Surgery News - December 2007 - (Page 6)

6 S U R G E R Y NEWS • D E C E M B E R 2 0 0 7 THE THE E Clinton Aims to Expand Health Care Choices Editor’s Note: This article is part of a series of reports developed from health policy forums held at the Kaiser Family Foundation in Washington. Upcoming articles will feature the proposals of several other presidential hopefuls. B Y J OY C E F R I E D E N Else vier Global Medical Ne ws WA S H I N G T O N — Health care would be the top domestic priority if she were elected president, said Sen. Hillary Rodham Clinton (D-N.Y.) at a health policy forum sponsored by Families USA and the Federation of American Hospitals. “This is, for me, a moral question and an economic one,” said Sen. Clinton, a candidate for the Democratic presidential nomination who is in her second Senate term. “Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?” Sen. Clinton said she learned a lot from her experience in her husband’s first presidential term when she led his efforts to develop a universal health care discriminating against enrollees based on preexisting conditions. Large emplan. “The fact that the White House took ployers would have to offer coverage or on the responsibility of writing the leg- help pay for employee health care; small islation turned out to be something of businesses would not be required to offer coverage, but would be a mistake,” she said at the fogiven tax credits to encourrum, part of a series of presage them to do so. idential candidate health polShe lauded the Bush Adicy forums underwritten by ministration for announcing the California Endowment that the Medicare program and the Ewing Marion would no longer pay for care Kauffman Foundation. She occurring as a result of medsaid that now she sees the ical errors. “That kind of president’s role on health connection between pay and care as “setting the goals and performance, quality and reframework but not getting SEN. CLINTON sults makes sense. It’s hard into the details.” Further, the Clinton plan of the early to do, but we have to experiment.” The recent increase in cases of noso1990s was just too complicated, she said. This time, she’s proposing comial infections such as methicillin-rethe “American Health sistant Staphylococcus aureus “should be Choices Plan,” which a wake-up call for everybody,” Sen. Clinwould allow people to ei- ton said. “A couple of hospitals I’m ther keep their current in- aware of have changed their infection surance coverage or choose from a va- control policies; they have cut the rate riety of plans similar to those offered to of hospital-borne infections. Everybody federal employees. They could also en- should be expected to do that. “When you look at some of the disroll in a public plan similar to Medicare. Sen. Clinton said coverage under her parities and disorganization, it’s because plan would be affordable and portable, we don’t have a good system to dissemand that insurers would be barred from inate evidence-based clinically proven 20/20 / 0/20 V SION O SIO SION IO treatments,” she continued. “It takes 17 years for something that is proven in the lab to be broadly disseminated. It should take 17 hours—17 seconds. With the Internet, why are we so far behind?” She estimated the cost of her plan at $110 billion per year. It would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually. Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal. “I’ve included the public plan option because a lot of Americans want it,” she said. “It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you have tremendous choice.” Sen. Clinton predicted that many people would choose a private plan because “if the private plans are competitive and smart, they’ll offer a lot of new features. What are we afraid of ? Let’s see where competition leads us.” ■ Comparison of Presidential Candidates’ Health Care Proposals Candidate Sen. Hillary Rodham Clinton (D-N.Y.) How to expand access Individual mandate requiring all Americans to either keep existing coverage, or choose plans similar to FEHBP or Medicare. Cost $110 billion, paid for largely by rolling back Bush tax cuts for annual incomes over $250,000. Effect on insurers Cannot deny coverage to people who have poor health or charge them higher rates. Effect on employers Large employers must either insure employees or contribute to government-run pool. Small businesses receive tax credits. Effect on physicians/ other providers Financial incentives for using team approach and providing coordinated care. “Best Practice Institute” to finance research. Improved use of health information technology (IT). Liability reform. Overhaul patent process for breakthrough drugs. Emphasis on preventive and chronic care. Former North Carolina Sen. John Edwards (D) Individual mandate similar to Clinton plan. Create regional health care markets; provide tax credits to subsidize coverage; expand Medicaid, SCHIP, FEHBP. Free market stimulation. Provide tax deductions to buy health insurance; tax credits for low-income workers; block grants to help states enroll uninsured. Expand use of health savings accounts. Free market approach similar to Giuliani plan. Also expects individuals to take responsibility for preventive care. Expand community health centers. Mandated coverage for children only. Provides subsidies for health care with access to plans similar to FEHBP. $90-$120 billion, paid for largely by rolling back Bush tax cuts for annual incomes over $250,000. Must make plans available to everyone, regardless of medical history and preexisting conditions. Must cover employees’ insurance or contribute to regional health care markets. Former New York City Mayor Rudolph W. Giuliani (R) Cost estimates unavailable. Stimulate competition among plans through development of interstate markets. Must move away from employer-based benefits. Increase quality and price transparency. Invest in health IT to reduce medical errors, improve efficiency. Promote wellness and better outcomes. Increase efficiency in drug approval process. Liability reform. Emphasis on chronic disease management. Increased accountability/transparency for costs. Pay for performance. Single bill for coordinated care. Expand health IT to improve coordination. Increase importation of prescription drugs and use of generics. Emphasis on prevention. Enhance IT capacity. More cost and quality transparency. Liability reform. Sen. John McCain (R-Ariz.) Cost estimates unavailable. Interstate markets. Cannot deduct health care costs from taxes. Sen. Barack Obama (D-Ill.) $50-$65 billion, paid for largely by rolling back Bush tax cuts for annual incomes over $250,000. Cannot deny coverage for illness or preexisting conditions. Supervision from new National Health Insurance Exchange. Facilitate competition. Large employers must provide or contribute to cost of health insurance. Former Massachusetts Gov. Mitt Romney (R) Dependent on state proposals. Free-market approach similar to Giuliani plan. Provide block grants to states to encourage them to pass reforms necessary to meet needs of their populations. No employer mandates. Notes: FEHBP is the Federal Employees Health Benefits Program. SCHIP is the State Children’s Health Insurance Program. Source: American College of Surgeons

Table of Contents Feed for the Digital Edition of Surgery News - December 2007

Surgery News - December 2007 Contents Breast Radiation Boost Cuts Cancer Recurrence Mortality Soars in Some Patients With Respiratory Distress New Codes Promote Alcohol Screening New Ideas News From the College: Quality Standards General Surgery: Helping Hand Trauma: Spleen Protocol

Surgery News - December 2007

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