First District Congressman Roger Marshall says Obamacare has done more to damage the quality and cost of health care than anything he’s seen in his professional lifetime as an obstetrician for more than 20 years in Great Bend.

“I would love to repeal it,” Marshall said in a conference call Monday with reporters at Kansas newspapers, including The Hays Daily News.

Doctors and nurses are quitting because of the Affordable Care Act, nicknamed Obamacare, he said, adding it has resulted in huge consolidations of hospitals, as well as doctors and their practices. Overregulation — whether in banking, agriculture or health care — consolidates industries, he said.

“It’s just the worst thing I’ve ever seen in my life,” said Marshall, who is running on the Republican ticket for re-election to the Big 1st, which covers 63 counties in western and northern Kansas.

“I spend most of my waking hours trying to fix health care,” he said. “Trying to figure out: ‘So what would the replacement look like?’”

He said his solution is to drive down costs with transparency, innovation and consumerism.

“Health care costs are hidden so many ways,” said Marshall. “The kickbacks that pharmacy benefit managers give to insurance companies, to big pharma, those should all be transparent. The deals that hospitals are cutting with insurance carriers, with their group purchasing organizations, that all needs to be transparent. Before you have a surgery or a service you should be shown what it’s going to cost. What the cash price is.”

Innovation, he said, can do more to drive down costs than any legislation he could write. Government must get out of the way, he said, because so many rules and regulations get in the way and prevent innovation.

Marshall also would expand health care savings accounts so that patients can use their own pre-tax dollars to pay for out-of-pocket costs. He described Democratic solutions as socialized medicine, saying it controls patients and prohibits patients from making choices, as well as creating long waiting lists for services.

“More than repeal Obamacare, I want to fix health care,” he said, by “driving the cost down but keeping the same quality — give the consumers more choices.”

As for the poor who are uninsured and underinsured, Marshall said a stronger economy would mean more people would have jobs, enabling them to get health insurance through an employer. He said there are about 28 million people without health insurance, and that he doesn’t consider Medicaid access to health care because more than half of physicians don’t accept it.

Marshall said the backbone of his plan is a subsidized high-risk pool in each state.

“So your Blue Cross’s, your Aetna’s of the world, would all come in and have policies or plans for those same people who purchase health insurance through individual markets, but whenever they hit a price point, they would be kicked up to this high-risk pool that’s subsidized by federal dollars, state dollars, as well as current insurance companies in that state,” he said.

Safeguarding consumers against discrimination for a pre-existing condition is an important priority, he said.

“The way this would do that — as long as Blue Cross and Aetna knew, if you hit a price point, you’d be kicked up to that high-risk pool, and they wouldn’t care a lot about your pre-existing condition,” he said. “As far as you’re concerned, you’re still getting your monthly bill from Blue Cross Blue Shield, and you don’t even realize you’re in that invisible high-risk pool, nor does the hospital, or the provider realize you’re in that invisible high-risk pool.”

Marshall also favors having organizations like Kansas Farm Bureau or American Farm Bureau to purchase health care as a group for their individual members. He spoke favorably of the Medical Sharing Marketplace, where shared cost offers cheaper prices due to less regulation of those plans.

In other comments, Marshall indicated support for the “Muslim ban” or travel ban upheld by the U.S. Supreme Court that came about through an executive order signed by President Trump and which suspended the entry of immigrants from seven countries, all of which have Muslim majorities.

“Border security is a huge thing to me,” Marshall said. “In general I’ve supported the president’s direction.”

Marshall also indicated support for a Trump administration cap of 30,000 in 2019 on the number of refugees who can resettle in the United States, the lowest since the program was begun in 1980. Stating that 50,000 people try to cross into the United States from Mexico each month, Marshall said he supports the Trump administration, with a caveat.

“I’d like that number to be higher,” he said. “We need more workers.”

First, though, there’s a need to beef up border security, reform immigration, take care of DACA recipients, and improve the process to vet refugees, he said. “Once we have better border security, then we can increase those numbers,” he said. “We need to allocate money to secure the border wall.”

Along those lines, Marshall said he supports an agriculture guest worker visa, noting that Kansas has 70,000 jobs dependent on an agriculture guest worker visa. “You can’t have solutions in isolation,” he said. “Refugees stress the system, and our system isn’t able to keep up with the processing and vetting of them.”

Foreign workers with legal status, he said, should be eligible for in-state tuition. To get the visa, employers would have to vouch for them that they have both a job and health care coverage, so they wouldn’t need Medicaid. Their children, however, should be eligible for food stamps and the WIC program. “I just think it’s the right thing to do, for the children,” he said.

In other comments:

• Marshall said he supports Supreme Court nominee Brett Kavanaugh despite allegations of sexual assault by a woman who will testify in Congress against him on Thursday. As a physician who’s done more than 100 rape exams and testified many times as an expert witness in rape cases, Marshall said the claim must be taken seriously, vetted and examined, despite the fact he thinks the timing seems politically motivated.

“Judge Kavanaugh still has my full unequivocal support,” he said. “I think he’s not only a good candidate, I think he’s the best candidate for this job. I think he’s a person that’s going to follow the constitution. He’s not going to be steered one way or another from the political winds of the world. So he has my full support.”

• Marshall endorsed Kansas Republican gubernatorial candidate Kris Kobach. “He’ll represent strong conservative values and will continue to turn the Kansas economy around,” Marshall said. “He’s promised lower property taxes, which is a big deal to my agricultural producers in the western two-thirds of the state. I think he’s by far and away the person who will lead Kansas into a brighter future.”

• Marshall said the Trump Administration’s trade war is to secure zero tariffs and full access to markets. “We can’t keep doing what we’ve been doing. For the past 20 years or more, agriculture has been slowly bled to death by the trade policies,” he said. Other countries have high tariffs on U.S. commodities, subsidize agriculture products, and dump products on the world market, Marshall said.

“I think NAFTA is really, really, really close,” with some concessions from Canada, he said. Right now, however, Canada doesn’t respect U.S. copyright on books, movies, pharmacology or music. “Ninety percent of the counterfeits that come into this country, come in through Canada, made in China,” Marshall said. “China is stealing over $500 billion a year of intellectual property from us … We need to stand up to them now.” We need NAFTA soon, he said, but the issues with China may take six months to a year to resolve.

• Marshall said logistically it’s virtually impossible to get the Kansas farm bill passed quickly. “It would be a minor miracle to get it done this week,” he said. “I”m deeply, deeply disappointed.” Marshall said he and Sen. Pat Roberts did everything possible to move the bill along, and that the bill is close. One priority for him is a better work training requirement to move people from welfare to work. “The work participation rate is still remaining very low,” he said. “Last year 7 million men between the ages of 24 and 54 were not working. Nine million people on food stamps between the ages of 18 and 59 without a disability weren’t working, with zero income.”

• Marshall said Trump campaign manager Paul Manafort’s guilty plea doesn’t alter his view of the investigation by Special Counsel Robert Mueller into President Trump’s alleged election collusion with Russia. “In my opinion, it’s been a witch hunt,” he said.

• Marshall favors cultivation of industrial hemp as a drought-resistant commodity crop to aid the Kansas economy, but is opposed to legalizing marijuana for medical or recreational use.

• Marshall defended his bipartisan approach in Washington by citing various examples of his friendships and positive relationships with Democrats, including numerous routine work-related and social events. “I could just go on and on with my relationships with people across the aisle,” he said, adding, “I know that on TV you see nothing but chaos and hatred, but that’s not my life at all…. I have close relationships with many, many Democrats.…. I’m a Republican in the vein of Sen. Bob Dole, Pat Roberts and Jerry Moran, they were all people that were known as peacekeepers bringing north and south and east and west together.”

• Marshall would ask the Pentagon to decide whether people who identify as transgender will be allowed to serve in the U.S. military. “I don’t think I should be micromanaging (the military),” Marshall said, adding he believes that transgender troops put some stress on a platoon. “I’m certainly not in favor of spending U.S. dollars on surgeries and hormones and all those types of things,” he said. “I think that’s not the right thing to do either.”