Skip to main content

More healthcare letters

And from fellow conservative Mark Hogeboom, a response from Senator Kyl to Mark's letter:

Dear Mr. Hogeboom:

Thank you for contacting me regarding health care reform. I appreciate the opportunity to respond.

The U.S. health care system is the best in the world, spurring advancements in new medical treatments and technologies. Such innovation helps physicians treat and prevent diseases better than ever before, eradicates once fatal epidemics, and helps Americans lead longer, healthier lives.

Despite these advances, millions of Americans struggle to find affordable health insurance options. From 1999 to 2008, the average cost of a family health plan increased by 119 percent from $5,791 to $12,680. Meanwhile, workers' wages increased 34 percent during the same nine-year period. Ensuring access to quality, affordable health care is a laudable goal. I support targeted solutions that lower health care costs and improve health care by building upon, not completely dismantling, our health care system.

Unfortunately, many of the proposals being considered in the U.S. Senate will make health insurance more expensive, jeopardize Arizonans' current coverage, and expand the government's control over health care. While you will not find the words "ration," "withhold coverage," or "delay access to care" in the pending plans, that is what will result from the web of federally-dictated insurance reforms, new legal obligations, and provider reimbursement schemes that are part of them. Such policies centralize the power of medical decisions with politicians and bureaucrats, not patients and doctors, and they will result in the delay or denial of care.

There are three main problems with the Majority party's proposals: the implementation of a government-run insurance plan, the use of comparative effectiveness research, and spending.

Government-Run Insurance Plan:

First, the Majority's proposals would create a new, government-run health insurance plan to compete against private insurance plans. The argument is that a government-run plan would give consumers a better range of choices and make the health care market more competitive -- "keep the insurance companies honest," as the President put it. However, well-respected, independent analysis provides evidence to the contrary. For one thing, a government-run plan would be subsidized by the taxpayers, giving the government plan a huge advantage over competitors. Yet, even government resources are not unlimited. To save money after tens of millions of people are added to the public plan, the government would cut reimbursement to doctors and hospitals, exacerbating the difficulty Arizonans' already encounter in trying to schedule doctor appointments. To make up for low government reimbursements to providers, insurance companies would have to charge more for private insurance, making it less attractive than the government plan.

Over time, there will only be room for the government plan according to the respected Lewin Group, as 119 million Americans would lose their current coverage. Remember, Fannie Mae and Freddie Mac were designed as independent "government-sponsored enterprises" to complement the private mortgage market. Now, Fannie and Freddie account for a combined share of 73 percent of mortgage originations in the second half of 2008. The two "government-sponsored enterprises" are now effectively owned and run by the federal government, after having sustained losses of over $100 billion last year alone. A Washington-run health care plan will do to the health care market what Fannie and Freddie did to the housing market.

Comparative Effectiveness Research

Second, the Majority's plan would create a new research entity to conduct so-called comparative effectiveness research (CER). CER is a mechanism used by medical professionals to provide information on the relative strengths and weaknesses of various procedures and treatments. In the hands of doctors, medical researchers, and other health professionals, CER can help patients and their own doctors make informed health care decisions. However, in the hands of government, CER can become a tool to delay or deny care. For example, the National Institute for Health and Clinical Effectiveness in Britain uses "cost-effectiveness research" to make health care decisions. By basing treatment decisions on cost rather than need, Britain prescribes fewer cancer drugs than any of the other big five European nations; its patients therefore have the lowest survival rate according to a May edition of National Review. The UK's system provides only half of the care for end-stage renal disease patients that we do in the United States. Obviously, such rationing of care is not something we should replicate in the United States.

It is telling that none of the Majority's proposals in Congress would bar the federal government from using CER to deny access to care. In fact, when I offered an amendment in April to explicitly bar the use of CER to ration care, it was defeated on a near party-line vote. I have now introduced a free standing bill to ensure that any information obtained through CER cannot be used to deny access to care. The Preserving Access to Targeted, Individualized, and Effective New Treatments and Service (PATIENTS) Act of 2009 (S. 1259) will protect the doctor-patient relationship and ensure access to the highest quality medical care. I will fight at every opportunity to ensure that any health care reform plan the Senate considers later this year protects patients' access to care.


Finally, the Majority's plans would cost between $1 trillion and $2 trillion, according to the nonpartisan Congressional Budget Office. But even that may understate the true cost. Consider that Massachusetts enacted near universal health insurance in 2006, and costs have exploded, doubling from $630 million in 2007 to an estimated $1.3 billion just two years later. To deal with those costs, the state has decided to slow enrollment of beneficiaries and eliminate dental coverage for its poorest residents. A special commission, which was established by the state legislature, has now recommended limiting coverage to those health care services that government deems to be cost-effective -- just like government-run health systems in other nations such as Canada and Great Britain do.

Furthermore, the plans would be financed by a combination of new taxes and cuts in Medicare spending, hurting seniors' access to care. The Medicare Trust Fund is expected to reach bankruptcy by 2017. Taking money from one program with urgent solvency problems, such as Medicare, to fund a huge expansion of health care benefits for others is not sensible.

I believe in the right of every American to choose the doctor, hospital, and insurance plan of his or her choice. No Washington bureaucrat should interfere with that right or substitute the government's judgment for that of a physician. Any health reform proposal should adhere to these principles.

I appreciate your sharing your thoughts on this important issue. Please stay in touch.


United States Senator

P.S. If you wish to share additional comments about this or any other matter, please visit my website at Do not reply to this email.

Obviously, this is a little more aligned with my thinking.

Keep on writing! They are listening!!!


Popular posts from this blog

Book Review: What Matters Now by Gary Hamel

Interview of Eric Schmidt by Gary Hamel at the MLab dinner tonight. Google's Marissa Mayer and Hal Varian also joined the open dialog about Google's culture and management style, from chaos to arrogance. The video just went up on YouTube. It's quite entertaining. (Photo credit: Wikipedia)Cover of The Future of ManagementMy list of must-read business writers continues to expand.Gary Hamel, however, author of What Matters Now, with the very long subtitle of How to Win in a World of Relentless Change, Ferocious Competition, and Unstoppable Innovation, has been on the list for quite some time.Continuing his thesis on the need for a new approach to management introduced in his prior book The Future of Management, Hamel calls for a complete rethinking of how enterprises are run.

Fundamental to his recommendation is that the practice of management is ossified in a command and control system that is now generations old and needs to be replaced with something that reflects an educat…
As happens this time of year, publishers list their most important/influential/etc. youngsters.  As an example, the May issue of Wired has “20 Unsung Geniuses”.  We think mature adults deserve recognition just as much as 20-something billionaires.  Here is our Sixty Over Sixty list of the most influential, annoying, important or folks we just find interesting.  Here then, sorted by age, is The Sixty Most Important Leaders Over Sixty.
Henry Kissinger.  Still the U.S. best thinker on foreign policy and diplomacy. His recently published book (at age 91) World Order is not only a best seller, it is extraorinary. Jimmy Carter.  Better as an ex-President than President.  His work for Habitat for Humanity is a lesson for all of us. T. Boone Pickens.  Oilman, energy expert.  Creator of The Pickens Plan for energy independence. Frank Gehry.  Showing the world what new materials and CAD design can do to architecture. Warren Bufett. Best investor in history.  Becoming one of the best philanthro…

The Acceleration of Asset Lite Business Models

The number of asset lite businesses is steadily increasing, as is the breadth of industries effected.  I first noticed them in the 1970’s, when Baron Hilton sold several flagship Hilton hotels while retaining management contracts that entitled Hilton Corporation to a share of revenue and earnings. Over the next two decades, Marriott Corp copied and then perfected the hotel management agreement business approach, coupling a Marriott franchise with a management agreement for any one of a growing stable of brands (Fairfield Inns, Courtyard by Marriott, Residence Inns, J.W. Marriott, etc. etc.), enabling absentee investor/owners.  It turns out, however, that asset lite business structures date back much earlier.
Franchises and Dealers Early versions of asset lite businesses include franchise and dealer organizations. Soft drink and beer distributors, auto dealers and tire and repair franchises date to the early nineteen hundreds, as manufacturers needed mass distribution. The dealers furn…