A decade after her universal coverage proposal failed and midway through her six-year term as a New York senator, Hillary Rodham Clinton is speaking out on health care issues and promoting her ideas for reform.
Clinton reiterated her concern for the growing number of uninsured Americans at the first Washington, D.C., chapter meeting of the Association of Health Care Journalists last month. More than 40 million Americans are uninsured, according to the Department of Health and Human Services (HHS).
“If Kerry wins the presidential election in November, and the Democrats take back the Senate, we can make incremental reforms that will move us closer to an affordable, accessible health care system.”
In contrast to a decade ago, Clinton did not recommend universal coverage or any other type of remedy for the uninsured; instead, she said that she was still in the diagnostic stage on those issues.
Clinton, responding to reporters' questions, criticized President Bush's Medicare drug prescription plan for giving subsidies to pharmacy benefit managers and the pharmaceutical industry for spending too much of its revenue on marketing and too little on research.
She supports efforts to prevent obesity, especially in children. “I favor reinstituting physical education in public schools and removing fast-food franchises that contribute to high glucose levels in children and diabetes.”
Clinton emphasized the need for strong legislation to prohibit health insurers and employers from discriminating against people based on their genetic information.
“The completion of the Human Genome Project carries unique opportunities and risks. In the next decade, a DNA chip will store an individual's genetic information including predispositions to illnesses,” Clinton said.
The Senate passed the Genetic Nondiscrimination Act of 2003 last October. S 1053 prohibits health insurance companies and employers from using genetic information or a request for genetic services to discriminate against an individual.
Despite having 240 co-sponsors last month, the House companion bill (HR 1910) has languished in the House Subcommittee on Employer-Employee Relations since last year.
Clinton discussed her bill, which was introduced last October, the Health Information for Quality Improvement Act (S 2003).
“Clinical decision tools, like handheld computers, exist that would allow doctors to pull up the latest research information immediately at the patient's bedside. We spend billions of dollars a year for medical research at NIH to produce this information, but it is worthless unless the doctor can retrieve it when needed,” Clinton said.
Her legislation calls for a new office to create a national health information infrastructure. A new medical safety initiative would collect data on whether the increased use of information technology improves and advances medical care. The bill also calls for protecting privacy and security of health information and prohibits health insurers from denying or preventing individuals with serious illnesses from participating in approved clinical trials. The bill also requires
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research on the effectiveness and safety of prescription drugs widely used in federally funded health programs.
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the development and use of standardized indicators of health care quality.
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a study on approaches to developing and disseminating practice guidelines.
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an evaluation of different approaches to linking health care performance to Medicare payments.
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an evaluation of using different professional organizations to disseminate information about health care quality to consumers.
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the development of standardized materials to assist non-English-speaking or functionally illiterate patients how to use prescription drugs safely and appropriately.
“Despite numerous studies showing the advantages of information technology [IT] systems, some hospitals and physicians' offices are understandably wary of spending millions of dollars on systems that may not talk to other systems or become obsolete in a few years,” Clinton said.
She continued, “Federal leadership is needed to encourage the adoption of health care information technology that promotes compatible operating systems, assures affordability, and reduces barriers to IT adoption.”
Meanwhile, HHS recently announced several IT initiatives (see
page 7) to jumpstart the creation of a national electronic medical records system. Clinton said she supports the Bush administration's IT efforts and has asked the president to support her legislation.
The Health Information for Quality Improvement Act can be accessed online at<http://thomas.loc.gov> by searching on the bill number, S 2003. ▪