Health Care Reform

Aug. 25, 2009

Transcript:

Ted Simons:
As a continuing feature this week, we're listening to what Arizonans have to say about healthcare reform. Joining me tonight is Roger Hughes, executive director of St. Luke's Health Initiatives, a public foundation focused on health policy and the development of healthy communities. Thanks for being here tonight.

Roger Hughes:
Pleased to be here.

Ted Simons:
Let's start with the basics. Healthcare reform. Is it necessary?

Roger Hughes:
It's absolutely necessary. I think what's frustrating for somebody like me who has studied healthcare reform for years, is that I think what we're going to get out of Washington is not healthcare reform. It's going to be nibbling around the edges but basically continuing the status quo.

Ted Simons:
Why is all of this nibbling going on around the edges?

Roger Hughes:
It's political. I think -- and I voted for President Obama. I think he's got a lot of wonderful characteristics. But I think his primary goal here is to get a healthcare reform bill passed that he can declare as a political victory so he has to please all of the stakeholders and give them something to come to the table. And frankly, all of the big stakeholders are primarily interested in continuing the status quo.

Ted Simons:
Why is healthcare as it exists right now so expensive?

Roger Hughes:
Well, there's a number of factors. But I think it's primarily, the analogy I like to use is imagine you were buying a car, but you didn't know how much cars cost. And imagine you were concerned about the quality of that car, but you had no way to find out what the quality of that car was. And then you found out you couldn't actually buy the car yourself but somebody else was going to buy it, and by the way, it was going to cost you $20. And basically, what I've just described is the way we pay for healthcare. We have a third party -- you know, system, that essentially is -- is a way of paying for healthcare. It's not health insurance at all. And it insulates the customer in this case, from the true cost of that care. And somebody else, you know, allegedly is picking up that tab. It happens to be the American taxpayer but somebody thinks it's the government or the employer that's providing this benefit. It encourages over-consumption, which in turn, encourages overproduction and creates a vicious cycle of rising prices.

Ted Simons:
And critics will say you've got providers expecting why in terms of profit. Is it helping to push us to this crisis?

Roger Hughes:
Let me say parenthetically when you look at other systems of welcome, both where there's a profit motive and those that are not a profit motive, public plans, you'll see lower costs than you will in the U.S. system. The fact remains the cost in European countries and America has roughly kept apace over about the last 10 years. The difference, of course, is that the prices in the U.S. are two to three to four times higher than they are anyplace else in the world. That's not true just for healthcare, but for practically example.

Ted Simons:
There's a higher percentage in the United States who don't have health insurance?

Roger Hughes:
Yeah, in Arizona, for example, it's about 17%, 18% of people between 18 and 64 years of age. But, you know, I think what's even more problematic, at least to me, looking at this over the long term, is what's coming out of Washington today is still wanting to hitch health insurance to an employer-based model and in my estimation, until we move away from that model and begin to consider what I think are the other two main alternatives, either some type of a single payer system, and that doesn't need to be government-owned and operated. But something like Medicare for all. Or some kind of a system where health insurance and costs are in the form of individual vouchers and tax credits. But, you know, as a small business CEO, it kind of bothers me that my health plan can raise my costs, they did this year, my premium costs, 72%, and whereas, if I worked for thousand, two thousand member firm, I wouldn't see those raises and to me, that's inequitable.

Ted Simons:
Can there be enough in the form of tax credits and vouchers to help you and other small businesses?

Roger Hughes:
There can be. Certainly not the way the Republicans have constituted it today. You know, they're talking about tax vouchers and things and the $5,000 range, you know, for individuals and such, and frankly, we do not have a sufficiently May tour -- mature healthcare market to provide a broad breadth of products for that kind of cost. But if do you something like a value-added tax and then have government self-insure under it for the 20% of the people that are consuming 80% of the cost, I think you can get there.

Ted Simons:
It sounds as if you see employer-based health reform and health care, I should say, on the way out. If that's the case, is there any other option but a public option?

Roger Hughes:
Yes, you know, I -- I think you can make a strong case for actually going to a true insurance model where everybody is required to have catastrophic coverage, just like you buy it on your house or your car. And then you -- and for the people that can't provide that, that is publicly subsidized and then you take away first dollar coverage and allow people to provide various plans, depending on their resources and their ability and their interest on the private insurance market the some people -- I mean, the only thing everybody has to be in the system, but individuals can still choose from a variety of individualized plans on what they want to purchase.

Ted Simons:
Quickly, you've got to make sure everybody is covered and that includes preexisting conditions or the whole thing get out of whack.

Roger Hughes:
It has to be mandatory. For a single payer or individual plan.

Ted Simons:
Thank you for joining us tonight.

Roger Hughes:
It's my pleasure.