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Rep. Murphy's Principles and Policies For Healthcare Reform

Choice of plans across the country. Health insurance shopping is limited to within a state’s boundaries, while there are sizeable cost disparities between states. Giving you more options and allowing you to shop for a health insurance policy will create competition, and lower costs.

Choice to join groups. Small businesses or individuals should be allowed to purchase insurance as a large group to increase purchasing power and demand lower costs.

Choice to purchase a basic plan. Choice is limited as states mandate what insurance companies have to cover. States have different requirements that end up driving up costs. You should have the option of purchasing a basic plan that fits your personal needs.

Implement quality reforms. Quality reforms should emphasize efficient, integrated evidence-based medicine that delivers the best care at the best price.

Personal, portable, permanent, and private. You should have the coverage you need that you can take between jobs without worrying your insurance will be cut because of an illness or preexisting condition — all without having the government interfere.

Washington should focus on fixing — rather than financing — the broken healthcare system.

Here are specific ideas that will improve the quality of care and reduce healthcare costs:
1. Fix Federally-Funded Care First.
Every fix to Medicare requires an act of Congress. Appoint a quality reform commission comprised of doctors and healthcare experts to identify and fix the inefficiencies in Medicare and Medicaid — allowing more money to be dedicated to improved and managed care. For instance, Rep. Murphy’s bipartisan SMART Act (H.R. 1063) eliminates the obstacles preventing billions of dollars from being repaid to the Medicare Trust Fund from so-called “secondary” insurers or payers. H.R. 1063 ends the bureaucratic red tape to ensure the money from secondary insurers is repaid quickly back into the program to support Medicare.


2. Promote Evidence-Based Medicine. The New England Healthcare Institute found that in a $2.4 trillion healthcare system, nearly $800 billion is wasted or misused. Unexplained variation in the intensity of medical and surgical services, including but not limited to back surgery, overuse of coronary artery bypass surgery, et cetera add up to avoidable costs of $600 billion. Misuse of drugs and treatments resulting in preventable adverse effects of medical care that could save an additional $52.2 billion. Promoting the use of evidence-based medicine could eliminate this waste.

3. Chronic Care Management. Medicare spends 90% of its budget to treat chronic illnesses like diabetes, hypertension, and congestive heart failure. In fact, half of Medicare’s 46 million beneficiaries have five or more chronic illnesses and make up more than three-quarters of all Medicare expenses. The Medicare system currently is a pay-for-procedure model, reimbursing physicians for every poke, prod, pinch, or prescription, wasting billions of dollars. Disease management and chronic care programs would be a major cost saver by reducing unnecessary hospitalizations and complications but Medicare won’t pay for it. In care management, doctors and nurses coordinate very complex medical care for people with chronic illnesses. For example, nurses help to keep diabetics’ glucose levels in check, thereby avoiding costly complications and rehospitalizations for vision loss, amputation, and kidney failure.

4. Quality And Transparency. Public reporting of hospital-acquired infections has helped to save $2 billion and 27,000 lives according to the CDC. Posting information about health outcomes for the public to review and compare will help to bring the market to bear on reducing costs and improving quality.

5. Use Health Centers for Primary Care Access. Community health centers save $25 billion a year, but a workforce shortage is making it hard to provide care to low-income and rural families. Currently, if a physician volunteers at a free clinic or works at a CHC, they receive malpractice coverage through the Federal Tort Claims Act (FTCA). But if they are employed at a free clinic or volunteer at a CHC, they are not covered and have to provide their own med-mal insurance, sometimes costing more than $100,000. Clinics can’t afford this expense, and illnesses go untreated because of it. Rep. Murphy’s Family Health Care Accessibility Act (H.R. 1629) breaks down this barrier to volunteerism and provides better healthcare access to millions of Americans. This bill will save Medicaid from paying for costly hospitalizations that result from a lack of primary care.