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How Brown, Warren Would Tackle Health Care

LOWELL, Mass. — Even with her wireless microphone, it takes Michelle Ramalho a little while to get the attention of her Friday lunch crowd at the Lowell Senior Center.

“Good morning everyone,” calls Ramalho, the center’s director. “Good morning everyone,” she tries again. “How about a great big welcome for Sen. Scott Brown?”

Brown enters a packed multipurpose room to applause. He weaves among tables shaking hands, pausing for pictures, and answering questions about his wife and daughters.

Medicare is a hot topic in the news these days, but what Eva Crawford really wants to know is: Why isn’t Brown wearing a seat belt while driving his signature truck in a series of TV ads?

“It is on,” Brown says, “it definitely is on.” Well, Crawford says, “you got to show it to us.” Brown waves. “I always wear my seat belt,” he says, moving to another table.

Brown is ready for a question about Medicare. It’s a topic that comes up a lot on the campaign trail. The focus, Brown says, must be on getting rid of waste, fraud and abuse.

“You probably heard of the doctor down in Texas, $300 million, one person, on Medicare fraud,” Brown says. “We can reform Medicare from within the system. But the message is: Anyone who is getting it or is about to get it should be grandmothered, grandfathered in, they’re not going to have any effect. We need to strengthen it from within the system for future generations.”

Brown does not support the Romney-Ryan plan to turn Medicare into a premium support (some call it a voucher) program with seniors buying coverage on their own.

Nor does Warren, who says the main problem with Medicare “is the rise in health care costs, and we’ve got to bring health care costs under control for everyone. And so the question is how we provide needed medical care for all our people at a price we can afford.”

Warren says Massachusetts is coming up with answers through research and pilot programs that will help guide the country. She rolls right into the example of an asthma study at Children’s Hospital.

“What they discovered is they could do more intensive treatment at the beginning,” Warren explains. “And for every dollar spent, they saved $1.46. They got those kids healthier, they kept them out of the hospital, fewer trips to the emergency room, and to me, there’s the heart of the game.”

Brown looks ahead to a political solution for rising health costs (he does not offer details).

“It’s not going to be a Democrat or Republican bill,” Brown says. “It’s going to be a bipartisan, bicameral bill that the president will sign. And that’s a big difference. I’ve been down there working together. Professor Warren, she’s going to be down there 100 percent with her party, and that’s not going to pass muster.”

Here, Brown is building on one of the main themes of the campaign. He claims that Warren won’t work across party lines. Warren counters that Brown is part of, and can’t avoid supporting, Republican priorities that aren’t popular in Massachusetts.

Personal Experiences With Health Care

But when it comes to personal experiences that have shaped the way Brown and Warren think about health care, there’s a lot of common ground. Both candidates grew up in families that did not have health insurance and often could not afford basic medical care.

“Everyone struggles,” Brown says. “My mom, as you probably know, was married and divorced four times each. I lived in 17 different homes by the time I was 18. I was the guy who was out stealing food when I was 12, so of course I know about struggles.”

Warren’s early health care memories start with her mother, putting her hand on Elizabeth’s hot forehead. “Then she’d always look up and recite the doctor bill, how much was outstanding. And then she’d make the calculation, how sick was I and whether or not to call the doctor. That’s hard on a mom and it’s hard on a kid.”

Both candidates say they are proud to live in Massachusetts, where nearly all residents have some form of health insurance. Brown voted for the insurance coverage law when he was in the state Senate. But he would repeal a similar federal law, saying it won’t work in many states. Warren says it’s critical to keep the federal law in place.

Health care is a decisive issue in many states, but may not be in Massachusetts, says Harvard Kennedy School professor Bob Blendon. That’s because voters here are largely happy with the state’s coverage law, Blendon says, which they don’t see threatened by the federal election.


We put five more health care questions to the candidates. Here are their emailed responses:

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  • J__o__h__n

    I read Scott Brown’s book and he appears to have drawn the wrong lessons from his life.  His mother was on welfare so he claims that it is important to be fiscally conservative and not that it is important to have a safety net for those who need it. 

  • Mass Doc

    As a physician, it’s hard for me to square all of Senator Brown’s positions on health care.  He insists he agrees with the President on all the particulars, but still wants to repeal the Affordable Care Act.  We now know, from both Kaiser Foundation and HHS analyses in recent months, that Medicare Advantage premiums have dropped 10% since the Affordable Care Act became law in 2010.  In addition, enrollment in Medicare Advantage has risen 30% as a result of those lower-cost premiums.  This is despite the standard GOP rhetoric, which the Senator has often repeated, that the President “stole” from Medicare Advantage when he re-negotiated payments to the insurance companies, device makers, hospitals and physicians.  Doctors and hospitals were willing to re-negotiate because they want Medicare to last, and now there won’t be a fiscal problem of any kind until 2024.  If the Affordable Care Act is repealed, we hit the wall in just 4 years.  My prescription?  We need a new Senator. 

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