In sickness and in health 

What is the Montana delegation doing about health care?

Anyone paying even the slightest attention to the issue of health care in the United States knows the facts: 41 million Americans—one in five Montanans—are uninsured, doctors are striking to protest high malpractice insurance rates, and workers and their bosses are paying higher premiums and getting fewer benefits.

What, if anything, is Montana’s congressional delegation doing about the crisis in health care? And is it truly a crisis, or, as Sen. Conrad Burns maintains, simply a problem?

Of Montana’s three representatives to Congress, Sen. Max Baucus has the most experience in writing health care legislation. As the ranking Democrat on the Senate Finance Committee, which oversees Medicare and Medicaid, he also has the most political clout in this arena. He spearheaded CHIP, the popular Children’s Health Insurance Program, which covers some 9,600 Montana children. With the support of 78 other senators he successfully fought an attempt earlier this year to cut $92 million out of the Medicaid budget, and he sponsored legislation that lessened costly regulatory burdens for 32 rural hospitals in Montana.

He has other ideas for improving access to health care.

“First of all,” says Baucus, “I believe in the Hippocratic Oath: First, do no harm.” That, he says, means keeping the health care programs already in place, and then building on their successes. To that end, Baucus favors extending health insurance coverage to the parents of children covered by CHIP. “CHIP works, so let’s build on what works,” he says.

Baucus also wants to extend Medicare benefits to those 62 to 65 years old by allowing them to buy in to Medicare before they become eligible at age 65. And for those somewhere between childhood and senior citizen status, Baucus supports employer tax credits allowing more employers to offer health insurance to more workers.

Rep. Dennis Rehberg says health care takes up more time than most other issues he faces as Montana’s sole representative in the House. “I will admit to you,” says Rehberg, “that no matter how long I spend in Congress I will spend more time on health care (than any other issue).”

Rehberg is adamantly opposed to universal health care because taxpayers ultimately have to decide how to ration health care. “Government run? No. We have the best health care system in the world because we do not have a single (payer) source.”

Rehberg believes health care to veterans “was a promise made but not a promise kept,” and supports efforts to improve the Department of Veterans Affairs health care system. Medicare also needs updating because it does not address prescription drug needs, nor does it emphasize disease prevention. Prevention not only keeps people healthier longer, it also keeps costs down in the long run. “You turn 65 and go on Medicare and have a heart attack (and incur large health care bills). Prevention needs to be a part of it.”

Rehberg has sponsored the Association Health Care bill, which would allow members of various types of professional, industrial and trade associations to band together and buy group health insurance. He also favors an unusual approach to health care maintenance: tax incentives paid by the federal government to people who practice healthy lifestyles, such as non-smokers, and people who exercise to keep weight and cholesterol down. The trick, of course, is to make sure the government doesn’t get too involved in the business of promoting lifestyle choices, he says.

Rehberg also favors caps on medical malpractice awards. The House passed such a bill in the last session, with Rehberg voting in favor. “The problem is the trial lawyers and the Senate won’t let it see the light of day.”

Rehberg recently voted with the majority in the House to provide $3 billion a year from 2004 to 2008 to help combat AIDS, malaria and tuberculosis around the world. The bill now goes to the Senate.

Burns isn’t convinced that health care is in crisis at all. “I think we’ve got a problem, not a crisis.”

Burns admits that health care is not his strong suit. “I just use it, is all I know. Fixed me up,” he says in his usual folksy style.

This month Burns sponsored a bill in the Senate that would create standardized national Medicare reimbursement rates for in-patient hospital services.

Other than his own bill, there is no pending legislation addressing the health care problem Burns particularly favors, though he supports prescription drug programs for seniors and low income citizens, and he supports CHIP. “We’ve got to take care of our kids,” he says.

Burns is skeptical of large, government-run health care. “Do we need to overhaul the whole system? You don’t have these giveaway programs without someone paying for them.”

Burns suspects that Montana’s ranchers are protecting their health and their families’ health by putting money aside for health emergencies. Others, he says without elaboration, are voluntarily opting out of health insurance programs.

Americans, in general, he says, overuse the medical system. “When any little thing goes wrong, you go hot-footin’ it down to the doctor.” When he was young, he says, people got sick and they simply “lived or died, I guess. We’ve made it complicated.”

A more positive trend, Burns believes, is that doctors are doing more volunteer work in clinics.

To contact your representatives on these and other issues, call: Sen. Max Baucus at: 800-332-6106; Sen. Conrad Burns at 800-344-1513; Rep. Dennis Rehberg in Washington D.C. at: 202-225-3211 or in Helena at: 406-443-7878.

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