The Democratic leadership shoved its health reform bill through the House with a two-vote margin. The $1.3 trillion measure will impose crushing new regulations on the health marketplace and dramatically expand the size and the scope of the government.
All but one Republican – and 39 Democrats – voted against it, saying they feared the bill would actually increase health costs, increase taxes on small businesses, and cause millions of people to lose the coverage they have now.
The American people want health reform, but not like this. They simply don't trust Washington to make sweeping changes to the health sector all at once. Instead, they want to build on what works and fix what doesn't. And they especially don't want reform plans to disrupt their current health coverage. A recent poll conducted for the Galen Institute found that 71 percent of Americans are concerned their health insurance will change if Congress' reform plans are enacted.
It's time for lawmakers to stop insisting on a major overhaul of the system and reset the debate. They can begin with ideas that will empower individuals and families to take control of their health care decisions and leverage the power of market competition to lower health costs.
Here are some common sense, patient-centered reforms that should be at the center of what could be called a "Health Freedom Contract" with the American people.
We can begin by giving people more choices in health insurance. Currently, most people have just one option: whatever plan is sponsored by their employer. But Americans would be better off if they had more insurance choices and the freedom to tailor their coverage to their individual needs.
Insurance should also be portable from job-to-job. Indeed, because health coverage is usually tethered to employment, more than two million people who lost their jobs in the recession also lost their health insurance. Allowing people to buy coverage with pretax dollars and subsidizing private coverage for lower-income patients would transform the marketplace, giving people many more options of more portable coverage.
We could lower insurance costs and increase consumer choice by allowing people to buy health insurance across state lines. The price of a basic insurance plan varies dramatically from state to state because many state governments have onerous insurance regulations that dry up competition and require policies to cover a long list of services and procedures (think chiropractics, drug abuse counseling, and the like).
By fomenting competition across states, a national insurance market would yield lower prices and give people more options for group coverage.
For those with pre-existing conditions, lawmakers could provide additional funds to the states to support strong safety nets and innovative state programs to help those with pre-existing conditions.
Further, lawmakers must increase transparency in the health market. Patients should have easy access to information about the cost and quality of available plans. American consumers have proven time and again that they can find a good deal if they're well-informed.
The government also needs to do a better job of policing the programs it controls. Medicare and Medicaid face rampant fraud and exploding costs. Spending on health care for lower-income and disabled Medicaid recipients totaled $338 billion in 2007. That figure is expected to hit $717 billion within a decade. Fraud consumes around 10 percent or more of its outlays. This must be stopped.
Finally, lawmakers must address medical malpractice. Intelligent lawsuit reform would drive down costs without compromising the quality of care. A cap on noneconomic damages would help to bring down doctors' malpractice insurance costs and discourage the wasteful practice of defensive medicine.
Finally, wellness and prevention programs must play a more significant role in the delivery of health care. Some private companies, like Safeway, have already succeeded in cutting their health spending by providing financial incentives for workers to participate in exercise and nutrition programs.
It's time to press the reset button on health reform. The legislation passed by the House would increase the government's role in our health sector, drive up costs, and reduce the quality of care in the process. Reform should focus on putting the needs of patients first.
Published in The Orange County Register, Nov. 18, 2009