Congressman tells Rotary federal budget much worse than acknowledged
By SUSAN LEATHERS
Brentwood Home Page
U.S. Rep. Jim Cooper (D-Nashville) feels a target on his back from both sides of the political spectrum. “I get hit from both the right and the left,” the fiscally conservative moderate Democrat told members of the Brentwood Rotary Club on Friday.

Cooper’s topic was health care reform but he used dry wit and simple language to explain that the trouble with the federal government today goes far beyond that topic.

“Let’s face it – good people don’t run for office anymore. The whole culture has changed,” Cooper said. “They just have this deep distrust of politics. But we need more good people,” the five-term congressman said.

“We should have thinkers, … people who follow this Four Way Test,” he said pointing to the Rotary banner that featured the questions all Rotarians promise to consider before they think, say or do something: "Is it the truth? Is it fair to all concerned? Will it build goodwill and better friendships? Will it be beneficial to all concerned?”

“If the government used real accounting, it would make it harder to rob the piggy bank.” U.S. Rep. Jim Cooper (D-Nashville)

Cooper opened his presentation by quoting an Aug. 22 Wall Street Journal article that stated that Nashville is poised to benefit from the overhaul of the nation’s health care system. “As the country readies for electronic medical records, this Southern City is ahead of the pack, boasting over 250 health-care firms,” a graphic illustrating the story states.

But while the business of health care is central to the health-care reform discussion, it has only a small impact on the nation’s health itself, Cooper said. Behavior and genetics have a 70 percent influence on an individual’s personal health, he said. Socio-economic status determines another 15 percent. That leaves only a 15 percent influence from health care providers and other factors.

He used the growing obesity epidemic as an example of a behavior that has a negative impact on a person’s health – and drives up the cost of health care.

Cost, quality and access are the three major prongs of the health-care debate, Cooper said, but right now they are mutually exclusive of one another.

The cost, he said, is “literally bankrupting America.” He said health spending has gone up by inflation plus 2.5 percent for 40 years. Health reform, as passed last year, would limit the increase to the cost of inflation plus 1 percent.

He called Medicare today “a tsunami. A lot of people don’t even realize Medicare is a government program.”

And he said if the national debt was reported on an accrual basis rather than a cash one, it would shock people.

“We are not keeping up with the national credit card. The true national debt is not $14 trillion; it’s at least $62 trillion,” he said, quoting Bloomberg. The majority of people in Washington are in “massive denial” about the scope of the debt, he said, and that goes for lobbyists as well as members of congress.

“If the government used real accounting, it would make it harder to rob the piggy bank,” Cooper said.

Regarding access to health care, Cooper said most graduates of medical school today are choosing to be specialists because “that’s where the money is.” Yet what is really needed are more primary care physicians.

Duplication of services and the over-treatment, under-treatment and mistreatment of patients all have a huge impact on cost and access, he said.

Tennessee has the distinction of being the No. 1 medicated state in the nation; the average Tennessean has 18 prescription medications, he said. “We are bankrupting ourselves to poison ourselves.”

One of the biggest problems in health care today, he said, is the fact that “there’s no transparency at all” when it comes to the cost of healthcare. Finding out something as simple as how much an MRI cost is almost impossible, he used as an example. “A doctor doesn’t know and the patient is clueless.”

Electronic health records are a key component of health care reform, Cooper said, who said “$100 to $300 billion a year goes into that worthless paperwork.” But a fundamental problem is the fact that many medical practices are slow to come on board. In fact, “10 percent of physicians in Nashville won’t bill Medicare electronically,” he said.

Someone in the audience asked how the public is supposed to know what to believe as the bill is thousands of pages thick, Cooper – a lawyer, businessman and part-time business professor in addition to serving in Congress -- said he had read every page. He declared that “70 percent of the bill is good.”

“Any mule can kick a barn down; it takes a carpenter to build one. We need more carpenters,” he said, referring to elected officials working together to make health reform work.