Issue Position: Affordable Health Care for All

Issue Position

Issue Position: Affordable Health Care for All

Providing universal health care coverage is one of my top priorities. Every half hour a person dies in the United States because he or she does not have health insurance. I believe we have a moral responsibility to provide access to health care for the 48 million Americans who are now without coverage. Universal health care is not only the right thing to do - it also makes sense from an economic perspective. A more rational universal system can actually reduce health care costs, ease the pressure that providing coverage puts on business - especially our smaller ones - and ensure financial stability for hospitals and other health care institutions.

Universal Health Care Now - A Right for All Americans

Universal health care provides the best hope for controlling overall health care costs in the United States. As Senate Chair of the Joint Select Committee on Health Care Reform, I helped establish Dirigo Health, one of the nation's first comprehensive health care plans aimed at offering affordable and quality health care in Maine. Thousands of Maine people and small businesses have enrolled in the program which has saved millions of dollars in Maine's health care system. The program has been a model for other states also looking to improve access to affordable health care coverage. In fact, a report released by the Kaiser Family Foundation last year revealed that Maine is one of only 7 states - and the only state in New England - to reduce its uninsured population between 2000 and 2004; the percentage of people without health insurance in Maine has decreased in the last few years.

Evidence shows people with adequate insurance coverage are more likely to get care earlier, when treatment is less expensive. We also know providing coverage to the uninsured reduces the amount of bad debt and charity care provided to people who are without insurance - care that we all pay for through higher health insurance premiums. The U.S. spends more money on health care than any other nation, yet our health outcomes rank among the lowest. As health care costs continue to spiral in Maine - $8 billion in 2005 - and the rest of the country, so do insurance premiums; this leaves many individuals and businesses less able to afford coverage. The US is losing high quality jobs to other countries where health care is provided universally. We no longer can afford our current health care system- it is too expensive and failing too many American people and businesses.

I have proposed a national health care system that would expand the Medicare program to everyone in the United States. In the short-term, I do believe that we can provide Medicare to the 48 million Americans without insurance - but with the medium-term goal of making Medicare a national program.

The national Medicare program would also be expanded and enhanced to include not only primary care and hospitalization, but also mental health and substance abuse treatment, as well as long-term care.

A national Medicare program also has to tackle the issue of reimbursements to providers. I believe that reimbursements must be increased in order to make national expansion of Medicare a viable program.

Former Senator Bill Bradley estimates that such a program would have an initial cost of $300 billion, with declining costs thereafter. By contrast, the War in Iraq has cost over $500 billion to date in direct costs.

Supporting Medicaid, Medicare, and the State Children's Health Insurance Programs

Medicaid, Medicare, and the State Children's Health Insurance (SCHIP) are health care programs serving our most vulnerable populations - the elderly, people with disabilities, low-income working parents and children. These health care programs are crucial to reducing the number of uninsured and improving access to necessary health care services. In Congress, even if my proposal to expand Medicare nationwide does not pass, I will make it a priority to work to strengthen and preserve these programs against the attacks they face, so that patients will have access to the medical care they need and health care providers will have the financial resources needed to continue participating in them.

As Senate Majority Leader and as Senate Chair of the Health and Human Service Committee, I worked to preserve vital health care coverage for services provided through Medicaid, Medicare and SCHIP, and provide adequate resources to fund them. I helped restructure Maine's Medicaid program, opting to preserve benefits through better care management. I strongly support reauthorization and expansion of the federal SCHIP program.

The elderly, disabled and children rely on these programs for care, and health care providers, including physicians, hospitals, dentists and nursing homes rely on them for the resources to treat these groups of patients. I will make sure that these essential programs remain available to Maine citizens.

Reducing Prescription Drug Costs

While Maine has taken a number of positive steps to address the issue of prescription drugs, costs in this country continue to escalate. The U.S. spends one third more and twice as much for drugs than any other country in the world. The pharmaceutical industry is one of the most profitable in the world. I appreciate the importance of research and the need for development of new dugs to treat fatal disease and chronic illness. But the industry's use of questionable marketing and advertising techniques to promote more expensive - and often less effective - drugs to consumers and patients is not right. Drug companies spend 30 percent of their revenues on administration - which includes promoting and marketing - compared to the 11-14 percent dedicated to the research and development of new drugs. I have spearheaded several initiatives and supported others aimed at ensuring access to and controlling costs of prescription drugs in Maine including:

* Maine's Low Cost Drug Program (Drugs for the Elderly) providing Maine seniors and people with disabilities access to prescription drugs.
* A safety net to preserve access to necessary prescription drugs for Maine seniors who were forced to transfer to Medicare Part D as required by the federal government.
* MaineRx aimed at providing the uninsured with discounts on prescription drugs and providing the opportunity to negotiate drug prices if decreases aren't achieved over time.
* The creation of a Reimportation Task Force to study drugs from Canada as a mechanism for bringing safe drugs to Maine from other countries where prescription drugs are available at a much lower cost than in the U.S.
* Saving millions in state funds through the development of a preferred drug list, which allows access to higher costs drugs when medically necessary, while at the same time promotes the use of effective less expensive drugs; a cost effective model now used by many other states.

Too often now drugs, which are approved for use in the US, are heavily marketed before adequate assessment of safety issues are fully known and made public. Huge legal settlement involving Vioxx and Neurotin reflect the need for increased oversight and regulation of the industry and its marketing practices.

I will continue my work to improve access to and lower the cost of prescription drugs. Specifically, I will work at the federal level to require price negotiation under the new Medicare Part D program and promote simplification of the program - by allowing the federal government to negotiate with the drug companies, we can save enough money to close the "donut hole" that forces seniors who have more prescriptions to pay thousands out of pocket for drugs.

Finally, I strongly support initiatives which promote evidenced-based prescribing, rather than the pharmaceutical industry's practice of promoting expensive, often no more effective and sometimes more dangerous drugs. Evidence-based prescribing, which relies on science, rather than marketing strategies, promotes improved prescribing practices and better health outcomes, helps reduce cost, and enhances patient safety.

Source