Healthcare reform has been on the minds of numerous letter writers who've contacted Neil about the growing debate over this issue. Here's a sampling of the letters he's received and his responses.
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Letter to Neil about employer-provided health benefits: "As a small business owner, I'm writing to express my deep concern for the future of employer-provided health benefits as you work to reform America's healthcare system.
"I understand some in Congress support proposals which would threaten the current employer-based healthcare system on which more than 160 million Americans currently depend in favor of a government-run system. I strongly believe this is not the answer and urge you to oppose these efforts.
"America's small businesses are the leading generator of new jobs in this country - and our nation's greatest hope for a strong, vibrant economy. Yet for the last 20 years, healthcare has stood as small businesses' top concern. While millions of small business owners have the quality healthcare they need, we can do more to help uninsured and underinsured business owners provide affordable, quality healthcare for their families and employees.
"Please support building on the current employer-provided healthcare system that we have instead of creating costly new government alternatives to the employer-provided benefits that Americans enjoy today."
Neil's response: There have been many ideas discussed in the health reform debate. One proposal brought forward by Senator Ron Wyden, called the Healthy Americans Act, would try to make healthcare more portable by having individuals, rather than employers, be responsible for their health benefits.
I do not agree that we should get rid of employer-sponsored health insurance. Though it is important that healthcare is portable and accessible, I believe the employers help, not hinder individuals from obtaining health care. In fact, the chairmen of the relevant health committees all agree that health reform should mean that Americans must carry insurance, employers should be required to help pay for it, and that a public health insurance plan should be offered as an alternative to private insurance....
I believe our health care system is broken. Health care costs are growing faster than inflation and wages. More people are losing traditional employer-based coverage as companies can no longer afford the costs. People are denied insurance because of pre-existing conditions. The ranks of the uninsured swell.
This crisis is large and complex. However, I am committed to working with my colleagues to find solutions. Addressing our health care system will require us to find new ways to ensure everyone has coverage so we can avoid providing care through the emergency room and help ensure that premium costs do not overly consume too much of people's budget.
We must also work to control costs. Many are talking about better coordination of care through models like the medical home, where a patient has a primary care physician (PCP) who coordinates care. Other discussions center on creating value for our health care by instituting a pay-for-performance reimbursement structure rather than the current fee-for-service method.
Finally, many discuss the virtues of comparative effectiveness research, evidence-based medicine research that looks at the clinical effectiveness of various treatments against one another, and cost analysis of each treatment is analyzed together to encourage people to use the best and most cost effective treatments. Our current system of delivery is so fragmented and so often the system incentivizes the most expensive treatments and tests rather than the most effective. Major change is needed.
Major health reform must stand on the three pillars of access, quality, and cost. There is no policy that will solve everything, and instead reforming our health care system will require us to address many seemingly different issues at once.
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Letter to Neil about HR 676, the "United States National Health Care Act": "I would like to know your position on HR 676. I think the single-payer approach is the best reform. I support getting the insurance companies out of the healthcare system."
Neil's response: I agree that all Americans deserve access to quality health care. Consequently, I cosponsored H.R. 676, the "United States National Health Care Act," which would create comprehensive health insurance for all Americans, much like Medicare does for older Americans. Through this bill, people will no longer be denied care for pre-existing conditions or because they are unable to pay exorbitant insurance costs. We cannot continue to allow citizens to go bankrupt because of health care costs and be denied health care due to their conditions.
Throughout my time in Congress, I have continued to support efforts to find a solution to our current health care crisis.
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Letter to Neil about healthcare reform and Medicare: "Our current health care system costs too much, wastes too much, makes too many mistakes and gives us back too little value for our money - especially when it comes to Medicare.
"Right now, Americans on Medicare spend an average of 30% of their income on out-of-pocket health costs and thousands of older Americans can't afford their prescription drugs due to a gap in Medicare coverage. At a time when millions of Medicare beneficiaries have seen their retirement savings shrink, rising premiums, soaring drug costs, and increasing out-of-pocket expenses are undermining their health and economic security.
"We urge you to support health reform that keeps Medicare affordable and closes the coverage "donut hole" that forces older Americans to pay premiums without getting insurance coverage on prescription drugs.
"America needs you to take action to keep Medicare affordable and ensure that everyone has a choice of health care they can afford. I urge you to commit to working on a bipartisan basis to pass legislation that will strengthen Medicare, in addition to providing all Americans with affordable health care choices and improving long-term care services."
Neil's response: President Obama made a momentous announcement in his February speech to Congress in stating, "Let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year." Recognizing that many Americans are going bankrupt due to medical bills, businesses are further burdened by growing health care costs, and that millions of Americans that are currently uninsured, the president called for change.
He challenged Congress to begin work on a solution and, also followed his words with action by submitting a budget, which includes a $634 billion reserve fund for possible health reforms. Though President Obama did not specifically outline any details for the use of these funds, he took the first step in opening up the dialogue for Congress to begin forming legislation on reform.
I agree with President Obama's desire for immediate action. Health care has been an issue for too long and must be addressed to ensure the prosperity of Hawaii 's people. Therefore, as Congress moves forward on reform in the next months, please be assured that I support the inclusion of health reform in the federal budget and will keep your views in mind.
