Health | JoeSestak.com

HEALTH

Upon assuming office, one of Joe Sestak’s first priorities was to reform our healthcare system. He requested membership on the Small Business and Education and Labor Committees’ healthcare subcommittees and proposed eight steps: Shift away from fee-for-service programs; pay providers adequately; give patients the same choices as Members of Congress; share the costs; expand transitional health tax credits; institute mental health parity; improve performance in treating chronic disease and increase the use of health information technology.

We need a health care system that ensures every American has affordable, accessible and quality care through a shared duty between society and government. The best approach is not single-payer, but rather a system in which structured competition and transparency of standards ultimately discipline costs while providing high quality care. Joe strongly supports Medicare and Medicaid, but believes we can offer the best care by rewarding caregivers for quality, not 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. As part of reform, Joe supports inclusion of a public option plan that competes on a level playing field with private insurers, is subject to the same rules, regulations, and requirements as all other plans; and pays for care from individuals’ premiums and copayments -- not general government revenue.

HIGHLIGHTS OF JOE SESTAK’S EFFORTS TO SUPPORT AMERICA’S HEALTH SECURITY

VOTED FOR THE AMERICA’S AFFORDABLE HEALTH CHOICES ACT IN THE HOUSE EDUCATION AND LABOR COMMITTEE

Establishes an exchange where individuals and small businesses can purchase private insurance (or a new public option) at the discounted rate large employers currently receive.

Institutes market reforms to make health insurance fairer by eliminating co-payments for preventative care and preventing insurers from discriminating against individuals with pre-existing conditions or overly favoring healthy individuals.

Establishes coverage as a shared responsibility between individuals, employers, and the government, requiring that both employers and individuals contribute to health insurance costs while requiring the federal government to ensure it is affordable for all individuals.

Provides additional funding for community based preventative efforts, to reduce the incidence of disease, especially chronic illness.

Invests in the health care workforce.

CHAIR AND FOUNDER OF THE HOUSE PEDIATRIC CANCER CAUCUS

AUTHORED/PASSED BILL EXPANDING COBRA HEALTH COVERAGE FOR UNEMPLOYED WORKERS: Extends COBRA benefits for all Americans - not limited to age or length of employment- from 18 to 24 months if an employee reaches the 18 month coverage limit within one year of bill’s passage.

AUTHORED/ PASSED LEGISLATION TO MANDATE AND FUND TREATMENT FOR AUTISM: Mandate: Revises military healthcare plan (TRICARE) to authorize treatment of autism spectrum disorders, if a health care professional determines such treatment medically necessary for a child under the age of 18. Fund: Requires that the Department of Defense provide $36,000 in annual assistance to TRICARE registered families with children diagnosed with autism. Previous cap was $2,500 monthly.

AUTHORED/ PASSED LEGISLATION TO COMBAT POST TRAUMATIC STRESS DISORDER: Requires the Defense Department to conduct a study evaluating and comparing the effectiveness of programs to diagnose, treat and prevent post-traumatic stress disorder. Requires the report no later than after 18 months.

VOTED FOR CHILDREN'S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT: Provides health care for 11 million children, to finally provide cost‐effective health coverage for 4 million more children and preserve coverage for 7 million children already enrolled.

VOTED FOR FDA REGULATION OF TOBACCO: Allows the FDA to regulate advertising, marketing, and manufacturing of tobacco products, currently the leading cause of preventable death in America, responsible for about 1 in 5 deaths each year, costing $193 billion annually in health costs and lost productivity, and causing 1,000 children/day to become new, regular smokers.

VOTED FOR THE BUDGET RESOLUTION- INCLUDED SIGNIFICANT HEALTH CARE FUNDING/POLICIES:

Addresses Rising Costs — The average cost of an employer-sponsored family health insurance policy exceeded $12,000 in 2008, more than twice what it cost ten years ago. Insurance premiums have grown faster than wages, resulting in less take-home pay. The resolution includes provisions to reduce administrative costs and other inefficiencies that cause higher costs without added health benefits.

Path to Increase Coverage— The number of people without insurance grew from 38 million in 2000 to nearly 46 million in 2008 – nearly 1 out of 6 Americans. Most uninsured are in working families. Millions more are underinsured, with just bare-bones coverage that exposes them to significant financial hardship if they get sick

Improving Quality of Care — Cost and quality are closely related. Evidence shows that as much as 30 % of our total health spending, about $700 billion a year, is not producing better health. Prescription drug errors injure or kill more than 1 million Americans per year and one study found only 55% of recommended care is delivered.

CHAMPIONED THE AMERICAN RECOVERY AND REINVESTMENT ACT (ECONOMIC STIMULUS BILL):

-Provides $19 billion to accelerate adoption of Health Information Technology systems by doctors and hospitals;

Helps states avoid cutting eligibility for Medicaid and scaling back on services covered.

-Protects health care coverage for millions of Americans during this recession, by providing an estimated $87 billion over the next two years in additional federal matching funds to help states maintain their Medicaid programs in the face of massive state budget shortfalls.

-Provides $1 billion for a new Prevention and Wellness Fund. Studies have shown that investing in prevention can lower overall health care costs by billions of dollars.

-Provides $1.1 billion for comparative effectiveness research, to help patients and doctors determine the effectiveness of different treatments and improve the quality of care.

VOTED FOR FY2008 LABOR HEALTH, AND HUMAN SERVICES APPROPRIATIONS BILL:

-Expands health care/community health centers and enables community health centers to serve an additional 1.2 million uninsured Americans by investing 11 percent more than the previous year.

-Provides increase of $1.1 billion over 2007 – allowing NIH to support 1,400 more research grants than the President’s budget; $50 million for new state health access grants, start-up grants to states ready with plans to expand coverage to targeted groups, and $50 million for an initiative to help states provide insurance pools to support affordable insurance for almost 200,000 people who are medically high-risk.

VOTED FOR GENETIC INFORMATION NONDISCRIMINATION: Prohibits insurance companies and employers from discriminating on basis of genetic test results, removing fear that has prevented many from undergoing testing for early treatment and prevention of genetic-based diseases.

VOTED FOR STEM CELL RESEARCH ENHANCEMENT ACT OF 2007: Would have increased the number of stem cell lines that are eligible to be used in federally-funded research.

VOTED TO IMPROVE MEDICARE THROUGH LEGISLATION THAT:

-Directs the Secretary of Health and Human Services to negotiate with drug companies for lower drug prices for Medicare beneficiaries. (Medicare Drug Price Negotiation Act).

-Prevents 10% pay cut for physicians in Medicare, enhances Medicare prevention and mental health benefits, improves and extends programs for low-income beneficiaries, and increases access to care for rural seniors.

VOTED FOR THE PAUL WELLSTONE MENTAL HEALTH AND ADDICTION EQUITY ACT: Prohibits insurers and group health plans from imposing treatment or financial limitations when they offer mental health benefits that are more restrictive from those applied to medical and surgical services.

VOTED FOR NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM:

REAUTHORIZATION: A 5 year program that provides free and low-cost breast and cervical cancer screenings to low-income, minority, or uninsured women.

SUMMARY OF FUTURE INITIATIVES

We must ensure the passage of comprehensive health care reform legislation currently under consideration in Congress. This legislation carries out my ideals for health care reform and is a significant step toward the establishment of a health care system that functions for all Americans. Moving forward, we must do more to address the incentives in our health care system that lead to every more expensive care and encourage excessive treatment.

Reduce Health Care Costs

Include incentives for Account Care Organization (ACO) in the Health Insurance Exchange, Public Plan, Require Qualified Health Benefit Plans to contract with ACOs. Alternatively, require the public plan to contract with ACOs.

Implement Wellness Program in Medicare, Give premium and co-pay reductions to seniors who participate in chronic disease management programs and follow preventative care recommendations.

Establish Regional Accountable Care Organization reimbursement in Medicare, Provide pilot program to encourage a regional implementation of Accountable Care Organizations.

Invest In Health Care Infrastructure

Incentivize Primary Care, Increase Medicare bonus to Primary Care Physicians to 10% (from 5% in AAHCA), Maintain 50% of Stimulus bill increase in funding for National Health Services Corps, which provides tuition repayment for Primary Care.

Increase Health Care Workforce, Expand the National Health Service Corps to include additional providers and increase institutional funding of Nursing Education.

Invest in Preventative Care, Maintain 50% of new federal investment in prevention and wellness fund at CDC in the Stimulus, Increase funding for Community Health Centers.

Ensure Effective Health IT

Expand incentives for adoption, Enact bonuses Medicaid providers who implement Health IT. This would include a broader definition of provider and apply to specialties, such as pediatrics, that do not service Medicare patients.

Require interoperability as a component of “Meaningful use”, Direct the Office of the National Coordinator to establish a national standard for interoperability of Health Records by September 1st, 2010. Require the inclusion of interoperability in the definition of meaningful use of health information technology for federal technology incentives.

Provide Assistance to Small and Ancillary Providers for Health IT adoption, Establish loan guarantee program to aid smaller practices and health care providers excluded from Medicare bonuses in implementing Health IT.

Encourage Health Research

Encourage Future Research in Pediatric Cancer, Bring leaders of Pediatric Cancer research together with congressional staff and leaders to plot course for future research efforts.

Funding for NIH and NSF, Maintain funding levels at 50% of Stimulus funding in FY2011 budgets.

Reform Patent Law to Establish Consistency for Businesses, Establish a singular process for protesting copyright violations, which will reduce uncertainty for innovator companies but preserve the rights of generic manufacturers