Thursday, July 30, 2009
Baton Rouge, Louisiana
OBAMA AND JINDAL ON HEALTHCARE
ONE TOO MUCH, ONE TOO LITTLE
The President is facing an uphill fight in his quest to change the face of healthcare delivery in the US. Each day, more and more Americans are concluding that the billions being spent to shore up the economy, do to the economic collapse, is about all the country can afford, at least for now. Louisiana Governor Bobby Jindal has an alternative approach that he says will cost nothing. But is he merely proposing “health reform lite?”
First, the President’s plan. He keeps talking about how Republicans are fighting to block health-care reform. But all he had to do was to sell his health agenda to the Democrats. After all, his party owns the White House, has a 70-seat majority in the House, and a filibuster-proof Senate. Not one Republican is needed. All the Democrats have to do is agree on something.
His problem is that Democrats like Louisiana Sen. Mary Landrieu and Congressman Charlie Melancon go home to Louisiana each weekend and hear overwhelming apprehension and concern from their constituents. And the same thing is happening to Democratic members of congress nationwide.
In dealing with health insurance issues for some 12 years as Insurance Commissioner, I learned quickly that our health care system is engineered, deliberately or not, to resist change. To millions of people, they don’t realize they are paying the bill as money comes out of their paychecks and paid as insurance premiums without most users even realizing it. Often, a small co pay makes us think we are getting a lot for very little. So to many, why change?
Governors have reservations because of what will be an inevitable shift in much of the Medicaid cost to the states. Louisiana has a really sweet deal. 70% of Medicaid costs are paid by the federal government. The average state reimbursement is 57%. Health officials, particularly in Louisiana, are justifiably concerned about the major increase in what the state will have to pay.
When Obama was first elected, “change is good” was the mantra. But it’s the national mood that has now changed. Recently, the Congressional Budget Office released a study concluding that the purposed healthcare bill would not just save any money, but would actually cost more than a trillion dollars over the next decade. A majority of Americans, for now, are concluding that the deficit will be increased, taxes will go up, new fees and fines will be imposed, and they just can’t afford such a new program right now. If the most pressing problem is the economy, then start there before major healthcare changes are undertaken.
So in to the mix comes Gov. Bobby Jindal, returning to the national scene after a 5 month sabbatical recovering from his national meltdown address. His speeches and Op Ed columns in various publications talk about “massive new taxes being proposed,” and he sets out a 7 point alternative agenda for congress to consider. But here’s his Achilles heel. Every proposal listed could be adopted on the state level right here in Louisiana.
Jindal’s list includes pooling for small businesses, pay for performance, health savings accounts, and change in lifestyles to reduce likelihood of chronic disease, insurance reform, and medical lawsuit reform. But the Jindal plan does nothing to address the 40 million people who are uninsured, though some of his items would reduce present costs. Every single proposal the Governor lists could, and in most cases should, be put in place on the state level. In fact, by enacting a comprehensive “Louisiana Plan,” Jindal would have a platform to use in touring the country and saying; “Hey, look at all we did in Louisiana.”
He could begin immediately with lifestyle changes by implementing a wellness program for the 257, 000 state employees and their families who get their health insurance though the state group benefits program. Louisiana has the highest rate of obesity in the nation, and obese people spend 42% more than people of normal weight on medical costs. This amounts to more than $1500 more a year. A major wellness effort among public employees could result in huge savings for Louisiana.
The Governor goes on to suggest a litany of other needed changes. Post treatments and procedures to the internet, portable electronic health-care records, more coverage for pre-existing conditions (a cost increase), better coordination in care for chronic conditions, and other ideas that he thinks has merit and will help in controlling escalating costs. But Bobby Jindal needs to do more than just talk the talk. If he is really serious, then walk the walk.
Call a special session of the Louisiana Legislature this fall to implement his ideas. My guess is that lawmakers would readily go along. Then he has an agenda to point to. Jindal can take his program nationwide as an alternative to what the President is offering.
Right now, Jindal is adding just one bit of rhetoric in the mix. He has the unique opening to move towards implementation rather than just offering proposals. He should practice what he preaches and seize the moment. The President is bogged down and Jindal has a window opportunity to offer an alternative. Will he be both courageous and politically smart enough to take on the challenge?
"Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly, and applying the wrong remedies." —Groucho Marx
Peace and Justice
Jim Brown’s weekly column appears in numerous newspapers and websites throughout the south. To read past columns going back to 2002, go to http://www.jimbrownla.com/.