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How to Fix America's Broken Health Care Demand Greater Quality, Efficiency in How Medical System Operates

July 30, 2009 By:
Allyson Schwartz
Posted In 
The facts are clear on why health reform is such a focal point of Congress' agenda. Almost 50 million Americans are without coverage. Millions more worry about the stability of their coverage -- that in the case of an accident or illness, their insurance may not cover critical needs. Since 2000, Pennsylvania families have seen a 100 percent increase in their premiums. Nearly one in five Pennsylvania families pay more than 10 percent of their income on health care.

American businesses -- large and small -- are struggling with increasing premiums that force them to pass more of the cost to employees, to change health plans or to drop coverage entirely.

Our government is the single largest payer of American health care costs, currently handling nearly half of our nation's $2.5 trillion health care bill. And while costs keep rising faster than inflation, health outcomes are not improving.

The status quo is unsustainable.

President Barack Obama and Congress are committed to creating an American solution to reform our health system. This means providing stable, affordable coverage for all, including the nearly 50 million who are uninsured; and bringing everyone's costs under control.

As someone who's spent nearly 30 years working on the issue as a health care executive and policymaker, I think it's remarkable how much we've achieved this year. We expanded affordable health care to 11 million children; moved forward on modernizing medicine through health information technology; invested in research; and provided health coverage stability to families hurt by the recession.

In the first few months of 2009, we did more than had been done during the previous decade. These accomplishments demonstrate the commitment Congress and the president have to health reform.

We must reform America's health care system in a distinctly American way. Here's what reform will look like:

· If you like your insurance, you can keep it. For those without coverage, many of whom are working families, we'll help you buy private or public coverage. Everyone will have to pay something, but credits will help them purchase either private or public insurance based on a sliding scale.

· We'll set consumer protections, including ending exclusions for pre-existing conditions and making paperwork simpler.

· We'll demand greater quality of care and increased efficiency.

· We'll improve care for seniors, including eliminating the current co-payment for primary care under Medicare and improving coverage for prescription medicines.

· We will demand that all Americans take greater responsibility, including insisting that everyone has insurance.

Using the assets we have, including many of the world's best doctors, nurses, scientists and entrepreneurs, we'll renew our emphasis on best practices and high-quality outcomes.

And we'll work to ensure that everyone has access to the care they need, starting with a new focus on primary care. This includes providing loans and scholarships for primary-care providers, increasing reimbursement rates and providing incentives for ongoing relationships between doctors and patients, particularly those with chronic diseases.

As vice chair of the House Budget Committee, I've been outspoken about balanced budgets. This means that health reform must be fully paid for. Toward that goal, half of the cost will come from savings within the current system.

Such savings will come from reducing unnecessary hospitalizations, duplicate testing and medical errors; ending overpayments to private insurance companies that contract with Medicare; and insisting on lower prices for prescription drugs for seniors. These key steps will save hundreds of billions of dollars, savings that will be used to improve the delivery of health care for our seniors.

Health care reform will not be easy, but a failure to act means higher costs and greater uncertainty for all of us. Now is the time to act.

U.S. Rep. Allyson Schwartz, a Democrat, represents Pennsylvania's 13th District. She serves on the House Ways and Means Committee, and is vice chair of its Budget Committee.


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