The United States spends 16% of its gross domestic product on health care - far more than any other industrialized country - but fails to cover all of our citizens. That’s a scandal. Forty-seven million Americans, and 600,000 Oregonians, are uninsured. That’s a bigger scandal. National health care reform must address both problems: we must (1) provide everyone access to health care and (2) take steps to control costs. The rising cost of health care is eating into workers’ wages. And, especially as the baby boomers retire, health care costs (already about 20% of the federal budget) are projected to overwhelm the federal budget, forcing either massive tax increases or huge cuts in other services – or in Medicare and Medicaid themselves.
Coverage for All
How to expand access? If we were starting from scratch, I would likely favor a ‘single payer’ system, which cuts the insurance companies out: you'd be allowed to pick your own doctor, and the government would be the insurer, as it is with Medicare. However, there are legitimate concerns that switching to a single payer system immediately would be disruptive (for one thing, it would throw an awful lot of insurance company employees - not just CEOs, but regular working people - out of work). But a single payer approach would clearly be superior to our current system, so if it gets to the Senate floor, I'll support it.
The ‘single payer’ option is not the only way. Other plans, such as those proposed by Senator Ron Wyden and former Senator John Edwards, also meet the tests of fairness and good sense. Both proposals would: (1) provide health insurance to all citizens; (2) stop insurance companies from discriminating against anyone who might actually get sick; and finally (3) ensure that all employers pay something toward health care. If all employers had to pay something, it would end the unfairness of the current system. It’s unfair because employers who do provide health care are in effect punished for their responsibility. When the uninsured get really sick, they often go to the emergency room, and the hospitals make up those costs by raising rates for the insured patients and their employers.
I would support either Senator Wyden's or Senator Edwards' plan and as your Senator would work hard to get them passed and to implement the health reforms we need so desperately.
Controlling Costs
We also need a comprehensive effort to control costs. The federal government has a major role to play here.
The first and most obvious step is to allow Medicare to negotiate prices with drug companies - a proposal Republicans have blocked in the Senate.
I also believe that John Edwards’ proposal to move from the current patent system for drugs to a system that rewards true innovation is worth exploring.
Finally, we should adopt Senator Debbie Stabenow’s proposal to limit the tax deduction drug companies get for “direct to consumer” ads – ads we currently subsidize as taxpayers, driving up costs.
Beyond prescription drugs, we should adopt the Commonwealth Fund's recent recommendation that Medicare move from the traditional pay-by-the-procedure model (which encourages more procedures, regardless of necessity or quality) to payments for "episodes of care" or courses of treatment. The payments would be based on the most effective and cost-effective treatment as determined by independent research.
Another Commonwealth Fund proposal worth pursuing is to limit Medicare reimbursement rate updates in high-cost areas. We know that costs are inexplicably higher in some areas than others, suggesting that a culture of inefficiency pervades the medical establishment in some regions. Basing annual hospital and physician payment updates on cost per beneficiary in relation to a national benchmark, as the Commonwealth Fund suggests, is worth pursuing.
I also believe that the federal government should adopt strict 'certificate of need' requirements for hospitals, discouraging over-investments in expensive equipment.
The federal government should also, through improved school lunch quality standards, get junk food out of schools, reducing the obesity rate and associated health care costs. Similarly, the Farm Bill should be reformed to start shifting subsidies from wheat and corn (things most of us already eat too much of) to fruits and vegetables.
Related Links
Novick Statement on the House’s Failure to Override Bush SCHIP Veto
Steve Novick Calls on Greg Walden to Support the Child Health Insurance Program (SCHIP)
Novick: Time to Fix the Farm Bill for the Physical and Economic Health of Our Nation
I Get a Kick Out of Good Ballot Measures (Novick Gives the Rest of His Kicker to Measure 50)
Call Today To Urge Smith & Wyden to Co-Sponsor the Community Choice Act
Steve on Jefferson Public Radio October 19, 2007
Steve talks with Jessica Robinson about his campaign, his trip to
Southern Oregon over the weekend, his vision for health reform and
other important issues.
Steve on KPOJ June 21, 2007 (At 18:00)
Steve needles Gordon Smith's feckless stance on Iraq, offers support
for Sen. Ron Wyden's universal health care plan and champions smart,
fair immigration reform.
