Young Guns : A New Generation of Conservative Leaders (13 page)

The higher costs to American families under the Democratic health-care overhaul are driven by this fact: even though it doesn’t contain the so-called “public option,” Obamacare is still a government takeover of our health-care system. This is not reform that drives costs lower through choice and competition. It is reform that drives costs higher through centralizing resources and decision-making in Washington DC.

The premise of the Democratic system is that because everything is connected to everything else, government must ultimately control everything. It assumes that you can provide coverage for pre-existing conditions only if you have healthy people in the insurance pool to spread costs. Of course, to get young and healthy people into the system, you have to mandate that everyone buy insurance. But to do this, you have to subsidize people who can’t afford insurance and penalize those employers who don’t provide insurance. And once you start handing out subsidies and penalties, you give more and more people an incentive to join the system. Costs rise, and to slow their rise you have to impose limits on care by stripping decision-making power from patients and doctors.

The entire architecture of Democratic health care is designed to give the federal government control over what kind of insurance is available for patients, how much health care is enough, and which treatments are worth it for government to pay for.

In addition to setting the price, the Obama plan empowers Washington to determine the kind of insurance that will be available. It gives the secretary of Health and Human Services and an unelected group of federal bureaucrats—a new Health Benefits Advisory Committee—unprecedented power to determine what constitutes “acceptable coverage.”

It gives the U.S. Preventive Services Task Force new powers to further limit patient choice, allowing the secretary
of Health and Human Services to unilaterally deny payment for prevention services contrary to Task Force recommendations.

It empowers a “comparative effectiveness board,” created by last year’s “stimulus” bill that will restrict providers’ decisions about what treatments are best for their patients.

In the end, Democrats tried to argue that their plan will not only solve rising health-care costs, it will reduce the budget as well. They manipulated government accountants at the Congressional Budget Office (CBO) in an attempt to make the laughable claim that they—not opponents of Obamacare—are the fiscally responsible ones.

But as Ronald Reagan used to say, you are entitled to your own opinions but not your own facts. And the fact is that when all spending is counted, CBO concludes that the Democratic health-care reform will increase health-care costs, not decrease them. Premiums for individuals will increase and costs for middle-class families will rise. Costs will rise even further by the increase in demand created by the law accompanied by the decrease in supply it will create. President Obama’s own Medicare actuary has estimated that about 15 percent of providers who rely on Medicare could leave the system under the plan.

And as for the Democrats’ claim of deficit reduction, it is about as trustworthy as their promise to cut health-care costs. Their health-care program will cost an astounding $2.6 trillion in its first full decade after the spending is fully implemented. And to make matters worse, the Democrats
deceitfully kick the can down the road when it comes to paying this enormous bill. Their plan leaves it to another president and another Congress to tax so-called “Cadillac” plans in 2018. Even more egregious, it contains a promise—a promise that Democrats were implicitly breaking even as they made it—to make $208 billion in future cuts to physician pay under Medicare. No one—and I mean no one—believed Congress would ever make such a cut. As writer Yuval Levin put it, “This is not fiscal responsibility; it’s not even naïveté or self-delusion. It’s just dishonesty.”

One of my heroes, the economist Milton Friedman, used to have a saying: “There’s no such thing as a free lunch.” What he meant is that nothing is free; someone, somewhere, always pays. Despite utopian marketing promises, government health care is not exempt from Friedman’s dictum. Far from it. It will raise costs, and someone, somewhere, will pay. By creating a new health-care entitlement while doing nothing to restrain health-care costs, let alone the needless overuse of medical facilities, Democratic health reform will inevitably lead to rationing of care and higher costs. There is no “free” health care just like there is no free lunch. Someone always pays. The American people understand without having to be told that this “someone” is them.

Of all the many misfortunes of the health-care debate, the greatest is that, from the beginning, there was a better way.

From the very beginning of the debate, Republicans and Democrats have put forward responsible health-care reform proposals that empower consumers—patients—instead of government. Proposals that slow the growth of health-care spending by inviting true choice and competition into the health care market—all while preserving a safety net for those Americans who truly need it.

At the onset of the debate, I joined with several colleagues in the House and Senate in offering The Patients’ Choice Act—a comprehensive reform proposal that provide access to quality, affordable coverage for all Americans. It starts by ending the tax discrimination against people who don’t get health insurance from their employer. Every respected economist—and every honest politician—knows that the tax exclusion for employer-provided health-coverage subsidizes insurance companies instead of health care, hides the true cost of coverage, and disproportionately favors the wealthy at the expense of the self-employed, the unemployed, and small businesses. The Patients’ Choice Act replaces the bias in the tax code with universal tax credits so that all Americans have the resources to purchase portable, affordable coverage that best suits their needs, with additional support provided for those with lower incomes.

Through a combination of tax credits, high-risk pools, transparency, regulatory reform, and information technology,
patient-centered reforms would foster a vibrant health-care marketplace. In stark contrast to the plan passed by the majority in Congress, my plan unapologetically seeks to apply our nation’s timeless principles—our Founders’ commitment to individual liberty, limited government, and free enterprise—to today’s challenges. It does so in a way that honors our historic commitment to strengthening the social safety net for those who need it most.

In stark contrast to the Democrats’ 2,700-page monstrosity, House Republicans put forward a number of commonsense alternatives focused on addressing the fundamental problem of costs. Republicans offered solutions allowing consumers to buy health insurance across state lines with an eye to the product and the price that is best for the individual consumer. House Republicans put forward what Democrats dare not do lest they jeopardize their number one source of campaign funding: it ends the gravy train of medical malpractice lawsuits for the trial lawyers. House Republicans set out a series of substantive but incremental steps that could be agreed to by bipartisan majorities. It fixes what is broken in our health-care system without breaking what is working.

All of these proposals were deliberately ignored by President Obama and the Democratic majority that controls Congress because they didn’t fit with their government-driven plan. In retrospect, it’s clear that the last year’s debate wasn’t about health care at all. It wasn’t about how to get a grip on costs, make quality care more accessible,
put patients back in control, or even how to address exclusions for preexisting conditions.

Instead, this was a debate about changing America. From the crude attacks on alternative visions like my Roadmap, to the gutter politics of the new Washington Way, the last year and a half has been about a group of men and women exploiting a crisis and seizing their moment to redefine the relationship between Americans and their government.

The weekend in March that the House voted on the health-care bill, thousands of Americans swarmed the Capitol, waving signs and making their voices heard. Every hour, one hundred thousand calls came in from across the country. The reason? Washington Democrats weren’t just in the process of changing America, they were in the process of changing the life of every American. Because in the end, health care isn’t about budgets and balance sheets, it’s about your life and your family’s lives, and how best to protect them. It’s the most intimate, most deeply personal part of our public policy. And there we were, debating whether the government—in the form of unelected bureaucrats in Washington DC—should have a bigger role in our most personal decisions.

This entire episode represented a tragic missed opportunity to tackle the fundamental problems in health care. Skyrocketing costs are driving more and more families and businesses to the brink of bankruptcy, leaving affordable coverage out of reach for millions of Americans, and
accelerating our path to fiscal ruin. This is the central challenge, and yet the congressional majority went about addressing it backward. They used the force of government to cover all Americans, and now they will have to figure out which screws to twist to contain costs. They went for this approach because their concern was never about costs. It was about expanding coverage through an expansion of government.

A bill may have passed, but the challenge of how to deal with the seemingly inexorable increase of health-care costs is one from which Eric, Kevin, and I will not shrink. We intend to continue advancing true patient-centered reforms like attaching tax benefits to the individual rather than the job, breaking down barriers to interstate competition, and promoting transparency and consumer-friendly coverage options.

We will continue to fight to ensure that health-care decisions are made by patients and their doctors, not by bureaucrats, whether at an insurance company or a government agency. By inviting market forces into health care, we can encourage a system where doctors, insurers, and hospitals compete against one another for the business of informed consumers.

We will continue this fight because it is a fight about the idea of America. Americans aren’t any particular nationality. And America isn’t just a landmass from Hawaii to Maine to Wisconsin to Florida. America is an idea. It’s the most pro-human idea ever conceived of by man—the
idea that our rights come from our Creator, not from government.

Americans today are being asked to subscribe to an ideology that is against the American idea. It’s an ideology that says that government creates rights—and government takes them away. This ideology rejects the goal of government as securing equal opportunity, it demands that government create equal results. It is an ideology that treats citizens like children and politicians like divinities. It is not an ideology that need prevail in American life. Not on our watch.

We can take being the Democrats’ whipping boys. We can take the attacks. What we can’t take is losing the timeless ideas that made this country history’s greatest experiment in freedom—and that will endure as long as Americans keep faith with those ideas.

CHAPTER FIVE
The Tipping Point
 
 

Before I came to Congress I spent some time at what Washington self-approvingly calls a “think tank.” I wrote speeches about the economy for true conservative heroes like Jack Kemp and Bill Bennett at Empower America. For the past four years in the House of Representatives, I’ve been the leading Republican on the Budget Committee. So I’ve looked at the numbers. And for as long as I have been studying the amount of tax dollars spent by the federal government versus the amount of revenue it takes in, it has been painfully clear that America is on an unsustainable fiscal path.

We’re rapidly approaching a point of no return; a tipping point after which we become a country most Americans have never dreamed we would be. If we keep spending like we’re spending, America will become a place
where unprecedented levels of debt overwhelm the budget, smother the economy, weaken our competitiveness in the twenty-first-century global economy, and threaten the survival of programs for the truly needy. Worse yet, we will become a culture in which self-reliance becomes a vice and dependency a virtue; a place where so many Americans are dependent upon government that our country comes to reject individual initiative, entrepreneurship, and opportunity that made us great.