WASHINGTON – Sen. Tom Carper (D-Del.) voted in support of major health care reform legislation that passed out of the Senate Finance Committee today and will move to full Senate consideration in the coming weeks.
Below is the final statement Sen. Carper delivered in the Senate Finance Committee today:
I want to commend Chairman Baucus on the work he has done on this bill.
I believe that with the passage of this bill, we will begin to transform the health care system that costs more than any on earth, does not provide better outcomes, results in 14,000 people losing coverage every day, leaves over 40 million people without coverage, and puts American companies at an enormous competitive disadvantage with their business rivals around the world.
There are many facets of health reform that are necessary and integral in adopting sound health reform policy, but I want to make reference to three today that have been major priorities for me.
- One is reining in the growth of health care costs;
- Two is moving away from fee for service; and
- Three is encouraging wellness and incentivizing healthy behaviors.
I believe that July 16, 2009 was a game changer in the debate on health care reform. On that date, Senator Conrad, as Chairman of the Budget Committee, asked CBO Director Doug Elmendorf if any of the health care reform bills up to that point reined in the growth of health care costs.
Dr. Elmendorf replied NO and then went on to say that the health care bills up to that point significantly expanded the federal responsibility for health care costs.
On that day in July, we did not yet have a Finance Committee package to look to. We now have a Finance Committee package, and we have heard back from CBO on our Finance package:
- Our package would expand health insurance coverage to 94 percent of Americans—up from 83 percent currently.
- Our package as a whole costs $829 billion over the next ten years, significantly lower than the other reform proposals in Congress.
- Our package is not only completely paid for, but provides for a net surplus of $81 billion over the next 10 years.
- And last but not least, our package would reduce our federal budget deficit in the second ten years by up to $800 billion.
I have made it very clear that I will not vote for a bill that increases our national debt and does not rein in the growth of health care costs.
Over the last several months, I have become convinced that one key piece of reforming our health care system is moving away from our current payment structure of fee for service.
This current payment structure of paying health providers for each health service they give stifles collaboration and suppresses efficient care management in many instances.
During my visit to Cleveland Clinic—a non-profit health care delivery system that has moved away from fee for service and now pays its doctors a salary—I saw first-hand what can be accomplished when we move away from fee for service and create a patient centered model of care that focuses on primary care, prevention and wellness, managing chronic diseases, and harnessing information technology for the delivery of health care.
Although we can do more, our Finance bill takes a number of important first steps in moving away from our current payment structure.
One of the provisions in our Finance package that many of us believe can be a game changer in this regard is the creation of the CMS Innovation Center.
The Innovation Center’s purpose will be to test, evaluate, and expand different payment structures and models which aim to foster patient-centered care and improve quality.
In addition to reining in the growth of health care costs and moving away from fee for service, I believe that encouraging wellness and incentivizing healthy behaviors are critical to reform.
We know that if we incentivize people to take better care of themselves, we can rein in the growth of our health care costs, as well.
Recent findings have shown us that the biggest factor contributing to most people’s health status is their behavior.
Roughly 40 percent of our health status is a direct result of our choices about food and physical activity. Another 20 percent is a direct result of social and physical environments, such as our homes and places of work.
That means for most people, the way we eat, drink and exercise, as well as our work and home environments, shape as much as 60 percent of our underlying health status.
I was pleased during our markup that Senator Ensign and I were able to work together to fashion a bipartisan amendment that will better enable employers to incentivize employees to address some of the major causes of poor health that lead to higher health care costs.
None of us is suggesting that our committee’s proposal is perfect, but I do believe it represents an important next step.
And today, I hope that we will report out of committee a Finance package that will provide us the foundation as we move forward to merge the health care bills in the Senate.
The American people are counting on us. We cannot afford to let them down.