Health Care

The son of a nurse and a doctor, Alan believes we have a moral obligation to make sure that all Americans have health insurance and that we strive to provide the best medical care possible.

Health care costs are too high and going higher. But while Americans pay more for health care than people in any other country, we’re not always getting better quality care: The United States lags other nations in key areas such as infant mortality and life expectancy.

Alan believes that the health care bill signed by President Obama in 2010 was a good first step, but we must build on that landmark reform and continue to reduce costs, expand coverage, and improve the quality and delivery of care.

Start With the Facts The health care reform bill signed by President Obama in 2010 will extend health insurance to 34 million more Americans and, according to the Congressional Budget Office, reduce the federal deficit by $210 billion over the next 10 years. A 2007 study found that we overpay for health-care services and products by $500 billion a year. 15-30% of health care expenditures are wasteful. Medicare spending exceeded $500 billion in 2010, suggesting that $75 billion to $150 billion could be cut without reducing needed services. In 2010, Medicare covered 47 million beneficiaries with estimated outlays of $509 billion. It accounts for one fifth of all US health spending. Medicare costs are projected to grow substantially from approximately 3.6% of GDP in 2010 to 5.5% of GDP by 2035, and to increase to 6.2% of GDP by 2085.

Alan’s Plan

Enhancements to the Affordable Care Act such as:

• A “public option” to expand affordable care choices for families.
• Provide states with the flexibility to design their own plans to implement the law and to manage the expanded Medicaid program.

Pay for Performance and Global Payments instead of Pay per Procedure

These payment reforms pay a lump sum to doctors, hospitals, and other health care providers for all services in a course of treatment for an episode of care. The new health care law establishes a pilot program to test such “bundled payments” starting in 2013.

Accountable Care Organizations that have the potential to improve coordination and care while reducing costs.

Reform the Community Living Assistance Services and Supports (CLASS) Act

The CLASS Act is a new program to create a voluntary long-term care insurance program. The program attempts to address the important need for non-institutional long-term care but flaws in its initial design must be corrected to make it financially sound with changes such as marketing and educational programs to increase participation, indexing premiums to rise along with benefits, and collaborating with private insurers who may offer complementary supplemental coverage.

Identify, support and reward innovative solutions for reducing obesity, smoking and other behavioral sources of health care costs

Alan believes that many of the costs of individual behaviors that lead to health problems can be addressed by earlier, non-medical interventions. Experts have estimated the costs of treating diseases caused by obesity to be near $200 billion a year. In recent years, obesity has become a national crisis.

Modeled after President Obama’s successful “Race to the Top” program that rewards states for innovative approaches to improving public education, Alan will propose legislation to create a $500 million “Race to Good Health” challenge grant program (with federal grants needing to be matched dollar for dollar from private or state and local government sources) that will reward states, businesses, nonprofit organizations and school systems that develop effective programs to decrease obesity, stop smoking and encourage a healthy lifestyle. This initiative will pay for itself by reducing the costs of the healthcare consequences of obesity, smoking, and related chronic illness.

Create a national campaign to promote successful workplace health initiatives

Use incentives such as those proposed by the Healthier Lifestyles and Prevention America Act for businesses that offer comprehensive workplace wellness programs and the $10 Million in Affordable Care Act funds recently made available by the U.S. Department of Health and Human Services to establish and evaluate workplace health programs to improve the health of American workers and their families.

Malpractice reform

The Disclose, Apologize & Offer system pioneered by the University of Michigan encourages communication and problem solving with patients and families after adverse events. Under this model, healthcare providers have an incentive to report mistakes and “near misses” and apologize to the patients and their families immediately. All patients are made an early offer for dispute resolution, mediation is offered as an alternative to going to trial, and patients maintain the right to go to court if they are not satisfied with earlier offers.

Reduce Medicare fraud and waste

Take steps such as enacting recommendations of the US Government Accountability Office to develop an adequate corrective action process to reduce improper payments, improve controls over contracts, and improve management of payment for certain services. For example, if Medicare used the methodologies and payment rates of the lowest-paying private insurer of eight private insurers studied, it could have saved about $670 million of the estimated $2.15 billion it spent on home oxygen in 2009

Fully fund the National Health Care Workforce Commission

This diverse group of 15 healthcare experts, medical educators, and patient representatives will serve as a national resource that collects data and shares information and best practices so that our nation will have enough doctors and other health workers to meet the needs of our aging population. Unfortunately, the $3 million needed for this important work has been blocked by Republicans in Congress.

Reduce Medicare spending on prescription drugs

Prohibit brand-name companies from entering into “pay for delay” agreements with generic companies. Requiring drug manufacturers to pay Medicaid-level rebates for drugs dispensed to Medicare beneficiaries who receive Medicare’s low-income subsidy could reduce costs by $112 billion over the next ten years.

Support Partnership for Patients

This new public-private partnership to improve the quality, safety and affordability of health care for all Americans. This partnership will bring together hospitals, healthcare providers, patient advocates, and state and federal governments and develop models to deliver better care and prevent patients from getting injured or sicker while they are in the hospital and helping patients heal without complication. Specific areas of focus include preventing injuries that result from the use of medications, infections, falls, injuries during childbirth, and hospital-acquired conditions such as ventilator-associated pneumonia. Achieving the initiative’s goals would mean more than 1.6 million patients will recover from illness without a preventable complication, reducing costs by up to $50 billion in Medicare and billions more in Medicaid over the next 10 years.