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Adam Smith explains his vote on health care

Post by John Henrikson / The News Tribune on Nov. 8, 2009 at 10:59 am |
November 8, 2009 10:59 am
Rep. Adam Smith, D-Tacoma
Rep. Adam Smith, D-Tacoma

After earlier sitting on the fence, U.S. Rep. Adam Smith ultimately voted along with fellow Democrats on the health care reform bill that passed the House 220-215 yesterday. In a lengthy statement the Tacoma congressman explained he still had misgivings about the bill, but found enough to like about it to vote for it and hope something better emerges from the legislative process.

Here’s his bottom line:

My vote, in effect, is to move the process forward. This is not the final phase in the process and in the weeks ahead the Senate will vote on its version of the bill and then the House and the Senate must reconcile their differences. I am hopeful that through this process my remaining concerns will be addressed and we can finally move to provide universal access to health care and reform our system in a way that protects individuals and reins in out of control costs. More than anything, my ‘yes’ vote today reflects the fact that, despite my concerns with the current bill, I cannot vote in favor of the status quo.”

Read the entire statement on the jump:

“Throughout the health care reform debate I have continually stated that our healthcare system must be reformed. It costs too much, doesn’t cover enough people, and incentivizes inefficiencies. Reform must expand access, reduce the overall amount of money we spend on health care, and promote quality of care over quantity. In order to succeed, real reform must be built on these three pillars, without which we will not be able to provide sustainable universal access.

“Real reform cannot take place unless the process continues to move forward and despite my strong misgivings with the current bill, I fundamentally recognize the dire need for health care reform in our country.

“There are far too many people in our country who either do not have insurance or are underinsured. This represents both a moral and economic problem. Additionally, and most importantly, our health care system needs cost containment reform, without which many individuals who currently have insurance will be unable to keep it. It is expected that next year employers who offer health insurance will likely see a 9 percent increase in cost. On top of recent increases, if costs continue to rise at this rate employers will no longer be able to afford to offer insurance to their employees and many more Americans will become underinsured or uninsured. This problem must be addressed.

“Additionally, the United States currently spends more per capita on healthcare that any other country in the world. Beyond this, our government spends more per person than many countries with single-payer systems. If we do not address the inefficiencies in our system and rein in the cost of care, difficult as it may be, we will never be able to provide sustainable universal coverage to all Americans. The costs will simply be too high to sustain and will weigh down our economy.

“The initial bill before Congress, H.R. 3200, had significant problems and would not have received my vote. The current bill, H.R. 3962, has made progress toward achieving the kind reform I have consistently advocated, but any final bill must go even further.

“One of the most important changes from H.R. 3200 is the inclusion of a geographic variation study that will reassess the unfair reimbursement rates across the country and benefit seniors in Washington state. While the study could have been more aggressive and could be enacted sooner, this is a very positive step toward correcting the unfair bias that has hurt Washington state’s seniors for too long.

“In addition, H.R. 3962 takes some real steps toward addressing the inadequate fee-for-service model through the establishment of several pilot projects aimed at changing the way we pay for health care. These changes are a step in the right direction. H.R. 3962 also includes incentives to promote bundling of services and payments, which has proven in many settings to reduce the cost of care while maintaining a high quality.

“Further, H.R. 3962 begins to address some of the inefficiencies in Medicare and slows the rate of growth in Medicare spending from its current rate of 6.6% to 5.3% annually. It also decreases the national deficit by $109 billion in the first ten years and is projected to continue to reduce the deficit in the second ten years.

“Finally, I do appreciate the process that gave sufficient time for all of us to thoroughly examine the details of this important piece of legislation. I was deeply troubled by the push to vote on the original bill last July before the August recess. The additional three months given to consider the bill was a very positive step. I also appreciate that we have had the full text of H.R. 3962 available on line for over a week. Far too often in the past major legislation has been rushed to a vote in a matter of hours.

“While these steps show real progress, more must be done. This bill still costs too much and does not do enough to rein in the cost of care. Moreover, the many regulations in this bill can and should be simplified to make it easier for businesses and individuals to understand and comply with them. The final bill will need to make great strides in these areas to earn my vote.

“My vote, in effect, is to move the process forward. This is not the final phase in the process and in the weeks ahead the Senate will vote on its version of the bill and then the House and the Senate must reconcile their differences. I am hopeful that through this process my remaining concerns will be addressed and we can finally move to provide universal access to health care and reform our system in a way that protects individuals and reins in out of control costs. More than anything, my ‘yes’ vote today reflects the fact that, despite my concerns with the current bill, I cannot vote in favor of the status quo.”

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