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Sen. Hillary Clinton, D-N.Y., has proposed what she calls the "American Health Choices" plan: a seven-step strategy that she says will provide coverage for all Americans and will reduce health care costs while increasing affordability, accountability and quality. Here are some of her proposals:
Reduce the incidence of obesity and diseases, such as diabetes and cancer.
- Require all insurers participating in federal programs to cover high-priority preventive services. Insurers would provide individuals and providers with financial incentives, such as eliminating co-pays for high-priority prevention services.
- Target prevention by coordinating and pooling public funding. A public-private collaboration to ensure that prevention is pushed outside the boundaries of the health care system and into schools, workplaces and communities through free provision of preventive benefits.
Institute a new paperless health information technology system.
- Require providers participating in federal programs to adopt private, secure and interoperable technology.
- Provide one-time financial assistance to help hospitals and doctors' offices adopt and implement health information technology.
Transform care of today's chronically ill population to improve outcomes.
- Ensure higher quality and better coordination of care. Use state-of-the-art chronic care coordination models within federally funded programs such as Medicare and the Federal Employees Health Benefits Program.
- Provide incentives for participation in chronic care management programs. Services would include care coordination among and between providers, drug management, diet and exercise counseling, lifestyle management and the promotion of patient responsibility for self-management.
End discrimination to help reduce administrative costs.
- End discriminatory insurance practices. A "guarantee issue" system will build on the concept of shared responsibility by allowing anyone to join a plan. It would not relegate high-cost people to separate plans or public programs. Insurance companies would not be allowed to carve out benefits or charge higher rates to people with health problems or at risk of them.
- Reduce marketing costs and improve value for the premium dollar. Insurers would compete on low costs and high quality.
- Enact bipartisan health reform for all. In a reformed system where all Americans are covered and risk is spread extensively, administrative costs could be reduced by billions of dollars.
Create an independent "Best Practices" institute to empower consumers, providers and health plans to make the right care choices and invest in research for new treatments
- A new institute would be created and funded by the private and public sectors because its results will benefit all players. Research will compare the effectiveness of alternative treatments such as pharmaceuticals, devices and surgical interventions. This research will facilitate the development of quality outcomes and measures.
Implement smart purchasing initiatives to constrain excess prescription drug and managed care expenditures.
- Remove barriers to generic competition. Eliminate loopholes in federal law that allows drug companies to use the courts to prevent generic competitors from coming to market. Increase funding to eliminate the backlog of generic drug applications.
- Create a pathway for biogeneric competition. Give the FDA the authority to approve safe and effective biogeneric drugs -- ending the monopoly currently enjoyed by large pharmaceutical companies.
- Allow Medicare to negotiate lower drug prices. Eliminate the prohibition in federal law that bars the secretary of Health and Human Services from negotiating prescription drug prices in Medicare.
- Have Medicare crack down on overpayments to private plans. Reduce overpayments to private managed care plans and move toward a level playing field in the reimbursement of traditional Medicare and private managed care plans.
Put in place common sense medical malpractice reforms.
- Promote medical error disclosure and provider-patient trust. Encourage the adoption of a model that provides liability protections for physicians who disclose medical errors to patients and who offer to enter into negotiations for fair compensation.
Keep current health care coverage -- Americans who are satisfied with their current coverage can keep it. Other options would be available.
- Businesses, employees and the uninsured will have the option of buying group insurance through a new Health Choices Menu. All Americans would have the same set of insurance options as members of Congress. No new bureaucracy would be created. The Menu would be part of the Federal Employee Health Benefit Program.
- Public Plan Option -- could be modeled on the Medicare program but would cover the same benefits as guaranteed in private plan options without creating a new bureaucracy. It will provide a more affordable option in part through greater administrative savings. It will not be funded through the Medicare trust fund.
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*Clinton's voting record on health care issues: |
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Source: On the Issues
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"This plan is the result of a thorough analysis of the nature and extent of the health care crisis, starting with the reality that roughly eight in 10 of the uninsured, those who come through the doors of this medical center, come from working families, most are middle class. And families earning between $25,000 and $75,000 a year are the fasted growing group of the uninsured. We all know that younger adults, ages 25-34 and older adults, ages 45-64, are the most susceptible to losing insurance coverage, indicating that it's hard to obtain coverage when you first start out in the world of work and harder to maintain it as you age and experience health problems."
