The issue of ensuring that every American has access to affordable, high-quality health care is front and center in the national debate.   Currently, 43 Million Americans are without health insurance.  While we have a medical establishment that is the envy of the world, the cost of delivering health care is, on a per capita basis, one of the highest of the industrialized nations.    Regardless of where you fall on the political spectrum, I think we all can agree that the current system is not working.  Health care costs are increasing faster than the core rate of inflation.  Those who lack health insurance often delay seeking treatment until their condition deteriorates; therefore, they end up waiting, generally for hours, in the Emergency Room of their local hospital.  Federal law does not permit a hospital to refuse to treat a sick person.  The costs of treating that person are either charged to Medicaid or passed on to those who do have health insurance in the form of higher premiums and co-pays.   I am committed to working to establish a more efficient method of delivering health care than we currently have.  Here are some of the considerations which I believe must be taken into account in order to do that:

Wellness—first, we need to have a system that seeks to hold down the cost of health care regardless of who pays.  One of the best ways to do that is to make sure that we as individuals make healthy choices in our daily lives.  Lately, we have seen alarming increases in the rates of diabetes and heart disease.  These two conditions alone are responsible for a significant portion of the money that is devoted to health care in this country.  It is no secret that the rise in these diseases is correlated with our increasingly sedentary lifestyle which has left us overweight and out of shape.  I myself could stand to lose 20 lbs. while lowering my blood pressure.  Therefore, we should seek to incorporate policies which promote wellness and prevention such as:

Smoking cessation programs,  diabetes management education, even learning how to access health information from the internet, learning how to eat and cook for our families in healthier ways such as broiling instead of frying, and clear information on food labels so consumers can know they are choosing the healthiest products from the grocery shelves.
increasing our level of daily exercise through gym memberships or involvement with community recreation opportunities. 

Independence—doctors and other health care providers must be permitted to practice medicine in a responsible manner without undue considerations of cost.  Some doctors engage in “defensive medicine” which means they order tests or conduct procedures which are marginally useful to making a diagnosis or treating a condition;  generally out of concern for avoiding a malpractice lawsuit.  On the flip side, there is pressure from HMOs and insurance companies to minimize the time a person spends under a doctor’s care.  As an example, these days it is not uncommon for a woman to give birth at the hospital and be discharged the following day to continue her recuperation at home.

Prescription Drugs—literally thousands of new drugs are in various stages of development.  While it does cost millions of dollars to bring a new drug to the marketplace, I believe too much money is spent on advertising and promotions to physicians to write prescriptions for name-brand drugs when generic alternatives would be just as effective.  Furthermore, the new drug benefit for seniors which Congress passed a couple of years ago (Medicare Part D) needs to be reworked to permit the federal government to negotiate the price of prescriptions directly with the manufacturers.  We also should enact legislation to permit individuals to purchase drugs from Canada or other countries provided we have some assurance that the host country is exercising reasonable production oversight. 

Rural Concerns—many of the issues discussed above take on special significance to persons who live in the countryside as many of the voters in the First District do.  For these voters, access to health care has both a financial and logistical component.  In speaking to a group of voters in Dodge City, I learned of a woman whose son developed a swift and serious blood infection (sepsis) and needed to be moved from the local hospital to another facility in Wichita.  After being turned down by ambulance services in Wichita they had to use an ambulance from Salina which added three hours to his treatment.  Another concern which needs to be addressed is the lack of doctors willing to serve in rural communities.  While there is some increased remuneration from Medicare and Medicaid for health care providers in under-served rural areas, it does not appear that these incentives are sufficient to keep medical practitioners from moving to larger, more lucrative communities.  I believe the government should consider helping these doctors and nurses stay in their local towns by paying off a portion of their student loans for each year they agree to serve in rural or other under-served areas.

Privacy—Americans are rightly concerned that their personal medical records could be improperly accessed.  With the growth of electronic communication and the Internet, it is entirely conceivable a person could have their records hacked and put on display for the entire world.  We’ve seen this happen with the files of Hollywood celebrities where even members of the hospital staff improperly accessed the electronic medical records of patients undergoing psychiatric treatment or drug and alcohol counseling .  While Congress has attempted to address the issue by enacting the Health Insurance Portability and Accountability Act (HIPAA) we should be encouraging all health care providers take advantage of privacy software similar to the kind used by the Los Angles hospitals that altered management to unauthorized records access.

Finally, one issue to which I’m deeply committed is ensuring that those seniors who wish to live out their lives at home should be allowed to do so.  Health Care reform must include legislation which provides adequate reimbursement to family members caring for loved ones who would otherwise be forced into nursing homes.  This includes providing for certified home health aides to provide “respite” care on an occasional basis so that family members can attend to the daily needs of their own lives while they care for their relatives.