Matt Doheny continued his "50 Businesses, 50 Days" tour this week with visits to eight health care businesses.
"Affordable health care is one of our country's biggest challenges," said Doheny, the Republican, Conservative and Independence parties' candidate. "Unfortunately, the partisan reforms pushed by President Obama and my opponent have done little to contain costs, lower premiums and lessen the number of uninsured."
REPEAL AND REPLACE OBAMACARE
One of my opponent's very first votes was for ObamaCare. He subsequently voted for it again -- and has fought efforts to repeal this job-killing law multiple times.
It would, over ten years:
· Reduce Medicare spending by one half trillion dollars.
· Increase taxes by more than $800 billion by implementing 21 new or higher taxes.
· Increase health care costs and make coverage more expensive.
· Create a 15-member board of unelected bureaucrats who would make binding decisions that would restrict access to health care for seniors.
It has already generated 12,307 pages of regulations and notices. And it will require the IRS to spend $881 million on the law through 2013, hiring more than 2,700 new workers.
INCREASE COMPETITION BY ALLOWING PURCHASING ACROSS STATE LINES
Health insurance is regulated by states, which means New Yorkers can't access plans offered by out-of-state companies. States are often over-inclusive in their insurance mandates, which forces consumers to purchase plans that include non-essential services.
We need a national insurance market, which allows consumers to purchase plans from other states that more closely meet their needs.
My opponent opposes this plan, suggesting it would lead to a "race to the bottom." I could not disagree more. The market -- and a little political willpower -- will prevent that.
A shoddy product won't entice or keep customers -- and state lawmakers would surely hear from constituents hurt by inadequate regulation. Instead, consumers would dictate through their purchasing what regulations are needed.
HELP DOCTORS REDUCE THE COST OF PRACTICING MEDICINE
Doctors work in an environment where any mistake, no matter how small, can lead to a costly lawsuit. The threat of a lawsuit -- in which damages are not capped -- provides a perverse incentive for the medical professional to put the patient through unnecessary tests and procedures.
The nonpartisan Congressional Budget Office estimates that medical malpractice costs could be reduced by up to 35 percent nationwide if tort penalties and punitive damages were restricted. This would be welcome news for doctors and hospitals, as premiums for medical malpractice liability insurance rose almost twice as fast as total health care spending per person from 2000 to 2002.
My opponent opposes tort reform.
INSURANCE UP TO AGE 26
College graduates are finding few avenues for work while our nation continues to struggle to recover from a recession. More than half of those that own a bachelor's degree are either without a job or underemployed.
With the economy slumping, an ObamaCare provision that should return after repeal is the one that allows those up to age 26 to remain on their parents' insurance.
United Healthcare, Humana and Aetna -- the nation's largest, fourth-largest and fifth-largest providers -- announced before the Supreme Court's decision that they would continue the "under 26" policy regardless of the constitutionality of ObamaCare. The private market has determined it is good policy for their customers, and it should continue.
MAKE PLANS MORE FLEXIBLE
Portability: Employer-based health care has been the norm since World War II, but that's created some structural issues that can limit growth.
Individuals can feel bound to their employer, especially if that company offers a health insurance plan they like. If the plans were portable, however, it is likely those individuals would take more risk that could lead to positive economic effects -- either by changing jobs or leaving to start a business.
Health Savings Accounts: Health Savings Accounts are linked to high-deductible, low-premium insurance policies and are funded with pre-tax dollars.
Our current model of service offers no price transparency. An individual pays a small co-pay and thinks little of the cost.
In Indiana, Gov. Mitch Daniels offered health savings accounts to all state employees. What they discovered was that when employees spent their own pre-taxed dollars, they were much more likely to ask questions about how to get the best price.
Those that took health savings accounts cost the state $65 for every $100 incurred by those who opted for coverage that did not include HSAs, according to Daniels.
"The Indiana experience confirms what common sense already tells us: A system built on "cost-plus' reimbursement (i.e. the more a physician does, the more he or she gets paid) coupled with "free' to the purchaser consumption, is a machine perfectly designed to overconsume and overspend," Daniels wrote.
The annual contribution taxpayers can make to health savings accounts is $3,100, which is too low. The government should increase those caps.
IMPROVE DOCTOR RECRUITEMENT IN RURAL AREAS
The nationwide shortage of primary care practitioners is making it more difficult to have basic -- and inexpensive -- health care in rural areas like our own.
There is little financial incentive to be a practitioner of family medicine or internal medicine. They carry the same student loan debt as cardiologists and gastroenterologists, but have about half of the median salary.
We should continue to support programs that offer loan forgiveness to doctors who are willing to serve in underserved areas. The federal government has identified 113 areas in the 21st Congressional District where there is a health professional shortage.
North country providers are in a global competition for talent. There are some comparative advantages. But in order to attract the best, we have to attract their families too. That means investing in broadband Internet and better cell phone coverage, at minimum.
GIVE HOSPITALS FLEXIBILITY
The federal government has definitions for everything -- and how a medical provider is categorized makes a significant difference in how they obtain financing and the manner and speed in which they are reimbursed.
No two hospitals are the same, either. Some have acquired smaller practices and built a network, while others have worked on growing one central facility.
Administrators are creative in the ways in which they try to finance their capital improvements, but are sometime hamstrung by the federal government's rigid categorization.
Providers need to be able to maximize their structure, their financing and their reimbursement procedures.
One of the ways that rural providers can expand their coverage and better serve patients is through telemedicine. Regardless of the way it's delivered, telemedicine is a win for the patient -- less travel time and fewer hospital stays -- and a win for the provider -- shared staffing reduces costs, and an expanded base creates additional revenue.
Three barriers, according to the journal Telemedicine and e-Health, impede growth: licensing, credentialing and reimbursement.
There should be a national telemedical license, instead of requiring providers to obtain licenses for each state in which they operate.
The New York State Legislature is addressing the second part, by attempting to streamline the credentialing process for rural health care providers. Many states require doctors to be credentialed by every hospital they work in, including those that employ them only through telemedical means.
Finally, telemedicine's use has been diminished by a patchwork of reimbursement regulations that vary from state to state. The reimbursement process should be simplified -- or in some cases, clarified -- to entice hospitals into incorporating telemedicine.