Everyone in America would have health insurance within the next two years if Oklahoma's U.S. Sen. Tom Coburn's proposed "major overhaul" of the nation's health care system were enacted today, he said.
The Republican from Muskogee recently introduced in Congress his Universal Health Care Choice and Access Act, which he hopes will revolutionize health care in the nation.
Coburn, who is a practicing physician, is best known nationally for his attacks on the federal government's pork-barrel spending. Now he's turning his attention to misspent health care costs.
"What we are doing isn't working," he said.
"Health care costs are rising three times faster than the rate of inflation with no corresponding rise in quality. One out of every four health dollars spent in this country does nothing to help patients get well because it is wasted on defensive medicine, unnecessary paperwork or outright fraud," Coburn explained.
The lawmaker said his act addresses all areas of health care, puts patients in control of making their own decisions about doctors and insurance plans, and "guarantees access to universal, affordable health care for all Americans."
Tulsa's state Sen. Tom Adelson applauds Coburn's efforts to bring about an age of universal health care, but he isn't holding his breath.
Prior to becoming a lawmaker, Adelson served as Gov. Brad Henry's state Secretary of Health. As a lawmaker, the Tulsa Democrat co-chairs the Senate Appropriations Subcommittee on Health and Social Services and was a principal architect of last year's mammoth Medicaid Reform Act, which Coburn praised in an opinion-editorial piece he wrote for the Wall Street Journal.
A major provision of Coburn's proposals is for MediChoice tax rebates "that will shift tax breaks away from businesses to individuals."
"The existing tax code discriminates against individuals who do not receive health insurance from their employer, which in turn has contributed to the 46.6 million Americans who are uninsured," said Coburn.
His act would give every American a tax rebate check-- $2,000 for individuals and $5,000 for families--to buy their own insurance.
The average price of an individual health care policy in Oklahoma, he said, is $1,586. Nationally, it's $2,268.
Coburn said this would foster competition, thereby improving quality and driving down prices.
"This targeted approach ensures that lower-income Americans can access the same health care advantages as wealthier Americans do and can choose from the some of the same health care plans," he said.
If any of that money is left over after paying insurance premiums, another provision of Coburn's bill would enable Americans to deposit the difference (or the entirety, if they so choose) into a tax-free Health Savings Account.
"Decisions on how to spend the money are made by you, rather than by your boss or a health insurer," said Coburn.
"This means that a patient can choose their own doctor and make other health care decisions without the prior approval of an insurance company," he explained.
Adelson is hopeful but skeptical.
"By tax rebates if he means refundable tax credits, that will help but won't get you to universal coverage. If you don't earn enough income, you can't afford the cost," he said.
"The average cost of health insurance in Oklahoma may be $1,500, but there are individuals who utilize health care due to poor health far in excess of that amount," Adelson explained.
"If 20 percent of the population consumes 80 percent of the expenditures, I am not sure that HSAs provide much of a solution," he said.
Adelson also pointed to a problem common to unhealthy Americans: "Insurers can individually underwrite a potential applicant... there is the danger of adverse selection--insuring only healthy profiles," he said.
Under Coburn's plan, though, states would be able to purchase a default policy for every citizen without insurance and penalize insurance companies that refuse to insure high-risk patients.
If the penalty doesn't discourage insurers from dropping high-risk patients, those patients will still be covered under their state's default policy.
Prevention is another key issue Coburn attempts to address.
His bill would establish an inter-agency committee to coordinate duplicated and overlapping prevention efforts between federal agencies for the purpose of developing a "national strategic prevention plan."
Part of that national prevention strategy would include the Center for Disease Control "establishing a web-based prevention tool that would create a personalized prevention plan for individuals based on personal health and family history, body mass index and other individualized health factors," he explained.
The CDC would also implement national media campaigns to promote healthy lifestyles and preventative habits.
"I agree with Senator Coburn that lifestyle and healthy living is underemphasized and under-funded," said Adelson.
"Perhaps 70 percent of one's health status has to do with healthy living and genetics. However, I am not aware of any effective interventions. I certainly think we should try, but it's been very difficult to alter behavior," he continued.
Another key provision of the act would accomplish for health care what another law Coburn sponsored along with Sen. Barack Obama, D-IL, accomplished for the federal government. The odd couple's Federal Funding Accountability and Transparency Act mandates the creation of an online federal database by which taxpayers can track government expenditures.
Likewise, Coburn's health care overhaul would require hospitals and care providers receiving reimbursements from Medicare and Medicaid to publish their estimated and actual charges for all patients as well as the rates they are reimbursed through the federal government.
"The good hospitals will rise to the top and the bad ones will either improve or disappear," said Coburn.
As an attempt at a major overhaul of the national health care industry, Coburn's bill is vast in the number of other specific provisions it contains, but a running theme throughout is that the lawmaker hopes to foster competition and transform health care to resemble any other industry in the free market, making it less dependent on federal interventions to function.
Adelson has his own thoughts.
"The verdict is not out as to whether the healthcare industry could function like the automobile industry," he said.
"Further, Senator Coburn is critical of the public markets--Medicare and Medicaid. The fact is both these government run programs are more efficient (much lower administration costs) than the private market and have experienced per capita cost increases at favorable rates with the private market--in other words, they do a better job of controlling medical inflation," Adelson explained.
However, Adelson made it clear that he does not oppose Coburn's efforts. He just doesn't know if they'll work.
"I am glad that Senator Coburn embraces the goal of universal coverage. I don't have a particular ideology that drives me down one particular path versus another... just as long as we get there," he said.
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