tv Washington Journal Grace- Marie Turner Discusses Republican Health Care Bill CSPAN March 13, 2017 7:25pm-8:04pm EDT
would take upuals the rest that isn't paid for. that's not how it works today. what happens today is if a physician or hospital contracts with medicare or medicaid they agree that's the amount they are going to get paid and they are not going to collect anymore from the patient. if that were to change that would change the burden on the patient. the program we have today is one that is more consistent with fulfilling the promise that people expect from the programs. if we are going to make these kinds of changes is critical that we have open debate, open hearings and people really know what we are talking about. it would be one of the most historic changes in our government over several generations. host: andy slavitt is on twitter. washington journal continues.
host: joining us to talk about the republicans plans to replace the affordable care act is grace-marie turner, president and founder of the galen institute. tell us what your organization is and why it's named the galen institute. a think tank specializing in market-based solutions and we are named after the second century great physician who was very much ahead of his time and very innovative and forward-looking. host: you are the founder. what motivated you to start it? after the 1990's debate over health reform when the health security act did not get through it was clear that we needed a more balanced debate among ideas we believed could be market-based and those that were more government centric. i started this think tank to
create a larger conversation around consumer directed health care. host: you are no stranger to the debate on health care on capitol hill. you were invited by speaker boehner to be part of the long-term care commission. what was your take away on the situation and what became of the recommendations of that? one of the things about health care is israel he very complicated. our long-term care commission focused on just that one issue. there were people appointed by the speaker and the minority leader and we really came together around a lot of ideas. we had a lot of deliberation. we had a lot of hearings. we had about 70 recommendations that are making their way through the policy process. it's going to be something that's integrated into other measures through administrative action and through legislation.
it shows that a collaborative process really helps us all become smarter. host: we just finished a conversation with andy slavitt on medicare and medicaid. medicaid covers one half to two thirds of people in states who are on long-term care in nursing homes and things like that. how concerned are you -- is there a market solution for people in those situations? guest: for some people there really is not. if you are eligible for medicare , that's a place where the government really does need to step in and help people. dual eligibles are particularly the most vulnerable of our citizens and those that we need to protect the most. there is a proper role for government in most cases. i think there is a market for long-term care coverage for
those who are young enough to begin planning for their retirement to make sure they have control over how they are taken care of in their later couldand i think people begin to save for that and some of the ideas that are going to be in this new health law can begin to give people a chance to start saving longer-term for their health care needs. we need younger people to begin thinking now about taking care of themselves later so we have the resources to take care of the people who don't have those. host: our guest is grace-marie turner. we continue our conversation on the future of health care and focusing on the republicans plans to replace the affordable care act. join the conversation of (202) 748-8000 for democrats. (202) 748-8001 for republicans.
(202) 748-8002 independents. you wereyou were at the white hs vice president pence in a listening session with a number of other folks from different organizations. that meeting like and what did the vice president want to hear from you? andt: the vice president tom price, it really was a listening session. there were people in that room who were not happy with this law. hear why and the vice president was taking notes. what do we need to do to make sure you can get on board. they know that everybody in the room was on board with repeal. it's the replace part that a lot of people have trouble with. to take input.
we were invited to go over to the white house and we had a moment to talk with president trump in the oval office. it has been a while since we have been in the oval office. host: you said everybody is on board for repeal. how about the white house itself? guest: i believe they are because they really helped shape it as well. there were significant consultations after president trump took office about how to make sure the president is spending the campaign promises he has made. it is a white house product that has been 15 months in development. jim is in florida on the independent line. caller: good morning.
first politics of it, the republicans are going to get killed in the next election. supporters aren't on board with the increases for the elderly. that's going to be a big problem right there. second, why can't you just issue a policy for everybody? all of the insurance companies issued the same policy. there could be variants for different age groups. you could pay back on the mean. the biggest cost labor is you have to put a death with dignity provision. most people absorb these health care costs at the end of their lives. instead of giving money to the policy withbuy a the medicaid money. let everybody buy into the policy. so it all has the same codes. just put it through private insurance. if other companies want to issue other policies for other people that's great. a bare-bones policy everyone
could access so there is no uncertainty for older people. guest: thank you for that question. what this caller is talking about is the tax credits in the american health care act that the congress will soon be considering on the floor. it provides a $4000 tax credit for people over age 60. if they do not have job-based health insurance and they are not eligible for medicare or any other public program. the question about whether or not we can have one policy for aca came-- i think the about as close as they could to that with their platinum gold silver bronze policies which were pretty much the same. and we saw that really did not
meet the needs of the american people. in a country with 320 million americans you are going to have very many different perspectives on what is the right kind of health insurance for that person. some people may prefer to have a health maintenance organization. prefer tole may manage their out-of-pocket expenses themselves and make sure they have coverage for major medical bills. i think one policy for everyone would wind up being a policy that no one is happy with. one of the things the american giveh care act will do is the states an opportunity to give people many more choices of and if the plans state decides there should be just one policy clinic can do that. having one policy for the whole think we have gotten
close enough to see that really doesn't work. for: mark tweets about months experiencing that vermont tried a single-payer system and it failed because taxes would increase 150% to pay for it. christopher in tallahassee. good morning. good morning. i just have a couple of quick suggestions. first, i have been insured ever since i was a little baby. the last three years i have and having to fight to keep my insurance. this year i had to turn my sole proprietorship into a corporation just to keep my insurance. the second thing i would like to tell you -- here's my suggestion. the future i see a health insurance market where state farm, geico and progressive could even sell health insurance. car insurance is not too far. when you insure somebody for a
car, you do it for the worst thing they could do which is if they hurt somebody or hurt themselves. you have to do something about the price of prescription drugs. when we did this affordable health care act we did nothing to lower the price of prescription drugs. case in point, the epipen. epipen people were called to congress for a quick little hearing and they never showed back up again. here's a quick thought for you all to think about. and tylenol or add bill raises the price of their drug tencent mighters it and since it affect the stock price of that drug and it might affect how much the federal government is having to buy it at.
medicare and medicaid services, he's a physician and really understands the industry, understands the challenges of getting new drugs to market faster so they can be cheaper, i think you're going to see pretty transformative changes at this agency, but the law, the big being considered before congress now really doesn't have a platform to be able to address drug prices there because it has to fit through this narrow framework called the budget reconciliation process, which i'm sure you're familiar with, that allows only things that are directly pertinent to budget and spending on this particular issue to be considered.
so i think that's a serious, something for later, but the issue about health insurance and sole proprietorship, one thing the law would do, give you a lot more choices. one reason you might have had trouble keeping insurance, the policies required to be so comprehensive that many people couldn't afford them and had to restructure businesses, look for new ways to get support so they could afford the policies. one of the goals is to give you more choices with more competition and obviously hopefully lower prices. host: for christopher, going to look at "new york times" today, their look at who benefits, how g.o.p. health plan could affect you, not sure what kind of contractor you are, they point out, better if you are 50-year-old single man that makes $75, 000 a year, you would
get more under the plan. one beneficiary under it is plan, pros and cons are listed. nytimes.com. go to new york city, democrat line. mark, good morning. caller: good morning, thank you for c-spanned. i'm not in new york city, i'm in new city, new york. host: oh, i read it wrong. caller: i wanted to talk about my personal experience with private health long-term insurance that is what the lovely lady is selling and i'm not buying it anymore because i did purchase with my wife a long-term care nursing home insurance policy when i was young, it wasn't too expensive like i'm supposed to do, paid for 20 years, then they raised it 60%, now i can't afford it, that is why i don't believe in the private market place, it just doesn't work. we need government to take care
of us because not all of us have the money to pay for these expensive policies. i believe now we need medicare for all and that way anybody who is under 65 could buy into medicare that would strengthen medicare and the insurance companies would have to compete with medicare and that would keep the prices low. the free market will not work unless you have a lot of money. i'll hangup now and listen to what the lady has to say to that. guest: one problem of the long-term care insurance market, many people believe medicare covers services and it does not. they don't buy policies and people informed like you and your wife and did buy policies wind up getting caught in adverse selection, only people who are going to need expensive care keep the policy going. we saw some happening with the affordable care act. what we need is system in which your long-term care insurance is
purchaseed with perhaps other products so you wind up, i'm not selling insurance, never have sold insurance, not an insurance marketer. you need opportunity to have continuity of that coverage and for a lot more people to be buying into the market, as well w. medicare for all, there are number of people who feel solution, the problem is that medicare really is not sustainable without a lot of younger working people paying in, so if you are paying into medicare now because you're working and paying payroll taxes, you are helping support long-term care and medicare for -- medicare for people over 65. that is not something that is sustainable. the average couple puts in about $165,000, average wage over their life in medicare taxes, but they consume more than
$400,000 in medicare services after they qualify for medicare that, is not a sustainable model for the whole country. we've got to figure out a better solution to cover people with the kind of coverage that feels as secure as medicare. host: lisa on the independent line in ohio. i hope i got the name right, lisa, go ahead. caller: thank you. i wanted to mention yesterday cnbc had reported that annual income for the ceo of united healthcare is $66 million annually. the ceo of aetna is $17 million annually. the ceo of cigna is $13 million annually. do you think that the new legislation is no longer capping
the tax deduction that the private insurance companies can take on their corporate wages? it was capped under the original legislation at $500,000, this new legislation is taking that away. to me, that is criminal and everything that ryan is proposing is based on take aways that are really detrimental to the whole nation and only profiting individuals such as the three that i referred to. host: what are the tax breaks lisa is talking about in the proposal. guest: there is a tax break, i haven't studied this in great detail, it is something that puzzled me frankly when i saw this in the law and something obviously some conversations that have gone -- taken place so
companies have made the case for this, enough so congress included it in the bill, but it is something corporate ceo pay for health insurance companies is something that really grates on people and particularly doctors because doctors say, you know, here i am basically able to hardly able to keep my practice open and i see the ceo of the insurance company paying my fees winding up paying, getting higher salary, that is something i think as political problem. host: grace-marie turner is our guest. president and founder of the galen institute, fresh from a conversation at the white house with vice president pence and with health insurance tom price. he was on "meet the press" yesterday and asked by chuck todd about looking year or more down the road, who would still continue to be covered, what he thought coverage would look like. i want your thoughts on what secretary price had to say?
>> a lot of people are worse off right now paying for healthcare and not getting care they need. premiums are up, deductibles are up, if you are an individual making 50 to 60,000 and your deductible is 8, 10, 12,000 bucks, you don't have coverage. i hear from former colleagues all the time about patients who come into their office and recommend something for them and they're not able to get it because the deductible is so high. >> i notice you ducked the aspect of whether you can guarantee nobody will be worse off financially. >> i firmly believe nobody will be worse off continually in the process we're going through, understanding they'll have choices they can select the kind of coverage that they want for themselves and their family, not the government forces them to buy. there is cost that needs to come down and we believe we'll be able to do that through this system. there is coverage that will go up. remember, chuck, there are 20 million folks in this nation who said to the federal government fully, i'll pay penalty or i'll
take waiver, i will not get coverage in the system we currently have, that may be a system that works for government or insurance issue but not for people. we believe our system works for people. >> you believe your system will add additional 20 million over the peep they'll have coverage? you believe that? >> i believe and the president believes if you create a system accessible for everybody and provide financial feasibility to get coverage we have great opportunity to increase coverage over where we are now as opposed to where the line is going and people are losing coverage and we'll have fewer individuals covered than we do currently. >> grace-marie turner, what do you think of tom price's outlook there? >> i really do believe that in this law one of the things they're trying hard to do is create a life boat for everybody on coverage now. both by continuing subsidy necessary medicaid, continuing tax credit for people with exchange coverage and also providing money to the states to
help supplement the cost so insurance companies will stay in the game. this affordable care act is on shaky ground, trying to keep it up and working for until the new system and new insurance regulations at the state level are implemented so that people will have, as dr. price said, many more choices and peep kel buy the coverage they want. so many people have said, i like the coverage i had before, now i'm required to buy coverage more expensive than i can afford and this gives people many more choices and gives them an opportunity to work with state government and state legislators to make sure they have the policies that fit them and their needs. >> we'll get back to callers and hear from cathnejasper, tennessee on the republican line. >> yes, my mother is 87 years old, just turned 87.
she can't see or nothing. she has to pay for glasses, she has to pay for her hearing aides and everything else. poor people cannot do it. government is going to have to step up and help the poor people, especially little towns. i mean, it's hard for the people that can't get out and work, that can't afford medicaid or anything like that, what is people going to do? sit and rob people just to live? that can't happen in the towns, i mean, it's rough on the people can't afford to go out to buy anything to eat, especially or their medicine, they can't afford it. host: kathy in tennessee. do you think medicare and medicaid will be stronger under the republican proposal? guest: i think it will. there are more than 20 million people, 20 million seniors voluntarily signed up for
medicare advantage program, they give people more choices, including in many cases, vision care and hearing aids, i wonder if you're in an area that has the opportunity to give, get a private medicare advantage plan that may cover more of these services. i would hope also that you are taking advantage of the services available. when someone is 87 and thank heaven they have you, she has you to continue to take care of her. but she's vulnerable, she's the person that public programs most need to care for. one thing that happened with the affordable care act is that states have had a huge incentive to sign up younger able-bodied adult, childless adults for medicaid because they are seeing subsidized at such a high level while their waiting list for people who are more vulnerable at the lower end of the income scale and making it more
difficult for states to provide the kind of resources to your mother that she needs. this is i believe going to right the ship and helping to give states greater incentive to take care of people like your mother so she can get the care she needs. host: american medical association wrote the legislation, their concern on medicaid in particular saying that they wrote medicaid expansion, ama proven highly success envelope providing coverage for lower income individuals beyond expansion, underlying structure of financing ensures states are able to react economically driven changes and enroll sxment increased healthcare need by external factors, changes to the program that limit the ability of states to respond to changes in demand for services threaten to limit coverage and increase number of uninsured. what is your reaction? guest: i just don't think they have it right. the structure of medicaid would
change, states have greater incentive to be partner and making sure the money goes to the people that need the care rather than having federal government dictating to the states every single thing they can or cannot do in their state. what has happened, states wind up gaming the system rather than thinking about how to best take care of people that need that care. there will be per capita allocation based on need, it will not be one big, you know, check that goes to the state. it is going to be based upon how many people, like kathy's mom are on medicaid, how many young, healthy adults there are, but saying they increase coverage under medicaid by putting a lot of people on it who actually many would have had the opportunity for other coverage, crowds out resources needed for the most vulnerable and the states would have greater incentive to focus on real
fundamental need and value of the medicaid program. host: albuquerque next, we say good morning to debbie on independent line. >> yeah, hi, good morning. you made a statement that we can't have a one-size-fits-all. europe seems to be able to do this, which doesn't seem to be a problem, one-size-fits-all. and the idea we have a company that is called insurance that makes money off misery of others by being sick, that is horrible. we claim we're the greatest country in the world. i don't understand why we just can't take and have medical for everybody. tax gas, put on your paycheck, put on the food, whatever, and do it across the board for everybody and take insurance and say goodbye. guest: deb, thanks, i'm from albuquerque, beautiful. the other mile-high city, isn't it? let's talk for for profit and nonprofit, if i may tell a
personal story. my mother was on hospice and she -- started out with nonprofit hospice care facility. the care was not adequate, even adequate for her and we moved to another company that turned out, i didn't know at the time to be for profit company, the care was exquisite and they were there for her, they had ideas, they wanted to make sure every need was met. for prove sxit nonprofit, look at what the incentives are for companies to make sure they are doing what they need to do and taking care of people. but the europe has the same waiting lines, same delay necessary surgeries, the same fewer access to newer medicines that may be best for people, i really don't think there is utaupian system anywhere else, we have to figure out how to get it right in america. host: couple comments on
twitter. maverick tweets, in sad, the oval lady from tennessee will be under trump care just like the coal miners, they got hood winked. what percent of income do you believe is reasonable for people to have to devote to health costs? guest: my goodness, i think that has really been a problem we've had with affordable care act, the government has been telling us how much of our money should we spend on healthcare without knowing the other priorities that people have for themselves, that has to be a decision for people to make for themselves and for these who need help in purchasing coverage, this new bill would provide that, we have public support programs that provide that, but that is not a role for government. government needs to decide how we're going to have fair playing rules for everybody. we're the people who need it. host: couple more callers, one
more roanoke , virginia, barbara on the democrats line. caller: good morning. sorry, i missed most of the show, i hope i'm not repeating somebody. i had two points i'd like to make. one, on medicare thing, people take out more than they pay in, that ignores the fact some people die before they take out one penny and also most insurance works that way. if you only got back what you pay in premiums, nobody would buy insurance. it works out because some people die young, i've had peep nel my family who died in their 50s and had paid into medicare all their lives, i'm sorry, i'm out of breath, i just walked. host: what is your second point? caller: other point, individual mandate to buy insurance, it is just amazing to me this party that calls itself the party of
personal responsibility wants to do away with mandate and let people sarks i don't want to take part of that. they have a wreck or catastrophic illness and they expect taxpayers to pay for them, that is not personal responsibility, that mandate is needed and it is common sense. host: get a response, thank you, barbara. guest: thank you. i understand why people feel there is a mandate so everybody is playing by the rules, it just doesn't work. we had 23 million people subject to the mandate and didn't buy health insurance, i think about 8 million paid the fine. it didn't work. i think it is because it is oppositional to this culture. one thing the affordable care act does is to say that if you don't buy health insurance then you'll have to pay more for insurance for the next year after you get coverage. of course somebody is in a car accident, they go to the hospital and get care they need, that is one thing we do in this
country. but making sure people have coverage, giving them incentive to purchase it and the biggest incentive is to make the health insurance more affordable for people so they can buy a policy, a, they want, and meets their needs and doesn't crowd out other -- many people tell me their health insurance costs more than their mortgage, that is not sustainable over the long-term, getting people affordable coverage, people want health insurance, they want it at affordable rate and giving people that opportunity, i think is going to increase coverage over the long-term. and making sure there is an encouragement, just like in medicare and medicare prescription drug benefit to keep that coverage, if you get out, you have to pay penalty, that is how medicare works. host: for more from grace-marie turner follow her on