Congressman's Column by Adrian Smith

Government Takeover Not Good For Rural Health Care As anyone from Western Nebraska can tell you, there are many differences between urban and rural areas. Rural Americans face challenges completely unknown to folks from the big cities, and vice versa. In particular, rural Americans face health care tests unique to our geography. Per capita, rural populations are older and face specific health care concerns. When the distance to the nearest town from a farm or ranch can be measured in miles, access to care can be an even greater crisis. All Americans need access to quality health care regardless of where they choose to live. However, fewer and fewer are able to afford this care because of the rising costs of medical care and health insurance. Significant reform is needed to lower the costs of health care services and private insurance. As the health care reform debate begins in Congress, some lawmakers are pushing a one-size-fits-all government takeover approach to health care. I have severe concerns over this proposal, and I am not convinced a plan of this sort would reduce escalating costs. In fact, I am concerned such an approach would jeopardize quality. Proposals often sold as "free health care" in reality must be paid for through increased taxes or spending cuts in other areas. If it sounds too good to be true, it probably is. The truth of the matter is the non-partisan Congressional Budget Office estimates the Majority party's health care plan could cost in the neighborhood of $1.5 trillion over 10 years, and to pay for it they want to cut Medicare by $500 billion. This is unacceptable. We stand at an important crossroads when it comes to health care. Most would agree our current health care system requires reform to reduce costs. But I don't think the solution lies in having the government takeover your health care. I have long held a plan which will let patients and doctors - not Washington bureaucrats - make critical and personal decisions about their own health care is the proper direction to take this debate. Our focus should be on ensuring Americans who are happy with their health care plan can keep it instead of adopting a plan which would force as many as 114 million Americans to lose their current coverage. That's right - despite the President's claims, experts expect nearly 60 percent of Americans who are currently insured to be forced into the government's plan. Instead of going down this path, I recommend a more common sense approach. For instance, we should explore adjusting Medicare reimbursement levels to ensure rural health care providers are receiving payments equal to their urban counterparts. To this end, I have introduced the Medicare Equity and Accessibility Act, legislation designed to increase access to health care in rural communities by ensuring rural doctors receive a more equitable share of Medicare funds. Medicare law specifies a formula for calculating the annual update in payments for physicians' services, which discriminates against areas which are thought to have lower costs of living, such as rural states. This formula, then, effectively guarantees physicians in rural states receive reimbursements at a lower rate. Unless a fix is enacted, payments to medical professionals in rural areas will drop significantly in 2010, dramatically impacting care. My legislation aims to make sure that never happens. Competition and individual incentive always have led to greater cost control, efficiency, and effectiveness. Adopting a government takeover of health care would offer fewer options and less patient flexibility. Only a true exchange of ideas and a real debate on the different health care proposals will bring about the change needed.