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Byrne vs. Bolling: health care

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James A. Bacon
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In today’s AFP Blue Dog interview, LG candidates Byrne and Bolling discuss the current challenges Virginia health care faces moving forward along with the differences in party philosophies with the issue:

“So I would question whether or not the proposals put forth by Ms. Byrne are legally possible, and even if they were, I do not believe they represent sound public policy. And these proposals have no realistic chance of passage in the General Assembly,” Bolling said.

“Perhaps most important, they clearly show that Ms. Byrne’s answer to every problem begins and ends with another government program,” Bolling said.

What is Bolling’s alternative plan for lower health-care expenses?

“Good question,” Byrne said. “He chaired a study committee that was supposed to help Virginia come up with a plan to address health-care coverage for Virginia. He came up with nothing substantive, and he still hasn’t.”

Augusta Free Press : Byrne and Bolling are health nuts

What are your thoughts

~ the blue dog

“… political philosophy is motivated by a discordance between how people think the world should be and how they find it” ~ Todd May, Clemson University, 2000

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  1. Jim Bacon Avatar
    Jim Bacon

    The American health care system is the most regulated industry in the United States — and a case study in how government messes up everything it touches. The problem starts in Washington, so there’s only so much that policy makers here in Virginia can do. I would look at two reforms here in Virginia that could improve access and affordability on the margins:

    (1) Repeal all mandated insurance benefits. Big companies, which are self-insured, are exempt from these mandates. They can fashion health care plans that include or exclude any benefit they want. The mandated benefits extend to everyone else — primarily the small to midsized companies who aren’t big enough to self insure. Virginia mandates more benefits than nearly any other state in the country, hence limiting the flexibility of insurance companies to fashion more affordable insurance products. More affordable insurance policies don’t cover everything that patients might want, but they’re a lot better than no insurance at all. If we want to make health care more accessible to more Virginians, that is the place to start. But neither Kaine nor Kilgore are willing to take on the special interests who lobby for the mandates, so this will never happen.

    (2) Repeal the Certificate of Public Need. This antiquated regulation puts all sorts of administrative and procedural hurdles in the way of any company wanting to build a new health care facility. The idea is to prevent “duplication” and “redundancy” in health care facilities. The reality is that it grants hospitals territorial franchises and inhibits competition — especially by innovative companies that focus on providing a specialized service at lower cost and with superior medical outcomes. COPN needs to be abolished.

    The hospitals do have one legitimate argument regarding COPN. They carry the burden of treating money-losing uninsured patients and Medicaid patients. Specialty facilities can come in and “skim the cream” of the most profitable patients, sticking the unprofitable ones with the hospitals. One way to address that problem is to make sure more people have insurance (see No. 1 above). The COPN problem is fundamental. Of course, neither Kaine nor Kilgore want to tackle this one either.

    (3) Kaine has one good idea: Government could step in and help create insurance-buying pools for small business, making it easier for them to offer affordable insurance products to their employees.

    (4) Kilgore has a good idea, too: Encourage individual savings accounts.

    Finally, Kilgore observes that Virginia hospitals should be investing more aggressively in information technology. I totally agree. I’m just not sure what state government can realistically do to encourage that.

  2. James Atticus Bowden Avatar
    James Atticus Bowden

    Bowden has a good idea. Let individuals get together as communities – families, neighbors, co-workers, churches and pool resources for medical expenses and insurance. And do Kaine’s and Kilgore’s good idea too.

  3. TheModerate Avatar
    TheModerate

    The sooner we can create competition in our healthcare system, the sooner it will become more affordable.

  4. John K. Avatar
    John K.

    Good point Mr. Moderate. I’d add that forestalling lawsuit abuse and enacting tort reform should be on a parallel track.

  5. she devil dog Avatar
    she devil dog

    Mr. Blue Dog

    She Devil Dog here…. again!

    Please, a question to ask both candidates….if they are soooo concerned about health care….
    do they provide health insurance to the employees of their campaigns? if not, why not?
    how can they talk about small business concern about this issue when they don’t run their campaigns as small businesses, paying wages, employment taxes and insurance and providing health benefits?

    Background…
    Kilgore and Kaine both do.
    Baskerville was the ONLY Lt. Gov candidate from either party who had her campaign workers on payroll paying payroll taxes, unemployment and workers comp and providing health insurance benefits. Bolling had a person or two on payroll – no benefits. Most had people working as independent K’ors. (questionnable???) You can track this by looking at expenditures on http://www.vpap.org/

    I think that it’s interesting “context” when people prattle about stuff but don’t act consistent with their prattle.

  6. Anonymous Avatar
    Anonymous

    Most campaigns do not put their staff on payroll. Actually tends to be much cheaper for the campaign and if the staffer has half-a-brain they will learn that being an indep. contractor at their low-level salary tends to be more beneficial economically.

  7. Anonymous Avatar
    Anonymous

    Remove the tax breaks for employee-sponsored health care, or better yet make it illegal to provide employee-sponsored health care.

    This will force every person to find their own insurance, which will open up insurance competition which meets the needs of the individual, rather than insurance which meets the needs of an employee. It’s bad enough when the care we get is separated from what we pay by a 3rd party. But when that 3rd party is beholden to a 4th party, you set up a system where everybody is working against each other. For example:

    I pay my employee for insurance, my employee throws in money and pays a insurance company, the insurance company bids to my company and then tries to get doctors to take as little as possible.

    So I go to my doctor too often because I paid for it, my doctor doesn’t want to see me because it cuts into his profit, the insurance company doesn’t want to pay for anything special because they work for my company, my company tries to limit its costs by guaranteeing large numbers of employees to a couple of plans, and wants the plans to provide as little as possible while still trying to make me happy — but not too happy since THEY are paying for it.

    The doctors often don’t want to be involved, but do so only because they feel sorry for their long-term patients, so they try to exclude new patients and sometimes drop the insurance company.

    OK, it’s unworkable to destroy the current system. But we don’t seem to have this problem with car insurance or homeowner’s insurance.

  8. Jim Bacon Avatar
    Jim Bacon

    Anonymous 11:58. You are right, tax breaks for employer-sponsored health insurance is the ultimate cause of the jury-rigged, third-party-payer health care system we have today. But only Congress can change it. That’s why I say there’s only so much that either Kaine or Kilgore can do on a state level.

    That being said, eliminating mandated benefits would be one big step towards a solution. And I like Jim Bowden’s idea of allowing institutions other than businesses — churches, families, communities, whatever — pool resources for healthcare and insurance.

  9. Anonymous Avatar
    Anonymous

    Wasn’t Bolling the Vice President of a health insurer that went bankrupt amid fraud charges? Is this a guy we want talking about reforming health insurance in Virginia?

  10. Jerry Gray Avatar
    Jerry Gray

    Anonymous 5:23, Bolling was the VP, of now-bankrupt Reciprocal, but as I understand it, he claims he didn’t know anything.

    Connaughton brought it up during the primary, and Bolling was very defensive and tight-lipped about it.

    From his background and funding support during the primary, I’ll bet he has some “tort reform” lined up to help his buddies in the insurance field.

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