Capitol Comment: The Right Reforms to Our Health Care System Will Do No Harm

By U.S. Sen. Kay Bailey Hutchison | Nov 12, 2009

During medical school, aspiring physicians are often taught the principle of primum non nocere, more commonly known as "first, do no harm."

It holds that, faced with a delicate medical situation, a doctor should survey whether intervention will actually cause more trauma than healing.

Today, Congress is confronted with the critical task of reforming our nation's health care. As we debate legislation, or intervention, we would do well to remember those words: first, do no harm.

Unfortunately, the Democrats' proposed government-run insurance plan would first do harm by intervening in the sacred doctor-patient relationship and encumbering Americans' choices and access to the best quality health care. The Democrats have presented Americans with a false choice: their proposal or nothing.

However, there are other better remedies that will actually lower costs, expand access to quality care, and raise patients' choices � without the threat of government control. These other options will keep patients at the center of their health care, and take the bureaucrats out of the equation.

The key to meeting cost-saving goals in a sustainable and fiscally responsible manner is market competition. Therefore, any reforms we adopt must encourage competition among health insurance providers through transparency and value. This will make health insurance a buyers' market in which patients know what plans are offered and what they cost, allowing them to choose the options that best suit their needs.

A primary way to raise competition is to bring more consumers into the marketplace. Market trends indicate that, in order to compete for new consumers' business, insurance providers will offer better plans and present them in the clearest manner possible to stand out from other options.

To bring more individual consumers into the marketplace, there needs to be tax equity for those who do not have employer-sponsored health insurance. Americans whose coverage is administered through their employers receive an unlimited tax break on the value of their benefits. The same tax relief is not available to those who purchase private insurance. This tax exclusion should be replaced with a universal tax credit that would extend to all beneficiaries.

A recent Wall Street Journal editorial praised the equity approach, stating, "The current bias for one type of insurance has persisted for decades despite its unfairness and irrationality."

A second way to raise competition is to organize health insurance coverage options in an online marketplace that consumers can use to select the plan of their choice. This web-based marketplace would help give companies affordable options to offer employees and their families, while dramatically simplifying the employer's role in health care coverage administration by lowering administrative costs.

This approach would encourage more employers to offer help with coverage to employees, and it would increase the size of the risk pool, bringing down costs.

The Federal Employees Health Benefits Program (FEHBP) has successfully implemented this model in the government and could prove promising for private employers. Unlike Medicare or Medicaid, FEHBP is an employment-based system that makes it easy for families to shop each year for plans and to have portable coverage. Employees can choose from managed care plans, health savings accounts, and more.

This has provided choices and quality care for federal employees, and the same level of care should be broadly available. Replicating this in the private market could eliminate gaps in care because plan benefits are portable from job to job, provided that both employers participate in the exchange.

There are also other ways we can improve our nation's health care without the destructive government intervention being pushed by the Majority in Congress. Of critical importance is tort reform. Medical lawsuit abuse is prompting many physicians to scale back their practices to exclude high-risk specialties, such as obstetrics, or to close their doors altogether.

Others are responding by practicing defensive medicine, whereby doctors order costly and unnecessary tests or procedures to protect themselves from lawsuits. Medical liability has excessively burdened the health delivery system, and steps can be taken to protect doctors and patients alike.

Reasonable caps on non-economic damages make sure patients are compensated when errors are made, but will help curb the litigious abuse that has impaired health care across the U.S.

All these approaches have proven to be effective, and they will focus on fixing what's really broken about our health care system: soaring costs and limited access to quality coverage. Most importantly, this does not intervene where our system works.

Patients must always have choices governing their health care, and they should be able to see the physicians they know and trust. We must take care not to harm that.

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