In the coming weeks, Congress will be taking action on one of the most important pieces of legislation that will come before us - health care reform.
It is no secret that our current system of delivering and paying for heath care is broken. We all know someone who has lost a job and the health insurance that went with it. Or the cousin who could not get insurance because of a "pre-existing condition." Or a neighbor who is sick but can't afford to go the doctor. Or a friend who has insurance but had a claim denied because the services weren't covered - and they don't know how they will pay the bill.
It simply is unacceptable to have a country as great as ours where millions of people go without health care. It's estimated that nearly 46 million Americans - your friends, neighbors and relatives - have no health insurance. In Colorado alone, more than 800,000 lack coverage.
Earlier this year, we made a small but important dent in the problem when we enacted into law an expansion of the State Children's Health Insurance Program. This law, which I supported, expanded health insurance coverage to thousands of children who previously had gone without health care. This was an important step, and I'm proud to have been a supporter.
But more, much more, needs to be done. It's time for comprehensive health care reform.
The issue isn't whether the system is broken or whether major reforms are necessary. The devil is in the details, and this is where considerable discussion and debate are taking place. What should we do to reform a complicated, complex and expensive system?
Let's start with what's right - many Americans like the private insurance they have, as well as the doctors who treat them. They should be able to continue receiving the care they have become accustomed to.
Many seniors like the care they receive under Medicare - and many veterans like the health care provided under the VA health system. These, too, should continue to meet the needs of these groups.
There may be other aspects of the current system that should not be eliminated or are only slightly in need of some improvements. But that leaves us with the reforms that are necessary to fix the rest of the system.
Proposals include insurance reform - doing away with "pre-existing conditions" clauses that prevent millions of people from getting coverage when they need it the most. Coverage options and prices should be clear to individuals and businesses so they will be able to shop and compare plans to find one that fits their needs and is affordable. And insurance companies must no longer deny payment for claims - in effect, stepping in between the physician and the patient to decide what care is available.
The health care challenges facing rural communities must be addressed, as well. Too many communities are underserved by doctors, hospitals and clinics. We must find ways to attract more providers to communities and shorten the distance between facilities and patients by increasing the use of telemedicine and other creative uses of technology. Reimbursements from Medicare and insurance agencies must reflect the challenges rural providers face in a setting where there are fewer patients, higher costs to deliver prescription drugs and medical equipment. Reimbursements cannot be based on cost of living prices.
There is considerable talk about including some kind of public option to compete with the private plans. I think a public component may very well be necessary as part of any real health care reform.
Finally, there are the costs. I strongly think any reform must be deficit neutral and fiscally responsible. We can find ways to pay for health care reform by eliminating duplication and inefficiencies in the current system, such as promoting the use of electronic medical records and stopping waste, fraud and abuse. Prescription drugs cost too much, so we must find ways to lower those prices for the sick to be treated. Unnecessary testing must be decreased, along with incentives that result in such testing.
None of this will be easy. Many powerful interests have a stake in the way the current system operates, and they won't give in without a fight. But I think we have too much at stake to simply sit and do nothing about the current situation. Too many people have been hurt by a health care system that is supposed to heal. Too many people have been broken by a broken system. Too many people have gone without in a system that is supposed to provide.
It's time to heal our ailing health care system. It's time for real reform.
Congressman John T. Salazar represents Colorado's Third Congressional District in the U.S. House of Representatives.