The availability of quality, affordable care for all Americans is central to my vision for healthcare reform. All too often though, the imperative of retaining and improving the quality of care is lost in the health reform debate.
Just this month, the Commonwealth Fund released new survey data documenting a troubling story about our healthcare system’s waste and inefficiency, a high rate of medical errors and poor outcomes relative to the rest of the developed world.
In the richest, most industrialized country in the world, doctors, nurses and other healthcare providers face countless systemwide roadblocks to delivering high-quality, patient-centered care. These include: healthcare delivery systems that are all too often driven by the services that are covered, rather than the care that is needed; inadequate investment in and dissemination of clinical comparative effectiveness research to empower providers and patients to make the best treatment choices; few incentives to appropriately prevent and manage chronic disease conditions; underinvestment in critical primary care, nursing and other personnel; and, of course, the tens of millions of under- and uninsured Americans, whose uncompensated care is taxing providers and levying a hidden tax on those fortunate enough to have insurance.
America faces a choice: Continue the status quo or reform our healthcare system to tackle the problems of quality, cost and coverage. And this choice has real consequences. Papered-over policy prescriptions that allow the status quo to continue—or even make it worse—would condemn our citizens and those who care for them to a system that increases costs and the numbers of the uninsured with no improvement in quality. I have great confidence that Americans will choose to support a new direction that preserves and strengthens the best of our system and fixes what is broken.
My health reform vision, the American Health Choices Plan, is based on three key building blocks: quality, affordability and coverage for all Americans.
First, we must make quality job No. 1 in our healthcare system. My plan empowers clinicians by providing federal support for physician-driven certification programs and existing private-public organizations, such as the National Quality Forum, to coordinate quality initiatives and set standards for high-quality care. My plan provides federal funding to address primary care, nursing and nurse faculty shortages, and retention issues by establishing innovative training and mentoring programs. And it seeks to develop new reimbursement models that reward innovative, quality care delivery, such as the “medical homes” model.
I would seek to empower patients by creating a straightforward, accessible quality database to help providers and patients navigate the system. We must also take action to modernize our antiquated healthcare system in order to provide higher-quality care and achieve savings in the form of reduced waste and greater efficiency. Our healthcare modernization strategy must be aimed at slowing the spiraling rate of health cost growth in America by ensuring quality care through a renewed focus on prevention, coordination of care and a reliance on privacy-protected health information technology.
We need to create a new, groundbreaking prevention initiative to ensure that we reduce the incidence of obesity and diseases such as diabetes and cancer. We must institute a paperless health information technology system to empower clinicians and reduce costly medical errors. We would create an independent “best practices” institute to empower providers, plans and patients by ensuring access to the most up-to-date information on innovative treatments and therapies. And we would transform the care of the chronically ill population in order to improve outcomes and decrease costs.
Taken together, these modernization initiatives will reduce waste in the system, improve outcomes, decrease costs and ultimately achieve tens of billions of dollars in national savings. This would let us help those who can’t afford health insurance without a net gain in taxes.
The fact that at least 47 million Americans remain uninsured in the wealthiest, most technologically advanced country in the world is a national disgrace. The American Health Choices Plan focuses both on those who have insurance as well as those who are uninsured. If you are satisfied with the private coverage you have, you keep it. If you are dissatisfied or do not have health insurance, you can choose from the same wide variety of private plans that members of Congress choose from, as well as one plan modeled after Medicare.
The American Health Choices Plan ends discriminatory insurance practices. My plan bars insurers from denying coverage for pre-existing conditions, requires automatic renewal and ensures that premiums collected by insurers are dedicated to the provision of high-quality care, not excessive profits and marketing.
My plan promotes shared responsibility. Recent studies have shown that about half of all hospital losses are passed along to other payers, such as American families and businesses. My plan ensures that all who benefit from a reformed, modernized healthcare system contribute to its financing, including insurance and drug companies, providers, employers, government and individuals.
The American Health Choices Plan ensures affordable health coverage for all Americans. My plan ensures premium affordability through a refundable tax credit for those who cannot afford coverage on their own, limits premium payments to a percentage of income, and creates an innovative small business tax credit to encourage even the smallest firms to provide affordable, quality coverage for their employees.
It also creates a strategy to ease the burden of retiree health costs for large employers by offering a tax credit for qualifying private and public retiree health plans to offset a significant portion of catastrophic expenditures.
My plan reflects the ideas and suggestions of patients, employers, health professionals and workers who deliver the care. Having spent much of my public life fighting for health reform, I have learned that having a plan is only part of the solution, albeit a central part. We must all continue to work together, in a nonpartisan fashion, to forge a consensus that builds on our shared knowledge, experiences and commitment to ensuring that every American has quality, affordable coverage.
