Health Care

I believe every American should have access to high quality, affordable health care. The excellent health care insurance options that are available to Members of Congress ought to be made available to every American. No employer should have to refuse to create new jobs or cut back on current jobs because of the high cost of providing health care. How we meet these goals and do so in a way that strengthens our economy, preserves consumer choices and maintains the very best care, is the challenge -- perhaps the most critical domestic policy challenge -- of our generation.

Overview

• Every American should have access to the high quality and affordable health care enjoyed by Members of Congress. My approach to such reform has been to insist that more power be given to health care consumers and their doctors, instead of insurance companies and the health care bureaucracy, and to support experimentation at the state level to bring more people into affordable insurance programs - particularly beginning universal coverage for children by expanding S-CHIP.
• Improved health care for seniors should be a national priority. In particular, we must take a serious look at preserving health care for seniors in rural areas, closing the "donut hole" in the Medicare prescription drug program, and rolling back physician payment cuts.
• The federal government must make an immediate investment into the health care innovation agenda, including updating our health care infrastructure and supporting medical research.

Moreover, an efficient and affordable health care system is critical to our national and economic security. Our health care system is a first responder to emergencies and catastrophic natural disasters. We need a health care system that is prepared for such emergencies. We also need health care policies that emphasize prevention and healthier life-styles.

We also must face the reality that nearly 47 million Americans, including 826,000 Coloradans, do not have health care insurance. Many of the uninsured are children, and we all pay for the emergency care that uninsured people receive when their health problems get worse. And for those who do have insurance, most rely on their employer to provide affordable health coverage. That means the great majority of Americans live with the risk of losing coverage if they lose their jobs. 

There is no single legislative solution to the many problems involved in health care reform. My approach has been to insist that more power be given to health care consumers and their doctors instead of insurance companies and the health care bureaucracy. That is why I have supported the Patient's Bill of Rights and championed an affordable prescription drug benefit in Congress. But these reforms are not a total solution to a very complex problem. I believe one important way that the federal government can help address the problem of rising costs and access is to support experimentation at the state level to bring more people into affordable insurance programs. Governor Ritter has very wisely begun a dialogue with Coloradans to explore a wide variety of policy options that fit our people and our communities. I support his efforts and look forward to doing more in the U.S. Senate to pass comprehensive health care reform.

I expect that health care will be a top issue in the 2008 election and it should be. I intend to listen carefully to Colorado's citizens as they participate in the process initiated by Governor Ritter. I also have a record of supporting health care reform and expanding health care services for our veterans.

Affordable Access to Health Care — A Shared Goal for Every American

We should begin the health care debate by insisting on the goal of ensuring affordable access to quality health care for every American.

We can start by making sure that every child in America has basic health care. The State Children's Health Insurance Program (SCHIP) has helped states like Colorado provide health care coverage for families that earn too much money to qualify for Medicaid, yet cannot afford private health insurance. The program has been successful in extending access to health care to those children who would not have it otherwise. That is why I voted with a bipartisan coalition in Congress to reauthorize SCHIP and over-ride the President's veto of this important legislation. I will continue to support SCHIP and believe it should be responsibly expanded to include more children in Colorado.

I also support public-private partnerships to make health care affordable for families living on low and moderate incomes, and refundable tax credits that can be used toward coverage of up to 65% of the costs of health care expenses under both individual and employer-sponsored health care plans.

Tax credits can also help those families who are temporarily out of work. Families needing long-term care could also benefit from interim help. To help offset the costs of purchasing long-term care insurance, I support bipartisan legislation to provide an above-the-line-deduction for long-term care insurance premiums. I also support an annual tax credit of $3,000 for caregivers to help cover the costs associated with caring for a sick relative living in the caregiver's home.

In this country, access to health care is usually dependent on access to health insurance. By providing federal grants to states to create health insurance purchasing pools we can significantly increase the affordability and availability of a variety of health insurance plans. State insurance pools, would enable individuals and businesses to select health insurance plans from a large selection of competing private and public health care plans, including a modified version of the health insurance plan offered to federal employees to serve as backup if the selection offered by the state pool is insufficient.

Finally, affordable access to health care is only possible with everyone's participation. If every American is covered by health insurance the increased distribution of health care costs will make health care more affordable for everyone. There is no question that every citizen will need to use our health care system at some point in his or her life. I believe a requirement for health insurance coverage, combined with increased affordability through health care tax credits and the greater choice in coverage available through the creation of state pools, will increase the distribution of health care costs over the entire population.

Improving Health Care for Seniors, Mental Health, and Care for the Underserved

Seniors

Improved health care for seniors should be a national priority. Unfortunately, Congress and the Bush administration have missed opportunities to make a bad situation better. The Republican-controlled Congress passed Medicare reform legislation in 2003, but the system is confusing and seniors continue to struggle to pay for life-saving medications. I will continue to work with other members of Congress to make improvements to the 2003 Medicare Reform Bill so that it better serves the health needs of our seniors. These improvements include:

• Preserving health care for seniors in rural areas.
  
  I am an original co-sponsor of legislation to continue Medicare Cost Contract health plans, which are of particular concern to seniors who live in rural Colorado. Medicare Cost Contracts are managed care plans that are reimbursed on a cost basis for providing care. The premiums cover deductibles and other services not covered by traditional Medicare, and seniors can use any Medicare provider. Under current law, these plans will expire unless Congress acts to extend them.

• Closing the "donut hole" in the Medicare prescription drug program.
  
  Under current law, seniors who spend more than $2,400 in drug costs are responsible for paying 100% of their drug bills until they reach $5,100 in costs. This is known as the "donut hole" and it has placed an incredible burden on seniors who have chronic illnesses and we must find a way to close the gap in coverage. I am a cosponsor of the Medicare Prescription Drug Benefits Gap Elimination Act (H.R. 1277) which would require the Department of Health and Human Services to investigate ways in which we can close the gap.

• Rolling back physician payment cuts.
  
  The Bush Administration has proposed cutting Medicare physician payments by 10 percent in 2008. This will have a devastating effect on seniors' ability to find or keep a doctor. Ultimately, the formula that determines Medicare physician payments needs to be changed so that it accurately reflects the cost of providing health services. However, in the meantime, I support preventing these cuts from going into effect and will work with my colleagues to make sure seniors have access to doctors.

Mental Health

In many cases people with mental health issues face barriers to treatment, not because they cannot afford insurance, but because their insurance policy will not cover mental illness. The consensus in the medical community is that there is no medical or logical reason to treat mental illness differently than physical illness. As a result, I am a co-sponsor of the Paul Wellstone Mental Health Equitable Treatment Act which would prohibit health plans from limiting their coverage of mental health benefits, substance abuse, and chemical dependency by instituting treatment limitations or financial requirements.

The Underserved

Community Health Center Programs like The People's Clinic, Clinica Campesina, SALUD, and Valley-Wide Health Systems are essential to expanding access to health care to the medically underserved. In many cases, community health centers provide a community's only access to health care and preventative care. I support increased funding for the Community Health Center Program and support doubling the number of centers open throughout the country.

Investing in our Public Health System, Health Information Technology and Medical Research

Our public health infrastructure is critical to the nation's ability to provide quality health care services and to prepare for emergencies. After years of underfunding and mismanagement, our health care infrastructure has been severely weakened. Due to budget restrictions, hospital staff, supplies, and space are limited. If current rates continue, it is estimated that the nation will lack almost 300,000 nurses by 2010.

I believe the federal government must take immediate action to strengthen the nation's health infrastructure. Congress should help fund state development of systems to coordinate emergency care and increase hospital capacity. Funding is also needed to educate medical personnel and first responders. Also, I believe that we must address the nursing shortage by fully funding the Nurse Reinvestment Act.

Our health care infrastructure must be ready to respond to emergency situations that will require more supplies and staff than those that are needed on a daily basis. Preparation for these catastrophic events means ensuring that we have an adequate stockpile of vaccines. In Congress, I am proud to have advocated for $450 million to support the CDC's Strategic National Stockpile (SNS). The SNS is a national repository of drugs and medical supplies for use in response to a national health emergency. Seventy-five million dollars of that funding would be dedicated to the stockpiling of supplies needed to respond to a pandemic influenza. I have also fought for full implementation of the Department of Health and Human Services' "Pandemic Influenza Preparedness and Response Plan," and have joined several of my colleagues in asking key lawmakers on the Senate and House Appropriations Committees for funding to detect and contain an Avian Flu outbreak around the world.

It is equally imperative that we avoid taking any action that will further weaken our emergency preparedness. In early 2007, the Bush Administration proposed rules changes to Medicaid that would have resulted in a $120 million loss for Colorado's hospitals, including $60 million for Denver Health and $30 million for University Hospital. The decline in funding would have created an immense financial strain on the hospitals and severely weakened their ability to care for the underserved, provide trauma care and respond to catastrophic events. In the case of Denver Health, the funding cuts would have forced the facility to close. I signed on a letter opposing the proposed rule change, and later voted against the change because of the negative impact it would have had on these essential Colorado facilities. Though this attempt by the Bush Administration was eventually unsuccessful, and the cuts were avoided, continued support for Colorado hospitals is essential to our emergency preparedness, and I will continue to oppose funding cuts for these medical facilities.

Our health care infrastructure must be able to adapt to changing times. Adequate adaptation depends on investing in innovation such as privacy-protected electronic medical record (EMR) systems and medical research. EMRs track a patient's medical history in a database and can be securely shared by multiple caregivers. The use of EMRs in health care delivery will improve care and cut down on administrative costs associated with providing health services. More importantly, EMRs have the potential to increase efficiency and accuracy in health care delivery by giving physicians accurate and timely information.

Another part of the health care innovation agenda is medical research. When I first came to Congress in 1999, I supported the bipartisan effort to double funding for the research initiated by the National Institute of Health (NIH). The NIH has been instrumental in advancing medical research and increased funding for the Institute will spur research into new treatments and cures for many of the terminal diseases now affecting our population, including heart disease, Alzheimer's, Parkinson's, HIV/AIDS, diabetes, Lupus, and cancer. Now is not the time to rest. Congress should build on its investments in medical research by providing an 8-10 percent increase in funding for NIH, which will allow the Institute to keep up with inflation and build on existing research. Our continued investment in medical research is critical to the sustainability of our health care infrastructure.

Additionally, we must put human lives and medical research above politics by expanding stem cell research. I have been a proud cosponsor of legislation to allow researchers to aggressively explore the great promise that stem cells can play in finding treatments or cures for some of the world's deadliest diseases, and to do it under federal guidelines that will ensure that this research is done in an ethical manner. By fully exploring and carrying out stem cell research, scientists will have the opportunity to hasten medical discovery, achieve breakthroughs, and turn scientific innovation into relief for patients.