White House Looks For Ways To Lower Health Care Costs

President Obama is hosting a second day of health care policy meetings at the White House, aimed at finding solutions that will reduce the exploding cost of health care services. Rep. Dennis Kucinich, a Democrat from Ohio, and Jane Delgado, of the National Alliance for Hispanic Health, discuss additional efforts by Congress to change the relationship between the federal government and the health care industry.

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MICHEL MARTIN, host:

I'm Michel Martin, and this is TELL ME MORE from NPR News.

Coming up, how to pay down your debt and keep up your credit score despite the recession. And a group of wealthy women have pledged big money to improve the lives of other women and girls around the world. We'll find out what they're doing in just a few minutes.

But first, the White House hosts a second straight day of health care policy meetings today. President Obama wants to create momentum for his health care reform effort. And he began the week by securing promises from industry stakeholders to slow the soaring cost of care. If those promises are kept, the president says the nation could save more than $2 trillion in health care spending over the next decade. But some health care advocates are asking, why is President Obama not apparently open to another path to reform, the single-payer system?

Here to talk about this is Congressman Dennis Kucinich, he represents Ohio's 10th district and is an advocate of the single-payer option. Also with us is Jane Delgado, she's president and CEO of the National Alliance for Hispanic Health. Her organization does not support a single-payer health system. I welcome you both. Thank you so much for joining us.

Representative DENNIS KUCINICH (Democrat, Ohio): Thank you.

Dr. JANE DELGADO (President and CEO, National Alliance For Hispanic Health): Thank you.

Rep. KUCINICH: Thank you, Michel.

MARTIN: Before we dive into the single-payer question, Congressman, can I get your thoughts about the cost-cutting measures President Obama was counting yesterday. Is this a path to health care reform?

Rep. KUCINICH: Well, no. Let's look at the math. If the private health insurers are saying they can save $2 trillion over 10 years, you have to sort it out. And what you find out is that they're calculating off of a $12.8 trillion revenue stream in 2020. What that means is that by slowing the rate of their revenue, they're going to - instead of having a 60 percent rate of profit over a period of 10 years, it'll be 35 percent. This is an unconscionable rip off of the American people. This is a bail out of the insurance industry.

Just like we bailed out the banks, we're now bailing out the insurance industries. Health care is a basic right. People should not exist for the health care companies. Health care should exist for us. And so, I'm emphatically disagree with the approach that the White House is taking. In the end, it's going to mean more tax dollars going to the insurance companies. Single-payer is the only form of health care under consideration that's known to save so much money from - that would otherwise go to administrative waste. There would be enough to cover all the uninsured and all the under-insured.

MARTIN: Jane Delgado, can I get your take on that, just that narrow question of whether these efforts at cost containment is a step in the right direction.

Dr. DELGADO: I think to start the conversation with cost containment is probably not the best place. I think the United States, we need to have a conversation about what we as Americans expect in our health care system. You know, a lot of people talk about how it's 17 percent of GDP. I don't think we ever talked about whether or not we think that's the right amount, if it's too much or too little. Because when they compare us to other countries, that amount actually includes other things that are not provided in many of the countries that have single-payer. So, we're not comparing apples to apples, but we all get very excited about this 17 percent number and think we have to change it.

MARTIN: So you're saying it should be - perhaps that number is too low?

Dr. DELGADO: It may be too low. For example, in that number, it includes everything - plastic surgery, research, teaching, long-term care. You know, a lot of things that in other places where there are more centralized program, it's not included there because some of those are part of the social services in those countries. And in other countries, they really don't have the nursing care infrastructure that we have here. Now, ours is not perfect, but I don't want to say, let's just stop doing it either.

MARTIN: Well, Dr. Delgado, I'm going to start with you because we know that Congressman Kucinich has very strong feelings about - in favor of single payer. So I'm going to start with you and ask why your organization does not support it, because we've have previous conversations, you and I…

Dr. DELGADO: Right.

MARTIN: …on this program, where we've talked not just about the cost of care but the quality of care. And the advocates of single-payer, as I'm sure Congressman Kucinich will point out, that in his view, it's the best combination of both quality of care and cost of care. So tell me why your organization does not support single-payer.

Dr. DELGADO: Well, first of all, I want to say the congressman has raised the discussion of quality and that's very important. Because when we talk about single-payer, we have to consider that, for most Americans, they are happy with the program that they have now for health insurance. But we need to provide for those people who don't have health insurance. So I think rather than changing our whole system to a government-run, government decision making process -which is not really an American value.

You know, in other countries, they set the value of a year of life, the government does. And we, as Americans, I don't think we would want that. But more important, look what's already happening with the comparative effectiveness research efforts, that it's all being done by a federal solution, where they're all feds who are on the panel and they're looking at research that doesn't include many of the communities that should be included to make decisions about health care. I don't think it's the answer, I think the answer is complex. And because of that, single-payer is too much like a sledgehammer. And in that process, lots of people would get hurt.

MARTIN: Is it your view that it's just politically not palatable or if that it simply is not the best approach?

Dr. DELGADO: Oh, that it's not the best approach. I mean, for me to say, look, people who say we're going to save money through prevention, that's not true. Because in the long term if you prevent illness, people live longer lives, they'll have more costs, and they'll eventually have to die and get an illness and there still be those costs. So, I think part of it is we have to have a conversation as Americans as to what do we really expect for health care for ourselves.

MARTIN: If you're just joining us, you are listening to TELL ME MORE from NPR News. We are talking about health care reform with Congressman Dennis Kucinich and Jane Delgado of the National Alliance for Hispanic Health. Congressman Kucinich, you have before - the first question I wanted to ask you is, do you think that single-payer is even on the table with this administration? Is it even a part of a conversation?

Rep. KUCINICH: Well, it needs to be and it's up to the public to demand it. The doctor says that single-payer would not be an American value. Well, apparently bankruptcy is an American value. And bail outs have become an American value. And 50 million Americans who have no health insurance, that's an American value. Half of the bankruptcies in the U.S. are related to medical bills. And this system that we're talking about, single-payer, that we can have exactly what people are paying right now for health care. And in addition - in terms of the overall money in the system, about $2.4 trillion a year but the operative numbers - not that it's 17 percent of the gross domestic product. The operative number is that $800 billion a year goes for the activities of the for-profit system - for corporate profit, stock options, executive salaries, advertising, marketing across the paperwork, 15 to 30 percent in the private insurance sector. If you took all that money, $800 billion a year, and you put it into care for people, you would have enough for all medically necessary care, a doctor of choice plus vision care, mental health, dental health, long-term care and prescription drugs would all be covered.

I mean, this to me is a basic human right, health care. And what's happening right now is it's been all fogged over. Even people of goodwill and people who should know better are now trying to say, well, we ought to stay with this insurance-based system, which has resulted in 50 million American people not having care - another 50 million under-insured with the U.S. having infant mortality rates higher than many industrialized countries, and life expectancy lower than many industrialized countries which have a single payer system. So the question is, are we going to wake up and break the shackles that these insurance companies have on our politics and start to have a health care that is not job related but is based as a right in a democratic society?

MARTIN: Jane Delgado, can I ask what is it that causes you to say that most Americans are happy with their insurance schemes now? Particularly given, you're saying the Americans who have health insurance are generally satisfied with the quality and cost of care? Because I would think that the data (unintelligible) particularly as consumers have borne increasingly the cost of care, their premiums have gone up, their co-payments have gone up.

Ms. DELGADO: If you actually look at surveys of people who have health insurance, most people are pleased with what they have. But I think that we have to have a solution for those people who don't have health insurance. A lot of them are not the people who are very, very poor but working poor, people who are contract employees who don't have access to some sort of health insurance. I think, yes, the government has to step in vigorously, and the president has made that a priority. You know, when he talks about doing something which is uniquely American, that is a combination of things, that's what we need.

MARTIN: And you're saying his focus ought to be in covering the uninsured as opposed to changing the health care framework for Americans who already have insurance. But what about Dennis Kucinich's point that the health care outcomes, I mean, life expectancy, infant mortality rate, a number of health care indicators are far less favorable in the United States than they are for other countries that have single payer health care programs.

Ms. DELGADO: Well that's the problem with health care data. Because in fact if you look at those other countries the people actually walk around a lot more than Americans. So people just look at things like end of life and they say, well, we also have these other numbers. We also know that infant mortality is much more complex than we thought. For example, Hispanics even though we have low income, less access and all this, we actually have birth outcomes that are better than non-Hispanic whites. So it's not as simple as people try to make these data. And people can pull together data and say well, we should do this and we should that. But I think fundamentally the consumer, the individual has to have more say in what happens in health care in the United States.

MARTIN: Congressman we only have about a minute left. So I want to give you the last word here. You are one of 60 members of Congress who have cosigned a bill that would advance single payer health insurance. And this bill has been on the table in various iterations for many, many years in Congress. You, during the presidential campaign, you're the only of the Democratic candidates, the only candidate who consistently advocated single payer health insurance. But the issue still does not advance. And I wanted to ask why you think that is.

Rep. KUCINICH: Well, first of all John Conyers and I coauthored the bill H.R. 676, which now has 74 members of Congress. And there is a growing movement nationally and it's present in a lot of states. In California, the state legislature twice passed a single payer bill. Pennsylvania, Colorado, Illinois, Montana, New York, Washington and Minnesota are home to single payer bills with strong grassroots movements behind them. One of the things we need to do, Michel, is to make sure that we preserve the rights of states to have a single payer model. And we have to do that by changing (unintelligible) which would preempt the states from enacting their own health care reform.

So I think we can move in that direction if we preserve the single payer option in this health care legislation.

MARTIN: All right.

Rep. KUCINICH: But I'll tell you something. The administration appealing to national pride by saying that we need a uniquely American solution, we have it right now. (Unintelligible) 50 million Americans.

MARTIN: We're going to have to leave it there, time is the one thing we don't have more of. Congressman, we thank you so much. Congressman Dennis Kucinich is a Democratic.

Rep. KUCINICH: Thank you.

MARTIN: He represents Ohio's 10th District. He joined us from the studios of WCPN in Cleveland. Jane Delgado is president and CEO of the National Alliance for Hispanic Health. She joined us on the line from Washington, D.C. I thank you both so much for joining us. Still to come, the recession has put many Americans on a financial roller coaster. We'll have some conversation about raising your credit score and dealing with credit debt that you may already have. That's just ahead on TELL ME MORE from NPR News. I'm Michel Martin.

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