Consider for a moment all of the teachers, policemen, firemen, soldiers, veterans and municipal employees making a government paycheck. Think of all the people working in city halls, statehouses and federal buildings in Washington. These people are all government employees, and just as their salaries are paid with taxpayer funds, their health care premiums are also paid out of the public purse.

In this way, the public sector already provides good health care to workers and their families – as well as all our seniors and the disabled every year through Medicare. And this public sector insurance (like Medicare and military health care) and hundreds of state and local government agreements with private insurers accounted for 46 percent of America's total health spending in 2007.

If citizens are already footing half the bill for the good health care provided by the public sector to public employees and seniors, shouldn't they have this kind of opportunity as well if they choose? And if instead they want to keep private insurance, at the very least they should be given greater power to weigh in on their own coverage - on both the cost they pay and the quality of care that they receive.

 

Reign in costs
First, we need to acknowledge that it is time that Congress and the President reign in health care costs and hold health insurance companies and pharmaceutical companies accountable to the people they're supposed to serve. Burgeoning health care costs continue to reel in more of Americans' paychecks. Over the last nine years, health insurance premiums have grown at three times the rate of wages. People are having to choose between filling their prescriptions at the pharmacy and filling their cars with gasoline. The exponential growth in health care prices is not going to end any time soon. Per capita medical costs are expected to rise 71 percent over the next decade.

It's a well-known fact that America spends more money than any other nation on health care, but Americans are actually less healthy than citizens of other countries. It seems only natural to ask where all of that money is going if Americans are not any healthier for it?

It's time that we demand more from insurance companies and find ways to ensure that hard-earned taxpayer dollars are going toward the provision of quality and cost-effective care. The public option will be a system that seeks to contain costs, but provides the type of important, medically-necessary treatments that people desperately need. The public option will not force a government takeover of health insurance. On the contrary, with a focus on keeping Americans healthy - not increasing profits - the public plan will give a healthy dose of competition to private insurers.

I have heard some expressing concern that under health reform, they believe that they would see rationing of care. But it is time that we wake up and realize that our care is already being rationed by insurance companies whose primary interest is their bottom line. These companies are in business to make money for stockholders, and so naturally they make decisions that oftentimes deliver healthy profits, but not always healthy patients. We hear the President talk about people he's heard from with terminal illnesses, who spend their dying days fighting with insurance companies that have denied them life-saving procedures. This type of rationing absolutely must end.

When insurance companies first started denying legitimate claims, Americans weren't in a position to ask why. They could not ask why when these same insurance companies started charging higher premiums based on gender, health history or occupation. When monthly premiums started to skyrocket and co-pays increased, those who could afford to pay higher prices begrudgingly kept forking over more of their salaries. Those who couldn't pay had to give up their access to care. We've had a system that has rationed care for decades - those of modest means have had to go without as costs kept rising.

If we do nothing, this disparity will continue to grow as more of the "haves" join the ranks of the "have nots."

 

Help small businesses
Foes of health care reform recite the plight of small businesses under the proposed legislation. But, already, small businesses are paying 18 percent more per worker for health insurance than large firms. In this faltering economy, there is no way that these small employers will be able to keep pace with the growth in health spending that is projected over the next decade.

Health care reform will not affect those Americans who currently have health insurance and like the coverage they have. Those people will be able to keep their doctors, dentists and pharmacists. However, these Americans are more likely to eventually face real adverse changes if we do nothing and allow health care prices to continue to soar. The oft-cited 46 million without coverage now is certain to grow as individuals can no longer afford their premiums and co-pays, large firms go belly-up and small firms have to shut their doors because the cost of health care has driven them out of business.

Equally important to ensuring that America is getting its money's worth on health care is the creation of the Health Insurance Exchange, an open marketplace where the public plan and private insurance companies can compete for individuals and small businesses looking to purchase insurance.

The Exchange will clearly lay out the competing benefits offered by each policy, as well as their costs. This will enable consumers to "comparison shop," and the increased ability of consumers to shop around will incentivize private insurance companies to ensure their policies are about maximizing health outcomes, not just their bottom line.  With easily-accessible information, consumers will be allowed to choose the plan that works best for themselves, their families and their businesses.

This is the type of change we need - a change that empowers consumers and small businesses and puts a healthy America ahead of the interests of big insurance firms and pharmaceutical companies.

 

U.S. Rep. Gwen Moore (D-Milwaukee) represents Wisconsin's 4th Congressional District.