WASHINGTON - After listening sessions and meetings with over 70 patients-rights advocates, doctors, nurses, hospitals, and medical groups, U.S. Reps. Mark Kirk (R-Ill.) and Charlie Dent (R-Penn.), and members of the centrist Tuesday Group, today released details of the "Medical Rights and Reform Act," a comprehensive health care reform proposal.
“The Medical Rights and Reform Act applies common-sense centrist principles to the health care debate by lowering costs and expanding access without compromising the doctor-patient relationship, jeopardizing the quality of American medicine or raising taxes on the American people,” Congressman Kirk said. “While some proposals would manage costs by letting the federal government delay or deny life-saving tests and treatments to millions of Americans, the Medical Rights and Reform Act guarantees patients’ rights while reducing the cost of health insurance for all Americans. We can reform health care without breaking the bank.”
“This package makes deliberate and responsible reforms to our health care system that reinforces the strengths of American health care while addressing the shortcomings,” Congressman Dent said. “We will expand access to care by making health insurance more affordable and giving all Americans more options and control over their health care decisions. We will improve the quality of care by focusing on prevention and wellness, employing technologies that reduce errors, and promoting medical breakthroughs.”
Protects the Doctor-Patient Relationship
The Medical Rights and Reform Act would mandate a fundamental principle – the government should not come between patients and their doctors. The Act will protect every American’s relationship with their doctor, the integrity of the medical profession and the right of Americans to choose the care they deem appropriate without federal delay or restriction.
Lowers Health Care Costs
A Kaiser Family Foundation survey conducted in October 2008 found that making heath care and health insurance more affordable is the most important health care issue cited by voters (50%), doubling the second ranked issue, expanding health insurance coverage for the uninsured (23%).
To lower health care costs, the Act will foster state innovation through insurance market reforms, high-risk pools, community health networks, and new association options for small businesses.
The bill also includes: lawsuit reforms to end the practice of defensive medicine and ensure fair compensation for injured patients; upgrades and acceleration of health IT programs to improve the quality of care and reduce errors; strong standards and processes to target waste, fraud and abuse; targeted prevention and wellness programs to address costly chronic diseases and promote healthy living; and greater tax incentives for individuals and small businesses to buy health insurance.
Expands Health Insurance Coverage
The bill also expands access to Americans without health insurance by: providing greater incentives to small businesses to cover their employees; encouraging state-centered insurance markets reforms; giving low-income families the option to use public funds to purchase private health insurance plans; enhancing Health Savings Accounts; allowing young adults to remain dependents on their parent’s plan; and expanding rural health care programs.
Problems in Canada and the United Kingdom
As Congress considers proposals for health care reform, mandating the government to take over health care decisions for families could have consequences. A close examination of government-run health care in Canada and the United Kingdom shows sharp contrasts in the quality of medical services:
• Americans more likely to survive cancer than Europeans/Canadians. One study puts the five-year cancer survivability rate for American women at 63 percent, but only 56 percent for European women. For men, the difference is starker with 66 percent survivability for Americans and only 47 percent for Europeans. A separate comparison of U.S. and Canadian citizens shows similar results. American women’s survival rate is 61 percent, compared to 58 percent in Canada. American men’s survival rate is 57 percent, and 53 percent in Canada. Sources: Lancet Oncology, 2007, No. 8; Health Status, Health Care and Inequality: Canada vs. the U.S., National Bureau of Economic Research, September 2007.
• Delay is denial of care. In the U.S., only 26 percent of sick adults waited more than four weeks to see a specialist. In Canada and the UK, more than twice as many citizens wait longer than a month to receive the care they need (60 percent and 58 percent, respectively). Source: 2008 Commonwealth Fund International Health Policy Survey of Sicker Adults.
• The sickest patients need intensive care. In Britain, government hospitals maintain nine intensive care unit beds per 100,000 people. In America, we have three times that number at 31 per 100,000. Source: High-Priced Pain: What to expect from a Single-Payer Health Care System, Heritage Foundation, 9/22/2006.
• New technology finds disease quicker. In America, doctors use 27 MRI machines per million people. In Canada and Britain, it is less than a fifth of that at approximately five MRI machines per million people. Source: Health Status, Health Care and Inequality: Canada vs. the U.S., National Bureau of Economic Research, September 2007.
• Long waits increase pain and morbidity. In the U.S., over 90 percent of seniors receive a hip replacement within six months. In Canada, less than half of patients are treated in the same time (43 percent) with many waiting over a year. In the UK, only 15 percent of patients are treated within six months. Source: Doing Your Own Health Care Thing: American Seniors vs. Canadian Citizens, Heritage Foundation, 7/1/2005.
• U.S. care for infants outpaces UK and Canada. In the U.S., we have over six neonatologists per 10,000 live births. In Canada, they have fewer than four and in Britain fewer than three. In the U.S., we have over three neonatal intensive care beds per 10,000 births, just 2.6 in Canada and less than one in Britain. Source: High-Priced Pain: What to expect from a Single-Payer Health Care System, Heritage Foundation, 9/22/2006.
• Women receive better preventative care (pap smears/mammograms) in America. Nearly 90 percent of American women age 40 – 69 have had a mammogram, while only 72 percent of Canadian women have had a screening. Likewise, 96 percent of American women age 20 - 69 have had a Pap smear, with 88 percent of Canadian women undergoing the test for cervical cancer. Source: Health Status, Health Care and Inequality: Canada vs. the U.S., National Bureau of Economic Research, September 2007.
Stories of poor care under a government-run system are common in Britain. Last February, the Daily Mail reported on Mrs. Dorothy Simpson, 61, who had an irregular heartbeat. Officials at the National Health Service (NHS) denied her care and told her she was "too old." The Guardian reported in June 2007 that one in eight NHS hospital patients wait more than a year for treatment.
A section-by-section summary of the Medical Rights and Reform Act is below.
MEDICAL RIGHTS AND REFORM ACT
Protecting Doctor-Patient Relationship, Improving Quality, Lowering Costs, Expanding Access
TITLE I. PROTECTING DOCTOR-PATIENT RELATIONSHIP
Sec. 101 Guaranteeing the Doctor-Patient Relationship- The Medical Rights and Reform Act guarantees the rights of patients to carry out the decisions of their doctor without delay or denial of care by the government. Our bill upholds the rights of individuals to receive medical services as deemed appropriate by their doctor to ensure all Americans have access to the care they need when they need it.
Sec. 102 Preserving Health Insurance- Currently over 160 million Americans have health insurance provided through their employer. Under other proposals in Congress, there may be an effort to eliminate or restrict employer-provided health insurance. Our bill will ensure that those plans are protected so that every American can choose to keep their current insurance plan.
Sec. 103 Promoting Quality Through Evidence Based Research- Research that evaluates and compares the implications and outcomes of health care treatments including procedures, therapies, pharmaceuticals and medical devices, will provide patients and health care providers with information to make informed decisions about the best course of treatment for each individual. Our bill will establish a governance structure for CER that is spear-headed by an independent commission that will work to ensure that CER is used to promote patient-centered care that best meets the needs of individuals and improves the overall quality of care while continuing support of medical progress.
Sec. 104 Compassionate Access - By providing terminally ill patients access to cutting edge treatments and drugs that have not been approved by the FDA due to their lengthy and extensive approval process, we can help save lives and give hope to patients and their families.
TITLE II. LOWERING THE COST OF CARE
Sec. 201 Promoting Health and Preventing Chronic Disease through Wellness Programs
Seventy-five percent of the nation’s aggregate health care spending is on treating patients with chronic disease, yet the vast majority of these diseases are preventable. Keeping people healthy and preventing disease must be an important part of improving our federal health system. Employers, communities and health insurance plans should be encouraged to promote participation in effective prevention and wellness programs.
• In the workplace-- with tax credits for both small and mid-sized employers when incorporating sound employee health management practices.
• For young people-- with competitive funding for programs available to schools, community health centers and others.
• For individuals and families-- incentivize participation through insurance premium reductions.
Sec. 202 Providing Flexibility and Control to Lower-Income Families- Families that are already eligible for public coverage but not enrolled in public plans currently offered should have the right to use their current public support to join a cost-effective private plan. Families who are not eligible for public programs but are struggling to afford insurance will receive tax credits to defray the cost of purchasing a health insurance policy. These policies will ensure that families who need help will have the same control as middle and upper income families in America in making their health care decisions.
Sec. 203 Equalize Tax Benefits for Self-Employed- Small businesses and self-employed individuals should have the same tax advantages that large employers receive for the purchase of health insurance.
Sec. 204 Lawsuit Reform- The proliferation of frivolous malpractice lawsuits threatens access to highly-skilled medical professionals, forcing doctors to practice defensive medicine. This drives up costs, denying access to care without improving the efficacy of care. Our policy will provide protections to safety net providers, stabilize compensation for injured patients, hold parties responsible based on their fault, ensure that meritorious claims are speedily resolved, reduce defensive medicine by encouraging doctors to follow evidence-based clinical practice guidelines, and encourage states to adopt “alternative to litigation” reforms such as early disclosure and compensation, administrative determination of compensation, and specialized health care courts.
TITLE III. IMPROVING QUALITY, PROMOTING INNOVATION AND ENSURING ACCOUNTABILITY
Sec. 301 Accelerate the Deployment of Health Information Technology- By setting standards to ensure interoperability and incentivizing adoption, our bill will encourage the rapid deployment of health information technology to increase the quality of care by reducing medical errors, improving health care outcomes, and lowing costs.
Sec 302 Public-Private Partnerships-To avoid the Innovation Gap, where public research ends and before investors commercialize a promising discovery, a public-private partnership will foster a bridge between the NIH and biotech companies, universities, patient advocacy organizations, pharmaceutical companies and research institutions to accelerate the deployment of new research into the practice of medicine. By establishing an Independent Cures Acceleration Agency to fund promising discoveries, our bill will make grants available to applicants with or without access to private matching funds and can lead to the development of life-saving cures.
Sec. 304 Eliminating Waste, Fraud and Abuse- By strengthening Medicare’s enrollment process for providers, expanding standards of participation and reducing erroneous payments, we can save billions in improper fraudulent payments. Implementing these common-sense changes will lower the cost of Medicare and ensure accountability to the American taxpayer.
TITLE IV. EXPANDING ACCESS TO CARE
Sec. 401 Small Business Health Options Program (SHOP)- By allowing small businesses to band together to obtain lower premiums for their employees, providing a tax credit for small business owners who pay for 60% of their employees’ premiums and a tax credit for self-employed entrepreneurs to purchase health insurance, we can significantly increase the number of insured Americans, make health insurance more affordable, predictable, and accessible for small businesses and the self-employed.
Sec. 402 State Innovation Program (SIP) - Establish a new State Innovation Program that will provide incentives and rewards to States that reform insurance markets to better meet the personalized needs of patients. States would be encouraged to design programs that will help improve the individual and small group insurance markets through innovative models such as:
•Universal Access Program (UAP) to provide affordable health care coverage for the sickest patients and people who have preexisting medical conditions. A Universal Access Program could include a sustainable reinsurance program or a functioning state high-risk pool.
•Health Plan Finders that provide patients with the tools to easily find the right health care coverage that best meets their needs.
•New mechanisms such as Small Business Health Plans, Cooperatives, Interstate Compacts, Catastrophic Coverage Plans that allow states, small businesses, and other organizations to increase their purchasing power by banding together and offering health insurance at lower costs.
Sec. 403 Dependent Children –By allowing young people up to age 26, who otherwise may not choose to purchase insurance, access to their parent’s health insurance, we can help to reduce the number of uninsured by at least 7 million.
Sec. 405 Expanding Rural Care-To ensure access to health care in rural areas, our bill will improve and expand the National Health Service Corp, expand access to care for rural veterans, establish a program that provides loans to eligible hospitals for residency training programs in primary care and reauthorize Area Health Care Centers.
Sec. 406 Health Savings Accounts (HSAs) - Americans who directly control health spending using a tax-deferred HSA will take a much greater role in their health care decisions, patient compliance and choices for end of life care if they control an account dedicated to this purpose which can also become part of their retirement savings or estate for their children. By expanding and improving Health Savings Accounts to give more Americans more control of their health care decisions we will allow more flexibility for HSA account holders to purchase health insurance, access preventative drugs and save for the future.
Sec. 407 Ensuring Physician Access for Medicare Beneficiaries-Every year, Medicare physicians face drastic cuts to their reimbursements as a result of the flawed Sustainable Growth Rate (SGR) formula that is used to calculate these rates. Medicare payment reform is essential in preventing further cuts from taking place and to ensure that all Medicare patients continue to have access to the doctors and care they need. Our bill will give physicians and seniors long-term peace of mind and address the SGR by replacing the SGR with the Medicare Economic Index (MEI), which is Medicare’s measure of the increasing costs of providing medical services. Our bill rebases the SGR (fills in the hole) for 1 year then repeals the SGR and switches to MEI.
Sec. 408 Strengthen Health Care Workforce – Our bill will promote policies to ensure a strong health care work force, including primary care doctors and nurses, to ensure that we are prepared to care for the specific health care needs of Americans.