10 things to know about Jeb Bush's views on healthcare

John Ellis "Jeb" Bush officially announced Monday he is running for president in the upcoming 2016 election, 27 years after his father was elected president and 15 years after his older brother, George W. Bush, was elected. Here are 10 things to know about the former governor of Florida's views on healthcare.

1. Mr. Bush feels the Patient Protection and Affordable Care Act is "flawed to its core," according to The New York Times. Mr. Bush served on the board of directors for Dallas-based Tenet Healthcare from April 2007 to December 2014. While serving on the board, Mr. Bush made his personal views on the PPACA clear, Tenet CEO Trevor Fetter told The New York Times. Tenet supported the law and encouraged people to sign up for insurance under it, according to the report, but Mr. Bush kept his personal views separate from his professional duties, Mr. Fetter said.

2. Mr. Bush would like to repeal the PPACA and replace it with consumer-directed and "catastrophic" health plans. He believes in providing catastrophic coverage that covers just major medical issues rather than comprehensive coverage, according to Politico. For the rest, he would like to install a consumer-directed model that gives patients more choice.

3. Medical billing is nontransparent, he says. After a 2013 knee surgery, Mr. Bush commented on the billing process while speaking in Wisconsin. "The whole experience is opaque," he said, according to the Milwaukee Journal Sentinel. "It's like smoke comes up, you don't know what's really happening, the third party pays."

4. Mr. Bush has spoken out against Medicaid expansion. In 2013, Mr. Bush spoke out against current Florida Gov. Rick Scott's move to accept federal funds to expand Medicaid, according to CNN. He doubted the decision because the federal funding would phase down. Gov. Scott has flip-flopped on Medicaid expansion since; this year he threatened to sue the federal government for withholding money to force Florida to expand the program.

5. As governor of Florida, Mr. Bush implemented a Medicaid managed care pilot program. Mr. Bush proposed the plan in 2005 that would allow Medicaid beneficiaries to buy their own health insurance from managed care organizations with vouchers, according to The New York Times. Dubbed "empowered care," the idea was a first for states. It allowed payers to decide what to offer and even allowed patients to buy coverage outside of Medicaid, according to Bloomberg. The idea was to let consumers shape the market to lower costs. The program did control costs: According to Politico, a study found counties that implemented the pilot slowed Medicaid spending growth to just $1 per person per month, compared with up to $28 per person per month in other counties. However, plans in this pilot ranked lower than the national average on 21 of 32 quality indicators, according to Bloomberg.

6. Mr. Bush has supported lowering medical insurance costs. In 2003, Mr. Bush signed a bill in Florida to reduce medical malpractice insurance to keep physicians from closing their practices. The law capped noneconomic damages to $500,000 in most cases, according to the Los Angeles Times. The law did not limit economic damages.

7. Medicare beneficiaries should be required to sign an advance directive, Mr. Bush says. While serving as governor of Florida, Mr. Bush intervened in the Terri Schiavo case. He passed a law supporting the Schindlers, Ms. Schiavo's parents, who wanted to keep her alive despite her permanently vegetative state. Ms. Schiavo's husband wanted to remove her feeding tube. The law was ultimately ruled unconstitutional and Ms. Schiavo died in April 2005, according to The Washington Post. "I think if we're going to mandate anything from government, it might be that if you're going to take Medicare that you also sign up for an advanced directive where you talk about this before you're so disabled that then there's fights amongst the family," Mr. Bush said in April. "I know for a fact that the Schindlers were more than happy to take over the care of this child. And I supported that."

8. He sees wearables as the future of healthcare. "On [the Apple Watch] in five years will be applications that will allow me to manage my healthcare in ways that five years ago were not even possible," Mr. Bush said in May while speaking at a brewery in Tempe, Ariz. "We'll be able to guide our own healthcare decisions in a way that will make us healthy. Ultimately, we have to get to a health system, away from a disease system."

9. Mr. Bush is pro-vaccines. This February he stated simply, "Parents ought to make sure their children are vaccinated," according to NBC News.

10. Mr. Bush does not support abortion. According to Real Clear Politics, Mr. Bush was a staunch opponent of abortion rights during his tenure as governor of Florida. He signed a law that required parental notification of teen abortions and asked a circuit court to appoint a guardian for the fetus of a rape victim in 2003.  


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