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House Proceeding 06-11-09 on Jun 11th, 2009 :: 2:33:40 to 2:48:20
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Allyson Y. Schwartz

2:33:39 to 2:33:59( Edit History Discussion )

Allyson Y. Schwartz: i rise this even what i hope will be a special order on a time with my colleagues. it's a little earlier than we thght so we are going to see as they make their way to the floor. hopellthey'll be joining me. as you know there has been a great deal of discussioabout health care reform. we just heard a special order

Allyson Y. Schwartz

2:33:40 to 2:48:20( Edit History Discussion )
Speech By: Allyson Y. Schwartz

Allyson Y. Schwartz

2:34:00 to 2:34:20( Edit History Discussion )

Allyson Y. Schwartz: from my colleagues on the other side of the aisle talking about health care reform and some of their thoughts about it. and i think sometimes we focus very much on controversial issues and some of the difficult decisions we have to make as we move forward to make sure when we start with what we are trying to do on health care reform on this. but we want to talk about

Allyson Y. Schwartz

2:34:21 to 2:34:41( Edit History Discussion )

Allyson Y. Schwartz: tonight some of the very important work we want to do as we really meet the president's goals. he's laid out to us the goals for health care reform and they are really three hold. they are to make sure that we contain costs. the fact that our businesses have said to us that cost of health coverage,

Allyson Y. Schwartz

2:34:42 to 2:35:04( Edit History Discussion )

Allyson Y. Schwartz: providing health benefits for their employees, is -- has gone up almost double digits every year. what that means is that we have doubled the number of -- the cost of healtcare benefits to our companies in the last 10 years. . that's unsustainable for busisses, whether they're

Allyson Y. Schwartz

2:35:05 to 2:35:27( Edit History Discussion )

Allyson Y. Schwartz: small businesses trying to be economically competitive in their community or large businesses functions -- functioning in the global marketplace and are competing with countries where health care is not an employer's responsibility and costs are more controlled. we know it's an economic competitive issue, no question about that. we also know it is an issue for

Allyson Y. Schwartz

2:35:28 to 2:35:48( Edit History Discussion )

Allyson Y. Schwartz: government, that i serve on the budget committee, the cost we talk about this, for medicare is unsustainable, if we don't do a better job of containing costs and improving quality and improving outcomes for our seniors, we're going to talk more about this this evening. it's also a huge problem for our families.

Allyson Y. Schwartz

2:35:49 to 2:36:09( Edit History Discussion )

Allyson Y. Schwartz: hear all the time from our constituents about family who was a break in coverage and find themselves faced with buying a family ol policy with a preexisting condition and the cost of that pa policy if they find one is too gh for them to afford. in the philadelphia area, a

Allyson Y. Schwartz

2:36:10 to 2:36:31( Edit History Discussion )

Allyson Y. Schwartz: decent family policy costs from $12,000 to $15,000 a year. a family earning even $50,000 a year, after paying their mortgage and paying their expenses and maybe trying to save something for the children to go to college and it's -- taxes locally and state -- don't have those kinds of

Allyson Y. Schwartz

2:36:32 to 2:36:52( Edit History Discussion )

Allyson Y. Schwartz: dollars left for them to find $12,000 to buy a decent policy. they are completely shut out. which is a very signifant problem when they want to go for health coverage. we know cost is absolutely a major issue for our businesses, families, and government. what can we do about it?

Allyson Y. Schwartz

2:36:53 to 2:37:13( Edit History Discussion )

Allyson Y. Schwartz: how can we ensure we'll contain costs and improve quality and extend coverage to the 47 million or 48 million americans who do not have ongoing health insurance coverage. the fact is we can do numbers of things. we have been working hard on this to make sure we create the kind of market reforms that will enable people to buy

Allyson Y. Schwartz

2:37:14 to 2:37:34( Edit History Discussion )

Allyson Y. Schwartz: meaningful coverage that's -- that is -- which is affordable for them and will have the kind of coverage that matters. we know we need to make changes in the delivery system. that's what we're hoping to focus on tonight. what i mean by that for all of us who go to see doctors and nurses and spend time at all in

Allyson Y. Schwartz

2:37:35 to 2:37:55( Edit History Discussion )

Allyson Y. Schwartz: the doctor's office for ourselveses or our loved ones, our numbers bear this out, we go to more specialists, we have fragmented care. what we don't have is access to primary care provider who knows us, who follows us, works with us when we get a serious disease, helps us know what it

Allyson Y. Schwartz

2:37:56 to 2:38:17( Edit History Discussion )

Allyson Y. Schwartz: is that we need to be doing, helps us comply with recommendations, and really also helps us know whether we need to see specialists. so whether you're fairly healthy or have a major health care crisis or a chronic ds we know you we can get better quality care and improve health

Allyson Y. Schwartz

2:38:18 to 2:38:38( Edit History Discussion )

Allyson Y. Schwartz: status for all of us, each of us, but also contain costs. i'm happy to give you some of the numbers that we have in terms of some of the primary care shortages. we often talk about primary care physicians but we also have a shortage of nurses, nurse practitioners, and physicians assistants and so

Allyson Y. Schwartz

2:38:39 to 2:39:00( Edit History Discussion )

Allyson Y. Schwartz: many providers that are there for us but there's not enough of them the council on physician and nurse supply says the u.s. may lack as many as 200,000 needed physicians by 2020. here we are saying that we want you to see a primary care physician or nurse practitioner, look at the massachusetts experience where

Allyson Y. Schwartz

2:39:01 to 2:39:22( Edit History Discussion )

Allyson Y. Schwartz: they worked very hard and effectively to extend coverage to the uninsured, what they found is people were still going to the emergency room because there simply were not enough primary care providers or clinics or community health centers for them to go to. let me go on with other numbers, if i may. they estimate ther shortage of 800,000 nurses by

Allyson Y. Schwartz

2:39:23 to 2:39:43( Edit History Discussion )

Allyson Y. Schwartz: 20. 46,000 of those fi zigs need to be primary care providers. the number of uninsured rose but the number of medical school graduate -- the number

Allyson Y. Schwartz

2:39:44 to 2:40:05( Edit History Discussion )

Allyson Y. Schwartz: -- there was a 30% growth in population and the number of physicians were the same. what's so interesting about that, we've heard, we have enough physicians but it's not in the right place. we've gotten that wrong. there are not enough primary care physicians or other practitioners. more interestingly, we may want to say that the number of medical students choosing

Allyson Y. Schwartz

2:40:06 to 2:40:28( Edit History Discussion )

Allyson Y. Schwartz: primary care is steadily declining. even amongst those specializing in internal medicine, i'll say that in 1985, half of all internal medicine ridents chose primary care. now, only 20% do. i was at a press conference this morning with congresswoman kathy castor and congressman john sarbanes and a young woman

Allyson Y. Schwartz

2:40:29 to 2:40:52( Edit History Discussion )

Allyson Y. Schwartz: who just graduated from osteopathic school she talked about the statistics and she said that most medical school $200,000 in debt. their first job is a resident still traing, is usually paid at $40,000. how do you train for another

Allyson Y. Schwartz

2:40:53 to 2:41:13( Edit History Discussion )

Allyson Y. Schwartz: three or four yrs, pay $200,000, that's medical school, you may have debt from college as well. it's a major issue going forward to make sure we have more primary care physicians. older americans also are seeking primary care services twice as often as other age groups. as the aging population we know the baby boomers are come, we

Allyson Y. Schwartz

2:41:14 to 2:41:34( Edit History Discussion )

Allyson Y. Schwartz: talk about them in terms of social security, but the fact is we know as we are aging and needing more health services, it is in-- it is very, very important for us to have access to primary care providers. let me also talk about the fact that one of the reasons we need primary care providers, all of us, but particularly those with

Allyson Y. Schwartz

2:41:35 to 2:41:56( Edit History Discussion )

Allyson Y. Schwartz: chronic conditions, we think about needing health care when we get sick, an episodic experience where we need to go to the hospital, might end up in the emergency room, many people, they have chronic conditions. and they need to have an ongoing relationship with health care providers. so that they can get the kind of care they need, get the kind

Allyson Y. Schwartz

2:41:57 to 2:42:17( Edit History Discussion )

Allyson Y. Schwartz: of advice, get the right prescriptions and be able to work with their medical practitioners to be able to comply with that advice and be able to make sure that they are healthy. the number out there is 50% of americans who get health care comply with recommended health care they're told to comply with.

Allyson Y. Schwartz

2:42:18 to 2:42:38( Edit History Discussion )

Allyson Y. Schwartz: so obviously we need some work here. this is not only the responsibility of those who pay for health services and those provided but for patients as well. let me say on chronic conditns, some of these numbers may surprise us. but the five most costly chronic conditions are

Allyson Y. Schwartz

2:42:39 to 2:43:00( Edit History Discussion )

Allyson Y. Schwartz: cardiovascular disease, cancer, diabetes, asthma, and mental health disorders. over 133 million americans suffer from at least one of these chronic diseases. over 75% of all medicare expenditures can be attributed to patients with five or more chronic conditions. just 10 years ago, these

Allyson Y. Schwartz

2:43:01 to 2:43:23( Edit History Discussion )

Allyson Y. Schwartz: beneficiaries counted for only 50% of the medicare costs. so something'srong. we have to fix this problem. we have to make sure that people can hopefully prevent some of these chronic diseases we might want to do that in a number of ways. i know there's discussion about wellness programs for prevention, we've seen some

Allyson Y. Schwartz

2:43:24 to 2:43:44( Edit History Discussion )

Allyson Y. Schwartz: very good models, some larger employers and insurance companies are working harder to incentivize people to eat right, exercise, prevent some of the worsening. but clearly we have a long way to go and we have much work to do to make sure we help folks with chronic diseases be able to be healthier to get better

Allyson Y. Schwartz

2:43:45 to 2:44:06( Edit History Discussion )

Allyson Y. Schwartz: to not have the disease get any worse and of course in that process, it'll save them and it'll save all of us the high cost of taking care of patients. any of us who ever visited a renal dialysis cent every know if we can do more to make sure that somebody who, for example,

Allyson Y. Schwartz

2:44:07 to 2:44:28( Edit History Discussion )

Allyson Y. Schwartz: is early diagnosis of diabetic, follows the prescribed treatment, does trto eat right, exercise, really take care of themselves and gets good, consistent health care, d can prevent themselves from becoming more seriously ill and of course going into any kind of renal failure and needing

Allyson Y. Schwartz

2:44:29 to 2:44:49( Edit History Discussion )

Allyson Y. Schwartz: renal dialysis would save them much problem and save us all a lot of the cost involved. just a f more numbers, i think they're telling. chronic conditions cost american businesses nearly $1 trillion each year in lost productivity. we don't think about the 234ur78 of dollars lost as workers take time off for

Allyson Y. Schwartz

2:44:50 to 2:45:10( Edit History Discussion )

Allyson Y. Schwartz: serious illnesses. about $125 billion of this is due to lost work days. the balance is due to diminished capacity while they're at work. it's insurance and benefits but there's also a cost when their own workers are not being able to really work at the full scale of their potential and

Allyson Y. Schwartz

2:45:11 to 2:45:32( Edit History Discussion )

Allyson Y. Schwartz: their capacity. so we node that we can do more. economic conditions, health benefits, really taking serious action to make sure that we have enough primary care providers and do a much better job of coordinating care for those with chronic diseases, we'll really have a dramatic

Allyson Y. Schwartz

2:45:33 to 2:45:54( Edit History Discussion )

Allyson Y. Schwartz: impact on americans and the cost to all of us. that's what we're going to do. we heard some others talking about e need to do medical research. we believe strongly in that. we've made very, very good commitment to doing that by putting more money into that by putting $10 million more into n.i.h. in the recovery and reinvestment act.

Allyson Y. Schwartz

2:45:55 to 2:46:16( Edit History Discussion )

Allyson Y. Schwartz: we do want to see better treatment and cures. that takes dollars for medical research and a commitment to the science of biomedical research and some new products and devices. it also takes prevention and it also takes better coordination of care. we -- patients with chronic diseases need access to primary care providers.

Allyson Y. Schwartz

2:46:17 to 2:46:40( Edit History Discussion )

Allyson Y. Schwartz: we need to be able to make sure they get good ongoing chronic disease management. i've introduced legislation, it's house bill 2350, and i have to say it's got enormous support here in the house. 100 co-sponsor, i'm very proud of that and many other looking at it, only introduced it a couple of weeks ago. the idea of that legislation is

Allyson Y. Schwartz

2:46:41 to 2:47:03( Edit History Discussion )

Allyson Y. Schwartz: to make sure that we preserve patient access to primary care and one way to do that is to increase the number of primary care providers by increasing the number of residency programs slots for primary care. we're going to hopefully do that and for more nurse practitioners and more nurses in this country would be very,

Allyson Y. Schwartz

2:47:04 to 2:47:25( Edit History Discussion )

Allyson Y. Schwartz: very helpful. see if a colleague of mine is going to join us, just finish this thought, we also want to -- there's reimbursement for a concept called medical home. this isn't a place, it's a group of services, a commitment on behalf of the provider, the doctors doctor, nurse

Allyson Y. Schwartz

2:47:26 to 2:47:47( Edit History Discussion )

Allyson Y. Schwartz: practitioner, to be able to provide a medical home so you know you have ongoing care, particularly when you have a chronic disease and we can talk more about that going forward. i did want to thank my colleague for joining me, i see congressman amount mire has joined us, he's also from pennsylvania, the other side of the state. also a community, pittsburgh, which is known for its medical

Allyson Y. Schwartz

2:47:48 to 2:48:08( Edit History Discussion )

Allyson Y. Schwartz: care and medical schools and has a lot of health care providers. i bet and would imagine that congressman altmire has some of the same experiences i do, while we have great quality health care, it is also too often fragmented, too often not accessible, it's too often not affordable for too many of our constituents.

Allyson Y. Schwartz

2:48:09 to 2:48:21( Edit History Discussion )

Allyson Y. Schwartz: so we're here tonight to talk about health care reform and particularly the commitment we're making as we move forward to expand and extend access to more americans to make it more

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