Ted Kennedy on Health Care Democratic Sr Senator (MA)

2006: Supported RomneyCare as model for other states

1. Those who could afford insurance would either buy it pay their own health-care costs--no more free riders showing up at the hospital expecting to ge care at tax-payers' expense
2. For those who couldn't afford health insurance on their own, the state would pay a portion of their premium with the amount of the subsidy determined on a sliding scale by income
3. To make it easier to insurers to service individual customers, the state would create a "connector" or "exchange" that would collect premiums and pass them on to the insurers.

1972 book, "In Critical Condition", favored national system

I introduced the first bill of my career for national health insurance. It was defeated: the first setback in a long, long struggle.

1974 cancer fight: address inhumanity of healthcare system

My many hours at Boston Children's Hospital were precious in another way. While Teddy was asleep, I wandered the halls, and sought out other parents who, like me, were keeping vigil. These were mostly working people. Their modest savings allowed them to raise their families comfortably and with hope--until catastrophe struck. It was in these conversations that the inhumanity of our health care system truly hit home to me. We shared common ground in our anxieties about whether our children would live or die, or survive with debilitating frailties. But for my new friends, this was only one terrible part of a larger nightmare.

1977: preferred single-payer but it's politically impossible

The moment called for bold leadership and swift action built around a single piece of legislation. We continued to work toward that end. But Pres. Carter continued to slow down the process. By the summer of 1978, I felt that the president was squandering a real opportunity to get something done. The Jimmy Carter who had declared that he wanted mandatory and universal coverage and had a plan that was nearly identical to mine had now been replaced by the President Carter who wanted to approach health insurance in incremental steps, over time, if certain cost containment benchmarks were met.

1970s: Quadrupled federal spending on cancer research

Without Ted's efforts to boost funding through NIH, Medicare, and many other programs, Boston's Mass General as it is now known would not exist. Nor would the great research hospitals lining Boston's Longwood Avenue. Nor would the outstanding hospitals in other parts of the country. Political leaders and historians had long acknowledged Ted's eminent role in expanding health-care treatments, but everyday citizens often failed to make the connection between Ted's health care policies and the great institutions they funded.

Quality health care is a fundamental right, not a privilege

Acknowledged expert on healthcare issues

This knowledge gap became apparent to me one day at a meeting with a group of Senators. Ted Kennedy, one of the true experts on healthcare, listened to question after question posed by his colleagues. Finally he barked out, "If you would just look at page 34 of the briefing material you'll find the answer to that question." He knew every detail--including page numbers--off the top of his head.

Let workers keep insurance when they change jobs

Hillary was adamant that she would not back such a bill, because "you can't fix part of the problem,. If you do this over here, it causes this bad reaction over there. You've got to do it all or do nothing."

AIDS victims need protection against discrimination

In every case, science, public health and painful experience have shown that the appropriate reaction is not to fear or to isolate, but to reach out with assistance and support.

In no instance is this response more essential than in the epidemic of AIDS. Beyond the fundamental issues of fairness and justice for individuals, protections against discrimination for people with HIV disease are essential to protect the public health. We cannot expect to bring this devastating scourge under control unless we make it possible for individuals who believe that they may be infected to come forward for counseling and testing.

Voted NO on means-testing to determine Medicare Part D premium.

SUPPORTER'S ARGUMENT FOR VOTING YES: Sen. ENSIGN: This amendment is to means test Medicare Part D the same way we means test Medicare Part B. An individual senior making over $82,000 a year, or a senior couple making over $164,000, would be expected to pay a little over $10 a month extra. That is all we are doing. This amendment saves a couple billion dollars over the next 5 years. It is very reasonable. There is nothing else in this budget that does anything on entitlement reform, and we all know entitlements are heading for a train wreck in this country. We ought to at least do this little bit for our children for deficit reduction.

OPPONENT'S ARGUMENT FOR VOTING NO: Sen. BAUCUS: The problem with this amendment is exactly what the sponsor said: It is exactly like Part B. Medicare Part B is a premium that is paid with respect to doctors' examinations and Medicare reimbursement. Part D is the drug benefit. Part D premiums vary significantly nationwide according to geography and according to the plans offered. It is nothing like Part B.

Second, any change in Part D is required to be in any Medicare bill if it comes up. We may want to make other Medicare changes. We don't want to be restricted to means testing.

Third, this should be considered broad health care reform, at least Medicare reform, and not be isolated in this case. LEGISLATIVE OUTCOME:Amendment rejected, 42-56

Voted NO on allowing tribal Indians to opt out of federal healthcare.

TRIBAL MEMBER CHOICE PROGRAM: Members of federally-recognized Indian Tribes shall be provided the opportunity to voluntarily enroll, with a risk-adjusted subsidy for the purchase of qualified health insurance in order to--
1. improve Indian access to high quality health care services;
2. provide incentives to Indian patients to seek preventive health care services;
3. create opportunities for Indians to participate in the health care decision process;
4. encourage effective use of health care services by Indians; and
5. allow Indians to make health care coverage & delivery decisions & choices.

SUPPORTER'S ARGUMENT FOR VOTING YES:Sen. COBURN: The underlying legislation, S.1200, does not fix the underlying problems with tribal healthcare. It does not fix rationing. It does not fix waiting lines. It does not fix the inferior quality that is being applied to a lot of Native Americans and Alaskans in this country. It does not fix any of those problems. In fact, it authorizes more services without making sure the money is there to follow it.

Those who say a failure to reauthorize the Indian Health Care Improvement Act is a violation of our trust obligations are correct. However, I believe simply reauthorizing this system with minor modifications is an even greater violation of that commitment.

OPPONENT'S ARGUMENT FOR VOTING NO:Sen. DORGAN: It is not more money necessarily that is only going to solve the problem. But I guarantee you that less money will not solve the problem. If you add another program for other Indians who can go somewhere else and be able to present a card, they have now taken money out of the system and purchased their own insurance--then those who live on the reservation with the current Indian Health Service clinic there has less money. How does that work to help the folks who are stranded with no competition?

LEGISLATIVE OUTCOME:Amendment rejected, 28-67

Voted YES on adding 2 to 4 million children to SCHIP eligibility.

Proponents support voting YES because:

Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:

1. It terminates the coverage of childless adults.
2. It targets bonus payments only to States that increase enrollments of the poorest uninsured children, and it prohibits States from covering families with incomes above $51,000.
3. It contains adequate enforcement to ensure that only US citizens are covered.

Opponents recommend voting NO because:

Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:

• On illegal immigration: Would the verification system prevent an illegal alien from fraudulently using another person's name to obtain SCHIP benefits? No.
• On adults in SCHIP: Up to 10% of the enrollees in SCHIP will be adults, not children, in the next 5 years, and money for poor children shouldn't go to cover adults.
• On crowd-out: The CBO still estimates there will be some 2 million people who will lose their private health insurance coverage and become enrolled in a government-run program.

Veto message from President Bush:

Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.

Voted YES on requiring negotiated Rx prices for Medicare part D.

Proponents support voting YES because:

This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.

It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.

Opponents support voting NO because:

Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.

Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.
Status: Cloture rejected Cloture vote rejected, 55-42 (3/5ths required)

Voted NO on limiting medical liability lawsuits to $250,000.

Proponents of the motion recommend voting YEA because:
• Many doctors have had to either stop practicing medicine due to increased insurance premiums.
• Patients are affected as well--due to rising malpractice rates, more and more patients are not able to find the medical specialists they need.
• The cost of medical malpractice insurance premiums are having wide-ranging effects. It is a national problem, and it is time for a national solution.
• I am pleased that S. 22 extends liability protections to all health care providers and institutions.
• These bills are a commonsense solution to a serious problem, and it is time for us to vote up or down on this legislation.

Opponents of the motion recommend voting NAY because:
• We have virtually no evidence that caps on economic damages will actually lower insurance rates. And in my view, these caps are not fair to victims.
• If we want to reduce malpractice insurance premiums we must address these problems as well as looking closely at the business practices of the insurance companies. What we shouldn't do is limit the recovery of victims of horrible injury to an arbitrarily low sum.
• This is obviously a complicated issue. This is the kind of issue that needs to be explored in depth in our committees so that a consensus can emerge. So I will vote no on cloture, and I hope that these bills will go through committees before we begin floor consideration of this important topic.

Voted YES on expanding enrollment period for Medicare Part D.

Voted YES on increasing Medicaid rebate for producing generics.

Voted YES on negotiating bulk purchases for Medicare prescription drug.

Voted YES on $40 billion per year for limited Medicare prescription drug benefit.

Voted YES on allowing reimportation of Rx drugs from Canada.

Voted YES on allowing patients to sue HMOs & collect punitive damages.

Voted NO on funding GOP version of Medicare prescription drug benefit.

Voted YES on including prescription drugs under Medicare.

Voted NO on limiting self-employment health deduction.

Voted YES on increasing tobacco restrictions.

Voted NO on Medicare means-testing.

Voted YES on blocking medical savings acounts.

Invest funds to alleviate the nursing shortage.

• Amends Medicare to provide for nurse education training payments to qualified entities.
• Amends Medicaid to temporarily increase the matching rate for Medicaid nurse aide training and competency evaluation programs.
• Amends the Internal Revenue Code to provide for the exclusion from gross income of amounts received under the National Nursing Service Corps Scholarship Program.
• Amends the Public Health Service Act to: (1) develop and issue public service announcements that advertise and promote the nursing profession, highlight the advantages and rewards of nursing, and encourage individuals from diverse communities and backgrounds to enter the nursing profession; and (2) award grants to designated eligible educational entities in order to increase the number of nurses.
• Establishes a National Nurse Service Corps Scholarship program that provides scholarships to individuals seeking nursing education in exchange for service by such individuals in areas with nursing shortages. Authorizes appropriations.

Let states make bulk Rx purchases, and other innovations.

To: The Honorable Tommy G. Thompson, Secretary, Department of Health & Human Services

Dear Secretary Thompson:

As you know, prescription drug costs have been surging at double-digit rates for the last six years. The average annual increase 1999 through 2003 was a massive 16%, seven times the rate of general inflation.

These increases fall hardest on senior citizens and the uninsured. Their health needs are often great, and their low incomes often make these products unaffordable. They have no ability to use their combined purchasing power to negotiate reasonable prices. Taxpayers pay tens of billions of dollars for the purchase of drugs by Medicaid—an expense that could be reduced significantly if states are permitted to negotiate for the best prices from drug manufacturers.

As you know, the Supreme Court has just ruled that Maine's innovative program to reduce prescription drug costs for the uninsured and senior citizens is not a violation of the Medicaid law. As a result of this decision, Maine can use the combined buying power of Medicaid and individuals purchasing drugs on their own to negotiate lower prices with drug manufacturers. Twenty-nine other states supported the position taken by Maine, and there is broad interest in many states in initiating similar programs.

The Supreme Court's ruling, however, left open the possibility that if the Department of Health and Human Services makes a finding that the Maine program violates the Medicaid statute, the Department's action would be upheld by the Court. We urge you not to intervene to block Maine's program or similar statutes in other states that achieve savings for taxpayers, the elderly, and the uninsured. Such programs must be carefully implemented to assure that the poor are not denied access to needed drugs, but there is no justification for the federal government to deny states the ability to negotiate lower drug prices on behalf of their neediest citizens.

Rated 100% by APHA, indicating a pro-public health record.

The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.

The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.

End government propaganda on Medicare bill.

Recently, the U.S. Department of Health and Human Services (HHS), through a public relations firm, distributed Video News Releases (VNRs) to numerous local television news stations across the country. These VNRs contain pre-scripted news story packages and B-Roll designed to influence local news station to run stories complimentary of the new Medicare law recently signed by President Bush. However, these VNRs may mislead many news stations because they do not identify that they are produced by the government. In addition, these materials are currently being evaluated to determine whether they are illegal "covert propaganda."

We urge you to immediately warn stations not to use these materials and pull any stories that use them.

These tapes can be identified as follows: Two English-language versions begin with B-Roll of video slides promoting the new Medicare law, followed by interview soundbites from Tommy Thompson, Secretary of the Department of Health and Human Services and Leslie Norwalk, Acting Deputy Administrator of the Centers for Medicare and Medicaid (CMS). Following these soundbites, a complete television news package is run, with a voice-over by a fictional reporter named "Karen Ryan." Following the news package, more B-Roll is provided, including scenes of President Bush's rally at the signing of the bill, scenes from a pharmacy and scenes of seniors playing table games.

It is critical to the credibility of an independent news media that covert government propaganda be rejected for use by news organizations. We also believe that honest government should not resort to such deceptive tactics, and it is our belief that these materials violate the above-mentioned Federal law. Thank you for your cooperation with this request.

Establish a national childhood cancer database.

Conquer Childhood Cancer Act of 2007 - A bill to advance medical research and treatments into pediatric cancers, ensure patients and families have access to the current treatments and information regarding pediatric cancers, establish a population-based national childhood cancer database, and promote public awareness of pediatric cancers.

Authorizes the Secretary to award grants to childhood cancer professional and direct service organizations for the expansion and widespread implementation of:
1. activities that provide information on treatment protocols to ensure early access to the best available therapies and clinical trials for pediatric cancers;
2. activities that provide available information on the late effects of pediatric cancer treatment to ensure access to necessary long-term medical and psychological care; and
3. direct resource services such as educational outreach for parents, information on school reentry and postsecondary education, and resource directories or referral services for financial assistance, psychological counseling, and other support services.

Preserve access to Medicaid & SCHIP during economic downturn.

A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn.

• Economic Recovery in Health Care Act of 2008 - Prohibits finalizing, implementing, enforcing, or otherwise taking any action, prior to April 1, 2009, on any changes to Medicaid programs or State Children's Health Insurance Program (SCHIP).
• Amends the U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007 to extend through April 1, 2009, the moratorium relating to the cost limit for providers.
• Amends the Medicare, Medicaid, and SCHIP Extension Act of 2007 to extend through April 1, 2009, the moratorium relating to rehabilitation services, school-based administration, and school-based transportation.
• Provides for state fiscal relief through a temporary increase of Medicaid federal medical assistance percentage (FMAP).

Disclose payments from manufacturers to physicians.

An amendment to provide for transparency in the relationship between physicians and applicable manufacturers with respect to payments and other transfers of value and physician ownership or investment interests in manufacturers.
• Requires any manufacturer of a covered drug, device, biological, or medical supply that makes a payment or another transfer of value to a physician, a physician medical practice, or a physician group practice to report annually, in electronic form, specified information on such transactions to the Secretary of Health and Human Services.
• Requires any such manufacturer, or related group purchasing organization, also to report annually to the Secretary, in electronic form, certain information regarding any ownership or investment interest (other than in a publicly traded security and mutual fund) held by a physician (or an immediate family member) in the manufacturer or group purchasing organization during the preceding year.
• Prescribes administrative penalties for failure to comply with these requirements.
• Requires report submission procedures to ensure public availability of required information on a website.

Expand the National Health Service Corps.

A bill to achieve access to comprehensive primary health care services for all Americans and to reform the organization of primary care delivery through an expansion of the Community Health Center and National Health Service Corps programs. Amends the Public Health Service Act to:
1. increase and extend the authorization of appropriations for community health centers and for the National Health Service Corps scholarship and loan repayment program for FY2010-FY2015, and provide for increased funding for such programs in FY2016 and each subsequent fiscal year; and
2. revise and expand provisions allowing a community health center to provide services at different locations, adjust its operating plan and budget, enter into arrangements with other centers to purchase supplies and services at reduced cost, and correct material failures in grant compliance.

Collect data on birth defects and present to the public.

Directs the Centers for Disease Control and Prevention to carry out programs to:
• collect and analyze, and make available data on the causes of birth defects and on the incidence and prevalence of such defects;
• operate regional centers for the conduct of applied epidemiological research on the prevention of such defects;
• provide information and education to the public on the prevention of such defects;
• collect and analyze data by gender and by racial and ethnic group9/6/2004
• collect such data from birth and death certificates, hospital records, and such other sources; and
• (3) encourage States to establish or improve programs for the collection and analysis of epidemiological data on birth defects and to make the data available.