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Sunday, May 3, 2009
HEALTH CARE FIX IS WITHIN REACH

Originally Printed in Omaha World-Herald

Nineteen years ago, after narrowly winning my first statewide race for governor in Nebraska, I was concerned by the direction of our state in needing to overcome the challenges of a difficult budget, an economic downturn and a property tax system in turmoil.

Today, the United States is not only facing similar financial troubles on a much larger scale but also is suffering from the compounding economic impact of rising health care costs and the uninsured. These twin burdens are strangling businesses and throwing sand in the gears of our economic engine, yet the most troubling impact is on American families.

From 2001 to 2007, premiums for family insurance coverage increased 78 percent while income increased just 19 percent, with inflation consuming these wages at the rate of 17 percent. This unsustainable path threatens the American dream and jeopardizes our global competitiveness.

Although there are signs of progress, partisan groups seem ready to, on the one hand, cast blame on anyone who does not support a public plan or, on the other, stir fears about separating you from your health coverage, your doctor or even your privacy.

I believe meaningful health care reform is within reach and Congress must find a middle ground to improve care by lowering cost and expanding access. This must be done without stifling minority views or using a fast-track reconciliation procedure to preclude bipartisanship.

What should health care reform look like?

First, achieving cost containment and improving efficiency in our health care delivery system is a mission-critical component of reform. Despite state- of-the-art treatment, some studies still reveal that Americans receive appropriate care just 55 percent of the time.

Congress took a step forward with the approval of the American Recovery and Reinvestment Act, which made a down payment on advancing health information technology and comparative effectiveness research, giving patients access to improved health records and better evidence about which medical treatments may best serve their needs.

Second, in a helpful move, America's health insurers have agreed to guarantee health care coverage to all and transition away from charging higher premiums to those who are most ill, if Congress agrees to support a requirement to obtain coverage.

While I have an aversion to mandates, I recognize that we all have a responsibility to obtain health care coverage because we all pay higher premiums when providers are forced to write off expensive, uncompensated care. If we can provide affordable coverage and agree on this collective responsibility, we can make dramatic improvements on portability and access.

Third, we often focus on the 45 million or more Americans who live without health care coverage, a critical problem to be sure. But we also must make sure we are not destabilizing care for those who have employer-based coverage or other private health insurance.

While some have called for establishing a public plan, we cannot solve our health care crisis if we establish a government-run option offering little more than cosmetic improvements and creating an unlevel playing field, thereby exacerbating the current cost shift to private payers. We already have public plans that suffer from sluggishness and insolvency. Instead, we must demand that insurers compete for service.

We also must empower consumers by creating state-based access portals. These could help Americans easily compare co-pays, networks, provider quality measures and access to medical records in order to ultimately make more informed coverage decisions.

Finally, the tax code can better serve our shared interests and help us meet the imperative of paying for health care reform without adding to the deficit. Some Americans currently have an unlimited tax advantage, while others receive no tax benefit at all for the cost of their health insurance.

Congress should consider using a small portion of the health insurance tax exclusion, while preserving a substantive amount of untaxed compensation for employers to offer their workers, to finance targeted tax credits and further leverage our tax code to increase coverage.

In the coming weeks, America will see a debate that tests our ability to confront this enormous challenge yet still preserve bipartisanship and reason. It is within the reach of Congress to meet in the center on a reform plan that would make major improvements in our health care system and put us firmly on the path toward cost containment, universal coverage and, ultimately, fairness for all Americans.
 

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