Jeb Bush on Health Care
Republican FL Governor; V.P. prospect
Bush added, "If the objective is, don't worry about the budget, we'll just finance it the same way we're financing our deficits right now, build a bigger debt, you could see this thing surviving," he said. "But it will have failed what the promises were. It will have failed the American people. And I don't think it will bend the cost curve."
Bush has emerged over the years as a strong proponent of school choice, immigration reform and what he calls "consumer-directed health care." He noted that he underwent knee surgery a month ago and forced himself into the conversation on billing. "The whole experience is opaque," he said. "It's like smoke comes up, you don't know what's really happening, the third party pays."
BUSH: Tactically it was a mistake to focus on something that couldn't be achieved. I would argue that allowing ObamaCare to be implemented, two things would happen. One, it would be so dysfunctional if it was implemented faithfully. Or it couldn't be implemented because the government is not capable of doing it. It looks like that, the latter rather than the former, may be happening.
Ted Cruz said, "Let's not agree to a funding resolution unless ObamaCare is defunded." Your message be to Ted Cruz?
BUSH: I think the best way to repeal ObamaCare is to have an alternative. We could do this in a much lower cost with improved quality based on free market principles. And show how ObamaCare, flawed to its core, doesn't work. It might actually be a politically better approach to see the massive dysfunction.
The second major change was to provide each person with a risk-adjusted allotment of funds.
To entice companies to insure some of Florida's sickest and poorest citizens, the state proposed to cap Medicaid benefits, and set a ceiling on spending for each recipient. Managed-care companies and other health-care networks would design alternative health plans that Medicaid patients would use. Beyond that, different managed-care networks could attract patients by offering additional services. However, patients would have a choice only among managed-care plans and no longer have access to traditional fee-for-service health care.
One embarrassing consequence of his lack of attention to social services agencies emerged in the days just before Bush left office when his secretary of the Department of Children and Families was fined and threatened with jail time for failure to provide enough beds to treat county jail inmates with severe mental illness. Records from the department showed that it had called repeatedly for funds for adult health and that Bush had slashed every request--in 1 year by 93% (Hunt, 2006; Rushing, 2006). To avoid court sanctions, the governor was forced to ask the Legislative Budget Commissions, an organization that authorizes appropriations when the legislature itself is not in session, for an additional $16.6 million for hundreds of new beds for these individuals.
The governor proposed his plan as a way in which the state could more accurately predict and control its costs. Critics pointed out that no benefits were guaranteed , that access to care for all low-income families was questionable, and that there were no safeguards to make sure that private plans kept their promises. In particular, the AARP questioned whether or not service packages offered by the participants would be meaningful and cover the needs of persons with chronic conditions and special needs that the private market chose not to cover. It also wondered whether the premiums to be offered would be sufficient to purchase an adequate service package.
A: Have you ever gone to HHS? Have you gone to CMS, the Centers for Medicare/Medicaid? It's scary. That's going to be the marketplace for health care if Democrats have their way. McCain had a fantastic health-care proposal that he had a hard time explaining, that said that basically you should empower people, individuals, to make choices, & they should be rewarded when they make choices that improve health-care outcomes. Under Obama, we're going to create a system that's not focused on quality; it's focused on access to care. You end up insuring fewer people the more government expands its insurance. People drop out of the private market. For every person the government takes on the rolls, there's an equal number of people leaving the private sector. We're like gerbils running in place. We're not expanding health-care access per se. There are all sorts of technologies that exist that allow us to improve health-care outcomes if we organize our system differently.
Jeb was saying this, but it was obvious that he wasn't enjoying it, probably because everyone knew it wasn't true. The "compromise" was hardly that--more like a near-total capitulation on Jeb's part. Behind him, state senators stood in the familiar semicircle of solidarity, but they were scarcely able to contain their glee.
Then, after hands were shaken and the senators had withdrawn to their private office, there were laughs and high fives all around. "This is probably the 1st time he's ever been spanked," crowed one. Said another: "I don't want to gloat. Well, yes I do."
In addition to Medicaid, KidCare includes other valuable programs--specifically Medikids, Healthy Kids, and CMS. These non-Medicaid programs provide the critical safety net many parents need to ensure their children are protected. They are not offered as cheaper alternatives for parents who currently buy coverage through their employers. Florida received additional federal funds in January, a bonus for fully using the federal dollars to serve Florida's children in need. The new money will allow us to serve even more children.
My veto of Senate Bill 330 does not diminish our stateís commitment to addressing the important public health issue of fighting and preventing cancer. In conclusion, the appropriation does not fulfill some of the most important criteria by which other appropriations are being evaluated. For these reasons I am withholding my approval of Senate Bill 330, and do hereby veto the same.
The Governors support efforts designed to enable small employers to join together to participate more effectively in the health insurance market. In fact, Governors have taken the lead in facilitating the development of such partnerships and alliances. However, these partnerships must be carefully structured and regulated by state agencies in order to protect consumers and small businesses from fraud and abuse and underinsurance. NGA opposes attempts to expand federal authority under ERISA. The Governors have identified the prevention of such federal legislation in the 107th Congress as a top legislative priority.
States have the primary responsibility for health insurance regulation. Across the nation, Governors are working to protect consumers and patients and to properly regulate the complicated health insurance industry.
As you know, preserving and protecting the state tobacco settlement funds is the nationís Governorsí highest priority. We strongly urge you to reach final agreement and pass the conference report on the emergency supplemental appropriations bill soon, and to retain the Senate provision that protects our settlement funds from federal seizure.
Many of our state legislatures are currently in session, and some have already completed work on their budgets. Therefore, it is critical that conferees reach agreement quickly on this issue. Governors are unified in their commitment to ensuring that the funds remain in the states and that there be no restrictions on statesí ability to tailor spending to meet the needs of their citizens.
We offer our strongest support for conferees to recede to the Senate version of the bill containing the Hutchison/Graham bipartisan tobacco recoupment protection legislation.
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Gubernatorial Debates 2014:
AL: Bentley(R) vs.Griffith(D)
AR: Ross(D) vs.Hutchinson(R) vs.Griffin(R,Lt.Gov.)
AZ: Ducey(R) vs.DuVal(D) vs.Mealer(AE) vs.Gilbert(L) vs.
CA: Brown(D) vs.Kashkari(R)
CO: Hickenlooper(D) vs.Beauprez(R) vs.
CT: Malloy(D) vs.Foley(R) vs.Walker(R,Lt.Gov.)
FL: Scott(R) vs.Crist(D) vs.Snitker(L,Lt.Gov.)
GA: Deal(R) vs.Carter(D) vs.Hunt(L)
HI: Ige(D) vs.Aiona(R) vs.
IA: Branstad(R) vs.Hatch(D) vs.
MA: Coakley(D) vs.Baker(R) &Polito(R,Lt.Gov.) vs.
ME: LePage(R) vs.Michaud(D) vs.Cutler(I)
MI: Snyder(R) vs.Schauer(D)
NM: Martinez(R) vs.King(D)
NY: Cuomo(D) &Hochul(D,Lt.Gov.) vs.Astorino(R) vs.Hawkins(G) vs.
OK: Fallin(R) vs.Dorman(D)
PA: Corbett(R) vs.Wolf(D) vs.
Up for re-election 2014:
AK-R: Sean Parnell
AL-R: Robert Bentley
CA-D: Jerry Brown
CO-D: John Hickenlooper
CT-D: Dan Malloy
FL-R: Rick Scott
GA-R: Nathan Deal
HI-D: Neil Abercrombie
IA-R: Terry Branstad
ID-R: Butch Otter
IL-D: Pat Quinn
KS-R: Sam Brownback
ME-R: Paul LePage
MI-R: Rick Snyder
MN-D: Mark Dayton
NH-D: Maggie Hassan
NM-R: Susana Martinez
NV-R: Brian Sandoval
NY-D: Andrew Cuomo
OH-R: John Kasich
OK-R: Mary Fallin
OR-D: John Kitzhaber
PA-R: Tom Corbett
SC-R: Nikki Haley
SD-R: Dennis Daugaard
TN-R: Bill Haslam
VT-D: Peter Shumlin
WI-R: Scott Walker
WY-R: Matt Mead
Term-Limited or Retiring 2014:
AR-D: Mike Beebe
AZ-R: Jan Brewer
MA-D: Deval Patrick
MD-D: Martin O'Malley
RI-I: Linc Chafee
TX-R: Rick Perry
NJ-R: Chris Christie (won)
NJ-D: Barbara Buono (lost)
VA-R: Bob McDonnell(Retiring)
VA-R: Ken Cuccinelli (lost)
VA-D: Terry McAuliffe (won)