There is no question that cost of and access to quality health care are critically important issues to individuals, families and businesses across Utah. Congressman Matheson knows that system wide, health care costs are the largest driver of federal government debt and deficit spending and that the current path is unsustainable. As a country, we simply cannot continue to allow health care costs to grow more rapidly than our economy as a whole without threatening our long term financial stability.
During the past couple of years, citizens, experts, and elected officials across our country have discussed and debated how we should reform our health care system. This conversation has at times been heated, but has also encouraged millions of Americans to speak their minds and to engage in the political process. As a starting point, most everyone agrees that something has to be done to lower health care cost inflation and to allow affordable access to insurance and care for those who want to pay for it, but have found it beyond their reach. Congressman Matheson opposed the 2010 health care reforms for this reason: because they did not include the kind of real changes that will put our country on a path to economic stability. While the United States has the most technologically advanced health care system in the world, he believes that we cannot simply add to an economically unsustainable system. As a country, we need to look for common sense solutions that provide for quality, affordable health care with an eye toward long-term fiscal responsibility.
As a member of the Health Subcommittee of the House Energy and Commerce Committee, Congressman Matheson has prioritized working across the aisle to make improvements to the current health care law. He has supported good ideas that work for American families and advocated for changes to programs that do not save money or impose bureaucratic or regulatory burdens on health care consumers. Matheson has worked to expand tax credits for individuals and employers to purchase health insurance and supports more opportunity for small businesses to pool together to provide benefits for employees. He also feels strongly that medical malpractice reform is a way to help control costs and prevent doctors from feeling compelled to practice “defensive medicine” out of fear of being sued.
Medicare is the federal health insurance program for the elderly and the disabled, providing health coverage to more than 270,000 Utahns statewide. According to the Kaiser Family Foundation, nearly half of all people on Medicare (47%) live on incomes below 200% of poverty and more than one-fourth of all beneficiaries have a cognitive/mental impairment. Medicare has four parts: Part A, which covers inpatient services such as hospital and skilled nursing facility stays; Part B, which covers outpatient services like physician visits and preventive services; Part C, the Medicare Advantage Program; and Part D, the Prescription Drug Benefit. While the program is vitally important to seniors, its excessive growth in costs is one of the main contributors to our nation’s long term debt challenge. Congressman Matheson believes we must work in a bipartisan way to continue this program by increasing efficiency and removing perverse incentives in the program as well as lowering the long-term cost trajectory that inhibits the long term sustainability of this program.
Medicaid is a public health insurance program for low-income individuals and children. It covers more than 60 million Americans, including children, pregnant women, and the elderly. The program is the largest source of assistance for nursing home and community-based long-term care and also provides health insurance to 1 in 3 children. Congressman Matheson believes that Medicaid is an important program which covers vulnerable populations but reforms are needed to aid states in the management of this program to ensure solvency moving forward.
State Children’s Health Insurance Program (CHIP)
The State Children’s Health Insurance Program (CHIP) is a Federal and State partnership that provides money to states to enroll children from working class families in privately-run health care plans. Congressman Matheson believes it is our duty to provide quality healthcare to children so they can grow, learn, and thrive. Statistics show that kids who have health insurance—the doorway to improved access to care---have a better quality of life, do better in school and grow to be more productive members of society. Providing health insurance for children is also cost-effective since preventing illness or treating it at the doctor’s office is more economical than waiting until illnesses are severe enough for a visit to the emergency room. Matheson is a strong supporter of CHIP and has worked to protect and expand the program to cover all qualified Utah children and decrease waiting lists for eligible families in the State.
Reforming Physician Payment
For far too long Medicare beneficiaries and physicians have dealt with the uncertainty of a payment formula which results in enormous payment cuts for physicians until Congress temporarily delays them. This last minute response by Congress is inefficient and costs the federal taxpayers billions of dollars. A permanent fix to this flawed formula- commonly known as the Sustainable Growth Rate (SGR)- is essential to preserve health services for our nation’s seniors, provide a stable business environment for physicians, and support the long-term economic health of our nation. Congressman Matheson is committed to finding that common sense solution and successfully passed a bipartisan amendment requiring Congress to move forward with a new payment methodology to ensure physicians can continue to serve Medicare patients.
Promoting Physician Education
According to academic institutions, there will be a shortage of about 63,000 doctors by 2015, with greater shortages on the horizon—91,500 and 130,600 for 2020 and 2025, respectively. With these alarming statistics, educating more doctors for the health care system will reduce the cost of--and improve patient access to-- care. Unfortunately, it is becoming prohibitively expensive to attend medical school. Students are often forced to choose more lucrative specialties within medicine to pay down their loans, abandoning primary care practices and leaving a shortage. Matheson has successfully sponsored and passed legislation, titled the Physician Workforce Enhancement Act, to help establish a hospital residency loan program that provides loans to eligible public or nonprofit hospitals to establish a residency training program, giving preference to rural hospitals.
Reforming Medical Liability
Current medical liability laws create an incentive for doctors and hospitals to practice defensive medicine for fear of being sued, resulting in unnecessary costs, higher insurance premiums for both doctors and patients, and at times physicians refusing to take on high-risk patients. According to the American Medical Association, 61 percent of physicians age 55 and over have been sued for malpractice at some point during their career. While a path for appropriate legal disputes must exist, raising the bar to prevent frivolous lawsuits would help improve quality and reduce cost. Congressman Matheson is a strong champion for reforming our medical malpractice system and has sponsored several pieces of legislation to achieve this goal, including legislation recently passed by the House Energy and Commerce Committee.
Matheson joined bipartisan passage in the House on March 22, 2012, of H.R. 5 - the HEALTH Act. The legislation proposes comprehensive medical malpractice reform as well as repeals the Independent Payment Advisory Board (IPAB), a controversial provision of health care reform. Read more about this legislation, as well as Matheson's successful amendment to give liability protections to Good Samaritan medical professionals who travel to the scene of a disaster to help save lives.
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