Wednesday, August 12, 2009

Questions for Rep. Mike Conaway's Health Care Open House


Representative Mike Conaway (R-TX) holds a health care open house today at Angelo State University. I have five questions and won't get to ask them all. They are:

1. The Odessa American quoted you as saying Republicans did "a lot," including introducing health savings account plans in 2004. Yet, the number of people without health insurance rose 2.2 million after the introduction of HSA's. The uninsured rose from 44.8 million in 2005 to 47 million in 2006.

Employer sponsored health coverage declined from 60.2 % of Americans in 2005 to 59.3% in 2007. The decade long decline in employer coverage continues.

Census Bureau statistics show the percent of uninsured in Tom Green County as 23% in 2006. It ranged from 28% to 40% in surrounding counties.

Data from a GAO study on health savings accounts revealed:

51% of people with HSA's make $75,000 or more vs. 18% of the general population

55% of HSA eligible plan enrollees contribute to their health savings account, while 45% do not. This leaves 45% potentially underinsured.

How did allowing people to effectively self insure, for first dollars paid using tax free money, help people in West Texas? What data do you have that shows the impact of high deductible health plans and funded health savings accounts in the Concho Valley?

2. Given your past misrepresentations on health care issues, like income levels for Medicaid expansion, and campaign donations from health insurance PAC's, like WellPoint and Humana, why should someone in the health field believe your current assertions on health care reform?

3. What have you done to help constituents in the Concho Valley get access to affordable health insurance and affordable health care during your terms in office? The Tom Green County Indigent Health program spends a fraction of its budgeted resources. In the late 1990's and early 2000's it spent it all and more, going to the state for subsidies. Our local community health center lost a sizeable chunk of its federal 330 grant funding. Only Obama stimulus money, which you voted against, provided a significant, but temporary back fill. As the uninsured problem likely grew due to the deep recession, Tom Green County experienced a deleveraging of health care resources for the indigent and uninsured. What do you plan to do to change this situation and mobilize resources on behalf of citizens?

4. Why are leaders in both parties misrepresenting health care reform? President Obama raises the 14,000 a day losing coverage as a critical motivator, when new coverage doesn't go into effect until 2013. Republicans talk about death squads in reference to living wills, a twenty year old practice of patient determination in health care treatment. Why are Republicans and Democrats trying to fool the public?

5. America suffered through managed care and capitation in the 1990's. They went away because patients didn't like the plan restrictions and providers resented heavy handed utilization measures. Why refresh them as accountable care organizations and global payment. Shannon created their vertically integrated health care system in response. Since then, they dismantled key divisions. Community Medical Center sold out to HCA as it had no strategy for managed care.

The latest round of for-profit deals, KKR's purchase of HCA and CHS's buyout of Triad Hospitals, added $2 billion in interest expense to the nation's health care system. No new hospital was built, no new doctor added or high tech diagnostic or treatment device installed. Companies changed hands and the bill increased $2 billion. What do you plan to do to rein this in?

Note: Given the long line of upset people, I chose not to ask any. The list has been e-mailed to Conaway's office. Should he reply, I'll post it.

Update: 10-2-09 No reply from Representative Conaway's office. The San Angelo Standard Times did not fact check the numerous assertions made by the Congressman or his constituents.

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