domingo, septiembre 13, 2009

2008 Republican Platform on Health care

Health Care Reform: Putting Patients First

Americans have the best doctors, the best hospitals, the most innovative medical technology, and the best scientists in the world. Our challenge and opportunity is to build around them the best health care system. Republicans believe the key to real reform is to give control of the health care system to patients and their health care providers, not bureaucrats in government or business.

There are reasons why American families and businesses are dissatisfied with the current state of health care:

  • Most Americans work longer and harder to pay for health care.

  • Dedicated health care providers are changing careers to avoid litigation.

  • The need to hold onto health insurance is driving family decisions about where to live and work.

  • Many new parents worry about the loss of coverage if they choose to stay at home with their children.

  • The need – and the bills – for long-term care are challenging families and government alike.

  • American businesses are becoming less competitive in the global marketplace because of insurance costs.

  • Some federal programs with no benefit to patients have grown exponentially, adding layers of bureaucracy between patients and their care.

It is not enough to offer only increased access to a system that costs too much and does not work for millions of Americans. The Republican goal is more ambitious: Better health care for lower cost.

First Principle: Do No Harm

How do we ensure that all Americans have the peace of mind that comes from owning high-quality, comprehensive health coverage? The first rule of public policy is the same as with medicine: Do no harm.

The American people rejected Democrats’ attempted government takeover of health care in 1993, and they remain skeptical of politicians who would send us down that road. Republicans support the private practice of medicine and oppose socialized medicine in the form of a government-run universal health care system. Republicans pledge that as we reform our health care system:

  • We will protect citizens against any and all risky restructuring efforts that would complicate or ration health care.

  • We will encourage health promotion and disease prevention.

  • We will facilitate cooperation, not confrontation, among patients, providers, payers, and all stakeholders in the health care system.

  • We will not put government between patients and their health care providers.

  • We will not put the system on a path that empowers Washington bureaucrats at the expense of patients.

  • We will not raise taxes instead of reducing health care costs.

  • We will not replace the current system with the staggering inefficiency, maddening irrationality, and uncontrollable costs of a government monopoly.

Radical restructuring of health care would be unwise. We want all Americans to be able to choose the best health care provider, hospital, and health coverage for their needs. We believe that real reform is about improving your access to a health care provider, your control over care, and your ability to afford that care.

We will continue to advocate for simplification of the system and the empowerment of patients. This is in stark contrast to the other party’s insistence on putting Washington in charge of patient care, which has blocked any progress on meeting these goals. We offer a detailed program that will improve the quality, cost, and coverage of health care throughout the nation, and we will turn that plan into reality.

Patient Control and Portability

Republicans believe all Americans should be able to obtain an affordable health care plan, including a health savings account, which meets their needs and the needs of their families.

Families and health care providers are the key to real reform, not lawyers and bureaucrats. To empower families, we must make insurance more affordable and more secure, and give employees the option of owning coverage that is not tied to their job. Patients should not have to worry about losing their insurance. Insurance companies should have to worry about losing patients’ business.

The current tax system discriminates against individuals who do not receive health care from their employers, gives more generous health tax benefits to upper income employees, and fails to provide every American with the ability to purchase an affordable health care plan. Republicans propose to correct inequities in the current tax code that drive up the number of uninsured and to level the playing field so that individuals who choose a health insurance plan in the individual market face no tax penalty. All Americans should receive the same tax benefit as those who are insured through work, whether through a tax credit or other means.

Individuals with pre-existing conditions must be protected; we will help these individuals by building on the experiences of innovative states rather than by creating a new unmanageable federal entitlement. We strongly urge that managed care organizations use the practice patterns and medical treatment guidelines from the state in which the patient lives when making medical coverage decisions.

Because the family is our basic unit of society, we fully support parental rights to consent to medical treatment for their children including mental health treatment, drug treatment, alcohol treatment, and treatment involving pregnancy, contraceptives, and abortion.

Improving Quality of Care and Lowering Costs

While delivering control of health coverage to families and individuals, Republicans will also advance a variety of targeted reforms to improve the quality of care, lower costs, and help Americans – men, women, and children – live longer and healthier lives.

Prevent Disease and End the “Sick Care” System

Chronic diseases – in many cases, preventable conditions – are driving health care costs, consuming three of every four health care dollars. We can reduce demand for medical care by fostering personal responsibility within a culture of wellness, while increasing access to preventive services, including improved nutrition and breakthrough medications that keep people healthy and out of the hospital. To reduce the incidence of diabetes, cancer, heart disease, and stroke, we call for a national grassroots campaign against obesity, especially among children. We call for continuation of efforts to decrease use of tobacco, especially among the young.

A culture of wellness needs to include the treatment of mental health conditions. We believe all Americans should have access to affordable, quality health care, including individuals struggling with mental illness. For this reason, we believe it is important that mental health care be treated equally with physical health care.

Empower Individuals to Make the Best Health Care Choices.

Clear information about health care empowers patients. It lets consumers make better decisions about where to spend their health care dollars, thereby fostering competition and lowering costs. Patients must have information to make sound decisions about their health care providers, hospitals, and insurance companies.

Use Health Information Technology to Save Lives

Advances in medical technology are revolutionizing medicine. Information technology is key to early detection and treatment of chronic disease as well as fetal care and health care in rural areas – especially where our growing wireless communications network is available. The simple step of modernizing recordkeeping will mean faster, more accurate treatment, fewer medical errors, and lower costs. Closing the health care information gap can reduce both under-utilization (the diabetic who forgets to refill an insulin prescription) and over-utilization (the patient who endures repetitive tests because providers have not shared test results).

Protect Good Health Care Providers from Frivolous Lawsuits

Every patient must have access to legal remedies for malpractice, but meritless lawsuits drive up insurance rates to outrageous levels and ultimately drive up the number of uninsured. Frivolous lawsuits also drive up the cost of health care as health care providers are forced to practice defensive medicine, such as ordering unnecessary tests. Many leave their practices rather than deal with the current system. This emergency demands medical liability reform.

Reward Good Health Care Providers for Delivering Real Results

Patients deserve access to health care providers they trust who will personalize and coordinate their care to ensure they receive the right treatment with the right health care provider at the right time. Providers should be paid for keeping people well, not for the number of tests they run or procedures they perform. The current cookie-cutter system of reimbursement needs restructuring from the view of the patient, not the accountant or Washington bureaucrat.

Drive Costs Down With Interstate Competition

A state-regulated national market for health insurance means more competition, more choice, and lower costs. Families – as well as fraternal societies, churches and community groups, and small employers – should be able to purchase policies across state lines. The best practices and lowest prices should be available in every state. We call upon state legislators to carefully consider the cost of medical mandates, and we salute those Republican governors who are leading the way in demonstrating ways to provide affordable health care options.

Modernize Long-Term Care Options for All

The financial burdens and emotional challenges of ensuring adequate care for elderly family members affect every American, especially with today’s aging population. We must develop new ways to support individuals, not just institutions, so that older Americans can have a real choice whether to stay in their homes. This is true not only with regard to Medicaid, where we spend $100 billion annually on long-term care, but also for those who do not qualify for that assistance.

Encourage Primary Care as a Specialty

We believe in the importance of primary care specialties and supporting the physician’s role in the evaluation and management of disease. We also encourage practice in rural and underserved areas of America.

Funding Medical Research

We support federal investment in basic and applied biomedical research. This commitment will maintain America’s global competitiveness, advance innovative science that can lead to medical breakthroughs, and turn the tide against diseases affecting millions of Americans – diseases that account for the majority of our health care costs. The United States leads in this research, as evidenced by our growing biotechnology industry, but foreign competition is increasing. One way government can help preserve the promise of American innovation is to ensure that our intellectual property laws remain robust.

Federal research dollars should be spent as though lives are at stake – because, in fact, they are. Research protocols must consider the special needs of formerly neglected groups if we are to make significant progress against breast and prostate cancer, diabetes, and other killers.

Taxpayer-funded medical research must be based on sound science, with a focus on both prevention and treatment, and in accordance with the humane ethics of the Hippocratic Oath. In that regard, we call for a major expansion of support for the stem-cell research that now shows amazing promise and offers the greatest hope for scores of diseases – with adult stem cells, umbilical cord blood, and cells reprogrammed into pluripotent stem cells – without the destruction of embryonic human life. We call for a ban on human cloning and for a ban on the creation of or experimentation on human embryos for research purposes.

We believe medicines and treatments should be designed to prolong and enhance life, not destroy it. Therefore, federal funds should not be used for drugs that cause the destruction of human life. Furthermore, the Drug Enforcement Administration ban on use of controlled substances for physician-assisted suicide should be restored.

Protecting Rights of Conscience

The health care profession can be both a profession and a calling. No health care professional – doctor, nurse, or pharmacist – or organization should ever be required to perform, provide for, or refer for a health care service against their conscience for any reason. This is especially true of the religious organizations which deliver a major portion of America’s health care, a service rooted in the charity of faith communities.

Medicare

We support the provision of quality and accessible health care options for our nation’s seniors and disabled individuals and recognize that in order to meet this goal we must confront the special challenges posed by the growth of Medicare costs. Its projected growth is out of control and threatens to squeeze out other programs, while funding constraints lead to restricted access to treatment for many seniors. There are solutions. Medicare can be a leader for the rest of our health care system by encouraging treatment of the whole patient. Specifically, we should compensate doctors who coordinate care, especially for those with multiple chronic conditions, and eliminate waste and inefficiency. Medicare patients must have more control of their care and choice regarding their doctors, and the benefits of competition must be delivered to the patients themselves if Medicare is to provide quality health care. And Medicare patients must be free to add their own funds, if they choose, to any government benefits, to be assured of unrationed care.

Finally, because it is isolated from the free market forces that encourage innovation, competition, affordability, and expansion of options, Medicare is especially susceptible to fraud and abuse. The program loses tens of billions of dollars annually in erroneous and fraudulent payments. We are determined to root out the fraud and eliminate this assault on the taxpayer.

Medicaid

Our Medicaid obligations will consume $5 trillion over the next ten years. Medicaid now accounts for 20-25 percent of state budgets and threatens to overwhelm state governments for the indefinite future. We can do better while spending less. A first step is to give Medicaid recipients more health care options. Several states have allowed beneficiaries to buy regular health insurance with their Medicaid dollars. This removes the Medicaid “stamp” from people’s foreheads, provides beneficiaries with better access to doctors, and saves taxpayers’ money. We must ensure that taxpayer money is focused on caring for U.S. citizens and other individuals in our country legally.

Building a Health Care System for Future Emergencies

To protect the American people from the threats we face in the century ahead, we must develop and stockpile medicines and vaccines so we can deliver them where urgently needed. Our health care infrastructure must have the surge capacity to handle large numbers of patients in times of crisis, whether it is a repeat of Hurricane Katrina, a flu pandemic, or a bioterror attack on multiple cities. Republicans will ensure that this infrastructure, including the needed communications capacity, is closely integrated into our homeland security needs.


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