Affordable, Quality Health Insurance

“We will not nationalize our health care system. We will promote individual choice. We will rely on private insurance. But make no mistake: In my administration, low-income Americans will have access to high-quality health care.” 
                                                                         — George W. Bush 

Let's give credit where due: More than 100 million American workers and their families have sound health insurance through their places of employment. The job-creating dynamism of our free economy has thus done more to advance health care than any government program possibly could. The tie between good jobs and good insurance coverage is the single most important factor in advancing health care for those who need it. 

That's why the Republican party remains determined to change federal law to give small employers the liberty to band together to purchase group insurance for their employees at reduced rates, thus providing them that important security. The tragedy is that this urgent expansion of coverage has this far been blocked by veto threats. With a Republican president, that will change. 

Uninsured Americans do not have a single face. Their situations vary tremendously, with changes in family status, age, and income. It makes sense to let them decide what kind of coverage best suits their needs. To give them that power of choice, we propose an unprecedented tax credit that will enable 27 million individuals and families to purchase the private health insurance that's right for them. We also support full deductibility of health insurance premiums for the self-employed.

Truly positive market forces occur when individuals have the ability to make individual marketplace decisions. We therefore strongly encourage support of the emerging concepts of defined contribution plans and medical savings accounts. Individuals should be free to manage their own health care needs through Flexible Savings Accounts (FSAs) and Medical Savings Accounts (MSAs). These initiatives make a government takeover of health care as anachronistic as surgery without anesthesia. We will make these accounts the vanguard of a new consumer rights movement in health care. Individuals should be able to roll over excess FSA dollars from one year to the next, instead of losing their unspent money at the end of each year. MSAs should be a permanent part of tax law, offered to all workers without restriction, with both employers and employees allowed to contribute.

Still, more needs to be done. A major reason why health insurance is so expensive is that many state legislatures now require all insurance policies to provide benefits and treatments which many families do not want and do not need. It is as if automakers were required by law to sell only fully equipped cars, even to buyers who didn't want or need all the extras. These mandates, extending far beyond minimum standards, increase costs for everyone, price low-income families out of the insurance market, and advance the interests of specific providers. They have no place in a health care system based on consumer rights and patient choice. One area of health care that is sadly ignored is the role of primary and preventive care. This is particularly important in our inner cities and rural communities, where the emergency room may be the only avenue for assistance. People in rural and underserved areas need access to critical primary care. We will boost funding for community health centers and establish stronger public-private partnerships for safety net providers and hospitals in rural and underserved communities.

When Congressional Republicans established the State Children's Health Insurance Program (S-CHIP) program in 1997, they enabled us to secure health insurance coverage for approximately 8 million youngsters. Republicans want to ensure that children have access to quality health care, and that states have the flexibility to innovate, expand family coverage without interference from the Health Care Financing Administration, and reach out to eligible households that are currently not enrolled in a health insurance program or in Medicaid. In a Republican administration, the first order of business at the Department of Health and Human Services will be to eliminate regulations that are stymieing the effectiveness of S-CHIP program and to stop imposing unwarranted mandates, so states can make sure children who need health care can get it. A streamlined enrollment process and energetic outreach efforts will finally fulfill the promise of S-CHIP. All it takes is caring.

Improving the Quality of Health Care

Protecting Patients’ Rights. The tremendous growth of managed health care was driven by a market response to the fractured system of health care delivery that preceded it. One result of that growth has been a welcomed slowing of the rapid increases in health costs that were a regular occurrence of the 1970s and 1980s. However, this has come at the cost of patient dissatisfaction with the at times impersonal or insufficient health care delivery mechanism. Simply put, patients deserve more protections if we are to achieve a patient-centered system that offers high-quality, affordable care. The parents of a sick child should have access to the nearest emergency care. A patient in need of a heart specialist’s expertise should be allowed to seek that opinion. A woman with breast cancer should be able to participate in a potentially life-saving clinical trial, and patients should have prompt access to independent physicians, or when appropriate, other health care professionals, to override any wrongful denial of treatment.

The traditional patient-doctor relationship must be preserved. Medical decision-making should be in the hands of physicians and their patients. In cases when a health plan denies treatment, a rapid appeals process geared toward ensuring that patients receive the right treatment without delays that might threaten a patient’s health — as opposed to a lengthy trial — must be readily accessible to everyone in all health plans. We believe a quick and fair resolution to treatment disputes without going to court is the best result. However, as a last resort, we also support a patient’s right to adjudicate claims in court to receive necessary medical care. In the interest of fairness to the thousands of businesses that purchase health benefits for their employees and for physicians who care for patients, employers and physicians should not be liable for the actions of the health plan and should be shielded from frivolous and unnecessary lawsuits.

Our overall philosophy is to trust state and local government to know what best suits the needs of their people. We believe the federal government should respect the states’ traditional authority to regulate health insurance, health care professionals, and health practice guidelines through their medical boards.

Medical Errors and Malpractice Reform. Our goal is to reduce the rate of medical errors, especially those that result in a patient’s death. We will support scientific research to provide the public and health care providers with information about why these errors occur and what can be done to prevent them. We should not displace the current, very effective hospital peer review system.

Another key step will be reform of malpractice law. In its current form, it encourages health care providers to conceal even innocent mistakes, lest they be subject to vilifying publicity through the trial lawyers’ system of jackpot justice. That is why a cloak of secrecy envelops operating rooms. We must open up the free flow of information concerning medical errors, both to protect patients and to reduce the cost of modern medicine. Patients who are genuinely injured should be rightly compensated, but the punitive and random aspects of today’s litigation lottery cry out for reform. Just as we hold all health care personnel to the highest standards, so too must public policy respect their ethical conscience. No individual or institution should be compelled to assist in providing any medical service that violates their moral or religious convictions. 

Women’s Health. As Republicans, we hold dear the health and vitality of our families. Our efforts to build healthier families must begin with women — our mothers, daughters, grandmothers and grand-daughters. This nation needs far greater focus on the needs of women who have historically been underrepresented in medical research and access to the proper level of medical attention. We are reversing this historic trend. 

Across this country, and at all levels of government, Republicans are at the forefront in aggressively developing health care initiatives targeted specifically at the needs of women. The enormous increases in the NIH budget brought about by the Republican Congress will make possible aggressive new research and clinical trials into diseases and health issues that disproportionately affect women as well as into conditions that affect the elderly, the majority of whom are women. And we are leading efforts to reach out to underserved and minority female populations, where disparities persist in life expectancy, infant mortality and death rates from cancer, heart disease, and diabetes.

Republicans are dedicated to pursuing comprehensive women's health care initiatives that include access to state-of-the-art medical advances and technology; equality for women in the delivery of health care services; medical research that focuses specifically on women; appropriate representation of women in clinical trials; and direct access to women’s health providers. 

The increasing focus upon health problems of the very elderly, the great majority of whom are women, holds the promise of advances concerning osteoporosis and other ailments which should no longer be considered the inevitable price of old age. Because nutrition is intimately related to health, we advocate state flexibility in managing the various federal nutrition programs for low-income families, especially those receiving TANF assistance, most of whom are female-headed households. Their transition to jobs and independence should include nutritional improvement both for mothers and for their children.

The united efforts of Republican leaders at all levels of government and within our communities will make sure that women gain greater access to relevant care, research, and education on health care issues important to them.

REFORMING HEALTH CARE

Today, a family's ability to ensure that all its members get the quality health care they deserve is challenged like never before. For the most fortunate, America offers the best health care in the world. But tens of millions of Americans pay too much and get too little from our health care system, and tens of millions more have no health insurance at all.

Skyrocketing health care costs not only hurt our families; they hurt our economy. American businesses pay more than their competitors for health care, reducing their competitiveness. American incomes suffer because raises are stifled by rising insurance premiums.

We will attack the health care crisis with a comprehensive approach. Our goal is straightforward: quality, affordable health coverage for all Americans to keep our families healthy, our businesses competitive, and our country strong.

In President George Bush's America, drug company and HMO profits count for more than family and small business health costs. Health care costs increased four times as fast as wages in the last year alone. Prescription drug spending has more than doubled during the past five years. Nearly 82 million Americans went without health care coverage at some point in the last two years. And the President has done nothing to bring costs down or lift these burdens. The few small proposals he has offered would further divide our health system between one that is affordable for the healthy and wealthy, and one that is unaffordable for the elderly, the sick, and increasingly, for America's broad middle class.

John Kerry, John Edwards and the Democratic Party believe in a better, stronger, healthier America. Our resolve to fix the health crisis is stronger than ever. In the wealthiest country in the world, every expectant mother should get quality prenatal care; every child should get regular check-ups; every senior should be able to get safe, affordable prescription drugs; and no hardworking family should ever lose everything because illness strikes a loved one.

Ensuring health care for children. The job begins with our children. It is a disgrace that nearly 8.5 million children still lack health insurance. We will strengthen Medicaid for our families and expand the children's health program created under President Clinton so no child goes without medical care.

Expanding coverage. Under the leadership of John Kerry and John Edwards, we will offer individuals and businesses tax credits to make quality, reliable health coverage more affordable. We will provide tax credits to Americans who are approaching retirement age and those who are between jobs so they can afford quality, reliable coverage. We will expand coverage for low income adults through existing federal-state health care programs. And we will provide all Americans with access to the same coverage that members of Congress give themselves.

Cutting health care costs. At the center of our efforts will be a plan to reduce health costs. We will lift a financial burden on families, businesses, and the self-employed by picking up the tab for the highest-cost medical cases. That will save America's families up to $1,000 on their premiums.

We will improve the quality of care and the efficiency of the medical system by using American technological know-how to cut billions of dollars wasted in administrative processing and paperwork. Today, about a quarter of all health-related spending is not even medical. We can do better. We will ensure that all Americans have secure, private electronic medical records by 2008, and we will give medical providers incentives and resources to simplify their paperwork so patients spend more time with doctors and less time filling out forms. We recognize that our health care system is substantially strengthened by the daily efforts of the men and women in a variety of health professions and we support fair treatment for all health professionals.

We will enact a real Patient's Bill of Rights to put doctors and nurses back in charge of making medical decisions with their patients � instead of allowing HMO bureaucrats to decide what a patient needs.

Helping seniors by protecting Medicare and cutting prescription costs. We oppose privatizing Medicare. We will not allow Republicans to destroy a commitment that has done so much good for so many seniors and people with disabilities over the past 39 years. Instead, we want to strengthen Medicare and make it more efficient.

We will ensure that seniors across the country, particularly in small-town and rural America, no longer suffer from geographic discrimination.

We will end the disgrace of seniors being forced to choose between meals and medication. Today, our seniors are paying too much for prescription drugs, while options abroad are far cheaper and just as safe. We will allow the safe reimportation of drugs from other countries.

The current Medicare drug program serves drug companies more than seniors. It allows these companies to change the price of prescriptions more frequently than seniors can change their plans. It does virtually nothing to bring down prescription drug costs. It forces seniors into HMOs. Elderly Americans deserve a real prescription drug benefit � one that uses the government's purchasing power to lower costs and ensures access to new therapies for their illnesses.

We will cut the waste and abuse that cost Medicare billions each year, using competitive bidding to lower the costs of buying medical equipment, educating providers to file claims more efficiently, and increasing penalties for those who bilk the system.

Dignity for all. We will ensure that elderly Americans and people with disabilities can live in dignity, with quality options for long-term care. We need to expand alternative care options and provide better assistance for those who give care. No one should be kept in a nursing home or institution if they prefer living in dignity elsewhere and can do so. And we will ensure that no person with a disability has to choose between quality health care and the dignity of work. We will also work to ensure that people with HIV and AIDS have the care they need, and we will support the community-based prevention programs, built on experience with real life, that President Bush has cut. We are committed to passing the Wellstone mental health parity legislation, ending discrimination against Americans with mental illnesses, and ensuring equal treatment for mental illness in our health system.

Eliminating health disparities. Millions of African Americans, Latinos, Asian Americans, Pacific Islanders, and American Indians continue to live sicker and die younger in America. Cultural and language barriers remain a particular problem for immigrant communities. We will fight racial and ethnic health care disparities by increasing research and training in the medical profession, breaking down language barriers, and ensuring good health care for all Americans. We will encourage and support enabling more minority students to enter the sciences. We will also work to ensure that women have access to the best medicines and state-of-the-art prevention and detection techniques to stop diseases early. We will also support prevention of illness through better nutrition and exercise.

. . .

Honoring our veterans. Finally, we will never forget the debt America owes our veterans. Patriotism means keeping faith with those who have worn the uniform of the United States. This Administration has broken its promises to our veterans � raising their health costs and reducing their access to care. John Kerry, John Edwards and the Democrats will keep faith with our veterans. We will continue the fight for mandatory funding for veterans' health care and we will make sure that disabled veterans and military retirees are not penalized with reductions in their pension benefits. And we will aggressively address the inexcusable backlogs in veterans' compensation and pension claims.

We believe in an America where health care is available and affordable. Where every family looks to the future with hope and excitement, without worry that the cost of health care is becoming too great to bear. Where strong, healthy families build a stronger America.

Health Care