Iowans have been focused on the health care debates in Washington and here at home this summer and many have been asking the same question: Can we get a health reform bill on which everyone will agree?
For people watching the media, they’d think there is nothing that Republicans and Democrats agree upon when it comes to health care. Here in Iowa, legislators from both parties have worked together to pass health care reform bills in the last two years. No one in the House or Senate would say that they got everything they wanted in these bills. But each side compromised and Iowa’s health care system is moving forward.
There are many ideas out there that all Americans would support and improve our health care system, while reducing costs. Instead of focusing all our efforts on divisive issues that could result in many Americans losing the care they currently rely on, Congress should instead be focused on those ideas with broad support. Here are a few ideas that could be the part of a bipartisan health care reform package that Congress considers:
Banning Pre-existing condition exclusions – If there is one reform that Americans want to the health care system, it would be to address the issue of pre-existing condition exclusions. For too many of us decisions about our lives are dictated by the fear that if we switch jobs, we could be forced to go without health insurance for ourselves or a loved one. It’s time we fixed this issue, by prohibiting insurance companies from refusing to cover pre-existing conditions. While this might cost each of us a little more, it would buy us peace of mind when our family members and friends get the care they need.
Promoting Wellness Incentives – Too often these days, people in Washington want to punish Americans for choices or behaviors that they deem to be “bad.” Instead of always using the stick, why not offer the carrot to get Americans to lead healthier lives? Insurers should be encouraged to offer incentives for Americans to make healthy choices like exercising, quitting smoking, and getting regular checkups and tests. A number of companies have used incentives like these to help reduce their insurance costs. Maybe it’s time to try these ideas in the public sector as well?
Setting Up a Uniform Billing System – If you talk to a doctor or hospital administrator, you will hear about the burden placed on them by insurance companies and government health programs having different systems for billing. We could dramatically reduce the administrative expenses for health care providers, insurers, and government by developing a uniform billing system used by everyone. It would save money for all parties and it would let health care providers focus more of their time and talents on doing what they want to do – providing care.
Establishing E-Prescribing and Electronic Health Records – We live in the age of home computers, thumb drives, and the iPhone. Why do still have to fill out a form every time we go to our doctor, and why do they still scribble out prescriptions that the CIA would have a hard time deciphering? It is time we commit to developing and using electronic health records and require prescriptions to be submitted electronically. Congress has provided money to help establish networks to handle the information, but we need to do more to help doctors and hospitals be ready to use this technology. We should develop the standards for their use and help providers bring this part of health care into the Twenty-First Century. And by using e-prescribing, we can cut down on medical errors due to bad penmanship.
If Wall Street gets to do it, why shouldn’t Main Street and our farmers?
Providing Tax Equity for Small Businesses and individuals – The federal tax code gives big businesses the ability to deduct the cost of providing health care before they calculate what they owe in taxes, or “above the line.” But our small businesses and individuals do not get the same benefit. If Wall Street gets to do it, why shouldn’t Main Street and our farmers? Giving them the same status under Section 125 of the tax code would go along ways to allowing small businesses to provide health insurance to their employees.
Paying for Health Care Quality, Not Quantity – Right now, health care providers are paid by the incident. If you get sick and you don’t get well, they keep getting paid each time you visit the doctor. The Mayo Clinic and other major health care centers are calling to change the payment structure so instead paying for the quantity of visits, providers would be paid on the value of their care. It has worked for Mayo, the Cleveland Clinic, and other providers. It will probably work for the rest of the health care system too.
Congress should focus their health reform efforts on these issues and others like portability of coverage, chronic disease management, medical malpractice reform, and price and quality transparency. By addressing those ideas where there is broad support for implementation, we can have a real health reform package. That is what the people want and that what they expect of their representatives at the state and national level. It’s time for Washington to step up and put the people’s interest first.