Congressman Gingrey on Health Care Reform

Today’s Courier Herald Column:

Most of this space has been dedicated to issues at the state level for the past two weeks.  That is, after all, our primary focus here.  The final weeks of the legislature are when most of the items of significance pass – or don’t pass – through the General Assembly.  Georgia commentary thus trumps national items.

As the legislative session was reaching its crescendo, the Supreme Court was arguing the landmark case of our day.  We should know in a few months if President Obama’s health care reforms are considered constitutional, and likely receive a ruling on whether or not the federal government can require its citizens to engage in commerce with private entities.

Georgia’s Attorney General Sam Olens was provided a front row seat to the proceedings as Georgia is a party to the suit challenging the law.  We’ll likely get his take here in the weeks ahead.

Georgia also has three medical doctors within the Republican Congressional delegation who have adopted the mantra of “Repeal and Replace”.  It’s clear that Congressmen Broun, Gingrey, and Price want the law repealed, but how it will be replaced has been much less specific.

Congressman Gingrey reached out to me and the other contributors at to create a dialogue on the topic.  He was kind enough to give us just under an hour just after getting off of a plane from Washington last week after observing some of the oral arguments.  It was a rather enlightening conversation.

The tone was set very early in the discussion when Congressman Gingrey admitted that Republicans did little to fix a broken health care system when they were in charge.  “Shame on us” he said, beginning with a frank candor that transcended partisan talking points.

The honesty in that opening was refreshing, and hopefully indicates a recognition that defeating “Obamacare” alone cannot be the goal.  Republicans must provide solutions if they are to keep the middle class, and specifically small business owners, on their side with this issue.

He spoke directly about the need to quickly replace the current law with one that includes protections for those with pre-existing conditions.  He sees each state running an effective high risk pool as part of a solution for those with pre-existing conditions who are excluded by most insurers.

With some of the more popular portions of the health care reform law such as the elimination of pre-existing conditions, Gingrey says there is wide support, and Congress could pass a bill limited to these items in broad bi-partisan fashion within weeks if current law is struck down by the court.   What is not needed, according to him, is another 2700+ page omnibus bill.

Instead, the easier items will be replaced first.  But the Republican solution will be a series of proposals, each standing on its own merits.  Some will be easier to pass and will pass quickly.  Others will take time to build a consensus.  Health Savings Accounts, ability to buy insurance across state lines, and employer and/or employee tax credits will be offered as part of the mix.

He also offered a word of caution on Medicare, even under the status quo, noting that the budget Republicans just passed doesn’t wait for a Supreme Court decision to address a problem staring the country and it’s retirees in the face right now.  The Medicare Trust Fund is projected to become insolvent between 2016 and 2024 if no changes are made.  The Republican’s Paul Ryan budget begins to address the problem by moving some seniors to private plans with premium support and gradually increases the eligibility age of Medicare to age 67.

Gingrey noted that Republicans have put themselves on record and at risk of attack from Democrats by starting to do what is needed to save a program on the edge of insolvency.  He also noted that Democrats are nowhere to be found on the issue.

There are no easy solutions to fix a $2.5 trillion industry that composes roughly one sixth of our nation’s GDP.  It is nice to see Congressman Gingrey coming to the table with contrition for what was not done between 1995 and 2006, as well as with ideas for what will replace current law should it be struck down.   Given current opinions of what is expected from the Supreme Court’s verdict, this discussion will likely move from the hypothetical to reality in just a few months.


  1. L. Max Lehmann says:

    Dr. Gingrey is one of seven Georgia House representatives that listened to the policy briefs presented by me and another Multiple Sclerosis advocacy volunteer in WDC last month.

    Points included maintaining the budget for National Institutes for Health and several awareness measures such as joining the existing Multiple Sclerosis coalition on the Hill.

    This post substantiates a position I have maintained for a long time – The GOP did not address looming health care financing issues while they had control of all three Fed branches of government. Our own Gov. Deal and Dr. Burgess (R-Texas) worked on excellent ideas, at that time, but to no avail.


    Not for lack of trying, timing and Majority political ‘will’ did not line up, plus some fierce opposition from powerful interests.

    Without ‘replacement’ plan of the PPACA, as credibly outlined by Rep. Gingrey, GOP risks association with a terribly negative connotation: “The Party of NO – We brought back pre-existing conditions.”

    I am pleased to see traction on the ‘replacement’ discussion for HC finance reforms for all Americans. In a Country as rich, compassionate, and educated as America, medical bankruptcy ought to be virtually eliminated, instead of a real possibility.

  2. kyleinatl says:

    Dr. Gingrey should elaborate on what he means by an “effective high risk pool”. The concept is not bad, but they’ve failed at the state level more often that not due to a lack of influx of funds. Now I realize in the RSC proposal, and maybe even the legislation that Dr. Price authored, they mentioned grants to states that create these pools, but do we really trust Georgia to effectively manage these funds? They can barely keep Medicaid afloat, and I feel like this is just asking for further waste and abuse.

    Believe me, I’m all for options for uninsurables, maybe more so than most that contribute here, but there’s a reason why Georgia never could make a high risk pool happen.

  3. L. Max Lehmann says:

    The reason GA has not adopted a high risk pool may be due to this fact: “…High-risk pool expenses will always exceed revenue from premiums because claims costs cannot be spread across low-risk individuals.” as outlined in this comprehensive State study:

    Idaho has a novel approach to the dilemma. If a claim exceeds a certain limit, then that cost is paid for by the insurance companies in Idaho. They pay a premium into a ‘reinsurance’ plan that covers the highest claims.

    As well, the Feds are making it easier for States to further their indebtedness by placing certain incentives on high risk pools before 2014. 2014 is the date whereby virtually all HC financing as we know it changes, if PPACA remains current law and is unchanged by either SCOTUS or a future Executive Order.

    Read about that, here:

  4. gcp says:

    I am glad to hear Mr. Gingrey is concerned about the Medicare Trust Fund. Was he concerned several years ago when he voted for Part D, the Prescription Drug Benefit? Also I will be interested to hear how he includes “protections for those with pre-existing conditions” and does not include a mandate for everyone to purchase insurance.

    • KD_fiscal conservative says:

      “Part D, the Prescription Drug Benefit”

      EXACTLY! Now the Dems are in power all the GOP’er start claiming to worry about medicare solvancy. During last 6-8 years of Repub. rule, the only major ‘reform’ we had to medicare was a massive increase via handing about free drugs(a MAJOR win for Repubican’s pharm. lobbyist buddies).

  5. elfiii says:

    The best thing for the Congress to do to fix health care is to get out of the health care bidness altogether and leave it to the states. What a novel idea.

  6. John Konop says:

    A few suggestions:

    End Medicare Part D and replace it with letting seniors buy drugs at the VA at a 60 percent savings ie 7 trillion dollar off the budget.

    Create public exchanges and let people across the country self insure and save 20 percent.

    Let states buy drugs for Medicaid, peachcare……ie poor at the VA

    For non emergency care have a phone for dial a doc at the emergency room or address of local drug store with nurse and create financial incentive for use over emergency room especially for uninsured, Medicaid……

    Create financial incentives for Medicaid elderly to be taken care of by family over institutions.

    Have an insurnce tax on anyone working without coverage

    Have everyone fill out out an end of life directive on their tax return.

    Just a start!

    • kyleinatl says:

      The problem is, these drugs are incredibly expensive in some cases and unless the state decides to use bargaining power akin to European countries, they’ll just lop it off their covered drug list in your scenario.

        • L. Max Lehmann says:

          At issue is how to accommodate the tremendous costs of the new, disease modifying, ‘biologics’ or personalized medicines that will become standard drug therapy in a decade.

          Hard to imagine but the drug cost to treat some cancers, Multiple Sclerosis, and many other chronic illnesses range from $3,000 to $10,000 PER MONTH. In the case of Multiple Sclerosis, there exists a relatively small patient population in which to spread R&D costs.

          What most folks do not realize is that in the next 5-10 years medicines made from non-controversial cellular (biologic) material such as a person’s own skin will not only positively modify a disease, but even reverse it’s course.

          Health plans must be designed to accommodate these costs in a fair manner that does not lead to people not taking their medications because they cannot afford the co-insurance payment, which is usually a percentage of drug cost, instead of a pre-set co-pay.

          • John Konop says:

            Great point as usual. On a macro your point also opens up the door about the pre-existing condition issue. The Libertarian view is survival of the fittest let them die. The pro-life/community view is I am my brother’s keeper. As I said in the past pro life libertarians on this issue are pro-birth not pro-life. On the rational side, it could be you one day, family……………. As you pointed out a healthcare incident should not be able to BK a person, family………….. One of the problems with this debate is how it is much more complicated than sound bites. And this issue does not fit nicely in a ideological box like most major issues.

            • L. Max Lehmann says:

              “…One of the problems with this debate is how it is much more complicated than sound bites. And this issue does not fit nicely in a ideological box like most major issues. …”

              “I treat sick people; not Democrats nor Republicans.” – Well known ATL Physician.

  7. Bert Loftman says:

    Rep. Phil Gingrey and most Republicans have no plan because of corporate cronyism. Obama at least had a plan for change, albeit a bad one. To really change health care, the number one problem is insurance through job-based health care. When you change jobs you must change insurance and if you have a pre-existing illness, you are out of luck trying to get individual health insurance. The cause for this is income and FICA tax breaks to job-based health insurance giving great profits to these corporations. The fix is the FairTax.

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