On the Record with Representative Ron Kind
Wisconsin Health News
By Tim Stumm
Representative Ron Kind, D-WI, says he has been almost 'singularly focused' on one topic: health care.
"If we are going to have a serious discussion about deficit reduction, and have a long-term plan to get unsustainable budget deficits under control, it's got to come back to the focus on health care reform," he said.
A staunch supporter of the federal health reform law, Kind says the rest of the country could learn a lot from Wisconsin in terms of delivering high-value care. But, both the state and the nation still have work to do. In a recent interview with Wisconsin Health News, Kind talked about the importance of preserving Medicare, his vision for health insurance exchanges, and whether a U.S. Senate run is in his future.
WHN: This week, after voting against increasing the debt ceiling, you issued a statement saying any serious discussion on the issue needs to include health care. What exactly did you mean by that?
RK: The largest and fastest growing area of spending at the federal, state, and local level is rising health care costs. If we are going to have a serious discussion about deficit reduction, and have a long-term plan to get unsustainable budget deficits under control, it's got to come back to the focus on health care reform. We need to change the way health care is delivered in our country so that it's more coordinated, more integrated, and more patient-focused. And equally, if not more importantly, we need to change the way we pay for health care so we award the value of care that is given and no longer the volume of care. That is something our health care providers in Wisconsin have been doing for years, but has been tough to accomplish politically on a national level because of powerful Congressional delegations in other states who prefer the status quo.
WHN: You said in the same statement that we need to "preserve and protect" Medicare for generations to come. Is that really possible?
RK: The studies show we are spending one out of every three health care dollars in both the public and private sector on things that don't work. That's close to $800 billion we are spending every year on a $2.4 trillion health care system that we are not getting a good bang for the buck for. That's why moving forward on health care reform is so important. We need to change the way health care is being delivered so it is more coordinated and more efficient. Whatever Medicare does will be a real driver of reform in the private health insurance market.
WHN: Representative Paul Ryan, R-WI, is spearheading a Republican budget proposal that he says substantively deals with the current unsustainable path of Medicare. Are Democrats playing politics by sharply criticizing his plan?
RK: I strongly disagree with what Representative Ryan and his Republican colleagues are calling for, which is eliminating the Medicare program as we know it today. All they are proposing to do is shift the cost and the burden of these rising health care costs onto seniors who can't afford it. They are not offering any solutions on reforming how health care is delivered in our country, or how we pay for health care. There will be no cost containment in their proposal, other than the guarantee that seniors will have to pay much more out of pocket every year for their health care needs, which will be a form of rationing inevitably. Those that can't afford it will be going without.
WHN: Wisconsin is known as a leader in delivering high-quality health care, and that's been especially true in western Wisconsin. What's so different about the care that's delivered in this part of the country?
RK: I wouldn't just limit it to western Wisconsin. You see a lot of quality health care providers throughout the state of Wisconsin. But in western Wisconsin, there are health care providers that figured out that the best way forward to reduce costs while still improving quality is to have a more coordinated care system. It's a model that most health care experts point to and say, if we can just duplicate that and take it nationwide we wouldn't have the health care problems we have today in our county. If Wisconsin wanted to, we could be the first state in the nation that goes to a value or outcome-based reimbursement system. We could do it in our own BadgerCare program. It would be a model of reform that other states could then duplicate. Our health care providers have established the coalitions and they have established the good quality measurements which will be necessary. We need to get rid of the redundancy and the excessive tests and procedures that gobble up a lot of the health care dollars without much to show for it.
WHN: What do you think a Wisconsin health insurance exchange should look like?
RK: I really envision these exchanges being set up and then expanding and broadening into other states of their choosing. There is nothing now preventing that from occurring. It would make sense if Wisconsin, Minnesota, or Iowa wanted to form a larger coalition of insurance exchanges. That way you are creating an even larger universe of competing plans and a larger pool of people that would be able to benefit from it.