By John Reichard, CQ HealthBeat Editor
May 24, 2007 – Sen. Hillary Rodham Clinton announced a health cost control plan Thursday she said would trim at least $120 billion a year from national health care spending. A key feature of the seven-point plan calls for a "National Prevention Initiative" that would require insurers doing business with the federal government to cover "high priority" preventive services as well as wellness programs to maintain health, the New York Democrat said.
"Building a national consensus around these cost savings is the first crucial step to cover all Americans with quality, affordable health care," Clinton said in a speech to George Washington University medical students outlining the proposal.
The Thursday address described the first part of what she said would be a three-part approach to tackling the nation's health care ills if she is elected president. The other two components of the approach are "improving quality for everyone" and "insuring everyone," she said.
Under her cost control proposal, insurers would have to follow the recommendations of the U.S. Preventive Services Task Force on what preventive care to cover. The federal advisory panel consists of academic researchers who sift through medical literature to determine which preventive services actually are effective in warding off disease and issue reports on their findings.
Better preventive care could reduce the incidence of obesity, diabetes, and cancer, Clinton said in her speech. "About 30 percent of the rise in health care spending is linked to the doubling of obesity among adults over the past 20 years," she said. If "our obesity levels had remained at 1990 levels, we would be spending 10 percent less on health today—a savings of $220 billion."
Only half of recommended clinical preventive services are provided to adults, and less than half of adults had their doctors provide them advice on weight, nutrition or exercise, she said.
Other elements of the proposal would aim to:
- improve health information technology. To help hospitals and doctors upgrade, "I would invest $3 billion a year in grants to help ramp up the system," Clinton said.
- streamline care for the chronically ill. "Americans with chronic disease such as heart disease and diabetes account for an astonishing" 75 percent of national health care expenditures, she said. Clinton would require that Americans with such conditions have access under Medicare and other federally funded plans to "chronic care coordination" plans providing a "medical home"—a provider or team of providers who would work together to avoid treatment complications or duplicative services.
- end insurance company "discrimination." As part of a plan for universal coverage Clinton said she will detail in coming months, she said, "We would create large insurance pools that lower administrative costs for small businesses and individuals by spreading the risk." She also said the plan would "end insurance company discrimination against people with preexisting conditions." Insurers would be required to allow anyone who wishes to join a plan to do so and bar insurers from charging higher rates to people with health problems.
- drive down costs with "best practices." Clinton said she would start a public–private "Best Practices Institute" to finance research comparing the effectiveness of various forms of treatment. Based on its findings, the institute would issue practice protocols.
- control prescription drug costs. Clinton would give Medicare the authority to negotiate for lower drug prices, allow the importation of low-cost drugs from abroad, and bring lower-cost generic versions of biotech drugs on the market.
- revise the medical malpractice system. She called for an approach that would encourage health systems to give liability protection to doctors who disclose medical errors to patients. Health systems that disclose these errors and move quickly to provide compensation are much less likely to be sued, she said.