WASHINGTON, Jan. 10 (UPI) -- The Congress may be new, but the problem isn't: What to do about rising health care costs and the ever-growing ranks of the American uninsured.
Congress's last major attempt at health care legislation was in 1994, when the Clinton White House sent a universal health insurance plan to Capitol Hill. The plan quickly failed as industry groups and lawmakers on both sides of the aisle balked at what amounted to a full-scale overhaul of 10 percent of the nation's economy.
The problem has had the last dozen years to grow. This week, government actuaries reported that U.S. health costs now eat up, a full 16 percent of the gross domestic product. The nation now spends nearly $6,700 per capita on health care, twice that of any comparable nation, despite health indicators that place the United States firmly in the middle of the pack.
Richard Foster, Medicare's chief actuary, warned earlier this week that the nation's aging population will likely combine with rising medical technology costs to push prices upward for the rest of the century.
"We don't really see much that's going to change that for a long time to come," Foster said
On Wednesday, Sen. Edward Kennedy, D-Mass., incoming chair of the Senate Committee on Health, Education, Labor, and Education, used the panel's first hearing of the Democratic-controlled Congress to ask experts what Congress should do to stop the financial hemorrhage in U.S. health care and expand health coverage to more Americans.
"The stakes couldn't be higher," Kennedy said. "Too many trends in health care are going in the wrong direction. Costs are up, and America is heading to the bottom of the league of major nations in important measures of quality care."
The good news? Congress may not have to dream up a new plan all on its own. A handful of states, including Massachusetts and Vermont, have recently enacted plans to extend health coverage to all their residents.
California Governor Arnold Schwarzenegger, R, this week unveiled his own plan for mandated insurance coverage for all residents. The plan combines an expansion of Medi-Cal, the state's Medicaid program, with subsidies and tax breaks for workers and employers. The plan already has its detractors. But several experts told lawmakers that the experiment should benefit a Congress struggling to overhaul the $2 trillion-per-year health care industry.
"This period of experimentation is a way ... for the whole federal government to have a great testing space to see what new ideas actually will crash and burn and which ones will actually take hold, take root, and actually then lead to new approaches to expand coverage," said John McDonough, executive director of Health Care for All, a nonprofit group based in Massachusetts.
The State Children's Health Insurance Program, known as SCHIP, is set to expire this year. The program already covers approximately 5 million low-income children. Experts see its reauthorization as a chance for Congress to expand health coverage for 9 million more who lack coverage. They also see it as a kind of dry-run, confidence building exercise for lawmakers to eventually tackle the 38 million other Americans who have no coverage.
"To the extent that you're able to effectively expand SCHIP and kids' coverage, you take kids out of the equation and you make it significantly easier for states to address the issue of uninsured working adults," McDonough said.
Policy proposals are already in play in Washington looking to expand efficiency through the use of electronic medical records, and to begin to pare back costs by incentivising high-quality care.
The Bush Administration has also begun using Medicare to push hospitals, nursing homes, and other organizations to make more quality information available to the public. President Bush has pushed to combine the information with consumer-directed health plans that force consumers to shoulder more responsibility -- and cost -- of their own health care
Larry Burton, executive vice president of the Business Roundtable, representing corporate CEOs, urged lawmakers not to abandon the approach.
"We believe consumer-centric health plans are an important option for health care coverage," he said.
Other experts warned this week that apart from children's coverage, lawmakers are unlikely to take the political risks needed to overhaul American healthcare without the galvanizing effect of the next presidential election.
Sen. Hillary Rodham Clinton, D-N.Y., considered the frontrunner for the Democratic nomination, has already vowed to aggressively pursue a fix. Mitt Romney, the former Republican governor of Massachusetts and a contender for the GOP nomination, is credited with enacting that state's universal health care plan.
But polices addressing the 39 million American adults who lack medical insurance will likely wait until after the next presidential elections, Thomas Miller, a resident scholar at the American Enterprise Institute, said this week.
"It's unlikely it will be solved now, so it becomes a 2008 issue. Frankly, it's unlikely to happen in 2009, either," he said.
Andy Stern, president of the Service Employees International Union, was more optimistic. But he put the onus squarely on members of Congress.
The solution is really no longer a matter of policy. It's a matter of politics," he said.
