An open Letter to Rep. Murphy of the NY 20th: It's Time to Support HR 2520

Dear Rep. Murphy:

Now the current Democrat House and Senate Health Care Reform Plans are dead.  Good.  They were bad Bills and they will not be mourned.

The time has come for “Blue Dog” Democrats to reach across the aisle to Rep. Ryan of 1st Wisconsin and the other sponsors of HR 2520, The Patients’ Choice Act.  This is a workable plan that is far cheaper, better thought out and more effective than the current failed proposals.

HR 2520 does have its drawbacks. The only real savings, for example, from “buying insurance across state lines” comes from being able to avoid expensive, state-law required coverage a consumer does not need. This is only useful in states, like NY, where the health insurance policy “bells and whistles” are laid on with a trowel.  Additionally, many payors will not have a provider panel in every state, possibly making it functionally impossible for this idea to produce any real reduced cost or increased competition in many parts of the Country.  

However, the ideas for “Association Plans” in HR 2520, that would let individuals and small businesses join Plans run by not-for-profits like the Chamber of Commerce, seem like an effective way to get both government and employers out of the business of buying or providing health insurance, something which neither does well or cheaply.

The State-level Exchanges proposed in the Democrats’ House and Senate Plans seemed to have all the charm of the IRS and all the efficiency of the DMV.  

In contrast, the Association Plans would enable something like the USAA model from auto insurance to be applied to health insurance, increasing quality, reducing cost and expanding access.  This is not dissimilar to the Professional Employees Organization (‘PEO”) you belonged to in order to provide health insurance for your small business, per our conversation at your Town Hall on August 7, 2009  at Granville.

Additionally, such Association Plans would make it much easier to spread risk, as Employment-based plans do, which would enable payors to expand coverage of people with pre-existing conditions.  In contrast, New York State adopted similar protections to those in the Democrat House and Senate Bills  for people with pre-existing conditions in the individual insurance market with Cuomo-era reforms to the NYS Insurance Law. These changes have reduced the number of New Yorkers covered by individual; non-employment based policies here, while that number has increased nation-wide.  

Further, HR 2520 would expand the use of Health Savings Accounts (“HSAs”), a concept you have said you favor.  This would allow people to “shop around” for the kinds of medical services where lay people can effectively shop based on price, such as routine checkups.  One of the real problems with the HR 3200 was that it made such routine care cost-transparent to patients by barring co-pays.  There is no cost savings to be had in making comparison shopping irrelevant to patients where they could do so, as opposed to areas like cardiac by-pass or cancer treatment, where this is more difficult even in the age of Web-MD.

While you are a fairly new member of Congress, Sen. Brown’s election shows what an impact one new member can have.  If you are able to do this, you will further demonstrate that you understand the heart-felt beliefs of your constituents in the NY 20thDistrict in limited and cost-effective government.  

This is something that would certainly benefit your career, given the national mood as demonstrated by Sen. Brown’s election.  As the great Rabbi Hillel said, “If not me, who?  If not now, when?”

I remain

Respectfully, John Minehan