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Dear Tom:
Thank you for contacting me to share your views on Congress's continued consideration of legislation that would overhaul our nation's health care system. I appreciate you taking the time to write to me on this important issue.
As you know, for the last few months, the American people have been engaged in a critical debate on how best to improve and reform our nation's health care system. Every individual, family, and business has a vested interest in making sure that Congress gets these reforms right and as various bills have been considered by Congress, I have continued to offer substantive proposals that would expand individuals' access to care, control the increasing costs associated with our healthcare system, and do so without placing the government in control of individual health care decisions.
I understand that there are deeply held views on all sides of this issue, but even those with drastically different opinions can agree that meaningful health care reform is long overdue. That said, it is increasingly clear that Washington's trillion-dollar, two-thousand page overhauls will not only fail to address what's broken in health care - but will actually make matters worse. On November 7, 2009, I joined members of both parties in opposing H.R. 3962, which ultimately passed the House by a narrow margin of 220-215.
Following the passage of H.R. 3962 by the House, this bill was debated and amended in the Senate. On Christmas Eve, in a 60 - 39 party-line vote, the Senate approved their version of H.R. 3962. The path to secure a majority of votes in the House and the necessary 60 votes in the Senate took place largely behind close doors in Washington, and this was reflected in the hundreds of new pages of legislative text which were added to the legislation just hours before its passage in both chambers.
To be sure, the Affordable American Health Care Act of 2009 has noble aims. It attempts to greatly expand health coverage; achieve higher quality care for all Americans; and lower health care costs so these expenditures do not cause unsustainable Federal budget deficits in the future. These are goals that Members of Congress on both sides of the aisle can agree upon, but the policies in this bill would likely cause the opposite effects.
I voted against H.R. 3962 and before explaining the alternative that I put forward, I wanted to elaborate on some of the most troubling aspects of this bill:
A Government Takeover of Health Care: Rather than address the current health care market distortions created by flawed government policies, H.R. 3962 would expand Washington's heavy hand and exacerbate what's broken in health care. This is not alarmist rhetoric; the legislation proposes:
- One-Size Fits All Health Care. The bill's rating restrictions, coverage mandates, and benefit requirements will halt innovation and drive individualized health products out of the market. The bill disqualifies Health Savings Accounts, which provide more than eight million people with access to low-cost coverage. Additionally, all plans would be subject to approval by a new Health Choices Commissioner, with the authority to penalize any health plan that does not comply with the rules set by this new federal bureaucracy.
- Government Rationing. The bill empowers the federal government with even greater leverage in deciding which medical treatments are worth paying for and which are not. In an effort to contain costs of its new health care entitlement, a new "Comparative Effectiveness Research" program will inevitably impose government control over physicians' medical decisions, and cause private-sector insurers to limit coverage in line with the government's choices.
- Price Setting. While the legislation suggests providers will be able to negotiate rates with the government, there is nothing to prevent this from becoming a take-it-or-leave-it, price-setting system. Put simply, prices will be dictated to health care providers at rates determined by a cost-wary Federal Government.
Another Unsustainable Health Entitlement: Current challenges in health care are driven largely by fundamental problems in existing Federal Government entitlement programs. Rather than address our existing entitlement programs, H.R. 3962 layers on yet another Washington-based medical program - a new $1.3-trillion health entitlement that will cost an estimated $2.4 trillion when fully implemented.
- A Faulty "Self-Sustaining" Public Plan. The bill's government-run, public health insurance program is intended to be financed by premiums from beneficiaries. As noted by the Congressional Budget Office [CBO], however, the public plan is expected to charge higher premiums than private health insurance - which Congress is unlikely to allow, and which appears to contradict the ostensible goal of boosting "competition" to "keep private insurers honest."
- Driving States Deeper Into the Red. Rather than make quality health care more affordable, H.R. 3962 attempts to cover the uninsured by adding them to ever expansive government-run programs. The dramatic expansion of Medicaid would force cash-strapped States to spend an additional $34 billion over the next 10 years, beyond the unsustainable Medicaid burdens States already face.
Heavy Taxes and Fees on Individuals and Businesses. The massive expansion of the government's role in the delivery of health care relies heavily on a number of mandates and tax penalties. The Congressional Budget Office estimates that $729.5 billion in new taxes would hit individuals and employers. Among those tax increases are:
- A total of $460.5 billion in job-killing small-business surtaxes (section 551).
- Another $135 billion in employer mandates, including the "play-or-pay" scheme punishing even small companies that cannot provide group health insurance (sections 511-512).
- An additional $33 billion in individual mandates - including an unprecedented Washington requirement that everyone must buy health insurance or be subject to Federal penalties (section 501).
It is critical to point out that H.R. 3962 is not the only way to tackle this issue. Democrats, Republicans, and Independents alike continue to offer substantive alternatives - proving that we can have universal access to health coverage in America without the government taking it over, without trillions in new taxes, spending, and debt. For instance, the Patients' Choice Act, which I introduced earlier in the 111th Congress, aims to fix what is broken in our health care system without breaking what is working. It would address the major problems of our health care system by focusing on a few core concepts:
Emphasize Prevention - Five preventable chronic conditions consume 75% of our health spending and cause two-thirds of American deaths. Investing in prevention will lower long-term costs and ensure Americans live longer and happier lives.
Create a Market that Works for Patients- The status quo regulation of the insurance market does not provide incentives for insurance companies to cover chronically sick patients and many sick patients are unable to afford premiums. Businesses must play by transparent rules and compete for patients' business. The market must work for every patient every time. Patients should have convenient and affordable options, and they should have control of those options. Doctors, hospitals, and nurses should be more involved in patient-centered care.
Guarantee Choice of Coverage Options- Patients should be able to choose from a variety of private insurance plans. The federal government would run a health care system?"or a public plan option?"with the compassion of the IRS, the efficiency of the post office, and the incompetence of Katrina. We cannot entrust the federal government to deliver high quality health care to every American. All Americans have a right to personalized and individual health care that will meet their unique needs.
Insist on Fairness for Every Patient- Patients already in government programs deserve a human approach to their health benefits and fewer bureaucratic barriers. Individuals struggling to purchase their own health insurance deserve the same tax breaks as Americans working in Fortune 500 Companies. Medicare beneficiaries deserve delivery choice when selecting between health benefits.
Fairly Compensate Patient Injuries- Patients should have the right to fair legal representation and fair compensation for tragic, inexcusable mistakes in the health care field. However, today's legal system serves the self-interest of personal injury lawyers, drives up costs, and delays justice. Science driven and results-oriented change is needed today.
Restore Accountability to Government Programs- The children covered under government health care programs today will face future tax increases in order to pay the $36 trillion unfunded liabilities in the Medicare program alone. Medicaid fraud and mismanagement waste at least $32.7 billion in taxpayer dollars every year. Reforms must bring about efficiency, transparency, and results. Failure to act now will jeopardize our nation's long-term fiscal security.
Include Ideas from Governors and States- Rather than one-size-fits all Washington mandates, a comprehensive solution to health reform must include governors, state legislatures, and every American citizen.
In many ways, the Patients' Choice Act shows that while there is division on how to solve the problems in our health care system; there is also agreement on certain reforms that should be enacted. We should look to end the practice of discriminating based on pre-existing conditions or increasing rates of insurance when individuals need it. We can and should reduce the waste, fraud, and abuse associated with Medicare and other government programs. But, we can make these improvements without driving our nation further into debt and without making government the primary actor in health care decisions.
As the New Year has commenced, Congressional leaders and the President have rightly recognized that although the American people want drastic changes to how they receive and purchase health care, they do not want H.R. 3962 to become law. Despite having passed legislation in both the House and the Senate, the President has been unable to reconcile the differences between the bills and Congressional Leadership is now determining whether to use the difficult budget reconciliation process to move H.R. 3962 or to return to the drawing board. Moving forward, I am hopeful that the President and the Majority will reconsider the heavy-handed approach that they have used to muscle this bill through Congress and will remain open to alternative solutions, such as the Patients' Choice Act.
Again, I appreciate you taking the time to share your thoughts on this critical debate and as Congress considers this legislation further, I will be sure to keep your thoughts in mind. If I can be of additional assistance to you regarding this or any other matter, please do not hesitate to contact me. I am always happy to respond and be of service to you.
Sincerely,
Paul Ryan
Serving Wisconsin's 1st District
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