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“Making History” Misses the Mark
By Paul Ryan
Representing Wisconsin's 1st Congressional District
November 4, 2009

Democrats, Republicans, and Independents alike agree that meaningful health care reform is long overdue. For millions of Americans, health insurance remains prohibitively expensive. Higher premiums and out-of-pocket costs continue to squeeze the paychecks for those with insurance. Health care continues to crowd out the balance sheets for businesses and governments alike.

It is increasingly clear that Washington’s trillion-dollar, two-thousand page overhaul will make matters worse. In nearly every analytical report there is a common trend: greater government control over health care further drives costs in the wrong direction. Congress is intent on creating a costly new entitlement, centralizing the decisions on what constitutes insurance, imposing mandates on individuals and employers alike, and adding hundreds of billions of dollars in new taxes – all without regard to the fundamental problem of sky-rocketing health care costs.

In making the case for reform, President Obama’s budget director, Peter Orszag, argued, “The single most important thing we can do to improve the long-term fiscal health of our nation is slow the growth rate in health care costs.” Yet the legislation White House and Congressional leaders are pushing does the exact opposite. 

In a report released on October 21, Medicare and Medicaid’s chief actuary delivered a critical warning last month that H.R. 3200 – the legislation that passed three House committees earlier this summer – would dramatically increase federal health care spending, threaten the coverage of millions of Americans, and bend the cost curve in the wrong direction. Medicare and Medicaid’s own accountant found national health expenditures would jump by an additional $750.3 billion (a 2.1% increase) over the next ten years as a result of H.R. 3200. 

The long-term consequences of the creation of a new open-ended health care entitlement are of the greatest concern to those that recognize our fiscal future is unsustainable. The nonpartisan Congressional Budget Office (CBO), the budgetary umpire on all legislative proposals, has offered a preliminary score of bill that Speaker Pelosi is hoping to bring to the floor this week. While Americans will be on the hook for over $1 trillion over the next decade, the CBO noted that H.R. 3962 “would increase both federal outlays for health care and the federal budgetary commitment to health care, relative to the amounts under current law”. Again, we’ve been warned that this bill will add to our already crushing burden of liabilities – exacerbating our fiscal challenges.

These details are among many facts being swept under the rug in pursuit of Washington’s effort to “make history”. Another troubling finding that has been largely ignored in the media is a recent study from Well Point, which administers the Blue Cross Blue Shield plan in Wisconsin and 13 other states. This report made clear that the provisions being pushed by the Majority would drive costs up for Wisconsinites already facing sky-rocketing health care costs. As the result of several provisions included in the proposed overhauls, young and healthy individuals in Milwaukee could see as much as a 199% increase in monthly premiums (from $96/month to $286/month). For individuals with average age/average health, monthly premiums will increase by as much as 122% (from $607/month to $1347/month). Small employers will similarly face increased burdens, a 53% jump for their young and healthy employees and a 17% increase for employees with average health.

In study after study – from the Congressional Budget Office and the Centers for Medicare and Medicaid Services to the providers of coverage and care – the overwhelming evidence demonstrates that consequences of this legislation contradict its own goals. Speaker Pelosi is now pushing a nearly identical bill through the House this week with an extra thousand pages added behind closed doors – it is a distinction without a difference. It is imperative that we discuss and understand these facts before Congress acts.

The health care legislation’s fundamental failure to address this central problem of cost exposes Washington’s pursuit of a greater ideological goal. Greater mandates and restrictions are not aimed to “bend the cost curve down”, as is often claimed. Having the government provide health insurance isn’t about “bringing greater choice and competition” to health care, just as quality, affordable food isn’t made possible by a government grocery store, nor is a government car company needed to boost the struggling auto industry. Leaders in Washington are seeking, unapologetically, to expand the size and scope of the federal government.

Congressional leaders are sincere in their belief that the federal government should have a greater role in the delivery of health care – along with most all aspects of our economy. Mandates and restrictions, higher taxes and less individual choice – these are not flaws, but rather features of their health care overhaul. Washington’s faith in itself to nudge us, guide us and decide for us is the prevailing sentiment advocated by the White House and leaders in Congress, yet it is antithetical to America’s exceptional and unique commitment to individual liberty and self-determination.

I will continue to push forward fiscally responsible health care reforms that ensure that the patient is the nucleus of the system, where the driving decision-making force is the patient and the doctor – not a bureaucrat. We don’t want insurance bureaucrats dictating these decisions, as they too often do today, and we sure don’t want government bureaucrats telling us how our health care is to be delivered, as will be the result if Washington gets its way. 

There are sensible, patient-centered reforms that tackle that central problem of cost containment. While most Racine readers are familiar with my alternatives (www.house.gov/ryan/healthcare), Democrats in Washington continue to insist that it is their way or the highway. The shame of this debate is that we could fix what’s broken in health care without breaking what’s working in health care. Should Americans continue to press Congress with their legitimate concerns, I stand ready to work with the Majority on common sense alternatives on this critical issue.

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