Charlie Norwood has heard howls in his day, especially from citizens on the receiving end of his drill. Those don’t match the pain he’s inflicting on fellow hotshot Republicans in Congress.
He is, after all, a dentist-turned-GOP congressman from Georgia. More telling these days, he’s a most unlikely scourge of the health-care, insurance and Republican Party establishments.
While Congress has been consumed with tobacco legislation and splitting for yet another election-year respite, it is involved in a struggle over your health-care future. It’s a tussle only slightly less titanic than the tobacco fussing, though the fights have much in common.
In each, some of society’s more powerful forces are allied to do what special interests do best in Washington: strive mightily, with checkbooks in hand, to maintain the status quo.
The two-term, right-leaning Norwood is smack in the middle of the fracas, if very surprisingly to the left of center on the issue.
And to understand where he’s coming from and why ideological enemies are drawn to his proposal for your future, just open wide and listen to how dentists can alter their ways due to the fiscal realities of managed care.
“Say a patient needs a crown,” Norwood explained, sitting in his office with his wife, Gloria, nearby. “Instead, you give him a filling, which is less expensive. You make more doing a less expensive treatment, which is sometimes the best way to go but sometimes isn’t.
“In my practice, we’d call people a day ahead to remind them to come in for their cleaning,” he said. With managed care, perhaps you don’t do that, figuring some folks won’t show. Because you might get paid based on the number of folks in the plan, that might be all the better, he explained.
Norwood’s in the fray because he has written a health-care bill, known by the cognoscenti as PARCA, which has drawn support from more than half the House of Representatives, including folks whose nostrils might normally flare at mere mention of his name. They include Democrats David Bonior of Michigan and Bobby Rush of Chicago, as well as quasi-socialist Rep. Bernard Sanders of Vermont.
But when it comes to Norwood’s party hierarchy led by fellow Georgian Speaker Newt Gingrich, that’s another matter. There’s a critical GOP health-care task force, headed by Rep. Dennis Hastert (R-Ill.), which will shape any final product. It’s navigating a minefield, wanting to do something to look consumer-friendly and still not anger business, and its ambiguity toward Norwood was underscored during a private session last week.
“We’re divided in our family,” Norwood told me after the meeting. By “family,” he means not just his legislative superiors but also bedrock Republican allies such as corporate America.
As he sees it, the insurance lobby takes all its money and clout and “gins up the chambers of commerce and says, `This (Norwood’s bill) will break you,’ ” which Norwood finds preposterous but a potentially potent fear.
Before confronting the sum and substance of his handiwork, be informed that Norwood, 56, is a Vietnam veteran-turned-dentist-turned-entrepreneur. He practiced in his district’s stronghold, Augusta (home of the Masters golf tournament) and once headed the state dental association. He also started a tree nursery and fabrics business, selling his dental practice after 24 years to try elective politics; he ultimately creamed a Democratic incumbent.
For someone who got started late in the game, he quickly gained a reputation as a very strong campaigner and impressive fundraiser, being one of the most successful shakers of the money tree among the 73 freshmen Republicans who entered in the GOP’s historic class of 1994 as the party took over Congress.
He also is very, very conservative, which means he’s prominent in the black book of groups such as organized labor. At hearings, for example, on the Teamsters, he has railed against the union and revealed a rather caricatured, right-winger’s image of a totally corrupt, undemocratic institution. The reality is far more complex than he and others would admit.
He has voted against a minimum-wage increase. He has voted to weaken occupational safety and health laws and the National Labor Relations Board. He has voted to make union organizing more difficult and against affirmative action programs. He has sought to let local government require citizenship tests before people can vote.
“He’s as bad as they come,” said Steve Rosenthal, political director of the AFL-CIO. “He’s no friend of working families.”
And, yet, he has spearheaded legislation that, by most accounts, would be very good for working families when it comes to health care.
In sum, his plan would improve access to medical care, increase the amount of information you can get about your care, hold the industry far more accountable and probably give you more choice, or at least give more discretion to individual physicians over your care. It is not materially different from the other major proposal, by prominent Democrats.
The most vivid provision of Norwood’s proposal would let consumers sue their health plans. As things stand now, that is limited by the federal law known as ERISA. If a self-insured plan denies a certain coverage, like for a mastectomy, it can’t be sued. If it decides some procedure is not medically necessary, it can’t be sued.
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In pushing this notion, which really makes the GOP leadership nervous, Norwood reveals how the interests of consumers and physicians can merge. The doctors believe that if health plans, rather than they, were sued more often, the doctors might be sued less. It’s an equity issue for them.
Norwood would liberalize access to medical specialists and demand more disclosure from plans, including whether there are appeals procedures to their decisions.
Speaking of appeals, his bill includes an appeals procedure whereby you could go to a neutral, third party if you clash with the plan. In addition, there are very controversial, somewhat ambiguous, elements dealing with due process for providers. If a doctor gets kicked out of a plan, there would be a due process system for him or her, which the insurers don’t like at all.
Then, he’s got goodies like a “prudent lay person standard” for emergency care. Say you’ve got a pain in your side and fear you have an acute appendicitis. You go to the emergency room, but it’s just indigestion and the plan won’t pay the $200 bill. If your decision is deemed that of a “prudent person,” the plan would have to pay.
Finally, there is the “point of service” provision. A typical HMO has a list of doctors and hospitals. A point-of-service plan lets you go to doctors not on the list and pay more. Norwood says if an employer only offers you an HMO, the plan must offer a point-of-service option, which increases consumer choice.
“The bill is certainly among the most comprehensive pieces of health-care consumer-protection legislation before the Congress,” said Larry Levitt, director of the changing health-care marketplace project for the Kaiser Family Foundation in Menlo Park, Calif.
“This would give people easier access to specialists, let them appeal decisions of their health plans and sue the plan if they’re wrongfully injured by their plan,” he said.
Make no mistake, the fact that Norwood is not marching in lock-step with the Republicans’ usual benefactors has created suspicions. He said one colleague approached him at Hastert’s health-care task force meeting and asked, “Who put you up to this?”
I said, “Nobody.”
“I’ve been in health care for most of my life,” said the Georgia dentist, who then paused. “Which is longer than most of these people have been up here in Congress.”