Health Care

HEALTH CARE IN ILLINOIS

1. A fully transparent health care system will make health care more affordable. We need to connect providers and consumers, so that consumers know:: a. the real costs of health care; and; b. the outcome of services providers; c. Insurance Commissions.
2. Overhaul government provided health care to be efficient and more effective without cutting funds or services.: a. Find and eliminate duplication in the Budget; b. Shift policy priorities so that money follows people, not bureaucracies.
3. Increase health care access by:: a. Bringing doctors to under served areas,; b. Remove red tape and hurdles to clinic, primary care, and specialty facility construction.

THE PROBLEM:

1. INCREASING COSTS.: “Over the past 8 years (2000 through 2007), family health insurance premiums for Illinois’s workers rose 5.6 times more quickly than median earnings. On average, health care premiums for families rose by 73.1 percent, while median earnings rose by only 13.1 percent.” [Premiums Versus Paychecks: A Growing Burden For Illinois’s Workers. Families USA, Pg 1.]
2. THE UNINSURED.: Sources indicate that as many as 1.75 million Illinoisans do not have health insurance. Some cannot afford insurance, some cannot find a company willing to provide coverage, and others choose to go without it. Whatever the reason, the uninsured cost us all money if they suffer a catastrophic health emergency and are unable to pay for treatment. [The Voice of the Uninsured. Gilead Outreach and Referral Center. April 2008.]
3. FRAGMENTED NETWORK.: Doctors, clinics and hospitals interact directly with the people. However, as patients we often do not know why certain treatments are utilized or not, nor the cost of those treatments. This makes it difficult for patients to know what treatments to seek out or what providers to contact. Now, public and private bureaucracies make our health care decisions for us. The patient has been divorced from the provider.
4. PATIENTS NOT OWNING THEIR OWN HEALTH INFORMATION.: When a patient visits a new doctor, clinic, or hospital the provider does not have immediate access to the patient’s health information. Unfortunately, in many cases neither does the patient. In addition the patient may not know if they are covered for a specific treatment and must wait to for information to be transferred from other providers.
5. BUREAUCRACY AT ITS WORST.: The problems of the health care industry are not limited to Illinois. Nationally there are over 1900 mandates that increase costs for doctors, clinics and hospitals to provide services. [Click here to learn more.] However, here in Illinois, government further increases costs by delaying Medicaid and Medicaid payments 48 business days. [The Illinois State Comptroller’s Quarterly. Edition 30, January 2009; Pg 1.]
6. CERTIFICATES OF NEED.: The Illinois Health Facilities Planning Board is a scandal-plagued board inhabited by the likes of Stuart Levine and Thomas Beck who work with businessmen like Tony Rezko. This “board” decides what health services are available to you. The original purpose was to “restrain health care costs” through the “certificate of need” program. The Department of Justice (DOJ) and the Federal Trade Commission (FTC) have determined that the Certificate of need programs “undercut consumer choice, stifle innovation, and weaken markets’ ability to contain health care costs.”

Click here to learn more about the Certificate of Need Program.

Click here to read the joint press release of the DOJ and the FTC regarding certificates of need.

Click here to read the joint statement of the DOJ and FTC regarding certificates of need.
7. PHYSICIANS LEAVING THE STATE.: Prior to 2005, physicians were leaving the state due to high medical malpractice insurance premiums. In response to physicians fleeing the state, the General Assembly passed a law that capped non-economic (punitive) damages at $500,000. Physicians began to return to the state and malpractice premiums dropped. However, the Illinois Supreme Court is hearing a case to determine the constitutionality of this cap and may invalidate it.

Adam Andrzejewski's Plan for Healthcare.

Adam understands the problems in the Illinois health care system. Any solutions in Illinois may be impacted by the new leadership in Washington DC. While, Federal action may significantly change our current system, we cannot wait! We believe the following steps can improve the situation immediately.

1. A transparent healthcare system will make healthcare more affordable by lowering costs.: As consumers we can go online to find the price of houses, cars, food, and electronics. We can also find user ratings on the performance and even reviews of the quality of the product. For instance, the Consumer Guide™ lists prices and qualities of goods, giving consumers different options for the best purchase.

How is it that we can’t ask a hospital’s front desk the cost of a room for one night and get an answer? It’s difficult to find a doctor in non-emergency situations because we can’t easily discover the price or quality of a doctor’s (or hospitals) services. At times, we don’t know the cost of treatment until after receiving it. We are also at a disadvantage because we don’t know the price insurance companies (or government) pay for the treatment. This puts the patient at a disadvantage when trying to contain health care costs.

As Governor, Adam will work to lower health care costs by providing transparency in health care prices and transparency in outcomes. He will require a clear posting of the cost all services rendered at a health care facility in the office and online. It will contain the price for services paid by the uninsured, by all insurance companies, and by government. Insurance companies and the government will also post online the amount paid for all treatments.

Find good doctors and hospitals: Hospitals and care providers will also have to post and make readily available, the outcomes of all treatments. Standardized report cards will be created for all hospitals and care provider. This will include, but is not limited to, statistics on the success rate for different services and the frequency of staph infections per patient.

Employers with over 100 participants are required to file a Form 5500. The Form 5500 requires full disclosure of commissions paid to the insurance agent/broker. Large insurance companies of over 100 brokers are required to disclose commissions; however, brokers in small firms are not required to do so.

Adam Andrzejewski will sign into law a bill that requires transparency of commissions and income for all insurance brokers and companies. This will empower consumers to make informed decisions regarding the insurance providers and brokers.
2. Overhaul government provided health care to be efficient and more effective without cutting funds or services.: Our goal is to cut through red tape and connect patients with health care providers by giving patients more information and increasing service choices.

State provided health care is in disarray. The state health care system is overburdened as coverage has been expanded without the proper funding. Financially overburdened, virtually insolvent, and facing an economy in recession, there is currently a 48 day delay in state payments to providers. After hard-work and researching the full scope of programs agencies, the number of departments and employees cannot be determined. All health care programs, departments, and agencies must be identified and reconfigured.

Adam’s ideas for reform: First, reorganize departments and eliminate redundant agencies to make it easier for people needing assistance to get it.

Second, utilize new tools in the health care industry to make the Medicaid and Medicare dollar go farther. Money will follow the patients not government bureaucracy. Adam will advocate for a new bill that creates Health Savings Accounts (HSA) for Medicaid and Medicare. The State will deposit a predetermined amount of money into an HSA. Patients will be empowered to spend the money on their own behalf and will be offered various options for catastrophic health insurance. This money can roll over from one year to the next and the recipient can keep the account if they obtain gainful employment.

Third, Adam will approve the use of non-traditional providers including walk-in clinics and urgent care facilities. This will increase choices for HSA recipients and help stretch their dollar further.
3. Adam will increase access to health care.: We will do this in two ways: first, we will bring doctors to under-served areas funded by a tax on punitive damages, and second, we will increase access around the state by removing red tape to clinic, primary care, and specialty facility construction.

A.    Studies show that excessive judgments in medical malpractice cases increase cost to patients and drive doctors out of state. The state has attempted to address this through limits on these excessive judgments. However, the Illinois Supreme Court is currently deliberating the constitutionality of the limit. A physician’s malpractice insurance premium increases each time they are sued. The increase in malpractice insurance leaves the physician with two choices: increase prices for all patients or quit practicing.

If the Illinois Supreme court strikes down these tort reform measures, as Governor Adam will sign a law that taxes punitive damages of medical malpractice awards at a rate of 30%. These funds would be used to bring physicians to under served areas by assisting in malpractice insurance.

In a lawsuit, punitive damages are not actual damages, they cannot be quantified. Punitive damages are to punish the offender and are often staggering. This increases the cost for patients because the same number of people will be seeking services from fewer providers or the provider will increase treatment costs to pay for the increased insurance premium.

B.    Adam will reform the certificate of need laws that prevent consumer demand from dictating health care providers.

The number of hospitals is not important; the people who work in them are. The government does not limit the number of bars, malls, box stores, or even dentists in a given area. This is because the government values giving people choice. However, when it comes to medical services, including hospitals, the government grants a geographic monopoly under the guise of “containing cost.” Under the certificate of need (CON) laws, a board of five individuals decide if another care center, hospital or health and fitness facility is needed in a geographic area. (Click here to learn more about CON.)

According to the Department of Justice and the Federal Trade Commission “CON laws impede the efficient performance of health care markets by creating barriers to entry and expansion, to the detriment of health care competition and patients.” Furthermore, “CON laws create opportunities for existing competitors to exploit the CON process to thwart or delay new competition; they can facilitate anti-competitive agreements among providers; and the CON process itself may be susceptible to corruption.”(Click here to view the statement)

Adam Andrzejewski will sign a bill reforming the CON laws. These reforms will limit the role of the Hospital Facilities management board to regulating only hospitals. Thus long-term care facilities, dialysis centers, ambulatory surgery centers, and alternative health care delivery models will not be required to go before the board.