Yes We Can! A New Way Forward for Health Care

By Congressman Earl Blumenauer.

Tuesday night, President Obama outlined 3 main priorities to get our economy and our country back on track. One of those priorities was an ambitious call for health care reform, an issue of significant interest to me and that has taken on immediacy in my legislative priorities with my recent appointment to the Ways & Means Health Subcommittee. President Obama has made it clear that long-term economic recovery cannot be attained without addressing major health care reform now.

And here is a statement that I have not been able to make for quite some time: I agree with our President.

The budget he outlined today includes a hefty down payment to pay for health care reform –over $630 billion in a dedicated reserve fund. He also makes positive changes in how we pay for health care, showing that the quality of health care is what we should value, not the quantity of services provided. This is a critical shift in how we finance health care.

For too long, the federal government has rewarded the over-treatment of patients in certain regions of the country. This situation requires taxpayers in more efficient, low-cost regions such as Oregon to subsidize expensive and unnecessary costs in high-cost regions.

For example, federal spending for a Medicare enrollee in Portland averages just over $5,000. An enrollee in Los Angeles averages nearly double.

Why the disparity?

The most significant factor is how many health services are consumed in each area. Medicare beneficiaries living in high-cost health care regions, such as Los Angeles, Miami, New York, and Houston consume approximately 60% more services than those living in low-spending regions.

This difference in the amount of services performed might be legitimate if the high-spending regions produced a high quality of care, but that is simply not the case. In fact, research shows that health care outcomes and patient satisfaction are often superior in areas like Oregon, areas that do more with less.

This is why I am developing legislation to change the financial incentives within Medicare and ensure that the federal government rewards appropriate, efficient, and effective health care to all Americans. We must eliminate unnecessary treatments and wasteful practices, and support a more coordinated, primary-care-driven health care system.

The budget proposal reflects these same priorities and I am hopeful that we are poised to enact real change which, if done right, will not only benefit Oregon taxpayers, but lead to better health care quality and improved efficiency nationwide.

  • self exile (unverified)

    Health care reform is not possible. There is no part of the socalled health care system that is not irredeemably broken.

    You want health care?

    Simple, drop the names of all people who filed IRS returns last year in a gigantic box.

    Draw 29 peoples names totally at random.

    Then send them to the 10 countries that have the longest life expectancy.

    Then they vote on which one is best and we copy what that country does exactly.

    Health care reform is a waste of paper.

  • cheetah (unverified)

    Don't forget Monkey Medicaid, Earl. It may not be the most important issue -- until tragedy strikes your family.

  • Scott J (unverified)

    I like the fact that we're making those earning over $250K pay for it through increased taxes and limits on deductibility on charitable donations.

    Oops! I guess that means that Mercy Corp, United Way, Salvation Army, etc are actually paying for quite a bit of this.

    In a comprehensive 2006 study on charitable giving shows that higher income individuals respond to changes in tax benefits of giving by giving less:


    This is disturbing since the top 4% of the income earners account for 66% of ALL charitable giving.

    Why in HELL would you vote for this Earl?

  • mp97303 (unverified)

    @self exile:

    It has already been done. See the PBS Frontline show: "Sick around the world:can the US learn anything from the rest of the world about how to run a healthcare system?"

    It aired early last year and was fantastic. The web page for the show is here

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    I thought Wyden's plan was basically revenue neutral or actually saved money from the get go, rather than costing billions extra, while still covering everyone. Why don't we just do that? Are any components of Wyden's plan incorporated into the administration's plan?

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    Get us on a path toward single payer for core coverage (and allow private plans for add-on or 'full menu' coverage) or any plan is just rearranging deck chairs.

  • Rick Hickey (unverified)

    Hmmmm, so we have an extra $600 Billion to put away right now? Really? Is that from the $787 Bil. Stimulus? no. From the $18 Bil. to stupid Car salesman? (who want another $40 Bil. now)no. From the $350 Bil. for the Banks? no. The $75 Bil. to pay home loans for Illegal's? no. This must be in the New $400 Bil. Omnibus bill with $8 Bil. in pork and 8,000 ear marks that Pres. O said would stop happening??? Maybe this is in the new $3.5 Trillion budget idea, an increase of over $1 Trillion in one year, that Pres. O just announced. It's hard to keep track of all this spending, whew.

    Or does that involve even more borrowing from Communist China? ohhyaa great idea.

    Wow! Pres. O and our Democrats in Congress sure think we are all rich and are spending our money years before they get it and boy we will fix the economy by spending our way out of it, won't we boys? Doesn't seem to work at home though huh.

    In Debt another tens of $Trillions in just 5 weeks! Good job D's.

    Self Exile - Answer? Japan! All pay a 30% co-pay for health care and live a long long time.

    I laugh at your collective inferior intellect and cheer at the day to come soon when Americans have had it (Gun sales have gone waaay up, hmmm) and the D's are tossed out. Could be 2010 or 2011, but people are getting mad and finally waking up.

    Socialism has never worked (ask the millions of Immigrants who come here who fled from it) and will not work here either, nice try but you'll see.

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    Rick squawking about "pork" and threatening armed violence. Gotta love wing-nut meltdowns.

    Curious, do you think it is evil to business with China because it is "communist" (in name only for the most part)...?

  • oslo (unverified)

    by all means, let's set aside more than half a trillion dollars for a program that doesn't even exist yet, and further, hasn't even had 10 seconds of public debate yet.

  • YoungOregonMoonbat (unverified)

    So long as you have the for-profit motive in US healthcare where MD graduates expect to make $300,000+ per year and health insurance preys on the sick and slightly overweight through a jungle of paperwork, deductibles, and insane, ever increasing monthly premiums, then meaningful healthcare reform is nothing more than pointless pandering.

    Massachusetts is the perfect example of trying to enact comprehensive healthcare reform without castrating managed care first. Let me direct you to:

    The profit motive in healthcare must go, otherwise there will always be someone without healthcare coverage.

  • The Libertarian Guy (unverified)

    Earl you might want to look at the McCarran-Ferguson Act. I think it was passed in 1948 and ask how that act impacts our ability to purchase insurance. Does it reduce competition in the health insurance business and thus drive up costs?

    Secondly you might look at what nurses are allowed to do in Europe, where I understand they account for 60% of healthcare spending, as opposed to the U.S. where doctors are the big cost. Not to mention midwives who deliver about 10% of infants in the U.S. and in parts of Europe midwives deliver 70% with higher survival rates and at lower costs than the doctors. How do we get more midwives in the U.S. medical system?

    Then there are the 20, or so states that have certificates of need for new medical facilities. Do such certificates reduce costs, or add to them?

    And how do we get all medical facilities to post their costs so that patients have an opportunity to see what the costs are? As I recall there was an article in the New York Times last year that pointed out that the $80,000 heart bypass was not any better than the $20,000 one.

  • Cory Atkinson (unverified)

    self exile is right, and first up! I have resigned myself to die rather than access the system. Life in this country is worthless. Only the neurotic blanks are interested in preserving and passing on their precious, failed genes.

    That's the plan. We're supposed to self-select out. Why the torture though? Instead of just "death with dignity", how about real "assisted suicide"? What kind of people will legislate for death with dignity and, accept as impracticable, life with dignity?

  • Fair and Balanced (unverified)

    Incentives are the key; you're right, Earl.

    I commend to anyone interested the New Yorker article from a couple weeks ago about how each industrialized nation achieved universal coverage in its own unique way, based on the traditions and circumstances it faced at the time.

    As much as we may want to trash the old system and jump straight to single-payer, the cost in lives and health of such a wrenching change would be incalculable. What we need, and still don't have, is a road map from where we are to where we need to go. Some roads pass through the Valley of Death, others traverse the Mountain of Discomfort (preferable). We need to pack some emergency rations and spare wheels, because none will be smooth.

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    Olso wrote: by all means, let's set aside more than half a trillion dollars for a program that doesn't even exist yet, and further, hasn't even had 10 seconds of public debate yet.

    Dude, time to start over with Civics 101. The President proposes, the Congress disposes. The President put it in his budget in order to START the public debate.

  • Harry Kershner (unverified)

    Dr. Don McCanne of PNHP on the Himmelstein(single payer)-Nichols (pay-or-die) debate noted by Moonbat above (can_us_achieve_meaningful_health_care):

    "Primarily because of political perceptions, Len Nichols continues to support what he believes to be the pragmatic approach of covering everyone with regulated private plans. However, when experts like David Himmelstein continue to confront him with the facts about our flawed financing system, Nichols' support for private insurance seems to be shifting from knowing that it would work, to wishing that it could, even though "our system is a mess." He needs to take the next step of acknowledging that private insurance can't work so that we can move forward and fix the "mess" by enacting a single payer national health program."

    "Pragmatism" will kill the movement for true universal coverage by bankrupting the system. As we see here, there is an elite consensus around drowning the baby (socially desired and desirable programs) in the bath water by increasing social costs and risks until programs must be abandoned altogether. As Physicians for A National Health Program argues effectively, the "middle ground" of competition between corporate health care and public programs is a disaster for those of us who are required to bear those costs and risks.

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