Tiahrt: 30 years of healthcare reform in America

Former U.S. Rep. Tom Tiahrt says healthcare reform debates have shifted over three decades—from the failed 1994 Clinton proposal to today’s focus on hospital costs and nonprofit accountability. Writing from his experience on the House Appropriations Committee, he recalls examining Medicare and Medicaid reimbursement, medical research, hospital safety and public health programs, while criticizing policies he says were bureaucratic, expensive and overly prescriptive. He argues that extreme hospital markups—sometimes above 1,000%—flow through insurers to higher premiums, deductibles and copayments, making bills less affordable for families. Citing a Lown Institute analysis, he says more than 75% of nonprofit hospitals do not return value commensurate with tax exemptions, totaling $14.2 billion annually.