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Analysis

Where 7 Healthcare Leaders Running in the Midterms Stand on ACA, Medicare-for-All

By Jack O'Brien  
   November 01, 2018

As the general election approaches on Tuesday, HealthLeaders has collected profiles of numerous healthcare leaders, including physicians, nurses, surgeons, and executives, discussing how they would affect health policy legislation if elected. 

Over seven weeks, HealthLeaders spoke to more than half a dozen healthcare professionals seeking higher office and asked them how they would seek to influence health policy in Washington, D.C.

This group included five Democrats and two Republicans, several physicians, a neurosurgeon, a former patient survey CEO, and the longest-serving Health and Human Services secretary.

The insights and opinions about what solutions would provide the most effective change and assistance to the healthcare industry, including the fate of the Affordable Care Act and a potential 'Medicare for All' bill, varied significantly across both sides of the aisle. 

Below are highlights from each profile ahead of the general election on Tuesday. 

Matt Longjohn, MD (D-MI-6)

Medicare for All:

"I think that everyone should have access to and be able to afford the essential health benefits as protected by the ACA. There are many ways to achieve universal healthcare besides single payer, but single payer is also attractive in a number of philosophical ways."

Future of ACA: 

"What I think our healthcare system needs besides protecting the aspects of the ACA related to essential health benefits and preexisting conditions, is to do a lot more of what I did at the Y with a focus on prevention and community integrated health."

What should hospital executives and health system leaders take away from your candidacy:

"I'll be honest, I don't think it's the fact that I'm an MD that should speak to [healthcare executives] most strongly. I think it's that I've been involved in healthcare service delivery reform; I've done everything from rewriting billing codes to testing alternative payment models [to] demonstration projects for Medicare. That has given me a clear view of what administrators of healthcare systems are looking for in the healthcare [industry]. Having been [around] for 20 years, working in charitable organizations, universities, healthcare systems, and organizations like the Y, [and] always focused on patient outcomes, I think that I share their mission and have a lot of experiences that they would want to see in Congress."

 

Dr. Jim Maxwell (R-NY-25)

Medicare for All:

"Yes, I think Medicare for All would be a disaster for a bunch of different reasons. No. 1, I don't think the federal government has the necessary skill set to run the whole healthcare system...No. 2, it's not an economically sustainable model."

Future of ACA:

"I would like to see it scrapped. I would like to go back to the drawing board and sort of start all over again. I think it has to be a bipartisan [plan], it can't be the product of one party. It's been a winner-take-all situation when it comes to healthcare and that's not the way to solve the problem. I would have no problem with a bipartisan committee in a two-year time frame to come up with another plan. I think scrapping Obamacare and replacing it with luck is a problem."

What should hospital executives and health system leaders take away from your candidacy:

"What I would like to do is put the patient more into the driver's seat of their healthcare costs options. Right now, they are in the back room and they're not included in the conversation about what's best for them...I would tell the CEOs, CFOs, and the CNOs to get out of the way a bit and let the patient drive the car. The patient would be more satisfied, and I think the whole problem with cost would come down."

 

Lauren Underwood, RN (D-IL-14)

Medicare for All: 

"Again, I think healthcare is a human right, and universal coverage is a great goal. I think that there are certainly political challenges towards [passing Medicare for All] in the immediate next session. But I think it's something I support [regarding] the underlying value statement, which is folks need healthcare to live their healthiest lives."

Future of ACA:

"It's no surprise that we've seen some of the symptoms of what's been going on [with the weakening of the ACA]. Incredibly high premiums, [instability] in the marketplace, that's been manifested in our community as well as real and deep anxiety: will we continue to have this as a coverage option? If the ACA goes away, what will [people] do?"

What should hospital executives and health system leaders take away from your candidacy:

"I'm a registered nurse, and my career is at the intersection of clinical and policymaking, working to help transform our healthcare system. We know there are real challenges, the ACA created some and helped some, but we will need to have another serious effort around health reform. It is critical to have the voice of patients and providers at this table. And I am excited to partner [with] providers, plans, patients, and even hospital CFOs in order to get this done. I think that we need to have these critical voices at the table because healthcare is not theoretical. So many people who have had the pen for too long see healthcare through a theoretical lens, and as a result, we have a system that is broken and fragmented and inefficient, and it's time we fix that."

Related: Here are the Healthcare Leaders on the Ballot for the 2018 Midterms

 

Mel Hall (D-IN-2)

Medicare for All: 

"As I said earlier, it's taken us [16 to 17 years] to move even partially from fee-for-service to pay-for-performance. Medicare for All is not practical because of the significantly increased costs, but I do think there are many things that we can do to ensure that our healthcare coverage is better."

Future of ACA:

"Yeah, I'm open to all sorts of ideas, like the individual mandate, but I try not to deal in hypotheticals. I think we can continue to find new solutions. We ought to be able to guarantee access [to healthcare] and folks should have quality care, but I think there are probably more efficient and consistent effective solutions than the individual mandate."

What should hospital executives and health system leaders take away from your candidacy:

"I think for people who work in healthcare, their primary motive is to make things better. I believe that to my core, that for most people in healthcare, it isn't a job, it's a calling. Whether that is a nurse, a hospital administrator, or a physician, most people get into healthcare because they want to make a difference. I believe in people who lead healthcare—doctors and nurses—are in it for the right reason. Most people in their life want to do well and do good and to make a difference."

 

Steven Ferrara, MD (R-AZ-9)

Medicare for All: 

"I think Medicare for All is incompatible with our healthcare system because we've seen from non-partisan think tanks that it would cost $32 trillion and double people's taxes, which is not something people want.I also think a top-down, one-sized D.C.–run healthcare plan is not agile, it's not flexible."

Future of ACA:

"I think one of the flaws in the ACA was that it was [passed] with a single-party vote, there weren't stakeholders on the other side. I would give equal criticism to the Republican replacement plan because that was a single-party vote. I think healthcare is such an important issue and it's such a big tent—every person in the country is a stakeholder—so it needs to be done in a bipartisan manner. I think unless we do this in a bipartisan way, we're not going to come up with any kind of a quality or endurable solution."

What should hospital executives and health system leaders take away from your candidacy:

"I think the biggest thing is my interest in improving the healthcare system in a bipartisan way and thinking about solutions and not semantics while being a problem solver. I'm not running on any platform related to Obamacare. I am running 100% to make healthcare work better for patients on the economic side and the clinical side. I am truly an honest broker when it comes to making healthcare better and I'm not a partisan about it at all, which I think makes me fairly unique."

 

Dr. Dawn Barlow (D-TN-6)

Medicare for All:

"I want to look at the numbers. I looked at the Medicare-For-All bill, and I see where there is concern. That's why I think [Congress needs] to sit down together and come up with a plan. We need to look at what it's going to cost us. I'm OK with a hybrid system as well. I'm not going to shoot down something that is good, that gives the vast majority of Americans coverage."

Future of ACA:

"I believe that we have to preserve the 10 essential benefits of the ACA. In Tennessee, we have companies that are selling non ACA-compliant plans. That means that they're able to deny people coverage simply because they're too sick or because they're older."

What should hospital executives and health system leaders take away from your candidacy:

"In Tennessee, we have hospitals closing and we have patients suffering. The reason our hospitals are closing and the reason our patients are suffering is because of the people that we have in state office, the governor's office, the House of Representatives, the Senate, and in the White House. I would recommend [that] the people who care about healthcare [should] start getting behind candidates who understand healthcare."

 

Former HHS Sec. Donna Shalala (D-FL-27)

Medicare for All:

"I think that's an expensive way to get universal coverage at this point in time, and I don't think that Medicare is good enough at this point in time. It doesn't have long-term care, it doesn't have dental benefits. And people who have better health insurance than Medicare ought to be able to keep their health insurance."

Future of ACA:

"[One thing] I would do with the ACA, in particular: I never thought that we got the subsidies right at the beginning. Normally, what you do is make tactical corrections after a year, but we were not able to do that. We have to look at the subsidies and the structure—there seems to be a family penalty involved; that is, you can cover the kids but not the spouse. But I think the most important thing is we need to get every state to expand Medicaid because we have millions of people in this country, including here in Florida, who are working every day that have no option in terms of access to affordable healthcare.

What should hospital executives and health system leaders take away from your candidacy:

"That I'm the most knowledgeable candidate on the subject of healthcare that probably has ever been elected. And they know that, they know me, and they know that I'm a reasonable person, and that I'll listen and they've worked with me before.

Jack O'Brien is the finance editor at HealthLeaders. 


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