Senate Resolution 9 - Introduced PAG LIN S.R. ________ H.R. ________ 1 1 SENATE RESOLUTION NO. 1 2 BY HATCH, BOLKCOM, OLIVE, HANCOCK, SENG, 1 3 WILHELM, HORN, WARNSTADT, DVORSKY, HECKROTH, 1 4 DOTZLER, DANIELSON, SODDERS, RIELLY, SCHOENJAHN, 1 5 KREIMAN, RAGAN, SCHMITZ, STEWART, BEALL, 1 6 BLACK, KIBBIE, GRONSTAL, COURTNEY, APPEL, 1 7 FRAISE, DEARDEN, DANDEKAR, QUIRMBACH, 1 8 JOCHUM, McCOY, and HOGG 1 9 A Resolution encouraging a federal state collaboration 1 10 to achieve quality, affordable health care for all. 1 11 WHEREAS, the United States is facing a worsening 1 12 health care crisis of ever=higher costs, inconsistent 1 13 quality, and lack of access to necessary coverage and 1 14 medical care for tens of millions of uninsured and 1 15 underinsured residents; and 1 16 WHEREAS, reforming the United States' health care 1 17 system to achieve a high=performing, affordable, and 1 18 quality system covering all residents is central to a 1 19 sustainable economic recovery and the health and 1 20 financial security of all residents, businesses, and 1 21 governments; and 1 22 WHEREAS, reform of the United States' health care 1 23 system is a paramount and immediate priority for 1 24 President=elect Barack Obama, his administration, and 1 25 the 111th Congress; and 1 26 WHEREAS, each state has unique economic, social, 1 27 geographic, and demographic factors that must be 1 28 accommodated to reach quality and affordable health 1 29 care for all; and 1 30 WHEREAS, states play a vital role in health care 2 1 for tens of millions of Americans by administering and 2 2 funding public programs such as Medicaid and the State 2 3 Children's Health Insurance Program (SCHIP) that 2 4 improve access to quality and affordable health care; 2 5 and 2 6 WHEREAS, states can help improve health care for 2 7 all residents of the United States by using public 2 8 programs and regulatory power to influence, guide, and 2 9 direct the broader health care system toward improved 2 10 and less costly care; and 2 11 WHEREAS, the federal government looks to states for 2 12 guidance in improving health care, and federal health 2 13 care reform is informed by state initiatives; and 2 14 WHEREAS, since the current health care system is 2 15 unsustainable and the cost of doing nothing would be 2 16 far greater than the cost of health care reform; and 2 17 WHEREAS, all states and the federal government 2 18 share a common mission to protect and provide for the 2 19 general welfare of all the people of the United 2 20 States; NOW THEREFORE, 2 21 BE IT RESOLVED BY THE SENATE, That the Iowa Senate 2 22 urges both state governments and the federal 2 23 government to collaborate with one another to reach 2 24 the goal of providing quality and affordable health 2 25 care to all Americans; and 2 26 BE IT FURTHER RESOLVED, That each state exercise 2 27 its inherent responsibility to assist in providing 2 28 access to quality health care; and 2 29 BE IT FURTHER RESOLVED, That all of the following 2 30 guiding principles be incorporated into a national 3 1 health care policy: 3 2 1. Stabilize financing through payment reform. 3 3 a. Implement a patient=centered medical home. 3 4 This practice emphasizes reimbursement of services 3 5 based on patient needs, with effective financial 3 6 incentives for coordinated care among 3 7 multispecialties. 3 8 b. Prioritize payments for primary and preventive 3 9 care. This prioritization will steer patients to 3 10 cost=effective treatments that promote wellness and 3 11 health. Equally important is to end Medicare's 3 12 regional reimbursement discrimination, whereby states 3 13 receive considerably more or less for the same 3 14 procedure based upon geographic location. 3 15 c. Support value=based purchasing efforts. 3 16 Value=based purchasing uses transparent quality and 3 17 cost data and patient incentives to steer care toward 3 18 high=quality, cost=effective providers. 3 19 d. Restructure national financing for long=term 3 20 care. As baby boomers age, long=term care needs will 3 21 skyrocket. A comprehensive financing strategy that 3 22 takes into account states' financial capabilities is 3 23 critical. 3 24 2. Improve cost containment policies. 3 25 a. Advance cost containment strategies. To ensure 3 26 a financially stable system, national standards for 3 27 cost containment should be advanced in areas such as 3 28 chronic care management and medical homes, pay for 3 29 performance, electronic health records, administrative 3 30 efficiency, public health measures, drug and medical 4 1 device negotiations, and sunshine laws to increase 4 2 transparency of financial arrangements among industry 4 3 stakeholders. 4 4 b. Establish national electronic medical record 4 5 standards. National standards should be established 4 6 for the states controlling the use and distribution of 4 7 electronic medical records. 4 8 c. Provide financial and technical assistance for 4 9 the creation and utilization of electronic medical 4 10 records. Modernizing medical records using current 4 11 technology will improve care and lower costs. 4 12 d. Facilitate the confidential sharing of patient 4 13 data within and across state borders. A national 4 14 interoperational standard will allow providers to 4 15 access patient records anywhere. 4 16 3. Increase access to affordable health insurance 4 17 coverage. 4 18 a. Expand coverage to everyone. Using private 4 19 market and publicly financed plans, affordable 4 20 coverage must be guaranteed to every resident. Total 4 21 health care costs for individuals, families, and 4 22 employers must be limited to an affordable percentage 4 23 of household income or payroll. 4 24 b. Allow for greater flexibility in state 4 25 regulation of federal Employee Retirement Income 4 26 Security Act (ERISA)=regulated insurance plans. ERISA 4 27 precludes effective state oversight of self=insured 4 28 employer=offered insurance coverage. This unintended 4 29 consequence of ERISA distorts policy and interferes 4 30 with a state's ability to provide for consistency in 5 1 coverage. 5 2 c. Eliminate preexisting conditions exemptions and 5 3 require guaranteed issue of insurance. Permitting 5 4 insurers to reject applicants based on health status 5 5 leaves those who most need coverage without any 5 6 affordable options, defeating the purpose of health 5 7 insurance. 5 8 d. Strengthen the health care safety net. 5 9 Increase the investments in public programs 5 10 administered by states and the federal government, 5 11 such as Medicaid, community health centers, and SCHIP. 5 12 e. Support state innovation by creating robust 5 13 national standards that serve to raise the floor for 5 14 state action, rather than limit state efforts to 5 15 achieve the goal of quality and affordable health care 5 16 for all. 5 17 f. Invest in increasing the number of primary care 5 18 providers, midlevel practitioners, direct care 5 19 workers, and laboratory and community health workers. 5 20 g. Carefully monitor specialty supply. Certain 5 21 specialists are in short supply, and policymakers need 5 22 to be attentive to these shortages. 5 23 4. Increase quality. 5 24 a. Develop evidence=based standards using robust 5 25 clinical and cost comparative=effectiveness findings. 5 26 Care options need to take into account both 5 27 effectiveness and price. Comparative effectiveness 5 28 research that evaluates treatments in terms of 5 29 efficacy and price will allow for the greatest value 5 30 in health improvement. 6 1 b. Require the use of informed, shared decision 6 2 making between the provider and patient. Patients 6 3 need to bring their preferences and values to the 6 4 medical decision=making process, just as providers 6 5 bring their experience and knowledge of medicine. 6 6 Informed joint decision making has been shown to 6 7 improve outcomes and increase patient and family 6 8 satisfaction. 6 9 c. Eliminate disparities and inequality. Numerous 6 10 social factors lead to widespread racial and ethnic 6 11 disparities in health care. The health care system 6 12 needs to systematically address these disparities if 6 13 the promise of health care for all is to be honored. 6 14 d. Invest in proven prevention programs and health 6 15 promotion activities. Public health activities such 6 16 as promoting healthy behaviors and teaching disease 6 17 management can improve overall health and lower costs. 6 18 e. Reduce unwarranted variation in care. Wide 6 19 variations in care, not matched by improved health 6 20 outcomes, show that much superfluous care is being 6 21 provided. Rooting out unnecessary care will both 6 22 improve health and save money. 6 23 f. Demand more effective public quality reporting 6 24 by all providers. Reporting allows consumers to 6 25 choose high=quality providers and encourages providers 6 26 to improve care; and 6 27 BE IT FURTHER RESOLVED, That a copy of this 6 28 resolution be transmitted to: 6 29 President Barack Obama; Vice President Joe Biden; 6 30 Speaker of the United States House of Representatives, 7 1 Nancy Pelosi; Secretary Tom Daschle, Department of 7 2 Health and Human Services; Senator Edward Kennedy, 7 3 Chair, Senate Health, Education, Labor and Pensions 7 4 Committee; Representative Henry Waxman, Chair, 7 5 Oversight and Government Reform; Senator Max Baucus, 7 6 Chair, Senate Finance Committee; Senator Harry Reid, 7 7 Senate Majority Leader; Representative Steny Hoyer, 7 8 House Majority Leader; Senator Mitch McConnell, Senate 7 9 Minority Leader; Representative John Boehner, House 7 10 Minority Leader; the members of Iowa's congressional 7 11 delegation; Iowa Governor Chet Culver; and Dr. Jeanne 7 12 Lambrew, Deputy Director, White House Task Force on 7 13 Health Care Reform. 7 14 LSB 1710SS 83 7 15 pf/rj/8.1