Matheson: Health Care Reform Needs More Work

Editorial from Congressman Jim Matheson, printed in the Salt Lake Tribune April 4, 2010:

During my time in Congress, there may have been only a handful of issues that have captured people's attention and generated as much passionate debate as health care. For the last year, our country has been engaged in an intense conversation about how important health care reform is and about how important it is to get it right.
I certainly respect the passion that is out there, and the emotion around the health care issue. It affects everyone so personally, including me. Now, after so much debate, a new health care policy has been signed into law. The emotions remain and I hold out great hope that more work can be done on reform.
Ever-rising costs and growing ranks of the uninsured illustrate why health care reform is needed.
There are policies in the new law we all embrace. Now, in our country, people will not be denied health insurance because of a pre-existing condition. That is a blessing to so many. Now, in our country, more children and young adults will have coverage. For so many families, that will mean peace of mind.
However I want to be clear about a critically important goal that still remains. After all the wrangling, the new law is too expensive, contains too many special deals, does not do enough to contain health care costs and -- according to the Centers for Medicare and Medicaid Services Actuary -- will result in increases in health insurance premiums for many Utahns. For those reasons and others, I could not support the bill.
Controlling rising health care costs, increasing quality and value and improving access to health care and to affordable health insurance coverage are critically important to me. But the wrong kind of reform -- which increases health care costs for individuals and for large and small employers -- does not accomplish those goals.
I rolled up my sleeves during this debate. I spent hours in health care hearings. I have met with White House officials and congressional leadership for hours to work toward language that would not just lower the growth of costs, but drive down costs to consumers. I have talked with thousands of Utahns about health care reform in general and this legislation in particular and in important areas it falls short. It does not come close to eliminating Medicare's long-term budget deficit.
Special deals benefiting Louisiana, Tennessee, Connecticut and Montana were left in the bill, benefits that were not extended to other states. The pilot programs for medical malpractice reform don't help doctors who are forced to practice defensive medicine, nor patients who are trapped in a dysfunctional system where 54 cents of every malpractice awarded dollar go to pay legal fees. The bloat and waste contributing to the fact that we spend 50 percent more on health care than the next industrialized country -- while our medical outcomes are merely average -- isn't addressed.
You might think these concerns are too pessimistic, until you look at what has already happened in the case of one state that opted to implement increased coverage without implementing reforms to rein in the high cost of health care.
It has been three and a half years since Massachusetts enacted bipartisan legislation to provide health care coverage to nearly all state residents. It imposed an individual mandate for the purchase of health insurance.
Since its inception, 430,000 people have gained coverage -- a good thing. However, Massachusetts did not enact reforms to address rising health care costs.
Since then, the demand for care -- particularly in medically underserved communities -- has increased. But escalating health care costs are already preventing some newly-insured residents from getting care. In fact, one in five residents went without needed care in the past year because of cost. People with disabilities and those in poor health experienced the greatest barriers. Also, Massachusetts now suffers from some of the worst primary care wait times in the country, despite having the highest concentration of doctors nationwide.
One state health plan and its hospital -- Cambridge Hospital -- had some HIV and Hodgkin's lymphoma patients experience an interruption in their care because they couldn't afford increased co-payments. In Massachusetts, growth in health care costs has compromised the effort to provide health insurance coverage.
While it is important that a means be found to enable everyone (including those who are currently uninsured) to be able to afford health insurance, achieving that goal cannot occur at the expense of people who are presently insured. The challenge of reforming our health care system -- especially cost containment -- still confronts us.
The passion around this debate is important. We need robust debate to make good policy and I embrace those difficult conversations. A year of debate is a long time, but there is a decade of work ahead to move this policy to a place where it can meet the ultimate goal of increasing coverage and lowering costs to Americans.