Issue Statements
Health Care Reform
Health Care Reform
Reforming America’s health care system is one of the most pressing challenges that this country must face and accomplish. The United States spends more than $2.2 trillion on health care annually, over 16% of GDP, and yet 45 million people do not have health coverage and the cost of health insurance is often prohibitively expensive. Finding better solutions to meeting Americans’ health care needs is critically important.
There are several priorities to consider when planning health care reform in the United States. First, the personal doctor-patient relationship must be protected. The federal government, should never be given the power to interfere with that relationship. The ability to choose one’s own doctor is a vital component to quality care.
Second, timely access to quality treatment should be maintained. In the government run health care systems of countries such as Canada or England, it can often take months before even a simple test, such as an MRI, is administered. Any plan for reform must ensure that both quality care and timely access are preserved. Waiting weeks for a critical test is absolutely unacceptable, because delayed care equals denied care.
Finally, our health care system should never be taken over by the government. A government takeover of health care would lead to politicians and bureaucrats in Washington making your health decisions for you. They could decide that you were too old for a treatment or that something was too expensive and deny your eligibility.
By having the ability to choose their provider and to choose which coverage to purchase, Americans currently have access to the newest and best medicines. Seventy-five percent of all the new drugs approved worldwide are available in the United States, making us the first country to get the latest treatments. Furthermore, unlike the government, the private health industry has a proven track record of developing needed new drugs and designing and implementing the newest technology and techniques.
As the debate on health care reform moves forward, I will continue to support reform efforts that focus on the patient, on increased access to and options for care, and on eliminating waste, fraud and abuse in the current system.
Issa Health Care Handbook
Reform Proposals
The Senate majority, the House majority, and individual Members of Congress are currently working on health care reform legislation.
Issa proposal -- H.R. 3438, "the Access to Insurance for All Americans Act"
Every American should have access to the same quality health insurance that Members of Congress have. The “Access to Insurance for all Americans Act,’’ H.R. 3438, gives Americans this access.
Using the existing framework of the Federal Employees Health Benefits Plan (FEHBP), the “Access to Insurance for all Americans Act” gives Americans the opportunity to obtain the same health insurance that Members of Congress have. FEHBP currently has 14 national and over 310 state and/or regional health plans available to enrollees.
This legislation would allow for a tax deduction equal to the amount paid for premiums during the taxable year for coverage for the taxpayer, spouse, and dependents. The coverage is portable, so employees can take their coverage with them when they change jobs. H.R. 3438 would minimize risk adjusted premiums making the plans more affordable and would be available to all regardless of pre-existing conditions.
Senator Harry Reid Proposal ***UPDATED***
Read the full bill text here (updated Nov. 19, 2009):
http://democrats.senate.gov/reform/patient-protection-affordable-care-act.pdf
Find out how much the bill will cost here (updated Nov. 19, 2009):
http://www.cbo.gov/ftpdocs/107xx/doc10731/Reid_letter_11_18_09.pdf
Senate Finance Committee proposal
Read or search the bill, S. 1796, "America's Healthy Future Act," here (updated Oct. 20, 2009):
http://finance.senate.gov/press/Bpress/2009press/prb101909.pdf
Find out how much this bill will cost (updated Oct. 7, 2009):
http://www.cbo.gov/ftpdocs/106xx/doc10642/10-7-Baucus_letter.pdf
Find out how much the CBO estimates consumer premiums will cost under this bill (updated Sept. 2009):
http://www.cbo.gov/ftpdocs/106xx/doc10618/09-22-Analysis_of_Premiums.pdf
Find out how much PriceWaterhouseCoopers estimates consumer premiums will cost under this bill (as of Oct. 2009):
Find out how much Blue Cross, Blue Shield, one of the nation's largest private insurance companies, estimates premiums will rise for consumers (as of Oct. 2009): http://www.tnr.com/sites/default/files/BCBS%20Letter.pdf
Senate HELP Committee proposal
Read the bill tex heret: S. 1679, "The Affordable Health Choices Act" (updated Sept. 23, 2009)
www.thomas.gov
Find out how much the Senate HELP Committee proposal will cost: http://www.cbo.gov/ftpdocs/103xx/doc10310/06-15-HealthChoicesAct.pdf
House Democratic Tri-Committee proposal
Read the House passed bill H.R. 3962, the "Affordable Health Care for America Act." (updated November 10, 2009):
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3962pcs.txt.pdf
Find out how much the bill will cost (updated Nov. 6, 2009):
http://www.cbo.gov/ftpdocs/107xx/doc10710/hr3962Dingell_mgr_amendment_update.pdf
House Republican Conference Proposal
Read the House Republican alternative health care reform bill here (updated Nov. 5, 2009):
http://docs.house.gov/rules/health/111_hr3962_boehner_sub.pdf
Read the House Republican bill summary (updated Nov. 5, 5009):
Opinion Articles
November 4, 2009 -- Dem proposals: Legislative Delusion
Politico, www.politico.com
By Rep. Darrell Issa
After widespread disapproval of their 1,000-page proposal for government control of health care, congressional Democrats have responded by producing a 2,000-page bill that leaves many Americans wondering why these “reforms” seem oddly familiar to failed experiments already tried at the state level. Strange indeed is the fact that many states are working overtime to undo the damage wrought by earlier “reforms” that closely parallel the ones now being pushed in Washington.
Consider the evidence.
Soon after implementation of Tennessee’s TennCare program, a single-payer public health option launched in 1994, many employers dropped their employees’ private coverage benefit. As a result, 45 percent of new TennCare enrollees came from private plans, not from the uninsured. Within four years of TennCare’s creation, more than one-sixth of the Tennessee population was enrolled in TennCare, expanding the state’s cost to nearly one-third of its entire revenue. Tennessee’s experiment has done little other than present the United States with a clear warning that government-run health care is a costly endeavor that causes private employers to drop existing coverage and reduce the availability of a competitive private market for coverage.
Kentucky didn’t do much better with its mid-1990s reform attempt. The Bluegrass State set caps on insurance premiums, required a minimum level of coverage for all insurance packages sold in the state and implemented a community rating system that absorbed the cost of insuring patients with unhealthy habits into the general pool. Within three years of the first substantial reforms, 40 insurance companies left the state, leaving only two underwriters of individual private plans for more than 4 million people. Premiums skyrocketed for everybody, options decreased and a state with a 12 percent uninsured population ended up with 16 percent. Ten years later, most of the initial reforms have now been repealed. Former GOP state Rep. Mark Treesh concluded, “I think we tried to do the wrong thing too fast.”
Sound familiar?
The Empire State’s reform efforts have resulted in some of the highest costs in the nation. Each year, New York City residents pay an average of $9,000 for individual coverage and more than $26,000 for family coverage. This is in part because New York has 51 insurance mandates, some of which include podiatry coverage and hormone replacement therapy. Leading health care experts at both The Brookings Institution and The Heritage Foundation have concluded that the most expensive mandates increase insurance costs by as much as 20 percent. And yet the Democrats in Congress want Americans to believe that all their new mandates will actually reduce costs?
Massachusetts is fighting out-of-control cost increases despite having established an “exchange” — or state health insurance connector — similar to the one now included in one version of the Senate health bill. As originally designed for Massachusetts, the insurance connector was to be a marketplace for competition, but because the state sets unreasonably high coverage standards, there are few options and little competition. All of which, mind you, results in higher prices and less access to quality medical care. Because of the influx of newly covered individuals in the state, wait times to visit primary-care physicians can take more than 100 days in some rural areas. As predicted by those who oppose expanded government involvement in health care, Massachusetts is experiencing some of the worst health care rationing in the country.
For months, Democrats have been rejecting common-sense proposals for real health care reform that have worked on the state level. Texas, for instance, has drastically reduced the cost of health insurance by implementing serious tort reform that discourages frivolous lawsuits and excessive payouts. Furthermore, Utah has implemented a creative reform that allows for greater flexibility through defined-contribution plans, which increase options for employees and control costs for employers.
But these innovative solutions are nowhere to be found in the Democratic bills.
Rather, Democrats are hoping that failed experiments in expanding government control of health care at the state level will play out differently on the federal level. It might not fit Einstein’s definition of insanity — doing the same thing over and over again and expecting different results — but it doesn’t take a nuclear scientist to figure out that the Democrats’ plan suffers from a certain legislative delusion.
When Democrats propose unworkable ideological schemes that the American people reject, I’m ordinarily not concerned. This time, however, is different. If Democrats implement their political suicide pact through health care reform, innocent Americans struggling under an already difficult economy stand to suffer enormous harm that will reduce the quality of health care, drive private insurance out of business and add to an already exploding federal deficit.
June 16, 2009 -- Reform Is Needed, but Don’t Use Medicare Model
Special to Roll Call, www.rollcall.com
By Rep. Darrell Issa
Somewhere between the health care extremes — no government involvement and total government control — real reform is possible. And reforming America’s health care system is one of the most pressing challenges that we face.
Serious problems have emerged. Skyrocketing administrative and liability costs, cumbersome interstate restrictions and the terrible reality that our nation’s poor receive primary care at the highest point of cost — emergency rooms — necessitate a thoughtful debate and comprehensive reform.
Currently, we spend more than $2.2 trillion on health care annually and yet 45 million Americans — 38 percent of whom are small-business owners, their employees and dependents — are kept from affordable coverage because of rising costs.
Since 1965, the percentage of the federal budget allocated to Medicare and Medicaid has grown out of control. Originally estimated at an annual cost of $12 billion by 1990, Medicare actually cost a whopping $107 billion that year. Likewise, Medicaid, which originally accounted for 2.9 percent of the total national health cost, rose to 15 percent by the year 2000, and the price tag keeps rising. In fact, the Congressional Budget Office projects that together the programs could consume as much as 20 percent of gross domestic product in the next generation.
Like every Member of Congress, I’ve been searching for a responsible solution. Such a solution must protect the patient-doctor relationship and allow the freedom to choose not only competitive insurance plans, but preferred doctors as well. It must ensure timely access to quality treatment, and it must avoid a government takeover that puts the important decisions about care and treatment in the hands of Washington, D.C., bureaucrats.
The key component of President Barack Obama’s plan for change is a government-run insurance option that would provide universal coverage at a staggering cost with limited options for the poor. Under the Obama/Speaker Nancy Pelosi (D-Calif.) scheme, the uninsured and underinsured will be enrolled in a plan modeled after Medicare — a program that will be bankrupt by the year 2018. Not content with only running the American auto, banking, mortgage and insurance industries, the president is now positioning himself to be our physician in chief.
How’s this sound for reform? Take one of the most fiscally problematic and bureaucratically bloated federal programs in modern history and replicate it on a universal scale. Mix it up with an apothecary’s dose of rhetorical hallucinogens, and package it nicely with the label of change and hope that the country buys it.
The president told us during his campaign that his plan would save every American as much as $2,500 per year on their health insurance premiums, but if his ability to estimate premium savings is anything like his ability to estimate job creation, I’m afraid we’re in for another unpleasant surprise.
Yet there are some areas where both parties are finding common ground. For instance, every American should be encouraged to purchase coverage through an incentivized tax structure.
For those who are unable to purchase coverage because of limited income, however, I support a voucher system that allows them to choose from an array of private plans on the open market. Rather than automatically enrolling underprivileged Americans in a plan they didn’t choose, I suggest empowering them to make decisions for themselves and their families, aided by a direct government subsidy when necessary.
Already, the federal budget includes the cost of primary care for the poor and underprivileged through Medicaid and other federal subsidies like the State Children’s Health Insurance Program.
What they are without, however, are the kinds of choices that President Obama promised — choices that Pelosi and every Member of Congress have. The choice to evaluate a range of competitive plans and determine which one meets his or her own needs. The choice to find your own doctor and change doctors when necessary.
We can reform the system — not just expand and repackage it — if we will hold fast to three basic principles. The private sector is more efficient and less costly than the public sector. The poor are better served by choice and assistance than by coercion and exemption. And Congress has a responsibility to enact responsible reforms that address long-term problems, not hasty legislation that limits the access of all Americans to timely, affordable and dependable medical care.
Rep. Darrell Issa (R-Calif.) is the ranking member on the House Oversight and Government Reform Committee.
Newsletter Articles
July 20, 2009 -- Costly Government-Run Health Scheme Threatens Doctor/Patient Relationship and Quality of Care
Experts: Complicated House Democrats’ Plan (HR 3200) $1 Trillion price tag could be much higher.
Rep. Darrell Issa (R-Vista) described a plan by Democrat legislators in the House of Representatives to create a government-controlled healthcare system as a “dangerous prescription for our economy and a threat to the health of every American.”
The massive proposal would create a government-run healthcare system to compete with private sector health insurance providers. The plan has drawn sharp criticism from medical professionals, patients and government watchdogs who note that it would likely shift millions of Americans from private health plans to government-controlled care subsidized by taxpayers.
As written, the Democrat-bill would enact punitive taxes against employers who do not provide insurance through a newly created government healthcare exchange; would levy an additional new surtax of up to 5.4 percent on the income of many small business owners; and would limit treatment options, interfering with the doctor-patient relationship and reducing the quality of care. Critics point to similar government run plans in other countries that often require patients to endure months-long delays for medical services and provide a lower standard of care.
“This is exactly the wrong approach,” Issa continued. “Our current system has some problems that need to be addressed, but it also provides the highest quality of care and access to the world’s most advanced life-savings drugs and treatments. Our goal should be to make this system better and to extend the benefits of it to the remainder of uninsured Americans, not to scrap it and adopt some mediocre foreign health care scheme. I will vigorously oppose any effort compromising the patient’s right to choose their own doctor or limiting their access to needed services.”
President Barack Obama has ordered congressional leaders to pass legislation creating a government-controlled health system and deliver it to the White House for his signature before Congress takes its traditional August break.