Healthcare Crisis In America

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DARIA DOLAN, CNNfn ANCHOR, DOLANS UNSCRIPTED: All right, today's "Totally Useless Tidbit": what percent of doctors in the United States receive their medical training overseas?

KEN DOLAN, CNNfn ANCHOR, DOLANS UNSCRIPTED: All right, let me think. Now, don't put the answer up. Twenty percent. What's the answer? Oh, all right, that was pretty good.

DARIA DOLAN: Twenty-three percent. You were very close.

KEN DOLAN: That seems to me a little bit high, though. I don't know.

DARIA DOLAN: Well, I recall back in the '60s, the son of one of my mother's friends could not gain admission to a U.S. institution, and so he went to Italy .

KEN DOLAN: Yes, Bolognese.

DARIA DOLAN: Bolognese.

KEN DOLAN: Was it Bolognese?

DARIA DOLAN: Yes.

KEN DOLAN: Yes, OK. Oh, baloney! No, just kidding. As we talked before, we have been talking about health care, Canadian versus U.S. versus U.K. versus Germany , which is the best, where are the best parts of it, what's happening is no secret. Excuse me.

DARIA DOLAN: We're finding out nobody has it quite right.

KEN DOLAN: Yes, exactly. As you know now, President Bush has taken his sort of Kerry – his gloves off, and he's got his Kerry punches going here.

Clearly, one important issue between now and election day is health care, and I think it's kind of important and timely that we all be informed voters, as it relate to this and other things, and talk about both side of the fence.

DARIA DOLAN: So we're going to find out, because it's sometimes tough with media sound bites of both President Bush and the Democratic challenger, Senator John Kerry, to find out what a particular position is by either.

So joining us to let us know what the Kerry health care plan is and what the President Bush health care plan is, is John Goodman. He is president of the National Center for Policy Analysis. It's NCPA. And he joins us from Dallas , Texas .

Good morning.

JOHN GOODMAN, PRESIDENT, NATIONAL CENTER FOR POLICY ANALYSIS: Glad to be with you.

DARIA DOLAN: Thank you.

KEN DOLAN: You're not going to move to Canada or anything, are you, John?

GOODMAN: No time soon.

KEN DOLAN: OK. John, if – sort of we'll do the last question and the summary before we begin. How would you easily – if it can be done – easily summarize the positions of Bush and Kerry?

Now, it's a complex question, John, I understand, but sort of a quick summary of either – of both.

GOODMAN: Well, Senator Kerry wants to spend a lot more money. He wants to expand public sector programs, like Medicaid and the SCHIP, the program for children. He has tax credits in there and a number of other things.

President Bush wants to rely more on the private sector. His tax cuts are more targeted. I think the taxpayers would get a better deal for the money they spend, and.

KEN DOLAN: John, what does private sector mean, as it relates to our discussion, companies, employers?

GOODMAN: Yes, plus, the private insurance that people buy.

KEN DOLAN: Oh, OK, OK.

GOODMAN: President Bush believes in personal portable insurance. It would be easier for people to buy their own insurance. They would get tax relief for doing that. That would be insurance they could take with them from job to job.

KEN DOLAN: Why – as President Bush – and I don't want to get political, John, because I'm simply not political. But has – since President Bush has taken office – and I don't know the answer; that's why I'm asking you – do we have more or less uninsured? We have 44 million. I can't believe we had this many four years ago. Maybe we did. But has it gotten any better or worse?

GOODMAN: Oh, it's probably gotten worse because we've been in a recession.

KEN DOLAN: Yes.

GOODMAN: But, you know, it was getting worse, even during the 1990s when we had the boom period.

KEN DOLAN: No, for sure. Yes, yes.

GOODMAN: So we do have a problem. Nothing's been done the last four years. President Bush put his political capital into the Medicare Reform Bill and prescription drugs.

KEN DOLAN: Yes, yes.

GOODMAN: And I wasn't for that bill, by the way, but that's what we did.

KEN DOLAN: Yes.

DARIA DOLAN: You know – and John, I have to say this, because it strikes me that whenever there is some sort of health care issue that the country faces, if there's any segment of the society that gets protected better or at least gets some discussion taking place, it's always seniors, because, let's face it, they vote more than the rest of us.

And I hate to sound so cynical, but did we really need to do that Medicare drug prescription bill now with 44 million uninsured?

DARIA DOLAN: With basically no coverage, John, versus expanding the coverage with those who have it?

GOODMAN: Well, I'm with you on this.

KEN DOLAN: All right.

GOODMAN: We're spending a lot of money on seniors. Some of them are millionaires. And we didn't do anything for the lower-income people.

But the next time around, the focus is all on the uninsured. And I believe we will do something. The problem I have with Senator Kerry is he spends too much money for what he gets. His own Democratic health economist estimates it will be about $95 billion in extra spending a year. We insure about 27 million additional people, but that works out to $3,300 per person or $10,000 for a family of three. Well, that's more than most people are spending on their own insurance, not a good deal for taxpayers, I don't think.

DARIA DOLAN: John, would we have less of a crisis and more affordable health care in this country, quite frankly, if we could get the plaintiff's bar out of this completely, with some of the malpractice lawsuits that you look at?

Now, I'll grant you, some of these lawsuits, it's, I believe, the doctor's fault for not cleaning their own ranks out of bad doctors. But I mean it's now mandatory to have tests that would be unnecessary.

GOODMAN: Absolutely. We need malpractice reform, and interestingly enough, both candidates are very good on this point. Senator Kerry, even though he's a Democrat and Democrats get support by trial lawyers, is for some pretty good malpractice reform.

KEN DOLAN: Would the fact that George Bush has done this Medicare situation, John Goodman – would it have anything to do with the fact that there are more than 40 million senior citizen voters in America ? Would that be just a coincidence?

GOODMAN: Oh, of course. But within that bill, there was something very good that helps insure the uninsured, and that's the health savings account that's now available to 250 million non-elderly Americans. And the statistics show that uninsured are more likely to buy insurance if they can combine it with these savings accounts.

KEN DOLAN: You're called the father of the MSA, is that true, Medical savings account?

GOODMAN: Well, that's what some people say.

KEN DOLAN: Wow. Now, when you say health saving, do you mean medical savings? Are we talking medical savings accounts on steroids? Are we talking two different things or the same thing?

GOODMAN: No, we're talking about another called health savings accounts.

DARIA DOLAN: Yes.

KEN DOLAN: Yes, OK, yes.

GOODMAN: If you buy a high-deductible plan, the law now allows you to have a savings account with that plan so that you can manage some of your own health care dollars. If you manage it prudently and you're careful with how you spend it, you save the rest, it grows year-to-year, you know, over a whole work life, you could end up with hundreds of thousands of dollars in those accounts.

KEN DOLAN: John, I don't think America understands health – I'm not knocking it, because I happen to think, in concept, it's a good idea. I think we, you, us, the world – I think we're doing a bad job of telling America about it.

How do we get the word – I guess we're doing it now, but how do we get this word out? Because you can go out on the street and nine-and-a-half people out of 10 don't know what a health savings account is.

GOODMAN: I know. But what's happening is the employers are now making these available to people.

KEN DOLAN: OK.

GOODMAN: The insurance agents are doing their job.

KEN DOLAN: OK.

GOODMAN: And you're going to see a lot of advertising of health savings accounts.

KEN DOLAN: OK, good, all right.

DARIA DOLAN: Let's roll the clock back a little bit, Dr. John Goodman, to the Clinton administration and the quote/unquote Hillary Care, the health care talks that the first lady, at that point, Hillary Rodham Clinton, initiated.

Now, obviously, it was, I think, the closed door nature of it that was off- putting to a whole segment of people from the get-go. But was there anything that should have been implemented from Hillary Care?

GOODMAN: Well, the problem was it was a huge plan. She was going to impose on all of America one way of doing it. And the White House was going to dictate everything, including how many mammograms women get every year. That's too much federal control over the health care system.

DARIA DOLAN: Yes.

GOODMAN: Instead, we need to – I like the Bush approach. Let's get very targeted relief to people who need help and let them get insurance, and if possible, have a savings account as well so they can manage some of their own money.

KEN DOLAN: Dr. John Goodman, thanks so much for spending time with us. We really appreciate it. We also, by the way, appreciate your work on the MSAs now, the health savings accounts, because we think that's a very, very positive step in the right direction.

We'd love to be able to say in our lifetime, John Goodman, that every American has some kind of coverage, and maybe we will.

GOODMAN: Glad to be with you.

KEN DOLAN: We'll talk to you again, John. Thank you.

DARIA DOLAN: Thank you so much.

KEN DOLAN: Dr. John Goodman, good guy.