President Barack Obama’s decision to move forward with a reconciliation strategy will have the opposite effect of what he intends. Instead of ending the debate with a sweeping reform bill, he will most likely achieve nothing and restart the debate. From the perspective of the American people, that is just as well.
The American people have already spoken on this issue, not just in polls but in elections. Starting over is not a talking point but a clear request of the American people. For instance, a recent CNN poll indicated that seven in 10 Americans want Congress to start over on health care or quit
working on the issue altogether.
Instead of pursuing a Plan B strategy, the majority would be better off with what Warren Buffett suggested — a Plan C strategy that addresses cost. All sides agree the fundamental problem in health care is cost. We spend twice as much on health care as any other industrialized country, but we aren’t any healthier as a result. A study by Thomson Reuters found that one in three dollars in our more than $2 trillion health care system does nothing to help people get well or prevent them from getting sick.
The debate we should be having is about how to control costs. When it comes to finding solutions, we do have some areas of agreement, but in many respects our two philosophies collide.
The argument that the president and the majority make — that health care costs too much because government hasn’t spent enough or regulated enough — is absurd. Their argument and strategy hasn’t changed for 80 years. During that time, government has assumed more and more control of our health care system to the point that federal and state government now controls 60 percent of all health care dollars. If more government spending was the answer, health care would have been fixed long ago.
The president and majority also believe reform is building on a health care system that was created just after World War II, when Americans stayed in one job for most of their lives. The third-party payer model and tax treatment of health care hasn’t changed significantly in more than 60 years. In computing terms, we are still operating under Windows 1945. New service packs — entitlement programs — have been created along the way, but the underlying operating system is the same.
What I, and many Republicans, believe is that government is not the solution but the problem in health care. Government, not the free market, has separated patients from doctors and patients from the purchase of their own health care. A new operating system — one that reconnects doctors to patients and patients to payment — is the key to reform. This idea is at the heart of the reform bill, the Patients’ Choice Act, that I introduced last May along with Sen. Richard Burr (R-N.C.) and Reps. Paul Ryan (R-Wis.) and Devin Nunes (R-Calif.).
This is a debate that we can win because the American people already accept the premise of this argument in every area of the economy except for health care. Americans trust themselves with their own money more than someone else.
The president and the majority, however, disagree. During the health care summit, House Energy and Commerce Chairman Henry Waxman (D-Calif.) ridiculed the notion that “prudent shoppers” could control health care costs and improve access. Economic history proves him wrong, however. Consumer choice, not government coercion, has made goods and services that were once scarce affordable and accessible.
For instance, in past 18 months, the number of unique iPhone applications available to consumers has gone from 500 to more than 140,000 with 3 billion applications downloaded. Consumers from all walks of life are not only prudent but savvy shoppers.
In the real world, consumer choice has been much more successful at creating universal access than government control. Products that were once rare and expensive — cars, televisions, computers, mobile phones, etc. — are now ubiquitous. The same market dynamics could lower costs and improve access in health care.
Whenever these ideas have been tested in the health care sector, the results prove this point. For instance, Indiana Gov. Mitch Daniels (R) recently published an important opinion piece in the Wall Street Journal about his state’s experience with one form of individual-centered reform — health savings accounts. Daniels found that participants in his plan spent 35 percent less than participants in traditional third-party payer plans.
Daniels concluded: “There will be no meaningful cost control until we are all cost controllers in our own right. Americans can make sound, thrifty decisions about their own health. If national policy trusted and encouraged them to do so, our skyrocketing health-care costs would decelerate.”
This is the heart of the health care debate. In the real world, companies like Microsoft and Apple that innovate and improve thrive and survive while those who repackage yesterday’s ideas fail. Our health care system is failing because politicians in Washington, D.C., keep repacking yesterday’s ideas. The president’s decision to ram through yet another government expansion of health care won’t be any more successful than the last several expansions of government-run health care. Those so-called reforms have brought our nation to the brink of bankruptcy and increased health care costs for millions of Americans. That’s why the American people are saying it’s time to start over.
Sen. Tom Coburn, an obstetrician, is a Republican from Oklahoma.