Town meeting crowd challenges Grassley on single-payer health care

SIGOURNEY, Ia. – Health care dominated U.S. Sen. Chuck Grassley’s town meeting on Tuesday, as southeast Iowa constituents pressed him on insurance affordability and challenged him to embrace a single-payer solution.

Congress is currently considering several proposals with the potential to lower insurance premiums, Grassley said, while a single-payer system in which government supplants private insurers is a nonstarter.  

One woman described to Grassley how the insurance plan her family bought on the state’s Affordable Care Act exchange rose from $1,400 to $2,200 per month – and will go away altogether in 2018.

Waving a copy of the American Health Care Act legislation that failed to pass the U.S. House last month, Grassley suggested easing regulations on insurers could spur more coverage options, more competition and lower prices.

On prescription drugs, he offered that he supported allowing the re-importation of lower-priced drugs from other countries and described efforts in the Senate to make generic drugs more readily available.

In an interview after the meeting, Grassley suggested that one solution to high insurance premiums might be high-risk pools, in which patients with expensive, chronic conditions are insured on government-subsidized plans separate from the much wider pool of healthier insurance enrollees.

Segregating the small sliver of health-care users responsible for a large share of overall costs, he said, could lower premiums for everyone else.

A bill introduced in the Senate, Grassley said, contains “elements” of such an approach.

Two attendees in the crowd of about 80 tested Grassley’s position on government-provided coverage for all, drawing hearty applause with their calls for a single-payer system and eliciting the strongest response of the day to Grassley’s answers.

The senator was all but shouted down when he told the audience that a single-payer system implied a medical system run entirely by the government, with doctors employed by the state. Grassley acknowledged that such a system wouldn’t have to include government employed doctors, but said in any case the current political landscape favored less rather than more government involvement in health care.

“Most people in the Congress, at least majority in the Congress, want to have less government direction of health care,” he said.

A while later, Steve Groenewold, a software engineer from Riverside, stood up to argue that while government may not be adept at everything, it is a capable health care administrator.

“Medicare and Medicaid are some of the most popular programs that we have. They do a great job of providing coverage, of controlling control costs as well as anything does, of providing certainty to our doctors and hospitals,” Groenewold told Grassley, noting that the administrative costs for the government health programs are far less than private insurers. “Why not give us a chance to see what might happen with a universal health care system?”

The question drew applause.

“This is what I think about when you talk about expanding Medicare and Medicaid to more people,” Grassley answered. “One-third of the doctors don’t take Medicaid people right now. So aren’t you promising people a lot of things you can’t deliver on?”

“But,” replied Groenewold, “That means two-thirds do.”