Column: Time to work together
WASHINGTON -- Kristy is a Rochester mother and breast cancer survivor. Access to affordable health insurance is a life or death matter for her and millions of other Americans.
Last year, Kristy's health insurance premium increased 17 percent.
Hard-working Americans every year see premiums rise faster than their take-home pay. This is a financial disaster in progress. If ignored, this will result in an explosion in the number of uninsured individuals, reaching far into the ranks of the gainfully employed and middle class.
Kristy's employer laid-off workers this year, in part because of rapidly rising health care costs. Small businesses across America are shedding good workers to cover sky-rocketing health care expenses, stifling entrepreneurship and innovation.
And then, recently, Kristy lost her job. She worries about whether she'll be able to get health insurance given her pre-existing medical condition, once her temporary COBRA coverage expires.
Last year, more than 700 of our neighbors in southern Minnesota went bankrupt because of medical bills. It is unconscionable for anyone to go broke solely because they get sick. Now, Kristy wonders if she's next.
Kristy's story has become all too common in America today.
It doesn't have to be this way. H.R. 3962, the Affordable Health Care for America Act, includes several important fixes, some generated by Democrats and others by Republicans. Many of the ideas were discussed in my town hall meetings in Mankato and Rochester. These proposed fixes tear down the status quo, rein in costs and bring stability and peace of mind to regular people like Kristy.
The House health care bill has four important pillars of reform:
The first pillar stops runaway costs and rewards quality care. A patient-centered initiative spear-headed by Mayo Clinic is at the heart of rewarding quality. The current fee-for-service payment model in Medicare perversely encourages health care providers to perform unnecessary procedures and tests.
This is backward. Hospitals and doctors should instead be rewarded for innovation, results and quality care. The Mayo-backed solution in this bill asks experts at the independent Institute of Medicine to come up with and help implement new pay-for-results policy in Medicare. This will help deliver better care for our seniors.
The second pillar reforms the insurance industry to benefit ordinary folks. It provides overdue transparency and accountability by ending health insurance companies' blanket exemption from anti-trust laws.
Firms will no longer be shielded from liability for price-fixing or monopolizing. We've seen what happened on Wall Street when corporations got too big to fail and their books too confusing to understand.
It goes further to protect consumers by making it illegal to deny coverage for pre-existing conditions like Kristy's or charging more based on gender, occupation, or health status. It also caps annual out-of-pocket expenses and prohibits unfair limits on benefits to ensure no American goes bankrupt because of illness. And, it allows individuals up to the age of 27 to stay on their parents' insurance plan.
The third pillar promotes competition and choice for people who don't have insurance today or lose it in the future. Under the bill, Americans will be required to obtain health insurance, just like drivers are mandated by state law to purchase auto insurance.
People who don't have health insurance today or lose it in the future can participate in the Health Insurance Exchange where they can compare and purchase insurance products that best meet their needs.
An analysis by MIT Economist Jonathan Gruber found that premiums for folks in the Exchange will be lower than they would be if those same people were buying individual insurance in today's market.
Privately-owned insurance companies, member-owned cooperatives and a government-backed public option will compete for business in the Exchange. Low-income workers will get financial credits to help them afford to buy insurance.
Another solution brought up at my town hall meetings and championed by Minnesota's Republican Gov. Tim Pawlenty is fostering competition and lower costs through interstate insurance sales. The House health care bill allows states to work together to do just that.
Finally, the fourth pillar will improve seniors' access to quality, affordable health care and protect the doctor-patient relationship. It addresses one of seniors' top concerns by immediately beginning to fill in the Medicare Part D donut hole, which will make prescription drugs more affordable.
I joined the president and Republicans in demanding that health care reform be fiscally responsible. The bill before us now is paid for and does not add to the national debt, according to the non-partisan Congressional Budget Office.
To the defenders of the status quo who are opposing health insurance reform, I have one question for you: How does your plan help people like Kristy?
It's time to stop playing political games and come together across party lines to solve the problem.
Tim Walz represents Minnesota's First Congressional District. Go to http://walz.house.gov.