Health Care Impasse Is An Opportunity

(CBS)  Tom Coburn is the junior United States Senator from Oklahoma. He is also a licensed physician.

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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

[yevgeniy29]

As a physician I'm strongly against UHC. Just the idea of putting all insurance companies out of business who have a whole system set up, have experience in management, contracts with doctors/hospitals and put in charge people with no experience, no sense how to run it who will raise and raise taxes and borrow money to pay for mismanagement and corruption. Anybody who really want to make medicine and everything else better will try to improve the current working system, not destroying it. There are so many normal people who talk about real reforms addressing real health care problems but nobody discusse it. 90% of all UHC changes nobody needs. The only real issues so far are cost and affordability. But unfortunately the UHC solution will only double or triple the cost and decrease quality. If you pay nothing for health insurance but pay 2 times insurance rate in taxes you are not really saving a lot plus if on top of you get fired because your employer can't afford you anymore after all this "refoms" it will not improve your financial situation either.
If we just start normal reform by addressing real problems like medical fraud and medical liability law which would decrease unnecessary testing, procedures and hospitalizations which takes huge amount of healthcare money we can save a lot. Then we can address medications cost and polypharmacy problem which is not the least important thing in the total cost and healthcare affordabilty. Then step by step we can move to other issues without rushing and destroying things.
The good thing I read more and more opinions againts UHC from more and more people which gives me hope that may be this nightmare will end.

[sjc_1]

As far as I know, no one is talking about Universal Health Care! Why do you insist in setting up Straw Man arguments that you can easily knock down. We are talking optional National Health Insurance...get it straight!

[sjc_1]

We are talking optional National Heath Insurance NOT Universal Health Care. I do not care what you are opposed to, it means nothing to me nor anyone else.

[sjc_1]

It is an opportunity to see if greedy capitalism reins supreme to bankrupt the country or whether common sense prevails and we do what is right for everyone.

[econfacts101]

Dear skyk and elz523:

My suggestion to you is read the bill. If you have parents who are age 70 or older, you will be shocked at what this bill proposes. I voted for Obama and I see him now as my enemy. This bill, which he admitted to the nation he has not read, basically is a death sentence to my mother who suffers from cancer. The Democratic party has turned their backs on the millions of Americans who supported them for years and made them a great party. READ THE BILL!!! Then let's see what you think.

[notmd]

Isn't it interesting that when President Obama pushed on universal health care all the players in the game starting revealing their cards..Drug companies..80 billion and the president thinks there contribution could be more..providers..155 billion..insurance companies..100 billion..we are on a roll ..don't stop now..

[babooph]

Wow ,just like under Clinton-the democrats will NEVER be the ones who stop revamping US failed health care,BUT well..........a lot of lobbyist bribes go a LONG way!

[didserve]

Single payer is the only way!

Now America will see who is in the pocket of the big money insurance companies!

[elz523]

We already have universal healthcare. It is called the emergency room. Hospitals cannot turn away anyone who require emergency care and we don't want them to. The problem is that this must be paid for by someone. Today we pay for it with cost shifting to those who have health insurance and taxes. We are continually seeing fewer people with healthcare insurance so the increasing amounts being shifted to those who have insurance is a primary reason for the increasing cost of health insurance.

You are already being taxed to pay for universal healthcare. It comes in the form of higher healthcare premiums for your family, lower pay raises as your employer has to pay more for insurance and so cannot offer you a raise, and through taxes paid pay for medicaid. With healthcare reform you will see more people paying into health insurance so the rates for everyone will decrease.

[elz523]

We already have universal healthcare. It is called the emergency room. Hospitals cannot turn away anyone who require emergency care and we don't want them to. The problem is that this must be paid for by someone. Today we pay for it with cost shifting to those who have health insurance and taxes. We are continually seeing fewer people with healthcare insurance so the increasing amounts being shifted to those who have insurance is a primary reason for the increasing cost of health insurance.

You are already being taxed to pay for universal healthcare. It comes in the form of higher healthcare premiums for your family, lower pay raises as your employer has to pay more for insurance and so cannot offer you a raise, and through taxes paid pay for medicaid. With healthcare reform you will see more people paying into health insurance so the rates for everyone will decrease.

[elz523]

You know, here is the thing. Healthcare is broken now and it needs reformed. Few doubt it. Everyone does have healthcare though. Currently, if you are poor you can get medicaid at no cost. If you are rich you can afford any insurance you like. Healthcare reform is meant for everyone in between. That would be the middle class, but it seems we lose track of that too easily.

Today, if you are self-employed, but have a pre-existing condition, you will be denied insurance. If you are employed and your employer offers health insurance coverage, your rates go up by considerably more than the rate of inflation every year. 20% of Americans are not covered by health insurance and while not every one of these 20% want to pay for healthcare, there isn't one of them who wouldn't like to be covered.

I work for a not-for-profit hospital and I know that hospitals provide billions of dollars every year in charity care. They also do not receive full reimbursements for the government health plans. Who pays for the uninsured and the underinsured? Everyone else. Those covered by insurance are covering everyone one else.

The system needs to be reformed or it will collapse and then no one but the rich will have healthcare.

[BJNEILL]

I believe that a Health Care Reform bill should make it mandatory that any insurance carrier that offers a health care policy must include as part of that policy a life policy. At this point in time, when an individual dies, the insurance company has no more exposure to claims. Insurance companies can dictate what tests doctors perform and determine what amounts are paid for claims, but they have no reason to keep us alive. Perhaps if they know they will be "out of pocket" at upon death, everyone will receive better health care.