A new solution may modify healthcare.

As a physician for over 25 years, I have witnessed all aspects of the healthcare debate. While there are many positive points in that debate, there are almost 47 million people of all ages currently not covered by any type of health insurance for various lengths of time. The growing number of uninsured in this country is extremely troubling. As remarkable as that number is, it continues to grow every year.

Covering the uninsured has become one of our nation's most pressing matters. Congress has taken steps to decrease the number of uninsured by reaching out to the Medicare and Medicaid populations as well as creating health-saving accounts for individuals. As advances to the healthcare-delivery system in this country have been made, we seem still to be missing something.

If there is one message that rings clear, it is this: Our healthcare system is not what it used to be. The doctor-patient relationship was sacrosanct in years past, and our medical system has not been able to move with today's dynamic social complexities. Reforms have been created and tested in the past. Many have failed. The "one-size-fits-all" approach cannot work for an issue as personal as healthcare. This country is far too large and complex for one solution to cover our entire population. Taking this into account, Representative Tammy Baldwin (D-WI) and I have authored the Health Partnership through Creative Federalism act, (HR 5864 introduced in the 109th Congress), a collaborative effort to break the congressional healthcare logjam.

True healthcare reform has failed at the federal level. Congress has become too partisan to move any real healthcare solution through both chambers. Representative Baldwin and I both see this dilemma, but we also see an opportunity for an innovative approach. Our legislation provides the states with the unique opportunity to implement reforms that are best suited for their population's needs. States as varied as Wisconsin, New Mexico, Massachusetts, Maine, and Illinois are already taking the lead with bold new initiatives.

Under this new approach, states would submit proposals to expand healthcare coverage and access. A commission made up of state, local, and federal appointees would create a slate of proposals which reflects a variety of state coverage options, such as tax credits, expansion of Medicaid or the State Children's Health Insurance Program, creation of pooling arrangements like the Federal Employee Health Benefit Program, single-payer systems, health-savings accounts, or a combination of these or other options. The slate will then be submitted to Congress for a single vote.

In this capacity, the federal government would serve as a facilitator to state reform. Rather than hindering individual state's efforts. Congress would authorize grants to individual states, groups of states, or even portions of states to carry out any of a broad range of strategies to increase healthcare coverage. Using the current waiver authority granted to states will make it easier for states to design permanent solutions without federal impediments.

Giving states the flexibility to find out what works is a step in the right direction in covering the uninsured. Demographics differ in every state. Empowering the states to tailor programs to their specific needs is far more productive and efficient than waiting on the federal government to offer a blanket solution. This legislation is different from other attempts. Other proposals make an effort to expand healthcare coverage, but in doing so, they favor one approach over others. Politically, "one-size-fits-all" solutions rarely succeed. Our proposed bill creates a process for a variety of solutions to be implemented and evaluated.

What makes this opportunity an even more viable option is that funded state programs will have a net cost of zero. The bill contains a budget-neutrality provision requiring funded programs to have no net increase in costs during the five-year operation of the program. The program does not merely give a blank check to states to cover their uninsured--far from it. We are looking for systemic change and innovation. By authorizing grants to states or groups of states, we are enabling these partners to enact the strategy best suited for them to ensure coverage for all, while driving down costs. The federal government should help, not hinder, states in their attempts to cover the uninsured. Ineffectiveness and bureaucracy have trumped innovation in healthcare coverage for far too long.

Since coming to Congress, Rep. Tom Price (R-GA) has advocated patient-centered health reform and finding solutions for covering the uninsured, including legislation to move the nation's healthcare-delivery system toward a defined contribution plan. Price has been an advocate for appropriate physician reimbursement for clinical services.

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By Rep. Tom Price (R-GA)

Reasons for not having health insurance

Among those who say they are uninsured:
What is the main reason you do not currently have health insurance?

Too expensive                                              54%
Cannot get it/refused due to poor health, illness, or age  15%
Not eligible for employer coverage                          9%
Employer does not offer it                                  5%
Do not need it                                              4%
Do not know how to get it                                   1%

Note: Do not know and "other" responses not shown.
Source: "Health Care in America 2006 Survey-Chartpack" (#7527). ABC
News/The Henry J. Kaiser Family Foundation/USA Today, October 2006
This information was reprinted with permission from the Henry J. Kaiser
Foundation. The Kaiser Family Foundation, based in Menlo Park, CA, is a
nonprofit, private-operating foundation focusing on the major health
care issues facing the nation and is not associated with Kaiser
Permanente or Kaiser industries.

Note: Table made from bar graph.