The coming Republican debate over replacing ‘Obamacare’

With a U.S. Supreme Court decision on health care reform in the offing, Republicans are making preparations.

Near the top of the GOP food chain, we’ve heard Attorney General Sam Olens and U.S. Sen. Saxby Chambliss both declare the party that brings down President Barack Obama’s premier piece of legislation should be ready to cope with the fallout.

It is akin to Gen. Colin Powell’s attitude toward the war in Iraq: “If you break it, you bought it.” (Although one could argue that a system in which an appendectomy might cost $1,529 or $182,955 – depending on the color of a California hospital administrator’s mood ring – already qualifies as damaged goods.)

Given his experience in Massachusetts, former Gov. Mitt Romney may allow congressional Republicans the first crack at floating a substitute. Already, several are blazing their own trails, including U.S. Rep. Paul Broun of Athens.

Broun, a physician, has come to recognize that the expectation of guaranteed health care is rooted in the federal law that allows no patient requiring urgent care to be turned away from a hospital’s emergency room. Paul’s bill, among other things, would allow a nurse or medical technician to conduct the triage – looking for conditions that pose “immediate risk to life or long-term health.”

Uninsured sprained ankles or cases of flu could be sent packing.

The problem is that, three years later – vague assertions aside — even Republicans don’t agree on what health care in America should look like. Or what might replace the mechanisms that Obama and a Democratic Congress pushed through.

Consider a local example — the case of SB 288, a lil’ ol’ bill that died in the state Capitol last month.

Possibly, you’ve heard one politician or another declare that government ought to simply get out of the way of business. But in fact, some of the most bitter, long-standing fights at the Capitol involve one profession attempting to gain advantage over another – or force a competitor to surrender his protections. These guilds demand government involvement.

This year’s fight over SB 288 was quiet — and bitter. The measure sponsored by freshman state Sen. Charlie Bethel, R-Dalton, would have allowed pharmacists to give approved vaccines to their customers without a prescription from a physician.

“It’s a common-sense approach, it saves money, and it increases access to something that we know is good for public health,” Bethel said. All things that resonate in the current health-care debate.

Pediatricians warned that some young women might not want to confess a pregnancy that could be harmed by a rubella shot. Bethel amended his bill so that it only applied to patients who are at least 19 years old. (The north Georgia senator also excluded the vaccine for the human papillomavirus associated with cervical cancer – the vaccine for young girls that got Texas Gov. Rick Perry into trouble during his GOP presidential campaign.)

Only a few years ago, during the last big flu epidemic, the General Assembly passed legislation to permit pharmacists to administer doses of influenza vaccine. It is this door that Bethel wants to open wider. It is also his answer to those who raise safety concerns.

“[Pharmacists] can give a flu vaccine now. And they can administer any vaccine that’s prescribed by any physician — now,” Bethel said. “So that argument doesn’t hold water.”

Bethel’s bill easily passed the Senate. But it never came to a vote before the House Health & Human Services Committee, chaired by state Rep. Sharon Cooper, R-Marietta, a nurse.

“When you start giving live viruses, you need to do an in-depth health history, and you need to know the background on a person,” Cooper said. Some vaccines – against shingles, for instance – are dangerous to people with depressed auto-immune systems.

“People that are HIV positive should not get it. Do you think they’re going to stand in a pharmacy line and tell a pharmacist that they’re HIV positive?” she said.

The Medical Association of Georgia, which represents physicians and is a powerful lobbying force in the Capitol, opposed SB 288. Pharmacists, by and large, favored it. But they weren’t the only parties involved. “The most aggressive pushers were the retailers,” Cooper said. Think grocery store chains with large pharmacy operations, urging you to get that next shot.

“They see money. It’s not about patient care, it’s about money,” Cooper alleged. But this is not entirely so. It is also about what health care, at least in Georgia, should look like.

Will it be a drive-through at McDonald’s, or sit-down service at Denny’s?

Cooper argued for the need to establish and preserve the “medical home” – the place where a patient’s medical history lives. “That is a place where they know about you. They know what you’ve had, they know your records,” the House chairman said.

Allowing patients to wander from pharmacy to pharmacy, creating separate histories in several places, would “fragmentize medical care” in the state, she said.

We would likely pay less, but those in charge of our treatment would know less about us.
Both sides promise that the fight will continue next year – no matter which way the U.S. Supreme Court rules in June.

- By Jim Galloway, Political Insider

For instant updates, follow me on Twitter, or connect with me on Facebook.

66 comments Add your comment

Dr Strangelove

April 25th, 2012
6:21 pm

My precious bodily fluids are buying futures in Leeches.

robo

April 25th, 2012
6:36 pm

Medical records need to be in a centralized locale so that a patient can easily go from the Kroger pharmacy to the Minute Clinic etc. Most items on the menu can be handled in these places instead of the e/r. If citizens visited these places first where a nurse practitioner could treat everything from the sprained ankle to colds to flu shots etc., costs would come down. Leave the life-threatening items for the e/r and the long-term problems for the hospital rooms. Why is the medical community and the insurance companies such monopolies? Answer: They seem to all have powerful lobbyists who buy and sell folks under the Gold Dome.

Dirty Dawg

April 25th, 2012
6:51 pm

I have a couple of things that the thought of really makes me chuckle…one is that come Nov 7 there’ll be a bunch of wing-nut billionaires that will have pi$$ed away hundreds of millions for nothing, and one of the others is that all this ‘planning’ by Georgia Pols for how Washington Republicans should handle health-care over these next four-plus years won’t be worth much when they don’t win the Presidency, hold the House AND Democrats get a ’super majority’ in the Senate. Face it Georgia, the rest of he country ain’t ‘bat-s@@t crazy’ like we are.

TruthBe

April 25th, 2012
7:24 pm

Dump Obama and the rest of the disgraceful lying dishonest corrupt Democrats from all offices. Vote these democrat scumbag communist out of office now.

zeke

April 25th, 2012
7:26 pm

how long have you been a nutbar?

Centrist

April 25th, 2012
7:53 pm

No doubt the things already implemented like not dropping healthcare for prior conditions, keeping adult dependents on plans longer, no lifetime maximums will remain. The enormous added expenses of forcing everyone into plans or fining them, Medicare cuts, insurance boards to decide who/what procedures are covered, and many, many other things are going to be re-jiggered. Since the Senate is no longer filibuster proof with the likes of a desperate PA Republican Senator switching sides hoping for payback – it will take BI-PARTISANSHIP. Democrats will have to work on this, too. What a novel idea.

ltrag

April 25th, 2012
7:59 pm

How about over the counter birth control pills? The only reason you can’t buy them now is because doctors want you to have to pay for an office visit to get a prescription.

Raymond

April 25th, 2012
8:24 pm

Given how little Georgia has done to protect Georgians against abuses by insurance companies, or to provide a safety net for those denied access to health insurance (like high risk pools), are we NOW to trust Senator Chambliss to offer some sort of protection for taxpayers all over the nation that are locked out of the free market? Really?

I pray so because Georgia has one of the highest mortality rates in the nation, if not the highest. All of us are at risk for losing everything we have worked all our lives for if you are not insured. You can’t get knee replacements in an emergency room. You sure as heck need it when you need it, so you can just keep working to put food on your table and a roof over your head. And, God forbid you might need chemo.

Thank you for tackling a replacement bill to fix for the broken health care insurance, Senator Chambliss. I hope you are sincere.

shady

April 25th, 2012
9:04 pm

Except these things that make Health Care better could have been instituted years ago. But, The Rep-tards choose to sit on the sidelines and spit tobacco juice on the process that was rushed through, first on campaigning for some kind of health care plan, and talked endless, and often errornousmly(sp) for two if not more years. Now, they come up with such lame excuses. Their tobacco juice was more useful as fertilizer! Poor silly souls.

honested

April 25th, 2012
9:06 pm

Oh I’m sure they’ll have a grand scheme, just like they did at the end of the shrub administration for cleaning up the Gramm-Leach-Blilay mess.

All talk and no talent.

honested

April 25th, 2012
9:08 pm

centrist,

I would hope that whatever clown-car plan they come up with, every Democrat votes no!

Of course, the Supreme Court will prevent them from having to show their incompetence.

Centrist

April 25th, 2012
9:12 pm

Anybody else stop reading posts and move on when coming across phrases like “scumbag”, “Rep-tards”, “Dumbocrats”, etc.?

mike123

April 25th, 2012
9:16 pm

The solution to health care is to get the government out of it. No Dem or Rep will ever push for that, especially go-along-get-along Saudi owned, big government, DC insiders like Sen. Chambliss.

WAW

April 25th, 2012
9:27 pm

Honested: Most of the “dedicated dissenters” who post here have no idea what Gramm-Leach-Blilay is and could care less. The US is changing too fast for them. They are proposing now what Sweet Sarah promised long ago NoCare and they have been voting NO ever since. The NOP is about to elect a Rockafeller Republican, the evangelicals are about to vote for a cult member (two months ago they said he was no he is fulfilling the Farwellan Doctrine), and the far Right will vote for the man who signed the first Socialist Health Bill in the nation. The “dedicated dissenters” will repeat the “spin” they’re told to and all the cattle will come into the barn.

Big Hat

April 25th, 2012
9:33 pm

The rich will get all the healthcare they want (including off-the-record abortions); poor people will get sick and die. What’s wrong with that? That’s the way it’s always been because that’s the way it should be.

td

April 25th, 2012
10:02 pm

And this is the way the world has always worked and will always work in the future. Money and power has always equaled better living conditions and in the case you stated better healthcare. There has never been and never will be a system where the rich and powerful are not treated better then the poor.

The goal is to do what it takes to become one of the rich or powerful. If you are not willing to sacrifice and put in the necessary work then you will get less.

Serious Robuck

April 25th, 2012
10:23 pm

Ah, the wisdom of td. How refreshing! Not to mention, how literate! td, I’m sure you were encouraged and thrilled by Jimmy Carter’s statement today that Romney is moderate enough for him to feel comfortable with him in the White House..

td

April 25th, 2012
10:33 pm

Serious Robuck

April 25th, 2012
10:23 pm

Between that comment and the one he made about a month ago about abortion I am beginning to wonder if he is starting to wonder what he knows about Obama that we do not know?

td

April 25th, 2012
10:36 pm

Serious Robuck

April 25th, 2012
10:23 pm

BTW: What in my “wisdom” was not factually correct?

yuzeyurbrane

April 25th, 2012
10:38 pm

Show me the numbers!! There are about 50 million uninsured now. Obamacare would cover more than 30 million of those. The Price (as in Dr. Congressman) alternative would have covered about 3 million presently uninsured. The Dr. Broun plan has not been analyzed from a numbers perspective yet but I would suggest that he show us the numbers. The ER solution he proposes would probably relieve the pathetic current ER situation but without basic health coverage as an alternative in would only result in a great many more deaths. What would Hippocrates say? Do these political doctors even care?

Centrist

April 25th, 2012
10:51 pm

Now that the smoke and mirror bogus accounting of Obamacare has partly cleared, even Nancy Pelosi has read part of it or been told what was in it after having voted for it – is there room for improvement when SCOTUS says it has to be rebuilt? Only 60 partisan Senate Democrats rammed it through – could a new bi-partisan plan be better for even “buyers remorse” Democrats? Maybe a plan can be put together where political favorite companies and unions won’t get over a thousand waivers. According to the CBO, as many as 20 million Americans could possibly lose their current coverage.

Politicians working TOGETHER can do better. Much better.

honested

April 25th, 2012
11:10 pm

td,

Two little items:

Of course we cannot expand the value of healthcare to all when there is a willing group of vassals to protect the privilege of wealth at the expense of their OWN SELF INTEREST.

What President Carter knows is that he will have an invitation to President Obama’s second inauguration.

honested

April 25th, 2012
11:13 pm

centrist,

Of course they could, but I don’t hear anyone discussing Centralized Single Payer.

What other commodity does anyone purchase where they believe it is just peachy to have an uninvolved entity scrape 35% off the top just for being involved in the transaction and then have an army of thugs to haggle about how much of the remaining 65% goes to YOUR MEDICAL CARE if you need it?

Imbeciles!

ld

April 26th, 2012
3:10 am

The only thing our reps–state or federal–seem to want to protect is their own power.

George W. Bush

April 26th, 2012
4:00 am

Big government was already involved in big government, long before Obama was born. The American Medical Association limits the number of admissions to medical schools and the supply of doctors. The insurance companies, hospitals, and doctors write legislation that is helpful to them. The high cost of medical care will result in more people getting their operations overseas. My family doctor is part of a practice that includes six doctors and all of them only see patients on four days. Most countries allow you to talk to the pharmacist and get most drugs without seeing a doctor.

Buckhead Boy

April 26th, 2012
4:46 am

If I remember correctly, the last Republican “health care plan” advanced pharmaceutical profits by prohibiting the government from directly negotiating drug prices for Medicare. Indubitably, the next will be equally beneficial — to some for-profit interest — and further expand the gap between cost and care that they misidentify as the “world’s best health system”.

Attack Dog

April 26th, 2012
4:52 am

The Dixiecrats’ contributions to the debate over the past three-years has been Death Panels, Contraceptives, Free Market, Pro-Life, anti-Mediaid, privatize Medicare, non-disclosed government regulations and cost to businesses (but nothing about tax credits, incentives, and businesses gaming the current system via low wages), and healthcare is a priviledge, among others. Has anyone seen the Dixiecrat house healthcare bill to replace the Affordable Health Care Act? All talk and no show. Women, Rise Up.

MiltonMan

April 26th, 2012
6:34 am

“…should handle health-care over these next four-plus years won’t be worth much when they don’t win the Presidency, hold the House AND Democrats get a ’super majority’ in the Senate.”

Wow Lib illogic is in full swing today. Please all-knowing one, let those of us with only average IQ in on how the democrats are going to pull this off?

Gravy Train

April 26th, 2012
7:01 am

Milton “Man,” Maybe you haven’t noticed, but the congressional approval ratings are in the single digits. That means all of these GOP “tea party” folks and the others that think they are getting paid to execute personal vendettas against the POTUS have some serious explaining to do come election time. It never ceases to amaze me how closed minded Georgians think the rest of the country agrees with them. Does the GOP even notice that their party is shrinking and aging with no help in sight?

Gravy Train

April 26th, 2012
7:04 am

…and no not all of us in Georgia are closed minded. We’re just drowned out by the mouth breathing, brain washed hoard.

Gravy Train

April 26th, 2012
7:08 am

Now go be mad as hell! Fox News commands it! Doses of Neil and Rush will fan the flames.

honested

April 26th, 2012
8:03 am

milton man,

There’s no discussing reality with you guys. You’re under the delusion you’ll get your own county if you support these clowns.

Eli

April 26th, 2012
8:09 am

Enter your comments here

Eli

April 26th, 2012
8:15 am

Well, the GOP had their chance at healthcare reform and did not take it. Congressional Democrats made a smart move by adopting 90% of the GOP health insurance and health care reforms discussed over the past 30 years. But, like a child, the GOP was not on board in 2009 because of the color of the jersey worn by the team that did propose the bill.

People like miltonman conveniently forget these bits of information.

Like those racists and morons that founded the Tea Party movement, I ask them to read the bill. I know it will not happen, that their command of the English language is insufficient for such a task, but there is so much misinformation being cranked out of the GOP communications wing (eg Fox, Rush, Beck, Boortz, etc) that overcoming stupidity on the right-wing may be impossible.

honested

April 26th, 2012
8:22 am

By the way, is there a hospital anywhere in GA that will still allows privileges to paul broun?

I didn’t think so.

madison

April 26th, 2012
8:31 am

Marvin Pontiac wasn’t insane. But was he a GA Legislator?

Shine

April 26th, 2012
9:27 am

Any solution from Republicans suck.

J Throckmorton Malcontent

April 26th, 2012
9:28 am

A complex civilization with many interconnected problems requires high level government management of available resources for essentials such as health care, you say? Well, who knew?

Al

April 26th, 2012
9:39 am

Centrist – I disagree with your statement. Healthcare was debated for nearly a year before it was passed. Democrats repeatedly came to Republicans for ideas and compromises to get them on board and their response was no even though many of the idea are things that they have pushed for in the past. They are the reason for no Government Option for healthcare if you need proof of that. As one poster stated, they didn’t want to come on board because they weren’t the ones pushing it through. It’s funny that when Democrats come to them about a bill and bipartinship, their response is no. It’s our way or the highway yet they will get on TV with one of their bills and scream how Democrats should come on board. Bipartinship by definition doesn’t work in one direction!

Weetamoe

April 26th, 2012
9:40 am

US Dept of Labor reports unemployment nears 3 month high. That darn right wing labor department.

Raymond

April 26th, 2012
10:27 am

Dr. Broun’s proposed bill did not include establishing high risk pools for those locked out of the free market system for health insurance, for any price, because of pre-existing conditions. His staff suggested those people might be covered by a provision in Dr. Broun’s bill which would allow an $8000 tax credit per doctor for those Docs willing to give pro-bono (free) services.

These days you can’t even rely on getting a broken arm or leg set in an emergency room, especially if you don’t have insurance.

Steve

April 26th, 2012
10:33 am

Only the wealthy now claim access to good healthcare in this country. We have high infant mortality rates, people going bankrupt because of health care issues (which, by the way, affects you and me and our economy), and insurance rates keep skyrocketing.

And our sensible western neighbors have streamlined single payer systems that reduce the per capita cost of health care per person by HALF of what we now pay.

Why are we are own worst enemies? Why are we so freaking stupid, especially here in the South – the last bastion of social back-assed policies.

zeke

April 26th, 2012
10:44 am

A better solution: doctors diagnose and give any relevant info about a patient, the a REGISTERED PHARMACIST NOT A PHARM TECH OR SUCH, being infinitely more qualified in medications than most doctors, would pick the appropriate medicine or vaccine for the patient!!!

Darwin

April 26th, 2012
10:46 am

Don’t hold your breath waiting for Republicans to create a system that moves to solve the current health care system problems. Even the Affordable Health Care Act (you know, ObamaCare) took the conservative approach and kep the free market system in tact. It just included a mandate (long suggested by conservatives at the Heritage Foundation). A single payer system will be the only method to bring down costs.

Republicans will float nonsense types of things that will only fatten the pockets of the special interests. They will not do anything that will bring down costs and eliminate the uninsured.

JB

April 26th, 2012
10:57 am

Mandate= off Government roles to insurance roles which equals skyrocketing rates for all. Case closed.

Real Athens

April 26th, 2012
11:00 am

Since the Heritage Foundation came up with the idea of the individual mandate and Romney was the first to institute it (you know he does as he is told) maybe they’ll just switch the name to Romneycare. Viola! GOP wins! Argument is silenced.

JB

April 26th, 2012
11:07 am

Obama report card for 3 1/2 years:
5 T in new debt.
food stamps up 41%
Unemployment over 8% the entire time
GDP historically sluggish
No end in site or plan to fix housing
wasting hundreds of millions of tax dollars on failed green energy scams
low consumer confidence
Constant drum beating of class warfare and taxing the people more already paying 70% of the taxes
giving away our missile defense system with nothing in return from the Soviet Union
Obama care, which 74% of bill has nothing to do with health, just government control.
Took GM away from the bond and stock holders and gave it to the unions, who destroyed it in the first place
Ignored the tradition of National day of prayer…..But has time to go the capitol to pray with Muslims.

And he wants 4 more years. God help us.

Oblama

April 26th, 2012
11:08 am

Emergency rooms should be for SERIOUS emergencies only. Pre-screen patients with a P.A. (not with a nurse practitioner which is less qualified) and ship the people that are not emergencies to an out patient clinic or home. Obese (30 lbs overweight) people should be educated about what to eat and not eat. They should be placed on a program of diet and exercise and monitored with a support system to call with any questions. They should be required to lose a set amount of weight every three months. If they don’t participate and show results. Cut them off of their “free” health care. Tired of lazy people breaking the system. Smokers, Rx pill addicts, alcohol abusers should be tested, monitored and put on a program to get them off of these addictive habits. Educate them and give them support much like AA. They must be tested every three months and show good effort that they are reducing their dependency in order to continue to receive “free” health care. If they have shown no will to cooperate cut them off! This is their choice. We can’t baby sit adults forever. Health care today goes hand in hand with drug laws. Anyone caught selling hard core illegal drugs such as meth, crack, heroine, etc. should automatically receive at least 10y ears in prison on a chain gain earning their keep by cleaning the streets, etc. A second offense receives a prison sentence until they are 65 years old or dead; whichever comes first. There should be ZERO tolerance with drugs in prison. A drug offender or any visitor to that offender caught smuggling drugs in to the prison should get an automatic life sentence in solitary. Any foreigner smuggling drugs in to this country gets the death penalty – no exceptions ( 3 months to trial and 1 year for appeal and then fry ‘em) Time to get serious about pushers that are murdering our children. Marihuana offenders should not be sent to prison unless they commit other crimes. They should have to wear orange jump suits and put on street cleanup detail every weekend for ONE year. Those caught selling marihuana or smuggling it in to the U.S. should be lose their U.S. citizenship and right to vote. It’s their choice. Time for accountability. We can’t baby sit adults forver

JB

April 26th, 2012
11:11 am

Darwin…………Do you understand Obamacare? Have you read the fine print? Not political hype, but the real LAW. Yes, it has bits and pieces of good stuff, but most of it is crap. Freedom gone. Choice gone.

Oblama

April 26th, 2012
11:14 am

Oblama set a good example. He is our first (admitted) President to experiment with CROKE CAINE. Congrats for being our first. You make us proud.