Below is my response to Senator Crapo (R- Idaho) after I had sent him a letter requesting his bi-partisan support to reform health care in the Senate. The date of the letter below is September 19, 2009. I also provide the email I received from Senator Crapo on September 18, 2009 that caused me to write again. This is a typical canned response from his office and never addresses specific recommendations Senator Crapo or the Republican party propose in a bi-partisan effort to reform health care. To date, February 8, 2010, Senator Crapo has not acknowledged that any of his constituents support any health care reform measures being debated before Congress. Senator Crapo's letter is immediately following this letter.
Dear Senator Crapo
Thank you for your response. I too have also walked the streets of Boise going door to door as a financial adviser. I met over 3,000 households in Boise and far too many Idahoans who had been forced to declare bankruptcy, downsize from homes to rent, young families forced to move in with parents or seniors forced to move in with children because of a financial major medical event. Middle aged, senior, and young couples struggling to make ends meet. I emphasized Maslow's Hierarchy of Needs (physiological, safety, belonging, and esteem) to those who needed someone to listen to their current financial burdens brought on by layoffs that left them without health care insurance at a time when the need was critical. Layoffs and financial burdens were deeply affecting the esteem of many family providers. They were far from self-actualizing. I couldn't sell financial products to these folks, but instead I did look over their financial situations, helped them track down their stimulus checks, made recommendations how to meet their medical financial burdens and referred them to appropriate social services available to help them. I even drew up comprehensive debt reduction plans to help these people to meet their financial obligations.
You see, we are quibbling over a Democratic plan or a Republican Health Care Plan. I could really care less who gets the title...because as far as I'm concerned it is an American Health Care Plan and it is reform we need now. The people you listened to in Idaho that do not want government "further encroaching upon their lives" have not taken the time to read HR 3200. I met people that harp about "government encroachment" or didn't want government messing with their Medicare or Social Security! Can you imagine this...people who live in Boise, Idaho who do not know where the money is coming from that supports their health and retirement. The problem is how current legislation is being represented - politically and rhetorically. Senator Crapo, now is the time to put politics and rhetoric aside and join a bi-partisan effort to resolve health care reform in the United States.
HR 3200 does not encroach upon anyone life unless that person is not covered by the employer or cannot get private insurance. Then there would be a public option. The public plan provides for an agent of the government to represent the few who can't find adequate cost effective coverage. But this is a small percentage of people. The public option is a peripheral issue. Not an issue to stake the lives of Americans who need care now upon. HR 3200 is foundation to build upon or modify. Stop the negative rhetoric about "logistics" and make suggestions to improve or strengthen the plan so it is amenable to the people you talked with. For me, I am familiar with the government being able to contract with companies to get good deals for our country - you might make a recommendation to that effect if you are so opposed to a public option.
As a business person, I really do not want to provide health care for employees. Employee benefits affect profitability. In my opinion based on human resource studies for a masters in business administration, the existence or absence of employee benefits do not a motivate employees for increased productivity. Further, the cost of labor and labor benefits affect decisions to build businesses in the US or export the business to less costly labor nations. Senator Crapo, it is much less expensive to hire scientist and engineers from Russia, China, and India than in the US. And with brainpower industries, it is far less expensive to maintain those highly skilled people in their home countries and commute/communicate via the Internet. If I can get better qualified labor at less cost than high school graduates in the US - why should I even want to locate my businesses in the US. Germany faced similar decisions when relocating BMW and Mercedes Benz plants to the US. German unions, labor cost, plus the cost of benefits to include health care were far greater than those in southern US where they located. We need to learn from the German public health care lessons and public health care lessons from other first world nations and build upon HR3200 to avoid problems those plans created.
As an American Citizen though - I see the need for health care on a daily basis. Companies expect employee loyalty yet the company has no loyalty to employees during tough economic times. Micron, Dell Computers, Zialog, HP, CITI are just some of the larger companies that have laid off thousands of Idaho employees to relocate operations overseas. My own niece (38 years old) could not get an appointment for a bladder infection for over 4 days because she did not have health care insurance from her employer because she was new to the job. By the time she was seen, the clinic sent her to the emergency room as the infection had progressed to the point that required x-ray for gall stones, treatment for high temperature, and intravenous fluids. A preventive visit of $250 turned into over $2,200 and counting. I've seen this type of treatment before in third world nations while I served in the Air Force (Panama, Tunisia, Sierra Leon) - this is not how I want Americans to be treated. Yet as I read your response - you seem focused on pointing out the logistical issues of HR 3200 and not focused on providing resolutions to actual American citizens who desperately need your help and leadership now.
I have been part of a government medical plan for over 35 years through the military and now Tricare. I had misgivings about my care while I was active duty because I did not have a constant doctor. Tricare is much better now that I am retired and I chose a physician assistant to manage my care. I see him annually and when needed. When I arrived in Idaho in 1997 we were having significant difficulty getting Idaho doctors and dentist to accept Tricare and Tricare Dental. But then Senator Kempthorn's work improved the situation for active, guard and retirees in the state of Idaho.
I agree with your suggestion that "individual patients must have more control, choice, and information to make their health care decisions. When individual patients have these choices, they will reward innovative insurers and providers who reduce costs and improve quality." HR3200 provides choice through employers, and a public option if the person cannot find a health care insurer. If you can spell out choice any clearer, please provide your suggestion.
Illegal aliens are specifically covered in HR 3200. And I do see the loophole - how do you verify eligibility - leading to the next problem how do re-coup the cost of treating illegal aliens. But, illegal aliens are a peripheral issue. It is a peripheral issue because illegal aliens health care issues are less than 10% of the total eligible US population if using 20-40 million illegal aliens for estimates. Eligibility is a totally separate issue that Republicans do not want to address because it affects rights to privacy and/or a national identification system. Just like the right to bear arms, conservatives do not want more invasions on their privacy through a state or national identification system. Ironically, between social security and state identification processes (Drivers licenses and picture identification cards), a national identification program is partially in place. Please do not kick Health Care Reform down the legislative road because of peripheral issues. Lets build an American Solution that will provide Health Care Coverage for all Americans and deal with the care of illegal aliens separately. My expectation for doctors to care for illegal aliens based on my limited knowledge of the Hippocratic Oath is that doctors have a moral obligation to see and treat all who need care. I would expect and have witnessed treatment when US citizens travel abroad - insured and uninsured, and I do not expect anything less of American doctors.
I'm glad you mentioned the $900 billion price tag. That is less than we have "spent" in both Iraq or Afghanistan. And we haven't finished either of those Bush/Cheney Administration initiatives. Iraq, Afghanistan and now Pakistan are now American issues that continue to drain lives and resources in the name of "national security." I'll concede Congressional Budget Office estimates suggest health care reform could cost over $1.6 trillion in the next 10 years. But lets again put this back in perspective for Americans. HR 3200 suggest $900 billion and the CBO suggest $1.6 trillion. These are estimates for a 10 year period which means the cost is is less than $3,000/year or $5,300 respectively for every man woman and child in our 304 million current population. The question I have addressed to President Obama is this cost in addition to the current rising health care cost. Never the less, "in the last decade health care insurance has risen over 119%" - an average 11.9% per year. "The average employer-sponsored premium for a family of four costs close to $13,000 a year, and the employee foots about 30 percent" (http://www.nchc.org/facts/cost.shtml).
If we do nothing to reform health care insurance, at the current rate, the average family or 4 costs will increase to over $20,000 ($13,000*1.119^4) in the next 4 years. What we fail to explain to the American public is that our national debt and ability to pay down national debt is directly tied to our businesses being able to contribute to gross domestic product. Businesses are hamstrung to increase profitability by rising health care cost that the Republican party is kicking down the legislative road. Republicans used to stand for business. Yet the stalling tactics will cost American businesses. "Without health care reform, small businesses will pay nearly $2.4 trillion dollars over the next ten years in health care costs for their workers, 178,000 small business jobs will be lost by 2018 as a result of health care costs, $834 billion in small business wages will be lost due to high health care costs over the next ten years, small businesses will lose $52.1 billion in profits to high health care costs and 1.6 million small business workers will suffer" (http://www.nchc.org/facts/cost.shtml).
While I do not want to belabor the discussion about the national debt, I feel it is irresponsible and playing on limited American economic and mathematical knowledge to play the billions and trillions numbers with Americans. The frame of reference is never discussed - typical Americans believe the US Government should balance the budget like citizens balance their checkbooks. Yet most citizens do not have a concept of a balance sheet, pro forma earnings expectations, or cash flow statement. The United States of America is a different economic being. A government with a lifespan, assets and liabilities that extend far beyond the human life span, with the ability raise money through taxation and expand and contract the availability of money. Quantify the asset value of the national highway system, FCC, FAA, national parks, national defense, TVA, NASA. The United States fought two world wars with the great depression in the middle and we have paid off both plus Korea and Vietnam, recovered from the savings and loan financial crisis in the 80's, the oil crisis of 1973, 1978, several recessionary periods while still funding 'highways to nowhere' and other pork programs tacked on to legislation by Senators and Representatives. I'm not proposing unbridled spending, but a national health care program where all Americans contribute and have access to health care is a responsibility meeting the highest ideals set forth in the Preamble of the Constitution "to promote the general welfare"
Senator Crapo, I expect your leadership and focused energy to bring health care reform for the United States before the close of 2009. American citizens lives and health are at stake. While I spent 25 years serving our national defense in the Air Force, executing missions authorized by NCA using resources authorized by congress and the president; the health care reform cannot be resolved by any other US institution other than the legislative and executive branch. Americans expect expediency and efficiency from their national defense. Americans deserve expediency and efficiency from congress to resolve national health care reform. I look forward to your action.
September 18, 2009
Dear AF Chief:
Thank you for contacting me to express your thoughts on President Barack Obama's health care reform proposal. I appreciate hearing from you and welcome the opportunity to respond with my suggestions for improving health care.
While health care reform is essential, the President's and many Congressional Democrats' proposals for overhauling the system are problematic. Quality and affordable health care is understandably one of the highest priorities among Americans. A successful health care plan would allow Americans the ability to choose plans that fit their specific needs and those of their families. Thus, any successful reform package must properly address all logistical and personal components of our nation's health care system.
In my weekly travels through Idaho, I have had the opportunity to listen to my fellow Idahoans' ideas and concerns regarding our nation's health care system. In doing so, I have heard overwhelming opposition from Idahoans regarding the prospect of the federal government further encroaching upon their lives. They continually express their distrust of a government plan, losing their existing coverage, and paying more money for an inadequate health plan. Instead of giving the government more power over health care, individual patients must have more control, choice, and information to make their health care decisions. When individual patients have these choices, they will reward innovative insurers and providers who reduce costs and improve quality.
Many health care proposals disregard this fact by continuing to support a costly and prohibitive government-option health care plan. I am opposed to such a system as it would certainly lower the quality of care that Americans enjoy and result in delayed or rationed health care. In addition, such a system would be extremely costly, burdening American taxpayers and the economy with large costs and inevitable, significant tax increases. Without the beneficial effects of competition, or cost-cutting measures, a government health care monopoly would likely lead to higher prices. The archaic, confusing, and inaccurate formulas and policies that Medicare uses to determine physician and hospital reimbursement levels serve as an example of the ramifications of adopting a government-run system.
Health care spending currently exceeds 16 percent of the Gross Domestic Product and continues to increase at an alarming rate. Unfortunately, the President's plan does not address this problem and instead includes a $900 billion price tag. The Congressional Budget Office (CBO) projects that some of Congressional proposals will add billions of dollars to the national deficit over the next ten years. The CBO also estimates that the these proposal will cause millions of people to lose their current coverage, which contradicts the President's repeated promise that those who are content with their current health care coverage will keep it. The President also targets popular programs such as Medicare Advantage, thereby resulting in even more Americans losing coverage. This is unacceptable.
The lack of specifics in the President's proposal is equally of concern. While the President states that his plan for reform will not insure illegal immigrants, no language in his - or any Congressional proposal - would require individuals to provide proof of citizenship before obtaining subsidized benefits that are funded by every taxpayer. Additionally, these proposals include tax increases that will disproportionately affect small businesses that will only lead to unemployment and further financial hardships for hard-working Americans.
Preserving access to high-quality private health coverage, focusing on prevention and wellness initiatives, improving the delivery system mechanism, and bending downward the growth curve of spending should be priorities in any comprehensive health care reform legislation. Fair insurance-market reforms that provide all Americans access to health care are essential to any successful health care system.
Providing quality health care for all citizens is my priority and must remain a priority for this Congress. Please know that I will continue to work with my Senate colleagues to establish a plan that works and truly represents the will of the American people.
Again, thank you for contacting me. Please feel free to contact me in the future on this or other matters of interest to you. For more information about the issues before the U.S. Senate as well as news releases, photos, and other items of interest, please visit my Senate website, http://crapo.senate.gov.
United States Senator