101 Reasons for SB 1085

==101 REASONS WHY BALANCED HEALTHCARE REFORM WORKS FOR PENNSYLVANIA==
1. Protect Pennsylvania jobs - by capping the employer contribution to
the Health Trust at 10% of payroll. Those Pennsylvania employers
currently paying for employee health insurance coverage will enjoy a
substantial savings and will no longer be at a competitive disadvantage
to those paying nothing toward the cost of health care coverage. This
also completely eliminates the administrative overhead costs
associated with employer paid health insurance.
2. Reduce the cost of prescription drugs - by using Pennsylvania’s
12.5 million citizens as a formidable bargaining entity in dealing with
drug companies.
3. Eliminate uncompensated care - by assuring that health care
providers are paid for all of the services they provide.
4. Assure comprehensive care for all - through a universal health
care system. Approximately one million out of our 12 million citizens
have no health coverage of any kind.
5. End wasteful “defensive” medicine - which, according to a recent
survey, 90% of Pennsylvania physicians admit to. We address this by
replacing the fault based malpractice system with a no-fault program
that emphasizes broader availability of compensation, quality
assurance instead of punishment. Those who believe they are better
off retaining their traditional fault based right to sue may opt out of
the no-fault system, but the Balanced Plan adopts the no-fault
approach as the default position and thus the vast majority of
Pennsylvanians will participate in the no-fault program.
6. Address racial disparity - through universal access and a
commitment to assuring the availability of quality providers in all
communities.
7. Dramatically reduce wasteful administrative costs - through a
single payer approach that eliminates the unnecessary and redundant
overhead of the existing myriad of public and private payers. Major
studies have agreed that approximately 20% of our health care dollars
are wasted due to the inefficiencies of the current system.
8. Remove health care as a recurrent union/management issue in
collective bargaining - by providing automatic, comprehensive, and
universal health care independent of the employment relationship.
This legislation does permit unions and employers to opt out of the
Commonwealth Plan so long as the benefits included in the collective
bargaining agreement are at least as comprehensive as the
Commonwealth Plan.
9. End health care expenses as the leading cause of personal
bankruptcy - thus preserving the dignity and savings of Americans
who already face the burdens directly associated with family illness or
accident.
10. Preserve the volunteer firefighter and emergency responder
base, especially in rural areas of the Commonwealth - through a
$1,000 per year state tax rebate to active volunteers we encourage
the retention and recruitment of this vital resource.
11. Reduce the cost of workers’ compensation insurance - with
universal coverage that meets an injured employee’s health care
needs independent of the employer’s workers’ compensation
insurance. By eliminating the health care expense and administrative
overhead workers compensation premiums will drop dramatically.
12. Eliminate duplication of facilities in over-served communities -
by requiring a certification of need communities already adequately
served with high tech diagnostics or surgery centers will not see
another (which would only threaten the financial viability of both) and
instead would-be investors will be encouraged to build in under-served
areas.
13. Restore the concept of a true “emergency room” - through
universal coverage that assures that all citizens will have ready access
to primary care physicians. Thus ending the wasteful and inefficient
practice of using hospital emergency rooms as primary care centers.
14. Reduce the cost of automobile insurance for business and
consumers - universal health care access eliminates the need to ever
file suit to cover past and future medical costs thus removing that risk
from the vehicle insurance coverage and leading to dramatically lower
premiums.
15. Restore and enhance the traditional physician/patient
relationship - by ending the unfortunate and counterproductive
environment where every patient is seen as a potential plaintiff.
16. Reduce infant mortality through better pre-natal care - and a
universal health access system that assures full and complete prenatal
management thus reducing the number of avoidable low weight
and premature deliveries.
17. Preserve the family farm - by eliminating the need for a farm family
to seek a “city” job that provides health care benefits and by avoiding
financial failures of farm families faced with uninsured or underinsured
health care expenses.
18. Retain high-risk specialists in the Commonwealth - by
eliminating entirely the burden on providers to fund a dysfunctional
medical malpractice system.
19. Support the home care model - where a family is willing to provide
a loving environment in a non-institutional setting. A universal health
system committed to emotional wellness as well as physical health will
provide the training and the specialized services required.
20. Provide sufficient substance abuse treatment facilities - by
including substance abuse as a covered component of the universal
health system we dramatically expand the funding for facilities and
trained personnel.
21. Preserve our investment in higher education - by separating
health care coverage from employment more economic opportunities
are created. When our college graduates are unable to find worthwhile
employment in the Commonwealth our investment in their training is
wasted and the Commonwealth loses more of its intellectual capital.
Additionally, new graduates will not suffer a gap in health coverage
while they search for that first job.
22. Encourage early retirement to open opportunities for younger
people - by making it possible for a worker to retire before they
qualify for Medicare at age 65. If a person is otherwise financially able
to retire before age 65, the universal coverage system will make it
possible to do so thus opening an employment position for a younger
person.
23. Encourage the best and the brightest to enter the health care
professions - through the elimination of the specter of financial ruin
due to a malpractice action, assured payment for all services, and
reduced overhead costs through a simplified and efficient single payer
system, the health care professions become more attractive career
options.
24. Level the competitive playing field between large and small
businesses - through a universal health care system that moots the
existing health care insurance premium costs between large and small
employers.
25. Reduce the cost of home-owner’s insurance - by assuring that a
person injured at your home has automatic health coverage and thus
eliminating the need for a homeowner’s insurance policy to insure
against the risk of being sued for medical costs. Lower risk equals
lower premiums.
26. Permit lawmakers to move on to other critical matters by
finally resolving the health care crisis - since every year the
General Assembly devotes substantial time to debating, again, the
issues surrounding access to health care, Medicaid allowances,
coverage for Commonwealth employees, and medical malpractice
reform. All of which distracts from other critical issues of the day. A
bold move to resolve the health care dilemma through a balanced and
fiscally responsible solution opens the legislative agenda for other
matters.
27. Allow Pennsylvania manufacturers to compete more fairly
against foreign manufacturers - most of whom have a government
sponsored health care system independent of the employer and thus
manufacturers in those countries do not have the overhead burden of
providing health care to their workers. By capping a Pennsylvania
employer’s contribution to health care at a fully deductible 10% of
payroll, we dramatically reduce the anticompetitive effect of the higher
premiums currently being paid by our hard-pressed manufacturers.
28. Shift health provider revenues from administrative to clinical
work - an estimated 20% of provider revenue is squandered on billing
and administrative paperwork required by the existing inefficient and
overlapping system of third party reimbursements. Those same
resources could be redirected to clinical care.
29. Encourage entrepreneurism - through a universal health care
system that eliminates the risk of being without health access for the
aspiring small business person and their family.
30. End the practice of requiring those in need to spend themselves
into poverty to qualify for long-term care assistance - by
including long term care in the universal health coverage package.
This will end the current humiliating practice of forcing an already sick,
usually elderly, person to spend themselves into poverty before
qualifying for assistance.
31. Accelerate the transition to a paperless “electronic health care
record” - through a single payer system it becomes easier to track,
document, and access an individual’s health care history. An
electronic health care record would be immediately available to any
authorized health care provider thus eliminating the delays and errors
associated with paper records scattered over a number of offices and
ultimately lost over time.
32. Enhance a new culture of health awareness and responsibility -
by using part of the trust funds to use the media and school system to
teach and encourage better health habits and by creating a sense of
social responsibility not to engage in self destructive or unhealthful
behaviors that add to the common cost of health care.
33. End the competitive advantage of those businesses which have
refused to provide health care insurance - by requiring all
employers to pay the same 10% of payroll health care levy as a
percentage of payroll. Small employers paying minimum wage would
pay just 52 cents an hour more, less net of taxes, toward a universal
health care plan.
34. Create a sophisticated health care society - through the creation
of an age appropriate K through 12 curriculum with an emphasis on
health equal to any other area of study.
35. Establish dedicated funding sources used exclusively for health
care - thus assuring that the Trust will be fully funded and not
endlessly debated year to year. By establishing dedicated funding
sources for health care the interest of health will not have to compete
against other government priorities for funding and taxpayers will be
less resistant to paying the health specific taxes if confident that all of
such revenues will be used exclusively for health care.
36. Reduce drug related crime - by assuring adequate and effective
drug treatment services for those supporting their addictions through
criminal activity or by becoming drug pushers themselves.
37. Assure available specialists in all geographic parts of the
Commonwealth - through a single payer system committed to
assuring universal availability of quality coverage through-out the
Commonwealth. For example, Providers who establish practices or
build facilities in underserved areas can be rewarded with bonus
reimbursements.
38. Reduce employment discrimination based on age and health -
through a universal health care system that ends the concern of
employers over the potential increase in group health insurance
premiums should they hire an older person or someone with a
personal or family illness. This resolves the individual underwriting
process now in use which takes the cost savings out of many group
plans.
39. End the COBRA irony - through a universal health system that
continues regardless of employment status and which ends the
absurdity of requiring a newly unemployed or divorced person to pay
substantial sums to continue health care for themselves and their
families when they are least able to afford it.
40. Preserve patient choice - by permitting the patient to choose their
physician among any Participating Provider.
41. Support the ability of charitable organizations to recruit and
retain staff - as all employees will automatically be covered under the
Plan. Non-profit organizations will no longer lose employees and
prospects to private industry solely due to the employee’s need for
health care benefits.
42. Free up capital for research and development - by capping the
employer contribution to the health care trust at 10% of payroll, thus
assuring employers will have cash available for the research and
development costs that are at the heart of future growth and
competitiveness.
43. Better coordinate epidemiological data - through a single payer
system that best captures in one database the occurrence of
environmental, viral, or bacteriological illnesses.
44. Reinforce and support primary care - through a reimbursement
system that emphasizes wellness and preventative medicine primary
care providers will be in greater demand and more appropriately
compensated.
45. Accelerate the introduction of new technology to improve
diagnostics - by providing a financing means for hospitals and
providers to acquire new technology even where the obsolete
equipment may not have been fully amortized.
46. Infinite and immediate adjustability of the revenue sources to
meet a disaster - with health care taxes adjustable in tenths of a
percent as needed, in the event of a natural or man-made disaster the
required revenues to meet the urgent medical needs can be instantly
and temporarily raised through a simple adjustment in the percentage.
Similarly, where Trust surpluses accumulate beyond what is required
downward adjustments in the taxes can also be readily and easily
made.
47. Free the courts from protracted medical negligence litigation -
through the introduction of an optional no-fault administrative
mechanism to compensate those injured by their care. We thus
remove from the court dockets the many and complicated medical
malpractice cases that consume a disproportionate share of judicial
resources.
48. Reduce state, local and school board expense - through the
adoption of a universal health care system whereby governments of all
sizes will be relieved of the annual angst of debating, providing, and
funding health care benefits.
49. Improve worker productivity - by providing ready access to care
for workers and their families. Less time will be lost from work due to
untreated conditions that ultimately worsen leading to extended
absences.
50. Improve highway safety - by fully funding substance abuse
treatment. With a reduction in impaired driving the frequency of
motor vehicle accidents will drop and with it the expense related to the
care and treatment of those injured.
51. Humanitarian treatment for migrant workers - through the
inclusion of critical but under appreciated migrant workers and their
families in the health care system. In doing so we assure the
responsible support of those who otherwise would be at the mercy of
illness and ultimately burden the emergency facilities of our hospitals.
52. Encourage and support the arts - by assuring that talented
individuals pursuing a career in the arts, or as independent
performers, are covered through a plan of universal health care.
53. Restore the spirit of joy and service to the health care
professions - through the elimination of the specter of malpractice
suits and the obsessive concern about whether or not a patient has
adequate insurance, health care professionals can again focus on the
patient.
54. Reduce abusive access to narcotics - through a unified electronic
health record system that immediately identifies situations where a
patient is seeking multiple prescriptions from different physicians.
55. Increase self reporting of medical errors - by eliminating the fear
of financial ruin. Errors can be more readily reported and thus
corrective action taken to limit the harm and to develop protocols to
eliminate recurrences.
56. More swiftly identify previously unknown drug side effects or
dangerous combinations of drugs - through a single payer system
that tracks patients and medications as well as the symptoms that are
later reported which may be the clue to adverse chemical reactions.
57. Eliminate the wasted motion of the specialist referral for
responsible consumers - by granting all patients the right to self
refer to a specialist, and then only limiting that right for those who
abuse it, the Plan assures that access to specialists is not delayed by
procedural barriers that punish the many for the conduct of the few.
58. End the “same sex” and “domestic” partner health care debate
- by automatically covering everyone under the universal plan.
59. Eliminate suicides related to the cost of health care - through a
universal health care system that relieves the chronically ill patient of
the guilt associated with potentially bankrupting their family with
health care expenses.
60. Reduce the incidence of chronic diseases that could have been
avoided or prevented through early intervention - by eliminating
the cost of care barrier, individuals with the early symptoms of a
disease, such as cancer, will more readily seek care and enjoy an
earlier diagnosis and better prognosis.
61. Reward the development of enhanced skills and experience - by
adopting a reimbursement structure that adds an incentive bonus to
those health care providers who invest in themselves and acquire
enhanced skills and experience.
62. End the wasted motion and paperwork associated with point of
service deductibles and co-pays - through the elimination of the
ritual of collecting and accounting for these charges.
63. Eliminate wasted employer management time - by ending forever
the annual dreaded ritual of receiving and analyzing the group health
insurance premium increase, shopping around for a lower premium,
evaluating how much of the premium cost can be shifted to the
employees through premium sharing, a reduction in benefits, an
increase in co-payments and the like.
64. End the “food or medicine” choice - through the inclusion of a full
prescription drug benefit covering all citizens.
65. Assure full access to mental health treatment - by fully funding
mental health therapy and treatment.
66. Maintain the continuity of care - by eliminating constant switching
of providers to accommodate different health plans.
67. Guarantee divorced spouses and their children have access to
health care - through universal health care marital status is irrelevant
to health care access.
68. Improve nurse retention - by reallocating funds from malpractice
insurance premiums and administrative overhead. Hospitals will be
able to use those resources to assure a rational patient to nurse ratio,
eliminate mandatory overtime, and enhance training.
69. Annuitize compensation for persons injured by their medical
treatment - by making compensation payments through monthly
disbursements, rather than by lump sum. This assures that the
money cannot be squandered over a short period of time, which is
often the case, and is more consistent with the concept of replacing
what was lost rather than granting a lottery type pay-off.
70. Assured coverage for those working multiple part time jobs - by
detaching health care access from employment there is no difference
in coverage based upon whether a person is working one full time, or
two part time, jobs.
71. Protection for domestic employees - through universal coverage
that assures that housekeepers, cooks, drivers, gardeners and others
working as domestic servants enjoy comprehensive access for
themselves and their families.
72. More extensive quality assurance review of errors and
complications - because every patient claim will be carefully
investigated for evidence of correctable mistakes and patterns. By
changing the emphasis to care improvement rather than blame all
involved can contribute to a more constructive analysis of what went
wrong, and what can be done to prevent a reoccurrence.
73. Preserve the free market system while assuring cost
containment - with a Plan that does not contemplate public
ownership of health care facilities or public employment of health care
workers. Rather, the free market system will be allowed to work such
that the providers with the best quality of service will attract the most
patients.
74. Assured dental coverage - through inclusion of non-cosmetic dental
services in the program.
75. Eliminate the health care coverage handcuffs that limit
workers’ ability to change jobs - and replace it with the freedom to
offer your services to the highest bidder thanks to universal coverage
that is independent of the employer.
76. End uncompensated care for providers - and instead assure
Participating Providers that they will be paid for 100% of the services
rendered to program beneficiaries.
June 20, 2005 11
77. Assured vision and optical care - through inclusion of eye health
services as an integrated part of the health care package.
78. Eliminate the financial insecurity and fear associated with the
aging process - by assuring that gaps in the Medicare program will
be filled through the Plan and no Pennsylvanian will suffer needlessly
simply based upon their ability to pay.
79. Create tens of thousands of high paying new jobs in health care
and health education - required to provide services to the
approximately one million currently uninsured Pennsylvanians and to
teach a “wellness curriculum” in our schools.
80. Fully protect the catastrophically ill or injured - through a health
care system that does not have the usual life time caps that are easily
exceeded by those with serious and chronic illnesses or disabilities
requiring intensive skilled care.
81. Saving Pennsylvania’s share of the 18,000 who die annually in
the United States due to inadequate access to health care -
through a universal health care program that assures that every
person who needs care will receive it.
82. Expand the availability of compensation more equitably to
those injured by their health care providers - through a no-fault
system that does not require a tedious and expensive litigation process
committed to finding someone to blame and which allows only a few to
recover anything at all. Rather, the optional no-fault program assures
expedited claim handling and eligibility with lower attorney fees and
other costs of traditional malpractice litigation.
83. Encourage the unemployed to accept entry level positions by
removing the fear of losing Medicaid or Adult Blue coverage -
with universal care automatic for all, there need no longer be a
concern that by accepting a modest paying entry level position a
worker will disqualify themselves or their families from access to
health care.
84. Assuring that the newly disabled, but under age 65, have
access to health care while they wait two years for Medicare
eligibility - through a universal coverage approach that does not go
away when the disabled lose their jobs.
85. Prompt payment of reimbursements to providers - through
electronic billing and electronic fund transfers within one week health
care providers have ready access to their money and avoid borrowing
costs.
86. End the practice of overcharging the uninsured - which is an
ironic and absurd reality in the current system. Many hospitals and
doctors charge uninsured patients a higher rate than the
reimbursement accepted from private insurers and government
programs. As a result the patients least able to pay have been
charged the most and often are driven into bankruptcy. Universal
coverage through a single payer ends this disparity once and for all.
87. Eliminate the need for outside billing and collection services -
thus saving the average physician up to 5% of their gross collections
otherwise paid to an outside collector.
88. Pay for Performance incentives - through a reimbursement system
that rewards excellence based upon objective performance criteria.
Providers who adopt best practices and achieve lower complication and
readmission rates will be rewarded and those who do not measure up
will be paid less.
89. Create millions of qualified first responders - through enhanced
health care education every graduating high school senior can be a
certified first responder ready and able to assist a family member,
friend, or even a total stranger until help arrives. This can mean the
difference between recovery and a lifelong disability or death.
90. Assure that every injured person is rehabilitated to their
maximum potential - by incorporating full rehabilitation within the
standard program benefits. In addition to being morally right, a
commitment to full rehabilitation will reduce the overall cost of care as
many more patients will be able to return to the workforce or at least
be better able to attend to their own physical needs.
91. Keep qualified and experienced physicians on the job - by
eliminating the burden of malpractice premiums and by simplifying the
billing and collection system.
92. Assure well baby care - with comprehensive post-natal care
included in the universal health care program.
93. Reduce the incidence of sexually transmitted diseases - by
simplifying access to primary and specialist care. STDs can thus be
diagnosed sooner and treatment initiated to reduce the spread of the
disease and to assure proper counseling to the affected patients and
their partner. Enhanced wellness education also leads to reduced
infection transmission.
94. Permit providers to challenge the adequacy of reimbursements
- through an administrative process whereby single providers or
groups can offer evidence in support of higher reimbursements.
95. Full transparency in the error investigation process - by assuring
that a complaining patient is afforded every opportunity to be heard
and is kept advised of the investigation and any corrective actions that
are ordered in response to an avoidable injury or complication.
96. Implementation of Pennsylvania Cost Containment Council
recommendations - through a process whereby all such
recommendations are reviewed and where providers are required to
implement necessary reforms.
97. Humane end-of-life care - by including hospice care within the
comprehensive health care package.
98. All licensed providers can compete - through a universal system
that does not try to artificially lower prices by freezing out providers
from networks in exchange for lower prices from other providers.
99. Protect early retirees who were promised health care coverage
by now defunct employers - through a universal health care system
that protects the young retiree from being left out in the cold by a
broken promise of retirement health coverage.
100. Prepare Pennsylvania for more cuts in Federal health care
support - by preparing our Commonwealth to be more self sufficient
and reliant on its own resources and efficiencies as Congress bit by bit
reduces grants to states for Medicaid and CHIP programs.
101. No more bake sales to fund health care - instead we embrace
health care as a community responsibility and a communal right
through a system of universal access.
==Links==
* Health Care
* Health Care-plank from Mark Rauterkus
category:wellness