| Hillary Clinton |
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Hillary Clinton's 7 Point Plan for Health Care Refom Proposals
In the coming days, Beyond Quotes will be providing information about each of the 2008 presidentials candidates positions on health care reform, for both parties. We begin with Hillary: In a recent speech, Hillary Clinton made several interesting points. According to the World Health Organization Americans rank 31st in life expectancy, and 40th in child mortality. We spend 16% of GDP on health care which totals to a staggering 2 trillion dollars per year. Even more sobering is the statistic that these costs are set to rise even further as it is predicted that within 10 years health care costs will consume almost 20% of our GDP. Additionally, Hillary made the point that about 75% of health care expenditures go to manage chronic diseases like heart disease and diabetes. During her speech, she unveiled a seven point plan. In some ways her speech was more interesting for what it didn’t say than for what it did. For example, Ms. Clinton alludes to universal health care coverage, but stated that more details would be forthcoming in later months. The first point of her seven point plan is:, “Building a national consensus around these cost savings is the first crucial step to covering all Americans with quality, affordable health care. First we’re going to focus on prevention, on wellness, not just sickness. Under my reform, all Americans will have access to comprehensive preventive care which will save money in the long run. The points of her plan can be summarized as follows:
Thank you very, very much. No matter where I go and with whom I talk, whether it’s small business owners, CEOs, doctors, nurses or patients, I hear growing concern about the crisis in our health care system, exploding costs, declining coverage, and short comings in care and prevention. Now I have tangled with this issue before, and I’ve got the scars to show for it. But I’ve learned some valuable lessons from that experience. One is that we can’t achieve reform without the participation and commitment of health care providers, employers, employees and other citizens who pay for, depend upon, and actually deliver health care services We spend 16% of our gross domestic product, 2 trillion dollars on health care. And by 2016, health costs are scheduled to exceed 4 trillion dollars, or almost 20% of GDP. If we spend so much, why does the World Health Organization rank the United States 31st in life expectancy, and 40th in child mortality? We’re worse than Cuban and Croatia. Our health care system is plagued with overuse, under use, and misuse. It is, simply put, broken. As president, I will make it my mission to fix it starting by helping the 250 million people with public or private insurance who face sky rocketing costs, inadequate care, and bureaucratic obstacles to coverage. Today I’m announcing a 7 point plan to lower health care costs for Americans, and again to make out health care system without doubt from any corner, the best in the world. Building a national consensus around these cost savings is the first crucial step to covering all Americans with quality, affordable health care. First we’re going to focus on prevention, on wellness, not just sickness. Under my reform, all Americans will have access to comprehensive preventive care which will save money in the long run. The second way to bring health care costs under control is to bring our health care systems record keeping in to the 21st century, finally leaving behind paper records and outdated, obsolete 20th century information technology. Right now if you rush to a hospital with a medical emergency, they may not be able to access your medical history, or to find out what medications you’re taking, what surgeries you’ve had or even what your blood type is. Electronic medical records would change that. A Rand study found that as a nation we could save more than 77 billion dollars annually through the widespread use of electronic medical records. And these savings could double with the addition of prevention and chronic disease management. Third, we’re finally going to streamline and coordinate the care our chronically ill patients receive. American’s with chronic disease such as heart disease and diabetes account for an astonishing percentage. When I first saw this, I couldn’t believe it that it was 75% of our national health care expenditures. And improving the quality of their care will help limit costs and improve health. To that end, I propose establishing medical homes similar to those operating right now in Oregon. Under this program seniors with complex diabetes have had a 20% reduction in mortality, a 24% reduction in expensive hospitalization, and up to 40% in improvement in control of their disease. Every patient should have access to a system with outcomes like that. Fourth, my plan will offer individuals and small businesses market access to larger insurance pools that will lower costs and end insurance company discrimination against people with pre-existing conditions. As part of a plan for universal coverage which I will discuss in detail in the coming months, we would create large insurance pools that lower administrative costs for small businesses and individuals by spreading the risks. In a system of universal coverage, insurance companies cannot as easily shift costs through cherry picking and other means 5th, I will work to improve the quality of care which will also help us drive down costs. I’ll start by establishing an independent public private best practices institute. This institute would be a partnership among the public and private sector to finance comparative effectiveness research so that doctors, nurses and health professionals as well as consumers and businesses would know what drugs, devices, surgeries and treatments work best. This would reduce the use of inefficient and ineffective treatments. And I believe that it would have tremendous benefits because we could evidence based medicine in to the blood stream of the country much more effectively. 6th If we want to get health care costs under control, we need to get prescription drug costs under control. We know that Americans pay the highest prices in the world for prescription drugs that we all know that we have already, in most instances funded the research on, funded the clinical trials on, done the FDA evaluation of then we put it in to the marketplace and we end up still paying the highest prices, and let’s remove the barriers to generic competition. While 53% of all prescriptions are generic medicines, they account for only 12% of total pharmaceutical costs. A 1% increase in the use of generics could yield four billion dollars in government savings The final point that I would make today about lowering costs is to reduce costs through medical malpractice reform. While some have overstated the role that malpractice insurance plays in the health care crisis, I think we can all agree that we need reform that works for doctors and patients alike. I have offered one solution that has been used successfully at the University of Michigan Hospital System. It is called the National Medical Error Disclosure and Compensation Act as I have borrowed it from the University of Michigan to put it in to law. It’s a novel approach to improving patient safety and the quality of health care while protecting rights, reducing medical errors and lowering malpractice costs. This act would encourage physician’s hospitals and health systems to provide liability protections for physicians who disclose medical errors to patients and offer to enter in to fair negotiations for compensation. I know very well that every one of these recommendations will run in to considerable opposition from forces that do not want change in our system. So I believe that, equally importantly to having a plan, we have to have a political consensus, and that is what I’m trying to develop as I talk about health care and engage in a conversation with the American people because I think that Americans are ready for change. They’re ready for a health care system that produces better results at lower costs and ends the shame of us not covering 45 million plus of our fellow Americans. I look forward to your ideas about how we can pursue these goals, and I hope you will join with me in being part of this broad based national coalition that will not only talk about and demand change but work to make sure starting in 2009 that our political system actually delivers the changes we all know out health care system desperately needs. |
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