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The Honolulu Advertiser
Posted on: Sunday, May 23, 2010

PRO: Health care bill dramatically cuts costs

 •  CON: No savings, just taxes, high premiums


By Rep. Jim McDermott

Hawaii news photo - The Honolulu Advertiser
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There have been countless polls released over the last few months about what the public thinks about the health care reform legislation, and I have been able to conclude only one thing from all the data: the public is understandably confused.

But now that parts of the bill are already taking effect and the noise level has decreased, we can begin to see what this bill will actually do to reduce costs — and the answer is a lot.

One of the Republicans' favorite talking points is that the legislation will increase costs by gazillions of dollars, which is simply untrue. You'll also have to forgive my surprise to hear that Republicans have recently discovered a concern for costs and fiscal responsibility after years of egregiously irresponsible fiscal management under their leadership.

The Congressional Budget Office estimates that this bill will reduce the deficit by more than $140 billion over the next 10 years, and an additional $1.2 trillion over the following 10 years.

What the bill will do is ensure that people's premiums won't skyrocket as they have been over the last decade and will keep premiums much lower than they would have been without reform.

Between 1999 and 2008, the average annual premium for a family increased by about 120 percent. While it's still too soon to say whether this legislation will slow the increase in health insurance premiums so that they more closely align with inflation, we included every approach suggested by leading economists in hopes of doing just that.

Many middle-class families are already seeing how the legislation can help their pocketbooks: One of the most significant provisions that has taken effect allows parents to keep their children on their insurance until the age of 26 so that they won't have to buy more expensive coverage on their own.

Another provision — one that aims to control health expenditures on a national level — is a bundled payment model, which would streamline and simplify how people pay for care.

This system is designed to dramatically reduce costs by allowing greater coordination among doctors for a single ailment, so that people wouldn't have to pay their primary care physician, surgeon and physical therapist separately — much like companies that now bundle cable television, Internet and phone services.

The bill also encourages the expansion of Accountable Care Organizations, which will help transform the way care is delivered by promoting efficiency. This system will help the primary care physician coordinate with the neurologist, who will work hand-in-hand with the cardiologist, who will work with the hospital — all designed to help reduce costs.

Last, the bill establishes a Center for Innovation, whose sole purpose is to look for new ways to further cut costs by creating more efficient and cost-saving policies down the road.

This legislation is far from perfect, and I know we are going to have to amend and improve it for years to come, just like we've done with Social Security and Medicare. The bill is a landmark piece of legislation that was nearly a century in the making, so it's going to take time to see its full effects.

Does this legislation take nearly every action proposed by leading economists to rein in costs and control medical expenditures? Absolutely. Are your premiums going to decrease 50 percent by next Tuesday? Probably not. I just hope that the public will be able to understand all the good that will come out of the legislation without the loud histrionics of some of my Republican colleagues.

U.S. Rep. Jim McDermott, D-Wash., is the only psychiatrist among the 16 medical doctors serving in Congress.