Letter from Pat Tiberi's Office

A while back I posted the text of a message I had fired off to Rep. Tiberi concerning a bill that he had introduced mandating insurers to cover reconstructive surgery for children.

I was working from a press release by an interest group, so I didn't want to make too many assumptions about the actual bill. The intent of the legislation seemed to be a good one, but from the sound of it the bill was not at all conservative in the way that it imposed government onto business practices, and not at all progressive in that it would possibly only benefit kids who already had private health insurance, and/or add even more costs to Medicaid, one of the entitlement programs whose budget sizes have become Mr. Tiberi's pet issue. So even though (perhaps especially because) I have no reason to believe that anything but a sincere desire to help kids motivated Mr. Tiberi, I was surprised at the form of the proposed solution and hoped to get some clarification.

In the past, I have never recieved anything but auto-replies from D.C., so I have to admit that I was surprised when I got an email back addressing each of my questions. I was also more surprised than I probably should have been to see that the tone was really quite polite. There has been a disorienting outbreak of civility lately amongst the local Republicans I follow. Civility may not make for the most riveting blog exchanges, but it is certainly a very welcome development. So for the time being, in which I've explained myself and my point of view, I think it's only fair to let Mr. Tiberi have a chance to speak for himself:

Dear (bonobo),



Thank you so much for your very kind email concerning my original cosponsorship of the Children's Access to Reconstructive Evaluation & Surgery (CARES) Act of 2007. This is indeed an interesting piece of legislation and I appreciate your encouragement and interest in this issue. Please accept my apologies for the delay in responding. Due to the large volume of mail I receive I am not always able to respond as quickly as I would like.



This legislation will help to provide necessary reconstructive surgical care for congenital deformities including cleft lip, cleft palate, skin lesions, vascular anomalies, malformations of the ear, hand, or foot, and other more profound craniofacial deformities. It is particularly important for children with these congenital conditions in helping them to achieve a sense of normalcy and function. I hope this is an issue that can be addressed by Congress. I also find it very interesting and encouraging that President Bush signed comparable legislation into state law while he was Governor of Texas.



In your email, you asked several questions concerning Medicaid, mental health, and the uninsured. Allow me to address the Medicaid and uninsured questions first.



As I'm sure you know, Medicaid is a joint state and federal benefit. States generally have wide discretion over payment methodologies. I understand that in the more recent past there has been a trend of moving Medicaid benefits into managed care plans and away from fee-for-service payments. The general basis for reimbursement, at least as I understand administration of benefits in Ohio, is that processes and procedures must be deemed "medically necessary and reasonable" in order to qualify for coverage. After speaking with several health care professionals in central Ohio, it is my understanding that the determination of medical necessity for children covered by Medicaid is made by the child's physician.



With regard to children who are not covered by private insurance and do not qualify for Medicaid, access to health care is admittedly more challenging. Right now, millions of Americans have no health insurance and millions more are underinsured. As you know, employer-provided health care benefits are the major source of health insurance for workers and their families. However, the spiraling cost of health care has made it increasingly difficult for businesses, particularly small businesses, to provide health insurance for their employees.



A number of different reform proposals have been discussed in Congress and, in some cases, have been approved repeatedly in the U.S. House of Representatives in recent years. These include initiatives to increase the availability of health insurance through new groups called association health plans (which will give small businesses the ability to join together to purchase insurance for their employees with the same advantages that large companies enjoy), and provide tax advantaged health savings accounts. However, there is much more work to be done.



My constituents in central Ohio are fortunate to have access to Columbus Children's Hospital. Columbus Children's is dedicated to providing medically necessary care for all of our children, regardless of their insurance status or ability to pay. Again, it is my understanding that medical necessity is determined by the child's physician.



You are correct that this is similar to the concept of mental health parity legislation. In fact, several bills have been introduced in Congress this year that address this issue, each in a slightly different way. Additionally, the Health Subcommittee of the House Ways and Means Committee has held a hearing on these proposals, and additional hearings are anticipated. While I'm not a member of this subcommittee, I have followed this issue with great interest. I expect that a consensus mental health parity bill will emerge at some point this year, and I look forward to supporting a responsible solution to this issue.



Thank you again for your email. Please feel free to contact my office if I may be of assistance in the future or if you would like to discuss any of these issues further.




Sincerely,



Patrick J. Tiberi



Representative to Congress

Personal Responsibility

I believe in due process, and in the proposition that a defendant is innocent until proven guilty beyond a reasonable doubt. Applying that standard will undoubtedly allow some criminals to walk. That's the price we pay in attempting to ensure that no innocent defendants are unfairly imprisoned. We could repeal the fourth amendment and get many more criminals convicted. I recognize and acknowledge that fact.

I believe in the freedom of speech. I recognize that allowing the public airing of viewpoints that dehumanize classes of individuals increases the likelihood of material victimization of the individuals in that class. There is a responsibility that falls on a society to protect its members from victimization, and perhaps a special responsibility on the part of those who defend the incendiary speech that plays a contributing role. I can accept that.

So just once, I'd like to hear someone from the N.R.A. or like-minded organization say: I believe in the right to keep and bear arms. A society that keeps its population disarmed keeps its population as a tempting and vulnerable target for a range of abuses. Handgun bans could have prevented the tragedy at Virginia Tech. I accept that. Occasionally 32 innocent people will die because a young man had the freedom to obtain the weaponry to kill them. It is a tragedy, and perhaps a preventable tragedy, but it does not justify taking guns away from lawful individuals.

That's a principled position that someone who is willing to take personal responsibility for the consequences of their opinions and actions might hold.

On the other hand, I'm still waiting to hear someone say: There is a distance between what the Second Amendment says, and what many reasonable people believe it to mean. There is quite probably a gap between the Framers' understanding of the role of firearms in society, and the actual role that arms play in our current society. As such, I believe that most forms of gun control are unconstitutional, and that we absolutely need to amend the Constitution to allow reasonable controls on guns.


That's another principled position that someone who understands the consequences of their opinions and actions might hold.

At the moment, however, whatever position you might take in this debate, when 33 people are dead, you lose. Everyone loses. For those whose lives will never fully recover from their loss, you have my deepest sympathy.

Post-Script on Post On Partisanship

Instead of re-typing the two thousand words I had written, then lost when the viewer tool on the state legislature's website crashed my browser, I'll try to sum up:

Webster's defines a partisan as:

1 : a firm adherent to a party , faction, cause, or person; especially : one exhibiting blind, prejudiced, and unreasoning allegiance.

One commenter on my earlier post 'On Partisanship' interpreted my self identification as a partisan blogger as something akin to "a firm adherent to a cause," and shared that identification. Another commenter felt that my I.D. was more akin to having a 'prejudiced, unreasoning allegiance to a party.'

I would pull something different out and say that I have a prejudiced allegiance to a party that is the result of a well-reasoned strategy to advance my goals as a firm adherent to a set of causes.

I'm not usually a means-to-an-end type of guy, but this is how the world works. I happen to agree with the vote on statewwide strip club standards that my State Senator David Goodman made yesterday, even though I supported his opponent in 2006. I bring this up, because today's Dispatch describes the history of Goodman and that vote:

Passing statewide standards now instead of in 2006 also avoided concerns about the re-election of Sen. David Goodman, R-New Albany. One reason Senate leaders took statewide strip-club standards out of the bill in 2006 was Goodman's opposition, and the fear that the vote could hurt him at the ballot.

Goodman won in November. He voted against the bill yesterday, half-joking that he can already envision future ads saying he supports lap dances.

Now, what were Democrats doing on this?

Senate Democrats tried a number of procedural maneuvers to stop the bill, all of which were rejected by Republicans. Six of 11 Democrats voted for the measure, which didn't surprise Minority Leader Teresa Fedor, D-Toledo, who voted no.

"Everything can be used against you," she said. "It may not be good public policy, but politically, who can vote against it?"

With the Republican majority safely re-elected, Goodman can vote against SB 16 on the floor, but Republicans get their way. With Democrats controlling the State Senate, most would be too gutless to vote against it, but the bad bill would never come up for a vote in the first place. I don't blog in a partisan manner because I put party over person, it's because I put policy over both.

Friday News Dump

After an insane week I just plowed through 300 items in my reader. Did you know that Bob Bennett resigned from the Cuyahoga BOE? Anyway, there were actually a number of things that only showed up once, that I would have expected to get more play. So here goes:

1) Columbus is the losingest U.S. Pro Sports Town. Ever. That doesn't count the Crew, but it does count the Panhandles.

2) Sherrod Brown is in a neck-and-neck battle with Amy Klobuchar. Bring that hammer down, Sherrod.

3) Oops. Sometimes you just want to use the troops as a political weapon to bash Democrats and CYA, but some idjit can't figure out cause-and-effect and blows the whole thing.

4) The Newark Advocate covers a visit by PT to OSU-Newark:

"We're going deeper into debt," Tiberi said.

Now, among some mistrust of the party, Tiberi said it's time for Republicans to go back to their roots.

"What we have to do now is think about what we're all about," Tiberi said. "You have to stand for something, and you have to project that." ...

Senior Austin Schorr said Tiberi was what you'd expect from a politician, as he was nice to students and answered all of their questions but didn't approach anything too controversial.

"He was very personable," Schorr said. "He was what you'd expect."

5) Progress Ohio is passing along info on a League of Women Voters meeting on redistricting. Call me crazy, but I think redistricting is a bigger issue and in more need of reform than touch-screen voting.


Time for me to take a breath.
Enjoy your weekend.

Every Day

One of the best pieces of blogging advice I ever read was that you need to post something new (nearly) every day to maintain interest in your blog. Boy, have I been failing miserably at that lately. I don't have time to answer the questions that have been left hanging in the comments to my last post, and they deserve some discussion before I move on, so I've got nothing of substance to put down at the moment.

I will ask any of my remaining readers if any of y'all have any gossip on Strickland's process for naming a new director of the Ohio Department of Mental Health (or any of the other three as-of-yet unfilled cabinet positions).

And finally, on Oct. 09, 2006, I said that I might have overestimated the Blue Jackets chances coming into the season. You think?