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Rep. John D. Dingell

Rep. John D. Dingell

Posted February 11, 2009 | 05:55 AM (EST)

Why Health Care Can't Wait


I am fortunate to be the longest serving Member in the history of the United States House of Representatives. I've been a witness, a participant, and a leader in some historical and important moments in our country's history, including the civil rights movement and the enactment of the National Environmental Policy Act, the 1973 Endangered Species Act, and Medicare in 1965. Yet I believe today we face one of the most important decisions in our Nation's history--how to address the insolvency of our health care system that threatens to decimate our country's budget, stability, and overall wellbeing. For 19,420 days, it has been my goal to ensure access to quality, affordable health care for every American. I have been committed to this since my first day in office and today, more than five decades later, my commitment remains steadfast. The resolve to achieve universal health care is just as noble as it was when I first entered Congress, but the urgency is far greater.

Our current system is failing the patients. People are having to choose between feeding their families, paying their bills, or filling their prescriptions. Copays and other fees are so high that even people with health insurance are opting not to see a physician. Further, the most simple, cost-effective, and efficient medical procedures, such as check-ups, physicals, and other preventative measures, are being forgone for more expensive, reactive treatments.

For years, people made the case against a heath care overhaul, claiming it would ration medical care. I would say that because of our failure to act, that is what we now have. Instead of taking care of our people, the best health care goes to those who can afford to pay for it.

Health care providers themselves are unable to navigate the inefficiency of our health care system. Primary care doctors, our first line of defense and the physicians most likely to serve underserved populations, can no longer maintain their practices. They can't keep up with payroll because of slow turn around on constantly shrinking reimbursements. We are driving doctors running small family practices into merging with mega-offices, where patients do not experience the kind of personal, quality care Americans need.

Our failing health care system is also hurting our businesses and industries. Everyday, our businesses are forced to choose between providing much needed health care for their employees or surviving to see another quarter. Many years ago, my father and Walter Reuther used to discuss how health care would eventually break the back of our industries. Our current system has placed American businesses at a competitive disadvantage in the world market. I see it nearly every day in Michigan with our automakers, which need a leveled playing field to compete with automakers in countries with national health care. In a time of such severe economic crisis, we simply cannot afford to let our companies fail under the weight of our inaction.

Our states are struggling under the weight of increasing unemployment and health care costs. States, which spend over 20 percent of their budgets on health care, are seeing 1.1 million new enrollees in Medicaid for every one percent increase in unemployment. Many of those newly unemployed do not consider COBRA a viable option. As Families USA recently reported, COBRA coverage would consume nearly 84 percent of family unemployment benefits - a price that is too great for many families to even consider. So, those people are forced to go without medical insurance. At a time when people need it most, the 45 million people without insurance--more than combined populations of California and Connecticut--are racking up debt at an even greater rate. In fact, medical debt has been cited as a factor in half of the home foreclosures wreaking havoc on our financial system.

With our economy under strain, our patients, businesses, and states suffering, it is apparent that we need to act now to reform the health care system that hemorrhages money to stabilize our economy. Right now, health care spending is 16 percent of GDP, or $2.3 trillion, and is growing at a staggering rate. Health care costs have been cited by the Congressional Budget Office as the most important factor in achieving long term fiscal balance.

If we are to succeed in making the necessary changes to reform our health care system, we must begin the process immediately. I know of which I speak, as I served as Chairman of the House Committee on Energy and Commerce during our last major push to reform health care in 1994. Too much time passed between a superb February 1993 speech by President Clinton, which won the solid support of the Nation, and the time the legislation arrived in Congress. Inertia stalled, and it became too easy for critics to derail the process. Special interests also commandeered the discussion, pouring as much as $500 million into lobbying against reform.

We cannot allow, nor afford, that to happen again. Our current financial stability and the health of future generations rests in our willingness to take action. We need a system that would lower costs and increase quality of health care, while making it universally available.

I know that Congress has the ability and the ingenuity to create a new approach to health care, however, it is clear that we must not let our window of opportunity go by. We must put forth a plan that will provide the American people with security and the flexibility to choose what's best for themselves and their families. However, for this to work, emphasis must also be put on ensuring that universal coverage truly is universal in that it covers those that are healthy and those that are sick. Congress must guarantee that health insurance does not exclude pre-existing conditions or limit care for families buying their own insurance. For these families and small businesses, we must also increase competition in the insurance market so that affordable options are available. Congress will have to be vigilant in its oversight, to ensure federal dollars that are being spent on health care are being spent wisely, and not simply to line the pockets of corporate executives and insurers.

As we move towards national coverage, we have to ensure that we have the public health infrastructure necessary to support additional patients. This includes addressing education and training of the next generation of health professionals, new investment into research and development for cures to chronic and debilitating diseases, disease management programs to improve outcomes, and improving access to school-based health care and support services.

These are lofty goals; however, they are also achievable goals. I firmly believe that if Congress ensures that everyone is invested, that means individuals, small and large employers, providers, insurers, state and federal governments, we can deliver a health care reform bill to President Obama by the end of the year. Through collaborative thinking and collective action, we can and we will put together a good, bipartisan bill that will ensure the working men and women in this country will never have to worry about access to health care. [You can read my letter to President Obama here (pdf).]

I know that this requires much work on my part, and for those that know me well, you know I never back away from a challenge. For more than 50 years, I have fought for universal coverage, and there has been no better opportunity than now. I will not let this window slip by, and I urge my friends, my colleagues, and the American people to join with me in making 2009 the year major health care reform legislation is delivered to the Oval Office.