U.S. Senator for Texas John Cornyn - Navigating the Health Care Landscape
by Drex Earle
Editor-in-Chief
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With all the tumult of the last year and a legislative session that seemed to last for decades, the future of American health care is still hanging in the balance, with many significant details yet unresolved.
As we go to press, the House and Senate bills are still being worked through special conference and the Obama administration is trying to find a compromise. Meanwhile partisan vitriol has intensified about what’s right and wrong with an admittedly imperfect bill.
Americans are confused, dismayed, anxious and equally excited about health care reform, yet it’s safe to say most don’t fully understand it. While the promise of universal care and lower medical costs is something everyone can agree on, the details of the final bill are still hazy. In essence, we don’t quite know what to make of what’s transpired in Congress thus far...or what’s to come. Among thousands of pages of legislation and heated political exchanges, determining what’s promising from what’s poisonous seems harder than ever.
For many frustrated opponents, the current legislation represents all that’s wrong with government — entitlements, hidden taxes and wasteful spending; a veritable socialization of the health care system. To them, a “do-over” is the only option left, particularly if privatization and consumer choice are to be salvaged for the American people.
For supporters, health care reform is not just long overdue, it can’t come soon enough. The unique opportunity to provide coverage to tens of millions is not only an unprecedented and historic moral victory, but potentially the country’s last, best hope to bend the cost curve and prevent a bankruptcy of future generations.
Regardless of where you find yourself in this controversial debate, our goal with this issue was to interview someone who really understands health care reform, deals with it on a daily basis and has analyzed it from every conceivable angle.
A political pragmatist and an active participant in national health care legislation over the last year, U.S. Senator John Cornyn is someone who not only gets what’s at stake, but he has a vested interest in getting it right. Considering that Texas has the worst rate of uninsured (24 percent versus a 16 percent national average), yet one of the fastest growing populations in the country, the need for health care reform in our state can not be understated.
This month, Senator Cornyn was gracious enough to sit down and share his thoughts about national health care reform, the power of preventive medicine as well as the role regular health and fitness plays in his own life. Additionally, we give you a peek at what’s happened over the past year with regard to this landmark legislation and just how much our health care system has evolved over the last century.
----- Q&A -----
HEALTH CARE REFORM
Q: Why did the Senate push to have their version of the health reform bill passed by Christmas? What are the consequences of this, both good and bad?
A: The rush came from an arbitrary deadline imposed by the Administration and Congressional leaders. I believe this was a mistake. The House and Senate have both passed thousands of pages of complex legal language, which will increase premiums for American families and spending in Washington. Rather than debate the merits of these bills, they were passed with multi-billion dollar sweetheart deals and political pay-offs for special interest groups. All of these were crafted behind closed doors, rather than the promised transparency of “having negotiations broadcast on C-SPAN.” I believe we need to start over and give the American people an open and straightforward process that solves the real problems in our health care system.
Q: Will Austinites currently with health insurance see a drop in their premiums as a result of this legislation?
A: The non-partisan Congressional Budget Office (CBO) found that under the Senate bill, families who get their health care through small businesses or larger employers will continue to face premium increases of five to six percent per year — double the rate of inflation. For families purchasing insurance on their own, the Senate bill will increase premiums by $2,100 — over the status quo increases.
Premiums would rise in part because the Senate bill would force workers to buy more expensive policies. Many workers, for example, currently choose to buy lower cost policies that cover catastrophic care, but this option would no longer be available under new Washington mandates. The Urban Institute estimates that these mandates could force individuals to pay more than $1,000 a year in additional premiums. The Joint Committee on Taxation has stated that the new fees on private industry — of nearly $150 billion — would be passed along directly to patients in the form of higher premiums. Finally, according to one study, “cost shifting” from government programs means higher premiums of $1,800 a year for the average family.
Not only will Texans’ health care premiums go up, they may also see their taxes increase to fund new programs from Washington. The Texas Health and Human Services Commission released an analysis indicating that the Senate bill will cost Texans an additional $21.6 billion over 10 years in new state-level spending.
Q: Why is the Texas uninsured rate so much higher than the national average?
A: The number of uninsured in Texas is unacceptably high and many families in Texas are going without essential health care services such as preventive screenings and immunizations that can save lives and prevent disease.
First, we need to support our state’s Federally Qualified Health Care Centers that provide affordable health care services to Texas’ uninsured and medically underserved. We need to enact meaningful tort reform, which has increased access to care by attracting hundreds of doctors to Texas’ rural and border communities since it was implemented in 2003. We need to enact reforms that help small businesses provide affordable coverage to their employees, including state-based reforms such as the Healthy Texas initiative. We need to focus on prevention and wellness for all generations of Texans, encouraging individuals to exercise, eat well and lead healthier lifestyles. And we must increase enrollment of low-income children in the State Children’s Health Insurance Program, or SCHIP, which currently has the ability to cover the health benefits of an additional 800,000 children in Texas that have yet to enroll in the program.
There are many areas where Democrats and Republicans can work together to make health care more affordable and more accessible, and I will continue working toward those solutions.
Q: By covering more Americans, wouldn’t this legislation make health care more affordable for Texas businesses and individuals?
A: The President’s own expert, CMS Chief Actuary Rick Foster, released his analysis of the Senate health care bill and concluded that passing the bill is worse than doing nothing. He reported the Senate bill would actually drive up this country’s unsustainable level of health care spending by $222 billion. Countless independent analyses have found that the Senate bill will drive up premiums for Texas businesses and individuals. We need health reform, but that reform must lower health care costs.
Q: Do you think opponents of this bill, citing exorbitant costs and fiscal irresponsibility, bear any similarity to those who opposed Medicare, a program now considered a relative success across party lines?
A: Medicare passed with significant bipartisan support back in 1965, but this bill is the result of a highly partisan process and ideas from only one side of the aisle. There is broad agreement that this country needs health reform, but that reform should be the result of open and honest debate to solve the real problems Americans are facing.
Q: What have been your most important priorities in stewarding health care reform?
A: Lowering costs through robust competition and mandated transparency; greater access through a more affordable system; tort reform, which we’ve seen lowers costs and increases access in Texas; and a process that embraces common sense solutions to real problems.
Q: What are three things you really like/approve of about the Senate bill that just passed?
A: The bill includes demonstration programs to move to a system that pays for value instead of volume. It also addresses the issue of pre-existing conditions and encourages employers to create programs that will incentivize healthier lifestyles for their employees.
Q: What are three things you’re most disappointed with in this bill?
A: If this bill is enacted, spending in Washington will continue to increase; premiums for Americans will rise, but even more quickly; and taxes will increase by half a trillion dollars amidst a struggling economy.
Q: In your opinion, what are the biggest misconceptions about health reform today?
A: I think the biggest misconception is that Republicans don’t want reform at all. My colleagues and I firmly believe that our system needs reform to lower costs, but we don’t need to create unsustainable new entitlements and give more power to Washington to do that.
Q: What are the most pressing health care concerns facing Texans today?
A: Like most Texans, I believe that our health care system needs reform. Millions of families have seen the cost of their private insurance skyrocket. Many are worried about losing coverage altogether. Seniors are concerned about the future of Medicare. Texans have told me they want to keep the coverage they have and don’t want Washington to make things even worse.
Q: Are there certain countries you look to as a model for health care legislation? If so, what piece(s) of their system would work for us?
A: Switzerland has a market-based health care system, which has achieved near universal coverage but also kept costs in check. They’ve figured out how to force insurance companies to compete based on cost and quality while still covering everyone.
PERSONAL
Q: What is the single most important thing you do to stay healthy?
A: It would have to be regular exercise, hopefully at least four or five times a week. This can be a challenge when I’m on the road, but thankfully most places where I stay have exercise facilities, or I can just pop outside for a jog. I work hard to build exercise time into my schedule. My experience is that if I don’t make it part of my routine, it’s much harder to do, and it’s always easy to find excuses not to exercise!
Q: How pivotal a role has fitness played in your life?
A: Well, I’m much more productive when I exercise and pay attention to what I eat. For me, exercising is a way to relieve stress, clear my mind and stay healthy — all of which help me to stay focused and energized.
Q: What does your regular diet consist of?
A: I try to follow a healthy diet low in carbs with plenty of fruits, nuts, vegetables and lean proteins.
Q: With the demands of public life and your busy schedule, how do you manage stress?
A: When I’m in Washington, I usually arrive in the Senate gym for my workout at 7 a.m. It’s actually amazing how much “work” I can get done in an informal setting, chatting with colleagues on both sides of the aisle. When I’m in Austin, it’s off to Town Lake for a jog, or on my elliptical machine, then some strength-training exercises. When I begin my day with a workout, I have a more positive attitude and the rest of my schedule seems easier to tackle.
Q: What is your favorite place to exercise in Austin?
A: Town Lake is definitely my favorite exercise venue.
Q: Favorite place for a healthy meal?
A: While Austin has a great array of restaurant choices, I’ve always found that what I eat is more important than where I eat, as long as there are good menu options.
MEDICINE
Q: In your opinion, how important is prevention in the modern medical landscape?
A: Too often, our health care system focuses more on “sick care” than it does on “health care,” and I believe preventive medicine and healthy lifestyles are critical to lowering health care costs while keeping Americans healthier and happier. I’ve seen the success of focusing on prevention in Texas, and I’ve introduced legislation in Congress to promote prevention and wellness.
Texas is home to many excellent examples of pioneering preventive health care approaches. This summer I hosted a multi-city health care outreach tour, which included a visit with employees at Whole Foods Global Headquarters here in Austin. I had the opportunity to learn more about how Whole Foods has innovated consumer-driven health care for its employees. Their plan incorporates personal wellness accounts and has had tremendous success.
In the Senate, I’ve introduced two bills that promote the concept of workplace wellness and disease prevention: the Workforce Health Improvement Program (WHIP) Act and the Healthy Workforce Act. The WHIP Act is a bipartisan measure I introduced with Senator Tom Harkin (D-Iowa) that would provide tax incentives for off-site wellness benefits offered by small businesses, many of which cannot afford to provide an on-site fitness facility for their employees. In the same vein, I introduced the Healthy Workforce Act of 2009, which would provide a tax credit to companies that offer effective and comprehensive wellness programs for their employees. By promoting physical activity at the workplace, we can make great strides in reversing the trend of preventable diseases.
Q: Do you think the practice of defensive medicine has contributed to rising health care costs over the last few decades?
A: According to the Journal of the American Medical Association, 93 percent of doctors admit to practicing defensive medicine, ordering excessive tests and procedures, not because their patients need it but because they fear lawsuit abuse. Defensive medicine increases U.S. health care costs by up to 9 percent a year and a study by Price Waterhouse Coopers put the annual cost of defensive medicine at $239 billion a year. Perhaps the greatest cost of excessive litigation is when doctors close their practices or refuse to perform high-risk procedures.
These costs were a growing problem in Texas until our state adopted medical liability reforms in 2003. Texas’ common-sense reforms have resulted in health care savings, which have directly benefited patients and increased access to care. Overall, more than 14,000 doctors have returned or set up new practices in Texas since 2003.
Q: Where do you see health care in the next 10 years? 50 years?
A: There is broad agreement that health care costs are unsustainable for both American families and taxpayers. Unfortunately, the Washington-centric health care proposals passed by both the House and Senate will only worsen those cost problems by adding new layers of bureaucracy and more spending to an already inefficient system. Without realistic solutions, in 50 years — or even just 10 — the results will be catastrophic. The only way we’re going to keep costs in check is to subject the health care system to the powerful forces of competition, transparency and individual choice. We need to change incentives so that providers compete based on quality and price and so that patients stay healthier.
As we go to press, the House and Senate bills are still being worked through special conference and the Obama administration is trying to find a compromise. Meanwhile partisan vitriol has intensified about what’s right and wrong with an admittedly imperfect bill.
Americans are confused, dismayed, anxious and equally excited about health care reform, yet it’s safe to say most don’t fully understand it. While the promise of universal care and lower medical costs is something everyone can agree on, the details of the final bill are still hazy. In essence, we don’t quite know what to make of what’s transpired in Congress thus far...or what’s to come. Among thousands of pages of legislation and heated political exchanges, determining what’s promising from what’s poisonous seems harder than ever.
For many frustrated opponents, the current legislation represents all that’s wrong with government — entitlements, hidden taxes and wasteful spending; a veritable socialization of the health care system. To them, a “do-over” is the only option left, particularly if privatization and consumer choice are to be salvaged for the American people.
For supporters, health care reform is not just long overdue, it can’t come soon enough. The unique opportunity to provide coverage to tens of millions is not only an unprecedented and historic moral victory, but potentially the country’s last, best hope to bend the cost curve and prevent a bankruptcy of future generations.
Regardless of where you find yourself in this controversial debate, our goal with this issue was to interview someone who really understands health care reform, deals with it on a daily basis and has analyzed it from every conceivable angle.
A political pragmatist and an active participant in national health care legislation over the last year, U.S. Senator John Cornyn is someone who not only gets what’s at stake, but he has a vested interest in getting it right. Considering that Texas has the worst rate of uninsured (24 percent versus a 16 percent national average), yet one of the fastest growing populations in the country, the need for health care reform in our state can not be understated.
This month, Senator Cornyn was gracious enough to sit down and share his thoughts about national health care reform, the power of preventive medicine as well as the role regular health and fitness plays in his own life. Additionally, we give you a peek at what’s happened over the past year with regard to this landmark legislation and just how much our health care system has evolved over the last century.
----- Q&A -----
HEALTH CARE REFORM
Q: Why did the Senate push to have their version of the health reform bill passed by Christmas? What are the consequences of this, both good and bad?
A: The rush came from an arbitrary deadline imposed by the Administration and Congressional leaders. I believe this was a mistake. The House and Senate have both passed thousands of pages of complex legal language, which will increase premiums for American families and spending in Washington. Rather than debate the merits of these bills, they were passed with multi-billion dollar sweetheart deals and political pay-offs for special interest groups. All of these were crafted behind closed doors, rather than the promised transparency of “having negotiations broadcast on C-SPAN.” I believe we need to start over and give the American people an open and straightforward process that solves the real problems in our health care system.
Q: Will Austinites currently with health insurance see a drop in their premiums as a result of this legislation?
A: The non-partisan Congressional Budget Office (CBO) found that under the Senate bill, families who get their health care through small businesses or larger employers will continue to face premium increases of five to six percent per year — double the rate of inflation. For families purchasing insurance on their own, the Senate bill will increase premiums by $2,100 — over the status quo increases.
Premiums would rise in part because the Senate bill would force workers to buy more expensive policies. Many workers, for example, currently choose to buy lower cost policies that cover catastrophic care, but this option would no longer be available under new Washington mandates. The Urban Institute estimates that these mandates could force individuals to pay more than $1,000 a year in additional premiums. The Joint Committee on Taxation has stated that the new fees on private industry — of nearly $150 billion — would be passed along directly to patients in the form of higher premiums. Finally, according to one study, “cost shifting” from government programs means higher premiums of $1,800 a year for the average family.
Not only will Texans’ health care premiums go up, they may also see their taxes increase to fund new programs from Washington. The Texas Health and Human Services Commission released an analysis indicating that the Senate bill will cost Texans an additional $21.6 billion over 10 years in new state-level spending.
Q: Why is the Texas uninsured rate so much higher than the national average?
A: The number of uninsured in Texas is unacceptably high and many families in Texas are going without essential health care services such as preventive screenings and immunizations that can save lives and prevent disease.
First, we need to support our state’s Federally Qualified Health Care Centers that provide affordable health care services to Texas’ uninsured and medically underserved. We need to enact meaningful tort reform, which has increased access to care by attracting hundreds of doctors to Texas’ rural and border communities since it was implemented in 2003. We need to enact reforms that help small businesses provide affordable coverage to their employees, including state-based reforms such as the Healthy Texas initiative. We need to focus on prevention and wellness for all generations of Texans, encouraging individuals to exercise, eat well and lead healthier lifestyles. And we must increase enrollment of low-income children in the State Children’s Health Insurance Program, or SCHIP, which currently has the ability to cover the health benefits of an additional 800,000 children in Texas that have yet to enroll in the program.
There are many areas where Democrats and Republicans can work together to make health care more affordable and more accessible, and I will continue working toward those solutions.
Q: By covering more Americans, wouldn’t this legislation make health care more affordable for Texas businesses and individuals?
A: The President’s own expert, CMS Chief Actuary Rick Foster, released his analysis of the Senate health care bill and concluded that passing the bill is worse than doing nothing. He reported the Senate bill would actually drive up this country’s unsustainable level of health care spending by $222 billion. Countless independent analyses have found that the Senate bill will drive up premiums for Texas businesses and individuals. We need health reform, but that reform must lower health care costs.
Q: Do you think opponents of this bill, citing exorbitant costs and fiscal irresponsibility, bear any similarity to those who opposed Medicare, a program now considered a relative success across party lines?
A: Medicare passed with significant bipartisan support back in 1965, but this bill is the result of a highly partisan process and ideas from only one side of the aisle. There is broad agreement that this country needs health reform, but that reform should be the result of open and honest debate to solve the real problems Americans are facing.
Q: What have been your most important priorities in stewarding health care reform?
A: Lowering costs through robust competition and mandated transparency; greater access through a more affordable system; tort reform, which we’ve seen lowers costs and increases access in Texas; and a process that embraces common sense solutions to real problems.
Q: What are three things you really like/approve of about the Senate bill that just passed?
A: The bill includes demonstration programs to move to a system that pays for value instead of volume. It also addresses the issue of pre-existing conditions and encourages employers to create programs that will incentivize healthier lifestyles for their employees.
Q: What are three things you’re most disappointed with in this bill?
A: If this bill is enacted, spending in Washington will continue to increase; premiums for Americans will rise, but even more quickly; and taxes will increase by half a trillion dollars amidst a struggling economy.
Q: In your opinion, what are the biggest misconceptions about health reform today?
A: I think the biggest misconception is that Republicans don’t want reform at all. My colleagues and I firmly believe that our system needs reform to lower costs, but we don’t need to create unsustainable new entitlements and give more power to Washington to do that.
Q: What are the most pressing health care concerns facing Texans today?
A: Like most Texans, I believe that our health care system needs reform. Millions of families have seen the cost of their private insurance skyrocket. Many are worried about losing coverage altogether. Seniors are concerned about the future of Medicare. Texans have told me they want to keep the coverage they have and don’t want Washington to make things even worse.
Q: Are there certain countries you look to as a model for health care legislation? If so, what piece(s) of their system would work for us?
A: Switzerland has a market-based health care system, which has achieved near universal coverage but also kept costs in check. They’ve figured out how to force insurance companies to compete based on cost and quality while still covering everyone.
PERSONAL
Q: What is the single most important thing you do to stay healthy?
A: It would have to be regular exercise, hopefully at least four or five times a week. This can be a challenge when I’m on the road, but thankfully most places where I stay have exercise facilities, or I can just pop outside for a jog. I work hard to build exercise time into my schedule. My experience is that if I don’t make it part of my routine, it’s much harder to do, and it’s always easy to find excuses not to exercise!
Q: How pivotal a role has fitness played in your life?
A: Well, I’m much more productive when I exercise and pay attention to what I eat. For me, exercising is a way to relieve stress, clear my mind and stay healthy — all of which help me to stay focused and energized.
Q: What does your regular diet consist of?
A: I try to follow a healthy diet low in carbs with plenty of fruits, nuts, vegetables and lean proteins.
Q: With the demands of public life and your busy schedule, how do you manage stress?
A: When I’m in Washington, I usually arrive in the Senate gym for my workout at 7 a.m. It’s actually amazing how much “work” I can get done in an informal setting, chatting with colleagues on both sides of the aisle. When I’m in Austin, it’s off to Town Lake for a jog, or on my elliptical machine, then some strength-training exercises. When I begin my day with a workout, I have a more positive attitude and the rest of my schedule seems easier to tackle.
Q: What is your favorite place to exercise in Austin?
A: Town Lake is definitely my favorite exercise venue.
Q: Favorite place for a healthy meal?
A: While Austin has a great array of restaurant choices, I’ve always found that what I eat is more important than where I eat, as long as there are good menu options.
MEDICINE
Q: In your opinion, how important is prevention in the modern medical landscape?
A: Too often, our health care system focuses more on “sick care” than it does on “health care,” and I believe preventive medicine and healthy lifestyles are critical to lowering health care costs while keeping Americans healthier and happier. I’ve seen the success of focusing on prevention in Texas, and I’ve introduced legislation in Congress to promote prevention and wellness.
Texas is home to many excellent examples of pioneering preventive health care approaches. This summer I hosted a multi-city health care outreach tour, which included a visit with employees at Whole Foods Global Headquarters here in Austin. I had the opportunity to learn more about how Whole Foods has innovated consumer-driven health care for its employees. Their plan incorporates personal wellness accounts and has had tremendous success.
In the Senate, I’ve introduced two bills that promote the concept of workplace wellness and disease prevention: the Workforce Health Improvement Program (WHIP) Act and the Healthy Workforce Act. The WHIP Act is a bipartisan measure I introduced with Senator Tom Harkin (D-Iowa) that would provide tax incentives for off-site wellness benefits offered by small businesses, many of which cannot afford to provide an on-site fitness facility for their employees. In the same vein, I introduced the Healthy Workforce Act of 2009, which would provide a tax credit to companies that offer effective and comprehensive wellness programs for their employees. By promoting physical activity at the workplace, we can make great strides in reversing the trend of preventable diseases.
Q: Do you think the practice of defensive medicine has contributed to rising health care costs over the last few decades?
A: According to the Journal of the American Medical Association, 93 percent of doctors admit to practicing defensive medicine, ordering excessive tests and procedures, not because their patients need it but because they fear lawsuit abuse. Defensive medicine increases U.S. health care costs by up to 9 percent a year and a study by Price Waterhouse Coopers put the annual cost of defensive medicine at $239 billion a year. Perhaps the greatest cost of excessive litigation is when doctors close their practices or refuse to perform high-risk procedures.
These costs were a growing problem in Texas until our state adopted medical liability reforms in 2003. Texas’ common-sense reforms have resulted in health care savings, which have directly benefited patients and increased access to care. Overall, more than 14,000 doctors have returned or set up new practices in Texas since 2003.
Q: Where do you see health care in the next 10 years? 50 years?
A: There is broad agreement that health care costs are unsustainable for both American families and taxpayers. Unfortunately, the Washington-centric health care proposals passed by both the House and Senate will only worsen those cost problems by adding new layers of bureaucracy and more spending to an already inefficient system. Without realistic solutions, in 50 years — or even just 10 — the results will be catastrophic. The only way we’re going to keep costs in check is to subject the health care system to the powerful forces of competition, transparency and individual choice. We need to change incentives so that providers compete based on quality and price and so that patients stay healthier.
Three Alternative Ways to Alleviate Austin Allergies, June 2009 Issue
Obesity and Sleep: What's the Connection?, August 2009 Issue
Get Energized!, July 2009 Issue
