As most Americans know, our healthcare system is second to none — if you can afford it or if you have a good enough insurance policy. The fundamental question (and problem) is why healthcare costs keep skyrocketing. The simple answer is: Lasers cost more than leeches.

Healthcare has been radically transformed since the 1950s, a time when the ambulance services were often run by the funeral homes — an unsettling fact for far too many patients, and a model I am sure none of us want to revive.  Medical breakthroughs are performing miracles, and we all want them no matter the cost.

So, how do we chart a path forward? As in welfare, states like Massachusetts (under then-Gov. Mitt Romney), Tennessee and California are experimenting with market reforms.  Some are further ahead than others, but this activity at the state level will lead to more substantial action at the federal level. The worst thing that could happen to healthcare reform is for the federal government to overreach and squelch these efforts. They deserve time to work and we need the time to learn from what works in these plans and what doesn’t.

We cannot, however, simply sit on the sidelines. Congress needs to engage in this debate. We estimate that there are as many as 46 million uninsured Americans. Now, that is a good and bad thing: good because 85 percent of Americans do have health insurance, bad because so many still do not.

Who makes up that 46 million? Just over one-third of that group (16 million) is made up of non-citizens and a Medicaid undercount. Another 4.4 million are eligible for Medicaid, but have not signed up. That leaves 26.2 million Americans without insurance, a little less than nine percent of the population.

What do we do with this group? How many can we reach?  Should we simply follow the example of other nations?

I firmly believe we can and should solve America’s healthcare crisis in an American way. History is a great teacher, and if we choose to go down the path that Western Europe or Canada has, it will be no surprise when we come to the same destination — a universal healthcare system that leaves your family dog with better coverage and care than you get. As the Canadian Supreme Court once opined, “access to a waiting list is not access to care.”

Unfortunately, that is exactly the way the new majority is going: attempting to simply enroll more Americans in a government-run program (the Dingell-Kennedy “Medicare for All” bill or the yet-to-be detailed massive expansion of SCHIP). Beyond the typical problems with government-run healthcare (lack of choices, lack of access, lack of performance for stockholders, i.e., taxpayers), consider the following from a recent CBO paper entitled “The State Children’s Health Insurance Program”:

“Estimates vary about the extent to which SCHIP has resulted in less private coverage … CBO concludes that the reduction in private coverage among children is most probably between a quarter and a half of the increase in public coverage resulting in SCHIP. That is, for every 100 children who gain coverage as a result of SCHIP, there is a corresponding reduction in private coverage of between 25 and 50 children.”

Bad enough? Well, there is more: “All studies … have estimated the reduction in private coverage among children only; they do not capture any possible reduction in private coverage among parents or other adults. Consequently, the available estimates probably understate the total extent to which SCHIP has reduced private coverage.”

Too much government-provided healthcare limits private sector opportunities. We should be expanding access in the private sector, not crowding it out.

The key to unlocking the potential of access to healthcare in the private market lies with the tax code. Why should we believe this? Answer: because it has already worked for more than 175 million Americans.
Reforming healthcare in America requires reforming our tax law, not expanding the size and scope of already unaffordable government programs.


Camp is a member of the House Ways and Means Committee and ranking member of the Subcommittee on Health.