Capitol comments: Two Georgia congressmen tackle health care

Costly measures tax citizens, mortgage our children’s future.

By Phil Gingrey

Members of Congress have fundamental disagreements about how best to ensure every American has access to affordable, quality health care. But, while our methods may be different, our overriding goals are the same. Despite this, my Democratic colleagues and our president have thwarted any attempt at legitimate debate while reporting solemnly — and incorrectly — that Republicans have no ideas.

The goals are clear. We must increase the ability of all Americans, particularly those with pre-existing conditions and without employer coverage, to access health insurance. We must drive down overall costs in the health care system while increasing the quality and ease of care. And, we must ensure that seniors who have paid into Medicare most of their adult lives don’t bear the cost of a political disagreement centered on the proper role of government in our lives.

Democrats believe the best way to accomplish these goals is to mortgage our country’s financial future with a $1.3 trillion government takeover of our health care system, ultimately resulting in government care for all under a financially unsustainable federal mandate. Republicans and most Americans know this is not the best path forward, particularly when you look at the specifics.

President Barack Obama has said if you like your current health care coverage, you can keep it. He states it because that is what the American people want — reform for those who need it without damaging the quality coverage of those who have it. Yet the president fails to account for the roughly 100 million people who are in real jeopardy of losing their current health coverage if his proposal is enacted, or the millions of seniors who will lose Medicare benefits due to a staggering $500 billion in program cuts over the next 10 years.

Obama has insisted that taxpayer dollars will not benefit those who are in this country illegally. Given the tough economic times, I would like to believe him. Yet, his plan would remove simple citizenship verification mechanisms in place today that help to ensure only citizens of this country can benefit from taxpayer-funded health coverage.

Obama also has stated that health care reform will not add to the deficit or increase taxes on middle-class families. Both are noble pledges and served to galvanize millions of voters. The uncomfortable truth is that the non-partisan Congressional Budget Office has estimated that some versions of his plan will increase the deficit by as much as $239 billion over 10 years. In the House version, HR 3200 includes a section entitled: “Tax on Individuals Without Acceptable Health Care Coverage.” The Senate version, on the other hand, clearly states that families would face an excise tax of up to $1,900 if they do not meet the government’s requirements for acceptable coverage. I may be a doctor and not a tax attorney, but those both sound like indiscriminate taxes to me.

Fixing our nation’s health care system is going to be complicated – it touches each and every one of us in many different yet equally important ways. However, the principles our elected politicians use to inform the citizens of this country should not be based on hollow talking points that in no way support the product they advertise. They should be based on what a majority of our constituents want — be they Republican, Democrat or Independent.

That’s why I have introduced the Health Care Bill of Rights. It outlines 10 principles that Congress should heed when considering any health care legislation. They are based on what the American people have been telling our president and our Congress since this debate began: no government-run health care, no new deficit spending, no new taxes, no cuts to Medicare to pay for health insurance reform, no rationing of care, no mandates and no coverage for illegal aliens. It also would require quick adoption of reforms that protect those with pre-existing conditions, enactment of meaningful medical liability reform and the lowering of health care costs for our patients and our government.

Ten simple principles that do not require a sales pitch because they embody the sentiments of millions upon millions of American citizens. These are the ideas around which the American people want us to form a consensus.

Rep. Phil Gingrey (R-Ga.), a physician, co-chairs the GOP Doctors Caucus.

Reform proposals fail to revamp third-party payment system.

By Jim Marshall

Well, I’ve certainly ruffled some feathers by saying American health care’s third-party payment system suffers from Soviet-style inefficiencies. “Soviet-style,” now that’s cussing by American standards.

I chose the controversial reference to find common ground among Washington partisans embroiled in the health care debate. It’s worked with a few representatives, just not enough. And it has also put me in a position where, as dad used to say, I’ve got some explaining to do. That’s good. If more people understand our third-party payment system disaster, maybe we’ll do something about it.

All Americans would like to improve health care access and cost without harming quality. I certainly would. I’d like to strengthen Medicare and Medicaid and increase the number of insured Americans. “Isn’t bearing added cost worth it?” reform proponents ask rhetorically. “Not with my tax dollars,” opponents reply, often adding “And don’t make my health care costs more expensive. They’re already too high.”

That’s the gist of the battle. Most of the debate is surreal. We largely wrangle over false choices that ignore the central, catastrophic problem with our current health care system. It is not sustainable. It not only bankrupts individuals, it is bankrupting the federal government. No credible financial expert disputes this fact. Analysts predict America will lose its AAA credit rating by 2012. Dramatically lowering federal health care costs is not just required for generational decency, it is fundamentally necessary for national security.

So the question is not whether to reform; it is how to reform. And getting the right answer requires that we understand what got us in such a fix.

Over the past 60 years, America has migrated from a relatively efficient, free-market health care payment system, one in which patients and health care providers directly managed health care costs, to an inefficient, third-party payment system run by health insurance companies, Medicare and Medicaid. Now most patients and their health care providers have only an indirect role in managing cost. This migration thankfully increased the percentage of Americans with reasonable access to health care. But as basic micro economic theory predicts, the third-party payment system path we chose to achieve this worthy goal has caused a dramatic increase in health care overhead, gross economic inefficiency, explosive cost growth and inevitable waste, fraud and abuse.

Don’t just take my word for it. You can find a thorough, readable description of how our health care system wandered into such a mess by reading David Goldhill’s article in The Atlantic entitled “How American Health Care Killed My Father.” Just search online for the title.

Making the needed payment system reform is very difficult and can only be done slowly. Without some crisis, it will only be legislated as a compromise that also involves expanding access. Instead of maintaining the status quo or moving toward a single-payer health care system, we should begin a migration to a health care system with millions of single payers, one in which most patients are the payers.

Unfortunately, the present House and Senate bills miss the opportunity to begin this critical migration. That’s why I oppose them. If these bills are defeated, then perhaps we can get reform that fundamentally changes the payment system, reform that can simultaneously improve access, maintain (or improve) quality and dramatically reduce costs.

Yes, you read that right. Done correctly, health care reform can actually pay for itself and provide better access and coverage by gradually eliminating the repeated and growing problems with gross waste, fraud and abuse that inevitably plague our third-party payment system. I’m afraid the current House and Senate bills only make things worse by further cementing us to this unwise payment system, adding costs and hastening federal bankruptcy.

In his thoughtful health care address to Congress, President Obama said “I am not the first president to deal with this issue, but I am determined to be the last.” He might indeed be the last, but only if he insists upon reform of our third-party payment system.

Rep. Jim Marshall (D-Ga.) represents Georgia’s 8th District.