PERSONAL CARE COMMUNITY: NATIONAL HEALTHCARE REFORM

While there may be a number of serious concerns w/respect to all 5 Federally proposed Legislative Initiatives, ANY viable National Healthcare Reform Scenario must address ALL of the following:

1. PROSPECTIVE FUNDING: we need an incremental, cautious & carefully crafted budget that guarantees Tax-payers that this 1-1.5 TRILLION dollar expenditure:
* WILL NOT add to the National deficit (current projections up from 7.1 Trillion to 10 trillion over the next 10 years)
* WILL NOT burden the next 2-3 generations w/outrageous debt
* WILL NOT raise taxes either for businesses (large or small), or for Individuals (either "Affluent" or not)

2. PROVIDER PAYMENTS: we need to be assured that our Provider Community (Doc's, Hospitals, speciality Providers et al) WILL NOT suffer undue fiscal harm due to Federal oversight &/or administration of a "Public Health Plan &/or Co-op":
*Providers' currently receive anywhere from 61-91% of the healthcare dollar from Government run plans, while cost shifting is up to 130% to the Private Marketplace

3. A CLEAR DEFFINITION OF WHO ARE THE "UNINSURED", numbers range from 8 Million to 50 Million
*are they actually UNINSURED;
*are they Under-insured;
*are they those who have chosen to NOT participate in their employer's plans;
*are they individuals who simply rely upon the "Pro-bono" generosity of our local providers & tax-payers
*what % of this number may be attributable to "illegal-aliens"

4. Do we have enough PCP resources to accommodate the surge of newly insureds' ??
*Lesson form Mass. re:Mandated Individual Healthcare, the state didn't have an adequate # of PCP's, Nurses, Family Practice Docs resulting in overwhelmed (closed to new patients)
Physician practices & longer ER waiting time
*U.S. enrollment in Family Practice Med. school students has dropped 52% since 1997: most have gravitated to higher paying Specialties
*PCP shortage by 2010 is expected to be approx. 40,000

5. Recommendations for reform:
*Level the Private marketplace playing field: remove all pre-ex. clauses from all Group & Individual contracts
*Provide for Portability of all Contracts
*Offer a greater variety of choice down to the Individual/Employee level
*Unilaterally remove lifetime caps.
*Handle Medicare deficit separately