Paul promises his own alternative to ‘Obamacare’ during Corbin health forum

U.S. Sen. Rand Paul speaks during a health care forum held at Baptist Regional Medical Center in Corbin Monday.

U.S. Senator Rand Paul said Monday he is working on a plan to totally replace the Affordable Care Act – a sweeping reform of the nation’s health care system that was signed into law in 2010 and that survived a critical test in the U.S. Supreme Court this summer.

Paul’s comments came during a health care forum hosted Monday by Baptist Regional Medical Center in Corbin. The forum was one of several the senator has participated in around the state, holding similar events in Paducah, Middlesboro, Bowling Green and elsewhere.

"Health care is a big part of everybody’s life," Paul said just before the forum got underway. "I want to meet with them and find out how they can cope with Obamacare."

Pejoratively known as "Obamacare" by opponents of the legislation – after U.S. President Barack Obama, who was its main champion – the law doesn’t take full effect until 2014. While it is vast and complicated, it essentially forces nearly every U.S. adult to purchase health insurance and utilizes a number of different means to help in that goal. The law also more tightly regulates payouts to doctors and hospitals, and greatly expands government programs, like Medicaid, that provide health coverage to those who have no private insurance.

"I think it’s going to be a disaster for the country and I will do everything possible to make sure he [Obama] doesn’t win reelection and is able to enforce Obamacare," Paul told members of the forum and about 60 people in attendance at the event.

The crowd consisted mainly of local political leaders and workers and administrators in the health care field.

"I’m very concerned about what is going to happen, not only to the country at large … but also what is going to happen to health care in particular."

Paul noted that health care makes up roughly 16 percent of the nation’s economy. He said despite the U.S. Supreme Court decision this summer to uphold the law, he still believes it is unconstitutional and should be repealed.

For those who aren’t concerned about the constitutionality of the law, Paul said there should still be cause for concern. He notes that the plan for funding the changes is to take money from Medicare, a program that is already "35 to 40 trillion" dollars "in the hole."

"Where’s the money going to come from?" Paul asked. "It’s a shell game. We are taking money from Medicare to pay for Obamacare."

A panel of health experts asked questions of Paul during the forum. Many of the questions centered on how the changes would affect reimbursements for doctors and hospitals.

Paul contends that one of the problems with the Affordable Care Act is that while physicians and hospitals may be able to get more reimbursement in cases now where they essentially provide "charity" care, many doctors may start refusing to see Medicare and Medicaid patients because the amount being paid for services is too low.

"Every able bodied person can’t be on Medicaid," Paul said. "You can’t just keep loading the wagon with able-bodied people. Charity should be given to people who can’t help themselves."

Paul said he favors requiring some kind of copay for services, even if it is only a few dollars.

"The problem with something that is free is that people tend to use too much of it," Paul said.

In response to a question by Carl Herde, Chief Financial Officer of Baptist Healthcare Systems, Paul said that the problem with the health care market today is that there is not much of a competitive marketplace at all. Himself an ophthalmologist, he noted that the price for most services, like cataract surgery, is fixed because it is what government will agree to pay through Medicare. Lasik surgery and contact lenses, on the other hand, are not covered by insurance companies and are generally very competitive.

"It doesn’t have enough of a marketplace," Paul said. "When you look at problems, you ask do you need more government or less. Obamacare approaches it that we need more government, but what you really need is more of a market … connecting the consumer to the market which means things we don’t want to hear like higher deductibles and health savings accounts."

Deborah Anderson, a Licensed Social Worker who deals with behavioral and health issues, asked Paul whether the federal government was looking at providing more money to treat prescription drug addictions.

Paul said he believes the issue should be treated less from a law enforcement perspective and more from a medical perspective. Doctors, he said, need to become more active weeding out patients who are shopping around to get more painkillers.

Following the forum, Larry Gray, CEO and President of Baptist Regional Medical Center, said he was heartened that Paul did not just criticize the Affordable Care Act, but also promised to provide a legislative solution in the future.

"There are a lot of elements of the Affordable Care Act that are already in play," Gray said. "When folks simply say ‘repeal, repeal, repeal’ but do not put forward a plan. That does not help our anxiety a whole lot."

Gray said even if people don’t totally agree with the new law, it has done some good in the sense that it has made health care a national priority.

"At least it has forced us into a conversation that we needed to have," Gray said calling it an "important national debate for all of us and our future."

Following the forum, Paul went to the Cumberland Valley Surgery Center in north Corbin to perform charitable eye surgeries.