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Former United States Senator Richard M. Burr (R-N.C.) and Lanhee J. Chen ’04, policy director for Mitt Romney’s 2012 presidential campaign, discussed the future of American health care policy at a Harvard Institute of Politics forum Tuesday evening.

The discussion, co-sponsored by the Harvard School of Public Health, was moderated by HSPH professor John E. McDonough. In their conversation, Burr and Chen discussed federal health care policies, including the Affordable Care Act and Medicare, as well as health care reform.

Burr, a Republican who opposed the Affordable Care Act in 2010 and voted to repeal it in 2017, defended his stance based on his personal experience on an “Obamacare plan.”

“I got to live through what it's like to have to participate in it, and there was no advocate, advocating for change in Obamacare — from a standpoint of how it's structured — where every insured life in an insurance plan is a lobbyist for changing the plan to reflect what they need,” Burr said. “What I found was, everybody in Obamacare — they have no voice in it.”

Discussing mental and behavioral health care, Chen said the U.S. is in an “epidemic” and called for increased funding toward research and health institutions, as well as “continuing to remove the stigma around seeking help.”

“Why don’t we have more foreign trained mental health providers and allow them to practice the top of their license in the United States? That’s a supply side reform that Congress, the states, could enact right away to ensure that we get the right supply of providers,” Chen said.

In addition to mental health-related issues, McDonough said America has been underperforming relative to similar developed countries on key health metrics.

“In the last decade — five out of 10 years now — we’ve seen life expectancy drop dramatically compared to our other West European peers,” he said.

Chen said the U.S. can learn from the the Singaporean health care system, which he described as more transparent and data-driven.

“What the Singaporeans do in their health care system is create radical levels of transparency around cost and quality,” Chen said.

Besides systemic changes to the health care system, Burr said there should be policies focused on helping Americans receive care before situations reach an emergency stage.

“In every hospital in America, where you got a door that says emergency room, cut a door next to it, and put primary care,” Burr said. “Let people know that they don't have to get sick to get medical care.”

“Participation is the solution to the problem we’ve got in this country,” he said.