For many Americans under 65, our country has a health system that is not working. Not only do we need to address the millions who do not have health insurance, we also need to address escalating health costs.
When President Clinton initiated his (unsuccessful) health reform efforts in 1993, the average costs for health care for a family of four was $7000. Today that same family spends $15,000. If we continue to do nothing, that family will be paying $36,000 for health care in ten years. Our economy-and our citizens-cannot sustain these costs.
The health care reform effort currently underway in Congress may be the single most important domestic issue to be addressed in a generation. A comprehensive health reform bill, America’s Affordable Health Care Act (H.R. 3200) has been reviewed by the committees of jurisdiction and will be ready for floor consideration in the fall. As with any major reform effort in Congress, rumors and innuendos abound. The political stakes could not be higher. As a result, too many are putting politics before what is right and using scare tactics to create unfounded fears. Few issues in my career have generated such false and troublesome rumors. For example, health care professionals and patients will be making all health care decisions-not the government.
As currently written, H.R. 3200 will enable citizens to obtain insurance through the proposed Health Insurance Exchange. There will be financial help for the self-employed and uninsured low income families to purchase this insurance. The Exchange will be a sort of marketplace where consumers can compare options and choose between private insurance and a public option.
The public option will work like any other health insurance policy. Beneficiaries will sustain the program through premiums, and it will be administered by the Department of Health and Human Services. The public option will cost less to operate since it will not need to post a profit. Private insurance companies typically devote up to 30 percent of their revenue toward administrative costs and profits. (Medicare’s administrative costs are currently three percent.) As a result, some of the $60 billion that is spent every year by insurance companies for purposes other than medical care will be saved.
While individuals are free to keep their current insurance policy, under the reform, all new insurance offerings will be required to provide a minimum package of essential benefits. These basic benefits include no co-pays for preventative care, an annual out-of-pocket limit, mental health parity, no gender bias and a prescription drug plan. No longer will insurers be allowed to exclude individuals with pre-existing medical conditions. Someone who survived cancer early in life should not be forced out of the insurance market for the rest of his/her life. Insurance is about sharing risk. Eliminating these people from the risk pool may be profitable, but it is not morally right. Under this legislation, insurers will not be able to drop coverage if a beneficiary develops a serious illness and the lifetime cap for benefits is eliminated. In fact, there will be no caps on coverage, which is critically important for people with costly chronic diseases such as cancer.
I am strongly committed to health care reform. The cost of doing nothing is simply too high for the American people to carry who today pay more than twice what people in other developed countries pay and who live longer, healthier lives.
