Answers to health-care questions from Rep. Giffords

Last Sunday, the call went out to Green Valley News readers to submit health-care questions they’d like addressed by Rep. Gabrielle Giffords. The idea was to give Rep. Giffords a sense of what the community is thinking and to get a commitment from her staff to answer the questions in writing before a health-care bill came to a vote.

Readers sent in dozens of e-mails with close to 200 questions. They were edited for clarity and length and submitted to her office Wednesday night. On Friday, her office contacted us and asked whether they could answer them all, in print, in Sunday’s paper.

Not all questions sent to us were sent to Rep. Giffords. Many came in after we’d sent our e-mail to her office. However, what you see is representative of the most common questions and concerns submitted. Her answers have not been edited. They also are available online at www.gvnews.com and www.sahuaritasun.com.

— Dan Shearer, editor

QUESTION: As H.R. 3200 (health-care bill) stands now, how will you vote?

ANSWER: The question is hypothetical because H.R. 3200 will not come to the House floor for a vote in its present form. At the current time, it is only a proposal. The staff of three House Committees — Energy and Commerce, Ways and Means, and Education & Labor — are going through the bill line by line. Changes are inevitable and we can count on numerous revisions before it comes to the House floor. As I have said before, I believe our health insurance system needs reform that protects a patient’s choices, improves the quality of care, makes coverage available to all Americans and lowers skyrocketing costs. I will decide how to vote on this legislation after I have reviewed the final bill that will be brought to the House floor.

Q: Do you support tort reform? Give specifics.

A: Yes. Frivolous lawsuits are harmful to everyone. During this debate, we cannot consider health insurance reform in a vacuum. I have voted for tort reform in the past and would like to see it included in any health reform legislation. It is important to note that according to the Institute of Medicine, 98,000 people die every year because of medical errors If you or a loved one is a legitimate victim of medical negligence, I believe that you should be able to seek just compensation.

Q: Do you believe the existing health-care system in the United States is broken?

A: Yes. The system is broken when it allows Americans to be denied coverage based on a pre-existing condition or because they have reached an arbitrary “life-time limit.” The system is broken when it allows an insurance company to decide your health care instead of you and your doctor. And the system is broken when it allows insurance costs to skyrocket while businesses and their employees struggle to pay the astronomical premiums.

The current system is not fair, it is bankrupting families and imposing tremendous financial burdens on businesses. We deserve good quality, affordable health care that you can rely on no matter how sick you are. We need a health insurance system that is truly competitive.

Q: Do you support health-care reform with coverage for illegal immigrants?

A: No. Opponents of insurance reform are spreading misleading information that illegal immigrants would be covered. The proposed House bill states that no one residing in the United States illegally will be eligible for care. I want this language to remain in the legislation.

This prohibition does not stop people from using our emergency rooms as their doctors’ office. Southern Arizona is affected more than any other part of the country. The cost to hospitals and local law enforcement is significant and this hits hard on already strained budgets. Every year since going to Congress, I have fought for increased federal funding for our hospitals and first responders. The federal government must repay Southern Arizona for the cost of failing to secure our borders.

Q: We retired from a large company with health benefits. What guarantee do we have that our company won’t dump us into the government plan?

A: Under the current draft proposal, the motivation for a company to provide health insurance will increase after insurance reform, not decrease. When much-needed competition is part of the equation, it will become more affordable for businesses to offer health insurance which will help attract and retain good employees.

The current proposal also says all employer-based plans are grandfathered in for 5 years, giving the employer-based plans plenty of time to meet the minimum criteria of benefits. In fact, most large companies offer insurance packages that will exceed the basic standards therefore these plans will not be affected.

Q: Can we generate enough primary-care physicians to adequately service the increased demand should national health care pass?

A: The need for more primary care physicians has been a problem for years and is a very serious issue in Arizona. As the representative of a district that includes many rural and remote communities, this is one of my biggest concerns. I am pleased to see that the draft version of the House bill provides tax credits as well as medical school repayments to people who choose to practice primary care.

Specifically, the bill provides incentives for primary care in several ways. It would increase the Medicare payment rate by 5% for physicians specializing in primary care and would provide an additional 5% in shortage areas; it would increase the loan repayment benefits for primary care doctors to a maximum of $50,000 per year; and it would provide new loan interest rates for primary care physicians and training for frontline doctors.

Q: Have you read the health-care bill? Do you understand it?

A: Yes, I have read the bill and I do understand it. This is my job. I encourage anyone who wants to learn more about insurance reform to visit my website: www.giffords.house.gov/insurancereform

Q: Should the president, his cabinet and members of Congress be covered by this plan?

A: Yes. My health insurance coverage is through the federal government and I am offered the same options as every federal employee. Insurance reform would and should treat the federal government like any large business. The government can enroll its employees in the Health Care exchange beginning in 2015, just like every other employer with more than 20 employees.

Q: Will we still be able to use our Tricare for Life plan (military) if there is a government health care plan?

A: Yes. Tricare would not be impacted in any way.

Q: How will the health plan affect those on Medicare? Will money be taken from Medicare/Medicaid to fund the new health plan?

A: Under the draft House bill, money will be saved from Medicare and Medicaid, it will not be taken. Insurance reform would restore fiscal responsibility by reducing payments to insurance companies that are currently being overpaid and have very large profit margins — some as high as 17 percent.

The Medicare changes in the House bill could work toward making the Medicare program more sustainable for the future and could reduce Part B premium growth in the coming years. All payment reforms currently proposed in HR 3200 consider seniors’ access to and quality of care. Some of the payment cuts to providers are reinvested back into Medicare and could be used to pay for closing the Part D donut hole or to provide assistance for low-income Medicare beneficiaries.

We should not forget that the Medicare Prescription Drug, Improvement, and Modernization Act was signed into law by President Bush in December 2003. Not only was it not paid for, after just one month, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the Bush administration’s original projections. Former U.S. Comptroller General David Walker has called this “probably the most fiscally irresponsible piece of legislation since the 1960s... because we promise way more than we can afford to keep.”

Q: Would Medicare payments be eliminated under a national plan?

A: No. Health insurance reform could deliver the consumer more choices through an exchange, or menu of options. In the exchange, Medicare would be available to you if you are over 65. The premium structure would be improved by reducing the Part B premium growth and closing the Part D donut hole.

This is an example of where the words we words really matter. Medicare is a government run “national” health insurance option for Americans over age 65. The “public option” under consideration would be a government-run insurance option for Americans under 65. Private insurance plans will also remain as an option.

Q: Should a national health plan cover abortion?

A: Since 1974, we have had a law on the books stating that no federal money will be used to pay for abortions. An amendment to the current House health insurance reform bill reiterating that point was adopted in the Energy and Commerce Committee.

I believe that pregnancy terminations should be covered if the life or health of a mother is at risk. Elective procedures should not be paid for with tax payer money. This is consistent with law that has been on the books since 1974.

Q: Who wrote H.R. 3200? If members of Congress, did they have help?

A: The draft House version of insurance reform legislation was written by three committees: Ways & Means, Education & Labor and Energy & Commerce. These Committees sought expert advice from many sources including hospitals, doctors, nurses, patient advocacy groups and others. The committees will continue to seek advice from these groups as they revise the proposed legislation.

I do not serve on any of the committees with jurisdiction over health insurance reform legislation. I serve on the House Armed Services, Science & Technology and Foreign Affairs Committees.

Q: Can we afford this with a deficit projected to reach $9 trillion in 10 years? Will our taxes go up?

A: We can pay for most of this bill through the savings found in ending windfall profits and reducing current inefficiencies. The majority of the initiatives that would pay for reform would come from cutting waste, fraud and abuse within existing government health programs. These cuts would be directed at unneeded spending that does not enhance care for Americans. But that doesn’t get us to the full cost of reform, so the draft plan also requires the very wealthiest Americans to contribute to the cost of reform. That means that 99 % of Americans would not be impacted.

The rising cost of health insurance is crushing families and businesses. We are spending more than $2 trillion a year on health care. Premiums have doubled in the last 9 years, 3 times faster than cumulative wage increases. An additional 9 million Americans have become uninsured since 2000. Since 2004, the number of “under-insured” families — those who pay for coverage but are not protected against high costs — climbed by 60 percent. A survey this year found over half of all Americans cut back on health care in the last year due to high costs. Without reform, families will spend an additional $1800 on health care. In my district, more than 950 bankruptcies have been resulted from health care costs. We cannot afford the status quo.

Q: Is it constitutional to require people to buy health insurance?

A: The words health insurance are not found in the Constitution. Medicare and Social Security also are not mentioned. But our Founding Fathers, in their wisdom, did say: “We the people of the United States, in order to ... promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.”

I believe these words are important in this debate. They remind us of our obligations as human beings to our fellow citizens. Health care for all is a principle rooted in the values championed by Madison and Jefferson that have guided us for more than 200 years.

Q: What would be the responsibility of small businesses (under 10 employees) in providing health insurance for employees?

A: As a former small business owner, I know the challenges small business face in providing health insurance for their employees. The draft version of the House bill includes an exemption for businesses with up to $500,000 in payroll and potentially higher. Over 96 percent of employers will be exempt from the employer requirement. Employers with payrolls between $500,000 and $750,000 will pay graduated rates of less than 8 percent. For businesses that aren’t exempt, a 50 % credit is made available for those with 10 or fewer employees and with average employee wages of $20,000 or less.

QWhat is the short- and long-term cost of not changing our health-care system?

ACurrently, 1 in every 5 of our dollars is spent on health care. The biggest amount — $425 billion — goes to Medicare alone. If we do not enact reforms, it will be 1 in every 3 dollars by 2030. There is almost no aspect of our society that this expense does not impact. Our global competitiveness is severely threatened by soaring health insurance costs. The looming Medicare insolvency only compounds this problem. We must reign in health insurance spending.

Q: Will retirees be better or worse off with health-care reform?

A: They will be better off. Insurance reform will benefit retirees. Slowing the growth of Part B premiums, closing the burdensome donut hole in Medicare Part D and providing additional savings for brand name prescription drugs are all actions that seniors have been demanding for years. Seniors deserve these changes.

HEALTH CARE TOWN HALL

Rep. Gabrielle Giffords will answer health-care questions from 9-11 a.m. Tuesday at the West Social Center, 1111 Via Arcoiris, Green Valley. RSVP (not required) at 881-3588, or e-mail RSVPGiffords.GreenValley@mail.house.gov.