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People, not Congress, should lead health care reform efforts

Congress is an institution typically not known for its speed or agility. Yet, with the urging of the president, it is rushing to consider major health care reform legislation that would affect one-seventh of the nation's economy.

Your choice of physicians and the kind of care and treatment you receive are some of the most personal decisions you can ever make. The prospect of having those decisions influenced by a new bureaucracy that would combine the efficiencies of FEMA with the compassion of the Department of Motor Vehicles ought to alarm every American.

Health care's portion of our economy is enormous. In 2009, health care spending is projected to be $2.51 trillion. Nearly half of this spending is done by federal and state governments through Medicare and Medicaid.

According to the U.S. Census Bureau, 45.7 million Americans were uninsured at some point in 2007. The number of individuals uninsured for a year or longer is around 31 million.

If you subtract people who are already eligible for existing government health care but are not enrolled, legal and illegal noncitizens (because this issue extends beyond the health care debate) and young people between the ages of 18 and 24, who because they tend to be healthy don't make health insurance spending a priority, the number gets significantly smaller.

There are about 22 million people who make less than three times the federal poverty level and are either ineligible for public program coverage or don't have employer-sponsored coverage available, according to the Congressional Budget Office. These are real people with real needs, but their situation is no reason to allow government a greater influence in the health care choices for everyone else.

So hold onto your wallet. Not only would this giant bureaucracy get a seat next to you in the examining room, it would require wholesale tax increases to fund it. Some of the ideas for these taxes include a tax increase on small businesses, a tax on employee benefits, even a tax on soft drinks. This is incredible.

But it does not have to be this way. We can take significant steps to address this problem, steps guided by principles based on freedom of choice, transparency and openness, and a competitive free market.

First, we need to commit to protecting the physician-patient relationship, and not place the federal bureaucracy between you and your doctor.

We can do a better job of managing outcomes in America. About 75 percent of all medical spending goes to managing and treating chronic disease. By encouraging wellness and prevention programs, we can incentivize people to lose weight, get healthier, manage their diabetes and lower their cholesterol or blood pressure.

We can adjust rules to use existing technology to allow the sharing of electronic medical records and health information to help eliminate mistakes that cost up to 98,000 lives a year. The ability to quickly share patient information would benefit all Americans, but it would be especially important for our snowbird neighbors who live part of the year in Florida and part of the year in other states.

We can improve access and choices for patients by encouraging a thriving market-based competition in health care that allows doctors to decide what specialty they want to train for and patients to decide what hospital to go to. We can make medical billings and evaluations of doctors and clinics more transparent, allowing patients to make better informed decisions about the cost and quality of treatment.

We can allow people to purchase insurance across state lines, expanding competition and driving costs lower.

And we can preserve and improve competition by establishing small business health plans. These plans would extend the benefits currently enjoyed by large corporations and labor unions to every small business in America. Under such a system, individual restaurants could join together to have the bargaining power of McDonald's. Or independent businesspeople like real estate agents could work together to have the bargaining power of a Fortune 100 company.

These are the sorts of reforms that will allow people to have the mobility and freedom they expect in a country like the United States and unleash medical innovation to drive costs lower and quality up. These are the principles we should adhere to in the coming debates.

Adam Putnam, R-Bartow, represents Florida's 12th congressional district in the U.S. House of Representatives.

People, not Congress, should lead health care reform efforts 07/19/09 [Last modified: Sunday, July 19, 2009 5:30am]

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