The landmark economic recovery package proposed by President Barack Obama and passed by Congress in February was a decisive first step to leading Americans out of the worst economic downturn since the Great Depression.
But it was only a first step. The key issue in building a sustainable recovery is reform of health care. The piecemeal, uncoordinated and inefficient system we have today is crippling families and employers; the safety net is strained and struggling to keep up with ever-growing demand. Our health care system is unhealthy yet high cost, and without reform, it will hinder efforts to renew and revitalize America’s economic engine.
More Americans than ever before are without health insurance, yet health care costs are skyrocketing to more than 16 percent of our nation’s gross domestic product — the most in the developed world — and many necessary treatments are out of reach financially for even those Americans who are covered by health insurance. Without reform, health care will consume more than one in every five dollars earned in America in less than 10 years.
The health care system does not serve the interests of the American people as well as it could. It is not sufficiently focused on prevention. Too many of the costs are devoted to treatment in emergency rooms — the most expensive health care theaters in the country — where desperate patients in need, without any other alternative, turn as a last resort.
Resolving the fundamental contradictions in health care is key to America’s competitiveness. Rising health care costs are a burden on companies and industries that export to the world, and they make us less competitive. The spiraling costs companies bear are an inhibition to growing the work force.
We are losing at every turn: the health of the population generally, the vitality of American business and the economic security of our families.
Obama’s budget recognizes the priority this issue must receive. By endorsing cuts in tax breaks for the very wealthiest Americans and tackling waste, inefficiencies and mismanagement, he has put more than $600 billion on the table as a down payment on rebuilding America’s health care system.
I believe health care reform, to be meaningful, must have several essential components.
First, there must be universal access to health insurance and it must be affordable. Only with universal access to health care can we begin to get a grip on health care costs by spreading them across the largest pool of enrollees.
Second, we need better management of health care costs and improved efficiency. If we can get a better handle on health care costs, the savings can be used to expand services to all. This is a fundamental equation in the formula of reform; we need to ensure our system is sustainable over the long run.
Third, we need improved access to primary and preventative care. Prenatal care, preventative medicine such as wellness care and dental care, and early treatment and intervention together mean a healthier population. And the cost of early prevention and treatment is far less than fighting advanced illness and disease. We also need to examine access to care through a lens that brings into focus the racial, ethnic and geographic health disparities that have plagued our country for far too long. All Americans deserve a first-rate health care system.
Fourth, while we need to improve efficiency and quality in Medicare and Medicaid, we also have significant areas of need remaining in those programs. Among many priorities, we must work to improve access of Medicaid beneficiaries to their providers; address problems in Medicare’s physician payment system; and improve the functioning and fairness of Medicare’s prescription drug benefit.
Many ask, given the failures to adequately address these issues in the past, whether this is truly achievable in this Congress. I believe it most certainly is — and that we cannot afford to fail.
There is a growing consensus among my colleagues from both parties that the health care system is broken, and we must fix it. We don’t agree on all the solutions, and not necessarily even on the cause, but I sense a profound understanding that this is the time for very serious work to bring about fundamental change — precisely because it is costing the American people too much and delivering far too little.
We also have firm leadership on this issue in Congress and in the White House. Kathleen Sebelius (D), who has been nominated to serve as secretary of Health and Human Services, has boldly articulated the need for health care reform. As a governor, she knows what the current system costs our states, and she understands that we need solutions that are pragmatic and workable.
I believe we are moving beyond ideology in dealing with the crisis in health care — people of goodwill across the political spectrum and interests affected want to find a common path to enable the enactment of comprehensive health care reform in this Congress.
This is as important an issue as any on which we are engaged. If we reform health care, we will help rebuild an engine of growth under the economy overall. Businesses will have fewer health care costs; employees will have fewer health care burdens. The system will be more equitable and will deliver better health care services for ourselves, our families and our children.
It is imperative we succeed.
Rep. Henry Waxman (D-Calif.) is chairman of the House Energy and Commerce Committee.