Let Congress Walk Mile in Shoes of Uninsured

Posted December 2, 2007 at 11:00pm

A checkup of the American health care system reveals a troubling trend: 48 million Americans lack health insurance. And the side effects are worrisome for everyone as costs rise, care is compromised and confusion reigns in doctors’ offices and operating rooms.

In many ways reducing the number of uninsured Americans is like armchair quarterbacking Dallas Cowboys football. We’re all authorities on the subject, but expertise is just talk when you aren’t calling the game firsthand.

In Washington, D.C., both sides share sad statistics and tell heart-wrenching tales of families coping without coverage. Rhetoric about reform is rampant in our marble hallways. Unfortunately, common ground is rarely sought to find a prescription to remedy the problem.

Here’s an interesting idea. What if Members of Congress were to get out of the armchair and actually walk their talk in health care? In other words, what if all 535 Members actually joined the ranks of the uninsured and called the proverbial insurance game firsthand? My guess is our attention would be focused like a laser beam on the problem, partisan politics aside.

Former Speaker Newt Gingrich (R-Ga.) is famous for saying “real change requires real change.” Well, what if real change in health care begins with Members of Congress losing the health insurance provided to them?

On Nov. 15, I introduced H.R. 4190, a bill to end health care coverage for Members of Congress. A little unconventional? Sure. But, thought-provoking nonetheless. After all, if you really want to arrive at an answer, walking a mile in someone else’s shoes can help get you there.

Taking ownership of the health insurance issue actually may lead to some new and innovative solutions, which for too long have been overshadowed by the speeches and sound bites. In fact, if you drill down into the statistics, you would see that some of the solutions don’t have to be all that radical.

We rarely look beyond the headlines to see a breakdown of the 48 million people who are uninsured. We all cite the overall number, but few of us have investigated who really makes up this population.

One-fifth of the uninsured earn more than $75,000 a year and could afford insurance if we incentivized coverage. We could do that by simply changing some tax policy and mandate reform. That translates into nearly 10 million people dropping from the ranks of the uninsured.

Combine these folks with a similar number who are eligible for existing programs to help low-income individuals, such as the State Children’s Health Insurance Program or Medicaid, but for whatever reason have not applied. If we could find the courage to help the states get this population enrolled and covered, we could add another 10 million to the country’s coverage rolls.

Additionally, by crafting sensible policies that focus on more reasonable pricing, we could pick up some of the 2 million to 5 million uninsured who currently are university students or very recent graduates. This should be a pretty easy lift as this population is one of the healthiest and least expensive to cover.

If you add these numbers up so far, you will realize we’ve quickly reduced the number of uninsured by half, to around 25 million. Then consider that at least 10 million of the remaining uninsured are likely here without the benefit of citizenship and the figure is far more manageable. And all we needed to do to write the prescription for real change is to give Members of Congress the clarity of thought that results from finding themselves without their own health insurance.

The results of these kinds of reforms would be popular and profound as they greatly would improve affordability and access, while keeping medical advancements alive and well at the same time.

If more people are covered, more people will have access to the care they need and the system will be healthier for everyone. Health care also will be more affordable. Some of the country’s leading insurance executives estimate a 9 percent savings across the board in health care costs if more people had access to affordable insurance coverage.

Additionally, reform could help generate more competition in the insurance market itself when it comes to individuals, which would help drive down cost by increasing choice. In fact, maybe, just maybe, we would see health insurance available on an individual basis over the Internet, where it would be easier to find and select a policy that fits your particular needs and budget. And finally, we can make sure that advancements in medicine remain the hallmark of health care in America.

Now, there is a risk to this type of approach. Thinking of Members of Congress as part of the uninsured population could lead to unintended consequences like socialized medicine and rationed care because they appear to be a quick and easy fix.

Don’t be fooled. Band-Aid solutions to health care eventually shrivel and expose the chronic condition beneath. We need long-term solutions for what ails us in health care, and the sooner the better.

Now, I don’t see a line forming outside my door to sign up as co-sponsors for this unusual legislation. After all, next year is an election year and we’ve got other things to think about.

But, as a doctor with nearly three decades of in-the-trenches experience, I know the system is broken and needs to be fixed. I’m ready and willing to make meaningful changes, and I hope my colleagues will get out of the armchairs and help me do just that. As we say in medicine, take two of these reform pills and call me in the morning.

Rep. Michael Burgess (R-Texas) is a member of the Energy and Commerce Committee.