Issue Position: Health Care Record

Issue Position

Washington has managed to create by far the most expensive health care system in the world, while leaving more than 40 million Americans uninsured, and many millions more struggling to pay ever-rising premiums and prescription drug costs. Meanwhile, our businesses must compete with those in countries with far lower health care costs, or with publicly financed systems, placing them at a huge disadvantage. Yet special interests perpetually block any significant health care reform legislation.

We must have the courage to create change, and finally move towards universal health coverage.

Any national health care plan must deal with three separate challenges: cost, access and quality. And the next president should pledge to inaugurate a system of universal, affordable health care.

We can move quickly toward universal health insurance by expanding access to public health care programs, providing tax credits for those who cannot obtain employer-based coverage, and giving Americans access to collective purchasing power.

We can simultaneously reduce costs, boost quality, and make American healthier through a "quality revolution" in health care. We should use information technology to measure outcomes, hold providers and insurers accountable for results, and make preventive care and discovery of cures for chronic illnesses a major national priority. Clear public support for stem cell research will also help promote cures for some of our deadliest diseases.

Improving health care quality and emphasizing preventive care also requires a workable, fair and universal system of prescription drug coverage backed by the negotiating power of the federal government and making full use of low-cost generic drugs.

On the key issues of access, cost and quality, Tom Vilsack made steady improvements in Iowa's health care system over his two terms as governor, with expanded health coverage being his most notable accomplishment.

As of 2005, Iowa ranked second in the nation in the percentage of residents (91.4), and also the percentage of children (95.1), with health insurance. Over the last few years, Iowa was one of just three states that made improvement in the percentage of residents with health care coverage.

Vilsack also worked hard to expand the scope of health coverage, securing a Health Insurance Bill of Rights that set out minimum standards for insurance policies, and signed a mental health parity law that requires coverage of an array of mental illnesses. He consistently fought for equity for women in health services, signing legislation which required insurance companies that offer prescription drug coverage to extend that coverage to include women's contraceptives. Vilsack has been a steadfast advocate for a woman's right to choose.

As prescription drug costs skyrocketed in Iowa as elsewhere, Vilsack joined with the governors of Maine and Vermont to create a three-state prescription drug purchasing alliance to obtain better prices. He also pushed for the right to reimport prescription drugs from Canada to lower costs for retirees and state employees.

In an effort to make health care for seniors both more cost-effective and family-friendly, Vilsack established a Senior Living Trust program, which has enabled more than 15,000 Iowans to receive health services at home instead of entering nursing homes.

His emphasis on the quality of care was reflected in his initiative requiring the state to publish performance information on various health plans. Vilsack also successfully led a coalition that called for the allocation of Iowa's entire tobacco settlement fund ($55 million) to support preventive health care and anti-smoking measures.

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