This is the Sep. 3rd copy of MO State Rep. Nance’s enewsletter “Capitol Report.” In it he further discusses health care reform. This is a continuation of the topic from his last “Capitol Report.”


September 3, 2009

“A nation that is afraid to let its people judge the truth and falsehood in an open market is a nation that is afraid of its people.”

John Kennedy

I did receive feedback regarding my report last week. I would like to follow-up regarding the current healthcare debate.

I am for healthcare reform, but not what is being proposed. My comment about fearing that healthcare reform… in last week’s capitol report may have been worded poorly.  Missouri spends more on social services including healthcare as a percentage of our budget than all but one state. Any federal reform of healthcare will dramatically impact state budgets through mandatory spending for Medicaid by the state. So, I apologize for the wording. It was a concern that I will have to deal with in the upcoming budget.

As far as the Republican/Democrat comments, I believe there needs to be more “working together” and less of you must believe this way if you are a Democrat or you must believe that way if you are a Republican.  The Republicans did have a plan and were told outright that they would not have a seat at the table.

As far as what I believe, I don’t believe the federal government can manage its way out of a wet paper bag. Don’t get me wrong, there are many dedicated and talented government employees but the bureaucracy itself leads to inefficiencies.  I also believe that the biggest problem with healthcare is out of control cost and lack of access to healthcare.  Costs are being driven up more for numerous reasons but government reimbursement and regulatory requirements are the biggest reasons our costs are so high.

In regard to access, it doesn’t do any good to have Medicaid or any other government healthcare if you can’t get a doctor or specialist to accept it.  Medicaid pays very little and doctors lose money on caring for patients with this type of “insurance”.  Children especially have a long wait for care for primary care, dental and vision services.

As far as profits are concerned, profits are necessary to be able to purchase new equipment, offer new technology, and provide funding for new drugs and treatments (research and development).  As far as what is reasonable, I believe the pharmaceutical companies and insurance companies need more oversight.  Doctors are making less than they did 10 years ago and we have a severe shortage of healthcare workers.  Paying physicians less will only make the problem worse.  Not all practices are created equal. Primary care doctors, specialist, big physician groups, and small community practitioners have different situations. (“Do hospitals, doctors, and other healthcare providers collect money to be able to provide services or do they provide services to be able to collect money?” This is one of those questions that says is healthcare a business or is it a social service? The answer is probably both. If you don’t make money, you can’t buy equipment. If you can’t buy equipment, you can’t provide the service.)

One of the concerns that I have had is that about one fourth of the people that are uninsured qualify but are not signed up.  I introduced a bill to make it easier to get children signed up by requiring the state to work with the schools at the time of enrollment to identify and sign children up for SCHIPS.  The bill was amended to include presumptive eligibility if the child qualifies for free lunches.  Unfortunately, it did not pass. I also supported offering coverage to people with pre-existing conditions.  They need access also along with coverage for children with autism, and improved mental health coverage. The needs are great.

There is some help available for the unemployed. The economic stimulus package includes valuable assistance for those who have recently lost their jobs: some help paying the premiums to continue their health insurance coverage under COBRA. The federal government will pay for almost two-thirds of the full premium amount for up to nine months for certain former employees and their dependents. The new provisions went into effect on March 1, 2009. The real solution here is we need to get the economy going again so that people can have employer sponsored healthcare or the ability to purchase insurance.

We must be careful proceeding with healthcare reform in our current economic crisis. Expanding government control, increasing our deficit, and putting more burdens on the taxpayers should not be a part of any plan.

In your service

Bob Nance


Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s