Senator's Column by Mike Johanns

June 15, 2009 The Problems With Government Health Care Dear Nebraskans, Last week in this column, I presented some facts behind the statistics of the uninsured living in the U.S. I noted that of the 47 million currently without health insurance, there are 12 million who literally have no affordable health care options. I concluded that, before jumping to the rushed decision of overhauling the system, we should first focus on enrolling those who currently have access to an insurance plan, and lowering costs for those who don't. These problems would only be compounded by the expansion of a one-size-fits-all, government-run health care program. For decades, taxpayer-supported programs such as Medicare and Medicaid have provided valuable care to many Americans. Unfortunately, these programs are facing some difficult problems that also must be fixed. Just adding more citizens to these programs would do nothing to confront the problems, and indeed would make them worse. The strain on public health care has already begun to affect all Americans. Medicaid and Medicare currently reimburse doctors and hospitals between 20 and 40 percent below private insurance rates. To make up the difference, those with private plans are being charged more for everything from routine check-ups and co-pays to emergency surgeries. It is estimated that American families with private health coverage pay nearly $89 billion-or $1,800 more per family-just to cover the below-market rates of public programs. In 2004, Medicare's costs began to exceed the amount it was receiving in taxpayer dollars, and it is currently projected to go completely insolvent in 2017. Those enrolled in government health care are feeling the sting too, especially in rural areas. Many people are losing access to their preferred health care providers because an increasing amount of doctors and hospitals have stopped accepting new patients from public health programs. These providers simply can no longer afford to see Medicaid, Medicare, and SCHIP patients at a government discount. In turn, these patients face extreme difficulty finding a doctor as availability decreases. This problem is particularly worrisome in rural areas, where patients must travel long distances for both check-ups and emergencies. While no official Congressional projections have been finalized, it is expected that converting to a public health care system would cost between $1-1.5 trillion. Yet, no one has come forward with a plan for how to pay for such a systemic overhaul. More immediately pressing, we still have not determined how to prevent our current public programs, which already are indirectly subsidized by the private sector, from going bankrupt. These problems cannot be solved by simply creating another public program. It would be irresponsible to expand government's role in the health care system when we are not adequately addressing the current funding shortages. While we absolutely do need to reform our health care system, we must do so responsibly. Creating another unfunded, financially unaccountable government program is just not a common sense approach to this critical issue.