Sens. Coburn and Wyden find much to agree upon

Speaking via satellite to the “America’s Health Care at Risk: Finding a cure” conference in Orlando, Fla., Republican

Sen. Tom A. Coburn, MD, of Oklahoma, and Oregon’s Democratic Sen. Ron Wyden focused on prevention and portability issues in discussing healthcare reform.

A prevention paradigm
According to Sen. Coburn, Congress would do well to apply certain rules of medicine to any attempt at reforming the healthcare system: Do no harm and listen to the patients. His own proposal, the Universal Health Care Choice and Access Act (S. 1019), promotes health and disease prevention under a national strategic plan. It also provides a refundable tax credit for health insurance costs and provides for the sale of health insurance across state lines.

The healthcare system, stated Sen. Coburn, needs to move to a “prevention paradigm.” Although about $30 billion each year is spent on prevention, little return is seen on that investment. With 55 percent of all healthcare expenditures focused on the care of five chronic diseases and a projected shortage of 225,000 physicians by 2018, he urged insurers to begin paying physicians to teach patients wellness and prevention strategies.

Portability of plans
Sen. Wyden explained key points of his Healthy Americans Act (S.334), which he said enjoys strong bipartisan support. These include complete portability of healthcare plans, so that workers can take their insurance with them when they change employers, and a revamp of the tax code.

He also called for change in the current “inhumane insurance model.” Under his proposal, private insurers would be forced to compete on the basis of price, benefit, and quality and would be prevented from discriminating against patients deemed to be undesirable risks.

How much government?
Although Sen. Coburn professed to be “80 percent” in agreement with the main points of Sen. Wyden’s healthcare plan, he also stated that it proposes too much government involvement at the expense of freedom of choice.

“A good portion of the problem we have today is because the private sector is now starting to model Medicare,” he said.

Sen. Wyden argued that the issue is not the size of government’s role, but whether the government is appropriately targeting funds where they are needed.

“America has a mandate for health care,” he said. “Every hospital that gets federal funds has to see people. That’s a federal mandate. It sees them, however, in the hospital emergency room, in the most expensive end of the healthcare system.”

He suggested reshaping the government’s role to make health care accessible to those who can’t afford it, by emphasizing wellness and outpatient care.

Peter Pollack is a staff writer for AAOS Now. He can be reached at ppollack@aaos.org