Healthcare

Recently Tim Cunha answered a number of questions for two impartial nonprofit organizations. We invite you to learn about Tim’s stand on health care, medical, and pharmaceutical issues by visiting these websites:

OR you can view a summary of his responses further below following this position statement:

Hubert Humphrey taught us that the measure of a society is how we treat “those in the dawn of life, those in the twilight of life, and those in the shadows of life.” Certainly, these are important considerations in the practice of medicine.

Furthermore, the measure of our national vitality and viability, our strength and security, will be measured not only by how we provide for these who are the least powerful, but also by how we promote and protect all Americans in the process of reaching each American’s own personal potential. In no area of our national agenda is this more important than in healthcare, both in practice and in the clinical and preclinical research.

You’ve all heard the statistics: 47 million Americans are going without health insurance, 9 million of them are children. Did you know that 3.7 million people in Florida are without health insurance? That more than 1 in 5 in people in Florida go without routine access to a doctor’s care?

This means many people use emergency departments as their primary source of healthcare. Tough luck for them, some may say. But, our emergency departments should be for those truly in need of emergency medical attention—such as accident, heart attack, or stroke patients. The burden of additional non-emergency patients on emergency department doctors, nurses, and staff only compounds the resulting financial burden when a large proportion of those patients cannot afford to pay their bills. Hospitals often must write off the expenses for patients who simply cannot pay.

The solutions to our healthcare crisis must be as innovative and comprehensive as the problem is pervasive and complex.

First, health insurance—every American must be covered. For those who already have health insurance, the only thing that should change is that premiums be less. For those who don’t have health insurance or aren’t happy with their coverage, they should be able to seek an alternative in a cooperative or mutual non-profit group that would compete with the for-profit insurers. And, no one should be turned away from any insurance coverage because of because of a pre-existing condition or illness. Health insurance must be portable, not tied to employment. Furthermore, all insurers—private, non-profit, and public—must be required to use the same forms, and the same efficient and fair procedures for prompt and proper reimbursement.

Next, a related matter, Medicare. The prescription drug “donut hole” must be eliminated and we must negotiate for reduced drug costs.

Too little is being spent on prevention and public health: The nation faces epidemics of metabolic syndrome—obesity, atherosclerosis, hypertension, and insulin resistance—primarily because of poor nutrition starting with children, even starting in the womb. Other chronic diseases, pandemic flu, and bioterrorism threaten us. Yet less than for cents of every healthcare dollar is spent on prevention and public health.

When one person—adult or child—is sick and untreated, all persons are at risk. When one child develops a chronic lifelong illness or disability because of inadequate or unavailable pre-natal or early childhood healthcare, we all bear the burden. Public health must be a national priority as important as our military defense—because it is just as vital to our national security.

And, we must modernize our healthcare infrastructure across the board. For example, most medical records are still stored on paper, which makes it hard to coordinate care, measure quality, and reduce medical errors. How many times have individual physicians and nurses been blamed for mishaps not caused by them, but rather by an inadequate system?

Finally, we must invest more in bio-medical research and health education, providing new partnerships for progress in both the teaching and research missions of our health sciences colleges and universities—the best in the world, that we need to continually make even better.

We must support and increase research sponsored by the National Science Foundation and the National Institutes of Health, provide alternative sources of financing for heath profession education, and invest in a healthcare system that provides the broadest care possible as well as the best care possible.

There are many other areas of healthcare that we must address with innovation, creativity, and common determination, both here and abroad—AIDS, malaria, tuberculosis, immunization, malnutrition, mental health, lead poisoning, air and water pollution, disabilities and other chronic diseases….and more.

These health-related issues don’t necessarily require more government, but rather better government. It’s not about government working harder for all of us, but rather working smarter for all of us.

Research!America ~ Your CandidatesYourHealth

[What is] your view of our current health care system?

Significant changes are needed to make our health care system work much better. Just a few of the many changes needed: Emergency rooms are overwhelmed by noncritical cases. We must provide alternative comprehensive primary health care, including preventive care to keep every individual healthier, for themselves and for the community. Rural areas need immediate attention. Veterans are poorly served by a VA without the resources to meet the demands; they and their families should get benefits for use with ANY health care provider. Drug costs for seniors must be reduced.

In a recent survey, a majority of Americans (81%) say they are dissatisfied with the cost of health care in this country. If elected, how will you address health care costs for Americans?

Every American should have affordable quality health care, without preconditions. All children must be fully covered by the public without regard to their family circumstances. Adults need choices among private, public, and co-op plans, priced so that every adult is covered. Health insurance should not be tied to a job. ALL expenses of catastrophic illnesses should be covered after an affordable deductible. The prescription "donut hole" must end. Medicare must negotiate lower drug prices.

Do you agree or disagree that it is the responsibility of the federal government to ensure all Americans have basic health care coverage?

I agree.
HOW the federal government will do this is subject to debate, but it must cover every child and all adults and families with limited financial resources. We should offer choices among traditional insurance, a government-run plan, universal access to Medicare for those who chose it, & co-op nonprofit plans. Coverage must include preventive care to keep people healthier--that's good stewardship of resources. Coverage must be portable and must not exclude anyone for pre-existing conditions.

[What changes are needed in] the Medicare prescription drug benefit for seniors…?

We must negotiate for lower prescription drug prices for people on Medicare, just like we do for the VA. And, we must eliminate the "donut hole."

What strategies would you use to increase the focus on prevention and wellness in our health care system?

Among the many strategies I promote are: Nutrition education for young parents, expectant mothers, students, and seniors: many preventable diseases are caused or worsened by poor nutrition - obesity, diabetes, atherosclerosis, hypertension. Health screening affordable for all to detect and treat disease early. Improved phys ed in schools. Costs of fitness programs and wellness care fully deductible for those who can afford it and subsidized for those who cannot. Expanded addiction intervention.

The National Institutes of Health (NIH) is the agency that funds most of the medical and health research paid for by U.S. taxpayers. Since 2003, funding for the NIH has been outpaced by inflation. Which of the following statements comes closest to your view on funding for NIH?

The U.S. must increase investment in NIH as a critical strategy to improve health care. While much research is conducted by the private sector (e. g., pharmaceutical companies), it does require a foreseeable profit. Public funding is essential to assure we conduct basic research that expands our knowledge and core capabilities and educates emerging scientists. Furthermore, publicly-funded research is essential for the study and ultimate cure of "orphan diseases," those with too few victims to ever support a profit, but that destroy lives and increase overall medical costs.

The Centers for Disease Control and Prevention (CDC) is charged with protecting the health and safety of Americans. In recent years, funding for core programs (such as chronic disease and injury prevention, tobacco control and environmental health) at the CDC has been cut. [What is] your view?

Increase funding for core programs at CDC to improve public health.
As our population increases and we become a more mobile society, public health initiatives are increasingly important in protecting individual and family health care. "An ounce of prevention is worth a pound of cure" has never been more true. Possibly the biggest return on our health investments comes from pubic money spent on prevention and mitigation of disease and injury.

The Veterans Administration (VA) supports health research at VA facilities nationwide. In the proposed budget for 2009, research to improve health primarily for veterans is cut. [What is] your view?

Increase funding for research supported by the VA.
Research in general is a sound investment. Research by the VA is essential, particularly to address the unique conditions affecting veterans as a result of armed conflict, such as head traumas, loss of limbs, and exposure to toxic substances.

The Agency for Healthcare Research and Quality (AHRQ) is the lead federal agency charged with funding health services research, which seeks to rapidly translate discoveries from research into medical practice and improve the quality, safety and effectiveness of health care. From 2002 to 2007, funding for AHRQ was cut or remained flat. [What is] your view?

AHRQ funding should be increased as a strategy to improve health care quality and safety in the U.S.
Not only must we deliver healthcare to all, we must assure that it is of the highest quality and efficiency. As we spend greater percentages of our GDP on health, we must assure that it is spent effectively and economically. Any research that would promote that end is an investment worth making.

The Food and Drug Administration (FDA) is responsible for protecting the public health by assuring the safety and effectiveness of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics and products that emit radiation. [What is] your opinion?

Current funding levels for FDA are not keeping pace with accelerated drug and device creation or the increasing globalization of food supplies and should be increased.

We must adopt and fund methods to speed up and improve the process of getting new cures to market while fully safeguarding the public. People suffer and people die while potentially effective pharmaceutical treatments are unavailable because of avoidable delays caused by under-funding of FDA review.

How important would you say it is that the U.S. work to improve health globally? If important, please describe how you plan to increase our nation’s role in promoting and improving global health. If not, please explain why.

Very important.
We need to learn from our successes, such as our AIDS-Malaria-TB initiative that has worked so well in Africa. Improving basic personal & public health worldwide will have far-reaching positive effects: stabilizing economies, strengthening families, increasing productivity, etc. These initiatives should include universal vaccinations, adequate nutrition, prenatal maternal health, malaria nets, STD prevention, clean water supplies, sanitary sewers, accessible health clinics, & affordable drugs.

Studies show that certain health problems are more prevalent among people with lower incomes and among minorities. How important do you feel it is to conduct research to understand and eliminate these differences?

Very important In a civilized society, low personal income or wealth should not result in diminished health.

Do you support or oppose increasing federal funding for state/local health departments and hospitals across the country that are expected to prepare for and respond to threats to our health?

Support.

Do you agree or disagree that mental health services should be part of all health care plans in the public and private sectors?

I agree.
Neurological & psychiatric diseases cause untold millions to suffer no less than those afflicted by a "physical" illness. Prevention, early intervention, and intense treatment of mental illness would benefit society immensely by reducing the many direct and indirect costs of our failure to treat such as: long-term care; lost productivity & poor job performance; poor school performance; suicides; poor parenting; neglect of other health needs: anti-social behavior, e.g. DUI, crime; etc.

Comparative effectiveness research compares two alternative treatments for the same condition to see which works better for the average patient. Many feel Medicare and private insurers should only cover the most effective treatment. Others feel, since comparative effectiveness only determines which treatment works best on average, the ultimate decision as to what treatment to be used should be left to doctors and not the government or insurance companies. [What is] your view?

Comparative effectiveness research should be used to inform patients and doctors but the decision on which treatment to use should be made by patients and doctors, not government or insurance companies
A "one size fits all" approach makes no sense when applied to human beings with our vast genetic and metabolomic diversity. Many drugs and treatments may be totally ineffective for the vast majority of people, but be the very best for a small minority.

Do you agree or disagree with the following statement? "The U.S. is in danger of losing its global competitive edge in science, technology and innovation." If you agree, what approach would you take to change this trend?

I agree. Increased funding of basic research. Tax incentives for small business innovation. Reduction of risks for entrepreneurial ventures into research & development of new technologies. Dramatic enhancement of public support for science, math, and technology education from pre-K through graduate school.

Florida CHAIN—Community Health Action Information Network

... Describe the greatest challenges facing America's health care system.

One of the most critical challenges facing Americans is access to quality healthcare at a cost that is affordable. With close to 50 million having no health insurance and millions more having “insurance” of questionable value, all of us are at risk. The uninsured are forced to use hospital emergency rooms for primary critical care and have no resources for preventive medicine and for treatment of illness early to avoid escalation to a critical condition. This overburdens emergency services, placing everyone at risk, and endangers public health through the spread of untreated disease. Untreated and under-treated illness not only destroys the quality of life for the sick and their families, but also costs our economy and society dearly in many ways, including (but certainly not limited to) through diminished job and school attendance and performance, lower productivity, higher public costs for treatment of critical illness that could have been prevented or diminished through earlier intervention, and increased publicly-supported long-term care.

The new Congress must face many critical challenges—the sagging economy, surging energy costs, climate change, a failed foreign policy, social security, and more; but, none is more critical than reforming and revitalizing our system of delivering healthcare. Without a healthy thriving populace, all initiatives to address all the other critical priorities will be in vain.

We were able to develop atomic weaponry with the Manhattan Project during World War II when we were threatened with potential defeat, we landed a man on the moon and returned him safely to Earth when we were in danger of losing supremacy in space to our Cold War adversary. The crisis in healthcare is no less of a danger and threat. We must initiate, immediately, an all-out national offensive against chronic disease and disparity in healthcare equal to our military offensives. This requires extensive public support for exploring new treatment technologies, discovering drugs for “orphan” diseases not addressed by the large pharmaceutical companies, expanding preventive health resources, improving nutrition, removing toxins and pollutants from our environment, researching communications and data technologies to make medical expertise available everywhere, improving and expanding healthcare professional education, and more.

Our healthcare system is in crisis and the heath and vitality of our country is declining. Our children are beset by obesity and early-onset Type II diabetes. Our seniors are often successfully treated for critical illness only to linger and suffer with untreated or undertreated chronic disease. Healthy, vibrant people are the lifeblood of an enduring society. We must end the antiquated economic, legal, and social conventions that refuse to recognize that in order to improve the quality of life for each of us, we must do so for all of us. Our public policy must recognize that developing and managing an affordable, accessible, first class system of healthcare and illness prevention for each American is essential to our common good and must be a priority investment from our common resources.

[Some of the actions that Congress should] consider to increase the number of Americans with health insurance coverage:

Expand existing public programs (for example, Medicare or SCHIP).

Provide tax credits and/or tax relief to individuals and families that purchase coverage.

Provide tax credits and/or tax relief to small businesses that provide coverage.

Reduce regulations that restrict how insurance companies operate or compete in the market.

Create new public or public-private plan options.

Leverage the purchasing and negotiating power of the federal government.

[What is your position] regarding the reauthorization and expansion of the State Children’s Health Insurance Program (SCHIP), known as KidCare in Florida?