Hampton Roads lawmakers split on healthcare reform

To understand the degree of difficulty in finding common ground for reforming America’s health care system, look no further than the three congressmen and two U.S. senators who represent South Hampton Roads.

All agree that health care costs are ridiculously out of control and an oppressive financial burden on most people. All agree the system needs major changes. The country has the best health care in the world, they say – it’s just too expensive.

But how to fix it? That’s where they part company.

If U.S. Rep. Bobby Scott gets his wish, reform will lay the groundwork for a single government health insurance that covers all Americans.

U.S. Rep. Randy Forbes says giving government control of health care would be disastrous.

Somewhere between is U.S. Rep. Glenn Nye, who wants any federal coverage plan to be self-supporting and compete fairly with private plans. He’ll oppose any changes that raise the federal deficit.

The United States will spend about $2.5 trillion on health care this year – more than $8,000 per person, according to government estimates. If no changes are made, health care will make up 20 percent of the national output by 2019 with government programs, like Medicare, accounting for more than half the spending.

“We almost have to do this as a defensive basis,” said U.S. Sen. Mark Warner, D-Va. “We can’t afford not to.”

President Barack Obama has insisted major reforms be adopted. House Speaker Nancy Pelosi, a Democrat, told her chamber that she wants a bill passed by July 31. Democratic leaders in the Senate say this may be the best chance in decades to get action.

Most Americans want change and like the idea of a competitive government health care plan, according to a recent New York Times/CBS News poll. Eighty-five percent of respondents said the health care system needs to be fundamentally changed or completely rebuilt. But what they want for themselves and their families isn’t as clear. Seventy-seven percent of those polled said they were satisfied with the quality of their own care.

“It’s enormously complex,” said Forbes, a Republican whose district stretches from Chesapeake and Suffolk to rural areas west of Richmond. “I literally don’t know a single person on the planet who can say 'This is what we need to do.’”

Obama, who set aside $600 billion in his budget proposal to help pay for a new health care plan, said in early June that a reform package should include a government-run health care option to make the marketplace more competitive.

The independent Congressional Budget Office reported that one plan under consideration in the Senate would cost $1 trillion over 10 years and still leave 36 million Americans uninsured. Another plan would cost $1.6 trillion. The bills are now being overhauled.

For many of the region’s federal lawmakers, the issue is a moving target. They say they are leaning toward some proposals but are still trying to figure out what the best package might be. All, however, have certain core beliefs about what needs to be included and what should not be done – particularly when it comes to paying for reform.

None are writing the major health care bills, though Warner has authored a bill that would make end-of-life care part of reform. But all will cast votes and are sensitive to how their actions will be perceived back home.

Perhaps the most striking change is being espoused by Scott. The nine-term congressman wants a single-payer system run by the federal government. It would be cheaper than profit-driven private insurers, he said.

“There are some things we can do better as a group than everybody, one at a time, in a capitalist business group,” he said.

Acknowledging that a single-payer system will not pass Congress, Scott supports an optional government plan. If it’s created, a public option will be so attractive, he said, that people will leave private insurers, eventually creating one national insurance system.

“If I’m wrong, then people will keep what they have. This is not complicated,” said Scott, whose district includes Portsmouth, parts of Norfolk, and extends up to Richmond.

To make it work, he wants to require uninsured people who can afford health care to obtain insurance. All employers would also be required to offer health insurance.

He also wants raise more money to provide health care to the poor by repealing the alternative minimum tax, restoring a higher rate on estate taxes and begin taxing hedge fund managers.

“Is tax relief for a dead multimillionaire more important than universal health care?” Scott asked. “What are our priorities?”

Forbes argues that the Democratic controlled Congress is moving too fast. Just as Scott is excited at the prospects of shutting down private insurers, Forbes loathes the idea.

“I haven’t seen government run a plan of any kind yet that is as efficient as a private plan,” Forbes said. A government health care option “will destroy the private industry. … There’s no way you can compete with an entity that will print its own money.”

Forbes said he’s focusing on “two big things” in the health care debate. No changes should “suffocate” the relationship that people already have with their doctors, he said. Second, no plan should include deficit spending that “saddles the cost of my health care on to my grandchildren.”

On that last point, Nye agrees with Forbes.

The first-term Democratic congressman, who represents Virginia Beach, the Eastern Shore and parts of Norfolk and Hampton, said he can’t support increasing the federal debt to support health care.

“It’s one of my key principles,” Nye said, adding that he also doesn’t mind spending more time working out a legislative package that can get bipartisan support.

“I don’t necessarily think we need an arbitrary timetable,” he said. “However, the problems we have are out there now. Costs are going up day by day.”

Nye said any public insurance option has to be self-supporting because government subsidies would give it an unfair advantage over private insurers.

Sen. Jim Webb also likes the idea of a competitive public plan because it may be the only way to cover the more than 47 million Americans without health insurance.

“There is no reason to believe that private insurers alone will meet the public purpose of ensuring coverage for all American at an affordable price for taxpayers,” Webb and 15 other senators wrote in an April letter urging that a public option be approved.

Warner begs to disagree. Rather than a new federal insurance plan, Warner said last week he wants to explore creating non-profit health care cooperatives that would pool their resources to provide their members with benefits and would compete with for-profit insurance businesses.

Warner also has taken on one facet of the health care debate in proposing legislation that would expand Medicare’s hospice care for the terminally ill. He has said that with more advance planning and counseling, end-of-life care can be less expensive and save Medicare about $15 billion over 10 years.

As legislators work consider who might benefit from reform, local congressmen disagree on whether health care is a right that should provided to all Americans.

Scott believes it is. Nye says Americans have a right to access to affordable care.

“I don’t think it’s a right. It is a goal,” Forbes said. “Anybody who says that knows that we just can’t deliver that.” The New York Times contributed to this report.

Bill Bartel, (757) 446-2398, bill.bartel@pilotonline.com