Expand Health Care, Lower Costs
Anthony De Bella's historical analysis of government-funded healthcare begins:
"In 1793, President George Washington asked Congress to pass the first federal health law, a purely utilitarian proposal to allow the Chief Executive to convene Congress outside the Capitol if epidemic disease should threaten the members. Washington's move occurred when the great yellow fever epidemic forced the entire government to flee from Philadelphia... Congress obliged...It was quite another story when Congress debated a federal quarantine proposal in 1796. The House debate centered on the powers of the central government to impose the quarantine. States-rights proponents argued that the state's right to preserve health and life was 'inalienable' and paramount to the central government's power over commerce."
The assumption has always been that government has a significant role protecting the health of the people. The debate even from the founding of our nation is which level of government - the state or the central government - had that right and responsibility. Healthcare may be the #1 issue in the North Country and faced with the health challenges of climate change and new disease patterns, we must move forward with some guarantee of basic health services.
My Vision is easy access to world-class health services for all. I believe states are better positioned than the federal government to implement universal health care and I fully support the New York Health Care Act assuming legislation addresses concerns about care coordinators, privacy and other issues. The New York Health Care Act would cover all medically necessary care, prescriptions, vision, dental, hearing, mental health, substance abuse treatment and reproductive services.
At the same time, the federal government must play an overarching role to insure that taxpayer dollars devoted to healthcare are well spent and a public option for government-funded healthcare services is available to all. I have looked carefully at proposed federal legislation generally called Medicare for All and identified 8 amendments that would move us towards universal healthcare:
- Clarify purpose of Medicare for All legislation to focus on expanded access to comprehensive health care, lower costs and improved health care outcomes through government-funded insurance
- Given that between 2010 and 2016 every single one of 210 new drugs approved for market came from taxpayer-funded National Institutes of Health (NIH) and National Science Foundation (NSF) research, I support every legislative effort to reduce costs of pharmaceuticals – negotiate Medicare drug costs, cap out of pocket prescription drug costs, allow easier imports of generic drugs, repeal legislation and change FDA regulations to limit patent protections and enable quicker marketing of generic alternatives, use Bayh-Dole Act to transfer licenses or patents in instances of national security, fund open science collaborations and “NASA for Medicine” to focus on developing critical, affordable, taxpayer-owned, life-saving medicines
- Make sure expansion of healthcare preserves Medicare infrastructure of networks of providers and services
- Clarify that mental health services include family counseling, family reunification, peer support services, services specific to victims of violence, domestic violence perpetrators and “red flag” violent-prone individuals; include out-patient services
- Under prescription drugs Include medical marijuana for chronic pain, post-traumatic stress, seizures and other conditions
- Finances and Funding – do cost-benefit analysis to identify information systems that can be adapted (such as Department of Defense, the VA and current Medicare) instead of creating new confidential, electronic patient record system; NEVER increase taxes on payroll or self-employment income for individuals, working families and small businesses; jumpstart expanded healthcare services with money in under-served regions with a WAR in WASTE including $60 Billion of healthcare fraud; clarify reasonable financial and administrative costs to be paid to insurers as a result of conversion to non-profit status; eliminate two year’s salary for displaced workers in areas with expanding employment; and limit payments to Board members.
- Recognize that improving health outcomes is a whole-of-government effort and put in place mechanisms of cross-government coordination that will enable measurable health outcomes.
- Publish a clear roadmap for universal health care that includes:
- Publish National Health Care Assessment that summarizes existing state assessments (required by law) and maps well-served and under-served areas
- Publish plan to dramatically expand numbers of health care professionals in under-served areas
- Recognize that only 18% of Americans trust government to do the right thing so develop and implement information campaign that emphasizes Freedom of Choice; start again conversations to address concerns of the 19 states that refused to expand Medicaid (Texas has 2.5 million uninsured and left $65 Billion on the table)
- Demonstrate that government can make a difference by funding pilot projects based on best practices to solve a specific problem such as increasing childhood obesity or increased suicide rates
- Develop more realistic plan for Americans to understand and transition to new system
- Develop standardized electronic patient record system in accordance with federal guidelines for information systems including full testing at all stages of development
- Recognize and address hacking risks and lack of sufficient IT staffing in government
- Expand public health services in under-served areas including rural America and within Indian Health Services
- Address problems for improving VA healthcare and criteria for transition (recognizing veterans want an independent VA)
- Identify true administrative cost savings and employment transition costs given health care providers still need clerical and billing personnel
- Long Term
- Fully test new systems before going operational
- Clarify implementation plans and schedules – be realistic
- Develop measurement system that focuses on health outcomes