Weiner, McCaughey square off in healthcare reform debate

by Ellis Simon

NEW YORK, October 5, 2009 – Hope squared off against fear in a debate today at NYU Medical Center between two preeminent advocates on the healthcare reform issue, U.S. Rep. Anthony Weiner, a Democrat from Queens, and Betsy McCaughey, a former Republican lieutenant governor. The event was sponsored by DL21C, a young Democrats organization, and cosponsored by the Manhattan Young Republicans.
Weiner, who spoke first, characterized the issue as three problems: two that are easy to solve and one that is difficult. The 45 million Americans who lack health insurance and the millions more with inadequate coverage can be addressed through subsidies, he said. The bigger problem is controlling the spiraling increases in costs, which are unsustainable and detrimental to the economy, he added. “Healthcare now accounts for 17 percent of the Gross Domestic Product, and if it continues to grow at the current rate, its share of GDP will double in ten years.”
An ardent supporter of a public option, Weiner said President Obama’s version doesn’t go far enough since it only covers people who don’t have insurance or have watered down policies. Nevertheless, he considers including a public option essential to have any chance of controlling costs. “If you don’t have a public option, there is no incentive for insurers to compete on price.”
He pointed out that 40 percent of Americans are covered by and 47 percent of healthcare expenditures are paid by government-administered programs such as Medicare, Medicaid and the Veterans Administration. In all of these plans, doctors still control treatment, he notes. “The only thing to argue about is who gives the money to the doctors; the government or the insurance companies.”
Since government plans operate on a three percent overhead margin while private insurance operates on 30 percent overhead, Weiner points to the higher overhead as a place to achieve savings since it accounts for a large chunk of the $854 billion paid to private insurers.
McCaughey contends the two objectives of healthcare reform, extending coverage to those who are now uninsured and cost containment, are contradictory goals. She said the legislation now working its way through Congress would result in a lower standard of care, lead to government interference and delivery a body blow to New York’s healthcare system. She cited provisions calling for electronic delivery of healthcare protocols and penalizing doctors who do not adhere to them as interfering with the doctor-patient relationship. “It is not reform if doctors have to choose between their patients and avoiding government penalities. She added that the changes would limit access to the kinds of advances in medical science that have “transformed the experience of aging,” which allows seniors to live longer lives.
McCaughey advocates scrapping the current proposals and replacing them with a simplified bill plan that would cover between 12 and 15 million people who cannot afford insurance. “We could cover them for the next decade with the $500 billion in unspent economic stimulus money and could do it without dismantling our medical system.” She contends Americans spend more on healthcare than other nations because we can afford it due to our higher incomes. She also blamed politicians for imposing coverage mandates that result in people having to buy policies with all the bells and whistles that are the equivalent of requiring all car owners to drive luxury sedans,
Weiner disputes her charges about reduced care standards. He noted that Medicare could achieve additional savings by negotiation better deals with healthcare providers, something it does not do currently. Noting that Medicare will pay for a hip replacement operation but not the installing handrails in a bathtub that might have prevented a fractured his from occurring, he said: “We incentivize the most expensive treatments but not the least expensive.”
American is conducting two parallel experiments in health care, a public plan and a private plan, with the former operating on lower overhead. “If it’s your tax dollars, why would you give money to insurance companies? That’s the argument behind a strong public plan and single payer plans.”
McCaughey countered that two-thirds of the increases in healthcare spending are due to medical innovations and that single-payer plans control costs through rationing. She called for allowing people to buy insurance out of state. However, Weiner pointed out that insurance is regulated by the states and no states have entertained requests for out-of-state insurers to write policies in their states.
In addition, McCaughey argued that public plans operate at an advantage since private insurers cross-subsidize them through higher reimbursement rates to hospitals. “Public plans are not competitive since they are subsidized by plans,” she said, warning that as coverage shifts to public plans the remaining private plans will pick up more of the burden.