Stephanie Herseth writes:

Dear Bill:

Thank you for contacting me regarding health care reform. I appreciate hearing from you.

The strength of our communities depends on the health of our people. Unfortunately, quality, affordable care remains out of reach for far too many South Dakotans. Ensuring every American has access to quality, affordable health care has never been more important. I believe that fundamental reform of our health care system is needed to control rising health care costs, increase quality and value, and improve access to coverage and care.

To be sure, families and businesses across South Dakota have any number of reasons for wanting to improve health care. One thing most agree on is that the current system is broken and unsustainable. The skyrocketing cost of health care under the status quo is not only bankrupting families and businesses, it is leading this country down a path to fiscal disaster. If we ever hope to restore responsibility to government and protect our economy for future generations, we have to get health care costs under control. Put another way, we cannot afford not to reform health care.

That is why comprehensive reform must be deficit-neutral and "bend the cost curve" in the long run, in order to preserve our nation's fiscal health and preserve essential programs like Medicare. In fact, I'm already a cosponsor of the only bipartisan reform bill that has been scored by the non-partisan Congressional Budget Office (CBO) as bringing down health care costs over the long run. That's the Wyden-Bennett-Eshoo-Emerson bill, known as the Healthy Americans Act (H.R. 1321 in the House and S.391 in the Senate). It's not been the focus of attention in either the House or Senate committees. Instead, those committees have chosen to write their own legislation, but I hope the Healthy Americans Act will get greater attention as the debate continues.

In addition to being deficit-neutral and bending the cost curve in the long run, I believe reform must also preserve your choice of health care provider and maintain competition within the marketplace. Payments to rural health care providers and facilities should be fair and modernized in order to meet the unique challenges that they face. I am fighting for these principles as Congress considers comprehensive health care reform.

The Congress is considering several different approaches to reforming the health care system. By making sure there will be no vote on the House floor on health care reform before September, the Blue Dog Coalition, of which I am a member, successfully ensured that the members of the House of Representatives, and every American, would have time to read and assess the committee products on health care reform, both in the House and the Senate.

Progress has been and will continue to be difficult, but again, getting it right is more important than getting it done right away or working on artificial timetables. Before the full House considers a bill, the Blue Dog Coalition will assess the scoring by the CBO and ensure it appropriately reflects the principles we have articulated.

One important shift I'd like to see is a move from paying for volume to paying for value. Quite a number of areas in rural America, including in South Dakota - are leading the way in providing efficient, quality, lower cost care. Unfortunately, that reality is not reflected in Washington in the rates that Medicare pays health care providers in our region and in others. That's why I'm working to change the Medicare payment system.

I'd like to see more reform in the House bill on this issue, and this is one of many reasons I cannot support the House health care legislation in its current form. While it appears ongoing negotiations at the House committee level have so far yielded a number of important concessions in the direction of our principles, many Blue Dogs, including myself, remain concerned with various aspects of the House bill drafts or remain skeptical of the overall costs until we see more information.

Current indications are that there will not be a vote on the House floor until the end of September - another critical step, as that gives the Senate Finance Committee time to meet and hopefully come to a bipartisan agreement on a way forward.

There's no reason Congress can't make this bipartisan at the end of the day. It should be a bipartisan effort, and I hope that the Senate Finance Committee will produce a bipartisan bill that reflects a commonsense approach, as well as the needs of the Upper Midwest. There is no shortage of good ideas, and nothing could be more important for the future of our nation.

Access to quality and affordable health care should not be considered a luxury for hardworking families in South Dakota. I am dedicated to improving our health care system and searching for innovative ways to make quality health care more affordable and accessible, and will keep your thoughts in mind as the Congress considers broader health care reform. If I can provide any additional information, please don't hesitate to let me know.

Sincerely,

Stephanie Herseth Sandlin
Member of Congress

Well, Forumpians, what say ye?