War strategy in Afghanistan and President Obama's failed Olympic bid may have stolen the headlines last week, but beneath the surface the health care debate rages on.
Former Senate Majority Leader Bill Frist joined John Roberts on CNN’s “American Morning” Tuesday to talk about health care reform and his new book, “A Heart to Serve.”
Dr. Frist, who is a heart and lung transplant surgeon, says he strongly supports the bipartisan efforts of the Senate Finance Committee and Olympia Snowe’s “trigger” plan. Below is an edited transcript of the interview.
John Roberts: You said, not too long ago, if you were still in the Senate you would probably vote for a health care overhaul.
Bill Frist: A transformation of the health care system today.
Roberts: What exactly is it that you would feel comfortable voting for? Any of the plans that are out there now?
Frist: Two things. And again, these next two or three weeks are critical. We have to bring people together to get it done. It’s a great moment in time if it can be done. Number one, we’ve got to get the uninsured into the market itself. There’s too much cherry picking going on. There’s too much adverse selection.
Roberts: How many? All of them? Half of them?
Frist: The 46 million out there. There are 20 million, who are hardcore uninsured, who just can't get it because they can't afford it. So I would start there, but eventually we need to get them all into the insurance market. We just don't have enough money to do it right now, but 20 million hardcore. Number two, it’s the cost in health care. And basically, health care costs went up three times faster than inflation. Your typical person out there simply can’t afford it any longer. $15,000 policies being the average for a family of four is too much, but it's going up too fast.
So the health care reform we need is something that brings in as many as we can – I’d say 20 million now; that addresses issues – the spending – by putting benefits out there with competition on the marketplace, eliminating the about 30% waste in health care, and that can be done through information technology and transparency and accountability. And if we can do that, we can both afford it today and bring people into the market itself.
Roberts: Let's zero in on this idea of competition in the marketplace. Many Democrats believe the way to really get competition in the marketplace is to put forward a public option, which would have a government-sponsored health insurance program out there competing with the other ones. Would you support that?
Frist: A public option as a backup that is not federally controlled, but is controlled at the local level with local ownership.
Roberts: Are you talking co-ops?
Frist: It can be a co-op, but even the co-op people – it's kind of a new concept, but the idea of not having government out there controlling prices out there undercutting the insurance market. And that's the big fear. At the end of the day, you’re going to have to have some sort of a backup of a public plan. And at the end of the day, if the private sector doesn't step up, you have to have some other kind of trigger coming into play.
Roberts: So you're talking about Olympia Snowe's idea?
Frist: Olympia Snowe. And it’s what we did in 2003 with the Medicare Modernization Act, which was the prescription drug plan. If the private sector does not step up, and there’s not more than two plans there, a public plan that has local control, local and private implementation, has to step in.
Roberts: It sounds like the plan that's being written in the Senate Finance Committee is something that you might support?
Frist: I'm coming out very strongly in support of what's going on in the Senate Finance Committee. It's bipartisan. I hope that it ends up being bipartisan. If not, it’s going to be a destructive bill. But it's bipartisan. People working together. So we’re on the way there. I would not endorse the bill the way it is now. There’s still about 400 amendments out there so hopefully that process can come together.
Roberts: You and I saw each other a couple weeks ago at the U2 concert at Giants Stadium and we were talking health care. You suggested that you didn't think it was such a great idea to do this all at once, that you could do pieces of it.
Frist: Well the problem we have today – I actually write about it in my book, “A Heart to Serve” – is that in a time of recession and job loss, when we have really 46 million or 20 million people out there, we simply can't afford to promise them a Cadillac, gold-plated plan – and that’s what’s being done today. There are too many mandates out there. It's too expensive. We simply can’t do it. Taxes go up. Premiums go up. It can’t be done. Thus, what you can do is – yes, get universal care, but not promise everybody everything. And one thing you can do is do it like car insurance and make sure that we have at least catastrophic coverage so you can look people in the eye and say “You are not going to be driven to bankruptcy if your child gets leukemia,” for example.
Roberts: I want to talk about a couple things in your book, which you say is not a political memoir, but a story about leadership lessons “lived and learned." And talking about U2, you write about the time you spent in 2001 with Bono in Uganda going around the country. Just two guys. You didn't take any cameras with you as he did when he traveled with Paul O'Neil, the former Treasury secretary. What was that experience like?
Frist: The fun thing about writing a book like this – as you said it’s not a political memoir – it's about a third stories in health care, about a third stories on global health issues – the sort of stories like with Bono, and a third is on experiences in the Senate. It was written to inspire people to get involved in their communities, but I did put stories like meeting Bono, sort of serendipitously, very quietly. We did go to Uganda to see if policies the United States had in place were really working. No cameras. No constituents. No security. No rock star fans. We were there. Out of that came eventually legislation, HIV legislation that means about 23 million people are going to be treated for HIV.
Roberts: He gave you a shout-out at Giant stadium and again in Washington.
Frist: He did. And we worked closely on things like the Millennium Challenge Corporation, which is a way to give development aid in a very responsible way instead of just throwing it away. People like him who give voice to very accountable, transparent issues have a huge impact on global health and health here at home.
Roberts: That's a story that I knew – that you went to Africa with him. A story I didn't know, which I was fascinated by reading this book to find out, in 1991 you saved then Lieutenant Colonel David Petraeus' life.
Frist: Yeah. Again, this is a lesson in service and part leadership, but mainly service. Things come full circle. In 1991 when I was at a – long before politics for me, long before he was the famous general he is today – I got word there was a Life Flight helicopter coming in with somebody dying, shot through the chest with an M16, blew out his back, took off the top of the lung and hemorrhaging. And I went into the hospital and opened up his chest, put my hands around his lung and stopped the hemorrhage, and really two days later he was up walking around. Tough guy.
Roberts: He wouldn't be where he is today if it wasn't for you.
Frist: Not necessarily me. I happened to be the surgeon on call. I was the tool. I was the instrument. It would have been another trauma surgeon. But it is ironic. Long before politics and long before he was in Iraq, Afghanistan and the like, we come full circle.
Roberts: That was an accidental shooting. What's fascinating to me is that he insisted that he get back to Ft. Campbell two days after the surgery.
Frist: Five days after he insisted, which I didn't like, doing push-ups with his soldiers.
Roberts: He is a pretty tough guy.
Frist: Those are the kinds of stories that are in here, the back room, the inner working of the United States Senate, encouraging everyone to find their own passions, get out there, involve, develop them, so they can be of service to their communities.
It is a shame that the Blue Dog Dems have no "Spine". Simply put, their should be a public option. Max Baucus get some balls. More than 61% of the American people want a Public Option, so don't let them down.
I just don't get what the point of a "trigger" would be. It would be there if the HMO's don't reform on their own? Well they haven't. I just don't see what the point is.
The "public option" is inherently a "trigger" in itself. If the public option can find a way to deliver health care for cheaper then the HMO's then peopel will use it, people will join. If the "public option" can not deliver health care for cheaper then the HMO's, then nobody will join, it will have no impact and no cost.
So I just don't get it. If what Snowe and Frist and all these other folks are saying is true, that somehow we can expect the HMO's to step in on their own and reduce costs to a point where it would be cheaper for people then the public option then I don't see what they have to worry about. Nobody will join it.
The whole argument just doesn't make sense.
Seriously? You suggest that nationalizing health care will cut costs? You must be mad and completely out of your mind. Look at any other nationalized system in the world. They all suck by comparison. We need to change how we do healthcare, not just look at insurance. Get a clue... Nationalized healthcare isn't the answer.
The insurance companies aren't necessarily the bad apples.
If you look a little deeper you may see more:
For those that are insured, have you ever looked at what you are charged? Then have you compared that to what the insurance company actually pays to the provider and the provider actually writes off the rest?
For example... my newborn son was flown to a hospital out of state about 10 years ago. The transport bill was 8-10k. The insurance actually paid about $200 and the rest was written off. Of the MANY hospital bills that followed, I have seen hundresd of thousands of dollars written off like this after the insurance paid and deductables were met.
I can not imagine these types of bills for people with out insurance. And without insurance, those people aren't getting the insurance company write offs.
If these write offs are so easily done, then there must be an overcharge somewhere. Even a public insurance company would likely get these writeoffs.
There needs to be more focus on the provider billing heirachy than just assuming that universal insurance is the fix all. When you go see your doctor.... how long did you wait for your 10 minutes that you actually got to see him? And how much did he charge you or your insurance for those 10 minutes?
The problem with a trigger is that it is solely based on cost. So Insurance companies can cut their costs even more by continuing to force their customers to quit going to doctors and getting care, possibly give up a little profit, and the trigger is avoided. But who is better off??? No one! What we need is a public option NOW, not after some carefully crafted 'trigger' which will never be pulled.
Everyone should realize that with a 'trigger,' the insurance companies will distort the numbers for a few years, avoid the trigger, and then go back to business as usual.
It's a ridiculous proposal, period.
Charles – You are missing the point. Why should anyone profit off of people being sick? Again, we are the only country in the WORLD that makes this profit. No other country believes that this is morally acceptable. You want to look at a decent health care system – take a look at the Netherlands or England. WHile they may have some of their own issues, everyone is entitled to health care. Nobody has to worry about getting sick and not getting the care they need because they couldn't afford a health care premium equivalent to most peoples mortgage payments.
Seriously, how can you even suggest anything OTHER than a public option?
Ladyintexas – I can certainly believe those numbers when you take into account how many people have lost their jobs in the last year or so and with it, their health coverage. Those people are either unable to buy private health insurance because of cost or because of pre existing conditions. Cobra payments are usually not even do-able, even with the 65% subsidies. Then you have the people that can afford the premiums but are denied insurance based on something in their medical records. The only people that have the luxury of health insurance nowadays are the people who are still lucky enough to have employer coverage or people that are uber healthy and don't even really need it. Anyone else is pretty much screwed.
Those who think that the only way to reduce health care costs is to remove the profit motive need to remember this one thing: Our entire economy is driven by the profit motive. It is the single reason that we have the best quality of health care in the world – smart people are motivated to enter the medical field because they can achieve a higher income level by doing so.
If you remove the profit motive, the quality of our health care system will decline dramatically. Smart, talented people will no longer be motivated to enter medicine and the result will be fewer talented medical professionals, long waits and rationing of mediocre medical care. We will all suffer.
Ask yourself next time you need major surgery: Do you want an professional surgeon who will do an excellent job (but you have to pay for it) or do you want a government employee who is just putting in his time and may or may not do an adequate job.
Remember: In life you get what you pay for.
Instead, allow insurance companies to compete over state lines, remove govt
All you people who talk about Corporate and Doctors who are GREEDY... LOOK IN THE MIRROR.
What hypocirtes you are! Your asking for FREE heathcare and are unwilling to pay for it yourselves so you want the Government to make someone else pay for it.
Thats true GREED!
Your ignorance is amazing.
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