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Republican Whip Jon Kyl on Obamacare prospects in the Senate

Wednesday, December 2, 2009
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HH: I begin with the health care debate, because it will impact every single American, and very few people are covering it with the detail it deserves. I am joined by Republican Whip in the United States Senate, Jon Kyl from the great state of Arizona. Senator Kyl, always a pleasure, I hope you had a great Thanksgiving.

JK: Well, we did, Hugh, thank you very much, and all the best to you and your listeners.

HH: Thank you. Senator Kyl, the Washington Post today had a story that said Democrats have got some optimism about getting this thing out of the Senate before Christmas. What’s your reaction to that?

JK: Well, the Washington Post is one of the cheerleaders for the Democrat majority here. And one of the things they’re trying to do is create expectations and momentum, inevitability as it were. They’re wrong. The bill is not going to be done by Christmas. In fact, it won’t be done by the end of the year. Hopefully, it won’t ever be done. But in no event will it be done by Christmas.

HH: Now a lot of the conversation that I’ve had with some of the economists who’ve sent a letter to President Obama earlier, last month in November, and with proponents of the bill, goes to whether or not this bill actually cuts Medicare, and that whether or not senior citizens will feel a difference if it passes. How do you react to that, Senator Kyl?

JK: It absolutely will cut Medicare in several different ways. First of all, they get just about $500 billion dollars over ten years from Medicare. Now you don’t get that money by not cutting Medicare. What exactly do we mean by Medicare cuts? There are several kinds. $120 billion dollars of it is taken from the Medicare Advantage program. That’s the private HMO program that many seniors use as the alternative to regular Medicare. According to the Congressional Budget Office, the reduction in value from their premium will be about 65%, not premium, the reduction in actuarial value of what they receive for their premium, will be about a 64-65% reduction from $135 dollars to $40 dollars, or thereabouts. So there is a definite loss of benefits for seniors in Medicare Advantage. In addition to that, there are a variety of cuts to various kinds of people who take care of seniors – doctors, hospice care, home health care, hospitals, and so on. Each of those reductions will in turn result in less care to seniors – delays, denial of care, doctors not taking Medicare patients anymore, and so on, all of which will not only affect their access, but the quality of care that they receive.

HH: Now Senator Kyl, your colleague, Senator Dodd, went to the floor today, went kind of ballistic. I’d like to play a minute of him for you and get your comment. Here’s Senator Dodd earlier today on the Senate floor, cut number four.

CD: Fully 78% of beneficiaries are forced to pay higher premiums for non-Medicare extra benefits they will never see. Now again, I understand that some people would like to have these additional benefits. I understand that. They’re not guaranteed Medicare benefits. These are benefits that are provided for under Medicare Advantage. But 78% of our elderly are paying higher premiums so that a smaller percentage of people can get those benefits. Why should 78% of the elderly in this country pay a higher premium for a smaller percentage of people under private health care plans? What Senator Baucus and the Finance Committee tried to do is to reduce those costs. Those are not guaranteed Medicare benefits. There’s no guaranteed Medicare benefit that is cut under this bill. And I defy any member of this body to find one guaranteed benefit that is reduced under this plan

HH: Senator Kyl, it sounds to me like Senator Dodd wants to change the subject from what’s going to happen to people to a different conversation.

JK: Yeah, he’s a little bit excited there. What he is referring to is the fact that we have not gone into the fundamental Medicare statute and cut out benefits to people, to say to seniors, for example, we will no longer treat you for pneumonia. No, we haven’t done that, of course. But there are two things that we have done, or this bill would do. I’m not doing it. I swear. First of all, he talked about Medicare Advantage. That is being cut by $120 billion dollars. You can’t cut it without reducing benefits. It doest reduce benefits. Now what he’s saying is, it’s reducing the benefits in the Medicare Advantage program. True. How does that work? When Medicare Advantage gets the little subsidy, that the insurance company gets the subsidy it does, in order to provide care into areas that ordinarily wouldn’t have gotten it, that was the original purpose of this, they were required by law to put their savings into extra benefits. So we made them do it. This isn’t something that the insurance companies just decided to do. We said if you’re going…because you’re getting a little bit of a subsidy to go into these areas that otherwise wouldn’t be treated, we will give you a subsidy to do that, but you’ve got to translate that subsidy into extra benefits. So they have vision care, dental care, audio care, physical fitness, whole lots of things seniors rely upon. You know, wealthy seniors can get a Medicare supplement policy for things. These folks don’t do that. They in effect have HMO care. But it is very good care for them, and they want it, they like it. And those benefits will be cut. Now it’s semantics. We are absolutely correct that Medicare benefits would be cut for these folks. He is correct when he says well, we haven’t gone into the fundamental Medicare statute and excised some of the original benefits that are provided to all Medicare patients. We’re not saying that. So our statement is correct. Secondly, you cannot cut the reimbursements for all the doctors and hospitals and hospice care and home health care and all the rest of it, you can’t take $400 billion dollars out of those people’s hides, and still expect them to provide the same level of care to seniors. It won’t happen.

HH: Now today, the California Medical Association came out against the Senate version of Obamacare, Senator Kyl. They represent 35,000 physicians in California. They joined the Florida, Georgia and Texas medical associations, and their arguments are very, very simple. Right now, people aren’t getting treated under MediCal here, because the reimbursement rates are simply too low. If you lower them more, less people are going to get treated in California.

JK: Exactly. I mean, everybody knows that the Medicaid program, whether it’s MediCal or Access, which it’s called in Arizona, or the other Medicaid programs, because the reimbursement is so low, two things happen. First of all, those of us with private insurance are subsidizing those government programs by paying higher premiums so that the doctors and hospitals can stay in business. If they only get 60 or 70 cents on the dollar under the Medicaid program, they can’t stay in business. So the insurance companies make it up by charging us more. That’s one of the reasons that our premiums go up. Secondly, I lost my train of thought on the second point here.

HH: Yeah, they’re not getting doctors to take care of them. They’re refusing service.

JK: Precisely. And when you’re only getting 60 or 70 cents on the dollar, that’s the last person you’re going to treat in your waiting room, and that’s what doctors tell me. These patients, unfortunately, are the least likely to show up for subsequent appointments to do the things the doctors are asking them to do, and they get very little reimbursement for taking care of them. And the sad and troubling truth is that to some extent, care is rationed for those people. Now that’s not good. But you sure don’t fix it by reducing the reimbursement even more. And you don’t help Medicare by reducing the reimbursement under Medicare so that it begins to resemble Medicaid.

HH: Senator Kyl, I have not had a single doctor call up and cheer this in the weeks I have been talking about it. No senior citizens like this. Why then are the AMA and the AARP behind this devastation of American medicine?

JK: Well, two different reasons, and it’s kind of complex. And I always hate to go into people’s motives, but AARP, first of all, is less a lobby group for senior citizens than it is a left wing political organization that pushes a particular agenda. Secondly, it has certain financial insurance products, which many people believe would benefit as a result of legislation like this. But you can’t do the kind of damage to seniors that this bill would do, and represent them, and say that you’re for the bill. And with regard to…

HH: The American Medical Association…

JK: …the AMA, the American Medical Association, I hate to say it, because I am a very big supporter of physicians, I don’t think they get recognized enough or that their pay is adequate. But the organization that represents them back here in Washington, I think, has made some very big, political and tactical mistakes. I’ve been in close contact with their leadership. They’ve explained to me why they think they’ve had to make these decisions. I’ve told them I think they’re very, very wrong. And one thing that’s resulted is that you had a lot of people leaving the AMA. The numbers now, I think it’s under 10% of the numbers of AMA, excuse me, of the numbers of doctors in this country are active doctors in the AMA. I mean, I think they’re up in the teens in terms of representing the percentage of doctors, but a lot of those are faculty members and students. So it’s losing a lot of membership because of the positions it’s taken.

HH: So Senator Kyl, with a minute left, are you an optimist about stopping this at this time in the Senate?

JK: I am, because I know what can happen when the American people rise up against legislation, even though within the Beltway, it’s supposed to be a sure thing. And if the people in the states where there are more moderate Democrats will speak very firmly to their Senators about their views on this, then hopefully those Senators will listen to them. And that means that this particular version of health care reform will not move forward.

HH: That would be Arkansas, that would be Indiana, that would be Nevada, that would be a number of places. Senator Kyl, always a pleasure.

JK: Thanks, Hugh.

HH: Thank you for joining us and explaining where we are.

End of interview.

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