate of merit" and/or "early offer" medical malpractice programs in lieu of traditional medical malpractice litigation. States would be able to design their own certificate of merit/early offer programs.”

Q: “Why aren’t changes in legislation that would use market forces, such as allowing insurers to sell across state lines and increasing competition in premiums, being considered?”

A: “The purpose of the new Health Exchange is to use market forces to increase competition in the health insurance industry. This new marketplace will force insurers to compete on the basis of price and quality. Individuals will be able to clearly shop among a wide range of options to find the best fit for themselves and their families.

In this new market, insurers will no longer be able to game the system by denying coverage to people with pre-existing conditions, charging the sick and elderly exorbitantly high premiums, or canceling a person’s policy when he or she finds out they are sick. Insurance companies are making money by denying coverage, not good service.”

Q: “Won’t any “efficiencies” or “cost savings” actually come out of hospital/health care providers pocketbooks or ultimately harm care? I’ve also heard much concern regarding long waits for health service due to rationing and comparisons to problems in Canada’s health care system? Can you address those concerns?”

A: “There is rationing now. There will be no rationing under this bill. The costs savings and efficiencies will not harm care. In fact, these measures to reduce waste will actually incentivize higher quality care.

For example, hospitals will have a financial incentive to reduce unnecessary readmissions that drive up the cost of the entire system. A patient’s multiple doctors will be encouraged to talk to each other and work together in Accountable Care Organizations and Medical Homes to make sure that care is comprehensive and not duplicative. Additional cost savings come from cracking down on waste, fraud and abuse, which add no value whatsoever to a patients care, but greatly increase the costs of health care for all of us. The health care bill places a higher priority on preventive care.

It eliminates cost-sharing for preventive care to underscore the importance of preventive health services in making America healthier and lowering the growth of health care costs over time. The overall goal of achieving near universal health care coverage will also significantly reduce health care costs. When individuals have regular access to health care providers they avoid routine emergency room care, which adds $1,000 a year to each American family’s health care bills.

This health care bill is in no way based on the Canadian health care system. Instead, we have offered a uniquely American solution that builds on the employer-sponsored, and the private insurance industry. Health care reform will not lead to long lines and rationing. None of the proposals would stand in between an individual and his or her doctor. I believe those patient and doctor decisions are sacred, and will make sure they stay that way. Again, I would like to point out that we already have rationed care in this country. Care is rationed for those 47 million people who have no insurance, and the millions more who have insurance but find the costs of health care spiraling out of control. Care is rationed due to high costs, and if we fail to act, more and more people will have to forgo necessary health care.”

Q: “I received several emails that reflect much disbelief about the claim that 92 percent of people won’t face a tax increase because of this legislation. Can you address that concern?”

A: “The nonpartisan Joint Committee on Taxation has estimated that the health care surcharge would only apply to the top 1.2% of all households in the United States. The health care surcharge would have no effect on 98.8% of all households in the United States. The health care surcharge only applies to income earned in excess of $350,000.

If the health reforms included in the bill achieve projected cost savings, families making between $350,000 and $1,000,000 will need to contribute less than 1% of their annual income to help provide access to affordable health care for all Americans.

• A family making $350,000 would not owe any surcharge at all.

• A family making $400,000 would contribute $500 to help provide access to affordable health care for all Americans - 0.13% of their annual income.

• A family making $500,000 would contribute $1,500 to help provide access to affordable health care for all Americans - 0.3% of their annual income.

• A family making $1,000,000 would contribute $9,000 to help provide access to affordable health care for all Americans - 0.9% of their annual income.

Q: “Would you yourself be willing to forego your current health plan for the one your are proposing?”

A: “Members of Congress will be treated exactly the same as every one else under this bill. Nothing in the legislation exempts the Federal Employee Health Benefits plan (the plan members of Congress and staff enroll in) from the reforms.

By the end of 2018, all employer-sponsored health insurance plans will have to meet at least the same basic minimum standards of coverage as those insurance plans as offered through the exchange. These minimum standards include coverage for preventative care, inpatient and outpatient hospital services, maternity care, and mental health services, among others. The FEHB will also have to follow these rules.

People who work for medium and large employers will not be able to purchase insurance through the new National Health Exchange in the immediate years. When the time comes that these individuals can buy into the Exchange, I plan to do exactly what every other American will do, and that is exercise my choice. It is my belief that the policies offered will be very high quality and so, I just may purchase through the Exchange. “

Q: “What do you think of the number of people who are showing up to the town hall meetings and very loudly protesting this legislation? How does this reflect what you are also hearing from constituents in your office?”

A: “This is a major piece of legislation and deserves a lot of input from the American public. We are hearing from a lot of people who are concerned about health care reform will effect themselves and their families.

It is completely fair for them to ask questions and raise their concerns and I pledge to continue listening and answering them. I would be remiss, however, I didn’t mention that we are also getting a lot of calls and visitors who support this bill.”

Tina Reed can be reached at tinareed@annarbor.com or follow her on Twitter @treedinaa.

Comments

David Wallner

Fri, Aug 14, 2009 : 5:17 a.m.

It doesn't seem to me that Representative Dingell has added much to my understanding of the issues. On Wednesday I heard Senator Levin say in an interview that we "really don't know why the Health Care debate is so contentious". When my son cut his head a few years ago the bill at the Emergency Room of St Joe's was $1,000. They placed one metal staple in the flesh to close the wound and ran every test imaginable to protect themselves from the possibility of a malpractice suit. This is where the cost of our lack of tort reform shows up.

REBBAPRAGADA

Thu, Aug 13, 2009 : 9:22 a.m.

What is Health? What is Preventive Care? There should be a clear understanding about the term HEALTH. Very often, people tend to think that a person is in good health if he is not sick or ill. We try to approach health care as a medical intervention to diagnose and treat illhealth. The emphasis should be shifted to keeping people in good health. We need medical intervention to ensure that people are in good health and not for simply diagnosing illhealth. Early diagnosis of illness is not primary prevention. Prevention should be directed towards promoting,preserving, and sustaining people in a state of positive health. Any health care reform should be based upon a strong foundation and for this health should be defined as the physical, mental, and social wellbeing of an individual. Lack of insurance is not the only issue that affects the health of an individual.

timjbd

Thu, Aug 13, 2009 : 8:59 a.m.

Not sure why you pulled my earlier post pointing out that you DID NOT seem to pull any of the actual questions people had suggested from the earlier account of the Dingell Town Hall but, rather, had used the republican talking points as a launch pad and re-posed the same tired fantasies which have been debunked time and time again. _________________ For instance your first question about "tort reform" has been asked and answered so many times that the only people who believe the republican spin on this issue are the hardest of the hardcore Glenn Beck/Rush Limbaugh accolytes. Medical malpractice costs ar less than 1/2 of 1% of health care spending and the problem THERE is not frivolous suits, but rather the increasing number of disastrous medical MISTAKES which are causing grievous harm and death. There is also the fact that insurance companies have raised rates FAR BEYOND what is warranted by actual court costs. Why? Because they CAN, that's why. _________________ Read this: http://www.slate.com/id/2145400/ (Both Obama and Hillary Clinton had recognized the TRUE problem early on.) ______________ Quote: The Harvard researchers took a huge sample of 31,000 medical records, dating from the mid-1980s, and had them evaluated by practicing doctors and nurses, the professionals most likely to be sympathetic to the demands of the doctor's office and operating room. The records went through multiple rounds of evaluation, and a finding of negligence was made only if two doctors, working independently, separately reached that conclusion. Even with this conservative methodology, the study found that doctors were injuring one out of every 25 patientsand that only 4 percent of these injured patients sued. The Harvard study stands for a large body of literature. On their own, however, the results don't disprove the Republicans' thesis that many medical malpractice suits are frivolous. Maybe badly injured patients don't sue, while the reflexively litigious clog up the legal system, making tort reform a viable solution. But a new study, released in May, demolishes that possibility. Dr. David Studdert led a team of eight researchers from Harvard School of Public Health, Brigham and Women's Hospital, and the Harvard Risk Management Foundation* who examined 1,452 medical malpractice lawsuits. They found that more than 90 percent of the claims showed evidence of medical injury, which means they weren't frivolous. In 60 percent of these cases, the injury resulted from physician wrongdoing. In a quarter of the claims, the patient died. When baseless medical malpractice suits were brought, the study further found, the courts efficiently threw them out. Only six of the cases in which the researchers couldn't detect injury received even token compensation. __________________________________ And this: http://www.justice.org/cps/rde/xchg/justice/hs.xsl/1952.htm Quote: The American Association for Justice (AAJ) today released a report revealing the medical malpractice insurance industry has been price-gouging doctors through excessive premiums and needlessly contributing to the growing cost of healthcare. Written by former Missouri Insurance Commissioner Jay Angoff, the study is based on recent annual reports from the top 15 medical malpractice insurers as rated by A.M. Best. The report shows that these insurers artificially raised doctors premiums and misled the public about the nature of malpractice claims asserting that a so-called malpractice crisis exists. The report puts the lie to that claim. ________________________ Being a reporter is a serious responsibility. That responsibilty includes making at least minimal effort to find out what the actual facts of an issue are, not only what advocates TELL you they are. Please try to do better.

timjbd

Wed, Aug 12, 2009 : 10:03 p.m.

Furthermore, if you'd like a list of questions about the legislation being proposed (as opposed to the fantasies of Glenn Beck), your readers can help you with that. If you want to engage in the same Fox News smear campaign, do it on your own time, please.