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Real Clear Politics

May 20, 2009

An Alternative to Obamacare

By Tom Coburn, Richard Burr, Paul Ryan & Devin Nunes

While President Obama may believe the stars are aligned for major health reform this year it is far from certain whether Congress will pass a bill that works. The groups that are most likely to unravel this effort are not the president’s opponents, but his allies. Nothing will rally ordinary Americans against the president’s plan more than his allies arguing too forcefully for a system run by politicians and bureaucrats in Washington – what we call the “public option” in the Obama plan.

It should come as no surprise that this ideologically rigid position is coming under fire. As the Washington Post recently wrote, “the fixation on a public plan is bizarre and counterproductive … It is entirely possible to imagine effective health-care reform – changes that would expand coverage and help control costs – without a public option.”

We agree. We have introduced a comprehensive health care reform bill, the Patients’ Choice Act that, we believe, will bring us far closer to the goal of universal coverage than the Obama plan. Our bill, in specific legislative language, does the following:

Puts affordable coverage and choice within reach of all Americans. We do this by first ending the discrimination in the tax code that rewards corporations and employers for offering insurance yet offers no benefit to the unemployed and is unfair to the self-employed. Our current tax laws are a relic of the 1940’s when Americans stayed in the same job far longer than they do today. It’s time for a reboot.

Specifically, we would shift health care tax benefits to individuals and families in the form of a “Medi-Choice” tax rebate worth about $2,200 for individuals and $5,700 for families. Under our plan, if you like the health care you have, you can keep it – but you’ll have more money in your pocket because you will still receive a tax rebate.

The Patients’ Choice Act lowers health care costs and insurance premiums by more sensibly caring for those with chronic illnesses and those deemed “uninsurable.” In addition to innovative prevention initiatives, our plan utilizes risk adjustment mechanisms and other options at the State level – such as reinsurance and risk pools – to extend coverage to those with chronic medical conditions. These steps will empower these individuals with greater choice, greater financial security, and a higher quality of life.

Prevents cherry picking by guaranteeing access to coverage. Even though we’re confident that less government interference and more individual choice will control costs and improve quality and access, we recognize that markets can’t solve all problems. That’s why our bill prevents cherry picking – when insurance companies choose to cover only healthy patients – by equalizing risk across insurance companies and reversing the perverse incentives that leave those most vulnerable with the fewest options.

Our bill creates voluntary state-based solutions – state health exchanges – that will offer health insurance benefits using the same standard used for Members of Congress. Every American would have guaranteed access to coverage and care under this plan, regardless of patient age or health history. And to ensure that states get to design the solutions their patients need, states would have the freedom to form voluntary pooling arrangements with other state exchanges to diversify risk pools, ease administrative burdens and cover costs for insurance. We also provide simple new opportunities for automatic enrollment to help people who need coverage.

Strengthens the health care safety net. Currently, about 40 percent of doctors and hospitals do not accept Medicaid patients because payments are so low. This means that needy moms and kids may have health coverage, but poor access to health care. We remove the stigma from Medicaid recipients and give them the ability to purchase the health coverage and care they need from any provider. We preserve Medicaid for the blind, aged, and disabled and we eliminate widespread fraud in the programs. We do all this and still save states and the federal government about $1.3 trillion over the next 10 years.

Finally, our bill accomplishes these goals without spending any new federal money, or raising taxes. If this sounds too good to be true, we would note that the problem in health care is not that we don’t spend enough, but that Americans aren’t getting enough value for their dollars. On a per capita basis, America spends nearly twice what other industrialized nations spend on health care yet we are hardly twice as healthy.

The Obama plan promises change and progress, but it is based on old ideas. For the past 50 years, the Left has promised that a little more government intervention and spending will fix health care. If Washington can effectively run a health program like Obama’s public option, why are Medicare, Medicaid, and other federal health programs in such disrepair?

Today, federal and state government controls about 60 percent of our health care economy, which has helped create the chaotic system Americans loathe. Congress and the Obama administration are now on a path to finish the job and move us past the tipping point into a Canadian or UK-style government-run system.

The American people deserve better. Congress should be looking to 2040, not 1940 or 1965. We can achieve universal access to quality, affordable health care without bankrupting our children with trillions more in debt or imposing draconian tax hikes on all Americans. It can be done, and the Patients’ Choice Act shows us how.

Tom Coburn is a U.S. Senator from Oklahoma. Richard Burr is a U.S. Senator from North Carolina. Paul Ryan represents Wisconsin’s 1st congressional district. Devin Nunes represents California’s 21st congressional district.

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