For the past month, members of the House and Senate have been rushing to meet an artificial deadline set by President Obama to pass one of the most important domestic policy initiatives in our nation's history. Now, however, serious questions about the cost and scope of the bills are causing members on both sides of the aisle to step back and realize that it is more important to do reform correctly rather than quickly.
One problem with the so-called reform bills is that they are based on a flawed and confusing argument that says we must spend a lot now to save a lot later. The problem in health care is not that we don't spend enough, but that Americans aren't getting enough value for their dollars. On a per capita basis, America spends nearly twice what other industrialized nations spend. Any serious reform should make more efficient use of existing resources before demanding more sacrifices from taxpayers.
Backers of the House and Senate bills are also forgetting that every major health care program created by the government since 1960 has cost far more than originally envisioned. In 1965, Medicare was supposed to cost $3.1 billion a year. Today, it costs $455 billion a year and is headed for bankruptcy. Moreover, Medicaid has shown that access to a government program is not access to health care. Today, 40 percent of doctors refuse to see Medicaid patients because of a corrupt and broken payment system.
Last week the head of the nonpartisan Congressional Budget Office, Douglas Elmendorf, warned members that the bills being rushed through Congress did not contain "the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for health-care costs."
Elmendorf's statement was a bombshell not just because it contradicted the President's argument that the bills before Congress will save money but also because CBO has chronically underestimated the long-term costs of health care legislation and entitlements. Even in the short term, estimates based on CBO's projections are staggering.
When fully implemented, the Senate bill will increase the national debt by about 20 percent, or $2 trillion. States, many of which are in the midst of budget crises of their own, will be hit with an unfunded mandate of $500 billion in the form of a Medicaid expansion. Most importantly, CBO has no way to measure the cost of the collapse of the private insurance market. If 114 million Americans are forced to give up their current health plans and are herded like cattle into a government-run program, as the Lewin Group predicts, the costs of the program will balloon even further.
As a practicing physician, I know that health care costs are not just about dollars and cents but individual lives. Getting reform wrong has the potential to not merely bankrupt our economy but shorten lives. For instance, cancer cure rates in the United States are as much as 30 percent higher than in the United Kingdom, which saves the lives of 1 million Americans every year. Replacing this system with one run by the government could be a death sentence for those patients who now have a fighting chance.
The administration and congressional leaders now have a choice. They can continue to argue that there is a conspiracy of obstruction that includes the CBO, the Mayo Clinic, columnist David Broder, congressional Republicans, and moderate and conservative Democrats, all of whom have said the currents bills are costly and unrealistic. Or, they can conclude that people of good faith on various sides have honest, serious and substantive concerns and start over.
The fact is every member of Congress is committed to passing some kind of health care reform. I've introduced a bill along Senator Richard Burr (R-NC) and Representatives Paul Ryan (R-WI) and Devin Nunes (R-CA) called the Patient's Choice Act,which guarantees coverage and choice for every American without raising taxes or increasing spending. In fact, our bill will save taxpayers at least $70 billion.
What this week has shown is that any bill that can't withstand public scrutiny does not deserve to become law. The administration and congressional leaders would be wise to view this moment not as impasse but an opportunity to deliver the kind of post-partisan reform bill the American people deserve and expect.
By Tom Coburn