At his side during many if not all events of the August recess, Third District Republican Congressman Erik Paulsen has lugged the mammoth, 1,000 plus page copy of the house health care bill. The bill is a visual aid to illustrate how complex the issue has become.

Health-care reform is on the minds of most his constituents, and Paulsen has taken in a number of concerns as to whether the current plan offered through the House will improve or make worse American’s ailing system.

Paulsen told an audience of Eden Prairie Chamber members recently that when it comes to healthcare he’s not a believer in “keeping the status quo.”

That being said, what has been put together at the House is “just the wrong approach,” he said.

It’s not focused on enhancing quality of care, or reimbursing physicians on quality of care, but rather, increasing access to the uninsured through a public option or government plan, he said.
Paulsen noted that there are things that can be done from a business perspective: such as allowing small businesses to pool together to offer insurance, allowing people to stay on their parents’ policy up to age 26, and allowing people to buy health insurance across state lines. He expects health-care reform will pass this year, but is not convinced it’s going to be in the best form.

There are policy changes that can be supported on a bipartisan level, such as allowing small businesses to pool insurance together or covering pre-existing conditions, he said.

“You can pass those on a bipartisan basis,” he said.

In an interview, Paulsen noted that, in terms of the feedback he’s received this month, “There’s a consistent theme of worry or concern about whether the approach that is going on in Congress is the right approach.”

What he hopes will end up in the final legislation is policy that allows small businesses to pool to provide health insurance, allows insurance to be sold across state lines, covers preexisting conditions, allows younger people on their parents’ policies longer, includes medical liability reform, and finally, he said that it’s critical to have payment reform and pay physicians or providers, under the quality of care they provide as opposed to by procedure.

Getting feedback

During a recent forum with small business owners in Eden Prairie, Paulsen heard more concerns about how any legislation could impact the system.

Roy Terwilliger, a banker and former state senator representing Eden Prairie, said there is a real need for health-care reform. There should be a way to encourage people to get their own insurance instead of putting the requirement on small business, he noted. For instance, individuals buying their own insurance don’t get the tax deduction that businesses have. Secondly, he noted that patients don’t know about the costs of a procedure until afterwards “and you also don’t know whether or not you really need that procedure.”

We’ve got a system that continues to be built on people not knowing what the cost factors are, he added.

“There has to be market discipline put into it,” Terwilliger said.

Paulsen was in agreement with those points: “If we truly want to provide access we should be addressing the cost factor.”

Relating the story of his wife’s cancer treatment, Dave Ward wondered how his own life would have worked out under a single-payer system that is prevalent in Europe.

“I honestly, firmly believe that we’ve got to cover more people,” he said. “But how we do that should take into account people’s lives.”

Tuesday’s forum also touched on tax issues, regulatory issues and the Employee Free Choice Act (which makes it easier for workers to unionize). The thoughtful discussion was a far cry from the uproar that has been the focus of media attention at other legislator town hall meetings.

In lieu of district town hall meetings, Paulsen has opted to hold smaller forums with groups of constituents ranging from seniors to meetings with large employers and business leaders. Additionally, Paulsen has been holding “tele-town hall meetings” where constituents can put forward questions and listen to answers via a conference call. The plan is on to have one more tele-town hall meeting related to health care next week, he said. Even if a person’s question doesn’t make it to the front of a queue, Paulsen noted that staff gets back to everyone who’s submitted questions within 24 hours.

He said at first he was a little skeptical about this type of communication, but “the response has been overwhelming.”
He recently met with seniors and talked with them about tele-town halls, “they all loved them.”

He said he’s been surprised and encouraged by the amount of constituents he’s been able to contact.

“It’s using technology to make sure we’re reaching as many people as possible,” Paulsen said.

He said he wants to make sure they’ve got a great discussion going forward.

“Every one of our tele-town halls has been really good from that perspective.”