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Statement of Michael B. Enzi Senate Committee on Finance Hearing

 “Options for Expanding Health Insurance Coverage and Controlling Costs” February 25, 2009

Mr. Chairman, thank you for holding this hearing.  I look forward to working with the members of the Finance Committee and all members of the Senate to enact meaningful health care reform legislation. 

In order for us to enact health care reform, I believe there are four things Congress must do.  These include: providing relief to all Americans by implementing policies to decrease the cost of health care, changing our health care delivery system to one that focuses on health care rather than sick care, making sure we protect future generations by paying for health care reform, and ensuring we give all 100 members of the Senate the opportunity to debate openly and amend the proposal.  

Every American is feeling the pressure of increasing health care costs, and the single greatest challenge in reforming our health care system is rapidly escalating costs.  Last Friday, USA Today reported that many individuals who purchase their own health insurance faced double digit premium increases in 2008, with some plan premiums increasing by 20, 30 and in one case 56 percent.  These increases are not sustainable, and if we don’t address the problems driving this cost growth, more and more Americans will lose their health insurance. 

I believe the most important thing Congress can do to increase access to affordable, high-quality health insurance is to create an environment that forces private health insurance plans to develop innovative ways to control costs better and compete for our business.  The ability to choose among competing plans can drive down costs and produce better value, just like it has done in the Medicare Part D program. 

We should not adopt reforms that limit consumers’ choices or try to develop a federal one-size-fits-all approach that will stifle competition.  That also means that we cannot have public plans competing against private plans in any new health insurance benefit.  Medicaid and Medicare can impose price controls and shift costs to private plans, which gives them an inherently unfair advantage in any competition.  This will kill true competition and could ultimately lead to employers dropping employer-sponsored health insurance, which will impact the 160 million Americans that currently get their insurance through their job. 

We also need to change fundamentally the way we think about care in this country.  Right now, we think about sick care, not health care.  We only pay doctors and hospitals when we are sick and need services; we don’t pay them to keep us healthy.  Medicare has gotten us into this hole and every year we keep digging.  We need to stop digging and start climbing.  We can do that by changing the way Medicare pays doctors and hospitals.  CBO mentions some ideas in their two publications, and it is time for Congress to follow through.

Additionally, given the unfunded liabilities that already exist for Medicare and Medicaid, coupled with the recent massive increases in the federal deficit, it would be grossly irresponsible to discuss expanding health insurance spending unless we are also going to address how to pay for such expansions.  I have some ideas on how to pay for health care reform that I look forward to discussing with my fellow Committee members. 

Health care reform legislation will impact every single American in some way or another, and these critical issues deserve a full, open debate.  If we are really trying to get a bipartisan health care reform bill, we cannot do it through budget reconciliation.  To develop a truly bipartisan bill we will need a real bipartisan process.  Attempting to win the support of one or two Republican Senators at the very end of a process is not the way to build the broad consensus of support that we will need to make health care reform successful over the long term.

Mr. Chairman, I believe if we follow these four principles I outlined and if we use the information CBO has outlined, we can move forward on meaningful health care reform that benefits all Americans.  I thank you again for holding this hearing and I look forward to hearing the testimony of our witness.