Conservative Principles of Health Care Reform: The Road Ahead

by the Honorable Michael B. Enzi

Heritage Lecture #1124

I want to thank the Heritage Foundation for hosting this event. The topic today is "Conservative Principles of Health Care Reform: The Road Ahead," but before I discuss the road that hopefully lies ahead, I would like to discuss the road we are on.

Today, our nation's health care system travels a dead-end road. When I introduced 10 steps to reform our health care system almost two years ago,[1] I noted that because of our health care crisis, literally every American stood a heartbeat away from devastation. The problem has only worsened.

The Problem

The state of our health care system poses the single greatest long-term domestic threat to America's stability, and responsibly reforming this system poses the single greatest challenge to our nation's policymakers in more than a generation. Two years ago, I said that we needed comprehensive health reform. And today, I say it again. I agree with President Obama, millions of Americans, and many lawmakers on both sides of the aisle: The time for reforming our health care system is now.

Our current rate of health care costs is simply unsustainable. Health insurance premiums for the average American family have nearly doubled since 2000. As a nation, our total spending on health care has more than doubled as a share of gross domestic product over the last 30 years. Health care economists agree that, absent reform, this trend will only accelerate over the coming decades.

Spiraling costs are also forcing more employers to cut back or drop the health insurance coverage they offer to their employees. The United States currently has the largest percent of its population uninsured of any industrialized nation. And as recent unemployment numbers show a rise to nearly 9 percent, we are sure to face a growing number of uninsured in the coming months.

We are headed down this unsustainable path because most of the incentives built in to the current system are designed to raise costs. Both in the area of health insurance and in medical services, we currently operate under a system that promotes inefficiency, encourages waste, and invites fraud.

If we stay the course and do nothing new with our nation's health care system, we threaten the American Dream. Our future entitlement obligations will grow, people will pay even more money, and they will receive less care. They will have to fill out more forms and wait longer to get the tests and see the doctors they need to see. There will be fewer doctors, nurses, and health care professionals to take care of an increasing number of patients.

We must reform our health care system, and the time to act is now.

So both sides of the aisle agree on the problem. Now, to some people that might not seem like much, but when you consider the other policy issues being discussed like card check, global climate change, and enhanced interrogation techniques, sometimes agreeing on the problem is a bipartisan accomplishment in and of itself. So now let's talk about solutions.

The Solutions

Let me be clear: I want to support a bipartisan health care reform bill. I also believe that it is possible to get broad bipartisan support behind such a bill. Republicans, Democrats, Independents, higher incomes, lower incomes&--it doesn't matter. We all worry about health care, and if we are committed to finding real solutions, then we will find some that we can agree on.

There never has been a bill with as many moving parts that affect as many people. To get a workable solution, it will require the effort of every member of the Senate. If we can't come up with a plan that can garner the support of at least 75 or 80 Senators, this institution will not have the confidence of the American people, and the plan will fail.

I am working hard with the chairmen and ranking members and other key members of the relevant committees to see what we can achieve. I believe that such a bill would have the following elements...