(Due to the length of this article, we were required to break it up into multiple parts because of technical difficulties. It appears in the printed version as one story)
By Charles McClure
news@ltview.com
Doggett: Don’t be fooled by partisanship
Doggett has long advocated an overhaul of the nation’s health care system and has some very pointed observations concerning H.R. 3200. While he doesn’t believe it a perfect plan, he notes that it is worth passage.

So what does he like about H.R. 3200?
“I like achieving the objective that seeing the many people — as well as the many small businesses — that want to access health insurance — have a way to do it,” Doggett said. “I like the notion that it will increase competition in the private market and provide more individual choice. And there is no way we could effectively accomplish either without a strong public plan as one of the options.”
He categorically dismisses Smith’s objections that the plan is a government takeover of the health care industry.
“All of this talk about a government takeover and socialized medicine is simply nonsense,” Doggett said. “The same independent analysts who have raised legitimate concerns that the bill doesn’t bend the cost curve enough, which is a concern I share, have also said a decade from now, 90 percent of those who go to purchase health care will choose private insurance policies, and four percent will choose the government plan — a plan that is not all that different from TRICARE for your military retirees in Lakeway or your Medicare for your retirees in Bee Cave.”
While Doggett shares the outrage that many insurance companies cancelled policies and curtailed coverage, he said he has been even more impressed Potter for having the courage to reveal industry secrets that he once helped implement, but came to deplore.
Doggett would like to see H.R. 3200 eliminate some of the most controversial practices of the insurance agencies, but hedges on whether it can actually accomplish those goals.
“Yes, am hopeful it does,” Doggett said. “It attempts to prevent preclusion of pre-existing conditions. It attempts to prohibit this terrible problem where companies undertake the practice of ‘recision.’ Recision is the practice where insurance companies cancel policies where the premium has already been paid, based on some claim — often irrelevant — that the policyholder didn’t disclose when they got the policy in the first place just when they need the coverage the most. This practice also discriminates against people based on age and gender. It also takes advantage of small businesses that are forced to pay 18-20 percent more for the same coverage available to a larger company. I am hopeful that this bill does all these things. I am hopeful because we have some of the most qualified and brightest minds working for these giant insurance agencies. I do not under estimate their ability to keep lobbying the regulatory agencies to find the way to circumvent what we are doing. But I think we have done about as much on insurance reform as we can.”
The only way many small businesses have been able to continue to offer health insurance is through high deductibles — which frequently top $5,000.
Doggett is also encouraged by the broad support the bill has already received.
“I think it is important to all these people who are part of the ‘astroturf’ campaign to stop this at any cost, to note that this bill has been endorsed by the American Medical Association, the American Nurses Association, AARP and a range of other groups,” Doggett said.
The most common concern about H.R. 3200 is the issue of patient choice.
“Concerning patient choice, many organizations do not believe the Medicare reimbursement is adequate,” Doggett said. “They are very concerned about the public plan tying its rates to Medicare. They object to one of the ways that we bend the cost curve in the current bill because medical costs are soaring far above the inflation rate. We have to find a way to deal with this.”
Doggett said the reimbursement rate issue is a legitimate concern.
“In some areas, they [reimbursement rates] are very deficient,” Doggett said. “But we try to correct that in the bill. Next year, physicians are set to have their Medicare rates cut by 21 percent. Instead of cutting them 21 percent, this bill would raise the rate for all of them by a little more than a percent. And for primary care physicians, we raise that rate by five percent on top of that and in medically under-served areas [rural, sparsely populated areas], we try to raise that by another five percent on top of that.”
Doggett said that any time the bill attempts to contain costs, it is cutting into another area’s profit.
“So those affected groups object loudly, as some groups have,” Doggett said.
“Many of the notions that are being paraded before the public are misleading,” Doggett continued. “This notion that we are going to place a bureaucrat between the patient and physician is a good example. There already is a bureaucrat between the patient and physician — but it is an insurance corporate bureaucrat — whose sole goal is to see that the patient gets as little as possible. I believe this bill gives patients more choice than they have today.”
Doggett falls into the group of legislators that see H.R. 3200 as a good first step that will evolve with time.
“Yes, I think it is a very good start,” Doggett said. “Bear in mind, that while I would have liked to have seen this issue resolved yesterday, or several decades ago to be honest, it is also important for people to realize that this, if passed, will not all happen at once. Most of the provisions of this bill will not even become effective until 2013. It will take time to get these market reforms in place. It will take time to set the standards that all insurance carriers and exchanges have to meet. It will take time to set up the public option. So most of the benefits of this bill are several years in the offing, although I think it will begin impacting the private sector sooner — and in a positive way for consumers. But given the constraints we face, I think we have done about as good a job as possible.”
Doggett said the confusion is being manifested over a provision that allows doctors to be paid when counseling patients concerning a living will.
“The idea is to allow a doctor to counsel a person, say someone who has incurable cancer, to learn what their options are if they become incapacitated,” Doggett said. “Often family members are forced to make those decisions under the most trying of circumstances and they may not always know exactly what the patient may have truly wanted. But if the patient wants every possible measure to be taken to extend their life, they may do so. Doctors frequently don’t talk about it until it is too late.”
It is commonplace for hospitals to require a patient to fill out a living will, as well as a power of attorney, when major surgery that could prove fatal is planned in advance.
While Doggett said he was not aware of all the specifics made by the Commerce Committee last week, he said he does not believe that abortion funding will be included in the final bill that is voted on by the House.
“What the bill is silent on is that it does not prevent private insurance companies from providing that service, which many of them do,” he observed.
Doggett believes there is a lot of fear mongering being mustered up by opponents of the bill. He said the notion that the bill would give Americans a European-styled health care system has no basis if fact, adding that if it did, it would not have won an endorsement from the AMA. And he said it would not have won endorsement from the AARP had it cut medical benefits for seniors.
“Some of the claims that are made on television, talk radio or the Internet are absolutely and totally outlandish,” Doggett said. “Specifically, the claims about having a European or Canadian-styled socialistic system are just false. There is no government ownership of hospitals, there’s no government employing of physicians — the only role of government here is to level the playing field to increase competition. What we have done in the way of competition has not worked well to date, since there is so little of it anyway with one or two insurance companies dominating so many markets.”
He also said that no one could be forced into the Medicare-styled alternative, but it gives an additional choice.” Doggett said the bill has a host of safeguards to protect private insurance carriers so competition will be increased, and not decreased.
He said the allegation that comparative effectiveness is a “nice term for health care rationing is a misnomer. He said the term came out of the subcommittee he served on that worked on the bill.
“The idea is to get the data to find out what types of treatments are most effective to address disease and illness,” Doggett said. “In some parts of the country we are spending huge amounts of money on treatments that statistically prove to be ineffective. One of the reasons why we want to digitize medical records is so medical schools can look at the data over time to gain a better understanding to see what kind of procedures work best. This is a way to bend the cost curve and make Medicare sustainable and health insurance policies affordable. But it is based on good science, not rationing.
“When people start talking about rationing, I can’t help but ask: ‘What do you think we have now?’” Doggett continued. “We had over 20,000 people die in 2006 because the had no health insurance. Health insurance companies ration people out of their insurance every day, and have admitted as much. So our goal in the bill is to prevent the rationing that is already happening, or have their policy rescinded, or learn that in the fine print, that the coverage they thought they had, doesn’t apply in this particular circumstance.”
Doggett said there would be some new agencies required to implement new policies, if the bill passes.
“But right now the Republicans are passing around a chart that looks a lot like the one they used when the Hillary [Clinton] plan was proposed that looks like a maze of bureaucracy,” Doggett said. “But if you drew a chart of our current system, it would still look like a maze of bureaucracy. It is a complex issue that involves a lot of different agencies and industries. But the goal is to provide good regulatory measures for the insurance industry, which is way out of control.”
Doggett alleged that as things are now, private insurance agencies are dumping their “sickest patients” off their rolls, leaving indigent health care costs to either be absorbed by hospitals or various governmental entities. He added that no one would be bound into the government plan permanently.
“People are always talking about how the government can’t do anything efficiently, but in truth, Medicare operates far more efficiently than most private health care programs,” he said. “You just don’t ever hear anyone talk about it, but the statistical data proves it is true.”
He pointed out that extreme medical emergencies are the number one reason behind most personal bankruptcy filings. He also pointed out that medical claims are the number one reason behind out-of-control credit card debt.
Doggett, who faced some heckling from opposition hecklers last Saturday during a town hall in Austin, and part of the crowd followed him to Bastrop, realizes a major battle lies ahead if the bill is to become law. Subsequent articles appeared about the incident in the Austin American-Statesman and the New York Times. A video also appeared on the YouTube web site. For his part, Doggett alleged the incident was staged by area Republicans, and alleged the Republican Party of Texas posted the video on YouTube.
“I would defend a person’s right to get in my face and scream at me or to hold up posters opposing the things I advocate — that is their right,” Doggett said. “But what happened on Saturday was not a grassroots uprising. It was organized by the local Republican Party, it was on their web site.
“We have some big obstacles to overcome before this bill becomes law,” Doggett continued. “I think what we are seeing is how desperate some folks are to stop it.”
In the end, he said the protesters began chanting “just say no.”
“It became so loud that it was disruptive to the facility where the meeting was held, so at that point, I figured this wasn’t accomplishing anything. Then this group tried a very juvenile thing to block my departure.”
He said those detractors who shouted slogans at the meeting that the bill would authorize euthanasia has no basis in fact.
“Normally, when you hear such claims, you would just laugh it off,” Doggett said. “But when you hear it enough on television, the radio and the like, you can’t help but be concerned that some might actually think it is true, which of course it is not.”