Congressman Charles Rangel (D-NY) chairs the powerful House Ways and Means Committee. The committee released last week a bill designed to reform health care.
Kathleen Wells: Last week, the House Democrats released a version of the health care reform bill. One of the central issues that it addresses is the public finance insurance option, which competes with private insurance. Can you explain to me why you feel that having a public option is necessary and beneficial?
Congressman Rangel: Well, we have close to a trillion dollars going out there in subsidies in order to provide health insurance for people who don't have it or to supplement those who are underinsured. These people will have to try and get the best deal that they can get. There is a question as to whether they can do that, if only left [with] a choice between the private insurance companies. And so, what we've done is set up an exchange where people can go to the private insurance companies [or] the public option. They will be able to get what's best for them, the most efficient and cost effective insurance policy. And that's why we have the opportunity for people to have an option for a public choice.
Kathleen Wells: I know that some polls, depending on the poll, say that the majority of Americans want a public option included with health care reform. Other polls even indicate that as many as two-thirds of Americans favor a public option. Why are we seeing resistance in Washington?
Congressman Rangel: Because the private insurance companies are very powerful politically. They are the ones that brought down the Clinton National Health Insurance policy. But there is no question that most everybody has had a bad experience with private insurance companies or knows someone that has and so it doesn't surprise me that the public overwhelmingly supports it.
This is their [private insurance companies] survival - they initiate it. They are created not to provide health care, not to improve the quality of life, not to save people's life. They are created to make money.
Kathleen Wells: The version of the bill that you've released requires people with pre-existing medical conditions to receive coverage from insurers and it also caps "out of pocket" expenses. Am I characterizing it properly?
Congressman Rangel: That's true.
Kathleen Wells: Can you give us your thoughts on those particular provisions?
Congressman Rangel: Well, if somebody is sick and needs insurance, it is just immoral for them to be denied this opportunity. If someone has insurance and they are working, then they cannot afford to leave their job for fear of losing their insurance. So, it's very, very important that if you are going to have any national program that there not be any illness you may have that will deny you insurance because you need it more than anyone. Therefore, whether it is the public program or the private program, we deny the opportunity for people to say no to those who need insurance the most.
Kathleen Wells: Address the critics of the bill who say the cost is going to be too prohibitive. Specifically, they indicate a 5.4 percent tax will be assessed against those earning more than one million dollars a year.
Congressman Rangel: First of all, that's a very small percentage of Americans, wealthy people. Two, you cannot possibly score or keep track of the money that you are saving by having preventive care, Medicare and making certain that people do not lend themselves to chronic illness as a result of having coverage.
In addition to that, even though 50,000 thousand people don't have health insurance, they are getting health care and people are paying for it. So, if they come to a hospital, to doctors - now with insurance - common sense would indicate that people's premiums that they are paying for will be reduced because ... they will be insured people paying their own way with government support.
Kathleen Wells: How is the reform/overhaul of the health care system to be paid?
Congressman Rangel: Well, we are paying for it now. Taxpayers are paying for it. (Those) people who have insurance are paying for those people who don't have insurance. Premium rates are constantly going up. Just stopping and freezing the increase that we have in health care, bringing people to the table that have insurance and can pay their own way, keeping people out of intensive care, out of hospitals, preventing serious illness - all these are savings.
True, you can't get an accountant to put it down, but it just makes sense. Those who you are keeping from having health expenses are saving money, not only saving lives, but saving money as well.
Kathleen Wells: If your version of the bill passes the House and the Senate and gets on the President's desk, we won't see an increase in premiums for those that have existing insurance, correct?
Congressman Rangel: Not only that, but there will be a decrease in the number of people that will actually need health care, which is expensive to administer.
Kathleen Wells: What do you mean that there will be a decrease in the number of people actually needing health care?
Congressman Rangel: Well, if you have access to a doctor, if you have examinations, if you are able to get prescriptions, this clearly means that we can keep you out of intensive care - out of the hospitals, out of more serious sickness. The people that [need] the most expensive treatments are people that have ignored health care earlier.
Kathleen Wells: Does that mean preventative measures will preclude the need for more expensive treatments and make health care costs less expensive?
Congressman Rangel: That goes without challenge. There are so many kids that if they had health care earlier, they wouldn't end of up with loss of hearing, loss of sight, all types of illnesses that only an examination would have identified.
Kathleen Wells: And your bill addresses the preventative measures?
Congressman Rangel: No question about it.
Kathleen Wells: Yesterday, the President met with what are termed the "fiscally conscious" Democrats - the Blue Dog Democrats. Congressman Baron Hill, who is a Democrat from Indiana and a member of the Energy and Commerce Committee, has indicated that your bill has 12 policy areas that need altering to satisfy the Blue Dogs. How would you address his concerns?
Congressman Rangel: I have no idea what he is talking about. We thought we had tried to address all that should have been of concern to people that raised objections.
Energy and Commerce have not completed their bill. (We've) listened to the Blue Dogs; the President is listening to the Blue Dogs; the Speaker listened to the Blue Dogs. I'd like to believe from what I've seen and heard that the broad, general terms on which the Blue Dogs are insisting, that the bill addresses those concerns.
Kathleen Wells: Once a bill gets to the President's desk, what is the likelihood that it will contain a public option provision and the other provisions contained in your current version?
Congressman Rangel: I don't see how any bill can reach the President's desk without the inclusion of the public option.
Kathleen Wells: Why is that? Because a public option is something the President wants?
Congressman Rangel: He wants it and I think it's necessary in order to have effective reform that we not only subsidize, but we protect the people that will now have insurance. I think it is very, very important that we compete with the private sector and not capitulate to them.
Kathleen Wells: What do you say to those proponents of universal single payer health care legislation?
Congressman Rangel: I have been a supporter of single payer since it was first introduced. But it is a concept [for which] we cannot get a majority of the votes so, therefore, we are supporting the President's bill.
Kathleen Wells: Why isn't it possible to get a majority of votes supporting single payer health care insurance?
Congressman Rangel: Because a lot of people do not want a single payer government operated insurance and they won't vote for it. Unless you have votes, then you can't pass the legislation. They don't want the government to control healthcare in the United States.
Kathleen Wells: One last question. How does the Obama Administration differ from the Bush Administration?
Congressman Rangel: Well, I really think that the American people have spoken. They were looking for hope. They were looking for international respect and they were looking for a better America and I think that they have spoken and the nation is anxious to move forward in a more positive way.
Kathleen Wells: And you see that happening with the Obama Administration and his policies?
Congressman Rangel: Definitely. Well, the polls prove it. The polls are showing that he is a very popular president and he gives hope to a lot of people.