American Health Care Reformers Can Learn from Canada, Britain
Special to Roll Call
Governments regularly run out of money and this can have a real impact if they are in charge of your health care. Ontario canceled funding for child immunizations, routine eye exams and physiotherapy services. Government unions also go on strike. In British Columbia, 5,300 surgeries were canceled during a health care worker strike. The Fraser Institute, an independent Canadian research organization, reported the average wait for surgery is now up from 14 weeks to 18 weeks. Queen Elizabeth hospital in Halifax reports its X-ray machine (no MRI available) was installed during the Nixon administration. To compare, Northwest Community Hospital in Illinois would flunk its own publically-reported quality standard if a patient does not receive a percutaneous coronary intervention test within 90 minutes of heart surgery.
In Washington, there are many proposals to have the government take control of health care. Some bills in Congress even call for pushing all uninsured people, including illegal aliens, into Medicare. We should look carefully at such ideas. Medicare covers over 40 million patients at a taxpayer cost of over $400 billion annually. Adding another 40 million patients to Medicare’s costs would likely cost taxpayers an additional $400 billion annually. Knowing the government will run a $2.6 trillion deficit this year during the worst recession in living memory, can we enact a tax increase to cover this or just borrow it from China?
Seniors and lower-income Americans depend on the promises we make. The worst thing we can do is make commitments that are too expensive and pull the rug out from under those who can least afford to cope. We should back reforms the government can afford to keep.
There are a number of steps that Congress should take to expand access to care and bring down the cost of medicine.
First, we should expand the number of Americans with access to employer-provided health care. One of the best ways to do this is by allowing small businesses to band together to form larger pools of insurable employees and family members. We should also allow franchises to offer national health care plans to their members so that Starbucks, AlphaGraphics or Subway can create one large, national insurable poll of generally young and currently uninsured employees to cover.
Second, Congress should expand access to care for millions of self-employed Americans without insurance. A refundable tax credit for individuals and families equal in value to the same tax breaks large employers get would help them to buy insurance. Individuals could be eligible for a credit worth up to $5,000 annually. Lower-income families would be eligible for a credit worth up to $8,000 annually.
Third, as jobs become more portable, so should health insurance. We should protect Americans who lose their jobs and families excluded from coverage by pre-existing conditions. Congress can remove the current 18-month time limit on COBRA continuing coverage, giving family members the option of always sticking with the insurance plan they currently have. This expanded coverage would also act as a bridge for retirees who are not yet eligible for Medicare.
Fourth, we must pass common-sense measures to bring down health care costs. The Department of Veterans Affairs already uses fully electronic medical records to care for 20 million patients while saving lives and cutting wasteful spending. We also need lawsuit reform. State supreme courts controlled by the plaintiff’s bar (like Illinois) are expected to strike down local lawsuit reforms capping noneconomic damages in medical liability cases. We need federal lawsuit reforms to lower malpractice insurance premiums and retain doctors in high-risk professions.
Finally, the federal government should mandate and enforce the right to see data on in-house infections caused by hospitals. Nearly 2 million Americans contract hospital infections every year, costing Medicare $5 billion annually. We should create incentives for hospitals to reduce their infection rates and help us lower the cost of health care.
In sum, there is a great deal the next president and Congress could do to improve health care without making the mistake of Xeroxing 40 years of mistakes already made by government health care systems in Canada and Britain.
Rep. Mark Kirk (R-Ill.) is co-chairman of the Tuesday Group.
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