HEALTH CARE REFORM; BETWEEN THE CRACKS First Coast Leaders on What It Will Take to Fix Our Health Care System

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Byline: JEREMY COX

As the Tolstoyesque bills wending through Congress illustrate, reforming America's health care system is complicated business. What if reform could be accomplished in a more Hemingwayesque way? Say, in 200 words or less. That was the challenge, in essence, the Times-Union posed to several health care experts and other community leaders. Their responses were solicited to the following question: "Of all the things that could be re-engineered in America's health care system, what do you think is the biggest priority and how would you fix it?" Here is what they wrote back.

CORRINE BROWN

U.S. REPRESENTATIVE, DEMOCRAT, JACKSONVILLE

I am in full support of comprehensive health care reform; the need is clear. Many of my constituents, and minorities nationwide from the African American and Hispanic communities, make up nearly half of the estimated 50 million Americans without health insurance.

In Florida, nearly 21 percent of our residents are uninsured. Moreover, health care costs are unsustainable: Medicare and Medicaid may be near bankruptcy by 2017, and one-fifth of our nation's gross domestic product will go toward health care spending.

However, when many good ideas are introduced in Congress, what eventually translates to actual policy gets altered. And one aspect of health care reform of utmost importance to me is maintaining proper funding for Disproportionate Share Hospitals, like Shands Jacksonville and Miami's Jackson Memorial Hospital, which provide health care to uninsured and/or individuals with limited incomes.

Disproportionate Share Hospitals are invaluable, as they are the one true safety net for the working poor nationwide. For a state like Florida in particular, with a large elderly population, crippling [these hospitals] would be disastrous.

I will work with the Obama administration and my colleagues on Capitol Hill to make health care reform a better, more suitable plan for everyone, especially vulnerable populations.

ANDER CRENSHAW

U.S. REPRESENTATIVE, REPUBLICAN, JACKSONVILLE

America has the best quality of health care in the world, but when millions of Americans can't access it, we have a crisis.

First and foremost, any reform should lower health care costs so more people can acquire coverage and get better care, and ensure patients can choose their own doctor and get the treatment they need when they need it.

The Democrat-proposed government-run health care reform bill would do none of these. At a cost of $1.2 trillion, Americans will have to pay more for less choice. Instead, I and other House Republicans have offered a proposal that would increase availability and access and lower costs by:

-- Letting Americans who like their health care coverage keep it and give them the freedom to choose the health plan that best fits their needs;

-- Allowing states, small businesses, associations and organizations to band together and offer lower-cost health insurance;

-- Implementing comprehensive medical liability reform to reduce costly, unnecessary defensive medicine practiced by doctors trying to protect themselves from overzealous lawyers; and,

-- Promoting prevention and wellness by giving employers and insurers greater flexibility to financially reward employees working to achieve or maintain a healthy lifestyle.

LAURA GOODHUE

EXECUTIVE DIRECTOR, FLORIDA CHAIN, AN INFORMATION AND ADVOCACY NETWORK

First and foremost, our system of health coverage must focus on the health of patients.

That might seem to go without saying. However, the need for appropriate and timely access to health care is not what drives most of the decisions in our current system. In fact, that need is often an afterthought.

So if there's one key to reform, it's clearly setting the right goal, namely guaranteeing Americans access to affordable, quality health care. …