Healthy Debate

Reacting to what some have called President Barack Obama’s recent health care “infomercial” on ABC, Representative Charles Boustany, M.D. (R-LA) recently spoke via conference call to bloggers and journalists about the emerging Republican alternative to the 852-page Democratic proposal.

At the start of the call, Rep. Boustany gave a short and optimistic statement about the potential savings and benefits which the Republican approach possessed. “We believe that we can provide near universal coverage at a fraction of the cost of what the Democrats are proposing by using what’s working today in health care and building off that,” Boustany said, adding that quality and cost, “the two fundamental problems of healthcare…are related at the fundamental building block of health care, and that’s the doctor-patient relationship.” Therefore, Rep. Boustany argued, all healthcare reform should begin “With a doctor-patient relationship that’s built on trust and a long-term working relationship that’s built on trust” and instead of focusing on providing encyclopedic care for all potential sufferers, should instead focus on “preventative” measures such as stopping cigarette consumption or reducing obesity.

When asked about the Democratic healthcare bill, Rep. Boustany characterized the administration of the Democratic public option as “Something similar to a Fannie Mae and Freddie Mac of health care.”

Rep. Boustany also mentioned several areas of the Democratic plan where clarity was needed. “Is the taxpayer on the hook for an unlimited entitlement or does the program fold?” He asked. “Let’s say physicans refuse to sign up as providers, will the secretary of Health and Human Services then coerce physicians to participate?” Moreover, despite the large scope of such endeavors, Rep. Boustany said that “how expensive that’s going to be remains to be determined.”

Judging by the cost estimates on recent proposed Democratic plans, these results are unlikely to be encouraging. A preliminary estimate of the costs of the recently proposed Kennedy-Dodd bill by the Congressional Budget Office (CBO) read “According to our preliminary assessment, enacting the proposal would result in a net increase in federal budget deficits of about $1.0 trillion over the 2010-2019 period,” an estimate which Sen. Lindsey Graham (R-SC) has called a “death blow” to Democratic plans generally. More recently, a University of Minnesota professor estimated that the 10-year costs of the bill could be closer to $4 trillion.

When asked whether Republicans had any estimates of how much their alternative would cost relative to the Democrats, Rep. Boustany said no, but suggested that a plan proposed by Reps. Paul Ryan (R-WI) and Devin Nunez (R-CA) to transfer health care tax breaks from employers to individuals made more fiscal sense as it was “revenue neutral.”

By contrast, Rep. Boustany characterized the Republican plan as broadly anti-coercion in its approach. “On the Republican side, there’s nothing compulsory. We’re not going to force individuals to have health insurance, nor will we force employers,” Rep. Boustany said. When asked about health care savings accounts—a policy recently touted by Rush Limbaugh as a way to “force competition to come down”—Rep. Boustany responded positively. “We believe that we should be able to expand health savings accounts and that is a fundamental part of our plan,” Rep. Boustany said, adding that while no official side-by-side comparison of the Republican plan with the Democratic plan had yet been done, “There is no mention whatsoever of liability reform” in the Democratic bill. By contrast, the Congressman said, one of the options the Republicans were looking at was “specialty courts,” or trials where juries are composed of medical experts rather than laymen, so as to minimize deception.

Building on this question of deception, Rep. Boustany accused the Obama administration of bullying various groups out of asking questions. “We’ve got a lot of the big groups in Washington that’ve been cowed into silence. Senator Baucus has threatened a bunch of these groups to not talk to Republicans,” Rep. Boustany said. “That’s wrong and what the American public deserves is a full and honest debate on healthcare.”

Yet several commentators expressed concern over Rep. Boustany’s focus on preventive measures, asking whether the Republicans planned to micromanage individual behavior. “Why is near universal coverage a goal?” one reporter asked. “I don’t believe in managing behavior through the tax code.” In response, Rep. Boustany disavowed any intention to manage behavior, saying “You can’t really micromanage behavior through the tax code” but suggesting that “If you’re gonna cut costs, there has to be a modification of patient behavior with regard to living a healthier lifestyle and also physician behavior.”

Finally, in answering a question about Republican priorities with respect to spending, Rep. Boustany reassured his audience that “Republicans made mistakes over the past seven or eight years. I’ll speak for House Republicans—we have learned that lesson.”

Mytheos Holt is an intern at the American Journalism Center, a training program run by Accuracy in Media and Accuracy in Academia.