Dr. Gill's Rx for Health Care
The Preamble of the U. S. Constitution establishes the "promotion of the general welfare" as a fundamental reason for the federal government. What is more fundamental to the general welfare than adequate, accessible, and affordable health care for every American citizen?
To serve our people and compete effectively in world markets, we must get health care costs under control and expand coverage to all Americans. Until we finally adopt a comprehensive single-payer universal coverage national health care plan for all Americans, we will continue to see one disappointment after another in our health care services. We remain the only developed country in the world without a health care system that provides for the needs of its citizens from birth to death.
As your Congressman, I will work for a universal health care plan that empowers patients and providers and serves as a cure for the existing, broken system. Unlike my opponent's funding network, my grassroots campaign accepts no donations from corporations. When I go to Washington, I will work for you.
We need a comprehensive plan
I have been a member of Physicians for a National Health Program for 17 years. The plan endorsed by this group and 126 members of Congress recommends universal coverage for all Americans. This program will cover all medically necessary services, including primary care, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, long-term care, mental health services, dentistry, eye care, chiropractic, and substance abuse treatment.
Under this plan, patients will have their choice of physicians, providers, hospitals, clinics, and practices. Sensible regulation will streamline services and prevent costly abuses of the system.
We need to cut health care costs
Our broken health care system reduces our ability to remain competitive in an increasingly global economy. A single-payer insurance plan saves money by cutting down on HMO and insurance industry profits and overhead expenses through common-sense regulation.
My plan would cost businesses no more than a 5 percent payroll tax. Currently, business owners pay an average of 8.5 percent of payroll salaries for employee health care plans, and small businesses can pay up to 25 percent of payroll in expenses. A single-payer system lets business owners know exactly what they will be paying for health insurance, with no worries about drastic future increases in costs.
My plan is much less expensive for individuals. A 2 percent tax paid by individuals would cost the average family approximately $1,000/year. This would result in substantial savings for families who typically pay over $12,000 per year in combined costs under our current system.
There is a crisis in our health care system when 47 million Americans are not covered by the world's wealthiest system, when more than half of our bankruptcies stem from health care issues, and when 45,000 Americans die every year because they lack adequate health insurance. This crisis affects our seniors, our children, and every community. More than 80 percent of the uninsured work full-time. As an Emergency Room physician, I come face to face with this problem every day, and I understand the complexities of health care issues. It is time for a comprehensive national solution to the problem.
The current versions of health care reform that have been working their way through the U.S. House and U.S. Senate in the past year fall far short of the necessary reforms for which I have long advocated. In fact, many of the so-called reforms incorporated into the final bill will do little to correct the current systemic problems in health care, and some provisions stand a good chance of making an already bad situation even worse.
The leadership in both the House and Senate is unwilling or unable at this time to address the proverbial 800-pound gorilla in the room: the private health insurance industry and its stranglehold on American health care content, cost, and delivery. Until we have leadership in Washington that is willing to stand up to the private health insurance industry, most of what ails the American health care system will continue without significant improvement.
The current health care reform debate clearly demonstrates the pernicious influence of corporate financing for political campaigns. It is now plain that we cannot realistically expect to clean up our health care system until we clean up the way politics is financed in the U.S.
My opponent, as part of the corporate-funded Republican establishment, consistently touts the current American health care system as the best in the world. He thinks the status quo--in which 47 million Americans are uninsured, more than half of bankruptcies stem from health care issues, and 45,000 Americans die every year from lack of adequate health insurance coverage--is acceptable. His is a reliable Republican vote to obstruct Democratic health care initiatives, including State Children's Health Insurance Program (SCHIP) and reversing the Bush-era ban on stem cell research.
I do not rely on corporations for funding, and I am not a mouthpiece for the insurance industry. As an Emergency Room doctor, I have seen firsthand the suffering and tragedy that our broken health care system allows and even fosters. In order to make health care universal, accessible, and affordable, we must address reforms in malpractice law and revise the Emergency Treatment and Labor Act. Additionally, we must enact a reasonable patient co-pay system to prevent thoughtless overuse of resources and professional time.
Malpractice reform is necessary
Having been a physician for more than 20 years, I fully understand the pressures on health care providers imposed by the current flawed system of malpractice laws. The current system promotes overly defensive medical practices and unnecessary tests, adversely affecting providers and patients, raising costs, and exposing patients to possible harm through unneeded procedures and medications.
My opponent--a career politician--also worked for decades as an attorney. During his lengthy political career, Tim Johnson has demonstrated no interest in working toward necessary and practical reforms in the medical malpractice arena. In fact, he was recently the only Republican in the U.S. House to vote against the Republican version of health care reform. Tom Kacich of the Champaign-Urbana News-Gazette reported on November 10, 2009, "Johnson, an attorney, said he was opposed to provisions that limited damages in malpractice cases."
EMTALA must be revised
Working in Emergency Departments in both rural and urban settings for many years has allowed me to witness the failures of the Emergency Medical Treatment and Labor Act (EMTALA). This law mandates that any individual arriving at an Emergency Department must be treated without regard to the severity or triviality of the complaint. Common sense would suggest that individuals without true emergencies be met at the triage desk and politely redirected to a more appropriate non-emergency facility. EMTALA subjects hospitals to extremely stiff penalties--a single violation of this law can easily cost a hospital $50,000.
An inordinately large percentage of my time in the Emergency Room--where care is more expensive than anywhere else in our health care system--is spent with patients who do not actually have emergencies. I see and am required to treat three-year-olds who have had a fever of 100 degrees for one hour, adults who have had a simple sore throat for half a day, and so-called lacerations more superficial than simple paper cuts. That well-trained nurses and doctors should be forced to treat all who present themselves at the Emergency Room without regard to actual need for services is wasteful in terms of cost, professional time, and resources.
For the uninsured, the Emergency Room is often their only access to professional health care, and EMTALA's stringent requirements facilitate abuse of the system. Charges incurred for unnecessary emergency care are borne by the rest of society, through our tax dollars and through increased costs for insured health care services, in order to make up for all of these unpaid bills.
Treatment should always be available to those who have actual emergencies. Patients with emergent conditions should no longer have the efficiency of their care undermined by bureaucrats with little understanding of actual health care provisioning. As we reform our health care system, we should revise EMTALA so that nurses and physicians can take full advantage of their training and experience, applying appropriate triage to patients who arrive at the Emergency Room. Failure to enact such changes will result in a lost opportunity to eliminate waste, use available resources wisely, and strengthen our health care infrastructure.
Co-pays are necessary
Although I have long been a strong advocate of a national health care program, the American public should understand that health care is a service of tangible value. No system can function in a sustainable manner unless recipients as well as providers husband available resources wisely. Requiring co-pays sets a symbolic and affordable value on services and supplies provided.
Creating an impression of free health care is both misleading and hazardous--care provided is not free and abusing the system increases cost for everyone. France, which the World Health Organization ranks first in the world for health care quality, implements co-pays similar to the system that I have supported for many years. Such co-pays should be small (on the order of $2, $5, $10, $20). They can be adjusted to income, and they can be waived for true emergencies. Co-pays should not be designed as a source of revenue. Rather, they should serve primarily to give prospective patients pause, to allow for some reflection on the necessity and value of the care being sought.
As your Congressman, I will be a strong advocate for sensible cost-saving measures to our health care system, including malpractice law reform, revision of EMTALA, and institution of a reasonable and universal co-pay system.