Skip to content

As the 110th Congress concludes, one of its most glaring failures will be the Majority party’s unwillingness to take adequate action to address skyrocketing health care costs and the growing number of Americans without health insurance.  Although we took some small steps, I wish we’d done much more this year to reduce health care costs, expand access, and improve quality.  Unfortunately, the Democratic Leadership did not bring one comprehensive health care reform bill to the Senate floor for debate, let alone a vote.

I hope that the next Congress will not be paralyzed by the same inaction that characterized the 110th Congress.  I hope the Majority Leadership next year learns from the mistakes of this year and abandons the “my way or the highway approach” that has yielded so few results for the American people.

The fact is, if Congress is going to pass meaningful, comprehensive health care legislation, both sides will need to set partisanship aside and work together on a solution.  Republicans and Democrats in the House and Senate will need to work cooperatively with the next President to find and build upon areas of agreement.  Both sides will need to focus on reaching solutions for the American people, not scoring political points. 

Health care costs are too high.  Too many Americans are uninsured or underinsured.  Too many small businesses are forced to drop health insurance benefits for their employees in order to stay in business.  We need real solutions and we cannot afford to wait.

Some say the best way to make sure that every American has health care is for the government to collect even higher taxes and then run the U.S. health care system like Cuba does.  The government would tell doctors how much they could earn, it would tell you which doctors you could see, and a bureaucrat in Washington – not you and your doctor – would decide which services and procedures you could receive. 

I think this is the wrong approach.  The answer isn’t for the government to take more of the people’s money to pay for Washington-run health care.  The answer is to reduce health care costs through substantial reforms, and then let you keep more of the money you earn so you can choose the health care plan you want and need.

Combining standard tax deductions for most Americans who purchase health insurance with tax subsidies for low-income Americans will help everyone afford health insurance.  We need to reform our flawed, unfair tax code so that individuals who do not receive insurance through their employer can purchase it without being penalized by the IRS.  If you work hard to provide a living for yourself and your family, the government should make it easier – not harder! – for you to afford health insurance. 

No one should be stuck in a job they hate because they’re afraid that if they take a better job, they will lose their health insurance.  Yet millions of Americans face this “job-lock” dilemma.  By allowing you to take your health coverage from job to job, we would provide the kind of security families need.
It’s a fact that small businesses have been hit hardest by the rising cost of health insurance. Small business owners and working Americans should have the flexibility to pool their members across state lines, and even across the country, and use their combined purchasing power to negotiate affordable health care options. Why not provide this kind of flexibility and allow small business owners and their employees to choose the plan that best suits their needs?

To help bring quality health care within reach of working families, we need to make significant steps to reduce the costs of health services.  Two obvious ways to do that: promoting hassle-free electronic medical records with better use of health information technology, and enacting medical malpractice reform to keep malpractice insurance rates in check. 

But if we are serious about reducing medical costs across the board, then the most critical step we must take is to move our system from one that provides sick care to one that provides health care. We need a plan for an innovative system that will do more to help Americans prevent and manage chronic illness, so that they can live healthy lives with fewer medical costs. Prevention is the key to wrangling health care costs and helping Americans live longer, healthier lives.  As Ben Franklin said, an ounce of prevention is worth a pound of cure.

All of these practical reforms are included in a bill I have already introduced in the Senate called 10 Steps to Transform Health Care in America.  My 10 Steps bill will reduce costs and expand access so that every American can afford health insurance for themselves and their families. I would encourage readers to go to my website ( to learn more about each of these steps.

The Senate did act on one of my steps this year, by approving a bill to reauthorize Community Health Center programs and improve access to quality health care in rural and underserved areas.  We also passed a law to prohibit health insurers and employers from using genetic information to discriminate against persons with potential health problems, changes that will save lives and reduce health care costs by encouraging individuals to take advantage of life-saving genetic screening, counseling, testing, and new medical therapies. 

We accomplished this by working cooperatively across the aisle, and I hope next year’s Congress will follow this pattern of success.  If it does, we could enact any of my ten sensible, patient-centered proposals.

I am hopeful that in the next year we can move from talking about problems with our healthcare system to solving problems by working across party lines on 10 Steps and other reasonable plans to provide comprehensive health care reform.  As working families already know, we cannot afford to wait any longer.

Senator Enzi is the Ranking Republican on the Senate Committee on Health, Education, Labor & Pensions, and is the senior Senator from Wyoming.