Testimony of Peter R. Orszag, Director of the Office of Management and Budget Before the Committee on Finance, U.S. Senate March 10, 2009

The President is eager to work with Members of Congress to develop a comprehensive health care reform proposal that will provide high-quality, affordable health coverage to all Americans while addressing long-term drivers of health spending in public and private health programs. Many promising approaches to health reform have been proposed by many different people, and the President looks forward to developing a health reform approach through an open and inclusive process that explores all serious ideas that achieve the common goals of expanding coverage, improving quality, and constraining costs. To get a sense of what elements the Administration believes are key pieces to include in any health reform proposal, I want to summarize the Administration’s eight guiding principles for health reform.

Approach to Health Care Reform

1. Protect Families’ Financial Health.  The plan must reduce the growing premiums and other costs American citizens and businesses pay for health care. People must be protected from bankruptcy due to catastrophic illness.

2. Assure Affordable, Quality Health Coverage for All Americans.  The plan must put the United States on a clear path to cover all Americans. The plan must reduce high administrative costs, unnecessary tests and services, waste, and other inefficiencies that consume money with no added health benefits.

3. Provide Portability of Coverage.  People should not be locked into their job just to secure health coverage.

4. Guarantee Choice of Doctors.  The plan should provide Americans a choice of health plans and physicians. Also, they should have the option of keeping their employer-based health plan.

5. Invest in Prevention and Wellness.  The plan must invest in public health measures proven to reduce cost drivers in our system—such as obesity, sedentary lifestyles, and smoking—as well as guarantee access to proven preventive treatments.

6. Improve Patient Safety and Quality Care.  The plan must ensure the implementation of proven patient safety measures and provide incentives for changes in the delivery system to reduce unnecessary variability in patient care. It must support the widespread use of health information technology and the development of data on the effectiveness of medical interventions to improve the quality of care delivered.

7. End Barriers to Coverage for People with Pre-existing Medical Conditions.  No American should be denied coverage because of preexisting conditions.

8. Reduce Long-term Growth of Health Costs for Businesses and Government. The plan must pay for itself by reducing the level of cost growth, improving productivity, and dedicating additional sources of revenue.

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