Sen. Rand Paul listens to a question at Paducah medical town hall
(Paducah, KY April 18, 2017) - Senator Rand Paul was in his comfort zone addressing doctors and nurses. Senator/Dr. Paul, dressed in a sports jacket over scrubs, addressed medical professionals in a health care town hall meeting at the Carson-Myre Heart Center Auditorium, Baptist Health Hospital. The event was open to media and medical professionals, but not to the general public.
The Senator was introduced by Dr. Barbara Bowers, shown at right. Paul had performed two free cataract surgeries at Bower's Innovative Ophthalmology clinic earlier that morning. Bowers too appeared in scrubs for the event.
He started by blaming baby boomers for the crisis in health care. Or maybe the blame rests with boomer parents "for having too many damn kids."
He alleged there had been no real debate over Obamacare, which he called "loaded down with paperwork." He said the crux of the present law is the mandate to buy insurance or face a penalty. They added twelve to fifteen mandates. He said that for a healthy 22 year old, a penalty looks better than paying for insurance they don't feel they will use.
"Why would you buy insurance?"
Fewer people bought it, even with the mandate. As a result, the pool of the insured got sicker. That meant that insurance companies fled. In many counties, there is only one choice of insurer and when there is only one choice, prices go through the roof.
Paul reminded his audience that Congress voted sixty times to repeal Obamacare. President Obama vetoed them every time. Now that the GOP controls the legislative and executive branches, what happened?
"We got weak kneed and said Ah, we can't repeal the whole thing. Let's repeal parts of it and replace it with more government stuff."
Senator Paul spent a great deal of his time on stage dishing on insurance companies. He has no sympathy for an industry that made 11.5 billion dollars profit last year. "I don't give a you know what for insurance companies. They made 6 billion dollars before Obamacare and then they made 12 billion under Obamacare."
He told the audience that insurance companies make up the rules for physicians. If you try to band together and fight them, they will come after you for anti-trust violations as they did a physicians' group in Colorado. He wants anti-trust law amended to prevent that from happening.
Paul is not in favor of breaking up the big five insurance companies that have a lock on health care. "I'm not for breaking up companies. But I don't want to bail them out either."
Paul's plan is geared to the individual market which is about 10% of the market. His idea is to allow individual buyers to join a group. He wants to allow Farm Bureau, the NRA, even the hospital group he was speaking to with its hundreds of employees to act as a group to obtain medical insurance. Paul mentioned AARP, with its 30 million members as a potential group. When asked if he had discussed his proposal with AARP, Paul said he has not because group buying is "not legal yet." Paul said he had also spoken with President Trump about his plan.
Paul accused Washington of having an "insufficient admiration for capitalism." He believes that market forces will reduce health care expenses if allowed to act. He pointed to lasix surgery as an example. The surgery is not covered by insurance and competition has lowered the cost from thousands of dollars to a few hundred.
On Medicare, he believes that the wealthy should pay the full cost of their Medicare. It should be means tested. Premiums for those who can pay more should be higher. The way to save Medicare, according to Senator Paul is to raise the age of eligibility from sixty five.
As far as Medicaid, Paul says that "we can take care of people who can't take care of themselves." But he thinks that there are too many on the Medicaid program under Obamacare.
Paul continues to advocate for block granting federal medical dollars to states. He wants to put more medical control in the hands of the states because they can more faster and are closer to the problem.
Paul advocates for health savings plans that can be used for various preventative measures, like gyms, vitamins and smoking cessation programs.
Senator Paul's ideas are radical departures from current thinking on health care. He has been reviled from all sides. Opponents worry that putting those with pre-existing conditions in a pool will lead to unaffordable costs and less than ideal coverage. Others see his plan as too big and too radical a departure from the current system.
He has no problem with one group opinion of his ideas. When asked what insurance companies think of his plan, he immediately replied "Oh they hate it."
As with any other sweeping change, Paul says that health care cannot be fixed by one law. Repairing the present system will take a series of steps.
It doesn't appear that Congress has the patience or willpower to take those steps.