Tuesday, March 3, 2009

A First 100 Days Health Agenda To Improve Health

How should we start? Then what? A proposal:

Halt erosion of traditional, public Medicare.
■ Stop excess payments to Medicare Advantage plans. – Proposed in Budget
■ Cancel the 2010 Medicare Comparative Cost Adjustment demonstration. - Cancelled
■ Eliminate the arbitrary 45% cap on general revenue funding for Medicare. - Waived
■ Eliminate means-tested (income-based) premiums for Medicare Part B.

Extend and expand health coverage and access.
■ Children – Reauthorize SCHIP - Enacted
■ Expand SCHIP to cover ages 0 – 25.
■ Medicare – Expand coverage to start at age 50
• Eliminate the 24-month wait for Medicare benefits for persons with qualifying disabilities.
■ Medicaid – Increase enrollment and access:
• Increase the federal match in Medicaid funding and minimize cost shifting to patients.
• End categorical eligibility. Extend eligibility to everyone living in poverty, and to all uninsured recipients of unemployment compensation, as proposed by Sen. Baucus.
• Simplify documentation and application requirements.
• Increase transparency of the state waiver process that is eroding federal standards for Medicaid.
■ Safety-net institutions: Increase funding for public hospitals, and for community and migrant health centers. Proposed in budget.

Improve access to affordable medications.
■ Create a public prescription drug benefit within traditional Medicare, requiring CMS to negotiate drug prices. - Proposed in Durbin/Berry bill.
■ Allow the re-importation of prescription drugs. - Proposed in budget

Policy and Program Initiatives for the First Year

Improve the health of the nation
■ Link action across government sectors (employment, housing, education, environment, commerce and trade, health) to address the social and economic conditions and policies that make people sick and produce health inequities: economic deprivation, discrimination, and adverse conditions at work, in the environment, and in communities. Make improving health and reducing health inequities a criterion for all government initiatives. - Tax proposals reduce income inequality
(See report of the World Health Organization's Commission on the Social Determinants of Health: http://www.who.int/social_determinants/final_report/en/index.html)

Build a basis for effective, efficient financing and delivery of health care
■ Propose adequate, stable Medicare financing with cost-growth containment to ensure Medicare’s continued ability to meet beneficiary needs without being burdensome financially.
■ Investigate the effectiveness, efficiency, and discriminatory practices in the health insurance industry.
■ Strengthen primary care capacity. - Proposed in budget
■ Compare effectiveness of medical treatments, implement best practices. - In Recovery Act
■ Eliminate the barriers (financial, administrative, gender) to timely health care for veterans. - Proposed in budget
■ Enact universal coverage for quality, affordable, publicly accountable health care.

Proposed by:
Center for Policy Analysis www.centerforpolicyanalysis.org
Rekindling Reform www.rekindlingreform.org

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