After widespread disapproval of their 1,000-page proposal for government control of health care, congressional Democrats have responded by producing a 2,000-page bill that leaves many Americans wondering why these “reforms” seem oddly familiar to failed experiments already tried at the state level. Strange indeed is the fact that many states are working overtime to undo the damage wrought by earlier “reforms” that closely parallel the ones now being pushed in Washington.
Consider the evidence.
Soon after implementation of Tennessee’s TennCare program, a single-payer public health option launched in 1994, many employers dropped their employees’ private coverage benefit. As a result, 45 percent of new TennCare enrollees came from private plans, not from the uninsured. Within four years of TennCare’s creation, more than one-sixth of the Tennessee population was enrolled in TennCare, expanding the state’s cost to nearly one-third of its entire revenue. Tennessee’s experiment has done little other than present the United States with a clear warning that government-run health care is a costly endeavor that causes private employers to drop existing coverage and reduce the availability of a competitive private market for coverage.
Kentucky didn’t do much better with its mid-1990s reform attempt. The Bluegrass State set caps on insurance premiums, required a minimum level of coverage for all insurance packages sold in the state and implemented a community rating system that absorbed the cost of insuring patients with unhealthy habits into the general pool. Within three years of the first substantial reforms, 40 insurance companies left the state, leaving only two underwriters of individual private plans for more than 4 million people. Premiums skyrocketed for everybody, options decreased and a state with a 12 percent uninsured population ended up with 16 percent. Ten years later, most of the initial reforms have now been repealed. Former GOP state Rep. Mark Treesh concluded, “I think we tried to do the wrong thing too fast.”
The Empire State’s reform efforts have resulted in some of the highest costs in the nation. Each year, New York City residents pay an average of $9,000 for individual coverage and more than $26,000 for family coverage. This is in part because New York has 51 insurance mandates, some of which include podiatry coverage and hormone replacement therapy. Leading health care experts at both The Brookings Institution and The Heritage Foundation have concluded that the most expensive mandates increase insurance costs by as much as 20 percent. And yet the Democrats in Congress want Americans to believe that all their new mandates will actually reduce costs?
Massachusetts is fighting out-of-control cost increases despite having established an “exchange” — or state health insurance connector — similar to the one now included in one version of the Senate health bill. As originally designed for Massachusetts, the insurance connector was to be a marketplace for competition, but because the state sets unreasonably high coverage standards, there are few options and little competition. All of which, mind you, results in higher prices and less access to quality medical care. Because of the influx of newly covered individuals in the state, wait times to visit primary-care physicians can take more than 100 days in some rural areas. As predicted by those who oppose expanded government involvement in health care, Massachusetts is experiencing some of the worst health care rationing in the country.
For months, Democrats have been rejecting common-sense proposals for real health care reform that have worked on the state level. Texas, for instance, has drastically reduced the cost of health insurance by implementing serious tort reform that discourages frivolous lawsuits and excessive payouts. Furthermore, Utah has implemented a creative reform that allows for greater flexibility through defined-contribution plans, which increase options for employees and control costs for employers.
But these innovative solutions are nowhere to be found in the Democratic bills.
Rather, Democrats are hoping that failed experiments in expanding government control of health care at the state level will play out differently on the federal level. It might not fit Einstein’s definition of insanity — doing the same thing over and over again and expecting different results — but it doesn’t take a nuclear scientist to figure out that the Democrats’ plan suffers from a certain legislative delusion.
When Democrats propose unworkable ideological schemes that the American people reject, I’m ordinarily not concerned. This time, however, is different. If Democrats implement their political suicide pact through health care reform, innocent Americans struggling under an already difficult economy stand to suffer enormous harm that will reduce the quality of health care, drive private insurance out of business and add to an already exploding federal deficit.
Rep. Darrell Issa (R-Calif.) is the ranking member on the House Committee on Oversight and Government Reform.