Reform the marketplace on several fronts

The healthcare system in America is failing patients, providers and taxpayers and is in dire need of immediate wholesale reform. The troubling statistics are well-rehearsed, from the ever-growing number of uninsured Americans, to the escalating reliance on emergency rooms, to the fiscal crisis of the public healthcare programs, Medicare and Medicaid. No one disputes these problems must be addressed.

However, I am afraid some would propose to fix this situation by transitioning even more Americans into a government-run healthcare system already on the verge of collapse. When the Medicare program started over 45 years ago, no one envisioned the severe financial burden it currently places on the federal budget and American taxpayers. With the federal share of the program approaching $400 billion a year, it costs every man, women and child in this country almost $1,300 annually to fund the program. Premiums for Medicare beneficiaries for physician services have more than doubled over the past 10 years, increasing by 120 percent from $43.80 in 1998 to $96.40 today. The Medicare Trustees tell us that to bring the Medicare trust fund back into balance, payroll taxes would have to be increased by 122 percent. Moreover, if left unchecked, spending on Medicare and Medicaid will represent nearly 10 percent of the GDP in 25 years at the current rate of growth.

Our own experience with government-provided health insurance teaches us we should expect skyrocketing costs coupled with limited access to doctors if we reform healthcare in America by putting even more people onto a government program. This does not even account for the reduced choices provided to patients or rationing of healthcare services we have seen in other countries with socialized medicine. What benefit is there from a health insurance program the country cannot afford, in which physicians refuse to participate, and the government may not cover a life-saving treatment? Surely, this is a cure worse than the disease. No one expects our environmental problems will be solved by requiring everyone to drive an automobile designed and built in 1964, and we should not expect the problems with our healthcare system to be fixed by requiring everyone to use a healthcare program that was designed and built in 1964 either.

We cannot rely on bureaucrats in Washington to solve these tremendous problems. America’s healthcare system will achieve its full potential only when all Americans have their own affordable and portable health insurance plan, and all Americans are empowered to make the healthcare decisions that are truly best for them and their families.

In order to reform the health system in this way, we must not let the government micromanage payments and benefits, but instead should be guided by three principles: affordability, accessibility and personal responsibility. The system should be affordable for patients and for taxpayers. This test cannot be met by simply allowing the burden of expenses to be borne by the government. Healthcare services must be accessible. Patients should have their own choice of physicians and treatment options and not have those decisions dictated to them by insurance companies or the government. Finally, we cannot forget the vital role of individual responsibility. Shifting responsibility to the government weakens the incentive for people to care for themselves.

To be clear, this does not mean we abandon those in need but instead reform the healthcare marketplace to encourage people to care for themselves in the ways they are able.

Our system can be made more affordable by encouraging competition on the basis of price and quality of care. Patients deserve a system with transparent prices and better information about doctors’ and hospitals’ performance. Also, the health insurance market should be reformed to allow consumers to purchase policies across state lines and have better access to plans that meet their individual needs regardless of whether one is young and healthy or plagued by chronic disease. We must also eliminate the waste in our system caused by junk lawsuits, defensive medicine and the rampant fraud and abuse in our public programs.

Access to medical care can be addressed by reforming the payment system to ensure providers are being paid fairly for their work and by encouraging high school and college students to enter the medical profession. The uncertainty students face about their ability to pay off student loans the size of a home mortgage creates a significant barrier to entering medical practice. Unfortunately, finding a doctor is not the only barrier to care patients face in our current system. Even once patients get in to see the doctor they often find more roadblocks before they can pursue the treatment course prescribed by their doctor. By putting patients and doctors back in charge of treatment decisions, we can ensure patients have access to the care that meets their needs.

Finally, we must bring personal responsibility back into healthcare. As we study disease, we learn more and more about the benefits of certain lifestyle choices in preventing illness before it starts. These behaviors must be encouraged by providing consumers financial incentives for staying healthy rather than just penalties when you get sick. Also, patients should have the option to choose how they want to manage their healthcare dollars through Health Savings Accounts rather than sending their money to a middleman to spend their money for them. The American people successfully manage their purchasing decisions and personal lives every day, and there is no reason these same people should not have responsibility for their healthcare decisions as well.

Without question, our healthcare system is at a crossroads, and we cannot allow our current, deeply flawed system to continue to under-perform — there is simply too much at stake to allow the unacceptable status quo to continue. I encourage all Americans to continue to fight for needed reform of our healthcare system, and I encourage my colleagues on both sides of the aisle to join with me as we create a 21st-century healthcare system that works for us all.

Deal is a member of the House Energy and Commerce Committee.