Bean may be key swing vote in health care debate

As a centrist Democrat, Rep. Melissa Bean could be one of the crucial swing votes to decide the debate over health care reform.

Representing a former Republican district that supported George Bush, Bean's been attacked from both sides, and her chances of re-election could hinge on how this issue plays out.

The Barrington resident's opponents have called her a "coward" for avoiding town hall meetings where conservatives have ripped proposed changes in health coverage. Instead, Bean holds automatically-dialed conference calls with residents who have signed up expressing interest in the issue, which she says is a more constructive way to exchange ideas with thousands of people.

In a one-hour interview on health care with the Daily Herald Friday, Bean stressed the need for action to improve an increasingly expensive system that costs twice as much for medical care as in most other industrialized nations, but has 46 million people uninsured.

Bean expressed support for elements of President Barak Obama's proposal, but left herself room to disagree if and when a bill comes for a vote.

"The main objective," she said, "is securing and expanding affordable coverage."

To do that, she favors requiring all citizens to get health insurance, while requiring insurance companies to cover pre-existing conditions and to end caps on benefits, which she said has bipartisan, "universal" support.

Bean said she would support a government-administered insurance plan known as a public option, but, like the president, doesn't consider it a requirement.

She proposed incentives for electronic medical records and compensation to medical care providers based on health outcomes of their patients, rather than fee-per-service, to reduce unnecessary tests and contain costs.

Premiums for the public insurance should pay for itself, Bean said. She did not specify how to pay for estimated subsidies to low-income people ranging from $800 million to more than $1.2 trillion over ten years, but wants the revenue to equal the costs so it doesn't inflate the national debt.

Here is an edited version of the interview with the former small business owner and married mother of two, whose 8th district covers the northwest suburbs in Cook, Lake and McHenry counties:

Q: Do you support a public option for health insurance?

A: "I'm open to that if it stands on its on and stands on a level playing field with private insurance. I would also support legislation that secures affordable coverage... even if it doesn't have a public option. I would like to see not-for-profit options available. In Illinois, Blue Cross/Blue Shield is not-for-profit. Some states don't have that... The key element is choice. We cannot afford to undermine the private plans that the vast majority of Americans have. The Congressional Budget Office says less than five percent would use the public option... A co-op (which would pool together individuals and businesses to get coverage) is another way to provide not-for-profit competition."

Q: How would you contain costs?

A: "We're finding $500 million in waste, fraud and abuse in Medicare. We're looking at reimbursement rates where there has been waste."

"This is designed to be deficit-neutral. The Senate is looking at a surcharge on luxury insurance plans. The House is looking at a (tax) on businesses that do not provide health coverage."

"There's a lot of focus on moving from a pay-for-service model to results-oriented outcomes."

Q: "Would this cover illegal immigrants?"

"It explicitly prohibits it, in section 246, no undocumented aliens can participate in the exchange."

(Reporter's note: The Congressional Research Service reports the House bill does not specify a way to enforce eligibility, but authorizes a commissioner to do so. The White House said there would be no change in current law which compensates hospitals for treating illegal immigrants in emergency rooms.)

Q: Will yours be a deciding vote on this issue?

A: "Absolutely."