We need to do more to expand health insurance coverage in this country, but the answer lies in market based solutions—not mandating a nationalized system that restricts choices, limits options, and diminishes quality. We must have a bi-partisan solution that focuses on access to affordable care.
Bob McDonnell has concerns that Washington’s proposed reforms will drive the cost of health care up and jeopardize quality and access. Reforms being discussed in Washington could raise costs for those who already have insurance, harm small business owners and make it harder to create jobs, or shift millions of Virginians from their private insurance into a government run system, raise taxes and increase our deficit even further. Rather than centralizing control of health care at the federal level, or saddling Virginia businesses and workers with new mandates to pay for plans the government thinks they want, we should let individuals and families control their health care decisions.
We need to do more to expand health insurance coverage in this country, but the answer lies in market based solutions—not mandating a nationalized system that restricts choices, limits options, and diminishes quality. We must have a bi-partisan solution that focuses on access to affordable care. Mandates for increased eligibility may increase Virginia’s Medicaid budget by hundreds of millions of dollars in the coming years. Governors across the country from both parties have expressed concerns about these mandates that could cripple state budgets that are already using furloughs, layoffs and cuts to critical services. Bob McDonnell will encourage bi-partisan solutions that protect jobs, protect access to affordable health care and that don’t force costs back on consumers or the Virginia budget.
Although the health care debate has been focused on Washington, there are many things that can be done at the state level with bipartisan support. The McDonnell administration’s approach for health care system reform will be based upon six key principles.
- All Virginians should have access to affordable and high quality health care, even those with pre-existing conditions.
- Incentives for coverage of wellness care and prevention must be provided to reduce the occurrence of much more expensive care later on.
- Government should concentrate its resources to ensure those Virginians most in need have access to high quality health care, while also providing incentives to Virginia employers, employees and citizens to obtain affordable health insurance.
- Virginia should focus on reforming the health care system to lower the cost of health care and reduce the growth in health care spending.
- Virginia should provide encouragement and resources for family members that provide care and support for their loved ones.
- Reform should be bi-partisan, promote innovation, quality and cost-effectiveness without adversely affecting employment opportunities and economic growth.
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Help Individuals and Employers Afford Low-Cost Health Insurance
This past General Assembly session, Delegate Danny Marshall was successful in championing legislation to address this issue head on. His legislation allows health insurers to offer and sell group health insurance policies or contracts that do not include state mandated health insurance benefits to employers with 50 or fewer employees to provide coverage for employees. Mandates drive up the cost of insurance, so by allowing insurers to offer policies that don’t include state mandated benefits, the overall cost will be lower.
Encourage and Expand Health Savings Accounts
Health Savings Accounts (HSA) are designed to help individuals save for future qualified medical and retiree health expenses on a tax-free basis. Health Savings Accounts allow workers and anyone who pays taxes to set aside funds in a separate account held by a bank or other entity without paying wage or income taxes on the funds. Money from this account is then used to pay for health care. The funds in the account roll over year-to-year and are able to earn interest free from federal or state taxes. They essentially act like IRAs for health care.
Give Incentives to Families to Prepare for Long Term Care Needs
Families across the Commonwealth are faced with challenges caring for aging parents. Bob McDonnell understands this first hand. Bob struggled to keep his father, an Alzheimer’s patient, at home for five years with a caretaker, before turning to a nursing home option.
Purchasing long term care is not something at the top of anyone’s priority list, but it will go a long way to reducing health costs later in life. By 2030, the numbers of seniors requiring long-term care will more than double. We must ensure that Virginians and their families are saving now for long-term care in the future, just as they do for college tuition and retirement.
Expand the Supply of Nurses, Nurse Practitioners and Physicians
The McDonnell administration will expand loan forgiveness and scholarship programs for health care professionals with an emphasis on placing health care professionals in underserved areas. We recognize the importance of primary care and are concerned that the number of doctors entering the medical profession choosing to become primary care physicians is dwindling. We will focus on increasing the number of primary care physicians across the Commonwealth through loan forgiveness and scholarship programs. We will emphasize the need to increase the number of professors and educators to expand the capacity of Virginia’s colleges and community colleges to train health care professionals. We will offer state assistance to the new VCOM in Blacksburg and the Virginia Tech Carilion School of Medicine in Roanoke, to train more doctors and nurses to practice in rural Virginia.
Expand Assistance For and Through Safety Net Providers
Of critical importance to Virginia’s health care system are the safety net providers that provide health care at little to no cost for Virginia’s uninsured. The McDonnell administration will increase the funding provided to Virginia’s Community Health Centers and free clinics. Expanding access to safety net providers can help reduce costs to the overall health care system by taking those individuals using Virginia’s emergency departments for primary care and referring them to safety net providers. Emergency departments are the most expensive way to access primary care and drive the cost of health care for all Virginians up. We will form partnerships between the safety net providers, hospitals and the Commonwealth to help alleviate the burden on Virginia’s emergency departments and allow Virginians to access high quality primary care from safety net providers at a lower cost rather than overburdening the Commonwealth’s emergency departments. We will also help recruit more doctors to volunteer a certain number of hours per year to provide free health services for those in need.
Controlling Cost and Improving Patient Safety and Health Promotion through Health Information Technology
The McDonnell administration will make patient safety a priority by launching a health information technology initiative to reduce errors and identify opportunities for health promotion. According to the Virginia Hospital and Healthcare Association, the adoption of information technology in health care is hindered by lack of financial incentives for investment, lack of widespread industry experience, and a limited number of useful models, especially in the outpatient setting. Studies prove fragmented, disorganized, and inaccessible clinical information adversely affects quality and compromise patient safety.
Maintain the Current Cap on Medical Malpractice Insurance
The cost of medical malpractice insurance drives overall health care costs up. As Governor, Bob McDonnell will support keeping the cap on the amount of money one may receive in a medical liability lawsuit. If this cap were to increase, insurance premiums would likely increase, making insurance less affordable for many families. Our opponent co-sponsored a bill to triple the medical malpractice cap from $1 million to $3 million (HB 2628, 1999).
Focus on Prevention
We are firm believers that one of the greatest ways to reduce health care costs is through prevention and wellness. Employer spending on health promotion and chronic disease prevention is a good business investment. According to the American Heart Association, wellness programs have achieved a rate of return on investment ranging from $3 to $15 for each dollar invested with savings realized within 12 to 18 months.
Reform Medicaid by Auditing the Department of Medical Assistance Services
In the eight state fiscal year budgets ending in 2010, Virginia’s share of Medicaid has grown to more than 20 percent of state expenditures from around 12 percent in 2001. Medicaid spending grew a remarkable 94 percent or an average of 12 percent per year. With more than one in five of state dollars next year devoted to Medicaid, the next Governor must have the knowledge, skills and expertise to get Medicaid spending under control.
Mental Healthcare System
The McDonnell administration will be a strong advocate for Virginians with mental health needs and their families. When we invest in people and focus on outcomes, we can transform the system to provide services that families and individuals need to minimize the impact of disabilities and strengthen the abilities of individuals.
McDonnell is a recognized leaders in this area for proposing many substantial reforms to the mental healthcare system. While we have made strides in recent years, there is room for much improvement. Our strengths lie in the state’s evidenced based practices such as Assertive Community Treatment (ACT), which lead to lower hospitalizations and decreased criminal justice system issues. However, funding for transitioning to a community based system has been inconsistent and lack of housing for consumers is a serious issue for many individuals.