Another Georgia congressman proposes possible Obamacare replacement
Last week, I looked at U.S. Rep. Tom Price’s bill to repeal and replace Obamacare. His bill includes a section on tort reform authored by Congressman Phil Gingrey, who, like Price, was a physician before entering politics.
Well, Gingrey and Price aren’t the only doctors-turned-congressmen from Georgia. Paul Broun, who represents much of northeast Georgia in Congress, has submitted his own repeal-and-replace bill, the OPTION Act. It caught the attention of Avik Roy, a health-policy blogger for Forbes, who gave it a fairly positive review as “The Tea Party’s Plan for Replacing Obamacare.”
Some of the OPTION (Offering Patients True Individualized Options Now) Act’s provisions are similar to Price’s Empowering Patients First Act. Both provide for repealing the Affordable Care Act, a.k.a. Obamacare; both change the tax treatment of health care to put those buying coverage in the individual market on equal tax footing with people in employer-sponsored plans; and both allow for interstate insurance purchases and ways to let small businesses band together to form larger risk pools.
But whereas Price’s bill includes Gingrey’s tort reform measures and goes farther in establishing risk pools and addressing Medicaid, Broun would leave reforms of malpractice laws and Medicaid to other bills (he has proposed a separate bill to block-grant Medicaid funds to the states). Instead, he focuses on a premium-support model for Medicare, a la the Paul Ryan plan, and would change the law mandating emergency-room care, known as EMTALA. Roy summarizes those changes:
The OPTION Act includes two significant reforms to our charity care system. First, it gives physicians a tax credit (i.e., a subsidy) of between $2,000 and $8,000 a year for engaging in charity care, depending upon the amount of charity care they offer. “Today, I could be put in jail for giving charity care to a Medicare patient for free,” explains Broun. “What we’re doing is we’re taking all of those regulations out of the system.”
Second, it would allow emergency rooms to turn away patients, under EMTALA, that don’t have actual emergencies. “I had the experience of what every ER physician sees in this country,” says Broun, “which is people who aren’t having emergencies using the ER. They should be seeing their regular doctors.” This simple reform could do a lot to ensure that uninsured people with actual emergencies would get treated faster, with better outcomes, than they do today.
One thing is clear: This trio of congressmen with medical backgrounds stand to put Georgia front and center in the health policy debate whether or not the Supreme Court overturns part or all of Obamacare.
– By Kyle Wingfield
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176 comments Add your comment
Real Athens
April 10th, 2012
1:04 pm
Kyle -
as one who has never voted a straight ticket in his life, I’m disappointed in you trumpeting Paul Broun just because he has an R after his name. The guy really is certifiable. Oh, and he lost his medical license a long time ago. His father was truly a great man and would be aghast at what Jr. has become. Do a little research into him. His hypocrisy knows no bounds.
DawgDad
April 10th, 2012
1:06 pm
“If people don’t want to buy insurance, then they should not be allowed to shift their costs onto the responsible ones.”
BW – Why not? Are you a heartless soul to let the people suffer? Why is “insurance” the right and only solution?
Real Athens
April 10th, 2012
1:11 pm
Hillbilly – the Japanese are at the forefront of Kidney Stone research. They now believe the it is not a causation thing but a deficiency. Apparently we here in the “kidney stone belt” (VA to LA) due to genetics or something environmental we lack the ability to keep them from forming.
I had a stone biopsy and the chemist told me it was basically Dr. Pepper in hard form. I’ve never put that crap to my lips.
I try to drink 10 pints of water a day — keep it running clear.
Real Athens
April 10th, 2012
1:20 pm
“Second, it would allow emergency rooms to turn away patients, under EMTALA, that don’t have actual emergencies.”
Who decides what is an emergency? Do you really want a resident in the middle of 12 hour shift at 4 am to decide what an emergency is? Kinda sounds like a “death panel” to me. Don’t cha know, you betcha.
Rafe Hollister
April 10th, 2012
1:29 pm
One of the biggest drivers of cost, I think, is that the hospital/providers are in cahoots with the insurance moguls. Some one please explain to me, what is the point of showing the cost of the service at $10,000 on the providers bill, only to receive the insurance accounting statement and see that they have an contractual agreement to only pay $3695 for that procedure. They pay the hospital/ provider there 90% of that and you are left with the balance.
Does the hospital write off the $6305 that they were not contractually allowed to collect? I know if you do not have insurance they bill you the whole $10,000 amount because they have no contract with you. This practice is ridiculous and they justify it by saying they have to make more on you to make up for those who do not pay.
I wonder if both the hospital/provider and the insurance company don’t somehow profit off the $6305 that goes missing in this equation. Do any of you know what is going on here? I really would like to know if any of you have an answer, even a liberal answer would be appreciated. hah!
BW
April 10th, 2012
1:29 pm
Dawg Dad
The reason this conversation about health care is taking place is due to cost not coverage. Insurance or something that shows you can pay for your treatment is the generally accepted way to reduce costs. The people won’t “suffer” once they decide to get themselves covered. Obviously that pre-existing condition recission thing needs to stay gone. If you have any better ideas, by all means please volunteer them.
Kyle isn’t quite expounding upon this yet but some higher centralized authority, be it government at the state or federal level or the insurance industry, has to intervene to lower the increase of the cost of medical spending if we are to have any chance of hoping to balance our budget…especially if raising taxes are off the table.
Tiberius - Your lightning rod of hate!
April 10th, 2012
1:30 pm
“If you maintain that a jury of our peers is not competent to come to an accurate and fair judgment with regard to a malpractice case, then I have to wonder if you feel that such a jury would also not be competent to come to an accurate and fair judgment with regard to a death penalty case.”
Because juries “feelings” do not have to come into the equation to know right from wrong, or yes or no.
They have to be engaged in order to come up with damages, especially those of the ridiculous “pain and suffering” kind.
Inside Out
April 10th, 2012
1:38 pm
Ok…Tibs…..
Check out the link….. Then tell me, What does this person deserve?
http://www.nytimes.com/1995/09/17/us/doctor-who-cut-off-wrong-leg-is-defended-by-colleagues.html?pagewanted=all&src=pm
Kyle Wingfield
April 10th, 2012
1:49 pm
Real Athens: “I’m disappointed in you trumpeting Paul Broun just because he has an R after his name”
Well, if you’re going to make assumptions about why I do what I do, you can always find a reason to be “disappointed.”
How about Avik Roy? Do you assume he only wrote his article in Forbes about Broun’s plan because “he has an R after his name”? Is that the only reason any Republican ever gets written about?
Joe Mama
April 10th, 2012
1:51 pm
Tiberius — “Because juries “feelings” do not have to come into the equation to know right from wrong, or yes or no.”
I wasn’t speaking of juries’ feelings. I was asking about *yours.*
Once again, if you don’t feel that a jury is competent to come to a decision in a malpractice case, then do you feel that they are competent to come to a decision in a death penalty case?
Rafe Hollister
April 10th, 2012
2:11 pm
Real Athens
Who decides what is an emergency. I think a resident would be the best choice. Right now, it is the receptionist. Have you ever been to an ER. Unless you arrive in an ambulance you go through a preliminary triage when you check in with the receptionist. Notice how the folks who are bleeding using get moved right along while those with a stomach ache usually have to sit for awhile.
So, I think it would be perfectly OK for a resident to ask you a few questions and refer you to an outpatient clinic next door. One of the biggest drivers of cost is our inability to quickly make a decision and treat or non treat as the doctor decides. Everyone does not need expensive tests and prolonged secondary opinions in order to avoid a malpractice claim.
Real Athens
April 10th, 2012
2:21 pm
Kyle -
Nice straw man.
C’mon, you’re paid to provide a viewpoint of a certain slant. Remember? So yes, that is one of the reasons you write about people with R’s next to their name. However, I consider you informed and literate — even if a little testy today.
Paul Broun is a fool — an exploiter for personal gain. He is elected over and over because he is an incumbent and when he’s up for re-election he becomes a sloganeering, issue exploiting, nincompoop — often times scaring constituents with outright lies. He is the absolute definition of a do-nothing congressman. Find a bill he’s written that you support. Don’t take my word for it. Find out yourself.
Avik Roy is a brilliant man. He is a major proponent of consumer driven healthcare. I gather he knows very little about Paul Broun as well.
@@
April 10th, 2012
2:23 pm
Whoa!
Medicare has higher administrative costs per beneficiary
A more accurate measure of overhead would therefore be the administrative costs per patient, rather than per dollar of medical expenses. And by that measure, even with all the administrative advantages Medicare has over private coverage, the program’s administrative costs are actually significantly higher than those of private insurers. In 2005, for example, Robert Book has shown that private insurers spent $453 per beneficiary on administrative costs, compared to $509 for Medicare. (Indeed, Robert has written the definitive paper on this subject, from which the above figure is taken.)
Remember these points the next time someone tries to tell you that Medicare is “more efficient” than private insurance.
Ain’t nuthin’ efficient OR competent about government run anything. It’s not their money so why should they care? They don’t.
Interesting imbeds at Forbes.
Kyle Wingfield
April 10th, 2012
2:24 pm
Real Athens: Quick: How many times have I written about Paul Broun before today?
Inside Out
April 10th, 2012
2:31 pm
“Is that the only reason any Republican ever gets written about?”
Funny you should say that Kyle….I could turn it around and say that is why so many on the right think that African Americans voted for Obama…… Its silly to assign it to you and silly when those on the right do the same…….
Kyle Wingfield
April 10th, 2012
2:33 pm
Inside Out: So, fight silly with silly?
Real Athens
April 10th, 2012
2:35 pm
Kyle -
I have absolutely no idea. What does that have to do with what I wrote? Are we agreeing – just a little bit here?
.
Please, as a principled conservative, in the future call out this lunatic when he braying to the fringe, or scaring the pants off of seniors and I won’t b*#@h.
Equal time.
Real Athens
April 10th, 2012
2:41 pm
Are you attending the memorial for Professor Fink on the 27th?
Kyle Wingfield
April 10th, 2012
2:43 pm
Real Athens: Yes, I’ll be there.
Real Athens
April 10th, 2012
2:45 pm
“Good on ya.”
Inside Out
April 10th, 2012
2:53 pm
“Santorum drops 2012 bid for president”
http://www.politico.com/
td
April 10th, 2012
3:47 pm
Hillbilly D
April 10th, 2012
12:26 pm
I rent to Canadians every winter and they tell me a totally different story. They say that their HC is fine for routine problems but they have saved some money to come to the US if they need anything serious done.
Real Athens
April 10th, 2012
6:28 pm
Rafe:
FYI: I sat in a hospital emergency waiting room for 4 hours with a dislocated hip and fractured hip socket because I wasn’t “bleeding”. As a result, 18 years later I had a complete hip replacement — because of the damaged blood supply to the hip socket caused by the four hours of waiting for the for the hip to be relocated.
The orthopedic surgeon said the actions of the receptionist and resident in attendance bordered on criminal.
ld
April 10th, 2012
6:34 pm
With the Masters still in mind, think “handicap”.
When Dems say “fairness”, they are trying to apply the “courtesy” of a handicap to the economic “rat race”.
Also, the GOP “trickle down” economics only ended up p*$$ing on the employee class. That it produces American jobs is mostly a lie–unless you’re talking about lower-paying services jobs. It has been during “trickle down” economics that “downsize” and “outsource” became part of our daily lingo and multitudes of manufacturing jobs were moved overseas.
ld
April 10th, 2012
6:40 pm
oops
somehow got this prior post affixed to wrong blog.
Do hope Obamacare is struck down in its entirety by Supremes.
Do not believe any politition has yet come up w/an alternative that doesn’t best serve to line the pockets of their personal constituency.
yuzeyurbrane
April 10th, 2012
6:44 pm
Kyle’s 12:18 challenge for source of 50 million uninsured:
^ 2009 US Census Report: “Income, Poverty, and Health Insurance Coverage in the United States: 2009″ pp 22-28
^ Johnson, Avery (September 17, 2010). “Recession swells number of uninsured to 50.7 million”. The Wall Street Journal: p. A4. Retrieved 2010-11-21.
Wolf, Richard (September 17, 2010). “Number of uninsured Americans rises to 50.7 million”. USA Today: p. 8A. Retrieved 2010-11-21.
DeNavas-Walt, Carmen; Proctor, Bernadette D.; Smith, Jessica C. (September 16, 2010). “Income, poverty, and health insurance coverage in the United States: 2009″. Washington, D.C.: U.S. Census Bureau. Retrieved 2010-11-21.
Roberts, Michelle; Rhoades, Jeffrey A. (August 19, 2010). “The uninsured in America, first half of 2009: estimates for the U.S. civilian noninstituionalized population under age 65. Medical Expenditure Panel Survey, Statistical Brief #291″. Rockville, Md.: Agency for Healthcare Research and Quality (AHRQ). Retrieved 2010-11-21.
Cohen, Robin A.; Martinez, Michael A. (September 22, 2010). “Health insurance coverage: early release of estimates from the National Health Interview Survey, January–March 2010″. Hyattsville, Md.: National Center for Health Statistics (NCHS). Retrieved 2010-11-21.
. (August 26, 2008). “Comparing federal government surveys that count uninsured people in America”. Minneapolis, Minn.: State Health Access Data Assistance Center, School of Public Health, University of Minnesota. Retrieved 2010-11-21.
As to Broun’s proposal, obviously there has been insufficient time to analyze how many non-covered citizens would be covered by it but it is similar enough to other proposals which have been analyzed (viz. Dr. Price’s) to assume that it would be somewhere in the same range of the about 3 million est. for the Price proposal. The AARP did an analysis of the Price proposal when it first came out which supports this which I am sure they will be happy to provide. Nor do I think that Price challenged that number’s accuracy. I would be interested to know what Dr. Broun claims for his proposal and also of course of any independent analysis of that proposal, if there ever is one.
As to the ER issue, I read the post you cited and basically agree with you about the ER fiasco (a visit to any ER at night would be instructive for anyone) but disagree as to whether all states can be trusted to carry out Medicaid’s purposes. Maybe some experimentation is called for before a radical change of that system?