The false choice of student loans and prevention

The House proposal to subsidize student loans by eliminating the Prevention and Public Health Fund, scheduled for a vote Friday, is just a continuation of political maneuvers designed to prioritize politics at the cost of health. America cannot afford to sacrifice the Prevention and Public Health Fund.

Affordable Care Act opponents have tried to pit much-needed infrastructure fixes and popular programs against the Prevention Fund as a means of undermining the ACA more broadly, from Medicare payments for doctors to tax relief for small businesses. Now they’re using student loan subsidies to attack the Fund.

Young people desperately need  reasonable loan rates to make sure they can afford college. Congress knows that we all benefit when more young people go to college. We can’t have engineers unless we’ve invested in the infrastructure that allows students to take math and science classes. We won’t have doctors when we need them in the future if we can’t help them afford medical school now. Education is an investment that pays off—and that’s why we must create and resource the infrastructure today.


“Listening” is the key to creating value in health care

The Patient Centered Outcomes Research Institute (PCORI) established by the Affordable Care Act (ACA) recently published criteria that it will use to fund research to “help people make informed healthcare decisions.”  To this end, PCORI asserts that health care outcomes research should be guided “by the voice of the patient”. This “patient-centric” orientation is key to assuring that comparative effectiveness research truly serves the public.  At a fundamental level, all of us who design, deliver and finance health care need to continually remind ourselves that it is the public who we serve first and foremost. The first step in such service is simply to listen.
Whether or not the ACA survives the upcoming Supreme Court decision and/or the presidential election, it will have helped to focus the country’s attention on health care, its cost, its structure and its value to us as individuals. And, regardless of the ACA, the overwhelming issue of health care’s cost and its value to society will remain.


Health reform - Genie is out of the bottle

The cherry-picking of harsh Supreme Court questions about the Affordable Care Act has fed a misleading impression that health reform is on life support or perhaps already deceased. Here’s the reality -- health reform continues. Virtually every state is now engaged in using federal grants to build state exchanges and expand Medicaid – a process that will persist in some form even if the Supreme Court strikes reform.  

The reality on the ground is fuelling reform. Large insurers welcome the opportunity to end freeloading and the new revenue from individual premiums and federal government tax credits to cover everybody. Meanwhile, hospitals are eager to escape from the financial weight of caring for 53 million uninsured Americans, and family physicians and skilled nurses welcome new pools of patients with coverage for needed care without being buried in unnecessary paperwork. And large employers look forward to a day when they won’t be used as a piggy bank to pay for the costs of treating the uninsured – costs that can amount to $1,000 for every employee – and to reimburse medical providers for quality rather than driving up the number of services.

Whatever the flaws of health reform, many stakeholders prefer it over the disaster that existed previously and see it as a starting point for further reform to address its weaknesses.


Putting health ahead of politics: what do we really want to save?

It’s time to forego the rhetoric and have an honest dialogue about the state of our nation. We’re throwing away good health in the name of reducing debt. Those who oppose prevention would have us believe that the country’s suffering is primarily due to runaway debt. However, our spending must be informed by values—by what matters to us as a nation. When we see friends and family die unnecessarily, we know that health matters. When we fail to protect our health and wellbeing through prevention we are allowing linear thinking to replace values and common sense.

In truth, we are suffering, but the national debt is not the only reason. Right this moment, many in our communities are sick, injured and dying from preventable illness and injuries. Preventable chronic illnesses alone continue to account for seven out of ten deaths annually.

Our economy suffers as well and this suffering is not relieved when a recent Gallup poll finds that U.S. businesses bear the burden of $153 billion in annual lost productivity due to chronic diseases, including those resulting from lack of access to healthy food and opportunity for physical activity. When we don’t prioritize prevention, we’re failing to realize prevention’s 5:1 cost savings.


It is time to re-engage on the autism epidemic

On March 30, 2012, the Centers for Disease Control and Prevention (CDC) released their latest figures on the number of autistic kids in America. The numbers are sobering. Thirty years ago it was estimated that autism affected only 1 out of every 10,000 individuals. The latest CDC figures put the number at 1 in 88 American children (one in 54 boys); a 550 percent jump in cases since 2000. We are literally in the midst of a nationwide epidemic.
In the late 90s, my grandson was diagnosed with autism. Like other family members who have been touched by autism, I wanted to know more about this condition. During my tenure as Chairman of the House Committee on Government Reform (1997-2002) and the subcommittee on Human Rights & Wellness (2003-2004), I held no fewer than 20 hearings examining the state of federal scientific research into the cause of and treatment for autism. I am proud of the work we did to raise awareness of autism and draw more attention to the need for research; and I am firmly convinced that the work we did back then laid the groundwork for the historic Combating Autism Act and for the $1 Billion in Federal research into autism that is happening today.
Unfortunately, a great deal of misinformation has been thrown around in public and private about the Committee's focus on mercury in medicines as a possible factor in the autism epidemic. I’m not a scientist, but the Committee heard from many credible scientists and experts who are convinced that mercury is a contributing factor; and the theory is no less worthy of exploration than the theories being propounded today that the pregnancy weight of the mother or the age of the father at conception influences whether a child becomes autistic. When you have no idea what is causing a disease, policymakers and scientists should never be afraid to investigate any plausible theory. In fact, researching possible environmental factors is a central component of today's research on autism.


Every child deserves a fifth birthday

When it comes to promoting global health, the American people have much to celebrate and be proud of. With strong bipartisan support, the US government has not only committed many billions of dollars and saved many millions of lives, it has changed the way the world approaches foreign aid. 

President Bush built on the work of his predecessors but radically changed the landscape. He knew the character of the American people to be fundamentally compassionate, generous and committed to service. But he insisted that taxpayer dollars be held to high standards of transparency and accountability and demanded results. That revolutionary conceptual framework led to historic US initiatives including the Millennium Challenge Corporation; the President’s Emergency Plan for AIDS Relief – the largest international initiative in history dedicated to a single disease; the President’s Malaria Initiative; the African and International Education Initiatives; the Women’s Justice and Empowerment Initiative; the Neglected Tropical Diseases Initiative and others that definitively changed how the US serves its global sisters and brothers.  

At the same time, these solid investments in saving and lifting up lives have changed how people around the world view America and Americans – people know what you stand for when you stand with them – and has, therefore, made us more secure.  They have also led a global change in foreign aid focused on results and accountability.


Getting drugs to market place faster

Science is progressing at a rapid pace. The human genome sequence has been completed and evidence on how diseases occur at the molecular level is growing by the day. Researchers and clinicians have been steadily working to use this data to make personalized medicine become a reality. However, with all of this new information, these prospective breakthroughs aren't yet reaching patients as quickly as needed. In the coming year alone, cancer will claim the lives of over 550,000 Americans. To address this incredible burden, and to ensure that patients have access to the most beneficial treatments, the process for turning these scientific insights into safe and effective treatments needs to accelerate as well.
Our progress in understanding the specific pathways of disease has identified hundreds of new targets for potentially life-saving drugs that hold the potential to treat individual patients much more effectively.


ACA is a lifesaver for bleeding disorders community

Today, tens of thousands of families across our nation and around the world are celebrating World Hemophilia Day to raise awareness of bleeding disorders and focuses attention on the importance of comprehensive health care.

Bleeding disorders are a group of conditions in which there is a problem with the body’s blood clotting process. These disorders can lead to heavy and prolonged bleeding, either spontaneously or after an injury. Individuals with bleeding disorders lead productive lives with regular and ongoing access to needed treatments, therapies and specialized medical professionals.

Hemophilia and von Willebrand Disease (vWD) are two of the most common types of bleeding disorders and are lifelong, genetic illnesses in which one of the proteins needed to form blood clots is missing or reduced. Currently, there is no cure, and medication needed to treat the disorders typically costs around $300,000 annually per person.


On healthcare, NFIB doesn't speak for me

As the politically motivated lawsuit against the Affordable Care Act blanketed news headlines recently, a group calling itself “the voice of small business” enjoyed a moment in the media spotlight. The National Federation of Independent Business, or NFIB, continues to draw coverage as a “leading small business lobby group” opposing the health care law. I have only one problem with that: I’m a small business owner, and NFIB doesn’t speak for me.
As a cabinet maker with 10 employees, I’ve been just about breaking the bank for years to pay 85 percent of my employees’ individual health insurance costs. I know a thing or two about the broken health care system, and I find little to support in the NFIB’s “analysis.” Small business owners like me want to make health care reform work, not roll it back.


Obamacare's attack on federalism

The Patient Protection and Affordable Care Act (also known as Obamacare, a term which the President has now embraced) was indeed passed by an elected Congress; however, not with my support. The President did sign it into law.  And now the Supreme Court will determine its Constitutionality.

Unlike the President, I am less sure that they will allow the law to stand.  Our Founding Fathers set up a system of checks and balances, specifically because they feared a legislature becoming too powerful or an executive becoming too powerful. The three branches of our government are not designed to work in unison – they are designed to be, in a sense, adversarial in order to protect the rights of the citizens from an over bearing government - the reason they had fought for independence in the first place!

I was privileged to witness the last session of the Supreme Court’s oral arguments on Obamacare, which focused on whether or not the expansion of Medicaid forced upon the states was “coercion.” The law forces states to spend money and could even cut funding if they don’t comply.