Dan Sullivan Talks About Alaska Healthcare
Recently, State of Reform conducted an interview with US Senate candidate Dan Sullivan. The interview was Sullivan’s most extensive comments on health care to date during the campaign.
The conversation focused on healthcare policy issues, including healthcare reform. Erin Thurston conducted the interview for State of Reform. See the full transcript of the conversation below.
Erin Thurston: What can we do to get health care costs under control in Alaska?
Dan Sullivan: Well you know, you guys certainly know it is a huge issue. It is not only the costs, but it’s access to affordable care for everybody is a really high priority. But, what’s happening now is that costs are not going down and that was a huge part of what was promised by Mark Begich and Barack Obama with regard to Obamacare.
So, my campaign position, particularly after meeting with healthcare providers and doctors’ groups and other experts in the field, is that we need to repeal and replace Obamacare. You probably saw this, but one of the things right now is that rates are set to go up by as much as 40%. The promise that Obamacare would bring costs down, well, that’s obviously not happening. And as you probably also know, almost as many Alaskans have been kicked off their plans as have gained access to healthcare which is something that is hugely, hugely troubling.
But to me, there are a lot of ideas in regards to bringing down healthcare costs that I think could gain bipartisan support in Congress next year. The first one would be to allow individual Alaskans to come together to buy health insurance. You know small businesses that are allowed to do that, they save a lot of money by doing that. Transparency, as you guys know – you are the experts, [healthcare] is certainly one of the most opaque, if not the most opaque, markets in the country, and that causes the ability for costs to go up. I definitely think that Alaskans and families should be able to purchase health insurance across state lines. That is something that would provide competition, and competition is obviously good for costs. And, one thing that is a huge, huge issue when you talk to literally any health care provider, any doctor, any nurse, that they talk about – that was not included in Obamacare – and I think for political reasons, that nothing focused on tort reform. And as you know, the medical malpractice system in America is a huge driver in increased costs. So, I think those are the kind of reforms that would be very palatable for the vast majority of Alaskans – as a matter of fact, I was at an event last night talking about this with a bunch of doctors—and importantly, very much supported by families, particularly those struggling with affordable access to healthcare.
ET: What role can Medicare play to help encourage providers to coordinate care and do some innovative things to deal with costs and get better outcomes for patients?
DS: You know there are a lot of innovative things happening. Again, one of the great things about campaigning is that you hit the campaign trail with certain ideas, certain principles, certain views and approaches to government, priorities that you bring on board if you were elected. But, what continues to happen to me, and it is a real privilege to be able to campaign in front of so many Alaskans, is that you are constantly getting in front of our fellow citizens who have great ideas on these issues.
I was at an event yesterday – I can get you the name of the company – which was doing exactly these types of innovative things that you are talking about in the Medicare field.
This is something that to be perfectly honest, [is important] in my own personal life with me and my wife. My mother- and father-in-law are both in their 80s and they live in Fairbanks and there are a lot of challenges with Medicare and who is accepting it in Fairbanks. But, I think there is this home model that is being utilized. What’s called the “Nuka System of Care” by the Southcentral Foundation that I think is an innovative approach. It provides mid-level care for most primary needs, but utilizes a physician when the care becomes too complex and again, the company we were at yesterday does that kind of work in Anchorage and the valley.
But one of the frustrations that you see in regards to Medicare when you talk to medical professionals is either increasing the reimbursement rate to allow patients the freedom to keep their doctor. The big problem is—and you don’t see this a lot in regards to criticisms of Obamacare—but you know Obamacare makes those reimbursement rates a lot more difficult because it cuts close to a half trillion dollars in Medicare. And that is something that was a huge problem in regard to Obamacare that doesn’t often get cited as one of the problems with it.
So, I think we can let patients negotiate directly with their healthcare providers rather than allowing the government to act as a go-between, which again is the Obamacare model. Again, whenever you have the government as the go-between agent it increases costs. Senator Murkowski had a bill that was meant to do just that and Mark Begich and the Democrats in the Senate didn’t support it. So, there are a lot of innovative ideas out there, but boy, it is huge –I would say given the cuts to Medicare by Obamacare, it is an urgent issue for Alaskans.
ET: On that same vein, if we assume that Obamacare won’t be repealed entirely due to a federal veto, what changes would you like to see adopted to change the law?
DS: Well again, some of the ones I’ve already mentioned, but I can mention them again. The broader issue though for me comes back to I think a principle that I guarantee almost every Alaskan would be supportive of, and that is the basic idea of freedom. And when I talk about that I mean that what most Alaskans want is the ability to put together a healthcare plan that fits their budget and fits their needs. And one of the biggest problems with Obamacare is that it doesn’t allow that kind of freedom.
And so, for example, I met a woman in Anchorage who had a healthcare plan fit her budget, fit her needs, she had it since 1980 – Obamacare came up and booted her off her plan. Why? Because the federal government was telling her what her budget and needs were, in terms of her plan and when it didn’t fit what she had, she got kicked off her plan. That is not what Alaskans want. And this is not a party issue – Democrat, Republican, independent, undeclared – this is an Alaskan and an American issue.
So, for me, what does freedom look like? It’s consumer choice. As I mentioned earlier, allowing individuals to buy across state lines. It’s allowing small businesses to pool together their resources and purchasing power if they are going to offer healthcare to their employees in the same ways that a large corporation might, to have that stronger buying power in the market. It’s greater medical transparency, which I think almost everybody wants to empower consumers and patients to let them know what they are paying for. As you know, one of the big problems is often times you will have a procedure, then you get the shock afterwards with the bill that says, you know, “This procedure cost me $5000? Holy cow, I had no idea!” Tort reform, again, as I mentioned, it’s a huge driver of costs, the medical malpractice problems that we have across the country.
But I also believe that we need to make sure that we continue to try to protect the most vulnerable, and in that regard, we could establish well-funded, high-risk pools at the state level for people with pre-existing conditions. I do think that’s an issue that Obamacare has highlighted that we need to address. And we need tax reform. As I mentioned earlier, corporations are allowed to deduct healthcare costs – why shouldn’t families? So those are some ideas. The good thing about these ideas is, I think there would be bipartisan support, and if you had Democrats voting for it, as well as Republicans, it would be much harder for Obama to veto these kinds of reforms.
ET: Should federal funding of federal insurance exchanges be eliminated?
DS: Well you know this goes to an issue of Obamacare in the law and one of the big frustrations for not only for the people trying to get access to healthcare but those trying to implement it. What the Obama administration has done in regard to the rule of law is to me not just an issue for Obamacare, it’s an issue that is ultimately very, very damaging to the entire fabric of American government and society. You have a government that essentially ignores the law; you probably know, Obamacare since it has been enacted has been changed unilaterally over 30 times by this administration.
Where they have simply looked at provisions of the law and changed them, whether its coverage, whether certain elements of Obamacare are supposed to kick-in in terms of dates, the administration has just moved them or changed them. Under our constitutional system, that is not a power that is given to the Executive Branch. That is a power for the legislative branch. And, with regards to subsidies, right now when I have read the language, it seems very clear the intention of Congress was the subsidy be for exchanges set up by the states themselves. And, as you know right now, that’s in the courts. There have been a couple of federal courts that are reviewing this differently, and that probably means that it’s going to go to the U.S. Supreme Court for a decision.
But this goes to a broader issue, which I think again [ignoring] the rule of law is very troubling and it is a philosophical approach to government that I certainly disagree with Mark Begich on. You have now an approach to government, under President Obama, Harry Reid, and Mark Begich, which is to pass these gigantic laws. Obamacare was 2200 pages, nobody reads them. When I was Attorney General, I sued to stop Obamacare. I got together with a team of attorneys. We did read it. I am not going to say that I read every word, but it took us weeks to plow through this document, and I guarantee that I read more than Mark Begich or Barack Obama did.
But, nobody reads them, the agencies in power get regulations that are literally in the tens of thousands of pages, nobody understands them, and then all of this is hoisted on the American people and small businesses and families, and they are left to deal with it. And it’s creating confusion, huge costs and burdensome regulations on families and small businesses, and then you have now the federal government saying, “oh wait a minute, I know the law says this, but we didn’t really mean that,” and that’s an uncertainty that’s plaguing the entire healthcare system right now. So, we will see what the courts decide, but the language of Obamacare on this issue seems very clear.
ET: That concludes my questions. Is there anything that you would like to touch on that we didn’t get to?
DS: As I mentioned, the issue of affordable access to care is obviously a huge one, and it is important that we continue to work on it. The model that Obamacare is, which a top-down approach with the federal government dictating plans, budgets, and outcomes is not one that is working, and it is not one that most Alaskans prefer and that’s why there is so much frustration with Obamacare and that’s why one of the things I will do as a U.S. Senator is listen to my fellow Alaskans on this issue, as I have been doing for the past year, and work to implement reforms that bring us back the model of freedom.
ET: Great, thank you so much for your time Mr. Sullivan. I really appreciate it.
DS: Thanks a lot, Erin. Thank you for what you guys do.
Note: Edits inserted in the text were provided by the campaign for clarification of Mr. Sullivan’s remarks.