FODEMAN: Avoid making it worse

COMMENTARY:

Congress is working too fast. Lawmakers rushed to pass the $700 billion bailout bill … the $787 billion “stimulus” bill … the $400 billion “omnibus” appropriations bill.

Now they’re poised to rush through President Obama’s $3.6 trillion budget. The Congressional Budget Office estimates the bill’s unprecedented spending will generate a $9.3 trillion tidal wave of red ink over the next decade. Lawmakers need to slow down. And think.

Mr. Obama’s plan for health care spending is one place to start. The administration says it wants to “bend the curve” on escalating health spending. Yet its budget would raise that spending by $634 billion over 10 years. Reliable estimates say the cost of the plan would be at least double that amount.

Is our health system really that bad off? Patients the world over flock to the United States to get the world’s best care. Former President Bill Clinton travels the world earning millions in speaking fees, but he checks into Columbia Presbyterian for quadruple bypass surgery. Massachusetts is only a short hop from Canada and its socialized health system, yet Sen. Edward M. Kennedy, Massachusetts Democrat, opts to get his cancer treatments at Massachusetts General Hospital.

Of course, our health system has some big problems, including the many people who lack health insurance. But the vast majority of Americans are insured and rate their coverage as good or even excellent.

And the Census Bureau report pegging the number of uninsured people at 46 million can mislead, if not properly understood. Many of those 46 million were uninsured for only a short time. Typically, these are people who change jobs and must wait 30 or 60 days before their new coverage kicks in.

Another large chunk - about 20 percent of the uninsured - are uninsured by choice. Typically young and feeling”bulletproof,” they opt to spend their money on entertainment and other things, rather than on insurance.

Another 25 percent qualify for federal health coverage but, for whatever reason, don’t enroll. Plus, uninsured noncitizens, including those here illegally, get rolled into the 46 million as well.

A key thing to remember: insured or uninsured, legal resident or not, everyone residing in the United States can get medical care. The Emergency Medical Treatment and Active Labor Act of 1986 guarantees access to health services. No one is kicked out of a hospital emergency room because he can’t pay.

The part of our health system that’s broken isn’t the care; it’s the financing. The dysfunctional approach to public-private financing encourages excess utilization of medical services and drives up medical costs at the same time it prices insurance beyond the means of many families.

The way to fix the financing is not to have government pick up an even larger share of the tab. That would only exacerbate the core problem and increase the national debt. The answer is to give individuals more control over how their health care dollars are spent. That includes letting them decide what kind of insurance coverage they want, be it a health savings account or some other insurance options.

For this to happen, Washington will have to change the tax code so it no longer penalizes individuals and families for getting insurance outside the workplace. It also means establishing a national market for health insurance, where Americans can compare and select the coverage that best suits their situation - and keep that coverage as long as they want, even when they change jobs.

State officials also can help make coverage more affordable by reforming medical malpractice laws that benefit rapacious trial lawyers at the expense of consumers. Exorbitant malpractice awards and settlements drain billions of dollars from the health system - and into attorneys’ pockets - every year.

Some think the best way to get the most for our health care dollar is to let the feds run the system. But the folks who gave us $2,000 hammers and $800 toilet seats aren’t likely to run the system frugally. (Just look at Medicare’s $36 trillion in unfunded obligations.) And any outfit that dithers for years over when to switch from analog to digital television is unlikely to make life-or-death medical decisions in a wise or timely fashion.

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