Dennis Kucinich on Health Care Democratic Representative (OH-10)

Sub-sections under Health Care:
• Voting Record
• Other issues under Health Care

Insurance companies make money by NOT providing health care

Let the US be like every other industrialized democracy

A: Well, first of all, I’m for a national health-care plan. The whole debate about universal health care has been a fraud. All these other candidates are talking about keeping the for-profit insurance companies in charge of health care in America. That’s not what I’m talking about, because these private insurers make money NOT providing health care. And so, I’m saying no more role for them. Let the United States be like every other industrialized democracy in having a health-care plan, a national plan where we take care of our people. And we’re already paying for it. We spend $2.2 trillion on health spending, but $600 billion of it goes for the activities of the for-profit system each year. I’m talking about taking that money, putting it to care for people.

Q: And it would cost how much?

A: It would cost the same amount we’re spending now, except that all the money goes into the system.

Fake debate if we talk about maintaining present system

A: Let me explain something to the people who are here and who are watching. This debate about health care is a fake debate in this campaign, because all of these candidates are not telling the American people that what they’re talking about is maintaining the present system, where you have insurance companies controlling the system, and you are still stuck with premiums, co-pays & deductibles Everyone knows that insurance companies make money not providing health care, and everyone knows that as long as we’re stuck with this system, where insurance companies make $600 billion a year out of spending that ought to go directly into health care, we’re not going to get the care we need. It’s either health care as a right or health care as a privilege, and I stand for the people.

FactCheck:Insurance industry profit is under $97B, not $600B

In fact, health insurance companies don’t make nearly that much. According to the most recent historical data from the Department of Health and Human Services’ National Health Expenditures Accounts, the total of all premiums paid for private health insurance was $694.4 billion in 2005. But of that total, $596.7 billion was paid out in benefits. The remainder went to administrative and “net” costs, such as claims processing, disease and care management, sales, marketing, and taxes. These statistics don’t break out a figure for profits, but it would be some fraction of the $97.7 billion that doesn’t go to benefits, and a far cry from $600 billion.

Challenge system of premiums, co-pays and deductibles

Medicare For All: all long-term care totally covered

Other candidates are talking about maintaining this for-profit health care system, and anyone who has ever had a loved one who has needed medical care and couldn’t get it because they didn’t have the money understands the urgency of having someone not just in the race but in the White House who’s ready to rally the American people in the cause of not-for-profit health care, Medicare for all. And I’m doing that.

Healthcare access is a basic right in a democratic society

Half of all bankruptcies come from medical bills

Universal not-for-profit health care

A: The problem with our health care system--premiums, co-pays and deductibles which for-profit insurance companies run through the roof. I’m the cosponsor of the Conyers-Kucinich bill, H.R. 676, provides for universal, not-for-profit health care, takes that $2.2 trillion and puts it all into health care for people. We are already paying for a universal system of health care. We’re just not getting it.

Break the hold of the insurance companies

A: The insurance companies, when they look at a single-payer not-for-profit system, they’ll say, my God, rationing. What do we have now? 46 million Americans don’t even have coverage. Talk about rationing. They’re not even in the line! Another 50 million people are underinsured and the rest are paying these high premiums, co-pays and deductibles. We’ve got to break the hold the insurance companies have. And their public relations operations would say, well, rationing. The fact of the matter is this plan I’m talking about covers everyone. How do you reduce costs? Let’s look at the costs that are involved in the system rights now. Corporate profits, stock options, executive salaries, advertising, marketing, the cost of paperwork. All this takes about 31% out of the health care dollar. Now, what does all that have to do with health care? Zero, zip, nada.

Competition between insurers only drives up profits

Candidates up here are advocating that government provide subsidies to the insurance industry. What’s that about? I mean, didn’t we have enough with subsidizing the pharmaceutical companies with that phony Medicare D program that President Bush had? How are we any different as Democrats? Think about that.

Key to reform: end role for for-profit insurance companies

A: This health care debate is one of the biggest frauds that’s been put on the American people. In 2000 and 2004, I brought forth a proposal, Medicare for All. It’s embodied in the Conyers-Kucinich bill. It provides for covering everyone. The big difference between what I’ve been talking about and all the other candidates are talking about is that my plan doesn’t provide for a role for for-profit insurance companies. Our party really isn’t legit on the issue of health care, because whenever you talk to these candidates, there’s always a role for the for-profit insurance companies. Do you know, almost 31% of the spending that goes for health care goes for the for-profit system -- corporate profits, stock options, executive salaries, advertising, marketing, the cost of paperwork.

Streamlined national health insurance as Enhanced Medicare

Single-payer isn’t in platform because it offends donors

Not socialism, but a change from predatory capitalism

KUCINICH: My proposal is to have a universal single-payer, not-for-profit health care system, because that would lift tens of millions of Americans out of poverty.

Q: Harry Truman proposed that in 1948.

KUCINICH: Well, and you know what? John Conyers and I introduced the bill in this Congress. And that would provide all coverage for everyone, all medically necessary procedures, plus vision care, dental care, mental health care, and long-term care.

Q: In other words, socialism?

KUCINICH: What we have now is predatory capitalism which makes of the American people a cash crop for the insurance companies and the pharmaceutical companies. And so I’m talking about a change.

Not-for-profit system differs from Hillary’s pro-HMO system

A: No. What Senator Clinton was proposing was really more HMOs, and the competition in the insurance industry caused so many people in the insurance industry to be afraid of it. My proposal shifts the whole system into a not-for-profit system. It eliminates these corporate profits and stock options and executive salaries, the advertising, lobbying, marketing costs.

Tax employers to pay for single-payer plan

A: I will include complete coverage of prescription drugs in a single-payer plan that provides every man, woman, and child with comprehensive health coverage from whatever doctors they choose, and does so through a tax on employers that is lower than what employers who now provide coverage pay on average.

Rally to elect a new Congress to pass new health care deal

A: As a member of Congress I have had excellent relationships with both sides of the aisle. It is important for the President to work with Congress and I will use the relationships I have built through 4 terms to create a working partnership. I am also aware that my legislative agenda, which will include universal health care, will require support in the Congress which may not currently exist. As the nominee of our party, I will call upon the American people to support candidates for Congress who will take control of the health care system in the US away from the insurance companies and the pharmaceutical companies and create a system which truly serves all the American people with guaranteed health care for all. When FDR was the nominee in 1932, he asked the American people to give him a Congress which would help him implement the New Deal. I intend to rally the American people in this election to create a New Deal for a New Century.

I’m not selling insurance-switch to not-for-profit system

A: Many of the other candidates say they want to make sure all Americans have health insurance. I am not selling insurance. I want to create a system which makes it possible for all Americans to have health care. This means we must move from a for-profit health care system which is controlled by insurance companies and pharmaceutical companies, to a not-for-profit system. This is the essence of my proposal for Universal Health care, Medicare for All. A single payer system, it is embodied in legislation, HR 676. This fundamental change in our health care system will provide all Americans with access to quality health care. Whether you are working or not, you will be covered. The scope of coverage will include all medically necessary procedures, dental health care, mental health care, vision care, long term care and a prescription drug benefit.

Single-payer for alternative medicine, mental health, more

DEAN: In all due respect to all the candidates here, these folks have been in Washington a long time and talked about health insurance for a long time, and we have very little to show for it. In my state, 99% of the kids that are eligible for health insurance who are under 18, 96% have it. Everybody under 150% of poverty, all our working poor people, have health insurance. And a lot of seniors have prescription benefits. This does need to be a system that’s built on what we have. We’ve done that in Vermont. I’d like the opportunity to do that for the whole country.

7.7% tax to pay for full coverage

Health is a right, not a privilege

KUCINICH: I’ve introduced a bill which states that health care is a right, not a privilege, and it’s to get the profit out of health care, and here’s a copy of it. It’s H.R. 676. Congress right now has in front of it a plan that would cover all medically necessary health services, all individuals.

Take profit motive out of health care

Insurance companies do not heal people; practitioners do

Seniors forced to choose between medicine and food

Prescription for America: ceiling on drug company profits

Regulate prescription drug prices like utility rates

Medicare for All: universal single-payer national system

Private companies charge 18% admin & Medicare charges 3%

That’s why I say it’s time to take the profit out of health care. We have the money in the system, but right now the private companies are charging about 18% for administration, while the cost of Medicare administration is only 3%.

I think it is urgent that we take profit out of health care. How many homes have this discussion every day in America? “Well, I don’t feel well. Ah, we don’t have the money to go to the doctor.” Or, “Well, we can’t afford that surgery.” We need to stop those kind of discussions in America. We have the money in this country.

Raise taxes for guaranteed, single payer, universal care

KUCINICH: We can phase in [an increase] in the payroll tax to 7.7% on all employers and have that be our mainstay of our national health care plan. We have to get the profit out of health care. And that means get the private insurance companies out of health care. Any plan that fails to do that is not going to deliver the best quality universal health care. I introduced HR676, Medicare for all: guaranteed, single payer, universal health care. It’s time to have health insurance for the American people, not the insurance companies.

Q: The Republicans are going to say there they go again, Democrats are raising taxes again. Is there anyone willing to rule out raising taxes?

LIEBERMAN: I am not willing to raise taxes to pay for health insurance in [that] way. All I am going to do is put the tax rate back to where it was when Bill Clinton was president, because we did a lot better under Bill Clinton than we are under George Bush.

HR 676, Conyers-Kucinich bill, establishes Medicare for all

We’re being told here today to buy into a view of the world which says that, well, you know, but the insurance companies run the system. We’ll work out competition between the insurance companies & maybe we’ll have government subsidize the insurance companies. Where is our call for greatness?

I’m talking about a real deal for the American people, a universal single-payer not-for-profit Medicare for all. It’s already into legislative form. 62 members of Congress have signed on. Over 14,000 physicians have signed on. We can do this. Break the hold of the insurance company on our health care system and lift the American people out of poverty. That’s what my presidency is going to be about.

Voted YES on regulating tobacco as a drug.

Opponent's argument to vote No:Rep. HEATH SHULER (D, NC-11): Putting a dangerous, overworked FDA in charge of tobacco is a threat to public safety. Last year, the FDA commissioner testified that he had serious concerns that this bill could undermine the public health role of the FDA. And the FDA Science Board said the FDA's inability to keep up with scientific advancements means that Americans' lives will be at risk.

Proponent's argument to vote Yes: Rep. HENRY WAXMAN (D, CA-30): The bill before us, the Waxman-Platts bill, has been carefully crafted over more than a decade, in close consultation with the public health community. It's been endorsed by over 1,000 different public health, scientific, medical, faith, and community organizations.

Sen. HARRY REID (D, NV): Yesterday, 3,500 children who had never smoked before tried their first cigarette. For some, it will also be their last cigarette but certainly not all. If you think 3,500 is a scary number, how about 3.5 million. That is a pretty scary number. That is how many American high school kids smoke--3.5 million. Nearly all of them aren't old enough to buy cigarettes. It means we have as many boys and girls smoking as are participating in athletics in high schools. We have as many as are playing football, basketball, track and field, and baseball combined.

Voted YES on expanding the Children's Health Insurance Program.

• Reauthorizes State Children's Health Insurance Program (SCHIP) through FY2013 at increased levels.
• Gives states the option to cover targeted low-income pregnant women
• Phases out coverage for nonpregnant childless adults.

Rep. FRANK PALLONE (D, NJ-6): In the last Congress, we passed legislation that enjoyed bipartisan support as well as the support of the American people. Unfortunately, it did not enjoy the support of the President, who vetoed our bill twice, and went on to proclaim that uninsured children can simply go to the emergency room to have their medical needs met. As the Nation moves deeper into a recession and unemployment rates continue to rise, millions of Americans are joining the ranks of the uninsured, many of whom are children. We can't delay. We must enact this legislation now.

Opponent's argument to vote No:Rep. ROY BLUNT (R, MI-7): This bill doesn't require the States to meet any kind of threshold standard that would ensure that States were doing everything they could to find kids who needed insurance before they begin to spend money to find kids who may not have the same need. Under the bill several thousands of American families would be poor enough to qualify for SCHIP and have the government pay for their health care, but they'd be rich enough to still be required to pay the alternative minimum tax. The bill changes welfare participation laws by eliminating the 5-year waiting period for legal immigrants to lawfully reside in the country before they can participate in this program. In the final bill, we assume that 65% of the children receiving the benefit wouldn't get the benefit anymore. It seems to me this bill needs more work, would have benefited from a committee hearing. It doesn't prioritize poor kids to ensure that they get health care first.

Voted YES on overriding veto on expansion of Medicare.

• Extends Medicare to cover additional preventive services.
• Includes body mass index and end-of-life planning among initial preventive physical examinations.
• Eliminates by 2014 [the currently higher] copayment rates for Medicare psychiatric services.

I support the primary objective of this legislation, to forestall reductions in physician payments. Yet taking choices away from seniors to pay physicians is wrong. This bill is objectionable, and I am vetoing it because:
• It would harm beneficiaries by taking private health plan options away from them.
• It would undermine the Medicare prescription drug program.
• It is fiscally irresponsible, and it would imperil the long-term fiscal soundness of Medicare by using short-term budget gimmicks that do not solve the problem.

Proponent's argument to vote Yes: Sen. PATTY MURRAY (D, WA): President Bush vetoed a bill that would make vital improvements to the program that has helped ensure that millions of seniors and the disabled can get the care they need. This bill puts an emphasis on preventive care that will help our seniors stay healthy, and it will help to keep costs down by enabling those patients to get care before they get seriously ill. This bill will improve coverage for low-income seniors who need expert help to afford basic care. It will help make sure our seniors get mental health care.

Voted YES on giving mental health full equity with physical health.

• Paul Wellstone Mental Health and Addiction Equity Act of 2008: Requires group health plans to apply the same treatment limits on mental health or substance-related disorder benefits as they do for medical and surgical benefits (parity requirement).
• Genetic Information Nondiscrimination Act of 2008: Prohibits a group health plan from adjusting premium or contribution amounts for a group on the basis of genetic information.

SUPPORTER'S ARGUMENT FOR VOTING YES:Rep. PALLONE. This is a comprehensive bill which will establish full mental health and addiction care parity. The Mental Health Parity Act of 1996 authorized for 5 years partial parity by mandating that the annual and lifetime dollar limit for mental health treatment under group health plans offering mental health coverage be no less than that for physical illnesses. This bill requires full parity and also protects against discrimination by diagnosis.

OPPONENT'S ARGUMENT FOR VOTING NO:Rep. DEAL of Georgia: I am a supporter of the concept of mental health parity, but this bill before us today is not the correct approach. This path will raise the price of health insurance, and would cause some to lose their health insurance benefits and some employers to terminate mental health benefits altogether.

The bill's focus is also overly broad. Our legislation should focus on serious biologically-based mental disorders like schizophrenia and bipolar disorder, not on jet lag and caffeine addiction, as this bill would include. There are no criteria for judicial review, required notice and comment, or congressional review of future decisions.

I would ask my colleagues to vote "no" today so that we can take up the Senate bill and avoid a possible stalemate in a House-Senate conference on an issue that should be signed into law this Congress.

LEGISLATIVE OUTCOME:Bill passed House, 268-148

Voted YES on Veto override: Extend SCHIP to cover 6M more kids.

CONGRESSIONAL SUMMARY: This Act would enroll all 6 million uninsured children who are eligible, but not enrolled, for coverage under existing programs.

PRESIDENT'S VETO MESSAGE: Our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. My Administration strongly supports reauthorization of SCHIP. [But this bill, even with changes, does not meet the requirements I outlined].

It would still shift SCHIP away from its original purpose by covering adults. It would still include coverage of many individuals with incomes higher than the median income. It would still result in government health care for approximately 2 million children who already have private health care coverage.

SUPPORTER'S ARGUMENT FOR VOTING YES:Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill protects health insurance coverage for some 6 million children who now depend on SCHIP. It provides health coverage for 3.9 million children who are eligible, yet remain uninsured. Together, this is a total of better than 10 million young Americans who, without this legislation, would not have health insurance.

The bill makes changes to accommodate the President's stated concerns.

1. It terminates the coverage of childless adults in 1 year.
2. It prohibits States from covering children in families with incomes above $51,000.
3. It contains adequate enforcement to ensure that only US citizens are covered.
4. It encourages securing health insurance provided through private employer.

Voted YES on adding 2 to 4 million children to SCHIP eligibility.

Proponents support voting YES because:

Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:

1. It terminates the coverage of childless adults.
2. It targets bonus payments only to States that increase enrollments of the poorest uninsured children, and it prohibits States from covering families with incomes above $51,000.
3. It contains adequate enforcement to ensure that only US citizens are covered.

Opponents recommend voting NO because:

Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:

• On illegal immigration: Would the verification system prevent an illegal alien from fraudulently using another person's name to obtain SCHIP benefits? No.
• On adults in SCHIP: Up to 10% of the enrollees in SCHIP will be adults, not children, in the next 5 years, and money for poor children shouldn't go to cover adults.
• On crowd-out: The CBO still estimates there will be some 2 million people who will lose their private health insurance coverage and become enrolled in a government-run program.

Veto message from President Bush:

Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.

Voted YES on requiring negotiated Rx prices for Medicare part D.

Proponents support voting YES because:

This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.

It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.

Opponents support voting NO because:

Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.

Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.

Voted NO on denying non-emergency treatment for lack of Medicare co-pay.

• Allows hospitals to refuse treatment to Medicaid patients when they are unable to pay their co-pay if the hospital deems the situation to be a non-emergency
• Excludes payment to grandparents for foster care

Voted NO on limiting medical malpractice lawsuits to $250,000 damages.

Voted NO on limited prescription drug benefit for Medicare recipients.

Voted YES on allowing reimportation of prescription drugs.

Voted NO on small business associations for buying health insurance.

Voted NO on capping damages & setting time limits in medical lawsuits.

Voted NO on allowing suing HMOs, but under federal rules & limited award.

Voted NO on subsidizing private insurance for Medicare Rx drug coverage.

Voted YES on banning physician-assisted suicide.

Voted NO on establishing tax-exempt Medical Savings Accounts.

MEDS Plan: Cover senior Rx under Medicare.

Summary of the Medicare Extention of Drugs To Seniors Act (Meds)

Coverage:

• First-dollar 80%/20% benefit (may charge beneficiary less for generics)
• Catastrophic coverage begins at $2000 out-of-pocket.
• No beneficiary would have to spend more than $2288 for prescription drugs (including premium)

Prescription Drug Prices:

• (Reimportation) Beginning 2003, all FDA-approved prescription would be allowed for importation at world market prices after being tested for safety. Once fully implemented, Medicare could set fee schedules based on imported drug prices.
• (Allen Bill) To eliminate price discrimination, manufacturers would charge Medicare and its beneficiaries the price equal to the lower of either the lowest price paid for the drug by other Federal Government agencies or the manufacturer’s best price for the drug.
• (Reasonable Prices) Drugs developed with taxpayer funds would be subject to “reasonable price” agreements when patents are transferred to pharmaceutical companies.

Premiums and Low-income Assistance:

The Government would subsidize low-income beneficiaries to the following levels:
• 100% of the premium and cost sharing for beneficiaries below 135% of poverty.
• Partial subsidy on a sliding scale for those between 135% and 150%

Employer Incentive Program:

Rated 100% by APHA, indicating a pro-public health record.

The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.

The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.

Collect data on birth defects and present to the public.

Directs the Centers for Disease Control and Prevention to carry out programs to:
• collect and analyze, and make available data on the causes of birth defects and on the incidence and prevalence of such defects;
• operate regional centers for the conduct of applied epidemiological research on the prevention of such defects;
• provide information and education to the public on the prevention of such defects;
• collect and analyze data by gender and by racial and ethnic group9/6/2004
• collect such data from birth and death certificates, hospital records, and such other sources; and
• (3) encourage States to establish or improve programs for the collection and analysis of epidemiological data on birth defects and to make the data available.

Make health care a right, not a privilege.

The Progressive Caucus is united in its goal of making health care a right, not a privilege. Every person should have access to affordable, comprehensive and high-quality medical care. We must use our health care dollars efficiently and ensure public accountability in all medical decisions. Based on this goal, we support the following principles:
1. All Americans, including the 44 million currently without health insurance, deserve to have the health care they need, regardless of ability to pay.
2. Medicare must remain solvent and available for the millions of seniors and individuals with disabilities who rely on the program. The Progressive Caucus supports expanding the program to cover prescription drugs and other needed products and services for beneficiaries. We support a Medicare buy-in for individuals age 55 and older. We support lowering out-of-pocket costs for seniors who currently pay, on average, 20% of their income for health care.
3. Proposals should be rejected to change traditional Medicare from a defined benefit to a defined contribution or voucher system.
4. Balanced Budget Act cuts that are negatively affecting patient access to hospitals, nursing homes, and home health agencies must be restored.
5. Medicaid must have the resources to continue to provide coverage and care for low-income individuals, including children in the CHIP program.
6. Individuals with disabilities should retain their health benefits when they return to work and to have access to rehabilitative and other needed services.
7. Funding and outreach and other programs serving low-income Americans should be expanded. Examples of such programs are the Children’s Health Insurance Program (CHIP); Qualified Medicare Beneficiary (QMB), Specified Low-income Medicare Beneficiary (SLMB), and Qualified Individuals programs; transitional funds for Medicaid recipients who are also welfare-to-work recipients; and for HHS for mental health outreach for the elderly.