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Sen. Ron Wyden

Sen. Ron Wyden

Posted: September 3, 2010 02:54 AM

Missing the Point

What's Your Reaction:

In December of 2006, I introduced the Healthy Americans Act to reform the nation's health care system. Some on both sides of the aisle liked my bill, while others on both sides of the aisle did not. But the time has long since passed for debating the merits of the Healthy Americans Act. While I like to think that the legislation I spent many years developing helped advance and inform last year's debate, it became pretty clear at the beginning of 2009 that the White House and the Congressional leadership of both parties wanted to go a different way.

It's correct that I wanted health reform to do more to create choices and promote competition. But instead of spending the year on the sidelines criticizing my colleagues and advocating for my personal approach, I spent the year looking for opportunities to improve the legislation that WAS advancing through Congress. The same can be said of my health advocacy today, as I continue to look for ways to improve what is now law.

For example, in writing the Healthy Americans Act and working with the Congressional Budget Office on its score, I learned that giving consumers more choices is one of the most powerful ways to reduce health insurance costs and hold insurance companies accountable. While I certainly didn't get everything that I wanted, I did get a provision included in the final bill that will allow a small group of Americans to convert their tax-excluded employer subsidies into vouchers that they can use to choose their own plans on the new health insurance exchanges. And I am already looking for opportunities to expand this provision so that more and more Americans are ultimately empowered to make their own health care choices.

Another provision that I got included in the final law came directly from my original legislative proposal. "Empowering States to be Innovative" (Section 632 in the Healthy Americans Act and Section 1332 of the Patient Protection and Affordable Care Act) reflects my long held view that when it comes to health policy what works best for people in Tampa Bay, Florida doesn't always work as well for the residents of Coos Bay, Oregon. My state of Oregon has, in fact, long led the country in innovating approaches that have played a major factor in Oregon having some of the highest quality and lowest cost health care in the country. So both in writing my legislation and working to improve what is now law, I wanted to make it possible for states to keep innovating new approaches.

However, for states to really be empowered to be innovative the federal government has to be willing to give states a little leeway to implement their own approaches. A state, for example, will struggle to offer a public option on its exchange if it has to follow the exact standards of the federal law that doesn't provide for one. And, of course, no state-based approach -- no matter how innovative -- can work if everyone who participates in the state program gets fined by the federal government for failing to comply with the federal mandate.

So, in both the Healthy Americans Act and in the current health reform law, I included a provision that would allow states to gain an exemption from certain federal requirements -- such as the individual mandate, the employer penalty and the exact standards for designing the exchanges, subsidies and basic health insurance policies -- if they could find a way to do a better job of covering their state's citizens. And I have been working to help states, like my home state of Oregon, take advantage of this option and hopefully move-up the date when states can start applying for waivers. The reason for this -- as the legislators in my state will attest -- is that it's a lot less cost effective for states to implement their own approaches in 2017 if they also have to pay to implement the federally mandated approach in 2014. For those who claim this position represents a retreat from the health reform law, they are mistaken. I have been advocating virtually non-stop for states to have the right to go their own way, including during the Senate Finance Committee's mark-up up last fall when I got the provision included in the Senate bill. My letter to the state of Oregon last week was a continuation of my effort to promote state innovation in health care.

Of course, the temptation in today's gotcha political culture is to take any senator's comments on health care as being about scoring political points and either helping or hurting the White House. The truth here is that I have supported both an individual mandate and a state waiver for more than five years.

Again, both the individual mandate and the state waiver were a part of legislation that I introduced in 2006. And while this provision would allow states to opt-out of the federal health insurance mandate -- which is what some politically motivated people are calling for right now -- under my approach states will only be granted a waiver if they demonstrate they can do a better job of providing health care in their state than under the new federal law. To date, I haven't seen a single one of those states currently filing lawsuits against the individual mandate propose better ways of covering their citizens. In fact, one of the reasons I have been drawing attention to the state waiver is to highlight the insincerity of those filing lawsuits. If states aren't happy with the federal law they should be spending their energy innovating ways to do better rather than wasting taxpayer dollars on lawsuits that -- if successful -- would leave their state's citizens with nothing.

I continue to support the individual mandate unless a state can demonstrate that it will provide equal or better health care without one. I continue to prefer the individual mandate from the Wyden-Bennett bill to the one contained in the bill that passed, because it was accompanied by greater consumer choice and a rock-solid guarantee that all Americans would receive the same level of health coverage as their Member of Congress.

I voted for the Patient Protection and Affordable Care Act, not because I thought it was the best we could do, but because I thought it was a whole lot better than the current system. I still know that to be true. But in my mind, passing that law is far from "mission accomplished" and my constituents can count on me to keep working to improve that law and our nation's health care system, regardless of which way the political winds may be blowing.

 
 
 
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HUFFPOST SUPER USER
ftkl1234
12:25 PM on 09/07/2010
Good for you, Sen. Wyden! What's with Americans, those who tried to block this not-perfect but better-than-nothing bill? Can we think of our Constitution as a sketch or work in progress that still can be tweaked. The GOP will probably want to kill it if they get control of Congress.

It's reported that some states reps who voted against the bill are now collecting the kinds of benefits they voted against. Talk about hypocrites!
11:18 AM on 09/07/2010
Without an individual mandate, health care costs will soar because only the sick will be purchasing the insurance. You must include the younger and healthier people to balance out the costs. As with other mandates in our country like wearing seatbelts, or paying taxes to support schools (even if you don't have any kids in school) - it is for the good of the whole of society.
05:23 PM on 09/06/2010
The Republicans don't need a plan and even though their numbers are at historical lows --- they
are probably still going to win. Sad, pathetic, surreal -- you name it.

The litmus test for the Whimpocrats was the Public Option and they failed miserably.

As Americans, it's not in our nature to reward failure --- that's just how it is.
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HUFFPOST SUPER USER
Ipanemagirl
progressive
01:07 PM on 09/06/2010
The Republicans created the financial disaster and now they just spent 2 years in congress opposing every measure to fix it.!!!
Now if they regain the majority , they will be back in with NO PLAN other than the usual, lower taxes for the RICH 2%,,,,not the average american.that will make things worse for all americans except the rich.
Stimulus money is what puts people back to work, but they voted against that too....all the taxes they dont want to pay, would put most people back to work, and keep their jobs! Wake up America, you are blindly walking down the ramp!.
10:11 PM on 09/05/2010
You as well as any other single Senator could have singlehandedly forced the President to create a much better bill.

You could have threatened to tell the complete truth non-stop. You could have stood in the middle of the White House driveway 24x7 non-stop. There were countless actions that could have been taken. Hand wringing does not count.
10:56 PM on 09/05/2010
He had a script to follow --- which he executed flawlessly.
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HUFFPOST SUPER USER
Lil Orphan Annie
no longer empty
10:06 PM on 09/05/2010
Oops *long* look, not *ling*
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HUFFPOST SUPER USER
Lil Orphan Annie
no longer empty
10:05 PM on 09/05/2010
Please take a deep ling look at the Indian Health Services. It desperately needs reform. There are many enrolled members going without Health care, because of the regulations involved. Rather than one clinic per county, as in Washington state, there must be a better way. If one lives in the east end of Jefferson county, one must drive over 200 miles to get service from the clinic. Why not implement insurance programs with co-pays, choice of doctors, etc and give Native American Indians access to outside clinics? I shouldn't have to wonder if the local Tribal Council will okay payment for services outside the Tribal Clinic. Without a "social" connections, many of us have to make do with the limited offerings of the clinic. If one were to need x-rays, and the local Council has deemed no "social" ties, one is required to pay for the x-rays. Difficult, if one is unemployed. Often, the doctors are overwhelmed, due to the high volume of patients. Some are unequivocally unqualified for the position and have limited supervision. It's time the government lives up to our treaties.
11:19 PM on 09/05/2010
The shape of things to come...
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HUFFPOST SUPER USER
LawTalkingGuy
Rational human male.
11:25 AM on 09/07/2010
Really, you think the Indian Services is the shape of things to come, and not the wildly popular medicare - a program so popular that Republicans had to pretend to support it while opposing health care for the rest of Americans?
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HUFFPOST SUPER USER
Whale
08:37 PM on 09/05/2010
"choice and competition"????? What choice? If I am ill, especially if I am on my way to the ER, am I supposed to research who will charge the least but give good quality? And we currently have competition and you can see where that has got us. Healthcare is not the same as buying salad-shooters.

This choice and competition nonsense is just window-dressing for turning healthcare over to the corporados to suck us dry. Oh, and if people die, well that's the price we have to pay for this wonderful choice and competition.
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HUFFPOST SUPER USER
Ipanemagirl
progressive
01:13 PM on 09/06/2010
whale, you are absolutely right! That is just another lie that corporations use to scare people so that they can keep the status quo of "NO competition" so they can keep gouging the people, hence making incredible profits for themselves! Tea party are suckers for believing them and voting against what would actually be so much better for them!!!!. SUCKERS! They are just being "Used" by corporations to do their bidding.
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HUFFPOST SUPER USER
LawTalkingGuy
Rational human male.
11:25 AM on 09/07/2010
Exactly.

Americans once had a true idea of Freedom. Now, the only freedom they understand is freedom to choose from a wide range of consumer options on which to spend their wages. America has sold its birthright for magic beans.
04:50 PM on 09/05/2010
So much fun watching all the piggies squeal and run off in different directions...
06:15 PM on 09/05/2010
weasel out of something like this
sorry we remember
03:22 PM on 09/05/2010
So during the greatest economic catastrophe since the Great Depression, when 30 Million Americans are out of work, what do our President and Senator Wyden push? A mandatory Health Insurance bill with full access to all Americans' bank and 401(k) accounts. It's the biggest gift to the Health Insurance industry imaginable. And it guarantees businesses will not hire people due to the increased, yet unknown, health insurance costs. Way to go, Congress. Way to go, Barry.
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HUFFPOST COMMUNITY MODERATOR
Gudrun
My micro-bio is empty
05:09 PM on 09/05/2010
But the majority of people who have health insurance coverage through their employer report that they are happy with that situation and did not want it changed. Can't please everybody, I guess.
06:17 PM on 09/05/2010
someone making 44,000 will have to pay 3500+ 4500 co-pay
at 52,000 , pay 10,500+ 4500 co-pay (nytimes)

to subsidize those who get it free
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HUFFPOST SUPER USER
Ipanemagirl
progressive
01:13 PM on 09/06/2010
REALLY???? I DONT KNOW ANY.
07:21 PM on 09/05/2010
Perhaps a comment that you might have heard about 6-7 months ago, but now water under the bridge.

Wyden is probably reacting to comments that confused his highlighting the provisions about states devloping their own systems with lawsuits brought by some states on the healthcare bill that passed. Just like in Canada (provisional level), it will probably be at the state level that the most effective universal healthcare system will be developed. And it will probably be occur in a very blue state like Oregon.

Wyden has been looking for useful ways to reform healthcare that improves care and reduces costs to people. He does not deserve the criticism I am reading in some of the comments..
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SparkyDash
Still a BFD
01:08 PM on 09/05/2010
Thank you Senator Wyden!
10:29 AM on 09/05/2010
I contacted your office more than a dozen times, to warn you not to vote for this bill. You voted for it- You OWN it. Now get out.
12:50 PM on 09/05/2010
Yes, how lame

giving more $$ to the bad guys doesn't help
10:24 AM on 09/05/2010
"I voted for health care reform not because I thought it was the best we could do, but because I thought it was a whole lot better than the current system."

BS. You voted for that corporate sellout because you are just as much of a corporate whore as the rest of Congress, and when your corporate masters told you they had the bill they wanted, you stopped pretending to fight for regular americans and voted for it, just like Grayson, and just like Kucinich.

You all place your own careers and places amongst the establishment ahead of basic morality. You are cowards and corporate shills.

How is it better to give even more money to a for-profit industry that can turn around and use that money to even further influence you cheap whores to screw americans even more? Reports are already showing that even the meager benefits the bill should already be providing to regular americans are reaching almost no one.

But industry profits and premiums continue to soar, so all in all I guess its a job well done eh Wyden? But please, keep hoping most americans miss the point. Its about the only hope the dems have left come november, as the masses seem poised to again exchange one face of the corporate part for another.
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Grokenspiel
I grok, therefore I spiel
04:12 PM on 09/05/2010
It's tough to tell from your post where you stand on the health care reform bill and Wyden's role in its passing. I suggest you stop sugarcoating your opinions, as it makes you seem wishy-washy. Also, a touch of healthy suspicion and cynicism wouldn't hurt; this Pollyanna-ish optimism of yours is cloying.
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04:26 PM on 09/05/2010
Thank you. You made my whole body laugh.
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HUFFPOST PUNDIT
FZliveson
Beating the Conundrum
05:43 PM on 09/05/2010
Inane
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HUFFPOST SUPER USER
marijam
Independent
10:07 AM on 09/05/2010
It's a shame that dental care was not considered part of health care. Costs are as out of control for dental care as they are for health care. A friend's daughter is going to have her wisdom teeth pulled. His part of the cost is going to be $800 or $200 per tooth. I wonder how much the insurance actually is covering? I mean, come on, $200 per tooth plus what the insurance covers? It's ridiculous.
10:00 AM on 09/05/2010
T.R. Reid, the journalist who has studied health care by investigating in depth all of the various plans out there in the industrialized world, has shown that basically most countries have adopted one of four types of plans from a national health care system down to private paying systems. The one thing he found, however, is that all of these countries were able to adequately cover all of their citizens for about 50% of the costs of our system.

We, in the United States, historically have the most costly and inefficient system in the world. It includes everything from a nationalized system for our vets, to a government run system in Medicare, to a privatized system for businesses, to an Afghanistan type system of 'your out of luck unless you can pay out of your pocket' health care system.

The reform that was passed by Democrats was an improvement, as Wyden says, but it does not take us the distance. What is inexplicable however, is that so many Americans and Republicans would want to keep the old system. Why are we so content with being the worst in the industrialized world in terms of providing health care to our citizens. It doth boggle the mind.
12:51 PM on 09/05/2010
f & f
08:32 PM on 09/05/2010
Gee I don't know why people wouldn't believe the govt. could run health care better?
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santafesam
smart&snarky
08:55 PM on 09/05/2010
I've wondered the same thing - I just don't get it. I think there are a lot of people still who do not pay for their own health insurance, and have absolutely no idea what it costs. I know that my employer pays over $700 a month for mine. I am grateful beyond belief. But terrified of what happens if I lose this job or when BC/BS jacks up their rates even higher and my boss decides to hire someone younger Why are we so invested in the status quo and our own destruction and the devastation of our future?
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HUFFPOST SUPER USER
LawTalkingGuy
Rational human male.
11:33 AM on 09/07/2010
"I know that my employer pays over $700 a month for mine. I am grateful beyond belief. But terrified of what happens if I lose this job or when BC/BS jacks up their rates even higher and my boss decides to hire someone younger "

Exactly. The onlly thing that will save you in that case is a PUBLIC system that is run for the benefit of all Americans. Of course, some Americans are so spectacularly selfish that they don't realize having happy, healthy, productive citizens (consumers, employees, managers, voters) is good for all Americans. They themselves have good health and insurance and so they think extending these benefits to others will be somehow stealing from them. Of course it will mostly be making everyone, including them, much better off in the long run, but as I say they are selfish and ignorant.