FORT MYERS — The six Republicans vying for the District 19 congressional seat support some tenets of the Affordable Health Care Act, but vary on how to improve health-care coverage for Americans.
Health care is a major issue as the GOP contenders head to the Aug. 14 primary, when voters will choose one of the six to face a Democrat and an independent candidate in November for the seat held by Rep. Connie Mack, R-Fort Myers.
Mack is stepping down from his Southwest Florida Congressional seat after eight years in his run for U.S. Senate.
The U.S. House of Representatives candidates outlined their views three weeks after the U.S. Supreme Court, in a 5-4 decision, upheld the vast majority of President Barack Obama's health-care overhaul. The ruling came nearly 2½ years after Congress passed the Affordable Care Act, following a battle by Republicans, who voted against it and branded it "Obamacare."
The candidates all agreed on this much: Obamacare should be repealed.
Paige Kreegel, 53, a Punta Gorda physician, citrus farmer and state representative for eight years, contends that linking health care to employment keeps costs down.
"I don't think we should mess with something that already works," Kreegel said. "The real solution there is to get more people employed."
Only 12 percent to 15 percent of people in the U.S. aren't insured, he said, noting most of that percentage is illegal immigrants, young people just out of college who consider themselves "invulnerable," and those with pre-existing medical conditions. He recommended focusing on the latter and to take diagnosis into consideration.
"There are certainly going to be some government-led initiatives that will help these people," he added.
His opponents oppose linking health insurance to an employer.
Among the act's requirements is that insurance should be left to private markets and that by Jan. 1, 2014, people and businesses will be able to shop for private health coverage from competing insurers.
Chauncey Goss, 46, a fiscal policy analyst from Sanibel, points out that many workers change jobs frequently, which causes their insurers and doctors to change.
"As a result, it is difficult for doctors and patients to ever build the kind of relationship they need to focus on prevention and wellness," Goss said, adding that health insurance should start in college. "That would make it portable for the rest of their lives. When you're healthy and have preventive medicine, you will stay healthy. The insurance system has an incentive to keep you healthy."
Byron Donalds, 33, a Naples portfolio manager, maintains that if everyone purchased their own insurance, it would remove the burden from employers, cut their costs and boost the economy.
"If you want to bring down costs for all people, you need to have an innovative insurance market, like the auto insurance market," said Donalds, a tea party favorite.
Trey Radel, 36, a radio broadcaster and entrepreneur, said purchasing health care should be similar to buying auto insurance.
He believes in a free-market approach to insurance advocated by the Cato Institute, a libertarian think tank. Radel said insurers should be allowed to offer individuals two types of medical insurance, one similar to what we have now, covering doctor visits, medical expenses and prescriptions, and a separate health-status insurance individuals would pay into like a life insurance policy and would be accessed for catastrophic coverage, if something happened."I believe that consumers are better off when they, and not the government, dictate how their money is spent," Radel said.
Gary Aubuchon, 49, a Cape Coral real estate broker and home builder, agrees health insurance should be purchased by consumers in a free-market approach that would increase competition and provide the best services for the best prices.
"It should be portable with the person, not the job," Aubuchon said, adding that he supports health-care savings plans and increasing transparency for consumers to help them control their own costs.
Naples attorney Joe Davidow, 29, thinks employers should only pay for health care if it gives their business a competitive advantage over others.
Regulations also should be removed to enable all insurance companies to sell health care nationally, Davidow said, adding: "In essence, a deregulation of insurance-based health care so that private individuals have the opportunities to compete and put together better health insurance plans based upon more sound free market economic principles."
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The candidates all oppose an increasing "tax" penalty on consumers who refuse insurance. Radel pointed out churches, synagogues, charities and others have helped the uninsured and poor with health needs for hundreds of years, while Kreegel called the "tax" the "biggest job-killing concoction" legislators have come up with.
"It makes having an employee a liability," Kreegel added. "It's going to be an impediment to hiring people."
Goss suggested a plan like the one offered in December 2011 by Sen. Ron Wyden and Rep. Paul Ryan, who proposed market forces and a focus on health outcomes, not the procedures doctors now are compensated for on a fee-for-service basis.
"Their incentive is to run tests on you," Goss said, noting many probably aren't needed, but doctors are forced to conduct them. "They need to practice some defensive medicine. The incentives are misaligned."
Davidow believes doctors should be financially deregulated and given the option of taking patients with or without insurance.
"The goal is to get the patient and the doctor back involved in the conversation about the individual's health and what it will cost," he said, adding that it will make it more affordable.
Medicaid should act as a safety net for the poor, he said, but be stricter about who qualifies — and for how long.
"Unfortunately, this safety net has been abused for years as a free system of health care to assist these individuals from cradle to grave," he said. "We must create a system that incentivizes people to go back to work."