Contact: Josh Schwerin (202) 225-5614

Washington, Mar 27 - Editor's Note: Before the House of Representatives voted on the health care reform bill, we invited U.S. Rep. Scott Murphy in an editorial to explain his decision afterward to the citizens of the 20th Congressional District. Here is his response.

A year ago, I was a businessman, working to build companies all of which struggled to keep up with spiraling health care costs. I was also a father, frustrated by complicated, inefficient paperwork and medical billing. I started in Congress last April, and by summer was part of our national debate on health insurance reform.

In response, I set out to learn about what was and wasn't working in the system and to better understand what people in the 20th district wanted.

I started meeting with constituents all across the district. I traveled to all 137 towns, and held 100 public meetings to talk about health care. I sat down with a host of providers (doctors, nurses, hospital administrators) from all over the district to get their thoughts. I met with experts on health care economics, the former FDA director, and Republican and Democratic legislators who have been working on health insurance reform for decades.

Some of the conclusions of these discussions were clear. The United States has the most advanced research and the best treatment options in the world - if you can afford them. We spend twice as much as any other industrialized country on health care, but our average statistics are mediocre by world standards. We mandated to our hospitals that they treat anyone who shows up, without respect to ability to pay; and hospitals in return pass these costs along to those of us with insurance to cover their losses. Frustration with health insurance runs high, from people fighting to get bills paid, to those denied treatments their doctors recommend, to those who just can't afford it.

Three things were overwhelming popular: people are unhappy with the status quo and want change; people want to make decisions with their caretakers and get power back from insurance companies; and skyrocketing costs are strangling our families, middle class and small businesses. And it was also clear that there is wide disagreement about how to make these changes.

With that in mind, last fall I read through the entire House version of the health care bill and I voted no primarily because I didn't think the bill did enough to change the incentives in the system that are driving costs higher.

Not long after, I saw a "60 Minutes" piece about a drug dealer who changed careers to steal from Medicare because it was easier. Truly shocking. In response, I introduced legislation to crack down on the over $60 billion a year we lose to waste, fraud and abuse in Medicare. Much of that legislation made it into President Obama's health reform bill. I fought to get other provisions into the President's legislation to allow premium discounts to people who take care of their own health, to reward doctors for quality of care rather than quantity of care, and to protect local industries from unfair taxes.

This winter and spring, as the President's health bill began to take shape, I continued to meet with constituents and experts to understand the bill and how it would work. That also meant sitting down to read the bill, all 2,000 plus pages of it. I met with the President at the White House and we spent 40 minutes discussing in great detail the ways in which the bill would start to rein in skyrocketing health care costs for families, small businesses, and the government. And no, he didn't offer me anything for my vote, not even a game of basketball.

When the final 150 pages amending the bill came out last Thursday, I read through it and made my final decision. I asked myself the same question on this as any other legislation: Will this improve things for our district and our nation? There are no perfect bills, but this is a critical step towards putting individuals and doctors in charge of their health care and ending year after year of double-digit premium hikes.

The legislation empowers patients and doctors, giving more choices over their health care decisions by reducing the power of insurance companies. No longer will insurance companies be able to deny people care because of past illnesses, or turn off your policy when you get sick. Your children will be able to stay on your policy until they are 26, and insurance companies will have to pay most of what they take in as premiums out for medical care and not overhead.

By slowing the growth of health care spending through rewarding outcomes and quality rather than volume, it will reduce the federal deficit by $1.3 trillion over the next 20 years.

This bill changes our payment system by providing incentives for people to stay healthier, rewarding providers for quality rather than volume, getting congress out of the way of efficiency reforms, changing Medicare to reduce fraud and waste, standardizing that complex insurance billing, and creating exchanges to let families and small businesses band together to negotiate against insurance companies, just like our chambers of commerce and members of Congress do now.

Increasing choice and market forces are critical and I believe they will move us in the right direction. Are there things I would like to have seen more of or done differently? Of course. But I'll continue to fight to improve our system. We still need more common-sense tort reform to bring down the costs of defensive medicine, for example. I hope, too, that we will continue to see the level of engagement from so many citizens on other issues - it's the foundation of our democracy.

I also want you to know that this law requires that Members of Congress and our staff switch from the current Federal Employees Health Plan and instead get our insurance through the new exchanges that are being set up. While families and businesses have the option to use the exchange if they desire, members of Congress will definitely be using it.

Hundreds of hours talking with constituents and experts on health care made it clear to me that the current system is headed off track and can't be sustained financially. I decided to work to improve the President's plan and then make a decision on whether I thought the final product would move us in the right direction or whether we would be better off with the status quo. I strongly believe that this reform will make the system more responsive to patients, more affordable for families, and help end skyrocketing costs.

This is how I came to my decision. I strongly believe it's the right one for our district and our nation.

As always, we are happy to hear from you or to answer any questions you have. My office is at 136 Glen Street in Glens Falls. You also can call the Glens Falls office at 743-0964 or my Washington office at (202) 225-5614. I want to thank all those who have reached out over the past months.