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Boustany: Reform Lacks Transparency, Bipartisanship

June 11, 2009
As Washington debates health reform, many politicians seem to have forgotten what the whole debate is about — patients being able to get good care from their doctors at a reasonable price.

Too often, people are denied access to the doctor of their choice, especially as fewer and fewer doctors accept patients with Medicare and Medicaid — the government’s current healthcare plans.

Earlier this year, I received an e-mail from a Medicaid patient diagnosed with a brain tumor. Doctors told her that she would likely be put on a six-month waiting list for brain surgeons currently serving Medicaid patients. For timely care, she had to borrow a neighbor’s car, secure childcare for her autistic child, and drive four hours to a hospital in Shreveport. Patients in government-run plans clearly deserve better.

Unfortunately, a plan being developed behind close doors by liberal Democrats calls for a new, government-run, bureaucracy. Non-partisan experts agree that private insurers could not reasonably compete with a government-run system that sets arbitrary prices and limits or simply denies many services. Thus, millions of satisfied Americans would have their existing coverage eliminated and be forced into a government-run system.

This is a ludicrous policy given the looming bankruptcy both Medicare and Medicaid already face. The Government Accountability Office used the words “leadership deficit” when describing Congress’s failure to face Medicare’s financial problems.

According to the Medicare Trustees, saving the Medicare Hospital Trust Fund alone will require an immediate 53 percent benefit cut, a payroll tax increase of 134 percent or “some combination of the two.” The trustees add that “larger changes would be required to make the program solvent beyond the 75-year horizon.”

Some Democrats refuse to acknowledge this simple fact. Just last year, Ways and Means Health Subcommittee Chairman Pete Stark (D-Calif.) issued a press release insisting Medicare was “solvent and sustainable.”

So, despite ignoring the fact that we still lack a plan to pay for the two healthcare programs the government already has, Democrats want to create a third program. How much is this new plan going to cost? Experts at the Democrat-friendly Urban Institute recently reported President Obama’s plan would cost at least $1.5 trillion — more than double the $634 billion requested in the president’s budget.

Not paying for Medicaid, Medicare or a new government-run health program simply is not fair for patients or taxpayers. But most Democrats are playing by different rules. For the sake of future generations, we can hope that some will start working with Republicans to responsibly reform healthcare.

There is reason for hope. As Joe Antos of the American Enterprise Institute notes, “[t]he Blue Dog Democrats are concerned about making commitments that we will not be able to keep. We are now just eight years away from Medicare being unable to pay all of its bills. Can we in good conscience create a new entitlement when we have not yet addressed the serious fiscal problems facing the entitlement we already have?”

With this significant fiscal challenge in mind, Blue Dog Democrats continue urging House and Senate leaders to avoid “additional large-scale deficit spending.” They also wisely express worries that a new entitlement plan could force families to lose their current coverage. Unfortunately, a recent New York Times column quoted Democratic leadership staff doubting that Blue Dogs and New Democrats had the “the political will to do both.” We’ll have to wait and see who is right.

Just as patients deserve to hear the truth when they face a life-threatening illness, the American people deserve the same forthright discussion about how promises of a new government-run plan will be funded in addition to the existing entitlement programs.  Families and small businesses want help with rising health costs, not a plan that simply creates a new, unfunded entitlement and an ever-larger federal deficit.

As the president has said, Americans must be guaranteed to keep their existing health coverage if they like it, and Republicans fully agree with President Obama on this.  However, forcing millions of families into a new government-run system simply does not meet this promise.

Republicans want to make quality healthcare coverage affordable and accessible for every American, regardless of pre-existing health conditions. By reducing the cost of health insurance and providing extra help to those who cannot otherwise afford it, we can help more Americans develop a meaningful doctor-patient relationship. In addition, we will make plans more affordable by creating real choice and competition among plans in the small-group and individual market.

Republicans believe the private market can offer healthcare choices to cover all Americans with several meaningful changes to the current system. Republican proposals include increasing low-cost options for young adults who see little need for a benefit-heavy plan and allowing families and businesses to purchase insurance across state lines to increase competition, choices and lower costs through a more personalized plan.

Health reform should be bipartisan, open and transparent so Americans understand the difficult decisions we face and can see how any new law will affect them. That is not what is happening. Even moderate House Democrats recently complained in a letter to several committee chairmen about being left out of any meaningful discussions on health policy changes.

It is time to stop crafting healthcare reform in secret, it is time to start negotiating with moderates, liberals and conservatives of both parties, and it is time to reform healthcare the right way.

Boustany, a member of the House Ways and Means Committee, is a retired cardiovascular surgeon.