Jim is a medical doctor and he views the U.S. health care system from the perspective of the physician and his patient, rather than from that of the health industry. Before being elected to Congress, Jim treated a wide array of patients as a practicing psychiatrist, including Vietnam veterans, inmates of the King County jail, and State Department employees in sub-Saharan Africa, among others. In the course of this work, he experienced firsthand the limitations of the U.S. health care system, and this, in part, motivated him to become a member of Congress, where he could work to improve the system.
During his service in the Washington State Legislature, Jim crafted the Washington Basic Health Plan – the first state program in the country to provide low-cost health insurance to the unemployed and working poor. As a member of the U.S. Congress, Jim has long-focused on providing Americans with universal access to affordable, high-quality health care, which he believes is a right in a just, democratic society. Jim continues to push for a simpler health care system that provides better care and outcomes at a responsible cost.
Universal Health Care
Jim strongly supported the Affordable Care Act, the
pioneering health care reform bill that President Obama signed into law in
2010; this measure will increase the number of insured Americans by more than
30 million people. While the 2010 health care law is a huge step towards
improving the U.S. health care system, Jim recognizes that more needs to be
done to control costs, improve care, and include everyone. Jim knows that a
publicly financed universal health care system, rather than one based in the
private insurance industry, is the only approach the will enable the U.S. to
deliver high quality health care to all Americans in an affordable manner.
Publicly financed and managed health care systems in many other industrialized nations have proven themselves to achieve better health outcomes at lower cost. To that end, Jim has introduced the "American Health Security Act of 2011," which establishes a nationwide framework under which each state could provide publicly financed universal health coverage. Until universal health care is established at a federal level, Jim also supports allowing states that seek to establish a single-payer system on their own – like Vermont – to receive an earlier waiver than is allowed under the 2010 health care law.
Rebalancing the Health Care Workforce
The U.S. health care system desperately needs more
primary care doctors, as well as more advanced nurse
practitioners, physician assistants, nurses, and other professionals.
These primary care providers are in the best position to
evaluate and manage patients holistically. Unfortunately, our health care system pays doctors for each
procedure they perform, rather than for keeping patients healthy. As a result,
specialty practices are far more lucrative than primary care and
disproportionately attract the best talent from our medical schools. This
largely explains why there is an abundance of expensive, and often
counterproductive, procedures carried out and not enough basic prevention and
care coordination. While we certainly will always need excellent specialists,
rebalancing our physician workforce will lower costs and improve patient
outcomes. Most other developed nations have about 50 percent primary-care doctors,
compared with about 30 percent here in the United States.
One way to encourage new medical students to become primary-care doctors is to equalize the financial disparity between specialists and primary-care doctors. To accomplish this, Jim has introduced the “Medicare Physician Payment Transparency and Assessment Act,” which seeks to end the disproportionate influence that specialty doctors exert on setting Medicare (and, by extension, most other) reimbursement rates. Allowing a neutral intermediary to play a role in setting reimbursement rates will help even the playing field between primary care and specialty practices. Jim is also exploring an initiative modeled on the ROTC, under which new medical students at state institutions would receive federally-funded medical education in exchange for a commitment to serve a few years in the U.S. Public Health Service as a primary care doctor after graduation.
Fighting
HIV/AIDS
Fighting the HIV/AIDS epidemic has been one of Jim’s
priorities since he arrived in Congress in 1989. Jim’s experience as a Foreign
Service medical officer in Zaire (now the Democratic Republic of Congo) brought
him into contact with the African AIDS epidemic while it was in its infancy,
and this experience fortified his desire to fight HIV/AIDS as a lawmaker. One
of Jim’s first legislative accomplishments in Congress was authoring the
Housing Opportunities for Persons with AIDS (HOPWA) program in 1990, which was
included in the Cranston-Gonzalez National Affordable Housing Act that
President George H.W. Bush signed into law. Under HOPWA, the Department of
Housing and Urban Development distributes grant funds to states and localities
nationwide to provide housing assistance for financially vulnerable people
living with HIV/AIDS.
Jim also launched the Congressional HIV/AIDS Caucus in 1992 and has since served as its co-chair. Jim remains committed to enlarging the United States’ position as the global leader in destigmatizing, containing, and ultimately finding a vaccine and cure for this disease both at home and abroad. Jim recently re-launched the Caucus with Congresswoman Barbara Lee (D-CA) and Congressman Trent Franks (R-AZ), marking the first time that the group has bipartisan support.
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