Even if you didn’t vote for Obama, you have to admire him for his leadership and the precision with which he carried out his campaign. As part of a grassroots effort, I had reached out to both presidential candidates regarding their healthcare plans and asked them five important policy questions. Below are Obama’s answers. One of my goals is to create a mechanism for physicians to have a front row seat at all health policy discussions. The voice of physicians will no longer be ignored.
The foundation of our healthcare system, the primary care doctor, is critically endangered. What would you do to ensure an adequate supply of primary care physicians to care for our growing and aging population?
Our ability to improve the health care system and reduce costs through greater care coordination and prevention depends on an adequate supply of primary care physicians. Yet, the numbers of primary care physicians are dwindling and the existing workforce is further challenged by inadequate training for new health threats such as bioterrorism and avian flu, antiquated funding and reimbursement mechanisms, and limited access to real-time information and technical support. Joe Biden and I will increase the number of primary care physicians through expanded funding-including loan repayments, adequate reimbursements, grants for training curricula, and infrastructure support to improve working conditions- to ensure a strong workforce that will champion prevention and broader public health activities.
Driven by profit motives, third parties are increasingly dictating the practice of medicine by exercising undue authority over healthcare processes. What is your plan to prevent these entities from standing in the way of patient care and the doctor-patient relationship?
Our health care plan recognizes that our current health care system is straining relationships between physicians and their patients. It recognizes that physicians and all health care providers feel under-appreciated and overworked in an increasingly stressful environment overrun by paperwork, bureaucracy, and rules. Health care executives are often too far removed from the front-lines to appreciate their problems, and healthcare workers often feel unheard. Our plan addresses the pressures on medical practice, including the crisis in our ERs and the growing shortage of primary care providers. Joe Biden and I will help physicians do their job more effectively by reinforcing the patient-provider relationship and reducing unnecessary paperwork. Some of the specific ways our plan will strengthen physician-patient relationships include:
• Ensuring that all Americans have access to affordable health coverage, so that families don’t need to use emergency rooms for routine care
• Decreasing the need for doctors to fight with insurance companies by promoting coverage of necessary preventive services
• Providing support for good medical decision-making by promoting best practices
• Reducing bureaucracy, administrative costs, and overhead with health information technology
• Reducing medical errors to reduce malpractice suits
• Improving reimbursement for primary and preventive care
Do you believe that physicians in general are fairly compensated? What steps would you take to ensure fair and adequate compensation of all physicians given the intense commitment and financial burden that it takes to become a physician?
We believe that the health care system can improve how it reimburses physicians to ensure that they are fairly compensated for their commitment to improving patient care. For too long our health system has failed to reward care coordination, prevention, and other common-sense interventions that improve patient quality and lower health care costs. We will seek to change the way we reimburse for patient care to paying adequately for care coordination, case management, and innovative care-delivery models, such as team-based care and electronic communication. Further, we believe that private insurers and Medicare should fairly pay physicians. Payment reforms should improve patient outcomes and should lower overall costs by removing incentives for unnecessary care and rewarding the right care, provided at the right time, for the right reasons. Unlike our opponent, we returned to Washington to vote to block impending cuts to Medicare physician payments. Our health care plan recognizes that we can’t start reforming health care by penalizing doctors.
Do you believe that healthcare requires more regulation in this country? What are the main areas where you would want to see more regulatory control and oversight?
We will strengthen employer-based coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference. Our plan is the correct balance between the two extremes of government-run health care and insurers companies running amok without any accountability to patients and health care providers. Unlike, our opponent who recently wrote that he would like to deregulate the health care industry just like the banking industry, we understand that government oversight and accountability can be wisely applied to improve patient care and reduce costs while preserving consumer choice of doctor and care.
We believe that we can improve the way that insurance companies operate. The insurance business today is dominated by a small group of large companies that has been gobbling up their rivals. In recent years, for-profit companies have bought up not-for-profit insurers around the country. These changes were supposed to make the industry more efficient, but instead premiums have skyrocketed. Over the same time period, insurance administrative overhead has been the fastest-growing component of health spending.
Our plan will prevent insurance companies from abusing their monopoly power through unjustified price increases. In markets where the insurance business is not competitive, our plan will force insurers to pay out a reasonable share of their premiums for patient care instead of keeping exorbitant amounts for profits and administration.
Our plan will also reduce the price of prescription drugs by allowing for the safe importation of drugs from developed countries if the drugs are safe and have lower prices than those sold in the U.S. It will also increase the availability of lower-cost generic drugs and allow Medicare to negotiate for cheaper drug prices.
The practice of defensive medicine is a substantial burden on our healthcare system and many physicians are distressed and financially strained by the current malpractice situation. What liability reform plans do you endorse to deal with this problem?
Increasing medical malpractice insurance rates are making it harder for doctors to practice medicine and raising the costs of health care for everyone. Our plan will strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance. We will also promote new models for addressing physician errors that improve patient safety, strengthen the doctor-patient relationship, and reduce the need for malpractice suits.
Our plan recognizes that our goal should be to reduce malpractice suits by preventing patient injury. Our plan will promote alternative models of dispute resolution that will strengthen the doctor-patient relationship and ensure errors to be addressed in a fair manner that helps both parties. Our plan also ensures greater oversight and monitoring of the behavior of malpractice insurers, and strengthening antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance. Above all, our plan focuses on improving systems of care so that the injuries that generate litigation are reduced. Our plan recognizes that we need to allow physicians to focus on improving patient safety instead of worrying about being sued.
