Dear Steven

I have been writing to my representative, Wally Herger, about my support for health care reform and here is the response that I received yesterday. As usual, it is filled with half truths and innuendo. Even a lie or two, certainly not deliberate though. He repeats the Party Line throughout. Sigh…nothing new here.

Health care costs in general have increased very rapidly over the last few years. This has created severe financial pressures for individuals, employers, states, and the federal government, a problem that is only intensified by the current economic situation. Research indicates that the number of Americans lacking health insurance is rising, and now exceeds 45 million. We spend 17% of our economy on health care, nearly twice the level of other developed countries, yet our system does not provide consistently high-quality care.

 The number one priority of health reform must be to make health care more affordable for working and middle-class families. Only then will it be possible to achieve the goal of ensuring that all Americans have access to high-quality health care. To help make health care more affordable, we should change the incentives in the health care system so that it focuses more on preventing illness and keeping people healthy, to reduce the need for more expensive treatment down the road. Second, we should reform the medical malpractice system and rein in overzealous trial lawyers so doctors don't have to order unnecessary tests and procedures just to protect themselves from a frivolous lawsuit. Third, we should change the tax code so millions of people who have to purchase their own health insurance on the individual market can get the same tax relief as those who receive health benefits from their employers. For example, I have introduced bipartisan legislation with Congressman Ron Kind of Wisconsin to extend tax relief to the 4 million Californians who are self-employed.

 Health reform should also increase access to affordable coverage while improving the quality of care. The number of uninsured Americans could be dramatically reduced through a few relatively simple steps. Up to 7 million people could be covered just by allowing dependents to remain on their parents' health plan until age 25. Ten million uninsured Americans have access to employer plans and could be covered by encouraging businesses to move to an "opt-out" rather than "opt-in" system for employee benefits. Another 10 to 12 million people are currently eligible for public programs like Medicaid but have not signed up. Tax credits could help many of the remaining uninsured afford coverage. With respect to quality, Congress should reform Medicare payment systems to reward providers that offer top-quality care and provide the public with access to information about the quality of different hospitals and physicians.

While we must fix the problems with our health care system, we shouldn't throw out the parts that do work well. Currently, 160 million Americans get health coverage through their employers. President Obama has repeatedly said that if you like the health coverage you have, you should be able to keep it, and I strongly agree with that principle. However, studies have shown that creating a new government-run plan to "compete" with employer-sponsored insurance on an unlevel playing field -- as the President has proposed -- would result in 120 million of these people losing their current coverage and being forced into the government-run system. That's the wrong way to go. Instead of undermining the employer-based system through a so-called "public option," I believe we should preserve employer-sponsored health insurance while expanding access to affordable market-based coverage for those whose employers do not offer health benefits. 

 Additionally, I believe health reform must uphold the overarching principle that medical decisions should be made by patients and their doctors, not insurance companies or government bureaucrats. A tiny provision buried in a $1.2 trillion spending bill passed by Congress earlier this year sets up a new federal agency to fund "comparative effectiveness research" to evaluate the effectiveness of various medical treatments. While this research is important and should be pursued, it needs to be conducted transparently and it should not be used to make unilateral coverage determinations. Yet Congress failed to provide these key safeguards. In fact, an early version of the bill flatly stated that medical treatments found to be "more expensive" would "no longer be prescribed." I have introduced bipartisan legislation with Delegate Donna Christensen, the Doctor-Patient Relationship and Research Protection Act (H.R. 2824), to ensure that this research is used to provide information for doctors and patients, not to deny coverage for medically necessary treatments based on their cost.

 As the ranking Republican member of the House Ways and Means Subcommittee on Health, I will be closely involved in discussions about legislation to make health care more affordable and reduce the number of Americans without health insurance. I have also been working with other Republicans in the House of Representatives to develop a proposal that reflects the principles I have outlined.  Please know that I will keep your views in mind when Congress considers legislation concerning health care.