I believe in access to quality, affordable health
care for every American that preserves individual choice and protects
the doctor-patient relationship.
Preserving Patient Access to Quality
Care
Arizona is one of the nation’s fastest growing
states. As its population grows and ages, so, too, does the demand
for health-care services. Yet, Arizona suffers from a critical
shortage of health care professionals, including primary care
physicians, specialists, and nurses.
According to the Health Resources and Services Administration’s
(HRSA) 2004 analysis of state health workforce data, Arizona ranked
49th among states in per capita health services employment. HRSA
estimates that Arizona has 172 physicians per 100,000 people,
well below the national average.
The shortage of health care professionals is due,
in part, to Medicare’s efforts to control costs. Medicare
limits the amount it pays for services, which, in turn, causes
health-care providers to limit the number of Medicare patients
they see or stop treating Medicare beneficiaries altogether. This
is particularly serious in Arizona which has a growing and aging
population.
The American Medical Association estimates that
Medicare will cut physician payment by 40 percent from 2008 to
2018. This is a loss of over $4 billion to Arizona alone.
For these reasons, I led efforts that successfully
averted scheduled cuts in physician payment for 2005, 2006, 2007,
and the first half of 2008. Additionally, I am working with my
colleagues to devise a long-term payment solution in order to
ensure continuing access to quality care.
Strengthening Health Professional Training
and Retention
In 1994, the Centers for Medicare and Medicaid Services
(CMS) singled out teaching anesthesiology programs, implementing
a payment change that resulted in the closure of 28 of them. Only
129 academic anesthesiology programs remain. Medicare’s
payment policy challenges a teaching program’s ability to
fill vacant faculty positions, retain expert faculty, and train
residents, particularly in rural and underserved communities.
And, perhaps most importantly, as training programs close, patients
increasingly encounter anesthesiologist shortages.
Senators Vitter, Rockefeller, and I introduced the
Medicare Anesthesiology Teaching Funding Restoration Act to restore
Medicare payments to anesthesiologists who teach. Restoring this
funding would help preserve patient access to safe, quality health
care and alleviate one of a growing number of health professional
shortages.
Creating Small Business Health Plans
(SBHPs)
Small businesses are struggling to provide health-care
benefits to their employees. Currently, less than 40 percent of
small firms in Arizona offer employee health insurance coverage.
To make it easier for small businesses to offer
coverage, I supported the Health Insurance Marketplace Modernization
and Affordability Act. The bill would enable small businesses
to band together to purchase health insurance for employees and
use their combined bargaining power to negotiate better health
benefits at better prices, just like large companies do.
According to the non-partisan Congressional Budget
Office, SBHPs would newly insure nearly 750,000 Americans. Three
out of every four small business employees would pay premiums
lower than under current law, and employer premiums would decrease
by 12 percent (an estimated savings of $1,000 per employee), according
to a study by the respected actuarial firm, Mercer Olive Wyman.
Also, federal and state Medicaid spending would decline by nearly
$1.4 billion over 10 years.
Preserving Comprehensive Medicare Prescription
Drug Coverage
Medicare beneficiaries may enroll in comprehensive
prescription drug coverage under Medicare Part D. As a member
of the bipartisan team that crafted the Part D legislation, I
am committed to ensuring its successful implementation. I will
fight attempts to erode Part D coverage.
Despite its initial challenges, Part D is off to
a strong start. Nearly 820,000 Arizonans receive some sort of
assistance under Part D. 500,000 Arizonans have enrolled in a
prescription drug plan or a Medicare Advantage prescription drug
plan. Eight out of 10 enrollees report that they are satisfied
with their coverage.
Due to robust competition among health plans, Medicare
beneficiaries also have more affordable health coverage options.
The average beneficiary premium is $25 in 2008, well below the
initial estimate of $41. Beneficiaries are saving $1,200 on average
per year. And, the projected cost of Part D has dropped by 10
percent, or $113 billion, over 10 years. Of those savings, $96
billion is directly attributed to competition.
Arizonans who are interested in more information
regarding Medicare Part D may contact 1-800-MEDICARE or visit
Medicare’s website (www.medicare.gov)
and click on “Compare Medicare Prescription Drug Plans.”
Both of these options help beneficiaries select the coverage that
best suits their health care needs. Please make sure to have a
list of current prescriptions handy. As always, also feel free
to contact one of my offices at 602-840-1891 (Phoenix), 520-575-8633
(Tucson), or 202-224-4521 (Washington, D.C.) for further assistance.
Protecting Health Insurance Coverage
for Low-Income Children
In 1997, Congress created the State Children’s
Health Insurance Program (SCHIP) to help states provide health
insurance to uninsured children of working-poor families who do
not qualify for Medicaid. Last year, nearly 6.6 million children
received health insurance through this program. I support the
reauthorization of SCHIP. Funding was recently extended through
March 31, 2009.
I cosponsored the Kids First Act which would
reauthorize SCHIP and enroll 1.3 million new children. It would
phase out adult enrollment (the program was created for children,
not adults) and minimize the erosion of private coverage.
Promoting Health Savings Accounts (HSAs)
Health savings accounts (HSAs) allow all Americans
the opportunity to have more affordable, quality health coverage.
HSAs combine a high-deductible health plan with a tax-free personal
savings account for medical expenses. HSAs are portable, allowing
individuals to continue their health care coverage even if they
are between jobs. More than three million people, many of whom
were previously uninsured, have an HSA. Access to HSAs was expanded
by the 2003 Medicare law, which I supported.
Reforming Medical Liability Laws
The dramatically rising cost of medical liability
insurance for physicians and other health-care providers is driving
up the cost of health care for all consumers. In some cases, it
is making it too expensive for doctors to continue to offer care,
further compromising patients’ access to affordable health
care.
There are only a few ways doctors and hospitals
can bear such liability costs. They pass on costs to patients
or they alter their practice patterns. Some physicians have cut
the salaries of their professionally trained medical staff, reduced
the size of their practices, or completely eliminated some gynecological,
surgical, or high-risk obstetric procedures. Perhaps most disturbing
are the ever increasing instances of physicians retiring early,
relocating their practices to states with friendlier laws, or
dropping certain specialties altogether.
The average wait for a consultation with a
gastroenterologist in the Phoenix area is now two to three months.
Mesa hospital administrators report acute shortages of both orthopedic
surgeons and neurologists, resulting in emergency room and inpatient
consult delays. This is partly due to exorbitant medical liability
premiums and the lack of physicians willing to practice under
the threat of lawsuits. Meanwhile, trial lawyers benefit. A Hudson
Institute study found that 57 cents of every dollar awarded in
malpractice cases does not go to the patient who was harmed, but
to trial lawyers.
I have consistently supported medical liability
reform to limit these costs and ensure access to affordable, quality
care.
Promoting Health Research
The National Institutes of Health (NIH) is the standard
bearer for medical research the world over. As such, NIH must
be adequately funded to continue making important scientific breakthroughs.
In 1997, I voted to begin the process of doubling funding for
the NIH over a five-year period, and I have supported additional
appropriations for the NIH since then.
I also cosponsored the Breast Cancer and Environmental
Research Act, which would encourage multidisciplinary and multi-institutional
research on the environmental factors associated with breast cancer.
The bill would establish Breast Cancer and Environmental Research
Centers of Excellence and make grants available to public or nonprofit
private entities for the development and operation of such centers.
I also helped win funding for the Translational
Genomics Research Institute (T-Gen) in Phoenix. T-Gen’s
researchers are working to eradicate breast cancer, melanoma,
pancreatic cancer, and diabetes among other diseases. Without
this funding, critical basic research would go undone due to a
lack of incentive for the private sector to engage in that activity.
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