Do Health Reform Right Instead Of Doing It Quickly

July 26, 2009|By Frank Kratovil

In his press conference last week focusing on health care reform, President Barack Obama stated, "If we do not control these costs, we will not be able to control our deficit." I could not agree with him more. Our economy is buckling under the weight of a health care system that has us spending nearly twice as much per capita than other industrialized countries. Health care already represents 17 percent of our gross domestic product, and that figure is projected to rise to 25 percent by 2025 if action is not taken. With our national debt now topping $11.6 trillion and growing at a rate of more than $1 trillion this year, we urgently need to pass comprehensive health care reform that expands coverage while bringing costs under control.

In the rural parts of our state, including much of the Eastern Shore, we face the added challenge of having to address a worsening shortage of qualified providers. Low insurance reimbursement rates and a flawed Medicare payment formula make it difficult for Shore communities to attract and retain skilled doctors and nurses. Even if health care reform eliminates the coverage gap, rural Marylanders will still have a tough time finding a doctor if these systemic flaws are not adequately addressed within the reform legislation.

The challenges facing lawmakers on all three of these fronts - coverage, cost and rural access - are considerable. After decades of debate, we now have what may be a short window to finally make progress by passing health care reform legislation that will put our nation back on a path toward fiscal stability and middle class prosperity. That means that Congress has a responsibility both to this generation and future generations to get it right.

That is why recent comments from Doug Elmendorf, director of the nonpartisan Congressional Budget Office (CBO), were so concerning. Mr. Elmendorf testified before a Senate panel that the legislation pending before the House would not adequately address the cost crisis, and would actually worsen our federal government's long-term fiscal outlook. While I agree with President Obama that skyrocketing costs and a lack of coverage signal a need to reform health care in our country, the CBO's findings cast legitimate doubts as to whether the legislation before the House will accomplish these shared goals.

At the very least, these questions about this bill's long-term fiscal implications should highlight the need to be deliberative and thorough in reviewing this health care reform legislation. We should not rush any plan through Congress that has not been properly vetted. The bill must be tweaked until neutral budget analysts confirm that it will sufficiently bend the cost curve to improve our fiscal outlook.

Members of Congress must then have the time to talk with local stakeholders - such as the health care providers on the Eastern Shore who are at the front lines of the rural access crisis - to judge whether it adequately address these regional concerns. Getting this right is more important than getting this done by an artificial deadline.

I realize that there are some in Congress who will oppose any type of reform, not based on merit but for purely political reasons. But for those of us who reject this obstructionism and are firmly committed to reforming our system the right way, it is imperative we spend the time to get this right. I have urged both the White House and Democratic congressional leaders to make sure we have enough time to thoroughly review any proposal before a vote. I believe that anything worth doing is worth doing right, and I will not support any legislative proposal until its full consequences for cost, coverage and rural access have been thoroughly examined.

Frank Kratovil represents Maryland's 1st District in the U.S. House of Representatives. He may be contacted through his Web site at

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