Joyce Frieden

WASHINGTON — Anyone who asks Rep. Dennis Kucinich (D-Ohio) about health care policy should be prepared for the conversation to evolve into other areas—such as the Iraq war.

“Health care spending does not occur in a vacuum,” Rep. Kucinich said at a forum on health care policy sponsored by Families USA and the Federation of American Hospitals. “You cannot separate this from war.”

Rep. Kucinich, who is seeking the Democratic nomination for president, noted that money spent on the war in Iraq—an estimated $1.5 trillion, according to a Congressional Budget Office report he cited —is money not being spent on domestic concerns such as education and health care.

“As we speak, our government is planning to bomb Iran,” which will divert more money from health care concerns, he said at the forum, part of a series of forums with the presidential candidates underwritten by the California Endowment and the Ewing Marion Kauffman Foundation.

Although he sometimes connects health care policy with other topics, the fifth-term congressman and former mayor of Cleveland is very direct when it comes to universal health care coverage: He is the only candidate who supports a single-payer system financed by the government.

“Is health care a right or a privilege? If it's a right, then it's appropriate for the government to have a role” in providing it, he said. “If it's a privilege, and it's [market-based], then we're left to the predations of the market, which is, if you can't pay for it, you're out of luck. And 47 million [uninsured] Americans are now out of luck.”

He noted that studies show health care debt is responsible for half of bankruptcies in the United States. “The median income is $48,000 a year, and some families are paying $12,000 a year for health insurance; that's a quarter of their gross. I'm talking about breaking the shackles insurance companies have on American families.”

Under Rep. Kucinich's proposal, which has been introduced in Congress as H.R. 676, all for-profit health care entities would be converted to nonprofit entities, with shareholders being compensated by the government. That compensation would be financed through Treasury bonds, he said. Physicians would continue to have private practices, but they, along with hospitals and other providers, would be paid by the federal government, which would disseminate federal funds through a series of regional budgets. There would also be separate budgets for capital expenditures and for medical education.

Coverage under Rep. Kucinich's plan would include inpatient and outpatient services as well as dental care, vision care, mental health care, and long-term care. There would be no deductibles or cost sharing.

When a reporter pointed out that in other countries with government-financed health care, a private system developed alongside the public system for those who could afford it, Rep. Kucinich said that was no surprise. “Privatizers are at work in every country. If health care is such a losing proposition, then why are [they] trying to privatize it? Because there are huge amounts of money to be made. But [if] you have a for-profit system, you're going to have people cut out of it.”

Another government-run system that people are trying to privatize is Medicare, Rep. Kucinich said. “Medicare is discouraging doctors by cutting their fees. There's a strategy to privatize Medicare by getting doctors to walk away from [it].” The passage of the Medicare prescription drug benefit was another part of that plan, he added.

A for-profit system puts the wrong type of pressure on physicians, he said in an interview after the forum. “Doctors are under pressure from private insurance not to provide health care.” When that collides with efforts such as Medicare's pay-for-performance initiative, “there's built-in inertia. We want to encourage doctors to improve their performance, but under a for-profit system, doctors have cost pressures. That [won't] encourage the results you want.”

During the forum, Rep. Kucinich contrasted his proposal with those offered by two other Democratic presidential candidates, Sen. Hillary Rodham Clinton (D-N.Y.) and former Sen. John Edwards (D-N.C.). Under their proposals, Americans would be required to purchase health insurance; they could choose from a variety of private health care plans as well as a public plan modeled after Medicare.

“If you can't afford it under the current system, how are you going to afford it under [their] system? And if you do buy it, you're forced into plans that inevitably are going to have extraordinary copays and deductibles, and a limited level of coverage.” But with his proposal, “I'm talking about a plan where everyone's covered, [and it] covers everything. And the fact is, we're already paying for it—we're just not getting it.”

And he's not concerned a universal coverage plan would strain the system by having people who previously had no health insurance start coming in for lots of services.

“When I was a city councilman in Cleveland, I had a proposal I thought would do a lot to protect the environment and move people around our community efficiently. I proposed free [public] transit. And the people who attacked the idea … said, 'My God! If we have free transit, everyone's going to be riding the bus!' Exactly. That's what we want. You want people to use the health care system, so that they're healthy.”

'I'm talking about a plan where everyone's covered, [and it] covers everything.' REP. KUCINICH

WASHINGTON — Anyone who asks Rep. Dennis Kucinich (D-Ohio) about health care policy should be prepared for the conversation to evolve into other areas—such as the Iraq war.

“Health care spending does not occur in a vacuum,” Rep. Kucinich said at a forum on health care policy sponsored by Families USA and the Federation of American Hospitals. “You cannot separate this from war.”

Rep. Kucinich, who is seeking the Democratic nomination for president, noted that money spent on the war in Iraq—an estimated $1.5 trillion, according to a Congressional Budget Office report he cited —is money not being spent on domestic concerns such as education and health care.

“As we speak, our government is planning to bomb Iran,” which will divert more money from health care concerns, he said at the forum, part of a series of forums with the presidential candidates underwritten by the California Endowment and the Ewing Marion Kauffman Foundation.

Although he sometimes connects health care policy with other topics, the fifth-term congressman and former mayor of Cleveland is very direct when it comes to universal health care coverage: He is the only candidate who supports a single-payer system financed by the government.

“Is health care a right or a privilege? If it's a right, then it's appropriate for the government to have a role” in providing it, he said. “If it's a privilege, and it's [market-based], then we're left to the predations of the market, which is, if you can't pay for it, you're out of luck. And 47 million [uninsured] Americans are now out of luck.”

He noted that studies show health care debt is responsible for half of bankruptcies in the United States. “The median income is $48,000 a year, and some families are paying $12,000 a year for health insurance; that's a quarter of their gross. I'm talking about breaking the shackles insurance companies have on American families.”

Under Rep. Kucinich's proposal, which has been introduced in Congress as H.R. 676, all for-profit health care entities would be converted to nonprofit entities, with shareholders being compensated by the government. That compensation would be financed through Treasury bonds, he said. Physicians would continue to have private practices, but they, along with hospitals and other providers, would be paid by the federal government, which would disseminate federal funds through a series of regional budgets. There would also be separate budgets for capital expenditures and for medical education.

Coverage under Rep. Kucinich's plan would include inpatient and outpatient services as well as dental care, vision care, mental health care, and long-term care. There would be no deductibles or cost sharing.

When a reporter pointed out that in other countries with government-financed health care, a private system developed alongside the public system for those who could afford it, Rep. Kucinich said that was no surprise. “Privatizers are at work in every country. If health care is such a losing proposition, then why are [they] trying to privatize it? Because there are huge amounts of money to be made. But [if] you have a for-profit system, you're going to have people cut out of it.”

Another government-run system that people are trying to privatize is Medicare, Rep. Kucinich said. “Medicare is discouraging doctors by cutting their fees. There's a strategy to privatize Medicare by getting doctors to walk away from [it].” The passage of the Medicare prescription drug benefit was another part of that plan, he added.

A for-profit system puts the wrong type of pressure on physicians, he said in an interview after the forum. “Doctors are under pressure from private insurance not to provide health care.” When that collides with efforts such as Medicare's pay-for-performance initiative, “there's built-in inertia. We want to encourage doctors to improve their performance, but under a for-profit system, doctors have cost pressures. That [won't] encourage the results you want.”

During the forum, Rep. Kucinich contrasted his proposal with those offered by two other Democratic presidential candidates, Sen. Hillary Rodham Clinton (D-N.Y.) and former Sen. John Edwards (D-N.C.). Under their proposals, Americans would be required to purchase health insurance; they could choose from a variety of private health care plans as well as a public plan modeled after Medicare.

“If you can't afford it under the current system, how are you going to afford it under [their] system? And if you do buy it, you're forced into plans that inevitably are going to have extraordinary copays and deductibles, and a limited level of coverage.” But with his proposal, “I'm talking about a plan where everyone's covered, [and it] covers everything. And the fact is, we're already paying for it—we're just not getting it.”

And he's not concerned a universal coverage plan would strain the system by having people who previously had no health insurance start coming in for lots of services.

“When I was a city councilman in Cleveland, I had a proposal I thought would do a lot to protect the environment and move people around our community efficiently. I proposed free [public] transit. And the people who attacked the idea … said, 'My God! If we have free transit, everyone's going to be riding the bus!' Exactly. That's what we want. You want people to use the health care system, so that they're healthy.”

'I'm talking about a plan where everyone's covered, [and it] covers everything.' REP. KUCINICH

WASHINGTON — Anyone who asks Rep. Dennis Kucinich (D-Ohio) about health care policy should be prepared for the conversation to evolve into other areas—such as the Iraq war.

“Health care spending does not occur in a vacuum,” Rep. Kucinich said at a forum on health care policy sponsored by Families USA and the Federation of American Hospitals. “You cannot separate this from war.”

Rep. Kucinich, who is seeking the Democratic nomination for president, noted that money spent on the war in Iraq—an estimated $1.5 trillion, according to a Congressional Budget Office report he cited —is money not being spent on domestic concerns such as education and health care.

“As we speak, our government is planning to bomb Iran,” which will divert more money from health care concerns, he said at the forum, part of a series of forums with the presidential candidates underwritten by the California Endowment and the Ewing Marion Kauffman Foundation.

Although he sometimes connects health care policy with other topics, the fifth-term congressman and former mayor of Cleveland is very direct when it comes to universal health care coverage: He is the only candidate who supports a single-payer system financed by the government.

“Is health care a right or a privilege? If it's a right, then it's appropriate for the government to have a role” in providing it, he said. “If it's a privilege, and it's [market-based], then we're left to the predations of the market, which is, if you can't pay for it, you're out of luck. And 47 million [uninsured] Americans are now out of luck.”

He noted that studies show health care debt is responsible for half of bankruptcies in the United States. “The median income is $48,000 a year, and some families are paying $12,000 a year for health insurance; that's a quarter of their gross. I'm talking about breaking the shackles insurance companies have on American families.”

Under Rep. Kucinich's proposal, which has been introduced in Congress as H.R. 676, all for-profit health care entities would be converted to nonprofit entities, with shareholders being compensated by the government. That compensation would be financed through Treasury bonds, he said. Physicians would continue to have private practices, but they, along with hospitals and other providers, would be paid by the federal government, which would disseminate federal funds through a series of regional budgets. There would also be separate budgets for capital expenditures and for medical education.

Coverage under Rep. Kucinich's plan would include inpatient and outpatient services as well as dental care, vision care, mental health care, and long-term care. There would be no deductibles or cost sharing.

When a reporter pointed out that in other countries with government-financed health care, a private system developed alongside the public system for those who could afford it, Rep. Kucinich said that was no surprise. “Privatizers are at work in every country. If health care is such a losing proposition, then why are [they] trying to privatize it? Because there are huge amounts of money to be made. But [if] you have a for-profit system, you're going to have people cut out of it.”

Another government-run system that people are trying to privatize is Medicare, Rep. Kucinich said. “Medicare is discouraging doctors by cutting their fees. There's a strategy to privatize Medicare by getting doctors to walk away from [it].” The passage of the Medicare prescription drug benefit was another part of that plan, he added.

A for-profit system puts the wrong type of pressure on physicians, he said in an interview after the forum. “Doctors are under pressure from private insurance not to provide health care.” When that collides with efforts such as Medicare's pay-for-performance initiative, “there's built-in inertia. We want to encourage doctors to improve their performance, but under a for-profit system, doctors have cost pressures. That [won't] encourage the results you want.”

During the forum, Rep. Kucinich contrasted his proposal with those offered by two other Democratic presidential candidates, Sen. Hillary Rodham Clinton (D-N.Y.) and former Sen. John Edwards (D-N.C.). Under their proposals, Americans would be required to purchase health insurance; they could choose from a variety of private health care plans as well as a public plan modeled after Medicare.

“If you can't afford it under the current system, how are you going to afford it under [their] system? And if you do buy it, you're forced into plans that inevitably are going to have extraordinary copays and deductibles, and a limited level of coverage.” But with his proposal, “I'm talking about a plan where everyone's covered, [and it] covers everything. And the fact is, we're already paying for it—we're just not getting it.”

And he's not concerned a universal coverage plan would strain the system by having people who previously had no health insurance start coming in for lots of services.

“When I was a city councilman in Cleveland, I had a proposal I thought would do a lot to protect the environment and move people around our community efficiently. I proposed free [public] transit. And the people who attacked the idea … said, 'My God! If we have free transit, everyone's going to be riding the bus!' Exactly. That's what we want. You want people to use the health care system, so that they're healthy.”

'I'm talking about a plan where everyone's covered, [and it] covers everything.' REP. KUCINICH

WASHINGTON — Anyone who asks Rep. Dennis Kucinich (D-Ohio) about health care policy should be prepared for the conversation to evolve into other areas—like the Iraq war.

“Health care spending does not occur in a vacuum,” Rep. Kucinich said at a forum on health care policy sponsored by Families USA and the Federation of American Hospitals. “You cannot separate this from war.”

Rep. Kucinich, who is seeking the Democratic nomination for president, noted that money spent on the war in Iraq—an estimated $1.5 trillion, according to a Congressional Budget Office report he cited—is money not being spent on domestic concerns like education and health care.

“As we speak, our government is planning to bomb Iran,” which will divert more money from health care concerns, he said at the forum, part of a series of forums with the presidential candidates underwritten by the California Endowment and the Ewing Marion Kauffman Foundation.

Although he sometimes connects health care policy with other topics, the fifth-term congressman and former mayor of Cleveland is very direct when it comes to universal health care coverage for Americans: He is the only candidate who supports a single-payer system financed by the government.

“Is health care a right or a privilege? If it's a right, then it's appropriate for the government to have a role” in providing it, he said. “If it's a privilege, and it's a market-based thing, then we're left to the predations of the market, which is, if you can't pay for it, you're out of luck. And you know what—47 million [uninsured] Americans are now out of luck.”

He noted that studies show health care debt is responsible for half of bankruptcies in the United States. “The median income is $48,000 per year, and some families are paying $12,000 a year for health insurance. That's a quarter of their gross. I'm talking about breaking the shackles insurance companies have on American families.”

Under Rep. Kucinich's proposal, which has been introduced in Congress as H.R. 676, all for-profit health care entities would be converted to nonprofit entities, with shareholders being compensated by the government. That compensation would be financed through Treasury bonds, he said. Physicians would continue to have private practices, but they, along with hospitals and other providers, would be paid by the federal government.

Coverage under Rep. Kucinich's plan would include inpatient and outpatient services as well as dental care, vision care, mental health care, and long-term care. There would be no deductibles or cost sharing.

When a reporter pointed out that other countries with government-financed health care ended up seeing a private system develop alongside the public one for those who could afford it, Rep. Kucinich said that was no surprise. “Privatizers are at work in every country,” he said. “If health care is such a losing proposition, why are these companies trying to privatize it? Because there's huge amounts of money to be made. But the minute you have a for-profit system, you're going to have people cut out of it.”

Another government-run system that people are trying to privatize is Medicare, Rep. Kucinich said. “Right now, Medicare is discouraging doctors by cutting their fees. There's a strategy to privatize Medicare by getting doctors to walk away from [it].” The passage of the Medicare prescription drug benefit was another part of that plan, he added.

A for-profit system puts the wrong type of pressure on physicians, Rep. Kucinich said in an interview after the forum. “Doctors are under pressure from private insurance not to provide health care,” he said. And when that collides with efforts such as Medicare's pay-for-performance initiative, “there's built-in inertia. Of course we want to encourage doctors to improve their performance, but under a for-profit system, doctors have cost pressures. That's sure not to encourage the results you want.”

During the forum, Rep. Kucinich contrasted his proposal with those offered by two other Democratic presidential candidates, Sen. Hillary Rodham Clinton (D-N.Y.) and former Sen. John Edwards (D-N.C.). Under their proposals, Americans would be required to purchase health insurance; they could choose from a variety of private health care plans as well as a public plan modeled after Medicare.

But with his proposal, “I'm talking about a plan where everyone's covered, [and it] covers everything. And the fact is, we're already paying for it—we're just not getting it.”

He also said he was not concerned that a universal coverage plan would strain the system by having people who were previously without health insurance suddenly come in for lots of services.

“Years ago, when I was a city councilman in Cleveland, I had a proposal I thought would do a lot to protect the environment and move people around our community efficiently. I proposed free [public] transit,” he said. “And the people who attacked the idea threw up their arms and said, 'My God! If we have free transit, everyone's going to be riding the bus!' Exactly. That's what we want. You want people to use the health care system, so that they're healthy.”

'I'm talking about a plan where everyone's covered, [and it] covers everything.' REP. KUCINICH

WASHINGTON — Anyone who asks Rep. Dennis Kucinich (D-Ohio) about health care policy should be prepared for the conversation to evolve into other areas—like the Iraq war.

“Health care spending does not occur in a vacuum,” Rep. Kucinich said at a forum on health care policy sponsored by Families USA and the Federation of American Hospitals. “You cannot separate this from war.”

Rep. Kucinich, who is seeking the Democratic nomination for president, noted that money spent on the war in Iraq—an estimated $1.5 trillion, according to a Congressional Budget Office report he cited—is money not being spent on domestic concerns like education and health care.

“As we speak, our government is planning to bomb Iran,” which will divert more money from health care concerns, he said at the forum, part of a series of forums with the presidential candidates underwritten by the California Endowment and the Ewing Marion Kauffman Foundation.

Although he sometimes connects health care policy with other topics, the fifth-term congressman and former mayor of Cleveland is very direct when it comes to universal health care coverage for Americans: He is the only candidate who supports a single-payer system financed by the government.

“Is health care a right or a privilege? If it's a right, then it's appropriate for the government to have a role” in providing it, he said. “If it's a privilege, and it's a market-based thing, then we're left to the predations of the market, which is, if you can't pay for it, you're out of luck. And you know what—47 million [uninsured] Americans are now out of luck.”

He noted that studies show health care debt is responsible for half of bankruptcies in the United States. “The median income is $48,000 per year, and some families are paying $12,000 a year for health insurance. That's a quarter of their gross. I'm talking about breaking the shackles insurance companies have on American families.”

Under Rep. Kucinich's proposal, which has been introduced in Congress as H.R. 676, all for-profit health care entities would be converted to nonprofit entities, with shareholders being compensated by the government. That compensation would be financed through Treasury bonds, he said. Physicians would continue to have private practices, but they, along with hospitals and other providers, would be paid by the federal government.

Coverage under Rep. Kucinich's plan would include inpatient and outpatient services as well as dental care, vision care, mental health care, and long-term care. There would be no deductibles or cost sharing.

When a reporter pointed out that other countries with government-financed health care ended up seeing a private system develop alongside the public one for those who could afford it, Rep. Kucinich said that was no surprise. “Privatizers are at work in every country,” he said. “If health care is such a losing proposition, why are these companies trying to privatize it? Because there's huge amounts of money to be made. But the minute you have a for-profit system, you're going to have people cut out of it.”

Another government-run system that people are trying to privatize is Medicare, Rep. Kucinich said. “Right now, Medicare is discouraging doctors by cutting their fees. There's a strategy to privatize Medicare by getting doctors to walk away from [it].” The passage of the Medicare prescription drug benefit was another part of that plan, he added.

A for-profit system puts the wrong type of pressure on physicians, Rep. Kucinich said in an interview after the forum. “Doctors are under pressure from private insurance not to provide health care,” he said. And when that collides with efforts such as Medicare's pay-for-performance initiative, “there's built-in inertia. Of course we want to encourage doctors to improve their performance, but under a for-profit system, doctors have cost pressures. That's sure not to encourage the results you want.”

During the forum, Rep. Kucinich contrasted his proposal with those offered by two other Democratic presidential candidates, Sen. Hillary Rodham Clinton (D-N.Y.) and former Sen. John Edwards (D-N.C.). Under their proposals, Americans would be required to purchase health insurance; they could choose from a variety of private health care plans as well as a public plan modeled after Medicare.

But with his proposal, “I'm talking about a plan where everyone's covered, [and it] covers everything. And the fact is, we're already paying for it—we're just not getting it.”

He also said he was not concerned that a universal coverage plan would strain the system by having people who were previously without health insurance suddenly come in for lots of services.

“Years ago, when I was a city councilman in Cleveland, I had a proposal I thought would do a lot to protect the environment and move people around our community efficiently. I proposed free [public] transit,” he said. “And the people who attacked the idea threw up their arms and said, 'My God! If we have free transit, everyone's going to be riding the bus!' Exactly. That's what we want. You want people to use the health care system, so that they're healthy.”

'I'm talking about a plan where everyone's covered, [and it] covers everything.' REP. KUCINICH

WASHINGTON — Anyone who asks Rep. Dennis Kucinich (D-Ohio) about health care policy should be prepared for the conversation to evolve into other areas—like the Iraq war.

“Health care spending does not occur in a vacuum,” Rep. Kucinich said at a forum on health care policy sponsored by Families USA and the Federation of American Hospitals. “You cannot separate this from war.”

Rep. Kucinich, who is seeking the Democratic nomination for president, noted that money spent on the war in Iraq—an estimated $1.5 trillion, according to a Congressional Budget Office report he cited—is money not being spent on domestic concerns like education and health care.

“As we speak, our government is planning to bomb Iran,” which will divert more money from health care concerns, he said at the forum, part of a series of forums with the presidential candidates underwritten by the California Endowment and the Ewing Marion Kauffman Foundation.

Although he sometimes connects health care policy with other topics, the fifth-term congressman and former mayor of Cleveland is very direct when it comes to universal health care coverage for Americans: He is the only candidate who supports a single-payer system financed by the government.

“Is health care a right or a privilege? If it's a right, then it's appropriate for the government to have a role” in providing it, he said. “If it's a privilege, and it's a market-based thing, then we're left to the predations of the market, which is, if you can't pay for it, you're out of luck. And you know what—47 million [uninsured] Americans are now out of luck.”

He noted that studies show health care debt is responsible for half of bankruptcies in the United States. “The median income is $48,000 per year, and some families are paying $12,000 a year for health insurance. That's a quarter of their gross. I'm talking about breaking the shackles insurance companies have on American families.”

Under Rep. Kucinich's proposal, which has been introduced in Congress as H.R. 676, all for-profit health care entities would be converted to nonprofit entities, with shareholders being compensated by the government. That compensation would be financed through Treasury bonds, he said. Physicians would continue to have private practices, but they, along with hospitals and other providers, would be paid by the federal government.

Coverage under Rep. Kucinich's plan would include inpatient and outpatient services as well as dental care, vision care, mental health care, and long-term care. There would be no deductibles or cost sharing.

When a reporter pointed out that other countries with government-financed health care ended up seeing a private system develop alongside the public one for those who could afford it, Rep. Kucinich said that was no surprise. “Privatizers are at work in every country,” he said. “If health care is such a losing proposition, why are these companies trying to privatize it? Because there's huge amounts of money to be made. But the minute you have a for-profit system, you're going to have people cut out of it.”

Another government-run system that people are trying to privatize is Medicare, Rep. Kucinich said. “Right now, Medicare is discouraging doctors by cutting their fees. There's a strategy to privatize Medicare by getting doctors to walk away from [it].” The passage of the Medicare prescription drug benefit was another part of that plan, he added.

A for-profit system puts the wrong type of pressure on physicians, Rep. Kucinich said in an interview after the forum. “Doctors are under pressure from private insurance not to provide health care,” he said. And when that collides with efforts such as Medicare's pay-for-performance initiative, “there's built-in inertia. Of course we want to encourage doctors to improve their performance, but under a for-profit system, doctors have cost pressures. That's sure not to encourage the results you want.”

During the forum, Rep. Kucinich contrasted his proposal with those offered by two other Democratic presidential candidates, Sen. Hillary Rodham Clinton (D-N.Y.) and former Sen. John Edwards (D-N.C.). Under their proposals, Americans would be required to purchase health insurance; they could choose from a variety of private health care plans as well as a public plan modeled after Medicare.

But with his proposal, “I'm talking about a plan where everyone's covered, [and it] covers everything. And the fact is, we're already paying for it—we're just not getting it.”

He also said he was not concerned that a universal coverage plan would strain the system by having people who were previously without health insurance suddenly come in for lots of services.

“Years ago, when I was a city councilman in Cleveland, I had a proposal I thought would do a lot to protect the environment and move people around our community efficiently. I proposed free [public] transit,” he said. “And the people who attacked the idea threw up their arms and said, 'My God! If we have free transit, everyone's going to be riding the bus!' Exactly. That's what we want. You want people to use the health care system, so that they're healthy.”

'I'm talking about a plan where everyone's covered, [and it] covers everything.' REP. KUCINICH

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

"I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines," Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. "What other functions can we delegate out, given appropriate oversight and training?"

For example, she said, "I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care."

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

"This is, for me, a moral question and an economic one," she said. "Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?"

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan.

"The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake," she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as "setting the goals and framework but not getting into the details."

Further, the Clinton plan of the early 1990s was just too complicated, she said. "It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way."

This time, Sen. Clinton has a different plan. The "American Health Choices Plan" would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees. They would also have the option of enrolling in a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and fully portable, and that insurers would be barred from discriminating against enrollees based on preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would be given tax credits to encourage them to do so.

She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal. "I've included the public plan option because a lot of Americans want it," she said. "It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice."

Sen. Clinton predicted that a lot of people would still choose a private plan because "if the private plans are competitive and smart, they'll offer a lot of new features. What are we afraid of? Let's see where competition leads us."

Sen. Clinton also expressed her support of the increased use of electronic health records to make the health care system more organized.

Paying providers based on their outcomes was another recent innovation mentioned by Sen. Clinton. She lauded the Bush Administration for announcing that the Medicare program would no longer pay for care occurring as a result of medical errors. "That kind of connection between pay and performance, quality and results … makes sense. It's hard to do, but we have to experiment." The recent increase in cases of nosocomial infections such as methicillin-resistant Staphylococcus aureus "should be a wake-up call for everybody," Sen. Clinton said. "A couple of hospitals I'm aware of have changed their infection control policies; they have cut the rate of hospital-borne infections. Everybody should be expected to do that.

"When you look at some of the disparities and disorganization, it's because we don't have a good system to disseminate evidence-based clinically proven treatments," she continued. "It takes 17 years for something that is proven in the lab to be broadly disseminated. It should take 17 hours—17 seconds. With the Internet, why are we so far behind?"

If we can't quickly increase the number of primary care physicians, we need more advanced practice nurses. SEN. CLINTON

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

"I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines," Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. "What other functions can we delegate out, given appropriate oversight and training?"

For example, she said, "I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care."

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

"This is, for me, a moral question and an economic one," she said. "Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?"

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan.

"The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake," she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as "setting the goals and framework but not getting into the details."

Further, the Clinton plan of the early 1990s was just too complicated, she said. "It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way."

This time, Sen. Clinton has a different plan. The "American Health Choices Plan" would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees. They would also have the option of enrolling in a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and fully portable, and that insurers would be barred from discriminating against enrollees based on preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would be given tax credits to encourage them to do so.

She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal. "I've included the public plan option because a lot of Americans want it," she said. "It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice."

Sen. Clinton predicted that a lot of people would still choose a private plan because "if the private plans are competitive and smart, they'll offer a lot of new features. What are we afraid of? Let's see where competition leads us."

Sen. Clinton also expressed her support of the increased use of electronic health records to make the health care system more organized.

Paying providers based on their outcomes was another recent innovation mentioned by Sen. Clinton. She lauded the Bush Administration for announcing that the Medicare program would no longer pay for care occurring as a result of medical errors. "That kind of connection between pay and performance, quality and results … makes sense. It's hard to do, but we have to experiment." The recent increase in cases of nosocomial infections such as methicillin-resistant Staphylococcus aureus "should be a wake-up call for everybody," Sen. Clinton said. "A couple of hospitals I'm aware of have changed their infection control policies; they have cut the rate of hospital-borne infections. Everybody should be expected to do that.

"When you look at some of the disparities and disorganization, it's because we don't have a good system to disseminate evidence-based clinically proven treatments," she continued. "It takes 17 years for something that is proven in the lab to be broadly disseminated. It should take 17 hours—17 seconds. With the Internet, why are we so far behind?"

If we can't quickly increase the number of primary care physicians, we need more advanced practice nurses. SEN. CLINTON

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

"I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines," Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. "What other functions can we delegate out, given appropriate oversight and training?"

For example, she said, "I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care."

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

"This is, for me, a moral question and an economic one," she said. "Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?"

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan.

"The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake," she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as "setting the goals and framework but not getting into the details."

Further, the Clinton plan of the early 1990s was just too complicated, she said. "It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way."

This time, Sen. Clinton has a different plan. The "American Health Choices Plan" would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees. They would also have the option of enrolling in a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and fully portable, and that insurers would be barred from discriminating against enrollees based on preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would be given tax credits to encourage them to do so.

She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal. "I've included the public plan option because a lot of Americans want it," she said. "It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice."

Sen. Clinton predicted that a lot of people would still choose a private plan because "if the private plans are competitive and smart, they'll offer a lot of new features. What are we afraid of? Let's see where competition leads us."

Sen. Clinton also expressed her support of the increased use of electronic health records to make the health care system more organized.

Paying providers based on their outcomes was another recent innovation mentioned by Sen. Clinton. She lauded the Bush Administration for announcing that the Medicare program would no longer pay for care occurring as a result of medical errors. "That kind of connection between pay and performance, quality and results … makes sense. It's hard to do, but we have to experiment." The recent increase in cases of nosocomial infections such as methicillin-resistant Staphylococcus aureus "should be a wake-up call for everybody," Sen. Clinton said. "A couple of hospitals I'm aware of have changed their infection control policies; they have cut the rate of hospital-borne infections. Everybody should be expected to do that.

"When you look at some of the disparities and disorganization, it's because we don't have a good system to disseminate evidence-based clinically proven treatments," she continued. "It takes 17 years for something that is proven in the lab to be broadly disseminated. It should take 17 hours—17 seconds. With the Internet, why are we so far behind?"

If we can't quickly increase the number of primary care physicians, we need more advanced practice nurses. SEN. CLINTON

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

“I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines,” Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. “What other functions can we delegate out, given appropriate oversight and training?”

For example, she said, “I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care.”

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

“This is, for me, a moral question and an economic one,” she said. “Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?”

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan. “The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake,” she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as “setting the goals and framework but not getting into the details.”

Further, the Clinton plan of the early 1990s was just too complicated, she said. “It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way.”

This time, Sen. Clinton has a different plan. The “American Health Choices Plan” would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees. They would also have the option of enrolling in a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and fully portable, and that insurers would be barred from discriminating against enrollees based on preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would be given tax credits to encourage them to do so. She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal.

“I've included the public plan option because a lot of Americans want it,” she said. “It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice.”

Sen. Clinton predicted that many would still choose a private plan because “if the private plans are competitive and smart, they'll offer a lot of new features.”

Sen. Clinton also expressed her support of the increased use of electronic health records to make the health care system more organized. “It's very hard to think about having a system when you don't have any way for people to move [their records with them] from place to place.”

Paying providers based on their outcomes was another recent innovation mentioned by Sen. Clinton. She lauded the Bush Administration for announcing that the Medicare program would no longer pay for care occurring as a result of medical errors. “That kind of connection between pay and performance, quality and results … makes sense. It's hard to do, but we have to experiment.”

The increase in cases of nosocomial infections such as methicillin-resistant Staphylococcus aureus “should be a wake-up call,” Sen. Clinton said. “A couple of hospitals I'm aware of have changed their infection control policies; they have cut the rate of hospital-borne infections. Everybody should be expected to do that.”

'I think nurses have a great opportunity to do much more than they're doing.' SEN. CLINTON

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

“I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines,” Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. “What other functions can we delegate out, given appropriate oversight and training?”

For example, she said, “I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care.”

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

“This is, for me, a moral question and an economic one,” she said. “Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?”

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan. “The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake,” she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as “setting the goals and framework but not getting into the details.”

Further, the Clinton plan of the early 1990s was just too complicated, she said. “It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way.”

This time, Sen. Clinton has a different plan. The “American Health Choices Plan” would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees. They would also have the option of enrolling in a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and fully portable, and that insurers would be barred from discriminating against enrollees based on preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would be given tax credits to encourage them to do so. She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal.

“I've included the public plan option because a lot of Americans want it,” she said. “It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice.”

Sen. Clinton predicted that many would still choose a private plan because “if the private plans are competitive and smart, they'll offer a lot of new features.”

Sen. Clinton also expressed her support of the increased use of electronic health records to make the health care system more organized. “It's very hard to think about having a system when you don't have any way for people to move [their records with them] from place to place.”

Paying providers based on their outcomes was another recent innovation mentioned by Sen. Clinton. She lauded the Bush Administration for announcing that the Medicare program would no longer pay for care occurring as a result of medical errors. “That kind of connection between pay and performance, quality and results … makes sense. It's hard to do, but we have to experiment.”

The increase in cases of nosocomial infections such as methicillin-resistant Staphylococcus aureus “should be a wake-up call,” Sen. Clinton said. “A couple of hospitals I'm aware of have changed their infection control policies; they have cut the rate of hospital-borne infections. Everybody should be expected to do that.”

'I think nurses have a great opportunity to do much more than they're doing.' SEN. CLINTON

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

“I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines,” Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. “What other functions can we delegate out, given appropriate oversight and training?”

For example, she said, “I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care.”

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

“This is, for me, a moral question and an economic one,” she said. “Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?”

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan. “The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake,” she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as “setting the goals and framework but not getting into the details.”

Further, the Clinton plan of the early 1990s was just too complicated, she said. “It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way.”

This time, Sen. Clinton has a different plan. The “American Health Choices Plan” would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees. They would also have the option of enrolling in a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and fully portable, and that insurers would be barred from discriminating against enrollees based on preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would be given tax credits to encourage them to do so. She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal.

“I've included the public plan option because a lot of Americans want it,” she said. “It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice.”

Sen. Clinton predicted that many would still choose a private plan because “if the private plans are competitive and smart, they'll offer a lot of new features.”

Sen. Clinton also expressed her support of the increased use of electronic health records to make the health care system more organized. “It's very hard to think about having a system when you don't have any way for people to move [their records with them] from place to place.”

Paying providers based on their outcomes was another recent innovation mentioned by Sen. Clinton. She lauded the Bush Administration for announcing that the Medicare program would no longer pay for care occurring as a result of medical errors. “That kind of connection between pay and performance, quality and results … makes sense. It's hard to do, but we have to experiment.”

The increase in cases of nosocomial infections such as methicillin-resistant Staphylococcus aureus “should be a wake-up call,” Sen. Clinton said. “A couple of hospitals I'm aware of have changed their infection control policies; they have cut the rate of hospital-borne infections. Everybody should be expected to do that.”

'I think nurses have a great opportunity to do much more than they're doing.' SEN. CLINTON

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

“I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines,” Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. “What other functions can we delegate out, given appropriate oversight and training?”

For example, she said, “I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care.”

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

“This is, for me, a moral question and an economic one,” she said. “Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?”

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan.

“The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake,” she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as “setting the goals and framework but not getting into the details.”

Further, the Clinton plan of the early 1990s was just too complicated, she said. “It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way.”

This time, Sen. Clinton has a different plan. The “American Health Choices Plan” would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees or a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and portable, and insurers would be barred from discriminating against enrollees with preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would get tax credits to encourage them to do so.

She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal. “I've included the public plan option because a lot of Americans want it,” she said. “It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice.”

Sen. Clinton predicted that a lot of people would still choose a private plan because “if the private plans are competitive and smart, they'll offer a lot of new features. What are we afraid of? Let's see where competition leads us.”

Sen. Clinton expressed support for the increased use of electronic health records to make the health care system more organized. “It's very hard to think about having a system when you don't have any way for people to move [their records with them] from place to place and job to job.”

Paying providers based on their outcomes was another recent innovation mentioned by Sen. Clinton. She lauded the Bush Administration for announcing that the Medicare program would no longer pay for care occurring as a result of medical errors. “That kind of connection between pay and performance, quality and results … makes sense. It's hard to do, but we have to experiment.”

The recent increase in cases of nosocomial infections such as methicillin-resistant Staphylococcus aureus “should be a wake-up call for everybody,” she said. “A couple of hospitals I'm aware of have changed their infection control policies; they have cut the rate of hospital-borne infections. Everybody should be expected to do that.

“When you look at some of the disparities and disorganization, it's because we don't have a good system to disseminate evidence-based clinically proven treatments,” she continued. “It takes 17 years for something that is proven in the lab to be broadly disseminated. It should take 17 hours—17 seconds. With the Internet, why are we so far behind?”

'What are we afraid of? Let's see where competition leads us.' SEN. CLINTON

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

“I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines,” Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. “What other functions can we delegate out, given appropriate oversight and training?”

For example, she said, “I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care.”

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

“This is, for me, a moral question and an economic one,” she said. “Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?”

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan.

“The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake,” she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as “setting the goals and framework but not getting into the details.”

Further, the Clinton plan of the early 1990s was just too complicated, she said. “It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way.”

This time, Sen. Clinton has a different plan. The “American Health Choices Plan” would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees or a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and portable, and insurers would be barred from discriminating against enrollees with preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would get tax credits to encourage them to do so.

She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal. “I've included the public plan option because a lot of Americans want it,” she said. “It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice.”

Sen. Clinton predicted that a lot of people would still choose a private plan because “if the private plans are competitive and smart, they'll offer a lot of new features. What are we afraid of? Let's see where competition leads us.”

Sen. Clinton expressed support for the increased use of electronic health records to make the health care system more organized. “It's very hard to think about having a system when you don't have any way for people to move [their records with them] from place to place and job to job.”

Paying providers based on their outcomes was another recent innovation mentioned by Sen. Clinton. She lauded the Bush Administration for announcing that the Medicare program would no longer pay for care occurring as a result of medical errors. “That kind of connection between pay and performance, quality and results … makes sense. It's hard to do, but we have to experiment.”

The recent increase in cases of nosocomial infections such as methicillin-resistant Staphylococcus aureus “should be a wake-up call for everybody,” she said. “A couple of hospitals I'm aware of have changed their infection control policies; they have cut the rate of hospital-borne infections. Everybody should be expected to do that.

“When you look at some of the disparities and disorganization, it's because we don't have a good system to disseminate evidence-based clinically proven treatments,” she continued. “It takes 17 years for something that is proven in the lab to be broadly disseminated. It should take 17 hours—17 seconds. With the Internet, why are we so far behind?”

'What are we afraid of? Let's see where competition leads us.' SEN. CLINTON

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

“I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines,” Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. “What other functions can we delegate out, given appropriate oversight and training?”

For example, she said, “I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care.”

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

“This is, for me, a moral question and an economic one,” she said. “Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?”

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan.

“The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake,” she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as “setting the goals and framework but not getting into the details.”

Further, the Clinton plan of the early 1990s was just too complicated, she said. “It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way.”

This time, Sen. Clinton has a different plan. The “American Health Choices Plan” would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees or a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and portable, and insurers would be barred from discriminating against enrollees with preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would get tax credits to encourage them to do so.

She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal. “I've included the public plan option because a lot of Americans want it,” she said. “It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice.”

Sen. Clinton predicted that a lot of people would still choose a private plan because “if the private plans are competitive and smart, they'll offer a lot of new features. What are we afraid of? Let's see where competition leads us.”

Sen. Clinton expressed support for the increased use of electronic health records to make the health care system more organized. “It's very hard to think about having a system when you don't have any way for people to move [their records with them] from place to place and job to job.”

Paying providers based on their outcomes was another recent innovation mentioned by Sen. Clinton. She lauded the Bush Administration for announcing that the Medicare program would no longer pay for care occurring as a result of medical errors. “That kind of connection between pay and performance, quality and results … makes sense. It's hard to do, but we have to experiment.”

The recent increase in cases of nosocomial infections such as methicillin-resistant Staphylococcus aureus “should be a wake-up call for everybody,” she said. “A couple of hospitals I'm aware of have changed their infection control policies; they have cut the rate of hospital-borne infections. Everybody should be expected to do that.

“When you look at some of the disparities and disorganization, it's because we don't have a good system to disseminate evidence-based clinically proven treatments,” she continued. “It takes 17 years for something that is proven in the lab to be broadly disseminated. It should take 17 hours—17 seconds. With the Internet, why are we so far behind?”

'What are we afraid of? Let's see where competition leads us.' SEN. CLINTON

Bill Promotes Phys. Ed.

A measure proposed by Sen. Tom Harkin (D-Iowa) would require school districts and state education agencies to report to parents on the quantity and quality of physical education provided. The Fitness Integrated With Teaching Kids (FIT Kids) Act (S. 2173) also would require school counseling programs to take into account students' emotional and physical well-being; support professional development for health and physical education teachers; and authorize the Institute of Medicine to report on how physical activity can be included in all aspects of the school day. “As every parent knows, engaging children in physical activity throughout the day improves fitness, burns off excess energy, and boosts concentration in the classroom. I hope this bill will empower our schools and parents to help improve our kids' health,” Sen. Harkin said in a statement.

One-Third of Americans Uninsured

Almost 35% of Americans uninsured had no health care coverage for at least part of 2006-2007, up from 30% in 1999-2000, Families USA reported. Of these, 19% were uninsured for longer than 1 year; more than half were uninsured for longer than 6 months. Of the 89.6 million people who lacked coverage, 71% had full-time jobs and another 9% were working part time; only 17% were unemployed. The numbers are substantially larger than those published by the U.S. Census Bureau (which cites 47 million uninsured in 2006, or 16%), because those statistics include only those who were uninsured for a full year. The report is at

www.familiesusa.org

Disordered Eating in Overweight Teens

Factors such as teasing by family, personal weight concerns, and dieting/unhealthy weight-control behaviors are strong and consistent predictors of overweight status, binge eating, and extreme weight-control behaviors later in adolescence, a study in the American Journal of Preventive Medicine found. About 40% of overweight girls and 20% of overweight boys in the study engaged in either binge eating, extreme weight control, or both. The findings “suggest a need for decreasing weight-related pressures within an adolescent's social environment, decreasing weight concerns, and decreasing unhealthy weight control practices while promoting healthier alternatives,” the study's authors concluded.

Medicaid Enrollment Declines

Enrollment in Medicaid declined in 2007 for the first time in nearly a decade, primarily because new documentation requirements have caused significant delays in processing applications and because of the strong economy and lower unemployment, according to a new 50-state survey from the Kaiser Family Foundation. But states expect enrollment and spending to increase in 2008 as they move forward with program enhancements, according to the survey. “States are turning to Medicaid to address the rising number of uninsured to help fill in the gaps for low-income families,” Diane Rowland, executive vice president of the Kaiser Family Foundation, said in a statement.

Push for Medicare E-Prescribing

A coalition of 22 health, business, and consumer organizations has asked Congress to pass legislation requiring physicians who see Medicare patients to adopt electronic prescribing by the year 2010. “Last year, the Institute of Medicine estimated that preventable medication errors harm an estimated 1.5 million Americans each year,” said a letter from the coalition, which includes Aetna, Consumers Union, the Corporate Health Care Coalition, the Pacific Business Group on Health, and the Pharmaceutical Care Management Association, to leaders of the Senate Finance Committee, House Ways & Means Committee, and House Energy and Commerce Committee. “In the report, the IOM called on all physicians to adopt electronic prescribing (e-prescribing) by 2010 to address this problem. Unfortunately, fewer than 1 in 10 physicians are meeting this challenge. As a result, neither patients nor physicians take advantage of critical, available, real-time information that would improve outcomes, save lives, and dramatically reduce health care costs. To address this problem, we urge Congress to approve legislation this year calling for full physician adoption of e-prescribing in Medicare.”

Wal-Mart Expands $4 Generics

Wal-Mart has added 24 medications to its growing list of generic prescription drug products that patients can receive for $4 for a 30-day supply. The prescriptions can be filled at 4,005 Wal-Mart, Sam's Club, and Neighborhood Market pharmacies in the United States. Among the 24 new medications are levobunolol, carvedilol, warfarin, and nitroglycerin. Wal-Mart claims that since its $4 generic program began in the fall of 2006, customers have saved $613 million. The generics represent 40% of all prescriptions filled in the last year. Because of state laws, some of the drugs cost more than $4 in California, Colorado, Hawaii, Minnesota, Montana, Pennsylvania, Tennessee, Wisconsin, and Wyoming.

Partisan Views on Health Reform

While 82% of Democrats agreed that “it is the government's duty to ensure that all Americans have adequate health care coverage,” only 47% of Republicans agreed with that statement, according to a

WSJ.com/Harris

Arkansas Reworks BMI Program

Arkansas' 4-year-old program to combat childhood obesity, which includes mandatory school-based body mass index screenings, appears to have halted the rise in the obesity rate for the state's children. A report released last month showed that nearly 21% of tested schoolchildren were overweight last year, while just over 17% were at risk for being overweight, about the same figures as the previous year. However, a new state law has reduced screenings to every other year and makes it easier for parents to opt out their children, leading some health experts in the state to voice fears that the changes could weaken the successful program. But Arkansas Surgeon General Dr. Joe Thompson said in an interview that scaling back the screenings will allow schools to concentrate scarce resources on the children and families who need the most help battling obesity.

Bill Promotes Phys. Ed.

A measure proposed by Sen. Tom Harkin (D-Iowa) would require school districts and state education agencies to report to parents on the quantity and quality of physical education provided. The Fitness Integrated With Teaching Kids (FIT Kids) Act (S. 2173) also would require school counseling programs to take into account students' emotional and physical well-being; support professional development for health and physical education teachers; and authorize the Institute of Medicine to report on how physical activity can be included in all aspects of the school day. “As every parent knows, engaging children in physical activity throughout the day improves fitness, burns off excess energy, and boosts concentration in the classroom. I hope this bill will empower our schools and parents to help improve our kids' health,” Sen. Harkin said in a statement.

One-Third of Americans Uninsured

Almost 35% of Americans uninsured had no health care coverage for at least part of 2006-2007, up from 30% in 1999-2000, Families USA reported. Of these, 19% were uninsured for longer than 1 year; more than half were uninsured for longer than 6 months. Of the 89.6 million people who lacked coverage, 71% had full-time jobs and another 9% were working part time; only 17% were unemployed. The numbers are substantially larger than those published by the U.S. Census Bureau (which cites 47 million uninsured in 2006, or 16%), because those statistics include only those who were uninsured for a full year. The report is at

www.familiesusa.org

Disordered Eating in Overweight Teens

Factors such as teasing by family, personal weight concerns, and dieting/unhealthy weight-control behaviors are strong and consistent predictors of overweight status, binge eating, and extreme weight-control behaviors later in adolescence, a study in the American Journal of Preventive Medicine found. About 40% of overweight girls and 20% of overweight boys in the study engaged in either binge eating, extreme weight control, or both. The findings “suggest a need for decreasing weight-related pressures within an adolescent's social environment, decreasing weight concerns, and decreasing unhealthy weight control practices while promoting healthier alternatives,” the study's authors concluded.

Medicaid Enrollment Declines

Enrollment in Medicaid declined in 2007 for the first time in nearly a decade, primarily because new documentation requirements have caused significant delays in processing applications and because of the strong economy and lower unemployment, according to a new 50-state survey from the Kaiser Family Foundation. But states expect enrollment and spending to increase in 2008 as they move forward with program enhancements, according to the survey. “States are turning to Medicaid to address the rising number of uninsured to help fill in the gaps for low-income families,” Diane Rowland, executive vice president of the Kaiser Family Foundation, said in a statement.

Push for Medicare E-Prescribing

A coalition of 22 health, business, and consumer organizations has asked Congress to pass legislation requiring physicians who see Medicare patients to adopt electronic prescribing by the year 2010. “Last year, the Institute of Medicine estimated that preventable medication errors harm an estimated 1.5 million Americans each year,” said a letter from the coalition, which includes Aetna, Consumers Union, the Corporate Health Care Coalition, the Pacific Business Group on Health, and the Pharmaceutical Care Management Association, to leaders of the Senate Finance Committee, House Ways & Means Committee, and House Energy and Commerce Committee. “In the report, the IOM called on all physicians to adopt electronic prescribing (e-prescribing) by 2010 to address this problem. Unfortunately, fewer than 1 in 10 physicians are meeting this challenge. As a result, neither patients nor physicians take advantage of critical, available, real-time information that would improve outcomes, save lives, and dramatically reduce health care costs. To address this problem, we urge Congress to approve legislation this year calling for full physician adoption of e-prescribing in Medicare.”

Wal-Mart Expands $4 Generics

Wal-Mart has added 24 medications to its growing list of generic prescription drug products that patients can receive for $4 for a 30-day supply. The prescriptions can be filled at 4,005 Wal-Mart, Sam's Club, and Neighborhood Market pharmacies in the United States. Among the 24 new medications are levobunolol, carvedilol, warfarin, and nitroglycerin. Wal-Mart claims that since its $4 generic program began in the fall of 2006, customers have saved $613 million. The generics represent 40% of all prescriptions filled in the last year. Because of state laws, some of the drugs cost more than $4 in California, Colorado, Hawaii, Minnesota, Montana, Pennsylvania, Tennessee, Wisconsin, and Wyoming.

Partisan Views on Health Reform

While 82% of Democrats agreed that “it is the government's duty to ensure that all Americans have adequate health care coverage,” only 47% of Republicans agreed with that statement, according to a

WSJ.com/Harris

Arkansas Reworks BMI Program

Arkansas' 4-year-old program to combat childhood obesity, which includes mandatory school-based body mass index screenings, appears to have halted the rise in the obesity rate for the state's children. A report released last month showed that nearly 21% of tested schoolchildren were overweight last year, while just over 17% were at risk for being overweight, about the same figures as the previous year. However, a new state law has reduced screenings to every other year and makes it easier for parents to opt out their children, leading some health experts in the state to voice fears that the changes could weaken the successful program. But Arkansas Surgeon General Dr. Joe Thompson said in an interview that scaling back the screenings will allow schools to concentrate scarce resources on the children and families who need the most help battling obesity.

Bill Promotes Phys. Ed.

A measure proposed by Sen. Tom Harkin (D-Iowa) would require school districts and state education agencies to report to parents on the quantity and quality of physical education provided. The Fitness Integrated With Teaching Kids (FIT Kids) Act (S. 2173) also would require school counseling programs to take into account students' emotional and physical well-being; support professional development for health and physical education teachers; and authorize the Institute of Medicine to report on how physical activity can be included in all aspects of the school day. “As every parent knows, engaging children in physical activity throughout the day improves fitness, burns off excess energy, and boosts concentration in the classroom. I hope this bill will empower our schools and parents to help improve our kids' health,” Sen. Harkin said in a statement.

One-Third of Americans Uninsured

Almost 35% of Americans uninsured had no health care coverage for at least part of 2006-2007, up from 30% in 1999-2000, Families USA reported. Of these, 19% were uninsured for longer than 1 year; more than half were uninsured for longer than 6 months. Of the 89.6 million people who lacked coverage, 71% had full-time jobs and another 9% were working part time; only 17% were unemployed. The numbers are substantially larger than those published by the U.S. Census Bureau (which cites 47 million uninsured in 2006, or 16%), because those statistics include only those who were uninsured for a full year. The report is at

www.familiesusa.org

Disordered Eating in Overweight Teens

Factors such as teasing by family, personal weight concerns, and dieting/unhealthy weight-control behaviors are strong and consistent predictors of overweight status, binge eating, and extreme weight-control behaviors later in adolescence, a study in the American Journal of Preventive Medicine found. About 40% of overweight girls and 20% of overweight boys in the study engaged in either binge eating, extreme weight control, or both. The findings “suggest a need for decreasing weight-related pressures within an adolescent's social environment, decreasing weight concerns, and decreasing unhealthy weight control practices while promoting healthier alternatives,” the study's authors concluded.

Medicaid Enrollment Declines

Enrollment in Medicaid declined in 2007 for the first time in nearly a decade, primarily because new documentation requirements have caused significant delays in processing applications and because of the strong economy and lower unemployment, according to a new 50-state survey from the Kaiser Family Foundation. But states expect enrollment and spending to increase in 2008 as they move forward with program enhancements, according to the survey. “States are turning to Medicaid to address the rising number of uninsured to help fill in the gaps for low-income families,” Diane Rowland, executive vice president of the Kaiser Family Foundation, said in a statement.

Push for Medicare E-Prescribing

A coalition of 22 health, business, and consumer organizations has asked Congress to pass legislation requiring physicians who see Medicare patients to adopt electronic prescribing by the year 2010. “Last year, the Institute of Medicine estimated that preventable medication errors harm an estimated 1.5 million Americans each year,” said a letter from the coalition, which includes Aetna, Consumers Union, the Corporate Health Care Coalition, the Pacific Business Group on Health, and the Pharmaceutical Care Management Association, to leaders of the Senate Finance Committee, House Ways & Means Committee, and House Energy and Commerce Committee. “In the report, the IOM called on all physicians to adopt electronic prescribing (e-prescribing) by 2010 to address this problem. Unfortunately, fewer than 1 in 10 physicians are meeting this challenge. As a result, neither patients nor physicians take advantage of critical, available, real-time information that would improve outcomes, save lives, and dramatically reduce health care costs. To address this problem, we urge Congress to approve legislation this year calling for full physician adoption of e-prescribing in Medicare.”

Wal-Mart Expands $4 Generics

Wal-Mart has added 24 medications to its growing list of generic prescription drug products that patients can receive for $4 for a 30-day supply. The prescriptions can be filled at 4,005 Wal-Mart, Sam's Club, and Neighborhood Market pharmacies in the United States. Among the 24 new medications are levobunolol, carvedilol, warfarin, and nitroglycerin. Wal-Mart claims that since its $4 generic program began in the fall of 2006, customers have saved $613 million. The generics represent 40% of all prescriptions filled in the last year. Because of state laws, some of the drugs cost more than $4 in California, Colorado, Hawaii, Minnesota, Montana, Pennsylvania, Tennessee, Wisconsin, and Wyoming.

Partisan Views on Health Reform

While 82% of Democrats agreed that “it is the government's duty to ensure that all Americans have adequate health care coverage,” only 47% of Republicans agreed with that statement, according to a

WSJ.com/Harris

Arkansas Reworks BMI Program

Arkansas' 4-year-old program to combat childhood obesity, which includes mandatory school-based body mass index screenings, appears to have halted the rise in the obesity rate for the state's children. A report released last month showed that nearly 21% of tested schoolchildren were overweight last year, while just over 17% were at risk for being overweight, about the same figures as the previous year. However, a new state law has reduced screenings to every other year and makes it easier for parents to opt out their children, leading some health experts in the state to voice fears that the changes could weaken the successful program. But Arkansas Surgeon General Dr. Joe Thompson said in an interview that scaling back the screenings will allow schools to concentrate scarce resources on the children and families who need the most help battling obesity.

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

“I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines,” Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. “What other functions can we delegate out, given appropriate oversight and training?”

For example, she said, “I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care.”

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

“This is, for me, a moral question and an economic one,” she said. “Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?”

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan.

“The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake,” she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as “setting the goals and framework but not getting into the details.”

Further, the Clinton plan of the early 1990s was just too complicated, she said. “It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way.”

This time, Sen. Clinton has a different plan. The “American Health Choices Plan” would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees. They would also have the option of enrolling in a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and fully portable, and that insurers would be barred from discriminating against enrollees based on preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would be given tax credits if they did so.

She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal.

“I've included the public plan option because a lot of Americans want it,” she said. “It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice.

If we can't quickly increase the number of primary care physicians, we need more advanced practice nurses. SEN. CLINTON

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

“I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines,” Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. “What other functions can we delegate out, given appropriate oversight and training?”

For example, she said, “I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care.”

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

“This is, for me, a moral question and an economic one,” she said. “Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?”

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan.

“The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake,” she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as “setting the goals and framework but not getting into the details.”

Further, the Clinton plan of the early 1990s was just too complicated, she said. “It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way.”

This time, Sen. Clinton has a different plan. The “American Health Choices Plan” would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees. They would also have the option of enrolling in a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and fully portable, and that insurers would be barred from discriminating against enrollees based on preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would be given tax credits if they did so.

She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal.

“I've included the public plan option because a lot of Americans want it,” she said. “It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice.

If we can't quickly increase the number of primary care physicians, we need more advanced practice nurses. SEN. CLINTON

WASHINGTON — According to Sen. Hillary Rodham Clinton (D-N.Y.), primary care physicians don't get enough pay or respect, and there aren't enough of them. Her response to the problem? The federal government should try to help increase the supply of primary care doctors, but in the meantime nurses, pharmacists, and others should fill the gaps in care.

“I'm intrigued by the fact that a lot of states are permitting pharmacists to give vaccines,” Sen. Clinton, a candidate for the Democratic presidential nomination, said at a health policy forum sponsored by Families USA and the Federation of American Hospitals. “What other functions can we delegate out, given appropriate oversight and training?”

For example, she said, “I think nurses have a great opportunity to do much more than they're doing. If we're not going to be able to quickly increase the number of primary care physicians, we need more advanced practice nurses, and they've got to be given the authority to make some of these [treatment] decisions, because otherwise people will go without care.”

Sen. Clinton, who is in her second Senate term, said that health care would be her top domestic priority if she were elected president.

“This is, for me, a moral question and an economic one,” she said. “Do we want to continue to be so unequal and unfair that, if you are uninsured and you go into the hospital with someone who is insured, you are more likely to die?”

Sen. Clinton said she learned a lot from her experience in her husband's first presidential term when she led his efforts to develop a universal health care plan.

“The fact that the White House took on the responsibility of writing the legislation turned out to be something of a mistake,” she said at the forum, part of a series of presidential candidate health policy forums underwritten by the California Endowment and the Ewing Marion Kauffman Foundation. She said that now she sees the president's role on health care as “setting the goals and framework but not getting into the details.”

Further, the Clinton plan of the early 1990s was just too complicated, she said. “It was a source of concern to a lot of Americans who didn't understand how it could work, and it certainly wasn't presented in the best way.”

This time, Sen. Clinton has a different plan. The “American Health Choices Plan” would allow people to keep their current insurance coverage, but if they didn't like their current insurance or were uninsured, they could choose from a variety of plans similar to those offered to federal employees. They would also have the option of enrolling in a public plan similar to Medicare.

Sen. Clinton said coverage under her plan would be affordable and fully portable, and that insurers would be barred from discriminating against enrollees based on preexisting conditions. Large employers would be required to offer coverage or help pay for employee health care; small businesses would not be required to offer coverage, but would be given tax credits if they did so.

She estimated the cost of her plan at $110 billion per year and said it would be paid for by rolling back tax breaks for Americans who make more than $250,000 annually.

Sen. Clinton said critics who called her plan a back door to a single-payer, government-run health care system were either misinformed or were misrepresenting her proposal.

“I've included the public plan option because a lot of Americans want it,” she said. “It will not create a new bureaucracy; it will not create a government-run system unless you think Medicare is government run. In Medicare, you choose your doctor, you choose your hospital—you have tremendous choice.

If we can't quickly increase the number of primary care physicians, we need more advanced practice nurses. SEN. CLINTON

Editor's Note

This look at the health care proposals of former Sen. John Edwards (D-N.C.) is the first in a series that will highlight the health policy views of candidates in the 2008 U.S. presidential race. Each article is to be based on a 1-hour health policy forum with an individual candidate held at the Kaiser Family Foundation in Washington, sponsored by Families USA and the Federation of American Hospitals. Forums that have been announced so far feature Sen. Hillary Clinton (D-N.Y.), Rep. Dennis Kucinich (D-Ohio), Sen. Joe Biden (D-Del.), Sen. John McCain (R-Ariz.), Sen. Christopher Dodd (D-Conn.), former Gov. Mike Huckabee (R-Ark.), Gov. Bill Richardson (D-N.M.), and Rep. Ron Paul (R-Tex.).

WASHINGTON — According to Democratic presidential candidate and malpractice attorney John Edwards, the best way to solve the malpractice insurance crisis is to put the onus on … malpractice attorneys.

Mr. Edwards, a former U.S. senator from North Carolina, spoke at the first of a series of health policy forums with presidential candidates sponsored by Families USA and the Federation of American Hospitals.

“I think that the bulk of the problem is created when cases are filed in the legal system that should never be there,” he said. “The result is years of litigation and costs incurred by the health care provider that should not have been incurred. What I would do is put more responsibility on the lawyers.”

In Sen. Edwards' ideal world, before a medical malpractice case could be filed, the plaintiff's lawyer would have to conduct a complete investigation, which would include independent review by at least two experts in the field “who determine that the case is, first, meritorious, and second, serious,” he said. “Then you require the lawyer to certify that that has been done as part of the filing. … If they fail to certify, the lawyer should bear the cost. If they do it three times, it's three strikes and you're out; you lose your right as a lawyer to file these cases.”

The bigger topic at the forum, though, was covering the uninsured. In February, Sen. Edwards unveiled a universal coverage plan, which calls for expanding both the State Children's Health Insurance Program and Medicaid, and for keeping Medicare in place. Employers would be required either to provide coverage to employees or to contribute to a system of regional Health Care Markets—nonprofit purchasing pools offering a choice of insurance plans. At least one of the plans would be a public plan based on the Medicare program.

Once the markets were set up and other provisions put in place—including tax credits to help people purchase policies and limits on premium contributions for low- and moderate-income families—an individual mandate would go into effect requiring all citizens to obtain health insurance. The penalty for people who did not sign up for coverage would likely be “losing your individual tax exemption or some [other] tax consequence for not signing up,” Sen. Edwards said at a press conference after the forum. “Anybody who comes into contact with the health care system or any public agency will be signed up. If you go into the emergency room and are not part of the system, in order to get care you will be signed up.”

To help save costs in Medicare, Sen. Edwards said beneficiaries should have a “medical home” with a single provider responsible for coordinating chronic care “so we don't have overlapping care or unnecessary care.”

He also said that he favors three steps to lower the cost of prescription drugs in the Medicare program: using the bargaining power of government to negotiate prices with pharmaceutical companies, allowing prescription drugs to be “safely imported” into the United States, and “[doing] what we can constitutionally to control drug company ads on television.”

This universal coverage plan “was not intended to take us from where we are today directly to [a single-payer system],” Sen. Edwards said at the forum. “It was intended to allow Americans to decide whether they want government-run health care, or whether they want to continue the private system they have today.”

He noted that there are “real benefits to single-payer [systems]. The administrative cost associated with [government-run systems like] Medicare is 3%–4%, compared with 30%–40% profit and overhead in private insurance companies.” But some people hate single-payer systems like those in Canada and the United Kingdom, and they say that people have to wait too long for some procedures, he added.

“We're going to let Americans make that decision” by choosing which type of plan they prefer, he said. “Over time, we will see in which direction this system gravitates. It will be an extraordinary American model for what works and what doesn't work.”

Sen. Edwards said that the cost of his plan was estimated at $90–$120 billion, and that he would pay for it by reducing tax cuts for people making more than $200,000 a year.

A reporter asked Sen. Edwards about the differences between his plan and that of rival presidential candidate Sen. Hillary Clinton (D-N.Y.), who released a plan in September with many provisions similar to Sen. Edwards's plan, such as an array of private plans for people to choose from as well as a public plan similar to Medicare.

“One difference [is] … how big a priority you made this and how early you came out with a comprehensive plan,” he said. “It's a huge priority to me, and I will not bend on universal [coverage].” Further, “Sen. Clinton appears to believe that you can take money from health insurance and drug company lobbyists and sit at the table with them and negotiate a compromise. “I absolutely reject that. The way you get it done is to convince the American people about the rightness of what you want to do,” Sen. Edwards said.

Beneficiaries should have a 'medical home' with a single provider to coordinate care. SEN. EDWARDS

Editor's Note

This look at the health care proposals of former Sen. John Edwards (D-N.C.) is the first in a series that will highlight the health policy views of candidates in the 2008 U.S. presidential race. Each article is to be based on a 1-hour health policy forum with an individual candidate held at the Kaiser Family Foundation in Washington, sponsored by Families USA and the Federation of American Hospitals. Forums that have been announced so far feature Sen. Hillary Clinton (D-N.Y.), Rep. Dennis Kucinich (D-Ohio), Sen. Joe Biden (D-Del.), Sen. John McCain (R-Ariz.), Sen. Christopher Dodd (D-Conn.), former Gov. Mike Huckabee (R-Ark.), Gov. Bill Richardson (D-N.M.), and Rep. Ron Paul (R-Tex.).

WASHINGTON — According to Democratic presidential candidate and malpractice attorney John Edwards, the best way to solve the malpractice insurance crisis is to put the onus on … malpractice attorneys.

Mr. Edwards, a former U.S. senator from North Carolina, spoke at the first of a series of health policy forums with presidential candidates sponsored by Families USA and the Federation of American Hospitals.

“I think that the bulk of the problem is created when cases are filed in the legal system that should never be there,” he said. “The result is years of litigation and costs incurred by the health care provider that should not have been incurred. What I would do is put more responsibility on the lawyers.”

In Sen. Edwards' ideal world, before a medical malpractice case could be filed, the plaintiff's lawyer would have to conduct a complete investigation, which would include independent review by at least two experts in the field “who determine that the case is, first, meritorious, and second, serious,” he said. “Then you require the lawyer to certify that that has been done as part of the filing. … If they fail to certify, the lawyer should bear the cost. If they do it three times, it's three strikes and you're out; you lose your right as a lawyer to file these cases.”

The bigger topic at the forum, though, was covering the uninsured. In February, Sen. Edwards unveiled a universal coverage plan, which calls for expanding both the State Children's Health Insurance Program and Medicaid, and for keeping Medicare in place. Employers would be required either to provide coverage to employees or to contribute to a system of regional Health Care Markets—nonprofit purchasing pools offering a choice of insurance plans. At least one of the plans would be a public plan based on the Medicare program.

Once the markets were set up and other provisions put in place—including tax credits to help people purchase policies and limits on premium contributions for low- and moderate-income families—an individual mandate would go into effect requiring all citizens to obtain health insurance. The penalty for people who did not sign up for coverage would likely be “losing your individual tax exemption or some [other] tax consequence for not signing up,” Sen. Edwards said at a press conference after the forum. “Anybody who comes into contact with the health care system or any public agency will be signed up. If you go into the emergency room and are not part of the system, in order to get care you will be signed up.”

To help save costs in Medicare, Sen. Edwards said beneficiaries should have a “medical home” with a single provider responsible for coordinating chronic care “so we don't have overlapping care or unnecessary care.”

He also said that he favors three steps to lower the cost of prescription drugs in the Medicare program: using the bargaining power of government to negotiate prices with pharmaceutical companies, allowing prescription drugs to be “safely imported” into the United States, and “[doing] what we can constitutionally to control drug company ads on television.”

This universal coverage plan “was not intended to take us from where we are today directly to [a single-payer system],” Sen. Edwards said at the forum. “It was intended to allow Americans to decide whether they want government-run health care, or whether they want to continue the private system they have today.”

He noted that there are “real benefits to single-payer [systems]. The administrative cost associated with [government-run systems like] Medicare is 3%–4%, compared with 30%–40% profit and overhead in private insurance companies.” But some people hate single-payer systems like those in Canada and the United Kingdom, and they say that people have to wait too long for some procedures, he added.

“We're going to let Americans make that decision” by choosing which type of plan they prefer, he said. “Over time, we will see in which direction this system gravitates. It will be an extraordinary American model for what works and what doesn't work.”

Sen. Edwards said that the cost of his plan was estimated at $90–$120 billion, and that he would pay for it by reducing tax cuts for people making more than $200,000 a year.

A reporter asked Sen. Edwards about the differences between his plan and that of rival presidential candidate Sen. Hillary Clinton (D-N.Y.), who released a plan in September with many provisions similar to Sen. Edwards's plan, such as an array of private plans for people to choose from as well as a public plan similar to Medicare.

“One difference [is] … how big a priority you made this and how early you came out with a comprehensive plan,” he said. “It's a huge priority to me, and I will not bend on universal [coverage].” Further, “Sen. Clinton appears to believe that you can take money from health insurance and drug company lobbyists and sit at the table with them and negotiate a compromise. “I absolutely reject that. The way you get it done is to convince the American people about the rightness of what you want to do,” Sen. Edwards said.

Beneficiaries should have a 'medical home' with a single provider to coordinate care. SEN. EDWARDS

Editor's Note

This look at the health care proposals of former Sen. John Edwards (D-N.C.) is the first in a series that will highlight the health policy views of candidates in the 2008 U.S. presidential race. Each article is to be based on a 1-hour health policy forum with an individual candidate held at the Kaiser Family Foundation in Washington, sponsored by Families USA and the Federation of American Hospitals. Forums that have been announced so far feature Sen. Hillary Clinton (D-N.Y.), Rep. Dennis Kucinich (D-Ohio), Sen. Joe Biden (D-Del.), Sen. John McCain (R-Ariz.), Sen. Christopher Dodd (D-Conn.), former Gov. Mike Huckabee (R-Ark.), Gov. Bill Richardson (D-N.M.), and Rep. Ron Paul (R-Tex.).

WASHINGTON — According to Democratic presidential candidate and malpractice attorney John Edwards, the best way to solve the malpractice insurance crisis is to put the onus on … malpractice attorneys.

Mr. Edwards, a former U.S. senator from North Carolina, spoke at the first of a series of health policy forums with presidential candidates sponsored by Families USA and the Federation of American Hospitals.

“I think that the bulk of the problem is created when cases are filed in the legal system that should never be there,” he said. “The result is years of litigation and costs incurred by the health care provider that should not have been incurred. What I would do is put more responsibility on the lawyers.”

In Sen. Edwards' ideal world, before a medical malpractice case could be filed, the plaintiff's lawyer would have to conduct a complete investigation, which would include independent review by at least two experts in the field “who determine that the case is, first, meritorious, and second, serious,” he said. “Then you require the lawyer to certify that that has been done as part of the filing. … If they fail to certify, the lawyer should bear the cost. If they do it three times, it's three strikes and you're out; you lose your right as a lawyer to file these cases.”

The bigger topic at the forum, though, was covering the uninsured. In February, Sen. Edwards unveiled a universal coverage plan, which calls for expanding both the State Children's Health Insurance Program and Medicaid, and for keeping Medicare in place. Employers would be required either to provide coverage to employees or to contribute to a system of regional Health Care Markets—nonprofit purchasing pools offering a choice of insurance plans. At least one of the plans would be a public plan based on the Medicare program.

Once the markets were set up and other provisions put in place—including tax credits to help people purchase policies and limits on premium contributions for low- and moderate-income families—an individual mandate would go into effect requiring all citizens to obtain health insurance. The penalty for people who did not sign up for coverage would likely be “losing your individual tax exemption or some [other] tax consequence for not signing up,” Sen. Edwards said at a press conference after the forum. “Anybody who comes into contact with the health care system or any public agency will be signed up. If you go into the emergency room and are not part of the system, in order to get care you will be signed up.”

To help save costs in Medicare, Sen. Edwards said beneficiaries should have a “medical home” with a single provider responsible for coordinating chronic care “so we don't have overlapping care or unnecessary care.”

He also said that he favors three steps to lower the cost of prescription drugs in the Medicare program: using the bargaining power of government to negotiate prices with pharmaceutical companies, allowing prescription drugs to be “safely imported” into the United States, and “[doing] what we can constitutionally to control drug company ads on television.”

This universal coverage plan “was not intended to take us from where we are today directly to [a single-payer system],” Sen. Edwards said at the forum. “It was intended to allow Americans to decide whether they want government-run health care, or whether they want to continue the private system they have today.”

He noted that there are “real benefits to single-payer [systems]. The administrative cost associated with [government-run systems like] Medicare is 3%–4%, compared with 30%–40% profit and overhead in private insurance companies.” But some people hate single-payer systems like those in Canada and the United Kingdom, and they say that people have to wait too long for some procedures, he added.

“We're going to let Americans make that decision” by choosing which type of plan they prefer, he said. “Over time, we will see in which direction this system gravitates. It will be an extraordinary American model for what works and what doesn't work.”

Sen. Edwards said that the cost of his plan was estimated at $90–$120 billion, and that he would pay for it by reducing tax cuts for people making more than $200,000 a year.

A reporter asked Sen. Edwards about the differences between his plan and that of rival presidential candidate Sen. Hillary Clinton (D-N.Y.), who released a plan in September with many provisions similar to Sen. Edwards's plan, such as an array of private plans for people to choose from as well as a public plan similar to Medicare.

“One difference [is] … how big a priority you made this and how early you came out with a comprehensive plan,” he said. “It's a huge priority to me, and I will not bend on universal [coverage].” Further, “Sen. Clinton appears to believe that you can take money from health insurance and drug company lobbyists and sit at the table with them and negotiate a compromise. “I absolutely reject that. The way you get it done is to convince the American people about the rightness of what you want to do,” Sen. Edwards said.

Beneficiaries should have a 'medical home' with a single provider to coordinate care. SEN. EDWARDS

WASHINGTON — According to Democratic presidential candidate and malpractice attorney John Edwards, the best way to solve the malpractice insurance crisis is to put the onus on … the malpractice attorneys.

The former senator from North Carolina spoke at the first of a series of health policy forums with presidential candidates sponsored by Families USA and the Federation of American Hospitals.

“I think that the bulk of the problem is created when cases are filed in the legal system that should never be there,” he said. “The result is years of litigation and costs incurred by the health care provider that should not have been incurred. What I would do is put more responsibility on the lawyers.”

In Sen. Edwards' ideal world, before a medical malpractice case could be filed, the plaintiff's lawyer would have to conduct a complete investigation, which would include independent review by at least two experts in the field “who determine that the case is, first, meritorious, and second, serious,” he said. “Then you require the lawyer to certify that that has been done as part of the filing. … If they fail to certify, the lawyer should bear the cost. If they do it three times, it's three strikes and you're out; you lose your right as a lawyer to file these cases.”

The bigger topic at the forum, though, was covering the uninsured. In February, Sen. Edwards unveiled a universal coverage plan, which calls for expanding both the State Children's Health Insurance Program and Medicaid, and for keeping Medicare in place. Employers would be required either to provide coverage to employees or to contribute to a system of regional Health Care Markets—nonprofit purchasing pools offering a choice of insurance plans. At least one of the plans would be a public plan based on the Medicare program.

Once the markets were set up and other provisions put in place—including tax credits to help people purchase policies and limits on premium contributions for low- and moderate-income families—an individual mandate would go into effect requiring all citizens to obtain health insurance. The penalty for people who didn't sign up for coverage would likely be “losing your individual tax exemption or some [other] tax consequence for not signing up,” Sen. Edwards said at a press conference after the forum. “Anybody who comes into contact with the health care system or any public agency will be signed up. If you go into the emergency room and are not part of the system, in order to get care you will be signed up.”

To help save costs in Medicare, Sen. Edwards said that beneficiaries should have a “medical home” with a single provider responsible for coordinating chronic care “so we don't have overlapping care or unnecessary care.”

He also said that he favors three steps to lower the cost of prescription drugs in the Medicare program: using the bargaining power of government to negotiate prices with pharmaceutical companies, allowing prescription drugs to be “safely imported” into the United States, and “[doing] what we can constitutionally to control drug company ads on television.”

This universal coverage plan “was not intended to take us from where we are today directly to [a single-payer system],” Sen. Edwards said at the forum. “It was intended to allow Americans to decide whether they want government-run health care, or whether they want to continue the private system they have today.”

He noted that there are “real benefits to single-payer [systems]. The administrative cost associated with [government-run systems like] Medicare is 3%–4%, compared with 30%–40% profit and overhead in private insurance companies.” But some people hate single-payer systems like those in Canada and the United Kingdom, and they say that people have to wait too long for some procedures, he added.

“We're going to let Americans make that decision” by choosing which type of plan they prefer, he said. “Over time, we will see in which direction this system gravitates. It will be an extraordinary American model for what works and what doesn't work.”

Sen. Edwards said that the cost of his plan was estimated at $90 billion to $120 billion, and that he would pay for it by rolling back tax cuts for Americans making more than $200,000 per year.

A reporter asked Sen. Edwards about the differences between his plan and that of Sen. Hillary Rodham Clinton (D-N.Y.), another Democratic presidential candidate. Sen. Clinton released her plan in September, and it contained many provisions similar to Sen. Edwards' plan, such as an array of private plans for people to choose from as well as a public plan similar to Medicare.

“One difference [is] how big a priority you made this and how early you came out with a comprehensive plan,” he said. “It's a huge priority to me, and I will not bend on universal [coverage].

“Sen. Clinton appears to believe that you can take money from health insurance and drug company lobbyists and sit at the table with them and negotiate a compromise. I absolutely reject that. The way you get it done is to convince the American people about the rightness of what you want to do,” Sen. Edwards said.

One way to lower drug prices would be to allow prescription drugs to be 'safely imported.' SEN. EDWARDS

Editor's Note

This look at the health care proposals of former Sen. John Edwards (D-N.C.) is the first in an occasional series highlighting the health policy views of those seeking to be our next president. Each article is based on a 1-hour health policy forum with an individual candidate held at the Kaiser Family Foundation in Washington, and sponsored by Families USA and the Federation of American Hospitals. Forums that have been announced so far feature Sen. Hillary Clinton (D-N.Y.), Rep. Dennis Kucinich (D-Ohio), Sen. Joe Biden (D-Del.), Sen. John McCain (R-Ariz.), Sen. Christopher Dodd (D-Conn.), former Gov. Mike Huckabee (R-Ark.), Gov. Bill Richardson (D-N.M.), and Rep. Ron Paul (R-Tex.).

WASHINGTON — According to Democratic presidential candidate and malpractice attorney John Edwards, the best way to solve the malpractice insurance crisis is to put the onus on … the malpractice attorneys.

The former senator from North Carolina spoke at the first of a series of health policy forums with presidential candidates sponsored by Families USA and the Federation of American Hospitals.

“I think that the bulk of the problem is created when cases are filed in the legal system that should never be there,” he said. “The result is years of litigation and costs incurred by the health care provider that should not have been incurred. What I would do is put more responsibility on the lawyers.”

In Sen. Edwards' ideal world, before a medical malpractice case could be filed, the plaintiff's lawyer would have to conduct a complete investigation, which would include independent review by at least two experts in the field “who determine that the case is, first, meritorious, and second, serious,” he said. “Then you require the lawyer to certify that that has been done as part of the filing. … If they fail to certify, the lawyer should bear the cost. If they do it three times, it's three strikes and you're out; you lose your right as a lawyer to file these cases.”

The bigger topic at the forum, though, was covering the uninsured. In February, Sen. Edwards unveiled a universal coverage plan, which calls for expanding both the State Children's Health Insurance Program and Medicaid, and for keeping Medicare in place. Employers would be required either to provide coverage to employees or to contribute to a system of regional Health Care Markets—nonprofit purchasing pools offering a choice of insurance plans. At least one of the plans would be a public plan based on the Medicare program.

Once the markets were set up and other provisions put in place—including tax credits to help people purchase policies and limits on premium contributions for low- and moderate-income families—an individual mandate would go into effect requiring all citizens to obtain health insurance. The penalty for people who didn't sign up for coverage would likely be “losing your individual tax exemption or some [other] tax consequence for not signing up,” Sen. Edwards said at a press conference after the forum. “Anybody who comes into contact with the health care system or any public agency will be signed up. If you go into the emergency room and are not part of the system, in order to get care you will be signed up.”

To help save costs in Medicare, Sen. Edwards said that beneficiaries should have a “medical home” with a single provider responsible for coordinating chronic care “so we don't have overlapping care or unnecessary care.”

He also said that he favors three steps to lower the cost of prescription drugs in the Medicare program: using the bargaining power of government to negotiate prices with pharmaceutical companies, allowing prescription drugs to be “safely imported” into the United States, and “[doing] what we can constitutionally to control drug company ads on television.”

This universal coverage plan “was not intended to take us from where we are today directly to [a single-payer system],” Sen. Edwards said at the forum. “It was intended to allow Americans to decide whether they want government-run health care, or whether they want to continue the private system they have today.”

He noted that there are “real benefits to single-payer [systems]. The administrative cost associated with [government-run systems like] Medicare is 3%–4%, compared with 30%–40% profit and overhead in private insurance companies.” But some people hate single-payer systems like those in Canada and the United Kingdom, and they say that people have to wait too long for some procedures, he added.

“We're going to let Americans make that decision” by choosing which type of plan they prefer, he said. “Over time, we will see in which direction this system gravitates. It will be an extraordinary American model for what works and what doesn't work.”

Sen. Edwards said that the cost of his plan was estimated at $90 billion to $120 billion, and that he would pay for it by rolling back tax cuts for Americans making more than $200,000 per year.

A reporter asked Sen. Edwards about the differences between his plan and that of Sen. Hillary Rodham Clinton (D-N.Y.), another Democratic presidential candidate. Sen. Clinton released her plan in September, and it contained many provisions similar to Sen. Edwards' plan, such as an array of private plans for people to choose from as well as a public plan similar to Medicare.

“One difference [is] how big a priority you made this and how early you came out with a comprehensive plan,” he said. “It's a huge priority to me, and I will not bend on universal [coverage].

“Sen. Clinton appears to believe that you can take money from health insurance and drug company lobbyists and sit at the table with them and negotiate a compromise. I absolutely reject that. The way you get it done is to convince the American people about the rightness of what you want to do,” Sen. Edwards said.

One way to lower drug prices would be to allow prescription drugs to be 'safely imported.' SEN. EDWARDS

Editor's Note

This look at the health care proposals of former Sen. John Edwards (D-N.C.) is the first in an occasional series highlighting the health policy views of those seeking to be our next president. Each article is based on a 1-hour health policy forum with an individual candidate held at the Kaiser Family Foundation in Washington, and sponsored by Families USA and the Federation of American Hospitals. Forums that have been announced so far feature Sen. Hillary Clinton (D-N.Y.), Rep. Dennis Kucinich (D-Ohio), Sen. Joe Biden (D-Del.), Sen. John McCain (R-Ariz.), Sen. Christopher Dodd (D-Conn.), former Gov. Mike Huckabee (R-Ark.), Gov. Bill Richardson (D-N.M.), and Rep. Ron Paul (R-Tex.).

WASHINGTON — According to Democratic presidential candidate and malpractice attorney John Edwards, the best way to solve the malpractice insurance crisis is to put the onus on … the malpractice attorneys.

The former senator from North Carolina spoke at the first of a series of health policy forums with presidential candidates sponsored by Families USA and the Federation of American Hospitals.

“I think that the bulk of the problem is created when cases are filed in the legal system that should never be there,” he said. “The result is years of litigation and costs incurred by the health care provider that should not have been incurred. What I would do is put more responsibility on the lawyers.”

In Sen. Edwards' ideal world, before a medical malpractice case could be filed, the plaintiff's lawyer would have to conduct a complete investigation, which would include independent review by at least two experts in the field “who determine that the case is, first, meritorious, and second, serious,” he said. “Then you require the lawyer to certify that that has been done as part of the filing. … If they fail to certify, the lawyer should bear the cost. If they do it three times, it's three strikes and you're out; you lose your right as a lawyer to file these cases.”

The bigger topic at the forum, though, was covering the uninsured. In February, Sen. Edwards unveiled a universal coverage plan, which calls for expanding both the State Children's Health Insurance Program and Medicaid, and for keeping Medicare in place. Employers would be required either to provide coverage to employees or to contribute to a system of regional Health Care Markets—nonprofit purchasing pools offering a choice of insurance plans. At least one of the plans would be a public plan based on the Medicare program.

Once the markets were set up and other provisions put in place—including tax credits to help people purchase policies and limits on premium contributions for low- and moderate-income families—an individual mandate would go into effect requiring all citizens to obtain health insurance. The penalty for people who didn't sign up for coverage would likely be “losing your individual tax exemption or some [other] tax consequence for not signing up,” Sen. Edwards said at a press conference after the forum. “Anybody who comes into contact with the health care system or any public agency will be signed up. If you go into the emergency room and are not part of the system, in order to get care you will be signed up.”

To help save costs in Medicare, Sen. Edwards said that beneficiaries should have a “medical home” with a single provider responsible for coordinating chronic care “so we don't have overlapping care or unnecessary care.”

He also said that he favors three steps to lower the cost of prescription drugs in the Medicare program: using the bargaining power of government to negotiate prices with pharmaceutical companies, allowing prescription drugs to be “safely imported” into the United States, and “[doing] what we can constitutionally to control drug company ads on television.”

This universal coverage plan “was not intended to take us from where we are today directly to [a single-payer system],” Sen. Edwards said at the forum. “It was intended to allow Americans to decide whether they want government-run health care, or whether they want to continue the private system they have today.”

He noted that there are “real benefits to single-payer [systems]. The administrative cost associated with [government-run systems like] Medicare is 3%–4%, compared with 30%–40% profit and overhead in private insurance companies.” But some people hate single-payer systems like those in Canada and the United Kingdom, and they say that people have to wait too long for some procedures, he added.

“We're going to let Americans make that decision” by choosing which type of plan they prefer, he said. “Over time, we will see in which direction this system gravitates. It will be an extraordinary American model for what works and what doesn't work.”

Sen. Edwards said that the cost of his plan was estimated at $90 billion to $120 billion, and that he would pay for it by rolling back tax cuts for Americans making more than $200,000 per year.

A reporter asked Sen. Edwards about the differences between his plan and that of Sen. Hillary Rodham Clinton (D-N.Y.), another Democratic presidential candidate. Sen. Clinton released her plan in September, and it contained many provisions similar to Sen. Edwards' plan, such as an array of private plans for people to choose from as well as a public plan similar to Medicare.

“One difference [is] how big a priority you made this and how early you came out with a comprehensive plan,” he said. “It's a huge priority to me, and I will not bend on universal [coverage].

“Sen. Clinton appears to believe that you can take money from health insurance and drug company lobbyists and sit at the table with them and negotiate a compromise. I absolutely reject that. The way you get it done is to convince the American people about the rightness of what you want to do,” Sen. Edwards said.

One way to lower drug prices would be to allow prescription drugs to be 'safely imported.' SEN. EDWARDS

Editor's Note

This look at the health care proposals of former Sen. John Edwards (D-N.C.) is the first in an occasional series highlighting the health policy views of those seeking to be our next president. Each article is based on a 1-hour health policy forum with an individual candidate held at the Kaiser Family Foundation in Washington, and sponsored by Families USA and the Federation of American Hospitals. Forums that have been announced so far feature Sen. Hillary Clinton (D-N.Y.), Rep. Dennis Kucinich (D-Ohio), Sen. Joe Biden (D-Del.), Sen. John McCain (R-Ariz.), Sen. Christopher Dodd (D-Conn.), former Gov. Mike Huckabee (R-Ark.), Gov. Bill Richardson (D-N.M.), and Rep. Ron Paul (R-Tex.).

WASHINGTON — According to Democratic presidential candidate and malpractice attorney John Edwards, the best way to solve the malpractice insurance crisis is to put the onus on … the lawyers.

The former senator from North Carolina spoke at the first of a series of health policy forums with presidential candidates sponsored by Families USA and the Federation of American Hospitals.

“I think that the bulk of the problem is created when cases are filed in the legal system that should never be there,” he said. “The result is years of litigation and costs incurred by the health care provider that should not have been incurred. What I would do is put more responsibility on the lawyers.”

In Sen. Edwards' ideal world, before a medical malpractice case could be filed, the plaintiff's lawyer would have to conduct a complete investigation, which would include independent review by at least two experts in the field “who determine that the case is, first, meritorious, and second, serious,” he said. “Then you require the lawyer to certify that that has been done as part of the filing. … If they fail to certify, the lawyer should bear the cost. If they do it three times, it's three strikes and you're out; you lose your right as a lawyer to file these cases.”

The bigger topic at the forum, though, was covering the uninsured. In February, Sen. Edwards unveiled a universal coverage plan, which calls for expanding both the State Children's Health Insurance Program and Medicaid, and for keeping Medicare in place. Employers would be required either to provide coverage to employees or to contribute to a system of regional Health Care Markets—nonprofit purchasing pools offering a choice of insurance plans. At least one of the plans would be a public plan based on the Medicare program.

Once the markets were set up and other provisions put in place—including tax credits to help people purchase policies and limits on premium contributions for low- and moderate-income families—an individual mandate would go into effect requiring all citizens to obtain health insurance. The penalty for people whodidn't sign up for coverage would likely be “losing your individual tax exemption or some [other] tax consequence for not signing up,” Sen. Edwards said at a press conference after the forum. “Anybody who comes into contact with the health care system or any public agency will be signed up. If you go into the emergency room and are not part of the system, in order to get care you will be signed up.”

To help save costs in Medicare, Sen. Edwards said beneficiaries should have a “medical home” with a single provider responsible for coordinating chronic care “so we don't have overlapping care or unnecessary care.” He also said that he favors three steps to lower the cost of prescription drugs in the Medicare program: using the bargaining power of government to negotiate prices with pharmaceutical companies, allowing prescription drugs to be “safely imported” into the United States, and “[doing] what we can constitutionally to control drug company ads on television.”

This universal coverage plan “was not intended to take us from where we are today directly to [a single-payer system],” Sen. Edwards said at the forum. “It was intended to allow Americans to decide whether they want government-run health care, or whether they want to continue the private system they have today.”

He noted that there are “real benefits to single-payer [systems]. The administrative cost associated with [government-run systems like] Medicare is 3%–4%, compared with 30%–40% profit and overhead in private insurance companies.” But some people hate single-payer systems like those in Canada and the United Kingdom, and they say that people have to wait too long for some procedures, he added.

“We're going to let Americans make that decision” by choosing which type of plan they prefer, he said. “Over time, we will see in which direction this system gravitates. It will be an extraordinary American model for what works and what doesn't work.” He said that the cost of his plan was estimated at $90 billion to $120 billion, and that he would pay for it by rolling back tax cuts for Americans making more than $200,000 per year.

A reporter asked Sen. Edwards about the differences between his plan and that of Sen. Hillary Rodham Clinton (D-N.Y.), another Democratic presidential candidate. Sen. Clinton released her plan in September, and it contained many provisions similar to Sen. Edwards' plan, such as an array of private plans for people to choose from as well as a public plan similar to Medicare.

“One difference [is] … how big a priority you made this and how early you came out with a comprehensive plan,” he said. “It's a huge priority to me, and I will not bend on universal [coverage].”

'We're going to let Americans make [the] decision' between government-run and private health care. SEN. EDWARDS

Editor's Note

This look at the health care proposals of former Sen. John Edwards (D-N.C.) is the first in an occasional series highlighting the health policy views of those seeking to be our next president. Each article is based on a 1-hour health policy forum with an individual candidate held at the Kaiser Family Foundation in Washington, D.C., and sponsored by Families USA and the Federation of American Hospitals. Forums that have been announced so far feature Sen. Hillary Clinton (D-N.Y.), Rep. Dennis Kucinich (D-Ohio), Sen. Joe Biden (D-Del.), Sen. John McCain (R-Ariz.), Sen. Christopher Dodd (D-Conn.), former Gov. Mike Huckabee (R-Ark.), Gov. Bill Richardson (D-N.M.), and Rep. Ron Paul (R-Tex.).

WASHINGTON — According to Democratic presidential candidate and malpractice attorney John Edwards, the best way to solve the malpractice insurance crisis is to put the onus on … the lawyers.

The former senator from North Carolina spoke at the first of a series of health policy forums with presidential candidates sponsored by Families USA and the Federation of American Hospitals.

“I think that the bulk of the problem is created when cases are filed in the legal system that should never be there,” he said. “The result is years of litigation and costs incurred by the health care provider that should not have been incurred. What I would do is put more responsibility on the lawyers.”

In Sen. Edwards' ideal world, before a medical malpractice case could be filed, the plaintiff's lawyer would have to conduct a complete investigation, which would include independent review by at least two experts in the field “who determine that the case is, first, meritorious, and second, serious,” he said. “Then you require the lawyer to certify that that has been done as part of the filing. … If they fail to certify, the lawyer should bear the cost. If they do it three times, it's three strikes and you're out; you lose your right as a lawyer to file these cases.”

The bigger topic at the forum, though, was covering the uninsured. In February, Sen. Edwards unveiled a universal coverage plan, which calls for expanding both the State Children's Health Insurance Program and Medicaid, and for keeping Medicare in place. Employers would be required either to provide coverage to employees or to contribute to a system of regional Health Care Markets—nonprofit purchasing pools offering a choice of insurance plans. At least one of the plans would be a public plan based on the Medicare program.

Once the markets were set up and other provisions put in place—including tax credits to help people purchase policies and limits on premium contributions for low- and moderate-income families—an individual mandate would go into effect requiring all citizens to obtain health insurance. The penalty for people whodidn't sign up for coverage would likely be “losing your individual tax exemption or some [other] tax consequence for not signing up,” Sen. Edwards said at a press conference after the forum. “Anybody who comes into contact with the health care system or any public agency will be signed up. If you go into the emergency room and are not part of the system, in order to get care you will be signed up.”

To help save costs in Medicare, Sen. Edwards said beneficiaries should have a “medical home” with a single provider responsible for coordinating chronic care “so we don't have overlapping care or unnecessary care.” He also said that he favors three steps to lower the cost of prescription drugs in the Medicare program: using the bargaining power of government to negotiate prices with pharmaceutical companies, allowing prescription drugs to be “safely imported” into the United States, and “[doing] what we can constitutionally to control drug company ads on television.”

This universal coverage plan “was not intended to take us from where we are today directly to [a single-payer system],” Sen. Edwards said at the forum. “It was intended to allow Americans to decide whether they want government-run health care, or whether they want to continue the private system they have today.”

He noted that there are “real benefits to single-payer [systems]. The administrative cost associated with [government-run systems like] Medicare is 3%–4%, compared with 30%–40% profit and overhead in private insurance companies.” But some people hate single-payer systems like those in Canada and the United Kingdom, and they say that people have to wait too long for some procedures, he added.

“We're going to let Americans make that decision” by choosing which type of plan they prefer, he said. “Over time, we will see in which direction this system gravitates. It will be an extraordinary American model for what works and what doesn't work.” He said that the cost of his plan was estimated at $90 billion to $120 billion, and that he would pay for it by rolling back tax cuts for Americans making more than $200,000 per year.

A reporter asked Sen. Edwards about the differences between his plan and that of Sen. Hillary Rodham Clinton (D-N.Y.), another Democratic presidential candidate. Sen. Clinton released her plan in September, and it contained many provisions similar to Sen. Edwards' plan, such as an array of private plans for people to choose from as well as a public plan similar to Medicare.

“One difference [is] … how big a priority you made this and how early you came out with a comprehensive plan,” he said. “It's a huge priority to me, and I will not bend on universal [coverage].”

'We're going to let Americans make [the] decision' between government-run and private health care. SEN. EDWARDS

Editor's Note

This look at the health care proposals of former Sen. John Edwards (D-N.C.) is the first in an occasional series highlighting the health policy views of those seeking to be our next president. Each article is based on a 1-hour health policy forum with an individual candidate held at the Kaiser Family Foundation in Washington, D.C., and sponsored by Families USA and the Federation of American Hospitals. Forums that have been announced so far feature Sen. Hillary Clinton (D-N.Y.), Rep. Dennis Kucinich (D-Ohio), Sen. Joe Biden (D-Del.), Sen. John McCain (R-Ariz.), Sen. Christopher Dodd (D-Conn.), former Gov. Mike Huckabee (R-Ark.), Gov. Bill Richardson (D-N.M.), and Rep. Ron Paul (R-Tex.).

WASHINGTON — According to Democratic presidential candidate and malpractice attorney John Edwards, the best way to solve the malpractice insurance crisis is to put the onus on … the lawyers.

The former senator from North Carolina spoke at the first of a series of health policy forums with presidential candidates sponsored by Families USA and the Federation of American Hospitals.

“I think that the bulk of the problem is created when cases are filed in the legal system that should never be there,” he said. “The result is years of litigation and costs incurred by the health care provider that should not have been incurred. What I would do is put more responsibility on the lawyers.”

In Sen. Edwards' ideal world, before a medical malpractice case could be filed, the plaintiff's lawyer would have to conduct a complete investigation, which would include independent review by at least two experts in the field “who determine that the case is, first, meritorious, and second, serious,” he said. “Then you require the lawyer to certify that that has been done as part of the filing. … If they fail to certify, the lawyer should bear the cost. If they do it three times, it's three strikes and you're out; you lose your right as a lawyer to file these cases.”

The bigger topic at the forum, though, was covering the uninsured. In February, Sen. Edwards unveiled a universal coverage plan, which calls for expanding both the State Children's Health Insurance Program and Medicaid, and for keeping Medicare in place. Employers would be required either to provide coverage to employees or to contribute to a system of regional Health Care Markets—nonprofit purchasing pools offering a choice of insurance plans. At least one of the plans would be a public plan based on the Medicare program.

Once the markets were set up and other provisions put in place—including tax credits to help people purchase policies and limits on premium contributions for low- and moderate-income families—an individual mandate would go into effect requiring all citizens to obtain health insurance. The penalty for people whodidn't sign up for coverage would likely be “losing your individual tax exemption or some [other] tax consequence for not signing up,” Sen. Edwards said at a press conference after the forum. “Anybody who comes into contact with the health care system or any public agency will be signed up. If you go into the emergency room and are not part of the system, in order to get care you will be signed up.”

To help save costs in Medicare, Sen. Edwards said beneficiaries should have a “medical home” with a single provider responsible for coordinating chronic care “so we don't have overlapping care or unnecessary care.” He also said that he favors three steps to lower the cost of prescription drugs in the Medicare program: using the bargaining power of government to negotiate prices with pharmaceutical companies, allowing prescription drugs to be “safely imported” into the United States, and “[doing] what we can constitutionally to control drug company ads on television.”

This universal coverage plan “was not intended to take us from where we are today directly to [a single-payer system],” Sen. Edwards said at the forum. “It was intended to allow Americans to decide whether they want government-run health care, or whether they want to continue the private system they have today.”

He noted that there are “real benefits to single-payer [systems]. The administrative cost associated with [government-run systems like] Medicare is 3%–4%, compared with 30%–40% profit and overhead in private insurance companies.” But some people hate single-payer systems like those in Canada and the United Kingdom, and they say that people have to wait too long for some procedures, he added.

“We're going to let Americans make that decision” by choosing which type of plan they prefer, he said. “Over time, we will see in which direction this system gravitates. It will be an extraordinary American model for what works and what doesn't work.” He said that the cost of his plan was estimated at $90 billion to $120 billion, and that he would pay for it by rolling back tax cuts for Americans making more than $200,000 per year.

A reporter asked Sen. Edwards about the differences between his plan and that of Sen. Hillary Rodham Clinton (D-N.Y.), another Democratic presidential candidate. Sen. Clinton released her plan in September, and it contained many provisions similar to Sen. Edwards' plan, such as an array of private plans for people to choose from as well as a public plan similar to Medicare.

“One difference [is] … how big a priority you made this and how early you came out with a comprehensive plan,” he said. “It's a huge priority to me, and I will not bend on universal [coverage].”

'We're going to let Americans make [the] decision' between government-run and private health care. SEN. EDWARDS

Editor's Note

This look at the health care proposals of former Sen. John Edwards (D-N.C.) is the first in an occasional series highlighting the health policy views of those seeking to be our next president. Each article is based on a 1-hour health policy forum with an individual candidate held at the Kaiser Family Foundation in Washington, D.C., and sponsored by Families USA and the Federation of American Hospitals. Forums that have been announced so far feature Sen. Hillary Clinton (D-N.Y.), Rep. Dennis Kucinich (D-Ohio), Sen. Joe Biden (D-Del.), Sen. John McCain (R-Ariz.), Sen. Christopher Dodd (D-Conn.), former Gov. Mike Huckabee (R-Ark.), Gov. Bill Richardson (D-N.M.), and Rep. Ron Paul (R-Tex.).