Op-Eds

Health Care: An Open Letter to the People of the 9th District

Washington, DC, July 15, 2009
As you know, in the next few weeks, there will be a lot of talk in Washington about reforming our system of health care. As the American people struggle to make ends meet, too many also live with the challenge of affording basic health care for themselves and their families.
As you know, in the next few weeks, there will be a lot of talk in Washington about reforming our system of health care. As the American people struggle to make ends meet, too many also live with the challenge of affording basic health care for themselves and their families. 
 
I believe that America’s health care system is broken and must be fixed.  I understand concerns about getting and keeping affordable coverage. I believe that poor quality care is caused by overuse, misuse, waste, fraud and doctors having to practice defensive medicine.  All of those things drive up health care costs.
 
I believe there are several common-sense things we can do to improve our health care system, and as the House continues to discuss and develop its approach to addressing health care, one thing is clear -- small business owners need meaningful reform that increases access to quality, affordable health care. Sadly, many of the provisions in the Democrats’ draft bills and most recent proposal fall far short of achieving those goals. Specifically, I oppose employer mandates that threaten the viability of our nation’s job creators. An 8 percent pay-or-play mandate would inevitably harm job creation. Research shows an employer mandate could cost 1.6 million jobs -- hardly what this country needs in these challenging economic times. 
 
Recently, the nonpartisan Congressional Budget Office (CBO) found that the Democrats’ House bill would cost a hefty $1.04 trillion and leave many Americans still uninsured.  To be sure, I believe in and will continue to champion increasing access to insurance.  However, in a lagging economy with a mounting unemployment rate, a trillion dollars is a lot of money to spend to leave many people still struggling to buy basic health care. Moreover, reforming health care does not mean we have to penalize businesses with more taxes. Under the Democrats’ House plan, many small businesses would be hit with a penalty equal to 8 percent of payroll if they fail to provide health insurance to workers.
 
As a small business owner and a member of the House Small Business Committee, I am keenly aware of the difficulties small businesses face in providing their employees with health insurance. That is why I support Small Business Health Plans to allow small businesses to pool together and increase their purchasing power so that they can provide health benefits to their employees at the same prices that are available to large corporations.
 
I support quality, affordable health care and believe that we should look closely at several potential health care reforms, such as making it easier to transfer care from one job to another. We should consider putting stronger rules and regulations on health care providers that would, among other things, require health insurers to cover pre-existing conditions. We should look at health care tax credits to ensure that hard-working folks have access to affordable health care in the first place, and in recognizing that not all high school and college graduates are able to find a job that offers health care coverage after graduation, we should consider allowing dependents to remain on their parents’ health policies up to the age of 25. This would reduce the number of uninsured Americans by up to 7 million. We must also act to prevent abusive lawsuits from driving up the cost of care and driving doctors out of business. While I support health care reform, I cannot and will not support a public health care system that rations health care and allows a government bureaucrat to make life-and-death decisions when it comes to people’s health.
 
I have already supported legislation that provides health care coverage to low-income children. H.R. 2 -- introduced in the House on January 13, 2009, and voted on the next day -- had a number of serious flaws, which led me to support a better, longer-term extension of the State Children’s Health Insurance Program. I voted for a seven-year extension of SCHIP that prioritizes covering low-income children without raising taxes. The plan I voted for would not have forced children with private insurance into a government-run health care system, nor would it have spent my constituents’ hard-earned tax dollars to provide insurance for families making $80,000 per year in New York. In addition, the plan I voted for maintained the requirement in current law that prevents illegal immigrants from gaining access to taxpayer-funded programs. 
 
Additionally, I have signed on to legislation that would initiate an evidence-based public education campaign about breast cancer in women under age 40, and I opposed a recent action by the Centers for Medicare and Medicaid Services (CMS) to deny Medicare coverage of computed tomography colonography screenings (CTC), also known as virtual colonoscopies. A lack of awareness and decreased access to screenings and detection undoubtedly result in a much higher mortality rate for cancer than there ought to be.
 
Given the health care shortages throughout the country, including many parts of my district, I have signed on to legislation that would improve access to health care by increasing the number of physicians trained in high-need specialties and by expanding the nation’s graduate medical education training capacity to a larger number of suburban and rural hospitals. Rural areas continue to suffer from a lack of diverse providers for their communities’ health care needs. 
 
As Congress tackles these and other important issues, I will continue to work tirelessly to make sure that any reforms to our world class health care system do not destroy the absolute right of patients to make very personal decisions on treatment with their doctors, and without interference of a third party like the government. 
 
Although not everyone agrees on this issue, I believe that we can all agree at least on this point: Any decisions we make on health care should not be motivated by politics but, rather, by providing better care for all Americans and all Missourians.