“Every State of the Union address contains ideas of two kinds – those that are destined to become topics of earnest debate, followed up by action from Congress, and those that will ultimately die a quiet death in some subcommittee room.

 

President Bush came to a Democratic-controlled Congress for the first time in his presidency on Tuesday night. 

 

Though it is always unlikely the president’s agenda will be completely adopted by Congress, the challenge of this speech was to find ideas that motivate both parties to take legislative action.  The national tragedy of the uninsured was an important issue raised in the speech, and I hope Congress will be responsive to this crisis, because health care insurance very much matters in rural Missouri and the Eighth Congressional District.

 

Nearly 47 million Americans have no health insurance.  Even more disturbing, a sizable subset of the uninsured is made up of children.

 

On the whole, too few Americans can afford health care insurance or choose to purchase it.  Considering the sheer costs of health care services and prescription drugs, let alone emergency expenses or catastrophic illnesses, the risks of life without health insurance are clear.  When more Americans are left without insurance, it is the public which pays the price: these costs are spread among us all in the form of crowded emergency rooms, high premiums and increased reliance on government support programs like Medicaid.  With nearly one in six Americans lacking health insurance, this national problem threatens to destroy our healthcare system from
within.

 

Individuals who wait until the last minute to get medical attention for a disease are bypassing one of the most important components of our health care system – preventative care.  The National Academies’ Institute of Medicine estimates that, every year, 18,000 Americans die from diseases which would have been treatable or preventable if the individual had health care coverage.

 

Clearly, there must be a minimum standard for health insurance in our country, provided by insurers who are compelled to offer an affordable product that provides a basic layer of coverage for at least the costliest of treatments and unexpected care. 

 

Our debate in Congress should center on how to advance this goal: through incentives in the tax code, through an employer-based system, or via a new alternative to the traditional idea of health insurance.  The protection of quality care will require creative solutions and a heavy hand to implement them.  We must explore options that place the responsibility of coverage directly with the beneficiary, not necessarily with an employer or taxpayer.  At the same time, let it be clear that the benefits of near-total health insurance coverage extend well beyond the individual, to our communities and our nation at large.  A solution that will yield 47 million new health insurance policies for previously uninsured Americans will undoubtedly be expensive, but it will also save
money. 

 

The president has taken an important first step in recognizing the public good of widespread participation in insurance plans.  His answer to this colossal problem will logically involve public support for insurance premiums for those who could otherwise not afford them.

 

A solution to this problem must not, on the other hand, reduce the number of health insurance choices available to the American people, nor should it encourage Americans already with health insurance to reduce their level of coverage.

 

Like many ideas posed in State of the Union speeches, we will have to wait until details of the president’s proposal develop.  But unlike many issues discussed in our nation this week, on health insurance, we cannot wait for long.”