Mr. Speaker, we are having debates about health care because Americans are nervous about changing something so important to their families, and that, of course, makes politicians nervous about reform. This skepticism is understandable.…
Mr. Speaker, we are having debates about health care because Americans are nervous about changing something so important to their families, and that, of course, makes politicians nervous about reform.
This skepticism is understandable. Attempting to adjust policies and programs that comprise now 17 percent of our economy, the biggest driver of the Federal deficit that literally touches every American family, poses daunting challenges. Yet, as people begin the analysis, the appropriate comparison is not some idealized, magical state but the comparison to the path we are on, which everybody agrees is unsustainable.
Medical costs, left unchecked, will literally bankrupt the country. The Department of Defense will spend more on health care this year than China uses to run its entire military operation for 7 months. Every objective, independent expert acknowledges and laments the fact that the United States is the world's health care underachiever. We pay more for health care than our major allies and competitors in Europe, Japan, and Canada, but our people get sick more often; they die sooner, and unlike any other country, people are bankrupted by medical costs--about 2,000 people per day. All the while, we have a record number of uninsured Americans--now over 50 million.
Sadly, we are getting exactly what we paid for: more procedures, multiple providers, an emphasis on specialty care rather than someone who can help us with our own efforts to negotiate this complex, fragmented health care system. America actually spends more administering our health insurance system and finding ways to deny care than any other country in the world spends on providing care.
Starting from scratch, we could give better care for less money, but we are not starting from scratch. We are starting with an economic and structural behemoth, encompassing, as I said, 17 percent of the economy. It is the largest employer in most communities, and it has evolved over two-thirds of a century of public and private investment and government legislation. Today, our hybrid system is largely administered through hundreds of agencies, programs, and large providers, with the Federal Government paying half the bill directly.
The good news is that we have proven that we can get better results for less than we are spending, and the health care reform legislation provides this framework. First, we don't need more money. In fact, if we implement the existing legislation, it can be a source of savings in the future.
The good news is we don't have to deal with unproven techniques or technologies. We know what to do. We don't even have to look at foreign models that are more successful than ours. We can look right here in the United States. My community of Portland, Oregon, delivers better health care for Medicare, for instance, to its recipients than other communities where costs are twice as high. It's not just Portland. This can be found in areas in the
West and the upper Midwest. There are also innovative health care practices in the Mayo Clinic, the Cleveland Clinic, and Gunderson Lutheran.
The government, itself, has proven how to be more efficient. The Veterans Administration has a practice model for older citizens with complex health problems that face our veterans. The VA has automated its medical records system. It pays its doctors for performance, not procedures, and they figured out a way to get better prescription drug costs for millions of our veterans.
Many of the techniques for reducing the number of unnecessary hospital admissions, for bundling services, for having accountable care organizations are known and actually supported by my Republican friends. They've been embraced by Republican Governors.
This is not foreign territory. We know it can work. The path forward is clear. It is important not to lose 2 important years in reforming our medical system, giving better health care, and starting to reduce these massive future deficits.
After having identified weak spots in the implementation, let's work to hold people accountable. Don't attack the CBO for scoring the bill as written, which is their job. Attack efforts to undermine the cost- saving elements of the bill. If States can more creatively provide health care envisioned in the exchanges, let them do it. Give them the waivers, and encourage them to experiment as long as they meet minimum national standards.
Absolutely allow people to purchase insurance across State lines to improve competition and choice, but only after everybody agrees to provide insurance according to the same quality standards of accountability. That prevents gaps in coverage. We don't want massive marketing budgets while denying the money for essential treatment. We need not to have long protracted battles over if we understand and agree upon the terms.
We've reached a critical point where we cannot continue on the path that we've been headed. We do have reform legislation that encourages much of what has bipartisan support. We are spending more money than we need to and there are huge opportunities to improve the quality of service. I would hope that this exercise would be the last of the political ritual on health care. Instead let's turn to working with the Administration to figure out how to achieve the objectives, so critical for our citizens.