The main problem with health care in America is health care insurance; the medical care itself is, without dispute, the best in the world, but the rising costs of health care delivery have resulted from the third-party payer system of health insurance being associated with employment.

Another factor that informs the Republican alternative is that the number of uninsured Americans is much lower than the Democratic talking points assert. The leading expert in Medicare and Medicaid, Dennis G. Smith, Senior Fellow in Health Care Reform, Center for Health Policy Studies at the Heritage Foundation, claims that instead of the 47 million uninsured (or 30 million as Mr. Obama claimed in his speech to the joint session of congress on September 9, 2009), the number is closer to 8-10 million.

The proposed Republican bill was offered as a substitute for H.R. 3962, the nearly 2000-page bill that narrowly passed the House with the vote 220-215 on November 7, 2009. The Democratic bill has been dubbed by the Wall Street Journal the "worst bill ever": "Speaker Nancy Pelosi has reportedly told fellow Democrats that she's prepared to lose seats in 2010 if that's what it takes to pass ObamaCare, and little wonder. The health bill she unwrapped last Thursday, which President Obama hailed as a "critical milestone," may well be the worst piece of post-New Deal legislation ever introduced."

The Republican Alternative
The Republican alternative, which was ignored by the House in November, consists of seven divisions, each with titles and/or subtitles that delineate and expound upon the provisions.

Division A: Making Health Care Coverage Affordable for Every American
By focusing on citizens who cannot afford heath care insurance but would buy it if they could, the Republican bill would make it possible to improve the insurance delivery as it exists. With lower prices, more citizens could buy insurance, and the insurers would be able to offer better coverage than is now possible. The many government mandates that already burden insurance carriers cause the prices to skyrocket as insurers struggle to offer a quality product, meet government requirements, and still turn a workable profit.

Division B: Improving Access to Health Care
Title III of Division B of the alternative plan would address the health care issue by "expanding choices by allowing Americans to buy heath care coverage across state lines." Because payments for doctor visits and hospital treatment are paid by the patient's insurance company, the patient seldom knows the costs of his treatment; he does not concern himself, because he is not paying it out of pocket. The corruption of such a system is self-evident. Suppose one had grocery insurance paid for by one's employee; there would be no motivation to compare prices at different stores. The competitive edge would be lost, and stores would have no motivation to lower prices and improve the shopping experience for customers.

Added to the health insurance problem, however, is the fact that competition is stifled by government regulation that prohibits buying health insurance across state lines. That gives the monopolistic result from raising prices because of lack of competition. There are 1300 health insurance carriers nationwide, but within a single state there may be only one; thus, the lack of competition drives up costs. If drivers had to purchase auto insurance from only one company in a single state, the cost of auto insurance would skyrocket. Unlike health care insurance, Americans can purchase auto insurance from any company anywhere in the country.

Division C: Enacting Real Medical Liability Reform
The Democratic bill does not offer any provision for tort reform, because of Democratic support from trial lawyers. But the outrageous sums of settlements to patients that hit health care workers is one the main factors in driving up health care costs. Physicians pay thousands of dollars yearly to insure against medical malpractice; these payments for insurance drive up the medical care costs offered by those doctors. The Republican bill addresses this issue, allowing patients who deserve compensation to receive it, but at the same time capping the amount of settlements.

Division D: Protecting the Doctor-Patient Relationship
Much of the Democratic bill is devoted to establishing a vast government bureaucracy which would be charged with deciding the kinds of services that a patient should receive. Of course, a major factor dictating those bureaucratic decisions would be cost, and as has been observed in Canada, the UK, and other government-run systems, the result is government interference in the doctor-patient relationship. The Republican bill guarantees that the doctor-patient relationship would be sacrosanct.

This division also calls for the repeal of American Recovery and Reinvestment Act of 2009, an Obama created, government think-tank, aimed entirely at establishing the many committees and groups that would direct doctors and medical facilities to adhere to bureaucratic mandates, whose sole purpose is to control not improve the health care of Americans.

Division E: Incentivizing Wellness and Quality Improvements
Instead of penalizing citizens by piling on layer after layer of taxation, the Republican plan would offer incentives for realizing better health through quality programs.

Division F: Protecting Taxpayers
The American taxpayer has been averse to subsidizing abortions ever since the Supreme Court handed down the ruling of Roe v Wade. The only way the current house bill passed was by eliminating abortion coverage from that bill, and still 39 Democrats voted against it. Any bill that would be acceptable to the far left wing of the Democratic Party would have to include abortion coverage, but the only way they could ever pass such a bill is by stealth; they would have to sneak in some provision that allowed coverage, by cloaking it in obfuscating language.

The Republican bill makes it clear that no federal funding can be used for abortion, unless the pregnancy is the result of rape or incest or it endangers the woman's life. It also recognizes that some health care givers may be averse to performing abortions and therefore protects that right.

The bill also protects Medicaid and Medicare through improved information sharing; thus, the issue of fraud and abuse of Medicaid and Medicare can be addressed.

Division G: Pathway for Biosimilar Biological Products
This division clears the way for generic medicines to come on the market faster while putting in place the appropriate safeguards that protect the patient.

Commentary
Although this bill will not be considered by the Democratic administration currently in power, it is nevertheless important that Americans know that these factors are afloat in Washington and that with legislators who understand that the current system can be improved without first being demolished, something resembling this bill might in future become reality.

To read this bill or other information about the health care reform discussion, please go to the Web site of Tennessee Republican Congressman Marsha Blackburn.