Ted Simons: In November, Arizona voters will decide if the state constitution should be amended to prohibit mandatory healthcare programs. The measure is seen as a way to fight national healthcare policy that's taking shape in congress. It's supported by a group called Arizonans for healthcare freedom. That group held a press conference today at which congressman John Shadegg and Steve Forbes discussed their concerns about federal healthcare reform. I had a chance to speak with both Shadegg and Forbes earlier today. And gentlemen, thank you both for joining us tonight on "Horizon." Congressman, let's start with you. The federal plan, impact of the plan on Arizona?
John Shadegg: I think the impact will be very dramatic at many different levels but not necessarily immediate. Much of the benefits in the program are delayed and don't go into effect until 2013, 2014, down the line. Under the two bills out there right now. Some of the impact in terms of taxes, for example, go into effect almost immediately. 2010. One of the impacts that I think Arizonans are going to be most concerned about is the legislation significantly expands the Medicaid program. Where the costs are shared between the states and the federal government and Arizona's cost of Medicaid is going to go up dramatically at a time when our budget is not in a good position to absorb those increases in cost. So there will be lots of impacts.
Ted Simons: The concern with the federal plan on the state level, are you seeing this in places other than Arizona?
Steve Forbes: Sure, the governor of New York where we have our office, complain, New York is a financial disaster. My home state of New Jersey, the same thing. This is nationwide. The government tells you what to do but doesn't provide the wherewithal to do it.
Ted Simons: You spent the day urging Arizonans to take a look at the Arizona freedom act. Why is this a good idea?
Steve Forbes: I think it gets to the basis of what this country is about -- and that's individual choice. People should have the right to say I don't want to buy this insurance. Or if I do, I want to buy what I want. Not what the government dictates. To be able to buy a health service and providers should be able to provide that health service and not be punished by the government for it. Where we're headed is the government is going to tell providers what they can and cannot do.
Ted Simons: Do you agree, where it's seems like it's the insurance company telling you what to do?
John Shadegg: I would argue they're screwed up because of government rules. As Steve said, there isn't a marketplace or what you and I might call individual patient choice in healthcare today. Your employer buys your healthcare plan and the plan picks your doctor. If you're unhappy with your plan, you can't fire it, because you didn't hire it. If it mistreats, you can't fire it. If it charges too much, you don't pay attention. I recently got procedures and I didn't ask what they cost. I don't pay for them. There's a huge disconnect between the service provider and the consumer. We put employers and plans in between. What we're going to do under this is put the government in between. What Steve and I are saying, let's have you and I as individuals be able to pick our own plan with the doctors we want or the services or hospitals we want and get both of employers out of the middle and the government.
Ted Simons: What if I want plan X, Y, Z but they decide we don't want you?
Steve Forbes: The nice thing about true competition is someone will want you. Right now, as you know, you can't shop nationwide. John has been proposing this for several years. I live in the state of New Jersey. Because of our crazy regulations a family plan costs $15,000 to $20,000. I can buy a similar policy in neighboring Pennsylvania for $7,000 or $8,000. But it's illegal. If you allow nationwide competition, you're going to get hundreds of companies trying to win your business. On TV every night, you have Geico ads and Progressive ads, Allstate ads. Somebody is going to want you because they'll figure out to make money. People are going to figure out how to provide healthcare services at more affordable cost like we do with the rest of the economy.
Ted Simons: Can you compare auto insurance with health insurance. You get in a car wreck, you don't have a car anymore.
Steve Forbes: Sure, right now, you can get it in the emergency room. You have the right to that. Under John's bill, as he can explain, if you do this right, you can have coverage as well. Food, more basic than healthcare. We don't have a food production problem. We have specific problems to deal with it. Like food stamps, why not do the same in healthcare? The government doesn't run the food production, or else we'd be starving.
Ted Simons: The idea of those who can't afford healthcare, those with preexisting conditions, who can't get coverage , this seems to be an overarching effort --
John Shadegg: My own bill eliminates preexisting conditions and can go to a state high-risk pool and get coverage. So the notion of preexisting conditions would go away. My bill and other Republican bills in the congress on the house and senate side provide universal coverage. Covering every American. The differentiation is two things. Number one, under the Democrats' plan, all health insurance sold in America would have to conform to federal guidelines. They're going to dictate what has to be on that policy. They get control of it. What we're saying is look, let people buy insurance on the same basis that a business can right now. That is, same tax basis. And provide them assistance. My bill gives them a tax credit to go out and buy health insurance. But the federal government does two things. One, sets the standard for every health insurance in America. And two, puts a gun at your head, saying you must buy this policy. Let's say, for example, you happen to like holistic medicine. You go out and buy that policy and spend money and you're satisfied with it, you will not satisfy the federal government's rules. They'll tell you that's not an approved government plan so we're going to fine you. The reality is there isn't competition and I think you can compare auto insurance and health insurance at least in this sense. Right now, the health insurance companies do not have to compete for our business or be accountable to us because we didn't hire them. They can raise rates too much. You and I don't care what healthcare costs because some third party is paying for it. And they're not competing for our business. As Steve points out, in the auto insurance industry, they're saying we'll sell you a better policy for a lower price. They don't do that in health insurance because the government makes it impossible.
Steve Forbes: Part of the problem, you look at the history of Medicare, they're laggard in terms of innovation and procedures. That's the problem with government. They're always behind the curve. We have a lot of innovation in both medicine and medical devices and they'll be squeezed out under a system that is trying to cut costs.
Ted Simons: And yet, Medicare is the third rail of politics. Every nation, as you well know as a national politician and candidate, you can't mess with Medicare or they're going to come at you storming the gates.
Steve Forbes: You don't have to take Medicare away. But it's being subsidized by private patients. And number two, in terms of Medicare, is they're taking away things that people do like, like Medicare advantage. Which nine million people are on. That system is going to go. And health savings accounts, those are going to be squeezed out. Any choice is going to go by the boards. It's going to be what the government dictates.
John Shadegg: Medicare is no longer the third rail of politics. They're in fact taking away much of the medicare benefits -- it's surprising that America's seniors haven't risen up and opposed it. Going to hurt minorities and that is a big issue here. But there were two reasons for doing healthcare reform. Number one was the uninsured. We should be covering all of them. The Democrats' plan -- the Republicans of giving people the funds to give everyone their own plan to cover ever single American. But the real problem is it does nothing to constrain costs. The president came forward and said, look, we cannot sustain this continued escalation in the cost of healthcare. But at the end of the day, with the bill they have, they've done literally nothing to restrain costs.
Steve Forbes: The only way they can constrain costs is by denying coverage. In Britain, if you’re over a certain age and you need kidney dialysis, forget it. You've never going to get in front of the line. That's how they control costs. Instead of productivity. Like Lasik surgery.
Ted Simons: Lots of people in this country aren't able to get a procedure because they can't afford it.
Steve Forbes: In terms of an immediate emergency, you can in an emergency room. In other countries, in Canada recently, somebody needed angioplasty, they couldn't do it. They had to go across the border. You have longer lines. And studies show. And if you look at the outcomes, 13 of the worse cancers you have a better outcome. Same with the heart disease.
John Shadegg: There are too many people in America that can't afford the care they need. Why is that? Steve just told you in New Jersey where they have all of these mandates, you must cover everything and you have guaranteed issue, the cost of a policy is $15,000 or $20,000. The same policy covering everything in neighboring Pennsylvania where they don't have those mandates is only $7,000. Why is that? Well, it must be that Pennsylvania figured out how to deliver healthcare at a lower cost. I think this initiative will force the health insurance companies to compete, thus bringing down the cost making it less expensive for more Americans. Add to that the tax credit that is in the Republicans' plan and many other plans so that nobody goes without healthcare and you've solved the problem. You know what happens? Where you and I are not buying a government-dictated product, but that the health insurance companies have to market and convince us is good but less expensive, then they're motivated to lower the price.
Ted Simons: Under this idea, will people be motivated to get health insurance if there's not a penalty, not some system that says you have to be in? The criticism is you are either all in or it's not going to work.
Steve Forbes: If you're going to have a government-run plan, yes, they need it all in. But the criticism is saying, gee, if you allow people to buy food when they want, no one is going to eat. They won't clothe themselves or house themselves. People are going to buy health insurance.
Ted Simons: Again, equating food with the -- tell a 20-year-old he needs health insurance, he's not going to buy health insurance.
Steve Forbes: And so when he has an accident, he's going to go to the emergency room, and get a bill for it, and then John's bill will kick in in terms what you have to pay to get this out of the way and they'll wake up to it. The nice thing about true catastrophic coverage, you can cover these hideous bills, for a young person, $30, $40, $50 a month, max.
John Shadegg: Tell a young person he's not going to get health insurance -- the vast majority of 20-year-olds are insured. More would be if it was less expensive. I would argue, and I think the statistical data shows, most who are uninsured are because they can't afford it. How do we solve that problem? In the legislation I've offered every single American, including the homeless, gets a tax credit to go out and buy a health insurance plan and under my bill, if they don't exercise their credit they're put in a pool and if they show up for care, the pool takes care of that care. Why don't the rest buy health insurance? Because it's too expensive. Why is it too expensive? I would submit it's the only place in the American market where we have taken price out. We've divorced the consumer from the person providing the good. The consumer doesn't care how much the price of the medical service is because he or she thinks they're not paying. My employer is paying or the government or somebody else is paying so I have no motivation to say to the insurance company --
Steve Forbes: In anything else you do, you ask what the cost is, what you're going to get for it. Yet if you go to a doctor or a hospital or a clinic and ask, they assume, one, you don't have insurance, or two, you're a nut case. Why would you want to know? What's it to you? So the system goes haywire.
Ted Simons: Last question: Is healthcare in America a right?
Steve Forbes: Healthcare, like food, it's something that everyone can have if you allow the free market to work and have the safety nets in place.
Ted Simons: Not a right?
Steve Forbes: Don't get into semantics. We can cover everyone. Everyone should have food and healthcare, and the reason I hesitate at the word of right, that's a government wedge to come in and say we have to provide it and shove everyone out.
Ted Simons: I used the word right because this initiative, this idea says there are rights and the right to choose your healthcare system should be included in these rights.
John Shadegg: You should have the right to control your healthcare. And not be denied the right to buy it from whoever you want as long as it's legal and not be compelled, as the federal bill will do, to buy something you don't approve of. Think of this from the health insurance perspective. Every single American is being told you must buy their product. They love this bill. They can sell lousy products if the government says you have to buy it no matter how bad it is.
Steve Forbes: We should have a mandate for magazine subscriptions. I'd love that.
John Shadegg: How about every night, everybody must watch at least an hour of channel eight?
Ted Simons: Sold, we've got a winner. Thank you, gentlemen for joining us.