Skip to main content

tv   Washington Journal Yvette Fontenot Michael Cannon  CSPAN  March 27, 2021 8:45pm-9:47pm EDT

8:45 pm
>> sunday night at 9:00 p.m. eastern, the washington post joby warwick discusses his book "redline." he is interviewed by author angela sten. joby: there are so many confusing things about the syrian conflict. why is this conflict still so horrific and so tragic 10 years later. why haven't someone been brought to justice? i try to explain some of the complexities in the book and i do it through human stories, making it more powerful, more real, more relatable. >> watch afterwords with joby w arwick.
8:46 pm
you can also listen to every "afterwords" program where you get europe outcast. -- your podcasts. thought we would spend the final hour of the program talking about it on the 11th anniversary. we are joined by yvette fontenot , senior strategist for protect our care and from the cato institute, policy study director michael cannon. good morning and thank you for coming on washington journal. guest: thank you for having us. guest: thank you, bill. host: with this headline from the washington post, 200,000 americans signed up for aca health plans during special enrollment. 11 years since the signing of that law, where do you think things stand in terms of coverage for americans? guest: what is important for viewers to understand and for all of those who need health insurance in this difficult time
8:47 pm
-- the debate over the aca and how the american people feel about it, whether it works as designed, etc., is over. we should talk about how to improve it, as democrats did in the american rescue plan, just signed by president biden. the american people have spoken. millions continue to sign up in the open enrollment, even after the trump administration sabotaged and tried to reduce enrollment. ballot measures to expand medicaid past in every state in which they have been taken to the people directly on the ballots. after a failed attempt at repeal in 2017, democrats ran and won on health care in four consecutive elections, including in 2020 where they won the white
8:48 pm
house and senate. that debate is over. time to move on. what is important to know for viewers is that in terms of coverage, at this point in time, if they are losing their employment, which many are, losing their health insurance, with that employment, they have an opportunity right now, just been extended until august 15 by the administration to go on healthcare.gov and get health insurance at a much reduced premium thanks to the american rescue plan just enacted. host: michael cannon, if the debate is over, what is to be done to prove the aca or health care in general, health care coverage in general in the united states? guest: i have been hearing that the debate is over for 11 years. every time there is bad news
8:49 pm
about it or someone criticizes, it is not working the way congress promised. premiums have skyrocketed under the aca. they are so high that in some places people are getting quoted benchmark premiums of almost $50,000. that is three quarters of median household income. obamacare is so expensive, congress has just passed legislation that would throw thousands of dollars that individuals making over $100,000 per year. a 60-year-old couple earning $210,000 per year could get a subsidy of $11,000 under the bill the democrats passed. if we are having to subsidize people making over $200,000 a year so they can afford obamacare coverage, this is not appropriately called the aca.
8:50 pm
this is not affordable at all. obamacare's approach to affordability violates the first rule. it throws more and more money at health insurance, which encourages providers to jack up rates which makes health insurance more expensive. you, if you throw more money at health insurance that way, it will become more expensive. that is not the worst part. the worst part is it provides millions of people with worse coverage than before and shuts off any other option people may have to buy better coverage. not far from where i'm sitting in washington dc, there is a seven-year-old girl named look colette briggs. she has leukemia. if obamacare left her family alone, she would have more secure coverage and access to cancer treatment than she has now but obamacare through her family -- threw her out of there
8:51 pm
plan, jacked up the premiums and ever since, the family has been struggling to get obamacare plans to cover her treatment because the obamacare pre-existing condition reward plans discriminates against patients like colette. we see this throughout the country. we see this with various diseases. multiple sclerosis is one. the narrow provider networks are an example of the pre-existing conditions encouraging people -- insurance companies to discriminate against the sick. it prevents people from buying more secure coverage, the kind of coverage that colette's family had before obamacare so people don't end up in a situation where colette is. even though they have obamacare coverage, they have to put together a gofundme page to pay for her care. host: lots of people covered but is the coverage as good as it
8:52 pm
should have been? guest: i did not hear in that segment the solution that michael and the republican side is proposing because they don't have a health care plan at this point in time. what is important to understand is that what was just passed in the american rescue plan, will address some of the shortfalls in the aca, which we can work to improve. no one who worked on the law ever claimed it was perfect. in the bill just passed, that makes generous subsidies available to 14.9 million uninsured people, so michael is right -- if you are one of those folk struggling with insurance issues right now and you just lost insurance, you can go on health care.com and get more assistance to buy your insurance. -- healthcare.gov. 4-5 enrollees will find a plan
8:53 pm
for $10 or less per month after tax credits. host: i want to explore those credits in the covid really feel in particular. i want to open up phone lines to viewers. (202)-748-8000 for democrats, (202)-748-8001 for republicans, (202)-748-8002 for independents. --(202)-748-8000 if you are currently receiving insurance through the aca. if you get private insurance, (202)-748-8001, including employee provided insurance. (202)-748-8002 for all others. npr piece on subsidies in the american recovery act. the headline says the covid relief bill expands the aca. doesn't come cheap. by next year, taxpayers will shell out more than $8,500 for every american who gets a subsidized health plan through
8:54 pm
the insurance market plan created by the aca. up 40% from the cost of marketplace subsidies, 2020, due to the augmented data from the nonpartisan congressional budget office. your thoughts? guest: i also heard that opponents do not have an alternative. if you look over my shoulder, you will see four books the cato institute has published since the aca passed that explain alternatives. they make access to health care better, improve the quality of health insurance and care and bring health care within the reach of people who cannot afford it today and make our health care sector more universal. it is not the case there are no alternatives to obamacare. there are. obamacare supporters don't want to debate them. as far as subsidies for obamacare, as i mentioned,
8:55 pm
obamacare has become so expensive, democrats in congress, in their judgment have decided even people making, in some cases $500,000 per year, need subsidies in order to help them afford these expensive plans. taxpayers are picking up the bulk of the expensive premiums, that obamacare has done nothing to constrain. subsidies don't bring down prices or make things more affordable. they increase prices. host: yvette fontenot, your thoughts on those subsidies. guest: that is an issue of working together to improve the law and reduce health care prices. a lot of republican alternatives, the problem with a lot of them is after 11 years of screaming for repeal, you are
8:56 pm
unable to include any of those in a replace plan and get it passed through congress. those are by the wayside. the solution pursued by the trump administration for a long time was to give people junk insurance. insurance you could not get if you had a pre-existing condition, wouldn't even be offered, that in most cases, did not provide coverage for essential benefits like maternity care, prescription drug coverage, inpatient hospital coverage, all benefits that the aca guarantees to you and insurers, if you are one of the 135 million people in america that has a pre-existing condition, you cannot be denied coverage or charged more than the average person for that coverage. you get what you pay for. premiums and cost-sharing on the exchanges in the aca have been declining steadily as plans get
8:57 pm
more experience with this population and will continue to decline as you bring more people into the risk pool. that is an issue we are addressing and will continue to work to improve on. to fundamentally say because there are problems with the law, it needs to be thrown out even though it is currently covering 20 million people in providing insurance to those people, just makes no sense at this point. host: we have phone calls waiting. yvette fontenot, please tell us about your organization and stand on the aca. protect our care. what is your role? guest: protect our care was created initially to fight against the repeal of the aca and has now become an organization that supports the aca and the need to improve it and extend it into the future and ensure all the benefits it
8:58 pm
provides, including protections for people with pre-existing conditions, preventative services, coverage of essential health benefits package, allowing those under age 26 to stay on their parents' plan, ending the annual and lifetime limits that existed before that, ensuring that women can no longer be charged double for insurance, improving access and financial security are all things that remain in place into the future. host: michael cannon, the health policy studies at the libertarian leaning cato institute think tank. you mentioned the books you have published on health care. generally, does that mean you as policy director are working with republicans on the hill to develop alternatives to present? guest: the cato institute is a nonpartisan, nonprofit think tank. we don't take positions on
8:59 pm
legislation, we don't align with any political party. as yvette fontenot said, i wish democrats would do the same. democrats end up agreeing with us sometimes and republicans other times. we just published a study a few months ago advocating among other things that the fda should make birth control available over-the-counter. it is available over-the-counter in more than 100 countries. the american institute of gynecologists says it is ridiculous. democrats tend to like the idea. we take a consistent stand at the institute in favor of individual liberty, limited government, free markets and peace. in health care, we want to protect your most fundamental health care right, which is the
9:00 pm
right to make your own decision. not only because it is right but because when government does that, we get better health care, more affordable, more secure and brings the reach of an ever-increasing number of people. host: irene, first up in aurora, colorado. caller: my complaint on the aca, they are leaving out the most important part, which is they cover pre-existing conditions. there are a lot of people not covered with pre-existing conditions before the aca. now there are a lot more people whose lives are being taken care of in a responsible way. guest: can i make a comment? host: yeah. guest: exactly right. if you buy insurance on your
9:01 pm
own, this is the law that ensures you can have access to that coverage and it is affordable if you have a pre-existing condition. 135 million americans have a pre-existing condition. that number is going up steadily. if you have ever been diagnosed, tested for covid, during this pandemic. it is a critical piece of the law. if efforts to repeal the law had succeeded, you would no longer have those protections and be assured access to health insurance. host: michael cannon, will that be part of its legacy? the protection of pre-existing conditions. guest: if you are concerned about pre-existing conditions, government is not your friend. they are the problem. those 135 million americans are in employer plans because the government penalizes them unless
9:02 pm
they buy employer-sponsored insurance which is the kind of coverage that disappears when your connection to an employer disappears. that often happens after a person gets sick. when that happens, with what should be the insured condition, becomes not insured. private insurance, with insurance companies does a better job of protecting people with conditions from ending up uninsured like that and yet the government has penalized americans unless they enroll in the type of coverage that drops you for no good reason after you get sick. that has been fueling the problem of pre-existing conditions for 70 years in this country. obamacare did not fix it. to put in place rules that say, insurance companies discriminate against patients with conditions when it comes to enrollment. what the same rules to his encourage insurance companies to
9:03 pm
discriminate against those patients, like colette briggs, when it comes to coverage and access to care. that is why the networks in obamacare are narrower than in junk plans or short-term plans. they don't operate under those rules obamacare put in place. when it comes to drug coverage, economic research shows those provisions, i would not call them protections, because they are not, those provisions are forcing drug companies, rather, insurance companies to make their drug coverage for expensive conditions like multiple sclerosis worse. these are not protections. if you want to know who is protecting you, think about who is denying you the choice of coverage you want. there are those of us who support a free-market health care that want you to have the choice of choosing a plan that
9:04 pm
does not operate under obamacare rules, that colette briggs had before obamacare that would have made access to care more secure through broader networks and other mechanisms. obamacare supporters don't want you to have that choice. they are offering junk insurance and labeling it a plan you may choose junk because they know better what type of health insurance you should buy. host: lawrence, newport news, virginia. caller: thank you. unfortunately, from my perspective, obamacare was, the aca, was presented with the opportunity for additional legislation to clear out or make corrections. unfortunately, after six years, individuals in congress have not seen fit to make the adjustments to legislation. we are constantly talking about how bad the aca is, yet we are
9:05 pm
not considering conditions we found ourselves in where major pharmaceutical firms were gouging customers with higher, inflated costs. if we would just get on the bandwagon of addressing deficiencies in the aca, i think all will be better. host: yvette fontenot, how do you do that with the political dynamic pretty much the same on capitol hill? guest: frankly, we just did it. congress, under the leadership of the president and vice president and the support of all democrats in congress just did improve the aca.
9:06 pm
they created additional tax credits, subsidies for those who have lost insurance, additional incentives for the 14 states that have not yet put the medicaid expansion in to take it up and they will continue to work to improve the aca. the point is we need to continue to work to improve the law, not throw the baby out with the bathwater and undermine the 160 million people who currently get insurance through their employer and leave that markets table while we improve the aca. -- that market stable while we improve the aca. it is an issue trump spoke about and did not affect at all. it is an issue president biden has spoken about and is serious about addressing drug pricing moving forward. it was part of his campaign. part of what he has put forward
9:07 pm
in his presidency and will work with congress as we move forward to begin to do something about those prices. host: michael cannon, do you want to talk about pricing? guest: democrats agree with libertarians in this area. we think the government pays too much for prescription drugs and applaud efforts by democrats or republicans to try to bring down those prices. the problem is government is a terrible price negotiator. every time you hear complaints from democrats that medicare should be negotiating with drug companies and similar complaints -- the situation they are describing is one where congress has already negotiated with companies and congress lost. when you give these decisions over health care purchasing to government and government bureaucracies, those positions and prices at which transactions
9:08 pm
execute, become captured by special interests who have an interest in those prices. that is the drunk companies -- the drug companies. that is not going to stop happening as long as we put government in control of defining what kind of insurance people have to buy, how much insurance they have to buy, putting government in the position where it is the largest purchaser of medical goods and services in the world. we have to take the money out of government hands, put it into the hands of consumers, let them choose their plan, how much coverage to buy, we will get must more -- much more cost conscious behavior, they can keep the savings and that will spark price competition that will break down the cost of prices for prescription drugs, all drugs and all medical goods and services across the board.
9:09 pm
it is not going to happen as long as we leave those decisions in the hands of government and to the extent government, if it does ever reduce health care spending, it comes at the expense of access to central care. host: on subsidies, in the 1.9 trillion dollar covid really feel passed and the congress a couple weeks ago, this was the headline in the washington post in their health analysis. the stimulus plan, 29% spending hike in obamacare subsidies. jesse, florida, on the air. caller: i agree with michael. the affordable care act is not affordable. the aca -- we had a problem in the individual market. we did not have a problem in the group market. when aca did what it did, no one foresaw you were going --
9:10 pm
[indiscernible] -- our rates and coverage had gone way up. we are talking about $800 per month for single coverage. we are talking about deductions of $7,000 before you do anything. you have killed 90% of the health care market with the aca. not stabilizing the market. you un-stabilized the market. host: michael cannon on the group market. guest: i disagree with the color. -- caller. employer-sponsored insurance has pluses and minuses.
9:11 pm
for 70 or more years congress has been tilting the playing field in favor of that type of insurance, which appears after you get sick for no good reason by penalizing workers unless they let employers control a huge chunk of their earnings and use that to choose and purchase a health plan for workers. this is a type of insurance that disappears when your job disappears, even if you have developed an expensive condition, instead of having insurance that goes with you. instead of letting people choose insurance that stays with them if they move from job to job. congress said, we are going to penalize you unless you buy a less secure type of insurance. 90% of americans with private insurance get it through an employer. it is not because employer-sponsored insurance is stable or serving the needs of american consumers. it is because of government.
9:12 pm
that weird quirk of the tax code. people like me have been advocating getting rid of the preferential tax treatment for employer-sponsored insurance for decades. people say we cannot destabilize the employer market and as a result, the problem gets worse and worse. more and more people develop expensive conditions and get thrown out of the plan the government forced them to buy. host: yvette fontenot, your thoughts on the impact of the aca on the employer marketplace? guest: 160 million people in this country get their health insurance through the employer-sponsored system. talking about upending that system at this moment in time makes absolutely no sense for people. the aca, what it tried to do was to address the segment of the market not working while trying to keep the rest of the market in place so people could continue to get what they were
9:13 pm
doing with, what they were comfortable with and familiar with and employers that wanted to provide health insurance to attract the best employees could continue to do that. best employees, could continue to do that. the affordable care act addressed the part of the market that was not working, in particular, for people with pre-existing conditions. in terms of the concern about the rise in prices, that is a separate issue that the affordable care act attempted to address by further aligning some incentives between providers and payers. that is an area we can work to improve. michael has mentioned the drug pricing issue and other areas where we could work to drive down health care prices together and improve in that area. the idea that the affordable care act should be thrown out and the employer-based system
9:14 pm
should be appended, at this point in time, particularly with people who are economically struggling, losing health insurance instead of improving it, building on it and providing more assistance to people at this moment makes no sense at all to me. host: our line for those of you who get your insurance through the aca. mike is in kissimmee, florida. good morning. caller: i am calling because i have aca. aca has hurt my job and with the employer mandate, they had to cut my hours. i work for the state of florida. because of that, the state of florida cut my job. i had to pick up a job in a separate state. i work in two separate states, both part-time.
9:15 pm
aca is outrageously priced. they don't cover anything. i have got a $6,000 deductible. my premium every month is almost $1000. i don't have to pay that much out of, but i'm still paying almost $100 a month and i still have to pay totally for my appointments. they are not covered. my insurance covers my prescriptions a little bit, but not enough. the employer mandate was bad. i'm glad they repealed the individual mandate. i think that was a great help. looking at this, i feel this plan was a step in the right direction, but a poor step in the right direction. at the same time, i have to say we are going to talk about
9:16 pm
insurance, should we be talking about people's health, accidents should be for sale prefer profit on the open market. host: a similar story tweeted to us by mark. he says he had a $6,000 deductible and his premiums were $2200 a month. do you care to comment about this? guest: different people value different things when it comes to health insurance. some people like low deductibles, some like high. rather than let people choose what is more important to them, obama care tries to fit everyone into a one-size-fits-all plan that produces junk insurance because a lot of people don't want the high deductible or the narrow networks.
9:17 pm
it is a result of obamacare's suppose it protections for pre-existing conditions. my questions for obama here -- obamacare supporters, we don't have republicans or opponents controlling either congress or the white house, why not let people -- it does not appear to be going anywhere, why not let people choose? if they want to enroll in obamacare, they can, if they want to enroll in a plan that allows insurance companies to price according to risk so that healthy people can get lower cost plans, they can pay lower premiums to get more secure access to care when they get sick as short-term plans do right now, why not give them that choice? guest: i would encourage your
9:18 pm
caller to go to healthcar.gov after april 1. they will not deny you care because you have a pre-existing condition and will not charge you more if you happen to be a women or because you are sick. there are multiple options there and the premiums will be much more affordable thanks to the packets that was just supported by president biden and passed in the american rescue plan. because they were calling from florida and rightly points out that florida is one of the 14 states that have not implemented the medicaid expansion yet, states that have implemented the medicaid expansion have been better positioned to respond to this pandemic emergency and to prevent the economic downturn that has worsened access for people to health care and has created health disparities. the american rescue plan did
9:19 pm
include additional incentives, more money than has been on the table for florida to take up the medicaid expansion. if all of the states that have not taken up that expansion yet were to expand, an estimated 4 million uninsured adults including 640,000 front-line workers, 500,000 people with disabilities and close to one million older adults from age 50 to 54, could gain coverage. more portly, people of color would make up more than 60% of this group. it is a racial equity issue and it is an incentive that was included in the covid relief package in the hope that state like florida would take up that expansion to actually make access or increase access and make health coverage more affordable for the entire population. host: the headline on politico, biden is extending the
9:20 pm
enrollment season. biden marked the health care law's anniversary on another in columbus ohio. 20 million covered under what is called obamacare. 38 states and d.c. expanded medicaid. about 30 million people lack health insurance coverage in the u.s. in the year 2019, the most recent year, according to bloomberg. back to calls. caller: i was private pay insurance for many years. eventually, my insurance company dropped my policy and i had to go on the american health care plan. when i did, i realized i could keep my income under so much a year, and i was given a policy where they were subsidizing 800 to $900 a month and i was only
9:21 pm
paying $100 a month. before, i was paying more with a $10,000 deductible. i now had this great insurance for three years before i went on medicare. my flaw with all of this is i am sitting on almost $1 million of assets. my assets were not considered at all for whether i qualify for credits or not. i don't understand how that is possible. can anybody explain that? host: do you have an answer for her? guest: i think that is something we should look at in the state of texas. normally, under the law, your assets should have been considered as part of your income when given the amount of tax credits he received. i'm glad you were able to find such affordable health insurance for the few years before you went on to medicare, which is the host: any specific guidance
9:22 pm
you can give our caller? guest: obamacare supporters in congress don't care. they're giving away subsidies to people earning $500,000 a year. to their mind, there is nothing that more government spending cannot fix. the problem is that this strategy and everything mentioned earlier about florida and the benefits that might come from obamacare are not benefits of fixing the health care sector, they are just the benefits that come with spending more government money and throwing more money at the problem. the problem here is that you are violating the first rule which is that we have the most expensive health care sector in the world and we are in this whole and we got there by throwing more government money at it. we keep digging yourself deeper
9:23 pm
and deeper into this whole. it is worth mentioning that this is really a fiscal hole. this money we're spending, we are not paying for with current taxes. we are keeping more and more debt onto future generations. when that bill comes due, all of the people that had enrolled in the medicaid expansion part of obamacare, their access to care is going to be in serious jeopardy because it is the first program government cuts when it faces a budget restrain. it is a very irresponsible thing to do because it puts a lot of low income people in a vulnerable situation. host: this is elise in california. caller: good morning. this is a very interesting conversation and i'm not as well versed as the two callers before me, but what i do know is that
9:24 pm
we americans pay taxes on everything we see, we hear, we eat or we drink. we take taxes on everything. paying for our health care through obamacare is probably the best thing that ever happened to america. it seems as though these right wing and heritage foundation want to eliminate the government make the government smaller. that does not help america. it does not help the american citizen. people need to look into the cato institute, the heritage foundation and understand who these people are to privatize everything, our prisons, post offices. they just don't want government. host: michael, i will give you a chance to respond. guest: first of all, we don't pay taxes to cover all of the government spending.
9:25 pm
obamacare originated at the heritage foundation. this is an idea the heritage foundation has endorsed since 1989. the cato institute has consistently opposed obamacare precisely because it does not fix the problems of our health care sector. it makes health care more expensive and makes access to care ultimately worse especially for people like a seven-year-old girl with leukemia struggling to get her obamacare plan to pay for her cancer care. yes, there are benefits when you spend tens or hundreds of billions of dollars. not even the government can spend that much without helping some people. on balance, what is happening here as we are making health care more expensive and reducing access in part by blocking or continuing to block innovations that would make health care more affordable and more secure.
9:26 pm
host: let's go to jason in falls church, virginia. caller: i guess my first comment is on michael's comment about government being influenced -- pharmaceutical companies, i think that is largely due to citizen united. the other problem is -- host: are you still there? caller: i'm sorry, just gathering my thoughts. the pricing on drugs, a lot of these pharmaceutical companies have no competition. i don't know how a free market is supposed to work when there is none. a lot of them that do have competition end up buying out their competitors and jacking up the prices. i think in the congressional
9:27 pm
hearings were bernie sanders was actually pointing out that there are places where government can step in and make changes like when they set price controls in canada, i don't know if that has ever been a consideration, but i think it is worth discussing, can we implement price controls to lower drug prices? host: how do both of you a chance to respond. guest: i think he raises a great point which is back to our discussion about drug pricing. over the past couple of years under the leadership of speaker pelosi, the house has passed a bill to allow medicare to negotiate drug pricing. the senate and committee has considered a couple of bills and president biden has talked in the campaign and as president about the need to control drug prices. it has been a priority for democrats. president trump talked about a lot, but did not affect a single
9:28 pm
drug price for anyone when he was in office. that is a debate moving forward that i think democrats in congress as well as president biden want to have and need to have in terms of the kitchen table impact on people's pocketbooks. that is certainly a debate that needs to be had. host: the caller mentioned that hearing the other day. your thoughts? guest: government pays for half of the health care we consume in the united states. in the private sector, government encourages excessive insurance to the point where between government and private insurance companies, we have third-party payers purchasing far more than our health care then we would if we just let consumers control the trillions of dollars we spend on health care every year. because they are terribly price negotiators, that is why we get
9:29 pm
these excessive prices. medicare is not a good price negotiator. medicare pays for lots of wasteful care, lots of low-quality care and it pays a lot of excessive prices for that care. every time medicare tries to reduce high cost or low-quality care, what happens? the day the government tries to do that, who winds up outside the door except lobbyist for all of those high cost, low quality providers. they lobby the government to stop those efforts because those efforts represent a threat to their incomes. when you get government control over two or three doubt -- $2 trillion or the $3 trillion that we spend every year, it is like putting a hot -- pot of honey out in the middle of your yard and you cannot be surprised about the bees start swarming.
9:30 pm
the only way to get rid of special interest influence over our health care sector is to get rid of government influence. as long as government controls the money, there will be special interests that are going to lobby the government and twist our health care sector in their favor at the expense of patients . as for citizens united, that was a case about the government banning books. caller: i get a little nervous when i call in. host: do us a favor and make sure you mute your volume so we don't hear the tv. caller: what i was going to say in the last speech i just heard, part of what i was going to say exactly to the tv. i would just bring in something a little bit off. when obama started this health care, he took billions of dollars out of social security and medicare to feed the funding
9:31 pm
of it so that insurance companies got super rich taking on this affordable care act. that was the payback for lobbying obama and the rest of the democrats to make this bill. the democrats are telling us we are running out of money for social security. in a few years, it is going to be broke. what are we going to do? we have to raise taxes. host: you were in the obama administration, influential in implement and part of obamacare. what about her criticisms? guest: obamacare did not touch -- there were no social security dollars used to pay for obamacare. there were medicare papers included to offset the cost of the law that addressed some issues with fragile and overspending in medicare as michael has been talking about. we tackled some of those to
9:32 pm
reduce some of that spending in order to pay for a huge coverage expansion and increased affordability for 20 million people in the affordable care act. the law was fully paid for over the 10 year window and the 20 year window. it did not increase about -- budget deficit. what is going on with the medicare trust firm right now is almost exclusively related to the pandemic. and the loss of economic revenues due to the pandemic, not the passage of the affordable care act. i think it is important to mention that while michael continues to point out that the government does pay for half of the health care spending in this country and medicare and medicaid combined cover 150 million lives and the affordable care act covers 20 million lives, the idea i think that highlights the fact that moving forward, what we need to do it
9:33 pm
his figure out how to improve the effectiveness of these programs and not continue to propose the government get out of health care because it is completely unreasonable to talk about upending the entire system. president obama went to great lengths to protect social security and to ensure all of these folks who rely on the government for their health insurance can continue to do that into the future as opposed to an unclear proposal for how to replace all of that coverage in the entire system and completely a bend where everyone is getting their health insurance. host: what do you both think we have learned about our health care system because of the pandemic? guest: one thing we learned is government blocks access to care innumerable ways.
9:34 pm
the first thing states did was they suspended a lot of regulations on clinicians that block access to care for people every day. they just realized there is a crisis. we really have to get rid of these restrictions. we have to let out-of-state doctors practice in our state and let out-of-state doctors treat patients in our state by telemedicine. the supervision requirements that are really just rent seeking, we learned the fda -- those restrictions block access to care all the time. we have learned the sba early because lives when a limited access to diagnostic tests. the vaccine was developed within
9:35 pm
days of sequencing the genome of january 2020, but because the fda blocked access, americans did not get access to the vaccines until november or december and some people still can't get access to them. the number one thing we have learned is that government gets in the way of making health care better and more affordable and more secure. guest: i think the largest thing the pandemic has highlighted in our health care system is that there are significant racial equity issues which existed before the pandemic, but the pandemic has highlighted them in terms of access to health care. i agree with michael that the extension of telehealth and the ability of people to access care
9:36 pm
remotely without leaving their house has been a really important production. moving forward, i think we need to figure out where these racial inequities were highlighted due to the pandemic because of race issues or because you live in a rural area and don't have immediate access to health care. you are in a tribal area where your access is limited. all of those fractures in our health care system where people don't have the access they need immediately that have really been highlighted by this pandemic, this is a case study moving forward. host: back to some calls.
9:37 pm
caller: good morning, enjoying the show. i would like to ask -- he seems to think that if you just let the private sector go, prosperity is just around the corner. we had the financial meltdown. if he would drive a couple of hours west from the washington area to go to appalachia, he will find there is tremendous poverty there and people have very little health care for their pre-existing conditions. what happened after obamacare? what happened after it was implemented? millions of people in appalachia
9:38 pm
lined up for health care. they lined up for heart conditions, diabetes, asthma, all sorts of pre-existing conditions that they had never treated before. millions of people in appalachia did that and it was all because of government regulations. host: do you want to respond? guest: if you give away free health insurance to people or what appears to be free health insurance, people will sign up for it. the problem is that it always does. it just throws money at this problem and takes away your freedom to choose another approach that might provide a better solution.
9:39 pm
it might bring health care within the reach of more and more people so they don't have to depend on government for their access to health care. their access to care may not be affected if they had a budget restraint because they cannot borrow as much money as they have been. we have talked about some of them, but unfortunately, congress is not talking about getting rid of those measures. states are talking about these problems to some extent because they have suspended a lot of the regulations that are making health care less accessible for low income americans. it remains to be seen whether states will take the step of making those regulatory suspensions permanent and even
9:40 pm
expanding on them in order to bring health care within the region of more people. caller: i want to comment that the access to care is being too much controlled by not allowing the doctors to recommend the treatments that control it. i see that with medicaid and the private insurance that there is a 90 -- on unequal treatment of patients. i have a child that was not diagnosed with cancer as an infant because i really feel that under the medicaid, the doctor did not have the control for testing. it was too much red tape as opposed to the private side where they're able to make a decision without all of the red tape. it is too much bureaucracy and the doctors are not able to make the treatment. that is where i think we fall short. guest: i think what laws like
9:41 pm
the affordable care act do is cover some of the uncompensated care so that providers can deal with patients and have more time to deal with patients across the board whether you have insurance or you don't. the provider is able to actually take the time because of the funding that comes in through laws like the affordable care act to find people that are uninsured. the regulations that the caller is talking about are certainly issues that i know folks work every day to try and reduce and ensure the access to care is easy to come by and is of high quality for patients who go into cds providers, but i think the underlying issue is that if you are one of the uninsured
9:42 pm
individuals in this country and continue to struggle with the issue of not being in short, you have zero access to care. programs like the affordable care act that has covered 20 million people in this country can sure you have access to care and can get to provider if your child is sick. what that access to care looks like and how convenient it is is something we as a country need to continue to work on and improve. host: as we wrap up, michael, any thoughts? guest: many of the millions of people obamacare covers are people that came out of their premium plans. as for the concern, health care is a very complex set of goods and services. it is unclear when an insurance
9:43 pm
company or governor -- government is looking over your shoulder, when the insurance company is saying no, sometimes they are right and the doctor is wrong. what is happening in our health care sector right now is the government is denying you your right to choose the type of health insurance plan and type of approach that you prefer. consumers don't get a free choice between plans that give the doctor a lot of free range. there are either thrown into a government program where the government decides what they going to get, or the government pent -- penalizes them or they get an eca plan where the rules the government puts in place dictate that insurance companies are going to have to discriminate and one of those ways is going to be looking over
9:44 pm
the shoulders of doctors saying no to care that a lot of high cost insurance patients need. host: thanks to both >> c-span's washington journal every day we take your calls live on the air on the news of the day. we discussed policy issues that impact you. coming up sunday morning brett jacobson discusses federal efforts towards space tech. former deputy ambassador to afghanistan will talk about the future of that country and middle east policy. watch "washington journal" live at 7:00 eastern sunday morning. join the discussion with your phone calls, facebook comments, texts, and tweets.
9:45 pm
>> sunday, april fourth on in-depth, a live conversation with science writer and author harriet washington. her most recent book is carte blanche. >> when companies use profit to measure the success in the medical arena, the problem is that we cannot expect the companies to care about us. we can't expect the companies to sublimate and make less money because they care about our health. they have already shown they don't care about our health. on government, the people that we pay we should expect to care about our health and should defend us. our government should be raining in these companies. they should be forcing them to develop to fit the public need and it is not. >> join in the conversation with your phone calls, facebook comments, texts, and tweets.
9:46 pm
>> on thursday, the ceos of facebook, google, and twitter testified on what their companies are doing on their platforms to combat misinformation and disinformation. for more than five hours they took questions from members of two house energy and commerce subcommittees. of facebook, google and facebook. >> today's hearing is being held

17 Views

info Stream Only

Uploaded by TV Archive on