There is a broad consensus that our health care system needs reform. It consumes huge financial resources at the national and state levels, delivers uneven care, buries doctors and patients in mounds of paper work, and puts our country at a competitive disadvantage for attracting and retaining businesses and workers. The solutions are controversial and wide ranging, but I believe any reform must satisfactorily answer four questions:
1. How do we provide access to care, especially for our most vulnerable citizens?
2. Who decides the medical procedures to be prescribed?
3. How do we provide competition and contain the costs?
4. What can we do to organize and deliver medical services more efficiently?

A national debate on how to answer these questions has raged for decades, and many administrations have learned that it is among the most complicated and contentious issues to address. In Virginia, one in seven citizens lacks health insurance coverage, and the costs to our Commonwealth continue to escalate. At the same time, our Medicaid reimbursement rates are among the lowest in the nation. We have taken action on a number of concerns and others are being considered through studies and commissions, but more needs to be done.

This past session of the General Assembly, I voted for two bills to help small businesses deal with health care costs. One will help small businesses offer extended COBRA benefits to their employees, and another exempts them from having to include state mandated health insurance benefits in their group policies or contracts. Each of these measures will help our many small businesses remain viable, especially in this difficult economic climate. Other initiatives and policies will help, and I offer five.

• I believe it is important to retain the medical malpractice cap at the current $2 million. The escalating cost of insurance is driving the best and brightest physicians out of the practice, just as the largest demographic in the country ages into greater need.

• We should harness the expertise of the dynamic technology industry here in northern Virginia to lead the state in reforming the organization and delivery of medical information and services. Nothing could be more business friendly or financially prudent than streamlining this industry. We have businesses that provide this service now; let’s provide incentives to them and others to encourage growth in this area.

• We can and should take advantage of public private partnerships in the health care industry to rein in costs. Two examples: the current Remote Area Medical program that served thousands of indigent people in rural Virginia this summer needs to be duplicated in other parts of the state with incentives and expedited licensing procedures to allow additional physicians to participate. The Heirloom Birth Certificate program currently under review allows a voluntary contribution for prenatal and neonatal care. We should follow through and establish this program to help our poorest prospective and new mothers and babies.

• Wellness and prevention programs will not solve our health care crisis, but they can help reduce costs overall. The cost of health care for each person who contracts age-onset type 2 Diabetes, frequently brought on by an individual’s poor diet choices and a sedentary lifestyle, will be about $100,000 during their lifetime. Think how much money we would save if they never contracted it in the first place. We have a “Healthy Schools” initiative to offer information about the importance of nutrition to our students, but we need to be far more directed and forthright in providing better school lunch choices and exercise too. Even modest grants drawn from interest in the Master Tobacco Settlement Fund could have a substantial impact here.

• I believe we must protect funding for our Family Access to Medical Insurance Security (FAMIS) program, and the Medicaid State Children’s Health Insurance Program (SCHIP). We have an obligation to protect the youngest and most vulnerable of our citizens. Mandated spending on Medicaid and children’s health insurance programs is fully funded in the current adopted budget, and stimulus funds have helped control costs, but any reform at the national or state level must protect these two programs.