2. Identify three biggest problems with health care system today.
Miceli: Portability — keep same coverage between agencies and jobs. Standardization of coverage. Businesses should be able to buy into pools like GIC. On national level we have nothing like that. Maybe single-payer option should be something to look at.
Eldridge: Solution to portability is universal health coverage. I was Legal Aid lawyer — many clients went into medical bankruptcy. Cost: Ch. 58 doesn’t control costs. In US, we spend far more on health care than anyplace else. Profits: have no place in health care (applause). Tsongas worries about profits for private health care companies. Imagine taking Fallon’s profits and preventing infant mortality.
Tsongas: We have problem with covering uninsured. Cost of insurance will go down when we have everyone in the system and provide preventative care. Need to get everyone covered now — as under Edwards plan. Nursing shortage.
Finegold: 18,000 die each year b/c they can’t get care. Cost of prescription drugs — drug companies spent 4.5 billion on drug advertising. We need to do better — that $ should be in R&D. Stop using ER as primary care. More preventative care.
Donoghue: Preventative care — get people coverage as quickly as possible. Focus has gone from patient care and safety to making money. Why do we have to buy drugs from Canada? Non-profits are making money too — MGH makes money.
Mitchell — impressed that candidates have done their homework.
3. Drugs: Fast-tracking of new drugs by FDA sounded like a good idea — was it?
Tsongas: Not under this current FDA. Maybe under different leadership … not now.
Finegold: Need to streamline, but no.
Donoghue: Vioxx was terrible example — given us pause.
Miceli: No for me too — but people do need access to experimental drugs.
Eldridge: No. Support bulk purchasing of prescription drugs.
4. Avian flu?
Finegold:I would vote for more $, prevention, education. Pushed for it at state level.
Donoghue:Need to stockpile beds and necessities. We can’t sustain a surge.
Miceli: Look at Katrina — no transparency of responsibility. Need to know who’s in charge.
Eldridge:Need to have FDA go to places where poultry is produced. Stockpile drugs. Be proactive, expand public health infrastructure. Provide for revenue.
Tsongas:Avian flu is coming — we don’t know when. Shared responsibility. Middlesex CC has aggressively considered what to do — that’s how we need to act.
#5: Tort reform?
Donoghue: Not too concerned. We have many deaths due to avoidable medical error. Depends on details, but it’s not the cause of our crisis.
Miceli: Doctors practice defensive medicine. I don’t want to shut anyone out. But sometimes folks aren’t getting the best care. Maybe we could have a schedule for holding docs harmless.
Eldridge: Under single-payer, docs will provide less defensive care. Fully re-imburse docs.
Tsongas: Create culture of safety — doesn’t single out doc but be guided on safety and appropriate care. But docs need to be held accountable.
Finegold: Need to stop frivolous lawsuits; need to control malpractice insurance rates. Need to keep OB/GYN’s here.
#6: What part of cost problem lies with doctors?
Miceli: A good part — defensive medicine. Docs inhibited from giving correct care.
Eldridge: Dont’ think it’s docs problem. Too many admin costs in system, reduce defensive medicine.
Tsongas: Docs instinct is to offer every service — but some aren’t effective. We need a best-practices institute.
Finegold: We need to fund health care better — docs are running around too much.
Donoghue: System needs re-alignment of incentives to provide good care.
Eldridge:I support Roe v. Wade — we need a Democratic president.
Tsongas: I support Roe v. Wade. EMILY’s list has recognized me as pro-choice woman.
Finegold: Appalled by SC decision.
Miceli: I am a pro-life candidate.
#8: Medical marijuana?
NT: Yes. Decriminalize small amounts, not legalize.
BF: Yes, with good distribution.
ED: No. Look to other drugs like Marinol.
JM: No. How do you control it?
JE: Yes. Gov’t should not limit how docs treat patients, just trying to ease pain. Fully support.
#9: Support Bush policy on stem cells?
BF: No. Fully fund.
JM: No. Need to explore with even more depth.
JE: No. Our president values stem cells more than a human being. I have a friend with cystic fibrosis — we could help cure this disease.
NT: No — signed letter to Pres to sign Stem Cell Research Act.
#10: Needle exchange programs?
ED: Not sure — look to MA plan for info on success or failure.
JE: Yes — science shows it reduces HIV, TB. Use science, not ignore like Bush admin.
NT: There’s been needle exchange in four communities — police support. Expand pilot programs to other places.
BF: Yes. Police and firefighters support.
#11: Drug reimportation from Canada?
NT: Yes, with standards.
BF: No — do it ourselves — cut prices in US.
ED: Yes — support Kennedy and Emanuel’s bill.
JE: No. GOP talking point.
BF: Not a substitute for health care coverage.
ED: No. You’re treating sickness, not wellness.
JM: Absolutely not. Came close to that in Bush I with Golden Rule. That would be an absolute disaster.
#13: Medicare and VA is effective and efficient. Private is not. Why is debate focused on the market?
NT: We have to contend with political realities — Truman filed legislation in 1945. We have emerging consensus based on MA plan. Cost is inextricably linked. Get everyone in the system, for prevention. We need Dem president to do just that.
BF: With Health Markets, you’ll have choice between public and private plans. I’m a business owner — trying to figure out plans takes a lot of time.
ED: VA and Medicare are good models, but political will isn’t there. There are cuts proposed for Medicare which would affect small hospitals. Need to get everyone covered quickly.
JM: Everything has to be available, on the table.
JE: We’re not going down there to accept political reality — we’re going down to provide leadership. Medicare is more efficient. MA plan is good, but doesn’t reduce costs, many are exempted, and premiums and co-pays are too high for working people.
Mitchell: We’re doing the best we can [laughing].
#14: Anybody *not* think gov’t should negotiate with drug co’s under Medicare Part D?
#15: Medicare doesn’t recognize same-sex couples. What would you do to protect them?
BF: I would support any legislation to get them benefits.
ED: Strong supporter of marriage equality. Provide legislation as necessary.
JE: Yes, I support marriage equality in MA House. Still couples in MA who are married but don’t get benefits b/c of DOMA. Meehan has gone against that — I’ll take up the lead.
NT: Supporter of marriage equality, on federal level, also Don’t Ask Don’t Tell, all rights that straight couples receive.
#16: Mental health, esp. for vets?
ED: Promise that 1st act will be updated GI Bill of Ri
ghts. It’s a disgrace the way they’re being treated — jobs, benefits.
BF: Mental illness affects 26% of people — we need to destigmatize. Applaud Sen. Antonioni. Make sure insurance covers mental illness. Have to make sure vets get proper help.
NT: Need to take care of those w/ mental illness. Puts tremendous pressures on people. Vets: Great travesty of Bush administration — no planning for taking care of returning vets. PTSD, physical care — has to be there, lifetime commitment.
JE: Proud to be MA resident and legislator: We have mental health parity mandate. Federal level: Single-payer. Provide mental health services. Highest increases in prison population are mentally ill. Suicides. We need mental rehab for them.
JM: We need new GI Bill with full benefits. Walter Reed was disgrace. I’d go farther: Fought for Tewksbury hospital. Not happy with what’s done on nat’l level. Definitely pro-parity.
JM: Longest serving – 16 terms. I’m good at constituent services — office hours, town meetings, people call me up. I’ve got the experience, I know what it’s all about. I’ve built a business with great health care benefits. I would do an outstanding job for you.
JE: There have been a lot of great proposals, but the only proposal that guarantees right to health care is National Health Insurance bill. For benefit of all of society. This isn’t about political reality, it’s about political leadership. It’s important to point out the differences: shouldn’t expand through marketplace. I don’t care if HMO’s have profits — that’s what’s damaged people. I’m only Clean Elections candidate ever elected to House — voted against Finneran.
NT: It’s time for a change in tone and direction: Health care is about people. We have an opportunity to put in system, first since Truman in 1945. Health care for every American. I believe in Massachusetts’ extraordinary health care system, from which I’ve benefited. Bring costs under control, but must first provide coverage to all. Stem cell research. Address nursing shortage.
BF: Would have district office in Hudson, as well as Lowell, Lawrence and Haverhill. Believe HC is a right, health markets will help us get there. Prevent cos from refusing coverage for pre-existing conditions. Ban drug advertising. I don’t want gov’t to make decisions between docs and patients — nor an HMO.
ED: Single-payer in ideal world would be way to go. I would fight for that in Washington. But leadership is getting results. Since 1993, what has happened? 10 million more uninsured. Doubled cost per family. Can’t wait another 15 years. In the meantime we get access to coverage as quickly as possible. Cover all kids under SCHIP; cover working poor under Medicare. Make employer coverage mandatory. 75% of health care $ are for diabetes, heart and obesity. Have to provide universal access. Needs massive reform to prevent massive gaming. Not defeatist, not shirking leadership — shows leadership. I have struggled with budgets — frustrating to see health care eating budgets. Have to work on all fronts.