Editor’s note: This is the first of a two-part series on health-care proposals from the candidates running on contested primaries for U.S. Senate and U.S. House.
When it comes to health care, at least three of the four Republicans who want to challenge U.S. Sen. Jon Tester say get rid of “Obamacare” – and let some form of the free market flourish.
The fourth candidate – Big Sky businessman Troy Downing – says arguments over health coverage miss the point, which is how to bring down the high cost of health care in America.
“Before you insure a broken system, let’s look at what’s making that system so expensive,” he told MTN News in a recent interview. “Let’s look at hospital billing practices, tort reform … Let’s look at skyrocketing pharmaceutical costs.”
Downing, former state District Judge Russell Fagg of Billings, state Sen. Al Olszewski of Kalispell and state Auditor Matt Rosendale are vying for the GOP nomination to take on Tester, a Democrat.
The primary election to choose the nominee is June 5, and absentee ballots will be mailed May 11.
The continuing high cost of health care, and what to do about it, is a front-line issue once again in Montana’s congressional races this year, for the U.S. House and U.S. Senate.
Republicans and Democrats often talk about the same elements – the high cost of care and coverage, lack of access to both, and government’s role in the system – but have vastly different approaches to addressing the problems.
Even within the respective parties, differences exist, giving voters who care about the issue a broad spectrum of choices.
Here’s a closer look at how the four Republican U.S. Senate candidates propose to reform health care in America:
Troy Downing: Among the Republicans, Downing stands out with his aggressive rhetoric on the cost of health care, often saying hospital charges and pharmaceutical drug prices are out of control and need to be reined in.
He says if a prescription drug is being sold in Canada for $100, that drug companies shouldn’t be allowed to turn around and sell the same drug in the United States for five or 10 times as much.
“Right now, the U.S. is paying for research and development for the rest of the world,” he says. “And I don’t think that’s fair.”
But on hospital charges, Downing says regulation isn’t the answer, but rather more “transparency” on pricing for consumers.
“What other business do you go to where you don’t have some expectation of what it’s going to cost to get something done?” he says.
Russ Fagg: Fagg says the Affordable Care Act, or “Obamacare,” should be repealed, because it’s too costly and is “simply unsustainable.”
In its place, Fagg wants a “choice and competition type of a system,” where consumers can shop for health insurance across state lines and have beefed-up health savings accounts, where consumers can deposit pre-tax dollars and use them to pay health bills in the future.
“I would like to see less government intrusion into the system, more of a free market,” he says.
When asked what would happen to the 120,000-plus Montanans who’ve gained coverage through Obamacare subsidies or Medicaid expansion, Fagg says “we’ll find a place for them.”
“Everybody deserves a little bit of health care, some basic maintenance-type of a health care system,” he says.
Al Olszewski: An orthopedic surgeon, Olszewski says health care is one of main reasons he got into the race a year ago.
Olszewski also would repeal the ACA, saying it has piled more regulations onto an already burdensome system and accelerated consolidation within the health-care and health-insurance industries.
“It’s destroyed your small-business physician and provider,” he says. “Now, your doctor and soon your dentist and your optometrist are going to be employed by hospitals. And guess what? They no longer work for you. They work for the hospital.”
He, too, says the cost of prescription drugs must be addressed – but doesn’t have a specific proposal to do so.
Olszewski says the entire system needs to move toward being more market-driven, so customers have more of an active role in paying and deciding prices.
Matt Rosendale: As state auditor/insurance commissioner, Rosendale has been working directly on health-care issues – and is a vocal critic of the ACA.
He applauds President Trump for issuing orders that will allow states and health-insurers to make available cheaper, less comprehensive coverage plans and other options, such as businesses pooling together on “association plans” for their employees.
“We’re going to see many more products and services that will be available in 2019 than were available in 2018, and continue to help offer options that allow people to accommodate their health-care needs in a way that recognizes their budget,” Rosendale told MTN News.
His office also is examining prescription-drug pricing, but hasn’t completed its work, and Rosendale is a big backer of expanded health-savings accounts.
Although Rosendale has said he wants to repeal the ACA, he is not calling for the withdrawal of Medicaid expansion, which has extended government-funded coverage to 95,000 low-income Montanans.
He thinks by offering a full range of less-expensive insurance products, some of those on Medicaid will opt for those plans.
Next: Proposals from the Democrats competing to challenge Republican Congressman Greg Gianforte.