As a physician who has cared for thousands of uninsured patients and families in Louisiana, I believe Congress must do more to expand access to affordable health-insurance coverage. Congress can also be effective in pushing our health care system to improve treatment outcomes, limit waste, reduce waiting times, and improve patient satisfaction.
We must also do more to empower health care consumers and providers with better information about health care costs and quality, and protect patients’ control over their individual treatment decisions. We should also allow individuals to choose the coverage that best suits their individual needs and make health insurance portable between jobs. These goals will remain among my top priorities as I continue fighting for the interests of Louisiana patients and caregivers.
Health Information Technology
In the aftermath of Hurricanes Rita and Katrina, millions of healthcare records were destroyed, and healthcare costs are squeezing family budgets in Southwest Louisiana and around the country. One way to lower the cost and improve quality is to adopt personal electronic records to help doctors and other healthcare providers limit duplication and errors, but we should go further to put the patient in control. This year, I introduced the Patient-Controlled Health I.T. Act to give the patient control over their electronic records enabling them to pass them from doctor to doctor while protecting their privacy. My legislation would spur investment in Health I.T. to help reduce the cost and improve the quality of health care for all in Southwest Louisiana.
A wide body of evidence indicates the need to engage patients more fully in their own health and care. Both patients and doctors could benefit from electronic tools to facilitate better care management, particularly in the area of chronic disease. Today’s tools, such as personal health records, are not used as widely as possible, in part because there is no easy way for patients to automatically download their health care data electronically, or share it with providers of their choosing.
The Patient-Controlled Health I.T. Act would:
- Give patients the right to receive their personal medical information in electronic form from providers who maintain electronic records;
- Create financial incentives for health information exchanges to provide electronic clinical data to patients’ personal health records;
- Provide incentives for physicians to utilize that data in the course of treating their patient;
- Help demonstrate how best to accomplish these goals, including examining the impact both financial incentives and availability of electronic data have on patients’ health outcomes.
SCHIP
When it comes to expanding enrollment in the State Children’s Health Insurance Program (SCHIP), our nation’s neediest children must remain the program’s top priority. When low-income children lack coverage, they often forego care or receive care in hospital emergency rooms where the costs are more wide-ranging. That’s why I voted for the law that provided more than $10 billion to maintain funding for SCHIP programs through March 2009.
I found it disappointing when House Majority leaders put forth legislation (H.R. 3162) that would have exacerbated provider access problems for needy children with SCHIP coverage. This flawed legislation would overextended the program by including childless adults, illegal immigrants and New York families who earn more than $80,000 in a program intended for needy uninsured children. The Congressional Budget Office reported that the legislation would have pushed more than 2.4 million children out of private health care plans onto a government program. To pay for this expansion, House Majority leaders proposed $193 billion in cuts to seniors’ Medicare benefits.
Too often, Washington confuses government health coverage with timely access. Congress has a duty to ensure that SCHIP or Medicaid coverage actually delivers timely care to enrolled children. A plastic government coverage card that only delays access and leads to long lines for care is an insult to low-income families. Parents, children and taxpayers deserve more accountability.
Too many families struggle to find a physician who will treat their sick children enrolled in SCHIP or Medicaid. Studies show children in these government programs receive fewer recommended check ups and fewer visits with primary care providers than those with private coverage. According to national data from the National Committee for Quality Assurance, more than half of parents with chronically ill children in Medicaid reported problems getting needed care quickly.
Beginning with the 2003 SCHIP annual reports, the federal government required SCHIP programs to report on children’s access to primary care physicians. Unfortunately, several SCHIP programs refuse to consistently measure and report primary care access. Other programs report poor access. In Wyoming, less than half of enrolled children ages 7 to 19 had a visit with a primary care provider in 2006. In West Virginia, only one-third of enrolled children ages 12 to 19 saw a primary care provider.
Instead of forcing children out of private insurance, bipartisan leaders must work together to ensure that SCHIP coverage means timely access for low-income children. This year, I introduced the Improving Children’s Doctor Access Act of 2008 (H.R. 6506) to encourage states to measure and report access problems for low-income children in SCHIP and to ensure that these children remain a top priority in states’ enrollment efforts.
The bill would:
- require SCHIP programs to report how many enrolled children actually receive a primary care visit;
- encourage SCHIP programs to survey parents to report whether enrolled children are getting needed care and getting it quickly;
- and require SCHIP programs to report their plans to target enrollment outreach to needy children who don’t already have private coverage.
Nursing Shortage
As the sponsor of the Nursing Education Opportunities Act of 2007, I’ve also been a leader in bipartisan efforts to reverse our nation’s looming nursing shortage. The shrinking of this workforce makes health care more expensive for all Americans, while delaying our access to life-saving treatment. The Department of Health and Human Services (HHS) recently warned that the nation’s nursing shortage could exceed one million nursing vacancies by the year 2020. Adding to the crisis, U.S. nursing schools must turn away thousands of qualified applicants every year.
According to one survey, these schools turned away 42,866 qualified applicants in 2006, citing faculty shortages as their primary reason. My bill would help to avert the impending crisis, and I am pleased Congress included parts of my bill when it passed the law reauthorizing the Higher Education Act.
Community Health Centers
If we fail to modernize our state’s healthcare system by attracting and keeping healthcare providers, and improving patient’s access to community-based primary care, Louisiana patients will continue to suffer in overcrowded emergency departments and face life-threatening waiting lists, while medical bills, insurance premiums and taxes become even more exorbitant.
I have been in frequent contact with the Department of Health and Human Services to urge the Bush Administration to direct adequate funding for the expansion of Federally Qualified Health Centers in high-need areas of Louisiana’s 7th Congressional District. In August 2007, HHS officials contacted my office and finally agreed to provide extra help for underserved communities in our area through its High Poverty County Initiative.
I’m also a cosponsor of the Health Centers Renewal Act (H.R. 1343), legislation to reauthorize federal funding for community health centers between 2008 and 2012. To help these community health centers attract and retain health care providers, I’m also a cosponsor of another bill (H.R. 1518) to allow health center employees to enroll in the Federal Employee Health Benefit Program. More information about federally qualified community health centers can be found on the Internet at: http://www.cms.hhs.gov/MLNProducts/downloads/fqhcfactsheet.pdf.
Ensuring Freedom to Choose Private Insurance Coverage
Moving towards the 2008 Presidential election, many groups have become more vocal in their support for leveling our entire health care system and shifting to a single-payer system. This quick fix solution would soon lead to dangerous waiting lists – as we’ve already seen in Canada. Waiting lists prevent early detection and increase the risk of death. Researchers report that 19 percent of Americans who develop prostate cancer die, compared to 25 percent in Canada and 57 percent in Great Britain. Likewise, breast cancer kills 25 percent of American victims, compared to 46 percent of similar patients in Great Britain and New Zealand.
Worse yet, under single-payer legislation, 70 percent of Americans would be forced to drop their existing coverage, and trust unelected Washington bureaucrats not to ration medically necessary care when a family member needs it most. Single payer proposals would make it illegal for Americans to purchase private insurance coverage for medically appropriate or necessary care. On June 9, 2005 the Canadian Supreme Court struck down a law that banned private health insurance for services covered under that country’s socialized health care program. In doing so, the court fittingly noted that: "Access to a waiting list is not access to health care."
Customize Coverage for Those Who Lack It
Instead of creating more problems with access in the United States, it seems more reasonable to customize coverage solutions for the different populations of uninsured Americans, beginning with low to moderate income Americans.
Congress should make coverage portable from job-to-job, and give Americans the same tax break when they buy insurance on their own that they receive when they get insurance through their jobs. We should create new purchasing-pool options to cover more people and provide more choices for individuals and families. We should make it legal for working families to buy health insurance across state lines in a national market. Congress could allow those eligible for public programs the choice to apply the value of their government health benefits toward the purchase of private health insurance, giving them more options for quality care.
