Gubernatorial Debate: Answers to Question 5
Welcome to our gubernatorial debate.
We're asking all 10 candidates for governor a series of questions leading up to the May 22 primary. If you'd like to submit a question, please send me an email or leave it in the comment section below. Please provide your first name and hometown.
Candidates may provide a 100-word rebuttal for as many of their opponents' answers as they choose. We'll also allow 50-word sir rebuttals. We'll post those as we receive them.
We'll announce our next question on Monday. Click here to see previous installments of our cyber debate.
- John Stamper
QUESTION
Medical businessmen and organizations who want to improve the quality or quantity of health care must first get Kentucky’s permission to do so. While both Indiana and Ohio have abandoned their Certificate of Need system, existing Kentucky health care facilities have lobbied hard to retain this law. Do you think Frankfort is better at assessing the demand for medical services than the free market?
- Kevin Kavanagh from Somerset
DEMOCRATS RESPOND
STEVE HENRY:
As a surgeon, I know that the free market doesn't always provide the right outcomes when it comes to health care. The free market wouldn't provide veterans with the care they need — which is why I unveiled a proposal to make sure that veterans have the voice they need to keep our Kentucky VA hospitals excellent.
And the free market is leaving too many families without access to affordable health care. As Governor, I'll put the free market to work on the kind of health care problems it can solve — and we'll work together to solve the rest.
OTIS HENSLEY:
No response.
BRUCE LUNSFORD:
The issue of access to affordable health care is of vital importance. That’s why I’ve proposed a real universal health care plan to cover all Kentuckians and lower the cost of health care. In large part, Certificates of Need guard against costly overbuilding of medical facilities and help control health care cost and growth. Certificates of Need should be granted based on an objective analysis of community need, and not because of special-interest politics. We need to strike a balance between responding to local community health care needs and appropriate regulation of health care facilities.
JONATHAN MILLER:
I believe in the free market for business. The laws of supply and demand left unchecked in the medical center field, however, would leave many behind without adequate access to health care, particularly in rural areas of our Commonwealth. Further, I have seen no compelling evidence that shows a revocation of the Certificate of Needs process would result in better healthcare for Kentucky. For those reasons, my comprehensive plan to bring universal healthcare for our citizens does not include a change in the certificate process.
JODY RICHARDS:
No response.
GATEWOOD GALBRAITH:
Lawmakers, who allowed retired state employees' pension funds to reach a $12 billion deficit and admit knowing little about the depths of Medicaid fraud, have let the Certificate of Need (CON) program run amuck in their desperate searches for incumbency.
For-profit corporations dominate healthcare; make large political contributions; lobby for CON to continue, driving up health costs while perpetuating their monopolies in the healthcare business. Just another example of the collective 80+ years of failed leadership of my opponents.
Free market competition can be applied to healthcare facilities to halt spiraling costs, eliminate the bureaucracy, and better serve Kentuckians.
STEVE BESHEAR:
Kevin,
Making affordable health care available to all Kentuckians is one of our top priorities and Dr. Mongiardo and I will be introducing a plan to make health care more affordable and reduce costs in the coming weeks. To do so will require a careful review of all our health care programs to determine if they are achieving their intended goals.
In the end, Dr. Mongiardo and I are committed to putting Patients First.
REPUBLICANS RESPOND
ANNE NORTHUP:
The Governor plays an important role ensuring every Kentuckian has access to quality health care through Kentucky's State Health Plan. We need a thorough review of the current CON system and any modification to the Certificate of Need process must be made within the context of changes to DISH payments, Medicaid reimbursement rates, the Provider Tax and medical information transparency. After a thoughtful update to the State Health Plan, increased competition between providers will improve both the cost and quality of health care while ensuring an effective medical infrastructure remains in place throughout Kentucky.
ERNIE FLETCHER:
I believe it is important for Frankfort to listen to the demands of the free market. My administration has done that by removing regulatory restrictions that previously prohibited any expansion of healthcare services in the Commonwealth. We have made a number of changes that allow expansion of healthcare services closer to home which will increase options for an aging baby boomer population. Many states who have abandoned CON laws have had to address this issue in other ways. It is important that we continue to foster a competitive healthcare market place that results in higher quality, lower cost healthcare.
BILLY HARPER:
You may remember my predictions that most people would not answer this question directly and other then Gatewood, Miller, and Harper, nobody did. I am amazed that not one politician took me up on my offer to provide a proof source or study on why to keep the CON. It was worth 1000.00 donation to that campaign or campaigns. I do not like to part with my money, but it was worth it to me to find out if there was any proof that shows the CON works. I am not aware that there is any proof, yet I was willing to put my money where my mouth is. NO TAKERS! Too bad. I wanted to be proven wrong, then I would know that the politicians had not sold out the future of this state for campaign donations. I am sad that is true. All anyone of them had to do was call the LRC and ask for the study and statistics showing the success of the CON policy in Kentucky. Why did then not do that? Because it is not there! That is the political reality of Frankfort and the power of the lobbyist. Gatewood and Harper answered for Kentuckians because they understand free market principles and they are not owned by special interest. Miller answered for the special interest but at least he answered. He also stated that there was no compelling evidence to abolish the CON. I will leave him the website again that shows the many articles that show why the CON should be abolished. He also did not take me up on my offer of providing any proof sources of his stance to continue the CON, if so I would have donated 1000.00 dollars to his campaign. I would encourage all Kentuckians to read the website listed below. I would also encourage you to use the freedom of information act with state and federal Government and ask for information on the CON. I would encourage John Stamper to do an expose on the CON, he should interview Dr. K and the KMA as well as the KHA and the CON. I am glad the question was asked, my predictions for the most part came true. I did state that Billy Harper would answer this question truthfully since he is not owned by anyone. Gatewood is the real deal as well. Too bad the perception is against him. Henry sold out on his answer, Lunsford was given a CON and a monopoly for his business (Vencor) which is why it went from 3 employees to 62,000 thousand employees, it is not because he is a good business man which obviously he is not since even with a monopoly he failed. Lunsford brags in his commercials that he is a successful businessman, yet he could not make it when he operated a monopoly, he was given everything but the kitchen sink, yet he failed. If you can not make it with a monopoly you can not make it at all. That was a sweetheart deal given to Lunsford by his cronies in Frankfort years ago, in a sense, it is your tax dollars that made Lunsford rich, and it is your tax dollars letting him run for Governor. It is like this, if the state gives you a license to be the only grocery store in a Region and everyone has to purchase groceries from you, yet with that type of set up you can not succeed, there is something wrong, that is what happened to Lunsford he had the only grocery store and he failed. Henry states that a free market could not give veterans the healthcare they deserve. The care Veterans get now is a monopoly system, it is a sampling of universal healthcare, and the headlines at Walter Reed should tell you what type of care that is. I do not want any part of Henry Care. Bashear is going to role out his version of Universal healthcare and it will be quite ridiculous. People the free lunch you want so desperately is never free, it will come with severe conditions. Sunshine time,I found this comical, most of the responses, especially Millers (sunshine man) stated that they had to continue with the CON in order to assure access of healthcare. Then they stated that they needed to make a Universal Healthcare plan because there was no access to healthcare in Kentucky. So the democrats are all saying that the certificate of need is needed for access to healthcare, then they are saying due to lack of access they need to create Universal Healthcare. That makes a lot of sense. Righhhhhhhhhhhht! There has never been a free market in healthcare for Kentucky thus the reason for it being broken. Kentucky by it's own statements has one of the worst healthcare systems in the country (please note series done in the courier journal). Kentucky has poor quality by the rankings, reduced access by the rankings, and an inflated high cost. In fact the healthcare cost is so high, the state can not afford to insure the state retirees and the crisis is going to hit the state workers and teachers very soon. 20 billion dollars in unfunded mandate, yet they are holding on to their policy of CON. That is how powerful the lobbyist are of the KHA. The crisis of costs has already hit the tax paying consumer, that is why their access has decreased. This is the outcomes of the failed CON policy, Miller knows this even though he insults our intelligence with his comment of "Further, I have seen no compelling evidence that shows a revocation of the Certificate of Needs process would result in better healthcare for Kentucky." Miller. That answer is code word for the KHA to give him more money. Watch it will happen. I think Miller is an intelligent person thus there is no way he could have made that statement truthfully. Regardless, my other prediction was that the Kentucky Hospital system would win and Kentucky tax payers would lose. If I could only handicap horse racing so well I would not need Universal healthcare. Finally to the Governors response, it was truthful, he has made some positive changes and he has made some negative changes in the CON policy and like we have seen during his term for Governor, change takes time, the aircraft carrier turns slowly, and it is difficult to understand that and have patience. Undoing 30 years of corruption takes time. So I think he is on the right path, time will tell. I would like to see Mr. Richards response, I know he has been busy working on legislation and I am sure he will post an answer soon. It stands to reason, proven by thousands of articles, and studies, proven by the federal government, proven by other free market states that the Certificate of Need is a failure. Politicians (dems) want to make this a values and morals debate so they can argue with emotion and hearsay instead of facts. The facts have been in for 30 years, the facts continue to show that this policy is a failure and I think the only thing that can help Kentucky is an expose by John Stamper or one of his fellow journalist. The politicians fear the great lobby group in Frankfort and will not fight for the people however, they fear the press even more. If the press did a fair balanced expose on this, the facts would come out. If I was Billy Harper or Gatewood Galbraith I would do everything I could do to expose the fraud of this policy, if the people saw what was really going on, it could possibly turn the election. This is the homerun I would look for. The KHA can not support everyone running for Governor or can they? Healthcare is a top issue, it is effecting everything, The dems want you to think they can fix everything with more government programs, can't happen, the repubs are changing slowly, maybe too slow. Changing this one policy would do more to fix Kentucky then all of the taxes and legislative sessions in the world could ever do. It is so simple. John Stamper this is your homerun to change the election, Billy and Gatewood, if you really have what it takes, this is your issue to make it happen. Lets see what you do? This one issue would effect every part of Kentucky in a positive manner including the KHA they just don't know it yet. This is the horse I would run with if I was an underdog running for Governor. Getting rid of the policy increases access, decreases cost, increases quality. Getting rid of the policy would shore up the retiree benefit issue, the 20 billion dollar shortfall is contingent on things staying the way they are which is yearly 35% increases in premiums. If we stop the increases the shortfall is no more. I predict by getting rid of the CON policy we would see yearly decreases in premium costs to the point of decreased by 7.5% a year for the next 7 years. Decreases versus increases. I predict that our quality would increase so much that people would look at Kentucky as a model of healthcare. I predict that tax revenues would triple and we could decrease if not abolish the state income tax. Thousands of new jobs would be created, high paying. It is impossible to bring biotech to a non competitive state. The policy is destroying their own policy of biotech job creation. The policies have to match. If you want to be Governor, here you go. Who has the courage, two of you have already stood up, so why not finish it. Wake up Kentucky you can make things happen for the better. Write John Stamper and his fellow journalist and ask for an expose on this subject. John Stamper is the real deal, he is a credible journalist, he can help Kentucky simply by exposing the facts and then by asking the question of WHY? If the politicians know these facts and we know they do, then WHY?
WEBSITE OF FACTS:
http://www.healthwatchusa.org/certificate_of_need.htm
Posted by: | March 16, 2007 at 03:57 PM
once again, mr. richards make it clear he could care less about the issues. blowing off serious questions from serious voters is not going to impress anyone, sir.
Posted by: | March 16, 2007 at 03:58 PM
As a surgeon, I know that the free market doesn't always provide the right outcomes when it comes to health care.
What is Henry talking about, when he did the fraudulent billing that was under a CON system. He has never worked in a free market system, so this is a lie.
Posted by: conservative | March 16, 2007 at 05:46 PM
And the free market is leaving too many families without access to affordable health care. As Governor, I'll put the free market to work on the kind of health care problems it can solve — and we'll work together to solve the rest
What in the world does Henry mean, my six year old can write better than this. He states that the "free market" which Kentucky is not leaves too many families without affordable access to healthcare. Kentucky is a Certificate of need state thus not a free market, so if it is true that there is a problem with access, then it is caused by the 30 year old monopoly system. Then he states he will work with the free market system to fix the problems that he stated the free market system caused. Double speak my friends, Henry, your 15 minutes are up. See ya, would'nt want to be ya.
Posted by: Conservative | March 16, 2007 at 05:50 PM
I believe in the free market for business. The laws of supply and demand left unchecked in the medical center field, however, would leave many behind without adequate access to health care, particularly in rural areas of our Commonwealth.
What in the world is Miller talking about, healthcare is a business which is why it demands free market. He states that we need Universal healthcare due to lack of affordable healthcare. How does it make sense that he states the Certificate of need is needed yet he then states that Kentucky needs affordable healthcare for accesss, which is what CON is supposed to do. I am so confused. If CON works then why do we need Universal Healthcare?
Posted by: Conservative | March 16, 2007 at 05:54 PM
Miller (smalls your killing me)
Further, I have seen no compelling evidence that shows a revocation of the Certificate of Needs process would result in better healthcare for Kentucky. For those reasons, my comprehensive plan to bring universal healthcare for our citizens does not include a change in the certificate process.
What in the world is Miller talking about, is anyone in the Dem world qualified to run for Governor? Dude it is called google, google CON and you will get all of the compelling evidence you need. I guess the fact that the state can not afford benefits for it's retirees under your watch is not compelling evidence. Where do they get these guys, Dude, you are paying people to run your campaign, at least let them do some 5 minute research so you do not look like you do not know what you are talking about. Clueless.
Posted by: Conservative | March 16, 2007 at 05:57 PM
For-profit corporations dominate healthcare; make large political contributions; lobby for CON to continue, driving up health costs while perpetuating their monopolies in the healthcare business. Just another example of the collective 80+ years of failed leadership of my opponents.
Gatewood, fix the perception because you are one sharp guy.
Posted by: | March 16, 2007 at 06:00 PM
Making affordable health care available to all Kentuckians is one of our top priorities and Dr. Mongiardo and I will be introducing a plan to make health care more affordable and reduce costs in the coming weeks.
Beshear, unless you follow what Gatewood stated, you are a retread. Unless the CON goes by by, you can not make affordable healthcare without creating a severly capitated system, which the hospitals would hate you for that even more than if you did the right thing and created a free market. What are you going to do, this will be a win or lose deal before it is over.
Posted by: conservative | March 16, 2007 at 06:03 PM
The issue of access to affordable health care is of vital importance. That’s why I’ve proposed a real universal health care plan to cover all Kentuckians and lower the cost of health care.
Lunsford, you already failed once with a monopoly, what makes you think it will not happen again. Your idea is a lib idea, it has already failed, your ideas are DOA. Can you just donate your money to my favorite charity since you are flushing it down the toliet.
Posted by: conservative | March 16, 2007 at 06:06 PM
The Governor plays an important role ensuring every Kentuckian has access to quality health care through Kentucky's State Health Plan. We need a thorough review of the current CON system and any modification to the Certificate of Need process must be made within the context of changes to DISH payments, Medicaid reimbursement rates, the Provider Tax and medical information transparency.
Does Ann have a pulse? Saying a lot without saying anything at all. Wow, this is incredible stuff. What a waste of time.
Posted by: Conservative | March 16, 2007 at 06:07 PM
believe it is important for Frankfort to listen to the demands of the free market. My administration has done that by removing regulatory restrictions that previously prohibited any expansion of healthcare services in the Commonwealth
The Governor has done this, not fast enough, but he does have other issues to work with. B+.
Posted by: Conservative | March 16, 2007 at 06:08 PM
Harper,
You can win the Governorship on this issue alone if you explain it correctly. Let me know if you want to win and need help. This is the greatest issue facing Kentucky. There is enough information to flip this election on its head if you choose to take the challenge. I am not convinced you want to win. This is the issue to do it with.
Posted by: Conservative | March 16, 2007 at 06:10 PM
To the liberal Dems:
I would challenge you all to promise the public that all state workers, teachers, legislature, retired state workers, retired teachers, judges, retired judges, ect.... are going to participate 100% in your Universal Healthcare plan, as a matter of fact any government worker, local, county, federal, all of them have to be bound by your Universal healthcare project. If you do that, then I will believe you. otherwise it is just something to pander to voters with. Pandering should not be allowed. What is it going to be Libs, put up or shut up.
Posted by: Conservative | March 16, 2007 at 06:14 PM
Check out here: http://osi-speaks.blogspot.com/2007/03/what-are-they-really-saying-certificate.html#links for what they're REALLY saying!
Posted by: KYJurisDoctor | March 16, 2007 at 06:43 PM
KYJURISDOCTOR,
Thanks for the link, that site probably plays it better than my play by play analysis. I just find it so insulting that these people running for governor do not tell the truth, or make it up as they go. If they can not do any better research other than "my lobbyist told me so" what is the point. I also want to see them put all of government into the progams they want to create. I can see a government worker in a Universal Healthcare plan, they are used to getting what they want when they want it, to go to a system that says we can fit you in for that CT in 6 months. If they are going to pander to the people they need to promise to put all public officials and government workers into the same system. We will see how long that last. Great site thanks for showing me the minimalism.
Posted by: conservative | March 16, 2007 at 09:16 PM
Dr. Mongiardo,
You know better, do not think I do not know. I know a lot of your friends and they have all told you why the CON is bad for Kentucky. Will you take on ARH, that is the question. We shall see.
Posted by: Conservative | March 16, 2007 at 09:24 PM
is steve beshear going to go back to being a lobbyist after he loses in the primary?
Posted by: | March 16, 2007 at 10:44 PM
Conservative: Thanks. Every week I'll analyze "what the politicians are REALLY saying". Last week's version on local tax options is here:
Osi">http://osi-speaks.blogspot.com/2007/03/what-are-they-really-saying-local-tax.html">Osi Speaks!: What are they REALLY saying?: Local tax option
Posted by: KYJurisDoctor | March 17, 2007 at 01:31 PM
conservative
go cry with your buddy ernie you rethug i bet you are for north carolina too
Posted by: steve hail | March 17, 2007 at 10:16 PM
Steve Hall,
Take of your skirt you little girl
Posted by: conservative | March 18, 2007 at 12:23 AM
Go, Kentucky, and no I am not for North Carolina, they are a CON state as well. Take off your wig you loser.
Posted by: Conservative | March 18, 2007 at 12:31 AM
One can argue that transparency in healthcare costs and quality must first take place before the CON is removed. There are examples of healthcare markets in Kentucky that have ample providers but still have high costs. However, when a consumer does not know the price or quality of the service he is buying how can competition exist? Thus, it is hard to argue with a candidate’s cautious approach before removal of the CON. It is my firm belief; removal is needed, especially in rural markets where virtual monopolies are granted by the state with little fiscal oversight. However, for removal to happen transparency in healthcare costs and quality must first take place.
Posted by: Kevin T Kavanagh MD | March 18, 2007 at 09:26 PM
John Stamper,
The certificate of need issue is begging for an expose. Otherwise, status quo will remain. Please consider doing an expose on this issue.
Posted by: Conservative | March 19, 2007 at 11:41 AM
The Failure of Certificate of Need Regulation
By Robert Cimasi
The following report is full of information and statistics regarding the CON programs in the United States. The report concludes the CON does not reduce costs or improve the quality of healthcare. The appendices of the report include a listing of state CON states.
"The Failure of Certificate of Need Regulation" Report
Posted by: conservative | March 19, 2007 at 12:45 PM
No Evidence That CON Reduces Cost
Three decades of experience has supplied ample evidence that Washington’s CON laws have not worked as their creators intended. A 1999 study by the Washington State Joint Legislative Audit and Review Committee (JLARC) and a 2005 study by Seattle’s Mercer Human Resource Consulting Group both concluded that Washington’s CON laws have neither reduced the cost of nor increased access to health care. A 2004 report by the Federal Trade Commission and the Department of Justice came to the same conclusion, and suggested that in some states CON laws have contributed to higher health care costs by reducing supply and stifling competition.
CON laws result in the opposite of their intended purpose, by actively blocking citizens’ access to health care choices and to modernized health care facilities. The laws also bog down health care providers in stacks of regulation and paperwork.
CON Protects Monopolies and
Puts State Bureaucrats in Charge of Health Care
In practice, Washington’s CON laws are not about improving health outcomes for citizens, they are about controlling access to health care. State bureaucrats—not communities and health care professionals—pick the winners and losers in the health care market as they decide what medical facilities will be built and where.
The program’s record indicates CON no longer serves the public interest, if indeed it ever did. The stated purpose of the program is to control costs and meet changing conditions. Yet, to succeed our health system requires the very flexibility CON is designed to prevent. In a state experiencing rapid growth and demographic change, CON prevents providers from adapting to the changing health needs of the community.
Policy Note
The Failure of Government Central Planning
Washington's Medical Certificate of Need Program
Read the full Policy Brief here.
by John Barnes, Policy Analyst
01-06
Posted by: conservative | March 19, 2007 at 12:52 PM
I can answer why we need to keep the CON process in Kentucky. I have been involved in request for a CON twice personally. I can tell you that it is a process that ties up several state paid lawyers, paralegals and clerks. It makes "busy work" for a great number of staff. It causes people who can not afford to "jump through hoops" not even begin to help in the care of Kentuckians. I assure you that the CON process does not interface with any of the programs mentioned by Anne Northup in any meaningful way. It also allows all the "competitors" to know who wants a place in "their" business so they can circle the wagons and prevent any opponent from setting up shop (even though the opponent might offer better care). Where else does a company get a heads up on anyone going into business across the street and then gets to sit in on the explanation of their business plan, testify against the need for the competition and have the "System" pay for it all? That is why the CON system works so well in Kentucky and I will take that $1000.00 for my campaign, thank you.
Posted by: MaDonna White | March 20, 2007 at 08:15 AM
Ms. White,
You are correct! Great answer!
Posted by: conservative | March 20, 2007 at 09:32 AM