Weekly Column of U.S. Senator Lamar Alexander (R-Tenn.) - The Wrong Way to Fix Health Care

Posted on August 2, 2009

We only have one chance to change our health care system, and we better make sure we do it right. I agree with the president and members of both parties in Congress: it is time for health care reform, and we want to accomplish it this year. But our goal should be, whether Democrat or Republican, to start with cost and make sure we can say to the American people they can afford their health care policy—and when we have finished fixing health care that they can afford their government, too. So far, the Kennedy and Pelosi plans we’re seeing right now flunk this most basic test of cost. On the other hand, a bipartisan group and some Republicans have offered different plans that will pass that test. As one example, last year I joined with Senator Wyden, a Democrat, and Senator Bennett, a Republican, by supporting their plan. It is a very good plan, and it has a completely different approach than the bill that came out of the Senate HELP Committee or that is coming through the House. It still needs some work before I would vote for it to become law, but I believe it is a better approach. The Wyden-Bennett bill is constructed along the idea of rearranging the subsidies we already give to the American people for health care and gives it to everyone in a way that will permit them—all the American people—to afford a health insurance plan that is about the same plan that United States Senators and Congressmen enjoy. Literally, we would say to low-income Americans: “Here, take this money and buy a private insurance plan of your own, like the rest of us do.” This is a much better idea than dumping 20 million more people into a failed government program called Medicaid, which is not only not serving those low-income people but bankrupting states, too. Unfortunately, this proposal has not been given the time of day. We have had very friendly discussions, but they do not qualify as bipartisan. I give the Senate Finance Committee members great credit for trying to work in a bipartisan way, but the plan they are still drafting is likely to head in the wrong direction. Like the Kennedy plan that came out of the Senate Health Committee, the plan coming out of Finance would expand Medicaid. I hope the President will see what is happening and say: “Whoa, let's slow down. I have stated what I want. I have put my neck out. I have said to the American people, if they have a health care plan they like, they can keep it.” Unfortunately, under the plans we have seen so far, they have a very good risk of losing their health care and ending up, if they are poor, with their only option being a failed government program that none of us would want to join. If congressional Democrats who are writing these bills don't want to take bipartisan advice, I would say, respectfully: “Why don't you listen to some others?” The Mayo Clinic (often cited by the President and many others as the kind of high-quality, low-cost health care we would like to have more of), the Iowa Clinic, the Marshfield Clinic, and other clinics say these health care plans are headed in the wrong direction, and one reason is because they would create a new government plan which would eventually drive the Mayo and other clinics out of the market—which means they wouldn't be serving Medicare patients. If what these reputable clinics say isn’t enough, what about the Democratic Governors who are saying the same thing? And if the nonpartisan Congressional Budget Office is saying we are adding to the cost and adding to the debt, wouldn't the wise thing be to say, “Well, maybe they have a point”? Governor Phil Bredesen knows a lot about health care and he says Congress is about to bestow "the mother of all unfunded mandates." Governor Bredesen, a former health care executive, continued: “Medicaid is a poor vehicle for expanding coverage. It is a 45-year-old system originally designed for poor women and children. It is not health care reform to dump more money into Medicaid.” He is exactly right. I want to work with the President and with friends on both sides to come up with health care reform this year. We want to be able to say to the American people, “We want a plan you can afford for yourself. And when we’re finished fixing it, we want a government you can afford.” If the Mayo Clinic and the Democratic Governors and the Congressional Budget Office are all saying we are headed in the wrong direction, then why don't we start over and work together and try to get a result we can live with for the next 30 or 40 years? We can only do this once, and we need to do it right.