Health Security

By Joe Sestak

Congressman Joe Sestak's Health Security Accomplishments/Future Proposals

What I know from my efforts in our community and in Washington is that our healthcare system is in desperate need of reform. There are 47 million uninsured and at least 16 million underinsured in America, and costs are rising at double-digit rates.

Upon being elected to Congress in 2006, one of the first priorities I set was to address healthcare reform. I immediately requested membership in the Small Business Committee's Subcommittee on Regulations, Healthcare, and Trade and joined the Education and Labor Committee and its Subcommittee on Health, Employment, Labor and Pensions.

Since taking office, I have held 5 Health Summits and various Medical Issue Roundtables in the District, as well as led numerous meetings with business leaders, hospital administrators, insurers, doctors, nurses, governmental officials and individuals to best address the healthcare issue.

These Health Summits and Medical Issue Roundtables included:

• Summit On Affordable, Accessible and Quality Healthcare;
• Summit On Senior Health Services;
• Summit on Mental Health Parity with Congressman Patrick Kennedy, Chairman of the Mental Health Caucus;
• Two Summits on Veterans' Healthcare Issues that brought together regional offices of the Veterans' Administration, VA Hospitals, and other federal agencies that deal with veterans' health issues;
• Autism Roundtable;
• Breast Cancer Roundtable;
• Juvenile Diabetes Roundtable;
• Mental Health Roundtable; and,
• Stem Cell Research Roundtable.

To meet the challenges of the future, we need healthy, educated Americans. In order to strengthen our health security, I believe we must: shift the emphasis away from fee-for-service programs; pay doctors and hospitals adequately for the quantity and quality of their service; allow doctors to enjoy the same choices members of Congress and federal workers have; share the cost of coverage between individuals, businesses, and government; expand the current program for transitional health tax credits; institute parity for mental health care with other medical coverage; establish a drug benefit that will help improve Medicare's performance in treating chronic disease; and, increase the use of health information technology to lower costs and increase the quality of care.

However, before we can implement these long term goals, we must work on the most fundamental and essential component of the pathway to affordable and accessible healthcare - prevention.

Preventive Care:

Because reducing healthcare costs begin with preventive care, I have supported legislation like the CHAMP Act, that eliminates co-payments and deductibles for preventive services, including free screening tests for glaucoma, initial preventive physical exams, prostate and colorectal cancer, mammograms and diabetes screening, bone mass measurement, and others; reduces co-payment for mental health services to ensure parity with other health care services; and stops doctors from leaving Medicare by reversing the 10% decrease in physician reimbursement with a .5% increase over the next two years.

It the same reason that I also recently voted for legislation that places a moratorium on seven imposed Medicaid regulations that would have cut $18 billion in services to seniors, families, and those with disabilities as well as cut payments to safety net providers.

As a member of the Autism Caucus, Diabetes Caucus, 21st Century Health Care Caucus, Congressional Mental Health Caucus, Nursing Caucus, and Cystic Fibrosis Caucus, I believe we have the opportunity to address affordable, accessible, quality health care for all American citizens, which is why I voted for the Labor Health and Human Services bill, which provided a 4.1 percent increase in funding for a total of $6.5 billion for the Centers for Disease Control (CDC) over Fiscal Year 2007, and $475 million over the requested amount, to support critical public health activities. Priority increases in the bill also included $34.5 million to combat chronic disease and $69,157,000 for diabetes programs. While the Bush Administration wanted to cut funding for the CDC by 3.5 percent, I fought to protect this funding increase as it is pertinent to improving health care outcomes and decreasing health care costs in the future. This bill also provides $770 million increase for Fiscal Year 2008 for National Institute of Health (NIH).

In addition, for the health security of working families and small businesses, I fought for:

• Legislation to improve access to health care in the workplace by extending COBRA health coverage for older displaced workers until they find new employment or become eligible to enroll in Medicare;
• Legislation to provide grants to help small businesses provide affordable health coverage for their employees;
• Legislation helping family health care with a 10% increase in funding for Community Health Centers; Legislation providing a health care tax credit for 85% of costs for workers' families displaced by trade actions and increasing breast cancer treatment to $650 million (9% increase) and along for a minimum two day stay after operation;
• Cosponsored and voted on a bill for parity in treatment of Mental Health and the Diabetes Care Act, to better care for diabetes patients; and,
• Cosponsored and voted for the Genetic Nondiscrimination Act, which prohibits employers and insurance companies from using genetic information when making decisions about hiring, firing, or providing health coverage.

• The Children's Health Insurance Program (CHIP) Reauthorization Act, a revised bill to provide health care coverage to 10 million children. Also worked to revise bill to meet certain concerns that had been raised. Specifically, it included changes to: better ensure low-income children are enrolled first; better ensure illegal immigrants are excluded; speed up the phasing out of adults; and minimize children leaving private insurance for CHIP;
• Originally co-sponsored the Conquering Childhood Cancer Act, which authorizes $30 million annually for childhood cancer research;
• Co-sponsored the Spinal Muscular Atrophy Treatment Act for SMA Research;
• Co-sponsored the Child Nutrition Promotion and Lunch Protection Act, which combats childhood obesity by providing more nutritious food in schools;
• Co-sponsored the Family Smoking Prevention and Tobacco Control Act, which gives the FDA authority to regulate tobacco products and marketing, especially to children;
• Obtained $29 million for treatment of autism; and, Worked for 18% increase, $120 million, in the Healthy Start Program for Children.

• Originally co-sponsored the Medicare Prescription Drug Price Negotiations Act that required the federal government to negotiate with pharmaceutical companies to lower senior drug costs; and,
• Supported the CHAMP Act that:
• -eliminates co-payments and deductibles for preventive services, including free screening tests for glaucoma, initial preventive physical exams, prostate and colorectal cancer, mammograms and diabetes screening, bone mass measurement, and others;
• -reduces co-payment for mental health services to ensure parity with other health care services; stops doctors from leaving Medicare by reversing the 10% decrease in physician reimbursement with a .5% increase over the next two years;
• -allows seniors to change their Medicare Drug Plan if the drugs covered y their pharmaceutical plan changes during the year;
• -eliminates financial penalty for seniors that enroll late in Medicare D.
• -Sponsored the Elder Justice Act to prevent the abuse, neglect and exploitation of the elderly, and that also prosecutes those who engage in such unconscionable acts; Worked for the FDA Amendments Act that imposed more stringent requirements to ensure drug safety.

• Fought to ensure our active and retired military men and women are getting the medical attention they need.
• Worked on and obtained a $4.4 billion increase in veteran's medical care;
• Worked on and obtained $2.9 billion for mental health and substance abuse, including $600 million for new initiatives for mental health and Post-Traumatic Stress Disorder (PTSD);
• Extended from two to five years following discharge the eligibility period to receive medical care by the Veterans Administration;
• Worked on and obtained $450 million for traumatic brain injury care and research; and prohibited increases in military and retiree health care and pharmacy user fees.

While affordable and accessible preventive care is so essential to reducing the overall costs of healthcare, we must also provide healthcare to all Americans through a system that is cost effective for families, businesses and providers.

I firmly believe that the health security of our citizens, like education, is not just an individual responsibility, but is critical for America's collective prosperity and broader national security. To meet the challenges of the future we need healthy, educated Americans. To accomplish this, I believe that we need a universal health care system which ensures everyone in America has affordable, accessible and quality health care, and is a shared responsibility between society and government. It is a health care system in which disciplined costs and high standards are a priority. I believe that competition and transparency of these standards will ultimately be the best approach to disciplining costs while providing quality health care. While I am a strong supporter of Medicare and Medicaid, I think that these goals can best be accomplished by rewarding care givers for the quality, not the quantity of care, encouraging competition, and requiring performance standards that lead us toward a system of preventive care, early diagnosis and treatment of chronic conditions. Ultimately, we all benefit financially because of the savings from reduced hospitalizations and other expensive health services.

That is why, I watched with great interest as a Republican governor and a Democratic legislature came together in Massachusetts in a bipartisan effort to mandate that everyone who is working participates in health coverage. Mandating participation ensures that the healthy as well as the less healthy are in the health care coverage pool. This will drive down the cost of premiums as individuals with health risks are distributed among the entire population. This plan also works by allowing small businesses to band together as large bargaining units to negotiate lower premiums from private insurers who are then forced to compete for their business, driving down costs. This competition will be the same type as approximately 20 quality health care plans that are available to the federal government, including Congress. With employees covered and provided with the necessary preventive care, less revenue will go into covering the acute care of those who otherwise would have been uninsured and would have gone to the emergency room for their acute care which would have cost us more. These savings can then be used to defray the cost of insurance premiums for those who are unemployed while they are transitioning back to the workforce.

I believe we can provide affordable, accessible, quality health care that covers all Americans in a manner that is fair to the patient, the employer, and the provider. Key to this is transparency and competition, which disciplines costs while providing quality healthcare to all.

Reducing Costs in the Healthcare System and Improving Quality of Care and Outcome: In recent years, workers' health premiums have increased three times more than their wage, and their deductibles have increased 20% each year. And even so, 55% of the time, patients don't receive the right care from their doctors and 48,000- 98,000 patients die each year due to medical errors in hospitals.

We need a health care system which ensures everyone in America has affordable, accessible and quality health care, and that it is a shared responsibility between society and government. It is a health care system in which disciplined costs and high standards are a priority. I believe that competition and transparency of these standards will ultimately be the best approach to disciplining costs while providing quality health care.

We must also work on the most fundamental and essential component of the pathway to affordable and accessible healthcare, which is prevention.

Because reducing healthcare costs begins with preventive care, which involves providing coverage for all Americans from childhood to adulthood, I voted for the CHAMP Act that eliminates co-payments and deductibles for preventive services, including free screening tests for glaucoma, initial preventive physical exams, prostate and colorectal cancer, mammograms and diabetes screening, bone mass measurement, and others; reduces co-payment for mental health services to ensure parity with other health care services; and stops doctors from leaving Medicare by reversing the 10% decrease in physician reimbursement with a .5% increase over the next two years.

That said, I believe we must provide immediate relief to the millions of Americans, including business owners and families, who are suffering from the high costs of insurance.

That is why, I worked to pass the Medicare Drug Price Negotiation Act, which directs the Secretary of Health and Human Services to negotiate with drug companies for lower drug prices for Medicare beneficiaries.

In addition, the Center for Disease Control and Prevention (CDC) estimates that every year two million patients get an infection after being treated in a hospital, and an estimated 90,000 deaths related to such infection. Congress has found that these infections are transmitted to patients when there is inadequate adherence to clean sanitation and patient safety procedures that would otherwise prevent infectious disease. Furthermore, these infections contribute to over $50 billion in annual medical costs - adding an average of $150,000 to a medical bill per patient.

That is why, I am proud to be a cosponsor of HR 1174, the Healthy Hospitals Act of 2007, which amends title XVIII of the Social Security Act to require public reporting of health care-associated infections data by hospitals and ambulatory surgical centers. This Act will put the necessary pressure on hospitals to evaluate their sanitation choices and promote accountability in our nation's healthcare industry by requiring data reporting and providing financial incentives for reduction in health-care associated infections.

I also believe in utilizing innovative technology to reduce costs in healthcare. One such example is the use of Health Information Technology (HIT). As was reemphasized during my recent visit to SIEMENS Corporation's Malvern location- the national headquarters of their HIT program- according to a RAND study, the use of Health Information Technology to protect, retrieve and transfer clinical, administrative, and financial information electronically within health care settings instead of paper, could save the US healthcare system $162 billion and would dramatically improve the quality and efficiency of care.

For this reason, I cosponsored HR 3800, which establishes a public-private Partnership for Health Care Improvement to recommend specific actions to achieve a nationwide interoperable health information technology infrastructure; provides for the adoption by the federal government of standards for the electronic exchange of health information; establishes the American Health Information Community to provide advice to the Secretary of Health and Human Services and the heads of any relevant federal agencies concerning the policy considerations related to health information technology; authorizes the Secretary to award grants for the: purchase of qualified health information technology systems, implementation of regional or local health information plans, and development of academic curricula integrating qualified health information technology systems in the clinical education of health professionals; and, requires the Secretary to provide for the development and use of health care quality measures to measure the quality and efficiency of health care that patients receive.