Issa Town Hall Meeting
Last night I attended the Darrell Issa townhall meeting. They announced attendance at over 3000, at least half of which was outside the auditorium … which was cooler than inside. There were loudspeakers so everyone outside could hear quite well.
There was a prepared handout explaining his position on the health care issue, which was assumed to be the order of the day. The contrast between this meeting and the others that make the blogs was significant. There were a few signs — not many. The crowd was generally quiet and respectful, although there was one major “BOO” when he mentioned that even the ACLU can take on the good cases. Overall, though, the difference was similar to the difference between the fire evacuees at Qualcomm Stadium a couple of years ago vs. the Katrina evacuees at the Superdome.
The handout had a number of parts. The first was a statement describing his position on the current approach (against). The second was a set of bullet points highlighting many of the flaws of HR3200 (prohibiting sale of future policies, 2.5% “uninsured” tax, causing 114 million to lose their coverage, etc.). There was a helpful copy of the chart to the democrat health plan. A description of his HR3438, which notes that the government already offers health care packages to congress and other goverment employees, and proposes that these health plans be made available to the rest of us. Last there was an article he had written for the North County Times discussing health care “rehab”.
Because he had the handout, most of the session was Q&A. This was handled by lottery. You took one half of a ticket, and dropped the other half in the box. They drew one ticket from the “outside” box for every two from the “inside” box. I took some notes, but they don’t read like english. I will try to decipher some of them.
Q: what about establishing price caps?
A: history has shown those don’t work. (ref. to wage & price controls in 70s)
Later in the session he talked about how he thought it would be a good idea if doctors in general could not be sued (the same way VA doctors can not be sued because they work for the government and the government can not be sued). I am not so sure this is a good idea, especially after hearing some of the stories of how the VA is run. However he is correct that liability issues are a major component in the current high price of health care. One of the first questions was about the government offering physicians liability insurance, but unfortunately I did not catch the answer.
Q: a man with epilepsy who had been paying for 20 years for his own insurance asked about guaranteeing coverage if he lost his current insurance (basically pre-existing conditions).
A: Issa talked about “assigned risk” and distributing the costs so that preexisting conditions could be taken on. He said this would have to be by government edict as if only one company did this they would become inundated and go under. He compared this to how the PUC decrees that rates should be the same for rural, suburban and urban customers even though the costs associated with each area differ greatly.
Q: should healthcare reform be tackled one piece at a time instead of a huge omnibus?
A: yes, but that is not they way they are going with it.
Q: what will happen to hospice care?
A: hospice care saves costs for a number of reasons, and should be protected. It would probably go away under the current proposal.
One question prompted a discussion on how costs are raised because the big insurers do not reimburse enough (with Medicare being the worst offender). This results both in doctors raising costs, and in doctors providing less actual care since they will not be reimbursed enough to make it worthwhile. Some doctors refuse to take Medicare for this reason.
Q: can we count on protection from the supreme court if the bill is unconstitutional but is passed anyway?
A: He really didn’t mention what he thought the court would do. He mentioned that the federal and state goverments regularly exceed their constitutional bounds and that it is up to us to challenge such laws. He mentioned Pacific Law Center here in California, and the ACLU (drawing that “Boo” I mentioned earlier) as agencies that do this. He also mentioned that he preferred federalism (i.e. handling things at state level if possible) to nationalizing whenever it is possible.
Q: much of government action is predicated on the “interstate commerce” clause, and promoting interstate commerce … but it is not even possible to buy “transportable” insurance.
A: auto insurance crosses states, so should health care insurance. a state may set standards,
but if the insurance meets those standards it should be purchasable from any other state. to
break this a state needs to bring this case before the courts.
There were some other questions as well, but these are a sample.
Darrell Issa’s home page: http://issa.house.gov
