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Democratic candidate John Avlon and incumbent Republican U.S. Representative Nick LaLota
Republican U.S. Representative Nick LaLota and John Avlon, his Democratic challenger in the 1st Congressional District race, agree that the political parties should find common ground to improve health care while controlling costs.
In separate interviews, the Republican incumbent and his Democratic challenger spoke about successes and shortcomings where “despite higher health care spending, America’s health outcomes are not any better than those in other developed countries,” according to the Peter G. Peterson Foundation.
Avlon emphasized construction of housing so that health care professionals can live in the district, where the cost of living, particularly on the South Fork, can be prohibitive even for them.
LaLota put emphasis on undocumented immigrants, who he said are taxing the system to an unsustainable degree.
“The good news is, there’s actually some bipartisan agreement on transparency and pricing as it relates to health care,” LaLota said. “There are a couple of bills that passed out of the House, this Congress, where we were bipartisan, we were productive working together to ensure transparency and lower prices for individuals on health care.
“I think we need to find a way that we can work together to accept Obamacare, to make it stronger, not to continue to try to undermine it. I think there’s broad popularity for protecting preexisting conditions, and nobody should be going bankrupt over getting hurt.”
“We’ve made a lot of progress ensuring more people are insured,” Avlon said, but there is “a lot of frustration, when I talk to small-business owners here on the East End and across our county, that the deductibles are too high, and the costs of the plans are too high, where it takes a big chunk out of people’s salaries, and it actually provides a disincentive for people to get the preventive wellness and health care they need. So, too often, they go to the doctor only when there’s a crisis, and that increases costs.”
A single-payer system, nicknamed “Medicare for All,” is not practical in the United States, Avlon said. Rather, “a public option is an appropriate vehicle to reduce costs,” something he said is the subject of pilot programs in several states. “It simply allows people to buy into Medicare coverage and to benefit from those reduced costs.
“We should be innovating without taking a maximalist view that would rip the system out by the roots, because I think that would create chaos. This is something that Barack Obama had talked about in the original passage of the [Affordable Care Act], which is now, of course, broadly popular and was fundamentally mischaracterized — despite the fact it was based on ‘Romneycare’ in Massachusetts — as a socialized big-government takeover. It’s the exact opposite.”
Congress has promoted telehealth, LaLota said, and “we think there are efficiencies to be had when patients can access medical care over virtual telecommunications or other Zoom-like capabilities. We think that that helps decrease costs and increase services, and we think that there should be more investment in that.”
He has spoken with doctors and visited hospitals when touring the district. He said they believe that artificial intelligence “is a cost-saver as well, that by telehealth and AI we may see a future with maybe not lesser cost but at least lesser health care inflation,” which has outpaced inflation in other sectors.
LaLota said that the federal Food and Drug Administration “is the American people’s voice” in regulating pharmaceutical companies to control costs. “You have a lot of good inventions and discoveries here in the United States, and we should both have a federal system that enhances those discoveries … but at the same time doesn’t abuse regular good people who need to be able to live on medications like insulin.”
Avlon’s grandfather, an immigrant, was a medical doctor. Of the American health care system, Avlon recalled that “the more bureaucratized it got, the more he felt that distance [from] the essential Hippocratic oath of simply caring for people, and often not accepting payment for caring for people.”
Ideally, he said, “we could return to systems that incentivize common-sense family medicine where people feel cared for by an individual that they build a relationship with. Remember that treating the emergency room as the doctor of last resort is the single most expensive way to do things. And it’s actually socialized, and it’s the least effective way to do things. And we should be emphasizing wellness and that holistic treatment of a human being.”
The Inflation Reduction Act has worked to lower cost of prescription drugs, Avlon said, “and that will proceed apace if Kamala Harris is elected. … We need a pro-family agenda that is positive, not negative. And, by the way, I think helping reduce the cost of [in vitro fertilization], that’s something that we can do. Let’s focus on areas where we can agree.”
LaLota spoke of the contentious issue of “where do you put these five, 10, 20 million people who are here illegally, or at least through the feigned asylum process? Where do they fit in our health care system?
“I’m so eager to hear from my friends from the other side of the aisle about how they would actually deal with that, because America’s riches are limited,” LaLota said. “There is an end to our budgets, and health care is certainly a large cost of many of our municipalities’ [and] our federal government’s budget, and some of my friends from the other side of the aisle just want to put more and more people onto Medicare and other programs. I just think that that’s unsustainable.”
He said that those not in the United States legally should not have access to its health care system. “We have to deal with the promises that we’ve made [to] generations of Americans. We should keep those promises specifically on Medicare, and we should not expand that promise to folks who are in this country not legally.”
Avlon said that more health care facilities should be built in the district, “but we also need to make it more affordable to have doctors and nurses living in and near the communities they serve. … We’ve got Stony Brook and Southampton, extraordinary medical centers. We’ve got Northwell Health. We’ve got great medical centers here on Long Island, but … one thing we can do is make sure that we are building housing in public-private-partnership ways so that doctors and nurses … but also first responders and teachers can live in the communities they serve.”
To that end, he referred to the HELPER Act of 2023, which would establish a program administered by the Department of Housing and Urban Development to provide mortgage assistance to law enforcement officers, elementary and secondary school teachers, firefighters, or other first responders. The Act, he said, “is a model that we could expand. It actually would help incentivize set-asides for housing that’s affordable for those very essential workers.”
