White House links health reform to economic growth

The President's Council of Economic Advisors (CEA) released a new report (PDF) linking health system reform and the nation's future economic growth. The CEA notes that, in the absence of reform, health care costs will grow from 18 percent of the nation's gross domestic product (GDP) this year to 34 percent by 2040. Even a 0.5 percentage-point reduction in the rate of growth in health care costs would limit the 2040 share of GDP to 30 percent, and slowing the rate of growth by 1.5 percent would significantly limit health care costs to 23 percent of GDP in 2040.

The report also details how health system reform will improve the nation's economy by improving federal budget deficit projections, lowering unemployment by one-quarter of a percentage point per year—which would account for about 500,000 jobs—and increasing the net economic well-being of U.S. citizens.

Key Concerns Describing the LSMS Opposition to H.R. 3200

1. Cost of Financing and Implementation

Cost estimates for implementing the provisions of this bill range from $1 trillion to $1.6 trillion dollars which will add to a federal debt that already ballooned significantly with stimulus and bail out packages approved by Congress this year.  Every dollar spent that is not supported by a real dollar of actual income pushes this nation closer to the brink of a financial cliff.  The financing of this bill is based on higher taxes and “estimates” of future savings extended through the next decade.  The CBO has already invalidated several of these estimates as being unrealistic and unverifiable.  In developing a plan for health system reform it is time for the Congress to voluntarily be bound by President Obama’s proposal on June 9, 2009 of “making pay as you go rules for federal spending into law”. 

Given the enormous task of reforming our health care delivery and financing systems, the process chosen to develop a workable plan and the timeline for key decisions/votes is totally unrealistic.  The current objective is to steamroll through the critical stage of design to get to the point of reconciliation of both chambers’ bills.  This shows a lack of respect for the American public and its right to provide valuable input and response into the shaping of a program that dramatically impacts their daily lives.  The commitment of the Congress should be to take the time to Do It Right and give reform a chance to succeed.  That is what the American people expect and deserve.

2.   The Ultimate Transformation to a Single Payer System

We oppose the creation of a Public Plan that will compete in the private insurance market. A government designed “wedge” plan will always have legislatively approved advantages that are not available to the private sector and positions it to artificially influence the balance of active competition.  The United States Treasury, at the discretion of the Congress, can provide a Public Plan the unlimited financial capability to drive down premiums and ultimately forcing out competitors in the private market leaving only a government plan option which becomes the single payer of health care services.  When true competition is eliminated, Choice becomes No Choice.

Currently almost 50% of the nation’s health care is paid for by a government program.  These programs include Medicare, Medicaid, Veterans Administration, TriCare and disability payments through social security. After decades of existence these programs have not clearly demonstrated superiority in providing access and cost containment versus private plans, then why would we assume yet another government program would?  This bill through creation of another government health plan extends the reach of government into literally every aspect of America’s health care system. It completely restructures America’s private insurance market, limits and/or channels patient choices of physician and coverage options, establishes direct and indirect control of payment for all health care services, and ultimately provides the framework for rationing of care as a response to cost escalation.   

3.  No Tort Reform in the Current Bill

There is no tort reform in this bill or others currently under consideration by the House and Senate.  The present medical liability system is fraught with inefficiencies highlighted by escalating and unpredictable awards, the high cost of defending against lawsuits, and forcing physicians to alter or limit patient services because of liability concerns.  It is widely acknowledged that the threat of suits and large awards has forced physicians into defensive medicine adding billions of dollars to the cost of health care each year.  No reform of a health care system should ignore the real savings that can accrue from addressing this major problem.  Some states, including Louisiana, have passed tort reforms that have been successful and any federal tort reform action should contain provisions to preserve those state laws.

4. Determination of Quality Care.

The determination of quality medical care m ust be made by the medical profession, not by a government bureaucracy. For decades standards of care have been developed, revised, and implemented by physicians through their specialty societies and national specialty certifying organizations. This process has served patients and the nation well producing standards and quality of care that are emulated around the world. Legislation that allows the government or third party payers to make determinations of  what constitutes quality medical care are rooted in cost containment goals or profitability and do not put the patient first.

5. The Right To Privately Contract. 

The right to privately contract is a fundamental provision of American law in our democratic society. Patients should have the right to enter into agreements with their physicians as to the fees and conditions for providing services.  When patients exercise the right to privately contract with physicians of their choice it respects their right to consider all options and implement their own decisions about the most personal and precious aspect of their lives and those of their families.

6.  Equating of Limited Licensed Practitioners with Physicians:

We oppose provisions in this bill that would define limited licensed health care practitioners as a patient’s primary care provider. Physicians recognize the value of these practitioners in the delivery of health care, however, the physician must always remain the ultimate director of health care decisions and medical care provided to patients. Limited licensed health care practitioners obtain specialized training to perform limited health care services. Physicians are educated and trained to provide the full spectrum of health care services that a patient may require. Limited licensed practitioners should never be equated to or substituted for the role of a physician.