Guest post by Rep. J. Randy Forbes
“Health care debate could derail over government plan.”
It was 7 a.m. and I had pulled up Google News to see a flurry of headlines on the health care debate in Congress.
“Lawmakers face health care fight.”
“Health-care debate heats up as the Senate and House grapple with plans.”
Reading the news it is easy to see why most Americans conclude that health care is a topic upon which Washington will decidedly never reach consensus. Last week, I myself, made a strong case for why government-run health care is wrong for America in my first piece of this series. And, just as I am opposed to this proposal, there are many in Washington fighting vehemently for its passage.
It’s no secret that the battle lines of the upcoming health care debate have been carefully drawn over the last year. Lobbyists, special interest groups, grassroots advocacy organizations and the like have each oiled their machines of information and persuasion as they prepare to battle for turf in what is expected to be a long, brutal, passionate debate that has the potential to profoundly shape the future of our nation and affect the lives of our families.
So, I turned away from my computer and I began making a list of those things in health care that most of America’s leaders agree on:
• We agree on the problem and that it is a big problem. Health care in America is a massive one-fifth of our economy, meaning one in five dollars Americans spend is spent on health care. It is credited with great successes but its history is also littered with spectacular failures: 46 million Americans do not have health insurance, medical problems contribute to over half of all bankruptcies and the average American spends almost $8,000 per year on health care. Furthermore, despite the fact that we spend almost twice as much per person on health care as any other country, international indices confirm what many of us know to be true: Americans get poor value for what we spend. In fact, according to the World Health Organization the United States ranks 37th in terms of health system performance and we trail many other countries in infant mortality, life expectancy and preventable deaths.
• We agree we must: work towards more choices in healthcare, safeguard the ability of Americans to keep their current coverage if they choose to do so, cover the uninsured or underinsured, ensure coverage for individuals with preexisting medical conditions, and fashion a system in which self-employed people can pool their health insurance risks.
• We agree that we need transparency in health care. The Obama Administration and some in Congress have suggested that we should create a federal or state health insurance exchange – a market where Americans can one-stop shop for a health plan, compare benefits and prices, and choose the plan that’s best for them, just as government employees currently can. This idea is worth exploring. Americans should be able to compare options, review prices, and have access to information that allows them to make an informed decision. Transparency of this nature would encourage cost- and quality-conscious decisions on the part of consumers and would create competition that would push health insurance companies to improve their services or lose customers.
• We agree that prevention is a dramatically under-utilized opportunity. Heart disease, for instance, is the leading killer in America, responsible for about 865,000 deaths per year. Along with the loss of life, the direct and indirect cost of cardiovascular disease and stroke in 2009 is estimated to be $475 billion. All total, our nation spends roughly 75 percent of all medical expenditures to care for chronic conditions such as heart disease, cancer, and diabetes – many might have been prevented by critical early detection or changes in diet and lifestyle. Yet we invest less than five percent of health care spending for the prevention of chronic disease. We agree: America needs a system that focuses on health care, not “sick” care.
• We agree America will never have top-notch health care if we do not utilize top-notch technology. Today our medical systems are functioning on “carbon paper” technology when “iPhone” technology exists. Each time a patient visits their doctor’s office they are asked to verbally recite their medical history. Little coordination exists between doctors and as a result billions of dollars are wasted each year as doctors repeat tests either because they are not aware of previous test results or because they are practicing “defensive medicine” to avoid abusive medical liability suits. The US Healthcare Efficiency Index estimates that if the entire US healthcare systems moved from a paper-based, phone-based system to an electronic one we could save $30 billion a year. Today, 90% of all medical bills are paid by mailing a paper check; electronic bill pay could alone save $11 billion a year.
• We agree on the need to reduce medical errors. According to a study done by the Institute of Medicine, between 44,000 and 98,000 people are killed every year in the United States due to medical errors. Even using the low estimate of 44,000 fatalities, medical errors would be the 8th leading cause of death in the United States, killing more people that AIDS, breast cancer and motor vehicle accidents. I hope there will be broad bipartisan support for my medical modeling and simulation bill aimed at reducing the $79 billion spent each year on medical errors. Hospitals under a trial medical modeling and simulation program saw their clinical error rate decrease from 30.9 percent to 4.4 percent.
• We agree that we need models of success. The President has called on Congress to examine places like the Mayo Clinic in Minnesota and the Cleveland Clinic in Ohio and other gold standard health care institutions that have successfully kept costs well below the national averages. He is right. We also need to look at free care clinics – some right in our own communities like the Chesapeake Free Care Clinic – that have developed innovative models for delivering high-quality health care to the uninsured. We could make leaps in improving health delivery and care by identifying “best practices” in health care and modeling the premier institutions that Americans and foreigners alike seek out when they need treatment.
• We agree that health care is expensive. The President states that health care reform must be deficit-neutral. This is Washington-talk for “we must pay for any reforms we make.” This is true and if America truly wants a new health care future it must be willing to pay for it.
The reality is that the vast majority of Americans – even those of us with excellent health care – agree that something must be done. And there are these major points – and more – that most agree on. Whether out of genuine concern for those around us without care, or motivated from the practical desire for more efficient, logical health care options; we agree that health care reform is critical to the success of our nation.
There’s a temptation to stop here. To pat ourselves on the back, shake hands and call it a day. But with every great challenge, with every great undertaking, there’s always that nagging question: How?
