Ensuring access to health care: the Bush plan.

Abstract

IBELIEVE THAT ALL AMERICANS SHOULD HAVE ACCESS TO affordable, high-quality health care. Rising health care costs impose a burden on families and small businesses and put coverage out of the reach of many Americans. My plan will help reduce the rising cost of health care, provide new and affordable health coverage options for all Americans, and provide not just a government program but a path to greater opportunity, giving millions of Americans more freedom and more control over their own health care and their own future. My plan reduces the rising cost of health care while improving quality and safety; provides new and more affordable coverage options—targeted to those who need it most: low-income children and families, employees of small businesses, and the self-employed; keeps health decisions with patients and physicians—not bureaucrats in Washington, DC; and results in more than 11 million and as many as 17.5 million newly insured Americans. The badly broken medical liability system is raising health care costs for everyone. The cost of medical liability insurance has forced good physicians, hospitals, and health care professionals to practice defensive medicine, curtail their services to a community, and in some case close their doors altogether. If we are going to ensure that health care is affordable and accessible in the future, our system demands a plan for effective and pragmatic medical liability reform that will reduce the number of frivolous lawsuits, lower health care costs for businesses and employees, and help maintain strong physician-patient relationships. My proposal for reform would ensure that injured persons are fully compensated for their full economic losses, while reasonably limiting noneconomic damages to $250 000. It would also reserve punitive damages for cases in which there is egregious conduct, ensure that old cases cannot be brought years after an event, and provide that defendants should pay judgments in proportion to their fault. Frivolous lawsuits and excessive jury awards are a national problem, and the crisis deserves a national solution. I also believe we can reduce costs, reduce preventable medical mistakes, and dramatically improve the delivery of care by increasing the use of health information technologies (IT) in our health care system. America’s physicians and health care professionals are managing 21st-century medicine with 19th-century tools. I set an ambitious 10-year goal for most Americans to have electronic health records, because I believe that health IT can transform health care in America. I have acted to accelerate the use of health IT and challenge the private sector to meet this goal in the next 10 years by doubling the funding for testing these systems in our nation and creating the new Office of the National Coordinator for Health IT to help facilitate the move to electronic health records. My administration is also working with many private organizations like the American Medical Association to develop and adopt the technical standards that will make it possible for sharing information privately and securely among health care providers when authorized by the patient. The most sizable portion of health care spending is devoted to the relatively small number of Americans with chronic illness. We need to do a better job of coordinating the care provided to these individuals. That is why the Medicare legislation that I signed last year will for the first time provide coverage of disease management and chronic care coordination. At the same time, consistent with efforts by my administration to encourage healthful lifestyles and disease prevention, the new Medicare law greatly expands coverage of preventive care, including a new “Welcome to Medicare” physical. Controlling health care costs will help make coverage more affordable. But we must do more to extend coverage to the uninsured. My proposals to expand coverage rely on empowered consumers, rather than on “one-size-fits-all” expansions of government programs that my opponent advocates. He has advanced a proposal that independent analysts estimate will add more than 20 million people to the Medicaid rolls, where their choice of doctor is limited. Vulnerable populations who live in medically underserved areas also have gained greater access to health care through my initiative to open or expand 1200 new health center sites to serve an additional 6.1 million Americans.