Scott Garrett : First, Do No Harm

When doctors learn how to treat patients in medical school, one thing they are taught is the phrase: “first, do no harm.” This centuries old maxim is an expression of humility. It acknowledges that, despite the best intentions, our actions can carry unwanted consequences.

I was reminded of this last week when Speaker Nancy Pelosi and Congressman John Dingell introduced H.R. 3962, the Affordable Health Care for America Act. This 1,990page bill, proposes to accomplish, in one fell swoop, a drastic restructuring of our health care system. It is anything but a humble acknowledgement of the nation’s problems, with a modest set of solutions aimed at inspiring the ingenuity of the American people. Instead, it attempts to micromanage the nation’s health care sector from Washington, D.C., raises the cost of health insurance; ensures that third party insurers will continue to make health care decisions best made by a patient and their doctor; and further entrenches the nation’s finances down a course of fiscal ruin. It fails the test of “first, do no harm,” and should therefore be defeated.

Like all of my colleagues in the House of Representatives, I firmly believe that our health care system is in need of reform. The majority of the population obtains their health insurance through their employer (meaning they are at risk of losing it if they lose their job); it is too expensive, and costs are projected to go up; and a significant number of people have difficulty obtaining it because of chronic health problems. Health care spending also consumes a larger and larger percentage of the federal government’s budget each year, leaving less money for defense, infrastructure, or research. This too is projected to increase.

But the health care bill proposed by Congressional Democrats fails to address many of these problems. According to the preliminary report by the Congressional Budget Office (CBO), if H.R. 3962 were enacted, health insurance costs would actually become more expensive, and spending on health care by the federal government would increase. To pay for this increased federal spending, the bill proposes $743 Billion in new taxes, including a 5.4% surtax that would fall heavily on small businesses. The bill also proposes to drastically reduce the price controlled payment rates to Medicare providers without reforming the Medicare payment system; jeopardizing millions of seniors' access to health care providers.
If history is any guide, because of the artificial assumptions made in the bill, the long term cost of the bill will be much higher than advertised. In 1967, government actuaries estimated that Medicare would cost $12 Billion in 1990. The actual cost in 1990 was $110 Billion. When the Disproportionate Share Hospital (DSH) program was added to Medicaid in 1987, it was expected to cost $1 Billion in 1992. The actual cost in 1992 was $17 Billion.

But more important than the program’s cost is the effect that this bill would have on the practice of medicine. The bill mandates that everyone in America purchase health insurance, but would empower a “health choices commissioner” to decide which benefits are “essential benefits” in the mandated coverage. This would lead to an unfortunate politicization of the practice of medicine, wherein certain specialties are deemed “essential” while others are not. Additionally, it would cement in place the current third party payment system; where insurers, rather than patients working in consultation with their doctors, would set payment rates and make coverage decisions.

Proponents who would like to see an increased government role in health care would be wise to evaluate the government’s recent action with respect to flu vaccines. Reports that the military has already inoculated terrorists held at Guantanamo Bay with the seasonal flu vaccine when many Americans are having difficulty obtaining this vaccine for themselves is just one example of the type of politicized health care decision which could become commonplace under the new health care bureaucracy envisioned in this legislation.

I sincerely hope that in the coming days, the American public will come to understand that, while this legislation may have the best intentions, it would inflict much harm on the country. I have advocated a number of reforms, such as allowing interstate purchasing of insurance, real medical liability reform, and ending the tax discrimination against individuals who purchase health insurance independent of their employer, that could be implemented incrementally that would immediately begin to bring down the cost of health care and preserve the patient-doctor relationship. If we all agree on the principles that health care should be portable, affordable, sustainable, effective, and innovative, then I am confident that Congress can enact the targeted reforms that are necessary for the future of America.

Sincerely,

Scott Garrett
Member of Congress