Moving Forward with Healthcare Reform

 

I have spent my professional life caring for people and educating doctors within a system that consistently puts bureaucracies before the health and wellbeing of individuals.  I have treated patients who would have remained healthy if they could afford basic preventative care.  And I have witnessed medical costs skyrocket, with little correlation to health outcomes – the result of an industry that rewards volume over value, and puts financial profit before quality of patient care.  
The legislation signed into law makes strides to reform our broken system.  However, the bill fails to adequately address runaway costs.  As a doctor, I understand in real terms how this legislation can impact caregivers and patients.  I also understand how we can refine and reshape the current law to reduce waste and fraud, empower the doctor-patient relationship, and improve the health of the American people. 
Moving forward with reform requires getting beyond the party politicking and “just say no” posturing we see in Congress.  Only then can we begin to shape this imperfect and incomplete legislation into an affordable reality that works for all Americans.  
Identifying and Addressing Cost Drivers
Healthcare in our country costs too much.  Retail charges are too high, and insurance premiums have become unaffordable to many employers, large and small.  As it stands, the current legislation fails to adequately address many of the inefficiencies that drive up costs.  We can improve this law by taking important steps to identify and address cost drivers – like fraud and wasteful, unnecessary practices. By doing so, we can ensure quality care is affordable for every family, business, and individual.  Read more… 
According to established research on multiple health systems, America can spend substantially less and produce better health outcomes for more people. The Commonwealth Fund Commission’s comprehensive cost/performance analysis suggests that the US has the potential to save between $50 and $100 billion dollars per year in healthcare spending – as much as $1 trillion over the course of a decade – while guaranteeing health insurance coverage to all, increasing the effectiveness of care rendered, and modernizing our public health infrastructure.2  
Two of the biggest drivers of cost in our system – waste and fraud – can be readily addressed by instituting more communication, transparency and accountability.  Achieving this does no t require increased government control – we can equip caregivers, medical staff, and patients with the tools to monitor the system themselves through the power of shared information, coordination, and increased consumer choice and competition.  
For example, we can use technology and research to determine what treatments do and do not work to improve health outcomes.  We can empower physicians and patients with the information they need to make the best treatment decisions by expanding electronic decision support. We can invent and implement a claims processing system for physicians, as we have for pharmacists, banks, and investments.  By investing in these tools and practices, we can save administrative dollars spent on billing and collection, and stop fraud before it gets out of control.
Ensuring Every American has Access to Basic, Essential Care
Every citizen should have access to basic, essential health coverage. This core value is reflected in existing laws, which do not allow care providers to check insurance status until after assessing a patient.  If the care is delivered, or if a patient is hospitalized because of medical necessity, our current system will deliver the care first, and worry about how to cover the cost later.  While this is clearly the compassionate thing to do, the cost is dramatic – the equivalent of not allowing you to check your car’s oil on a regular basis, while promising to replace your entire engine when your car eventually breaks down.  It would make more sense from both a financial and patient care perspective to provide basic essential healthcare up front. It’s going to take some time to get there, but I’m confident we can do it, and we can achieve this while increasing efficiency, lowering costs and improving health outcomes across the board.  
It is possible to build upon a Medicare-like delivery system that would offer every American a baseline policy, which could then be extended into richer coverage if an individual or employer so desires. This is premised upon the private sector delivering care, with the government contracting out providers and holding these providers accountable for quality, cost-effectiveness, and equity of care. Within this system, patients would be able to pick their health insurance and doctor – and keep the ones they currently have if they choose. Health care costs would be reined in through greater competition and accountability, and insurance companies would be prohibited from denying care based on preexisting conditions.  Additionally, coverage would be:
• Portable and secure – if you lose your job or move from one city to another, you do not lose your coverage. 
• Individually chosen and flexible – if you are dissatisfied with your private provider, you have the ability to change providers without restriction.
• Upgradeable – if you or your employer desire a richer coverage, you would have the option to upgrade your policy.
Making Sure Medicare is Secure and Solvent
Medicare has, for decades, acted as a foundation of our nation’s social safety net, providing the assurance of care to aging Americans and establishing the financial security necessary for a strong and prosperous economy.  In Congress, I will work to make sure this program is protected and remains strong, while aggressively attacking the waste and fraud that currently threatens the program’s long-term solvency.  Read more…
Several members of Congress, including my opponent, continue to advocate for the replacement of the current Medicare model with a privatized voucher system.  According to the Congressional Budget Office, vouchers would be set to grow more slowly than projected costs, meaning the average senior would exhaust nearly all of their income in order to attain Medicare-equivalent coverage.  Implementing this disastrous idea would result in an economic catastrophe for millions of Americans.
As a doctor, I understand that we have a lot of work to do in order to improve the efficiency and sustainability of Medicare.  But we must not be so reckless as to shift the costs to our seniors and other vulnerable citizens.  Instead, we must focus our energy on introducing existing technologies and practices capable of reducing the waste and fraud that now accounts for as much as 20 percent of all Medicare spending. 

I have spent my professional life caring for people and educating doctors within a system that consistently puts bureaucracies before the health and wellbeing of individuals.  I have treated patients who would have remained healthy if they could afford basic preventative care.  And I have witnessed medical costs skyrocket, with little correlation to health outcomes – the result of an industry that rewards volume over value, and puts financial profit before quality of patient care.  

 

The legislation signed into law makes strides to reform our broken system.  However, the bill fails to adequately address runaway costs.  As a doctor, I understand in real terms how this legislation can impact caregivers and patients.  I also understand how we can refine and reshape the current law to reduce waste and fraud, empower the doctor-patient relationship, and improve the health of the American people. 

 

Moving forward with reform requires getting beyond the party politicking and “just say no” posturing we see in Congress.  Only then can we begin to shape this imperfect and incomplete legislation into an affordable reality that works for all Americans.  

 

Identifying and Addressing Cost Drivers

 

Healthcare in our country costs too much.  Retail charges are too high, and insurance premiums have become unaffordable to many employers, large and small. As it stands, the current legislation fails to adequately address many of the inefficiencies that drive up costs.  We can improve this law by taking important steps to identify and address cost drivers – like fraud and wasteful, unnecessary practices. By doing so, we can ensure quality care is affordable for every family, business, and individual.

 

According to established research on multiple health systems, America can spend substantially less and produce better health outcomes for more people. The Commonwealth Fund Commission’s comprehensive cost/performance analysis suggests that the US has the potential to save between $50 and $100 billion dollars per year in healthcare spending – as much as $1 trillion over the course of a decade – while guaranteeing health insurance coverage to all, increasing the effectiveness of care rendered, and modernizing our public health infrastructure.  

 

Two of the biggest drivers of cost in our system – waste and fraud – can be readily addressed by instituting more communication, transparency and accountability.  Achieving this does not require increased government control – we can equip caregivers, medical staff, and patients with the tools to monitor the system themselves through the power of shared information, coordination, and increased consumer choice and competition.  

 

For example, we can use technology and research to determine what treatments do and do not work to improve health outcomes.  We can empower physicians and patients with the information they need to make the best treatment decisions by expanding electronic decision support. We can invent and implement a claims processing system for physicians, as we have for pharmacists, banks, and investments.  By investing in these tools and practices, we can save administrative dollars spent on billing and collection, and stop fraud before it gets out of control.

 

Ensuring Every American has Access to Basic, Essential Care

 

Every citizen should have access to basic, essential health coverage. This core value is reflected in existing laws, which do not allow care providers to check insurance status until after assessing a patient.  If the care is delivered, or if a patient is hospitalized because of medical necessity, our current system will deliver the care first, and worry about how to cover the cost later.  While this is clearly the compassionate thing to do, the cost is dramatic – the equivalent of not allowing you to check your car’s oil on a regular basis, while promising to replace your entire engine when your car eventually breaks down.  It would make more sense from both a financial and patient care perspective to provide basic essential healthcare up front. It’s going to take some time to get there, but I’m confident we can do it, and we can achieve this while increasing efficiency, lowering costs and improving health outcomes across the board.  

 

It is possible to build upon a Medicare-like delivery system that would offer every American a baseline policy, which could then be extended into richer coverage if an individual or employer so desires. This is premised upon the private sector delivering care, with the government contracting out providers and holding these providers accountable for quality, cost-effectiveness, and equity of care. Within this system, patients would be able to pick their health insurance and doctor – and keep the ones they currently have if they choose. Health care costs would be reined in through greater competition and accountability, and insurance companies would be prohibited from denying care based on preexisting conditions.  Additionally, coverage would be:

 

  • Portable and secure – if you lose your job or move from one city to another, you do not lose your coverage.
  • Individually chosen and flexible – if you are dissatisfied with your private provider, you have the ability to change providers without restriction.
  • Upgradeable – if you or your employer desire a richer coverage, you would have the option to upgrade your policy.

    •  

    Making Sure Medicare is Secure and Solvent

     

    Medicare has, for decades, acted as a foundation of our nation’s social safety net, providing the assurance of care to aging Americans and establishing the financial security necessary for a strong and prosperous economy.  As a physician, I’ve seen firsthand how successful this program has been, but we must do more to address Medicare’s long term solvency by eliminating fraud and abuse, standing up to pharmaceutical companies to reduce the costs of prescription drugs, and ensure that Medicare remains portable and accessible for beneficiaries.

     

    Several members of Congress, including my opponent, continue to advocate for the replacement of the current Medicare model with a privatized voucher system. According to the Congressional Budget Office, vouchers would be set to grow more slowly than projected costs, meaning the average senior would exhaust nearly all of their income in order to attain Medicare-equivalent coverage.  Implementing this disastrous idea would result in an economic catastrophe for millions of Americans.

     

    As a doctor, I understand that we have a lot of work to do in order to improve the efficiency and sustainability of Medicare.  But we must not be so reckless as to shift the costs to our seniors and other vulnerable citizens.  Instead, we must focus our energy on introducing existing technologies and practices capable of reducing the waste and fraud that now accounts for as much as 20 percent of all Medicare spending.