John Katko: Let's Talk Health Care Reform

Former prosecutor John Katko is the Republican running for New York's 24th district House seat, currently held by Dan Maffei, who took the seat back from Ann Marie Buerkle after she took it from him in their first battle.

Katko has a few of his own ads running; he's also got a boatload of outside-the-district money behind him, hammering away at Maffei on positions both real and imagined. (Maffei and his supporters are doing the same, by the way.)

I've made the case repeatedly about how the politicians we need are the ones who are more interested in talking about what they stand for and believe in, instead of those who simply badmouth their opponent. I know from Katko's ads that his wife loves him, that he's a great mentor, and that as a prosecutor he was strong on crime and helped get rid of several of the gangs that used to hang about a mile or so up the block from where I live.

For that last part, I offer my thanks, but I'm not sure how that equates to representing our district, unless his intention is to go to DC and break up the gangs that are holding Congress (and the country) hostage?

To find out what he believes, I checked out his website, where he posts issues videos called Katko Comments. I started with the one on health care, and after watching it I have some questions.

(1) Like most Republicans, you talk about people who lost their coverage after being told by President Obama they could keep it. Since most people with insurance have it through their jobs, and since the Affordable Care Act (ACA) did not force companies to drop coverage, reduce employee hours, change carriers (and provider networks), etc. have you talked with any business owners or company benefit reps to find out if they've changed their employee health insurance plans, and if yes, why? Will you share those details?

(2) You  note that you spoke recently with a person from Auburn who pays, between premiums and out of pocket, close to $25,000 per year for insurance. We don't know his specific situation, so all we can do is respond emotionally to that number. I wonder, what would you consider a reasonable annual cost for health insurance premiums and out of pocket expenses? $1,000? $5,000? $10,000? $15,000? And in general, do you support or oppose consumer-driven health care options, commonly referred to as high deductible health plans?

(3) You mentioned you don't want Washington bureaucrats coming between patients and their doctors. I've heard this several times from Republicans. Which specific provisions of the ACA put bureaucrats in the middle of the doctor-patient relationship?

(4) Like most Republicans, you support the wellness (preventive?) provisions of the ACA, keeping kids on the parents' policies until they're old enough to leave the basement and the elimination of preexisting conditions. I'm curious whether you support or oppose these other provisions:

• Coverage for essential benefits? 
• Elimination of annual and lifetime benefit limits? 
• Subscriber refunds, if administrative costs eat up too high a percentage of the premiums paid?

(5) You favor allowing insurers to sell across state lines.Why are you so willing to sacrifice me and my several hundred co-workers by inviting deep-pocketed national carriers into New York, carriers against which it would be nearly impossible for local/regional health insurers like my employer to compete? If you're successful in getting this 'nationalization' of health insurance approved, what steps would you take to assist us if we all lose our jobs?

(6) You speak about the ACA taking hundreds of billions of dollars from Medicare. Disregard for a moment that this same argument was debunked back in 2012, and that the ACA did not actually take money from Medicare, but instead reduced the proposed increases in Medicare spending over the next decade, by the same $700 billion that the Republican budget plan would have. If elected, would you ever vote for a budget that reduces actual or proposed Medicare spending?

(7) Finally, please identify at least three things you would propose to change in the ACA  to reduce health care costs - not health insurance costs, which are different -  for Central New York individuals and families, and explain specifically how you would work across the aisle to gain bipartisan support for these measures.

Thanks for clarifying your positions on this critical issue.