Mr. Speaker, I thank the gentleman from Kansas; and I thank him for his passion for keeping jobs here in America, for growing jobs in America, for understanding what it takes to have that happen. As I go around my district and talk to…
Mr. Speaker, I thank the gentleman from Kansas; and I thank him for his passion for keeping jobs here in America, for growing jobs in America, for understanding what it takes to have that happen.
As I go around my district and talk to businesses that are growing those jobs, health care costs are one of the top issues that they talk about to us. The gentleman has hit right on many of the key issues of medical malpractice driving doctors out of practice, getting them to do what they would tell you is unnecessary practices, just to make sure that they are covered in case something happens. We are going to get into talking about health savings accounts and flexible savings accounts and how we can really help individuals better control costs, and how association health plans can help associations of businesses that do not really have a good program available to them provide that to their many, many employees.
Mr. Speaker, there are two different ways that people think about how do we control costs long term. Some would suggest that we need to move towards a single-payer plan where one government entity is paying all of the health care costs across the country. We know what that looks like. That looks like government rationing. That looks like standing in a queue and waiting forever to get a basic procedure. We see that up in Canada. Canadians come down here to America to get their health care because they know what that looks like.
What we are talking about here is empowering individuals, putting individuals and their relationship with their doctor in charge of their health care, having them control the decision, having them have the say and the knowledge and the ultimate give-and-take on how to move forward. I look forward to talking about how each of the things we are talking about here really addresses that issue.
Mr. Speaker, that is absolutely the case. Health care will be allocated by some means. If it is totally free, totally available in a single-payer plan, then the government will come up with restrictions. We have too much today, even in this country, of government deciding to ration what they are going to pay for health care, ration the procedures, and having businesses make too many of those decisions.
One of the most beautiful things that we have done to advance health care empowerment of individuals is the health savings accounts that we passed as part of the Medicare reform last year. What this does is if you have a high deductible plan, a minimum of $1,000 per person, $2,000 per couple, it can be up to over $2,500 per person, $5,000 per couple, you can put that amount away, tax-free, into an account, use it for health expenditures tax-free. If you do not use it, you can roll it over, earn interest on it tax-free, and build up a nest egg that you can use in your senior years. But what this means is that rather than some impersonal party getting the bill that you never see for your health care costs, you can know what it costs, shop for the best price, and make decisions.
The best example I have is the young woman that helps me in my office on health care matters said that she once twisted her knee, and they had an MRI done. That MRI costs $1,500, and they found nothing. And she said, you know, if I had a health savings account and that was my $1,500 being spent, I might have had a simple x-ray done; and if nothing was broken, I would walk on it for a week before I decided I was going to spend another $1,500.
It is those types of decisions made over and over again that will affect health care costs; and we have seen when these types of programs have been put in place in businesses, they have dramatically reduced costs while, at the same time, they are giving individuals better care and better control over their care.
Mr. Speaker, I can tell my colleague that the health savings accounts let your father and your family be in control.
If a young person starts out and they are putting away the maximum amount you can into a health savings account and they live a healthy life and they spend their money frugally for health care costs, they can build up a pretty significant nest egg by the time they get to be your father's age. When you talk to people approaching their senior years, making sure they can have that control over their medical life and make the medical decisions that they want to are vitally important to them.
That is what I think these health savings accounts will do, ultimately. If they can build up $100,000 or $200,000 of a nest egg over a lifetime, they can make the decisions and have the resources for whatever the health care plan is saying to get that kind of treatment. If they have to go into some type of senior care rather than being forced to spend their way to poverty before we do anything in terms of long-term care, they can work with their children and say, hey, listen, I have this nest egg, so that you can buy the services I need, buy home health care and take care of me, and here is the resources for it.
So I think the flexibility, combined with the market-based services availability we have here in America, is vitally important.
I would also say, if you look to controlling costs, which is what we are talking about here with growing jobs and getting these costs under control, if you look at the growth in costs that we have experienced, whether you are a public or private plan, they are straight up. But if you look at what it is for cosmetic surgery, which is about the most personal and invasive surgery there is, those costs are almost flat.
Now, why are they flat? They are flat because the market is involved. If you look at Lasik eye surgery, the costs are down, because you have both the combination of the market and technology bringing that down. That makes everyone's costs more affordable. That makes our jobs more competitive here in America, and it makes whatever surgery you or your father are going to be having later on in life something that is more likely to be within their means. It is a great move forward, and a step that we are building on with the steps we are taking this week.
Mr. Speaker, we have also added other things in the Medicare bill that we just passed to get us going in this direction. We have strong incentives and encouragement for health care providers to do electronic prescriptions so that we not only have quality because we cannot always read the doctor's signature, but we have the ability to have a travelocity.com approach to getting that prescription. We also have strong incentives and requirements for increased quality reporting; and what we ultimately need to get to is, like you would with any other kind of product you are buying, where you can see it, call it up on the Internet: I am looking for this type of procedure, here is the ranking of the providers in my area, here is what each of them is costing, here is what the quality ratings are on them. Because if I were to look for this podium and want to buy a podium, the market offers me an endless variety of podiums and sizes, colors, styles, shapes, materials in every single product category imaginable except where we try to keep the market out, such as in education, in transportation, frankly, and in health care.
We have got to take away the barriers to providing quality, affordable services to our people, and that is exactly what we have done with the reforms that were part of the Medicare prescription drug bill. It is exactly what we are talking about in the additional reforms we are going to be passing this week in the House.
Mr. Speaker, I would just compare this to how you get your auto insurance. When you buy auto insurance, your auto insurance does not cover filling up with gas. It does not cover the oil change. It does not cover the car wash. It does not cover a whole lot of things.
It covers when you have a major accident and you have a major expenditure, and because of that car insurance, although when you have four teenagers like myself it can be pretty steep, it still has not had the type of increases that we have seen in health care.
We need to have a similar type of approach with what the health savings accounts provide which is basically saying we have catastrophic coverage. You and your employer, either one of you, or your family members, can contribute to the health savings account. You are going to spend those dollars. You are going to shop for the cheapest place for nonemergency service for health care, just like you would shop for the cheapest place for gas which, oh, by the way, if we got this energy bill passed, as my colleague mentioned, would be lower, and this is the type of thing that we need do.
I would just say that one of the things we are doing this week is loosening up the restrictions on flexible savings accounts, and flexible savings accounts are similar to a health savings account, but they are employer offered. They allow cafeteria plans, put in their pretax, but they are not really used because it is a use it or lose it.
We have allowed the rollover option in health savings accounts. Why was it use it or lose it? It is use it or lose it because those that want to have a single-payer government plan know how powerful this approach can be, wanted to limit that. So we are allowing people that have flexible savings accounts offered through their employer. If they do not use it all, be able to roll over $500 to the next year or take $500 out and invest it in their own personal health savings account that they can carry with them wherever they go, and given that the average 32-year-old has been at seven or nine different employers in their life, having that portable plan that is with you always should be a great comfort and a great benefit to them.
These AHPs, or association health plans, are a critical link in lowering the uninsured. Just repeating what you said, 60 percent of the uninsured are employed by companies that really have a hard time getting availability of health insurance. By the time you sell to that small company, it is, as you mentioned, a very high overhead cost.
So many of these would want to pool together, provide a plan that is tailored for the type of employees they have, and lower their cost in a bargaining pool.
Who would these associations be? These associations are like we just had
the Realtors in visiting us today. The major issue they spoke to me about, saying Realtors are a lot of times independent contractors with some umbrella firm. They need to have negotiated lower prices that can combine this with the health savings accounts very nicely, but they need it to be able to offer insurance to Realtors.
Look at restaurants that have a wide variety of full-time and part- time employees. They could tailor a plan specifically for those, again meshed with a health savings account.
So these are the types of plans that are going to really help to let more small businesses offer insurance.
One of the things that is important to point out is I know the gentleman from Kansas represents a rural State and has significant parts of his district which are rural, just as I have. A lot of times in those rural areas, they do not really have options. In our State in Minneapolis-St. Paul, there are multiple health plans available, and there are three or four or five, or significant options and several other smaller options; but if we get out into small-town U.S.A, you do not have a lot of options.
This really has even a stronger benefit for those small businesses operating in the rural areas that can combine themselves with an association health plan that goes across State borders, pools businesses of character. And it just does not need to be businesses; this could be a religious organization, a nonprofit organization, a community service organization. The Lion's Club, of which I belong, could do an association health plan for Lion's Club members.
It opens up the amount of people participating, thinking about how can we offer services to those with a commonality. Having more options is exactly what we need if we are going to really grab control of these health care costs and reduce the number of people that are uninsured.
Mr. Speaker, I would also say to my colleague that, unfortunately, what we see here too much on this floor and what we hear is anger and complaining about health care costs going up, they are being harder for the average family to afford. We agree, but we do not hear very often, unfortunately, except with the great dialogue we have had here tonight, about what the solutions are. And I would like particularly my fellow Members from the other side of the aisle to talk about what their solutions are, talk about how you are going to control costs.
The uninsured is a huge issue. Besides growing jobs, each one of these proposals reduces the level of the uninsured. This is really the most effective way for us to reduce the uninsured.
I would also suggest one more piece in the puzzle, which includes my Fair Care Act, which I have introduced and am pleased to have 127 other Members joining me on. And if we think about it, right now, the uninsured can go into a hospital and get care; but it is through the most expensive vehicle possible, the emergency room, through the EMTALA law. We could provide for that service at one-fifth the cost in a community clinic, if we had an individual on some base level of insurance at least, and probably address the underlying problem of that cost much more efficiently, and let people live a healthier life by letting us also do a better job of controlling costs.
Because what happens when an uninsured comes into a hospital and is not paying for it? It ultimately layers onto the premiums for the insured and increases their costs. As my friend from Kansas mentioned, when the cost goes up more on the insured, it creates a vicious, vicious cycle. My bill, to allow for a $1,000 credit per person, $500 per child, up to $3,000 for a family, refundable tax credit so they can get that insurance, pay for that insurance policy directly, is another piece of this puzzle.
And as we think about the uninsured side, we need to recognize that we have, just as we have in education, left too many of the disadvantaged behind. Thirty-five percent of Hispanic households are uninsured; 18 percent of African American households, with only 11 percent of white. There is a disparity in who is hurting, and we need to address them.
While we address the uninsured, we also get control of costs. By getting control of costs, we make American jobs more competitive, and we keep American jobs here. And I think it is also important as we look off on the horizon at how do we control the long-term deficit, how do we control the long-term liabilities that we have, the unfunded liabilities in Medicare and Medicaid are significant. The number one variable that will determine how we control those will be to help control health care costs.
These measures that we have proposed, that we have talked about tonight will not just lower the uninsured, will not just grow jobs here in America, but will get long-term costs under control so we can control that deficit, which again will help make for a stronger economy now and in the future.
So I thank my friend from Kansas for bringing this very important topic to the floor.
The flexible savings accounts and the ability to roll those over.