"Only a communist would talk as though health insurance and a college education ought to be available at a certain cost as a person's birthright. This is totalitarian collectivist nonsense at its worst. The United States is a constitutional republic. Kerry is running for office in the wrong country.” The Federalist 04-15 Digest

President George W. Bush would like to see all Americans have access to high quality and affordable health care. This is a noble goal. In a capitalist economy it’s reasonable to believe that this can be done through choice and competition. Capitalism promotes innovation, cost control, and more effective delivery of care.

Since we do not practice Communism or Socialism, it is not unreasonable to assume that the primary role of government should be to improve the health care market. The government should help the health care crisis by providing information, incentives to doctors and patients to make the best use of available resources, and address current regulations to ensure that they are serving their purpose. The government also can help those with low incomes and significant health care needs to participate in mainstream health care coverage.

The government presently tries to disseminate information by: providing consumer ratings of health plans and care; providing information about nursing homes; examining how information technology can improve safe patient care; promoting the use of bar coding for dispensing prescription drugs to reduce errors; developing voluntary standards to make the creation of an electronic health care record possible; examining model disease management programs; developing computer software that hospitals can use to identify quality problems; and assuring that recommendations for disease prevention are put into practice. The administration would like enactment of legislation to ensure that patient safety and quality reports are protected and not made available for trial lawyers to exploit in order to find new opportunities for litigation.

Bush’s approach to "treating” current health care practices is particularly noteworthy in that it tries not to impose more government on the industry nor incur significant costs to the health care industry or the patients, and limits a larger burden on the taxpayers. He has committed up to $400 billion over the next ten years in his FY 2004 budget to modernize and improve Medicare. This is compared to Kerry’s health plan, which is estimated would cost an average of $70 billion annually for the first five years, to be paid for by canceling some of the Bush tax cuts that specifically benefit the wealthy.

Our President firmly believes that patients should have a choice in and pick which health plan gives the best possible value. This is called patient centered health care because it makes the patient the primary decision maker and puts the patients’ needs first.

The President took office suggesting that there should be protection of employer sponsored health insurance and strengthened coverage of these policies with improved medical savings accounts, or health accounts. He urged that these accounts to be widely available to bring down high deductible limits and eliminate some restrictions on coverage which are in these plans. Basic and preventive care wouldn’t count against the deductible. Recently, President Bush signed legislation authorizing the creation of Health Savings Accounts (HSAs) which are tax-free savings accounts for medical expenses that allow more small-business owners to obtain affordable health coverage for themselves and their employees. Any taxpayer with a high-deductible insurance plan can contribute up to $2,600 a year ($5,150 for families) into an HSA account. The new law allows both employers and employees to contribute to these accounts. This became effective Jan. 1, 2004.

People shouldn’t be penalized for picking a health plan with doctors outside of a network of care. Currently, PPOs usually have significant out of pocket expenses that are not tax deductible. President Bush believes that flexible spending accounts should be rolled over to some extent rather than continuing the current "use it or lose it” practice, where the money has to be spent by the end of the year. Changes to Flexible Spending Accounts (FSA) would allow employees to keep any unspent balances at year's end and tax credits.

Many people are not holders of employer sponsored insurance plans. This administration wants to issue a fully refundable health insurance tax credit which can be used at the time of purchasing insurance to lower the month to month premium. Over 60% of the 41 million uninsured Americans are small business owners, their dependents or their employees and dependents.

For small businesses there should be a purchasing pool set up by the states to provide competing health insurance plans. In several states, small business owners have only one or two insurance companies from which to choose. Through an Association Health Plan (AHP), legislation would allow small business owners to band together across state lines to purchase health insurance as a group. Small business owners and employees would benefit from the same economies of scale, purchasing clout and administrative efficiencies that their big business counterparts already enjoy. The AHP would result in lower health care costs and new coverage options for the working uninsured, whose only current choices are the high-priced, over-regulated plans that may exist in their individual states.

Current political debate centers on two pressing concerns; one of which is the availability for purchase over the internet, of drugs from Canada. Democrats have made this a high profile issue in their campaign to win back the White House. The most pressing reason for our current administration not to endorse making Canadian drugs available to American consumers is because Canada imports drugs from countries that do not have the same strict rules and regulations regarding inspections of pharmacies and factories as the U.S. and Canada. Experts are often unable to distinguish a safe and effective pill from a counterfeit pill, contaminated, or expired pill.

There are other more complicated issues at stake with regard to importation. In my opinion, the most important of these is that importation reduces investment in discovering and testing new drugs because the low cost to manufacture pills offsets the costs of research. Patents are necessary to keep competitors from producing inexpensive knock-offs, allowing drug companies time to recover their initial outlay. Medicare reform legislation signed by President Bush last December might reduce AARP interest in drug importation.

Excesses in litigation contribute to doctors practicing defensive medicine; the costly use of medical treatments, to avoid litigation. Many doctors have given up practice, or limited their practices to patients without health conditions conducive to litigation risk, or moved to a state with a fairer legal system and where insurance can be obtained at a lower rate. Excessive litigation raises the cost of health care and impedes efforts to improve quality of care.

The President supports federal reforms in medical liability law which would help patients injured by negligence get quicker, unlimited compensation for their economic losses, ensure that non economic damages could not exceed $250,000, awards punitive damages only when there is clear and convincing proof that there was malicious intent or deliberate failure to avoid unnecessary injury to the patient, awards which would not be in excess of two times the economic damages or $250,000. Payment for damages can be awarded over time. Old cases cannot be brought years after an event. The jury may be informed if the plaintiff has another source of payment for the injury, such as health insurance, and defendants pay any judgment in proportion to their fault, not on how much money they possess.

The current administration isn’t trying to extend the federal government’s authority over the health care industry. The President follows Republican philosophy which is to promote a capitalist economy with minimal government interference. The Bush administration is working with existing programs to make them more cost effective, efficient, and competitive. This gives the consumer greater choice and better medical care, something that socialized medicine can never achieve. This is why when people get sick they seek care in the United States.

Confronting the New Health Care Crisis: Improving Health Care Quality and Lowering Costs By Fixing Our Medical Liability System
http://aspe.hhs.gov/daltcp/reports/litrefm.htm

HealthCare Crisis: Who’s At Risk?
http://www.pbs.org/healthcarecrisis 

NFIB The Voice Of Small Business
http://www.nfib.com/cgi-bin/NFIB.dll/jsp/issues/advocacyIssueDisplay.jsp?categoryId=-8003&clickType=Federal

Tax Credits and Purchasing Pools: Will This Marriage Work?
http://www.hschange.org/CONTENT/306/#brief2

The Health Care Crisis: The President’s Plan For High-Quality, Affordable Care
www.heritage.org/research/healthcare/hl768.cfm

The Pros and Cons of Importing Drugs from Canada
http://www.heartland.org/PrinterFriendly.cfm?theType=artId&theID=14824

2004 Presidential Candidates’ Positions on Health-Care Issues
http://www.aafp.org/x22202.xml?printxml

Nancy Salvato is a middle school teacher in Illinois and an independent contractor for Prism Educational Consulting. She is the Educational Liaison to IL Sen. Ray Soden and she works with national and local organizations furthering the cause of Civic Education. She is a columnist for American Daily, The Common Voice, GOP-USA, OpinionEditorials and The New Media Journal.us. Her writing has been recognized by the US Secretary of Education. She has been published in The Washington Times, The Washington Dispatch, Iconoclast, Free Republic Network & Townhall.com., as well as other nationally and internationally published media outlets.