Healthcare: A Public-Private Union?

Rep. Marsha Blackburn (R.-Tenn.) spoke about “The Future of Employer-Provided Healthcare” at the Heritage Foundation on Tuesday, emphasizing the need to increase access to healthcare while avoiding an entirely federally mandated system.

Blackburn, who serves on the House Energy and Commerce Committee, began by pointing out that, aside from the economy, “Healthcare and energy are at the top of domestic concerns.”

She said that reforms need to be made in the healthcare system and that “government has a role to play in terms of access.” She put forth that a “systematic overhaul” of the current scheme is necessary.

At the same time, she noted that paths have diverged: There are those who want strict government oversight and those who are more skeptical of state control. But “with Congress’s foot on the accelerator,” in terms of passing healthcare legislation, government control is moving at an alarming pace. This urgency defies the “patient-centered, consumer-driven” access, control, management, etc. that many others envision.

She was critical of the Senate’s myopia, noting that their proposed “pay for play” system strives to raise $300 billion over the next 10 years, but is hazy in terms of describing how these funds will be paid and who will be left with the burden. She opined that ultimately costs will fall on employers — especially on small businesses — while larger corporations are “allowed” to join in the exchange of these mass of funds.

As an example of the ineffectiveness of a central healthcare system, she used Tennessee’s localized Medicaid system “TennCare,” which was issued in 1994.

“If TennCare was a drug, the FDA would not allow it,” she joked.

With TennCare, Tennessee offered a public option (HMO) to cover children and the uninsured.

Costs exploded.

In 1994, state spending ballooned from $2.5 billion to $8 billion, consuming every dollar of new revenue generated by Tennessee. Accordingly, the costs of TennCare grew at a rate of 15% per year.

Yet TennCare had even more unforeseen consequences.

While 55% of those using TennCare previously had no insurance, many of its users had had private insurance but had opted for TennCare merely to lower costs.

But Blackburn quickly stressed that her vision of healthcare is “not about punishment” or “limiting access,” but rather about focusing on the positive: Reducing costs and increasing access.

On the other hand, she was not completely convinced that these issues can be entirely solved at the private level.

“I don’t think the public sector can solve this on its own,” she said. “I don’t think the private sector can solve this on its own.”

She opined that “collaboration” and “market forces” are needed to address the issue, and that there are things the private and public sector can learn from one another.

“We need to focus on a patient-centered delivery system and care,” she said. “All plans don’t work.”

Specifically, she mentioned portability, regulatory relief and tort reform. She described tort reform as reevaluating limits and addressing class-action lawsuits. A closer look needs to be taken at the “cost of liability to the system.” Health administration needs to be technological, ensuring that it is “easier for individuals to control health records” and guaranteeing a move towards “greater transparency.”

She also admitted that she is not in favor of sin taxes, preferring “educating individuals to make wise choices.” She said that more taxes should not be a ready solution, since they inevitably entail further taxation.

In response to a question regarding the philosophical nature of healthcare, she answered that she does not believe healthcare is a right. However, she elusively reemphasized that “access to healthcare” is imperative. A “right environment” is crucial for this aspiration.