NRLN Legislative Agenda… Suggestions for 2008   October 14, 2007

The RMAC and NRLN Health Care Advisory groups met on Friday, October 12, 2007 to discuss suggestions for the NRLN 2008 legislative agenda.  Our focus remains health care and associated legislation.  We reviewed activities for 2007 and decided to continue our present direction.  Specifically:

1.    Health care information technology.  Legislation of interest:

a.    Kennedy/Enzi Wired for health care quality act S.1693 (close to floor action, report submitted to floor.)

b.    Stabenow/Snowe   S.1408 (independent of above, but could complement)

We note that HHS is pursuing a course to have electronic records in place by 2014.  (See http://hhs.gov/healthit/  for details).  Trial implementations are now underway, coupled with the Fourth Nationwide Health Information Network forum December 11-12, 2007.  The HHS approach is a shared private/government effort.  If all legislation fails, HHS promises electronic records by 2014.  Current proposed legislation does NOT AGREE with the path taken by HHS, and seeks to have a system more tightly controlled and operated by the government.  HHS has voiced opposition to the legislation, and claims its path will succeed without.  If legislation is passed for a different direction, much of the work done by HHS over the last 4 years may be wasted effort.  Our efforts should be to help seek agreement.

2.    Universal Health Care

a.    Continue review and analysis of Kennedy/Dingell Medicare for All (formerly S. 2229, currently S.1218) if/as it develops.
b.    Review all new proposals for universal care

We note that little serious effort will be devoted to legislation for health care before the next election.  All presidential candidates are likely to propose a health care plan, but no plan seen so far has enough detail to conduct a meaningful analysis.  For example, the Clinton plan offers participation in the GEHBP, but neglects to say what degree of subsidy will be offered for those not in the government.  Our efforts should be to continue offering the NCHC guidelines as the appropriate direction,

3.    Modifications to Medicare

a.    Legislation is required to correct Medicare’s sustainable growth methods causing cuts in doctor payments.  Reviving the Medicare sections of the recent house CHAMP bill would suffice. Such action is promised by the House and is currently being drafted by the Senate Finance Committee.
b.    Catastrophic Coverage (Out of pocket spending limit/lifetime spending limit)

i.    An effort to add such coverage to Medicare took place in 1988.  Enacted on July 1, 1988, the MCCA was repealed 17 months later on November 22, 1989, due to controversy and opposition from senior citizens concerned about its financing and lack of long-term care benefits.  Our effort should be to get the discussion going again.  

c.    Improvement in preventive screening approvals.  This is already a well publicized request.
d.    Expansion to eliminate need for supplementary insurance.

i.    Perhaps an option for individuals to spend more for Medicare to replace current supplemental policies.  Our effort would be to float this idea for any response.