Wisconsin Representative Paul Ryan

By Diana Furchtgott-Roth - For a study in contrasts, look no further than President Obama’s State of the Union Address. The president, in a spasm of fiscal responsibility, asked Congress to freeze discretionary non-defense spending for three years, for $250 billion in savings over the next decade. Then, he proposed student loan write-offs, new middle-class entitlements, and reiterated support for expensive high-speed rail and $1 trillion health “reform.”

Mr. Obama declared, “By the time I’m finished speaking tonight, more Americans will have lost their health insurance. Millions will lose it this year… I will not walk away from these Americans, and neither should the people in this chamber. As temperatures cool, I want everyone to take another look at the plan we’ve proposed. ”

The Democrats’ health proposal featured overarching regulation on insurance companies governing what benefits their policies must offer and what range of prices they could charge; a requirement that individuals buy conforming policies; cuts in Medicare; a panel to determine allowed cost-effective treatments; and taxes on expensive plans, high-income individuals, and on employers who don’t offer the right kind of health insurance.

There has to be a better way to combine fiscal responsibility with health care reform. For better ideas, look no further than the food stamps program, which costs about $56 billion a year, and gives low-income people a debit card to use at stores to buy whatever food they choose. This approach to subsidizing nutrition allows freedom of choice and gets few complaints.

But imagine if, instead of food stamps, the government delivered bags of groceries to people’s front doors. Complaints would soon abound, because people probably would not like the contents. Some might say that they didn’t want Corn Flakes, they wanted granola. Others might reject Velveeta in favor of Kraft Slices, or chicken in favor of beef.

The Democratic health insurance bills take a similar approach, specifying what coverage people must buy. But one size does not fit all well.

Representative Paul Ryan, Republican of Wisconsin has applied the food stamps idea to health reform. In his Road Map for America’s Future, reintroduced this month, Americans would take refundable tax credits – $2,300 for singles and $5,700 for families – and choose private insurance. All insurance plans that are licensed in a particular state would be eligible, and each company would be free to set its own premiums. Low-income individuals would get extra tax credits so they could buy the same kind of health care as other Americans.

Medicare would remain the same for current beneficiaries and for those 55 and older when they reach 65. But when those born in 1955 or later become eligible for Medicare at age 65, their plan would change. They would receive $11,000, adjusted for inflation, to buy a Medicare certified plan. Those with lower incomes or with more serious health conditions would receive more funding.

Under Mr. Ryan’s plan, health insurance companies could offer high-deductible plans carrying lower premiums combined with health savings accounts, or more traditional managed care or fee-for-service plans. Persons with high-cost chronic illnesses, such as hemophilia or diabetes, would be placed in special affordable state high risk pools, with subventions paid by the government.

On Wednesday, Congressional Budget Office Director Douglas Elmendorf wrote to Mr. Ryan to tell him that this plan reduced health care costs and the federal deficit. He said: “Under the proposal, national health expenditures would almost certainly be lower than they would under the alternative fiscal scenario. Federal spending for health care would be substantially lower, relative to the amount in that scenario, for working-age people and the Medicare population.”

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On Monday, October 19, Senator Jon Kyl of Arizona shared with his colleagues in the Senate what he has been hearing from his constituents on Health Care Reform. Senator Kyl gave a 20-minute presentation in which he aptly articulated the concerns most Americans are expressing about the Health Care Reform bill.  Although it is a bit long, this is a “must-see” speech for everyone who cares about the future of health care in America.

‘We must ensure that well-intentioned efforts to bring about “change” are not exploited to create a federally controlled system that promises health care for all, but creates an oppressive bureaucracy hostile to human life and to the integrity of the patient physician relationship…’

 Health care reform is on everybody’s mind. And with good reason.

 We have the highest quality health care in the world. Look no further than Minnesota’s Mayo Clinic, which is a world-class destination for care. But high costs put health care out of reach for millions of Americans, especially middle-class families that make too much for government subsidies but struggle to pay the bills. Similarly, small-business owners struggle because they cannot use big business’ economies of scale to get affordable coverage.

We must do something to contain costs and make the high-quality care we have more accessible to everyone.

While the government-run approach, also known as the public option or co-op, is getting the most notice, there are actually a number of less dramatic alternatives that can really make a big difference. Moreover, while some in Washington are talking about what’s being called the “nuclear option,” or a Democratic Congress and White House joining together to pass their reform proposals with no Republican input, many of these lesser-known alternatives individually have broad bipartisan support.

We shouldn’t get lost in the glamour of big overhauls and look past meaningful reforms, like association health plans that let small businesses bond together to reduce coverage costs or health savings accounts that let you save for care tax-free. Bigger is not necessarily better.

Changes to the tax code, for instance, would make care and coverage more affordable while preserving consumer choices.

I’ve introduced the bipartisan Health Care Freedom of Choice Act to put patients in charge of their health decisions by tweaking the tax code. Under current law, businesses are allowed to deduct the cost of employee health care from their taxes, while individuals and families cannot. This bias in favor of employer-provided coverage leads to higher costs overall and reduces accessibility to care.

My legislation would erase this bias and extend the same tax incentives to businesses and individuals alike. From co-pays and premiums to long-term care, vision and dental, your high out-of-pocket costs would no longer be a barrier to care.

I’ve also cosponsored the Empowering Patients First Act, which puts the focus of health care decisions back on the patient, where it belongs. This legislation includes a sliding scale refundable tax credit for lower income Americans. It also covers pre-existing conditions and protects employer-sponsored insurance.

The bill would increase consumer choice by allowing individuals to shop for their health insurance across state lines, similar to how we purchase auto insurance, creating competition and giving Americans the greatest value for the coverage that best fits their needs.

Allowing consumers to cross state lines to purchase insurance would apply positive pressure to end the burgeoning number of health insurance mandates. If you don’t want to pay for hair prostheses in your coverage, you shouldn’t have to, but one in five states mandates that you do.

According to a study by the Council for Affordable Health Insurance, each mandate typically increases the cost of health insurance coverage by up to 3 percent. And, they identified 1,961 mandates in 2008.

Another provision in this legislation would rein in the money wasted on frivolous lawsuits.  Malpractice awards alone drive up the annual cost of U.S. health care by $20 billion to $40 billion a year. But even worse is the cost of defensive medicine, or responses a doctor utilizes primarily to avoid liability.One study by the American Academy of Orthopedic Surgeons puts the cost of defensive medicine at as much as $178 billion per year. We must have tort reform so that doctors can be doctors without fear of frivolous, career-ending lawsuits.

 And we must have tort reform so that doctors don’t abandon difficult specialties because their medical malpractice insurance makes it cost prohibitive. Increasing numbers of obstetrician-gynecologists, for instance, won’t deliver babies any more; it’s just too costly. Patients — particularly in underserved areas — are the ones who lose when doctors are forced to drop these important specialties.

 

These are just a few of the health care proposals we can enact that won’t break the bank and can pass quickly and with broad bipartisan support.

Our nation’s deficit and debt are at all-time highs. Medicare and Medicaid are broke. Social Security is broke. Can we really afford to trust Washington when it asks you to entrust them with your health care saying it will not only reduce costs, but increase both accessibility and efficiency for all Americans?