Health Care:
Today, many Americans have some of the best health care in the world while working Americans are increasingly unable to afford adequate medical care at all. Americans face double-digit growth in premium rates, growing gaps in what insurers will cover, and soaring prescription drug prices. Employers, for whom health care costs are one of the largest uncontrolled business expenses, increasingly must reduce the quality of coverage they offer, or decline to offer coverage at all. It should come as no surprise, then, that the number of uninsured Americans has grown by 6 million in just five years to reach its present level of 46 million. Fully 80 percent of the uninsured are in working families.
The end result of all this, of course, is that more and more families cannot afford adequate health care. According to a research report by the Center for Applied Rural Innovation, nearly a third of Nebraskans skipped medical care during the past year because they didn't think they would be able to afford it. The same number reported having difficulty paying for medical services they did receive.
Nationally, a study by the Kaiser Family Foundation and the Harvard School of Public Health estimated that 62 percent of those who couldn't afford the medical care they needed in 2004 actually did have health insurance. In other words, health care costs have gone up so much that health insurance can no longer do what it was designed to do: guarantee that you will be able to afford the care you need when you need it.
Clearly, our health care system is sick. And politics as usual won't cure it.
I supported the bill that offered additional prescription drug coverage for our elders, because it was unacceptable to me to hear of elderly in our Nebraskan communities who had to choose between medicine and food. But, as most people I talk to realize, that prescription program does nothing to address the basic problem at the heart of the American health care crisis: out of control costs. We must reform this law so that it does help control costs. We must allow government to use its leverage to negotiate reductions in the exorbitant costs of prescription drugs.
But even once we've done that, we are only dealing with the tip of the iceberg. Drug costs account for just a little more than 10 percent of health care costs today. Hospital care, on the other hand, accounts for one third of health care costs. And hospital spending is on the rise: In 2004 alone, hospital spending increased 11.3 percent for outpatient care and 6.2 percent for inpatient care. This leads to higher premiums. And higher premiums, year-after-year, force more and more Americans to go without health insurance.
In Nebraska today, it is estimated that 10 percent of the state population is uninsured. And all indications are that the situation is getting worse rather than better. Among rural Nebraskans aged 19 to 29, 18 percent reported not having health insurance in 2004.
Dealing with this national challenge begins by acknowledging that there is a crisis. And dealing with this crisis begins with being willing to lead. We all know what needs to be done. In fact, there is hardly a person I've talked to about health care in this state who couldn't rattle off in thirty seconds or less exactly what must happen to save the American health care system: we must lower the costs of health care, we must make Medicare fiscally sound, and we must increase the number of Americans with health care coverage.
Nebraskans understand that if you increase the access to preventive health care for thousands of Americans, then you will reduce the costs of hospital care by tens of millions of dollars. As one doctor friend explained it to me, if a man takes a pill to control high blood pressure, then he won't have to be treated for a stroke in the emergency room. And so we must support expansion of the Children's Health Insurance Program, which would help 5.3 million uninsured parents gain access to insurance and lower prices for healthcare services. We must support the use of tax credits and purchasing associations to help small and medium size companies provide more - and better - coverage to their employees.
Nebraskans also understand, from their own experiences in doctors' waiting rooms, that health care costs are inflated by the terrible inefficiencies built into the system at all levels. As one woman put it to me, "Why is it that banks in this country can reduce transaction costs to pennies on the dollar while, at the doctor's office, administrative costs still account for 25 percent of the bills we must pay?" We must introduce competition to the medical industry, so patients have the opportunity to search for the lowest cost provider of a particular service.
There is a way. It is up to us to summon the will.