NEWSFLASH: Tom Koos announced on Ocotober 31, that he fully supports the mission of Stanford Universities bold new program, the BeWell@Stanford program, which promotes integrated, healthy lifestyles for employees. Interested in learning more?
The U.S. spends $2 trillion on health care every year, and offers the best medical technology and scientific research in the world. Yet, the benefits of the American health care system come at a price that an increasing number of individuals and families, employers and employees, and public and private providers cannot afford. 47 million Americans - including nearly 9 million children - lack health insurance.
Health care costs are skyrocketing. Health insurance premiums have risen four times faster than wages over the past six years. Lack of affordable health care is compounded by serious flaws in our health care delivery system. About 100,000 Americans die from medical errors in hospitals every year.
Too little is spent on prevention and public health. The nation faces epidemics of obesity and chronic diseases as well as new threats of pandemic flu and bioterrorism. Yet, despite all of this, less than four cents of every health care dollar is spent on prevention and public health.
Tom Koos' Plan for a Healthy America:
Lowering health care costs and ensuring affordable, high-quality health care for all
Tom Koos believes we live in the greatest country in the world and that when it comes to health care, America can and must do better. The Koos plan will save a typical American family up to $2,500 every year on premiums by:
- Providing affordable, comprehensive and portable health coverage for every American.
- Modernizing the U.S. health care system to contain spiraling health care costs and improve the quality of patient care; and
- Promoting prevention and strengthening public health to prevent disease and protect against natural and man-made disasters.
Quality, Affordable & Portable Health Coverage for All
The Koos plan both builds upon and improves our current insurance system, upon which most Americans continue to rely, and leaves Medicare intact for older and disabled Americans.
1. Koos's Plan to Cover the Uninsured. Koos will create a new national health plan to allow individuals without access to affordable insurance coverage to buy coverage similar to that available to members of Congress.
The Koos plan will have:
Guaranteed eligibility. No American will be turned away from any insurance plan because of illness or pre-existing conditions.
Comprehensive benefits. The benefit package will be similar to the Federal Employees Health Benefits Program (FEHBP), and cover all essential medical services, including preventive, maternity and mental health care.
Affordable premiums, co-pays and deductibles.Subsidies. Individuals who do not qualify for Medicaid or SCHIP but still need assistance will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan.
Simplifying paperwork and reining in health costs.Easy enrollment. The new public plan will be simple to enroll in and provide ready access to coverage.
Portability and choice.Participants in the new public plan and the National Health Insurance Exchange (see below) will be able to move from job to job without changing their health care coverage.
Quality and efficiency. Participating insurance companies will be required to collect and report data to ensure that standards for quality, health information technology and administration are being met.
2. National Health Insurance Exchange. Koos will create a National Health Insurance Exchange to help individuals who wish to purchase private insurance. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible. Insurers would have to issue every applicant a policy, and charge fair and stable premiums. The Exchange will require benefits comparable to those offered in the new public plan. Insurers would be required to justify an above-average premium increase. The Exchange would evaluate plans and provide information about differences between them.
3. Employer Contribution. Employers that do not offer or make a meaningful contribution to the cost of quality health coverage for their employees will be required to contribute a percentage of payroll toward the costs of the national plan. Small employers that meet certain revenue thresholds will be exempt.
4. Mandatory Coverage of Children. Koos will require that all children have health care coverage.
5. Expansion of Medicaid and SCHIP. Koos will expand eligibility for Medicaid and the State Children's Health Insurance Program.
6. Flexibility for State Plans. Koos's plan allows states to continue innovating on health care reform.
Modernizing the U.S. Health Care System to Lower Costs and Improve Quality
1. Reducing Costs of Catastrophic Illnesses for Employers and their Employees. Catastrophic health expenditures account for a high percentage of medical expenses for private insurers. The Koos plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold if they guarantee such savings are used to reduce the cost of workers' premiums.
2. Lowering Costs by Ensuring Patients Receive and Providers Deliver Quality Care.
Helping Patients
Support disease management programs. Seventy five percent of total health care dollars are spent on patients with one or more chronic conditions, such as diabetes, heart disease, and high blood pressure. Koos will require that providers that participate in the new public plan, Medicare or the Federal Employee Health Benefits Program (FEHBP) utilize proven disease management programs.
Coordinate and integrate care.
Over 133 million Americans have at least one chronic disease and these chronic conditions cost a staggering $1.7 trillion yearly. More than half of Americans with serious chronic conditions have multiple physicians, leading to duplicate testing and conflicting treatments. Koos will support greater integration and coordination of care for those with chronic conditions.
Require full transparency about quality and costs.
Koos will build on his efforts in the U.S. Senate and Illinois State Senate to ensure that patients receive accurate information about hospital and provider quality. Koos will require hospitals and providers to collect and publicly report measures of health care costs and quality, including data on preventable medical errors, nurse staffing ratios, hospital-acquired infections, and disparities in care.
Ensuring Providers Deliver Quality Care
Promoting patient safety. Koos will require providers to report preventable medical errors, and support hospital and physician practice improvement to prevent future occurrences.
Aligning incentives for excellence.
Both public and private insurers tend to pay providers based on the volume of services provided, rather than the quality or effectiveness of care. Providers who see patients enrolled in the new public plan, the National Health Insurance Exchange, Medicare and FEHBP will be rewarded for achieving performance thresholds on outcome measures.
Comparative effectiveness research. Koos will establish an independent institute to guide reviews and research on comparative effectiveness, so that Americans and their doctors will have the accurate and objective information they need to make the best decisions for their health and well-being.
Harnessing the power of genetic medicine. Genomics has the potential to revolutionize the practice of medicine, but despite significant scientific advances, very few genomics-based tests or treatments have reached consumers. As President, Koos has a plan to overcome the scientific barriers, adverse market pressures, and outdated federal regulations that have stood in the way of better medicine.
Tackling disparities in health care. As a United States Senator, Tom Koos has fought to maintain funding for the Centers of Excellence in Women's Health at the Department of Health and Human Services and helped spearhead legislative efforts to address gender and ethnic health disparities. As President, Koos will continue to challenge the medical system to eliminate inequities in health care through quality measurement and reporting, implementation of effective interventions such as patient navigation programs, and diversification of the health workforce.
Reforming medical malpractice. Koos will strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance, and will promote new models for addressing physician errors that improve patient safety, strengthen the doctor-patient relationship, and reduce the need for malpractice suits.
3. Lowering Costs through Investment in Electronic Health Information Technology Systems.
Koos will invest $10 billion over five years to move the U.S. health care system to broad adoption of standards-based electronic health information systems. Koos will ensure that patients' privacy is protected.
4. Lowering Costs by Increasing Competition in the Insurance and Drug Markets.
Increasing competition. The insurance business today is dominated by a small group of large companies that has been gobbling up their rivals. Koos will prevent companies from abusing their monopoly power through unjustified price increases and force insurers to spend more funds on patient care instead of keeping exorbitant amounts for profits and administration.
Lowering prescription drug costs. Pharmaceutical companies are selling the exact same drugs in Europe and Canada but charging Americans more than double the price. Koos will allow Americans to buy cheaper medicines from other developed countries if the drugs are safe. Koos will also repeal the ban that prevents the government from negotiating with drug companies for the Medicare prescription drug benefit, which could result in savings as high as $30 billion. Finally, Koos will work to increase the use of generic drugs in federal benefits programs and prohibit drug companies from keeping generics out of markets.
Promoting Prevention and Strengthening Public Health
Tom Koos believes that protecting and promoting health and wellness in this nation is a shared responsibility among individuals and families, school systems, employers, the medical and public health workforce, and federal, state, and local governments.
1. Employers. An increasing number of employers are offering worksite health promotion programs andinsurance plans that cover preventive services. Koos will support and expand these important efforts.
2. School Systems. Koos will work with schools to create more healthful environments for children. He will work to get junk food out of vending machines in schools and improve nutritional content of lunches through financial incentives, increase grant support for physical education, expand federal reimbursement for school-based health services, and provide grants for health educational programs for students.
3. Workforce. Koos will expand funding - including loan repayment, adequate reimbursement, grants for training curricula, and infrastructure support to improve working conditions - to ensure a strong workforce that will champion prevention and public health activities.
4. Individuals and Families. The way Americans live, eat, work, and play have real implications for their health and wellness. The Koos health plan will require coverage of essential clinical preventive services such as cancer screenings and smoking cessation programs in all federally supported health plans. Koos will also increase funding to expand proven community-based preventive interventions.
5. Federal, State and Local Governments. Governments at all levels should develop a national and regional strategy for public health that includes funding mechanisms for implementation. Koos also supports greater organization of the 3,000 health departments in this nation and supports collaborative arrangements between government and the private sector. The Koos plan will also force government to examine its own policies, including agricultural, educational, and environmental policies, to assess and improve their effect on public health in this nation. As president, Tom Koos will prioritize these activities to strengthen prevention and public health, as well as fight for the following initiatives:
Fight AIDS Worldwide. There are 40 million people across the planet infected with HIV/AIDS. As president, Koos will continue to be a global leader in the fight against AIDS. Koos believes in working across party lines to combat this.
Improve Mental Health Care. Mental illness affects approximately one in five American families. The National Alliance on Mental Illness estimates that untreated mental illnesses cost the U.S. more than $100 billion per year. As president, Koos will support mental health parity so that coverage for serious mental illnesses are provided on the same terms and conditions as other illnesses and diseases.
Protect Our Children from Lead Poisoning. More than 430,000 American children have dangerously high levels of lead in their blood. Lead can cause irreversible brain damage, learning disabilities, behavioral problems, and, at very high levels, seizures, coma and death. As president, Koos will protect children from lead poisoning by requiring that child care facilities be lead-safe within five years.
Reduce Risks of Mercury Pollution. More than five million women of childbearing age have high levels of toxic mercury in their blood, and approximately 630,000 newborns are born at risk every year. Tom Koos has a plan to significantly reduce the amount of mercury that is deposited in oceans, lakes, and rivers, which in turn would reduce the amount of mercury in fish.
Support Americans with Autism. More than one million Americans have autism, a complex neurobiological condition that has a range of impacts on thinking, feeling, language, and the ability to relate to others. As diagnostic criteria broaden and awareness increases, more cases of autism have been recognized across the country. Tom Koos believes that we can do more to help autistic Americans and their families understand and live with autism. He has been a strong supporter of more than $1 billion in federal funding for autism research on the root causes and treatments, and he believes that we should increase funding for the Individuals with Disabilities Education Act to truly ensure that no child is left behind. More than anything, autism remains a profound mystery with a broad spectrum of effects on autistic individuals, their families, loved ones, the community, and education and health care systems. Koos believes that the government and our communities should work together to provide a helping hand to autistic individuals and their families.