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Floor Speech of Senator Mike Enzi on the health care decision of the Supreme Court

After Supreme Court decision, Congress must learn from its mistakes

June 28, 2012

Mr. President, it is disappointing that the Supreme Court has upheld the Constitutionality of the new health care law. Just because it is Constitutional, does not mean it is good policy. And just because the Court upheld the law does not change the fact that the American people have overwhelming concerns about it.

In fact, the Court affirmed that the new health care law is a massive tax increase on the American people. Congress must get serious about fixing our broken health care system. We can start by changing this misguided health care law that has divided the American people and failed to address rising health care costs. Congress should work together to make common-sense, step-by-step health reforms that can truly lower the cost of health care. I was pleased to see that the Supreme Court narrowed the Medicaid expansions because states cannot afford them. Hardworking Americans are still struggling in this anemic economy and need real action to make health care more affordable.

Reforms do not have to start here in Washington. Our nation’s states are laboratories of democracy and can play a significant role in addressing the health care crisis in America. Governors are in a special position to understand the unique problems facing their states and fixing health care, like most problems facing our nation, cannot be a one-size-fits-all solution. Efforts underway by Indiana Governor Mitch Daniels provide a great example of what different states are working on. He is moving forward with the “Healthy Indiana” initiative, which is an affordable insurance program for uninsured state adults aged 19 to 64.

Outside Washington, some health insurance companies have already stated that they will adopt several reasonable provisions to lower health care costs. These include allowing young adults to be covered until age 26 while on a parent’s plan, not charging patients co-pays for certain care, not imposing lifetime limits and not implementing retroactive cancellation of health care coverage.

One of the most effective ways Congress can address the rising costs of health care is to focus on the way it is delivered as part of the nation’s current cost-driven and ineffective patient care system. America’s broken fee-for-service structure is driving our nation’s health care system further downward and tackling this issue is a good start to reigning in rising health care costs. This method of payment encourages providers to see as many patients and prescribe as many treatments as possible, but does nothing to reward providers who keep patients healthy. These misaligned incentives drive up costs and hurt patient care.

The new health care law championed by President Obama and Congressional Democrats did very little to address these problems. The legislation instead relied on a massive expansion of the unsustainable government price controls found in fee-for-service Medicare. If we want to address the threat posed by out of control entitlement spending, we need to restructure Medicare, to better align incentives for providers and beneficiaries. This will not only lower health care costs, it will also improve the quality of care for millions of Americans.

Shifting the health care delivery system from one that pays and delivers services based on volume to one that pays and delivers services based on value is an idea that unites both Republicans and Democrats. There are a number of simple steps that can be taken immediately as Congress weighs the larger fixes needed for Medicare.

We can encourage insurers to offer plans that focus on delivering health care services by reducing copays for high-value services and increasing copays for low-value or excessive services. Consumer-directed health plans provide another avenue for linking financial and delivery system incentives, and have the potential to reduce health care spending by $57 billion per year. Bundled payments will support more efficient and integrated care. All of these options have already been utilized by a number of private sector firms with great success. The federal government should be willing to support viable reforms where it is needed, but also refrain from handcuffing innovative private sector designs with excessive regulations or narrow political interests.

Our nation has made great strides in improving the quality of life for all Americans, and we need to remember that every major legislative initiative that has helped transform our country was forged in the spirit of compromise and cooperation. These qualities are essential to the success and longevity of crucial programs such as Medicare and Medicaid. But when it comes to health care decisions being made in Washington lately, the only thing the government is doing well is increasing partisanship and legislative gridlock.

As I conclude today, I would like to leave the Senate with some words of wisdom from one of our departed members – Senator Daniel Patrick Moynihan from New York. He said in 2001, shortly before he retired: “Never pass major legislation that affects most Americans without real bipartisan support. It opens the door to all kinds of political trouble.”

Senator Moynihan correctly noted that the party that didn’t vote for it will criticize the resulting program whenever things go wrong. More importantly, he predicted the measure’s very legitimacy will be constantly questioned by a large segment of the population, who will never accept it unless it is shown to be a huge success.

Truer words were never spoken – we have seen each of these scenarios play out over the past two years as the new health care law polarized the nation. I hope this distinguished body has the courage to learn from our mistakes, because our nation still needs health care reform. But it has to be done the right way.

Providing Americans with access to high quality, affordable health care is something I am confident both Democrats and Republicans should be able to agree upon.