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September 22, 2004
The Honorable Bill Frist, M.D.
Senate Majority Leader
United States Senate
461 Dirksen Senate Office Building
Washington, DC 20510
Dear Senator Frist,
As the 2004
Presidential and congressional elections draw
nearer, increasing attention is being paid to the
candidates’ positions on health reform and proposals
to reduce the ranks of the nation’s 45 million
uninsured. In that vein, the American College of
Preventive Medicine (ACPM) was interested to learn
about the health policy proposals you outlined in a
speech to the National Press Club on July 12, 2004.
As
the professional society representing physicians
dedicated to the practice of health promotion and
disease prevention, ACPM offers its expert comments
on and suggestions for strengthening these
proposals. Further, we believe the College’s
upcoming annual meeting, Preventive Medicine 2005,
is an ideal forum for you to discuss with the
prevention community your 10-year vision for the
health care system, and we reiterate our invitation
for you to serve as a keynote speaker at that
meeting on February 17, 2005 in Washington, DC (see
attached invitation letter). ACPM anticipates
nearly 800 physicians and other health professionals
will attend Preventive Medicine 2005, the
premier public health and prevention conference for
physicians.
With regard to the reforms highlighted in your
speech, ACPM applauds your efforts to improve the
current health care system and to engage policy
makers and stakeholders in this important dialogue.
More specifically, the College supports the overall
policy goals you outline in your Health Care System
2014 Vision. These are all desirable outcomes. We
are especially gratified by your proposal to invest
more in prevention and public health.
ACPM feels, however, that your proposals should go
even farther to cover the uninsured. It is critical
that all citizens have access to essential health
services, especially preventive services that can
reduce the human suffering and economic burden
caused by preventable disease and disability.
ACPM supports health care reform measures that
“assure, for all U.S. residents, access to and
payment for a federally defined and nationally
implemented package of essential health services
recommended through a national guidelines
development process, with no denial of coverage and
minimum personal co-payment” (Health Care for All,
ACPM Position Statement, adopted November 16,
2003). Although your proposal will help reduce the
ranks of the uninsured, especially children, even
more aggressive steps are needed to provide health
coverage to all Americans.
Expanding Community Health Centers clearly is a
beneficial step to providing health care services to
medically indigent and underserved populations.
While expanding community health centers will help
broaden the country’s safety net, such an approach
simply highlights the fact that many residents will
remain uninsured and without affordable access to
private health insurance.
ACPM agrees that allowing individuals to fully
deduct the cost of purchasing individual health
insurance will create a more equitable system, but
again feels that such changes will have a limited
impact on the ranks of the uninsured. The premise
and complexity of the tax system inherently inhibits
the uninsured from gaining coverage. Provisions
also need to be developed to prevent insurer
avoidance of coverage to high-risk populations and
those with particular conditions.
Your support of preventive services for smoking and
obesity is laudable. ACPM of course believes that
prevention is critical to maintaining a healthy
population and, thus, should be a core component of
any reform plan. For example, ACPM supports
elimination of deductibles and co-payments for
preventive services, which have been shown to
inhibit the utilization of health promotion services
among the poor, as a way to increase the use of
preventive services. We would love to engage in a
dialogue with you about specific implementation
strategies and proposals.
ACPM supports efforts to utilize information
technology to streamline medical efficiency. Thus,
ACPM endorses your proposal for a universal
electronic health records system, as it will help
improve patient safety and health care quality and
facilitate the ability of patients to easily
transfer between insurers and caregivers.
Attached is a copy of ACPM’s position statement,
Health Care for All. I hope that you will find
these recommendations and this feedback helpful in
formulating a comprehensive plan to resolve the
growing health concerns facing the American public.
I also hope that you will be able to join us in
Washington, DC, on February 17, 2005 to discuss ways
to strengthen the nation’s health care system.
Sincerely,
Jordan H. Richland, MPH
Executive Director
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