Saturday, October 24, 2009

Congressman Ryan on Health Care

The following was recently sent to the founder of Acquire Life.

As health care is a "hot topic" right now that affects your wallet AND your quality of life, we thought you would be interested to here what Congressman Paul Ryan of Wisconsin's First District would have to say!

Dear Bernie:

Thank you for contacting me about the health care reform legislation currently making its way through the House of Representatives. I appreciate you taking the time to let me know your views on this important issue.

The call for fundamental health care reform has never been so loud and as necessary as it is right now. The third-party-payer model that serves as a framework for the financial underpinnings of our existing health care system no longer meets the needs of patients, doctors, hospitals, and governments. It has undermined the doctor-patient relationship and removed individuals from the decision-making process. Transforming America 's fractured and antiquated health care system demands wholesale and fundamental reform.

Real reform requires a sincere and open discussion of these important questions. Washington has failed in this respect - instead framing the debate as whether or not we are happy with the status quo. Congress and the White House have focused their public efforts on platitudes and press conferences, while the substance and the details have remained behind closed doors. It might surprise folks to learn that an actual legislative proposal was not released by the Majority until Tuesday, July 14, 2009. Before Members even had time to read the one-thousand page bill, it has already cleared three major House committees and is set to be fast-tracked through Congress in the days and weeks ahead. Those members of Congress who already voted for this bill in their committees did so without knowing what the legislation costs. Before it's too late, let's take a closer look.

At the center of this legislation (H.R. 3200) is the creation of a new government-run insurance "option." Its advocates argue that only the creation of government-run insurance can facilitate "honest" competition among non-subsidized private plans. With all due respect, this is a dishonest argument. The public option is not designed to keep private insurance honest, but to make private insurance go away.

A new government-run plan would stack the deck against any would-be competitors. The private sector has to pay taxes; the government collects taxes. The private sector has to account for its employees and benefits, while maintaining minimum reserve requirements; the government does not. The private sector pays whatever rates it negotiates with providers; the government dictates payments.

Here is how it works: the government-run plan would reimburse doctors and hospitals at below market prices in order to control costs, similar to how Medicare underpays providers. When the government short-changes doctors and hospitals, the rest of us will be forced to make up the difference: those not on the government plan will have to pay more for the same care. If the government will only pay $70 to your doctor for a procedure that costs $100, then your doctor will charge you $130 for the same procedure to make up the difference.

With costs continuing to mount, employers will find it increasingly more cost-effective to dump their employees onto the government-run plan and pay an additional 8% payroll tax for each worker. Some estimates state that under a government-run plan option, 2 out of every 3 Americans would lose their current coverage within three years. The President has yet to reconcile this actuarial fact with his promise: "if you like what you got, you can keep it."

As more and more people find themselves forced into the government-run plan, the only way to contain costs will be through rationing care by the federal government. The decision as to whether or not you receive a potentially life-saving treatment will not be a decision made by you, your family and your doctor. It is a decision the government will make for you.

That is why I offered a series of amendments when the House Ways and Means Committee held a 19 hour hearing on H.R. 3200 that would have addressed these issues. One of my proposals was to require that all Members of Congress enroll in the public plan. I believe if Congress is going to force millions of Americans into a government-run plan then their representatives should participate as well. Unfortunately, none of my proposals were accepted during this hearing. Despite this set back, it is my sincere hope that we can work together to bring about fiscally-responsible, patient-centered health care reform. With engaged participation from Wisconsinites in this critical debate, I believe that we can enact better solutions than those being rushed through Washington . We can - and we must - rise to meet the challenge before us.

To meet this challenge, I have proposed an alternative approach to reforming our health care system. My bill, the Patients' Choice Act, would put patients and doctors in control of health care decisions. It fundamentally changes the mechanics of Medicaid while strengthening the promise of health care and security for all Americans. Under my proposal, discriminatory tax rules would be reformed, ensuring that everyone gets the same tax benefits for the purchase of health care regardless of where they obtain that care. Every American receives an advanceable, refundable tax credit with which to purchase portable health insurance. We continue to encourage businesses to offer health insurance by allowing the current tax incentives for businesses to remain intact. So if you like what you have, you can keep it - but it will be your decision.

The Patients' Choice Act also reforms the second-class care for society's most vulnerable by converting the broken Medicaid program from a defined benefit to a defined contribution program. In addition to the universal tax credit, Medicaid beneficiaries would receive additional resources to pay for health care.

To ensure affordable, quality coverage for all, I propose real insurance reforms that reorient the incentives of these companies so that they jive with patients. The bill encourages state-based solutions - in the form of voluntary health exchanges - which will prevent cherry-picking against those deemed uninsurable, made possible with risk adjustment mechanisms and other options at the State level - such as reinsurance and risk pools. My proposal also includes commonsense reforms to expand coverage through auto-enrollment for individuals who do not select a plan at the beginning of the year.

To ensure that market forces can actually work in health care, patients must know what services cost and who provides the best service. I propose an industry-based Healthcare Services Commission that will bring much needed transparency to the currently opaque health care market.

This comprehensive reform legislation includes concrete prevention and wellness initiatives, health IT, long overdue entitlement reforms, and more. All of the reforms in this legislation demonstrate a clear, coherent path to achieving universal access to quality, affordable health care with the patient and the doctor - not the government or insurance companies - as the nucleus of health care in America .

In the meantime, if you wish to share additional information with me concerning this issue, please feel free to contact me by calling, emailing, writing, or faxing me. Please be advised that mail sent to my Washington office is subject to an additional two-week delay due to increased mail security. I thought you might also be interested in receiving regular updates on what is happening in Congress and the 1st District delivered directly to your e-mail inbox by signing up for my Instant News Updates. To receive the updates, visit my website at and click on the Instant News Updates graphic on the right side of the screen for this free service.

Thank you again for contacting me on this issue. If I can be of further assistance to you regarding this or any other matter, please do not hesitate to contact me. I am always happy to respond and be of service to you.


Paul Ryan
Serving Wisconsin 's 1st District

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