Tester talking health care reform

The Havre Daily News

by Tim Leeds

Sen. Jon Tester, D-Mont., told thousands of Montanans Wednesday that something needs to be done to reform the health care system in the United States.

Tester answered numerous questions about legislation intended to do that now passing through Congress, including a statement that he does not oppose a public insurance option. In his opening remarks, Tester said it is crucial for Congress to send a reform bill to President Barack Obama.

“Make no mistake about it, the system is broken, and I believe, as many of you do, that the worst option is to do nothing,” Tester said. The senator spent an hour on the telephone Wednesday answering questions about health legislation now in Congress during a telephone conference sponsored by AARP Montana. AARP reports that more than 8,700 households dialed in on the call, often with more than one person participating from each household.

The U.S. House of Representatives is working to reconcile bills passed from three committees to reform the health care system. The Senate is working to reconcile bills passed from its Finance Committee, chaired by Sen. Max Baucus, D-Mont., and the Health, Education, Labor and Pensions Committee, formerly chaired by the late Sen. Edward Kennedy, D-Mass.

After the opening of the program, callers were selected from around the state to present questions and comments to Tester and AARP Senior legislative representative Ahaviah Glaser in Washington. One caller, a retired nurse from Billings, took Tester to task on something she said she read in a news article. The caller said she believes the best option is for the government to provide health insurance in competition with private industry, commonly called the public option.

She said she had read that Tester is “cool” to the idea of that public option. “I’m not cool to it at all,” Tester responded. “I think the bottom line is, it needs to work for Montanans. “We need competition, and if we get a public option that will help Montana. I will support it,” he added.

In response to a caller from Helena, Tester said he agrees that benchmarks should be included in the bill, such as to track whether the legislation is meeting its goal of not adding to the federal deficit — a requirement Obama has set. Congress should be watching the impacts of the bill and making changes as needed, Tester said. “I think we should revisit it every year,” he said. “When all is said and done, there will be some things we need to tweak.”

Tester said he believes that a medical advisory committee proposed in the legislation also could help reduce costs while improving care. The committee could oversee and make recommendations on how to regulate the health care and insurance industries. Tester said the legislation will not hurt existing programs such as Veterans Affairs and Medicare. Reform will help those programs, by improving the quality and reigning in cost increases in health care, making it more consistent and by focusing on preventative measures such as screenings and checkups.

He added that the latter is something that he tries to focus on. “It’s kind of the low-hanging fruit, prevention and screening,” he said. Making tests and screenings fully covered by insurance will prevent many later, higher-cost procedures, he said.

Another caller, from Stevensville, expressed concern that the cost of medical care — mostly incurred by older Americans — will be passed on to the younger citizens. While they will need less care, they will be paying more, the caller said. “I think we can have the best of both worlds,” Tester responded. He said that, as the Senate bill comes to the floor, it will impose caps on out-of-pocket expenses, both yearly caps and lifetime caps. The proposal would set a limit on individual annual caps at $5,959 and less than $12,000 for families, he said.

At the same time, it will reduce cost increases in the health care industry and provide competition and accountability for the insurance agencies, he said. “I think it’s about making health care more effective and affordable,” Tester said. Glaser said the reforms should help, not hurt, younger Americans. While they may see an increase in premiums, which would be a slight increase, she said, the coverage would be much better. “It will make comprehensive coverage affordable for all Americans,” she said.

Tester said that is a situation in his own family — his children cannot afford comprehensive coverage, because the pool of people it would cover is small, he said. His 25-year-old son now cannot afford insurance although he is young, single and healthy, Tester said. Several parts of the proposed reforms, including letting younger people access Medicaid as well as prevention and screening, and competition in the marketplace, should help with that, Tester said. Tester and Glaser also responded to several questions on prescription drugs and the Medicare Part D prescription drug program.

Both said the reform would help with what is known as the doughnut in Medicare Part D coverage — once a Medicare recipient buys a certain dollar amount of drugs, including the amount paid by Medicare, they are responsible for the full amount until their out-of-pocket expenses reach what is defined as a catas t roph ic amount of expense. Tester said the legislation will cut the doughnut in half, reducing the problems that causes.

“The doughnut hole is a big, big problem,” he said. “We’re going to cut it in half immediately and look for other ways to shrink it and eventually fill it completely,” he said, adding that trying to deal with high drug expenses is especially difficult for people living on a fixed income. Glaser said that AARP is pleased with the Senate proposal to cut the hole by 50 percent, but her organization will continue to look for ways to eliminate it completely. “We'd like to take this off the table once and for all,” she said. A caller from Nye said the cost for drugs to treat her multiple sclerosis is $2,300 a month and asked what will be done to help with expenses like that.

Tester replied that a variety of changes should help with that problem. Closing the Medicare doughnut by half is one, he said, and putting in low annual out-of-pocket caps also will help, he said. Glaser added that other proposals, such as allowing the government to negotiate for prices on prescription drugs, as the VA does now, and allowing re-importation of some prescription drugs that sell in other countries for lower prices also could help. Reducing the time allowed for patents on some kinds of drugs also will allow generics to come to the market at lower prices sooner, she added.

Tester said in his closing remarks that the questions raised during the teleconferenc e show the need for reform. He said what he is looking for in the legislation as Congress is “rolling up its sleeves” to work on final legislation is ways to preserve patient choice in medical care, stability in the system and preserving programs like Medicare, making sure it “is stronger when we come out the other side.” “We can do this. We can do it by working together and by using a healthy case of common sense,” he said.