Opinion: How Health Care Reform Will Succeed

(March 22) -- With Congress having passed comprehensive reform of America's health care system, we are at a historic crossroads, just as in 1935 when Congress voted to establish Social Security, and in 1965 when Congress created the Medicare program. Both of those programs were bitterly opposed by defenders of the status quo. But, in the end, a critical mass of senators and representatives voted their hopes, not their fears. They created programs that were giant steps forward for the health and economic security of the American people.

Today, we are poised to take another giant step forward. And, with the help of projections by the Congressional Budget Office, released March 18, we can predict where the Patient Protection and Affordable Care Act will take us in the months ahead and in the years that follow.

CBO confirms that the legislation fulfills President Barack Obama's pledge that health care reform must be fully paid for and not add a dime to the deficit. Indeed, our bill will reduce the deficit by more than $100 billion in its first decade, and by more than $1 trillion in the second decade.

Our bill will extend coverage to 95 percent of Americans. If you already have insurance and you're happy with it, you will be able to keep it. However, the bill will provide better insurance options. And CBO estimates that, thanks to the bill, premiums will be lower for the vast majority of Americans, including small businesses and the self-employed.

When President Obama signs this legislation into law, some of the benefits will kick in immediately. The bill:

• Cracks down on abuses by health insurance companies -- abuses that currently leave most Americans just one serious illness away from bankruptcy. Among other things, the bill extends coverage to those currently uninsured with pre-existing conditions, and eventually will ban outright the practice of denying coverage due to pre-existing conditions. It prohibits health insurers from excluding coverage of pre-existing conditions for children, stops insurers from canceling the policies of people who get sick, and ends discrimination against women, who now pay premiums up to 48 percent higher than premiums for men.
• Makes health insurance affordable for the middle class and small businesses -- the largest tax cut for health care in history -- reducing premiums and out-of-pocket costs.
• Improves Medicare benefits with lower prescription drug costs for those in the "doughnut hole," better chronic care, free preventive care, and nearly a decade more of solvency for Medicare.

In addition, our bill includes a truly transformational element: a broad array of provisions promoting wellness, prevention and public health. The aim is to jump-start America's transition from our current sick care system into a genuine health care system, one that is focused on keeping us healthy and out of the hospital in the first place.

To this end, at the clinical level, the bill requires reimbursement for proven, cost-effective preventive services such as cancer screenings, nutrition counseling and smoking-cessation programs. This means health professionals will be able to offer these services to you before you get diseases such as diabetes, cancer or emphysema.

For essential screenings and annual physicals, the bill gets rid of the co-pays and deductibles that currently discourage many people from doing the right things to stay healthy.

Our bill makes major new investments in community wellness and public health, and helps businesses large and small to create workplace wellness programs. It requires large chain restaurants to post basic nutrition information right on the menu, so consumers can make healthy choices.

Make no mistake, the Patient Protection and Affordable Care Act doesn't just tinker around the edges; it changes the paradigm. Our aim is to recreate America as a genuine wellness society focused on healthful lifestyles, good nutrition, physical activity and preventing the chronic diseases that take such a toll on our bodies and our budgets.

We can learn an important lesson from the history of Social Security and Medicare. Both of those programs were born amidst bitter debate pitting Democrats against Republicans, left against right. But, today, they are hugely successful programs that enjoy overwhelming bipartisan support.

I predict the same success and eventual bipartisan support for these long-overdue health reforms. We are going to create a reformed insurance and health care system that works not just for the healthy and the wealthy, but for all Americans.

Sen. Tom Harkin,D-Iowa, is chairman of the Senate Committee on Health, Education, Labor and Pensions.


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