STAFF: The following is an unrehearsed interview with Iowa Senator Chuck Grassley speaking to you live from Washington. Participating in today's public affairs program are Nick Wilkens with KCII Radio in Washington, and Glenn Schreiber with Dayton Review in Dayton.
The first question will be from Nick Wilkens.
QUESTION: Senator Grassley, probably some of the biggest news this week has been the credit card legislation. And I'm just kind of wondering what your thoughts are on that and how you think that's going to affect Iowans.
GRASSLEY: Well, it's going to empower consumers.
First of all, thanks to both of you for participating.
It's going to empower consumers, and it's going to -- you know, I see a credit card as a contract between a bank and whoever is holding it. And you normally think of contracts that you'd be notified about changing the rules of the game. But in this particular instance, you know, overnight, they can just change that contract very easily -- raise the interest rates -- that's the most egregious thing -- without knowing it.
But other things that can be done as well. And so, basically, what this does in empowering consumers is that there has to be long advance notice before interest rates are going to be changed or before the rule of the game are going to be changed.
With the idea behind it that you don't want to do business with that bank any more, you can -- you can move on to another bank. And that's -- that's really the way it ought to be. These arrangements ought to be very transparent. And they haven't been very transparent. And this tends to do it and that tends to be, then, why I supported the legislation.
Can we go on to Dayton?
QUESTION: Yes, Senator.
GRASSLEY: Hey, by the way, thank you for covering my town meeting last summer when I was there.
QUESTION: Oh, we enjoyed your visit, Senator.
GRASSLEY: And I still remember the T-shirt I got.
QUESTION: Oh, right. Very good.
Thank you, Senator.
The national -- health care insurance is kind of a topic right now. And there are changes in our health care system are being discussed. And are there some changes, in our opinion, that make sense for America? And what parts of our system are working, do you think? And what parts of our system need to be changed? And then, maybe, how does all this impact Iowans?
GRASSLEY: Well, the most important thing is that we've got 47 million people that aren't covered. Now, that's about 16 percent of the population. In the case of Iowa, it's probably about 8 or 9 percent of the population, maybe a little higher now because of the recession.
But what we ought to do is provide for them to have health insurance because they're going to go to the emergency room. They're still going to get health care, but that's one of the most expensive deliveries of -- the most expensive delivery of health care. So getting them insured, getting them in the system.
People that tend to have insurance tend to be healthier than other people. And so, you know, it's cheaper to keep people healthy than to get them well after they get sick. So, you know, we want people to be able to get insurance. And in the case of low-income people, we'd have to have refundable credits for them to purchase it.
And we want it to be affordable. Now, even if you could buy insurance today, sometimes you can't buy it because pre-existing conditions. But even if -- with pre-existing conditions, you could get it, you might not be able to afford it. So the idea is to make it affordable and to make it accessible. That's our goal.
And in the process of doing that, you deal with issues like, you know, making insurance more understandable. So we would probably set up an exchange for people to get hooked up with insurance in an easier way than trying to fathom all the small print.
And then you deal with issues like should you make health insurance mandatory like we do car insurance if you drive a car and things of that nature.
I think that we've got to talk in terms of reimbursement based upon quality rather than quantity. Or another way of saying it is volume determines payout now. The more often you see a doctor, the more the doctor gets paid. So there's perverse incentives for wasting money. Where, if you're based on quality, you know, that's what we do in Iowa. But we don't get reimburse the as often because people don't go to the doctor as often, or you don't send people to the specialist as often or to the hospital as often.
So, you know, that's why we're low in reimbursement. But if we get reimbursed based on quality, Iowa is going to get more for its hospitals and its doctors. And we're going to be able to recruit easier. And you might call that pay-for-performance, but it's really paying to do it right the first time.
You know, 20 percent of the people that are put out of the hospital are back within a month. If it's done right the first time -- we've got Geisinger organization in Pennsylvania with a whole bunch much doctors and health care facilities. They concentrate on doing things better the first time and rewarding doctors accordingly. And they have increased quality and decreased cost. These are some of the things we're working on.
Let's go back to KCII.
QUESTION: Thank you, Senator Grassley.
The auto industry has been in the spotlight as of late. Many GM dealerships are losing their franchise and, I believe, more than 20 Iowa Chrysler dealerships are going under. And I'm wondering, also, with the legislation of President Obama requiring the higher fuel efficiencies, I'm wondering is the struggling auto industry -- has that been a fault of their own? Or are they just another victim of this economic downturn?
GRASSLEY: Well, I think they're I victim of the economic downturn. But don't forget, they're more of a victim than most businesses because they didn't run their organization right to begin with. And it's too bad to local dealers and the workers of those local dealers are being hurt by mistakes that were made decades ago in Detroit.
But, in fact, that's way it works. And I believe that the government doesn't do the American automobile manufacturer any favors by increasing the mileage standards right now when they're already in recession and may be going out of business. In other words, the government's contributing to this problem besides the bad management going on in Detroit.
And I was an advocate because I didn't vote for GM's bailout back in December. I was -- have a -- advocate for their going into bankruptcy then because they're still going to go into bankruptcy. And we've wasted billions of dollars in the process.
QUESTION: Senator Grassley, Guantanamo is back in the news. And it seemed like the Democrats and other members of Congress kind of changed their minds on this facility. It looks like that facility is going to be retained. What's your opinion on this matter?
GRASSLEY: Well, the votes were overwhelming yesterday. And I voted not to bring the prisoners to the United States. Now, the president's giving a speech on this today. Maybe he's already given the speech. But I don't know what he said, so I can't comment on that.
But I can comment on three votes yesterday that there was overwhelming bipartisan opposition to bringing any of these in. I would hate to justify to the people of Iowa that we would want terrorists put in any of our prisons in the state of Iowa.
QUESTION: Thank you.
GRASSLEY: OK. Next?
QUESTION: Senator Grassley, Southeast Iowa, where my radio station is located at, was particularly hard hit by last year's flooding. Do you think that the federal government is providing adequate assistance to those areas that were impacted by the floods?
GRASSLEY: Well, we're committed to providing adequate assistance. And right now, there's money that we appropriated back on October the 1st that's not spent. And under the theory and proposition and policy that the federal government is an insurer of last resort, when that money runs out, we will automatically, almost on a consensus basis, supplement the FEMA money.
QUESTION: Senator Grassley, we've got a lot of small towns in Iowa that are under distress, including the town that I represent and other communities that I represent and that we cover in our news coverage. And is it possible for some of the small towns to get monies that some of these larger communities seem to be getting grants for? Is that all feasible?
GRASSLEY: Yes, it is. Work through your regional planning government. And I suppose, for your city, that would probably be located in Fort Dodge. I would be surprised if Fort Dodge doesn't have what we call regional planning agencies. The one in Waterloo is called Northland (ph). I don't know what it would be called in Fort Dodge.
But any local community can work with them and find out what's available. And I would tell them if they make any grant application and they want my support, I won't know it unless they tell me, but if they make a grant application, I would be glad to write a letter in support of it.
Thank you, Nick and Glenn, for participating in today's public affairs program. This has been Senator Chuck Grassley reporting to the people of Iowa.