Bill Frist on Health Bill: I'd Vote For It
Or so the former Senate Republican Leader, a surgeon who has written a new book on health care, told me a few minutes ago in an interview.
Were he still in the Senate, "I would end up voting for it," he said. "As leader, I would take heat for it. ... That's what leadership is all about."
This is not to say that Frist is entirely happy with everything that is in the bill.
For one thing, he doesn't think it does nearly enough to bring costs under control. In his view, it does not fundamentally change the incentives that providers now have to provide more care, rather than better care. "There is really nothing to bend the cost curve," he says.
And Frist also predicts it will extend coverage to only 20 million or so additional Americans--far short of true universal coverage. Given the fiscal constraints, he says a better approach would be to provide a more bare-bones package of benefits, known as "catastrophic coverage." That less expensive insurance, while not covering as many routine medical services, would be affordable to more people and provide for care should they suffer a serious illness or condition that might otherwise bankrupt them.
However, he strongly supports other aspects of the bill--most notably, its requirement that individuals be required to purchase coverage, if they do not receive health insurance through their employers or under government programs. And he also lauds the provisions that would eliminate practices that allow insurance companies to discriminate against people based on their health history, including pre-existing conditions.
Frist also faults some in his own party for injecting alarmism into the debate. "Clearly, the death panels and public plan arguments have been overblown," he says. Frist noted that Republicans themselves voted for a Medicare prescription drug bill that would have established a version of a public plan--with the government negotiating directly with drug companies--if private-sector competition had failed to materialize. That is similar to the approach that Republican Senator Olympia Snowe is taking with her amendment to establish a public option with a "trigger."
While Frist believes that the bill will pass, he worries that the Obama Administration and Congress have not given enough attention to what happens next: the implementation. The first few years are likely to be rough, he predicts. States will be struggling to set up new marketplaces for insurance coverage, their medicaid rolls will grow, taxes will go up, and consumers will not yet see the benefits. "The Republicans will go wild," using the start-up difficulties as a tool for fundraising and for making their case in the next election, Frist says. "In the Congress, nobody's thinking about that." His advice for the Obama Administration: "Stay nimble," and be prepared to make adjustments as difficulties arise.
UPDATE: Our friend Jon Cohn has an interesting observation:
For those keeping a tally, that's three former Republican Senate Majority Leaders who have endorsed the sorts of reforms President Obama and his allies are pushing. Previously, Howard Baker and Bob Dole signed on to a plan they negotiated with Tom Daschle and George Mitchell, former Democratic counterparts, through the auspices of the Bipartisan Policy Center.
And this is as it should be. For all of the crazy talk about a radical government takeover, health care reform 2009 is an amalgam of compromises, many based on ideas taken straight from former Republican proposals--the kind of proposal, in other words, at least a few Republicans should be able to embrace in good faith.
Now if only some currently serving members of the party could take a cue from the retired elder statesmen...
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1
Did Frist review the video tape of the bill?
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1.1
just FYI.... Frist is now denying that he ever said he'd support the bill....
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http://www.salon.com/politics/war_room/2009/10/05/frist/index.html
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2
What does Glenn Beck say?
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flibbertyflibbertyflibberty... -
3
KT:
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This is a cogent, extremely relevant point:"...Obama Administration and Congress have not given enough attention to what happens next: the implementation. The first few years are likely to be rough, he predicts. States will be struggling to set up new marketplaces for insurance coverage, their medicaid rolls will grow, taxes will go up, and consumers will not yet see the benefits."
I really couldn't have said this any better myself.
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"The Day After: When Health Care Reform Hits the Real World" needs to be a much, much bigger story than it is now, otherwise the public will be in for some terrible shocks after "reform" passes.
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Even without the specifics of Obama's "15% left to do" nailed down, we can still do a lot of educated conjecture about what different communities will face when all is said and done --just using the Administration's vaunted "85% we all agree on".
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What do you think, KT? -
4
I disagree with him on just providing catastrophic care. We'd still have people waiting until it's too late to get care for preventable diseases.
Nevermind though, I wonder how long it will take for Rush and crew to beat Frist down and demand he return his republican party credentials for daring to admit the system actually needs reform?
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5
Righhhhhtttt.
Frist was as tea baggy as they came when he was in the Senate. He never stood up to the freaks when he was in power and he actually enabled them with his the way he pimped the Terri Schiavo tragedy.-
5.1
The Terri Schiavo issue was a lot more complex than you would think. And I'll just leave it at that.
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5.2
Republicans like to whine about so-called "tort reform" but rarely seem to do something about it on a state level, even though tort law is 99% state law.
If the good people of Texas or Alabama or Georgia or South Carolina or Alaska don't want doctors to be held liable (or want to severely limit liability or compensation) when doctors are negligent and hurt or kill a patient, then they can do so RIGHT NOW. Personally, I like the laws in New York, where I live. There are protections for doctors against frivolous lawsuits. And doctors can make an excellent living. And yet, if a doctor is negligent and causes an injury, a patient can bring a claim for compensation. The idea of Republican Senators interjecting their
corporate-financed"principled" opinions into the business of New York residents is repulsive.And I get really at irritated at the Republican tactic of hiding behind the vague and meaningless phrase "tort reform" (which polls well) instead of actually spelling out what reforms they want (because the specifics DON'T poll well). I can't tell you how many times I hear people suggest "reasonable reforms" such as "standards set by doctors" that are already the law! Here's a reform: the insurance lobby can stop lying to the public about what the existing laws are.
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5.3
spob,
The Terri Schiavo case in only complex in that it exposes the whole hypocrisy of the Republican party. Now they are arguing about government involvement in someone's health care, considering when they controlled Congress, they try to meddle in the Schiavo matter. What happened to limited government? Where is the Constitutionality of passing a bill which applies to one individual? They made themselves look foolish, which is one reason they got voted out of office.
Frisk looked foolish, where as a medical doctor he tried to render a medical opinion without having seen the patient. He went political for a moment and later realized his mistake. Now he has put back on the doctor's hat again.
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6
Thanks, KT. You rock. I still wonder what would've happened if Frist had gotten his way with the '05 nuclear option. KT, do you think today's HC debate / bills would be wildly different if we'd have no filibuster threat? I do – pushing thru a PO would be easier. But I'd still bet “Blue Cross” Baucus and Ben “Mutual of Omaha” Nelson would still be playing their pro-insurance games.
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Speaking of doctors, after interviewing Frist are any of you swamp reporters going to interview Howard Dean for his takes on upcoming Senate battle royale? (…and where is Jay? No word lately, literally. Any “1000 words” this weekend? But hopefully no more kick-the-messenger for awhile, but I don't do that.) If yes, hopefully YOU get the Dean gig. Thanks. -
7
What's gonna happen if the courts declare the individual mandate to be unconstitutional?
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7.1
What's gonna happen if giant alien sharks appeared in Tulsa Oklahoma and started destroying car dealerships by shooting laser beams from their eyes?
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Much more fun concern trolling about something like that... -
7.2
The individual mandate is problematic. What right does the federal government have to tell someone that they must buy something? You can yap all you want, but it's an issue.
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7.3
...will the sharks take out the saturn dealers first since they're shutting down? If they wipe out the chrysler ones too would anyone notice? But is there only one major river for them and not many lakes in the area? (you're right, this is more fun)
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7.4
What if the sharks fly down and incinerate the Arizona State Constitution, which incidentally states that no caps on lawsuits are permissible and dictates that damages are decided by juries? Will Federally mandated tort reform then be Constitutional?
Find out next week on Spob''s word of trolling and tea-bagging! -
7.5
It's frightening the level of ignorance on the left, especially regarding pre-existing conditions
My father died yesterday. I tried to buy life insurance on him, to pay for his funeral. The greedy insurance companies refused to sell it!
Why is this so hard for the President to grasp? If insurers were forced to sell insurance AFTER we got sick, why would anyone buy insurance BEFORE they got sick?
That's why the mandatory coverage is there. The insurance companies insisted on it, and what kind of fool would require coverage of pre-existing conditions WITHOUT mandatory coverage?
Typical liberal. When one regulation fails, don't repeal it. Blame the free market and add more regulations.
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7.6
Car insurance covering liability for injury and property damage happens to be mandated in most states. I don't hear any outcries or constitutional controversies over that.
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8
Pretty easy to be brave on the sidelines, isn't it?
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10
I commend Frist for his opinion. It is nice to finally see some rational discussion of both the good and bad parts of this bill.
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I am surprised tho, being a Physician, that he did not bring up tort reform. Did you ask him about that KT? I can't imagine being a Physician or even a former Physician that he did not have an opinion on that part of reform the Democrats have beaten down.
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But, I agree with Frist. There must be reform or this country will be in dire straits economically. He is also spot on so far as cost control is concern.
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I know stuart has done an admirable job in pointing out costs, and the difference that OECD countries pay out on healthcare versus the US. But, one question that I still have, is it all profit and markup by the insurance company that they are basing their figures on or simply the cost of healthcare is much higher. I still have not read anything which looks at comparisons to both of these "costs".
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And, I agree with stuart's point that he makes and agrees with Frist that the implementatoin plan has not even been discussed. Although there have been several Gov's who have pointed this out. Most of them Republican, but even Gov Rendell here in Pennsylvania has said he does not know where our State will find the money to fund Medicaid for the long term. Taxes will go up, and I believe go up considerably.-
10.1
rusty,
The reason Frist did not bring up tort "reform" is because he realizes it will do nothing to lower costs. As I have stated many times, malpractice premiums are not based on claims filed against doctors, or the payouts of insurance companies, the premiums are based on the insuance company's bottom line. When the dot.com bubble burst, and the insurance companies stock opinions tanked, they raised the doctor's malpractice premiums. Several states have enacted caps, and it has not affected malpratice premium one iota. Like I have stated before, why does a ObGyn who have never been sued in 30 years see his premiums triple? It is all about the profits, baby!
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10.2
"I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs," Obama said.
"Overall, these studies show that defensive medicine is a reality for physicians today. Although certain characteristics make some physicians more likely to have claims filed against them, the threat of a malpractice suit affects physicians in all specialties throughout the nation."
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We also have the auto insurance industry to prove that tort reform does save billions of dollars.
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http://www.house.gov/jec/tort/tort/tort.htm
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In my opinion the greatest savings would be realized not in the lower premiums Doctors pay for malpractice insurance coverage, but in prescribing less defensive medical practice. Lower malpractice insurance costs will no drive down the charges that Physicians charge a patient or the patient's insurance company for their service. If you think that is where the savings come from that I am advocating for you are sadly mistaken.
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Once you limit the fear of being sued for an unlimited amount of money, Doctors will begin to provide treatments and diagnostics that benefit the patient, and not to prevent lawsuits. Insurance companies will lower premiums for health care coverage overall simply because they also will know the limit to damages that can be incurred by the Physician, Physicians will be less defensive in their practice, which in turn lowers the cost to the health care insurance companies.
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There will be some time which will go by as Physicians will learn to trust that they cannot be sued for everything they are worth to stop the practice of defensive medicine and begin the practice of out comes based medical practice.
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It is not the end all and magic cure-all for healthcare costs overall. This is a much bigger problem than that, but I do strongly believe this is a significant part of the entire problem. -
10.3
I'd argue apples to oranges in comparing the effects of tort reform on auto insurance to the hypothetical effects of tort reform on health insurance.
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Texas for example, saw a paltry 1.2 percent decrease in medical-malpractice premiums after implementing tort reform, and notably fell behind six other states in health care quality rankings. Though while it did reduce the number of malpractice lawsuits, it is not a significant part of reform.
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In fact there is empirical evidence contrary to your claim: http://www.rwjf.org/pr/product.jsp?id=36768
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Thus, you can argue that enacted properly, tort reform could help produce some savings, but it isn't significant to bringing down health care costs.
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11
KT: Over at Crooksandliars.com Susie Madrak refers to a piece by the LA Times and another by ABC on the public health service our Congresscritters get from the Navy for $503 a year. Specialist care is included at no extra cost; and there is no waiting period or pre-determined condition problems. Would appreciate your comment.
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11.1
My question to you bitter, have you ever had the experience to be treated for a medical problem at a military hospital? Other than Walter Reed or Bethesda Naval, military hospitals are some of the worst hospitals in the country.
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The next worst medical care and poorest outcomes are in the VA Hospitals.
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That is not-withstanding all the bureaucratic red tape our verterans and military go through in paperwork and documentation.
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I wouldn't wish for my worst enemies' care to be handled by a VA or Military hospital. Prison systems have better medical care for convicted felons than what our military folks and veterans have received over the years.
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Take this study that was done on a Philidelphia VA Hospital on prostate cancer treatment.
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http://www.nytimes.com/2009/06/21/health/21radiation.html
."The hospital was last evaluated by the Joint Commission in August 2006, and though the hospital was accredited, Bernier said the survey indicated areas that needed improvement, particularly the way hospital staff manage patients' medications."
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http://www.islandpacket.com/news/local/story/877629.html
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http://www.washingtonpost.com/wp-dyn/content/article/2007/02/17/AR2007021701172.html
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This is a listing of the 50 "Best Hospitals" in the US. Unfortunately there are no military or VA hospitals listed.
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http://www.healthgrades.com/media/dms/pdf/Americas50BestHospitals2008Report.pdf -
11.2
Really? My Congressman (Elton Gallegly/R,CA-24) went on the record on his website claiming that he has to pay competitive full prices for all of his health care and that he gets absolutely no added benefits as a Congressman. He claims that Congress members pay additional out-of-pocket fees (that would be similar to anything any other person would pay) for their health care services. He, of course, does not mention the free health care he can receive at Bethesda or Walter Reed, nor the exact fees they have to pay for health care from the attending physician they have on staff in Washington, D.C.
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12
So when is he going to make the rounds of the talk shows making the case for Republican support?
*crickets*
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12.2
@ 12.1bet he does.
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Bet he stops after Rush slaps him up side his big head. I have no doubt that Frist will make the rounds to promote his book. In today's world there is nothing wrong with that when Ann Coulter gets invited on to promote silly writings. But, I seriously have my doubts that Frist will risk the wrath of the republican noise machine that will focus its fire on him if he seems to support this administration. Where is the evidence that he would show that type of courage?
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13
[...] been watered-down, Frist said that if he were still in office, he would vote for the bill. “I would end up voting for it,” he said. “As leader, I would take heat for it. … That’s what leadership [...]
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14
[...] and at the White House were abuzz on Friday afternoon after Time magazine's Web site published an interview with the former Senate majority leader, Bill Frist, Republican of Tennessee, saying he would vote in favor of the Democrats big health [...]
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15
[...] Frist, former Senate Republican leader, majority leader, and kitten murderer, shows us what “leadership” looks like — from the sidelines of the debate. Were he still in the Senate, “I [...]
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16
[...] a comment » Above: The pear reacts to Bill Frist's support for health care reform. Were he still in the Senate, “I would end up voting for it,” [Bill Frist] said. “As [...]
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17
[...] Bill Frist on Health Bill: I’d Vote For It [...]
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18
Wow this is quite a get KT. I'm sure he appreciates the link to Amazon so everyone can buy his new book. Jay Rockefeller has a new book, too. It's called "Eddie: the guy who was too poor to have ever seen Venetian blinds." Bill First should check it out free on the web. Maybe he'll learn why people need more than "bare-bones" insurance, and why "the medicaid rolls" are more than just abstract political concept.
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19
Great get, Karen! Just to get one Republican on the record evaluating the bill and not trying to distort all the facts, and then getting his endorsement of the bill! Amazing stuff!
Hope the Swampland servers will be up to the load....you're going to get a lot of traffic....
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20
[...] up, famous doctor and former Republican senate leader Bill Frist would vote yes on the health bill. “I would end up voting for it. As leader, I would take [...]
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21
KT: last I heard there were like 9 different bills that have finally come out of committees and the leadership (Pelosi/Reid) needs to determine what the final bills (senate/house) look like that are going to come for a vote before they get mashed up in the compromise machine that merges the two versions in order to present one to the President. Any word yet on which versions of the bill(s) are going to stick and come to a vote?
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21.1
i've been poking around on that very quesiton, and plan to write something over the weekend for TIME.com.
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22
[...] From Time: [...]
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[...] here to see the original: Bill Frist on Health Bill: I'd Vote For It – Swampland – TIME.com Comments [...]
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24
"Frist noted that Republicans themselves voted for a Medicare prescription drug bill that would have established a version of a public plan--with the government negotiating directly with drug companies--if private-sector competition had failed to materialize."
Excuse me? What competition? Hello? That was the same kind of "trigger" Olympia Snowe wants -- one that can never be pulled. That wasn't a good faith provision, that was a clever way to give a huge gift to the health care oligarchy, and it's one of those gifts that never stop giving.
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25
[...] Bill Frist endorses health bill — Time [...]
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