What Patients Want from a Healthcare System

The 110th Congress will define how each political party proposes to address health care reform. The debates over programs such as the Medicare drug plans or the State Children's Health Insurance Program boil down to a difference between those who want more affordable options for health care insurance or more government programs. The differences also involve more or less interference between physicians and patients.

There are a number of reasons health care is becoming more expensive: there are more and better treatments, tests, drugs and devices; people are living longer; and lawsuits against medical providers raise insurance rates. It also costs a lot to train health care professionals. And as the nation's fastest growing state, Arizona exemplifies the challenges ahead.

In the Health Resources and Services Administration's (HRSA) most recent analysis of state health workforce data, Arizona ranked 49th among states in per capita health services employment. HRSA estimates that Arizona only has 172 physicians per 100,000 people, well below the national average.

That same report also recognized that Arizona's population is projected to grow 18 percent between 2000 and 2020, and that the number of those 65 and older is projected to grow 72 percent.

In 2005, nearly 47 million people were uninsured nationwide. Arizona experienced one of the largest percentage increases in its uninsured population, reaching nearly one million Arizonans without health coverage. If left unchecked, these challenges will place an increasing financial burden on health care providers, federal and state governments, and taxpayers.

Earlier this year, in his State of the Union address, the President started the debate by proposing some bold health reform initiatives. The goal is to ensure access to quality, affordable health care for all Americans. The question is how?

The answer lies first in looking at what is working today. Rather than building a complex program for the government to provide prescription drugs to seniors, the Medicare Modernization Act (MMA) of 2004 expanded private health plan choices and competition in Medicare. It also emphasized prevention, disease management, patient safety, and quality, and made Health Savings Accounts (HSAs) more attractive, permanent, and available to all consumers. And, the MMA required more transparent accounting of Medicare's long-term liabilities.

Over 90 percent of those eligible have signed up and the program enjoys more than an 80 percent satisfaction rating. Costs have been reduced and there are many more choices than would exist in a purely government-run program.

Another answer starts by asking: what do patients want? The answer is access, affordability, quality, and individual choice and control without a lot of complexity or long waits.

Health Care America, a nonpartisan organization devoted to promoting access, choice, quality, innovation and competition in our health care system, recently released a national survey of 1,000 registered voters. The survey asked voters to consider a European-style health care system and asked them to rank tradeoffs (such as longer wait times and quality of service) as acceptable, unacceptable, or neutral. Voters ranked all tradeoffs as unacceptable.

What ranked as the most unacceptable tradeoffs? Longer wait times for doctor appointments and hospital procedures, a three-month waiting time between a breast cancer diagnosis and treatment, a limited choice of doctors and hospitals, and limited treatment options, such as an approved drug list.

I share the findings of this survey for two reasons. First, it confirms what we already know - patients want access to affordable health coverage. They want a doctor or hospital of their choice. And, they want the highest quality care.

Second, while Americans want more affordable coverage options, they are not asking their political leaders to abandon everything and start over. Americans' dissatisfaction with the current system does not signal a preference for a government-run health care system. In fact, the survey highlights that patients worry about an expanded government role and how it will affect the doctor-patient relationship and quality of care.

I support a consumer-driven, patient-focused health care system that harnesses the competitive market to lower costs, expands access to coverage, and maintains individual control over health care decisions.

The 110th Congress must make health care a priority. Among the reforms we should consider are small business health plans, medical liability reform, tax breaks for purchasing health insurance, and improved ways to save for future, long-term health care expenses.