Health Care Compact Heads to Governor’s Desk in Georgia

The Georgia General Assembly passed the Health Care Compact, making them the second state to send the Compact to its governor. The Compact, introduced in the Senate by State Sen. Charlie Bethel (R-Dalton), would allow Georgia to join a Health Care Compact and provide Georgia the freedom and responsibility to develop health care laws. The Health Care Compact allows consumers more power to make health care decisions by returning funding and authority to state governments.

“Preserving 10th Amendment rights so states can move forward with true health care reform has been a driving force behind support across this nation for this Compact,” said Bethel. “Here in Georgia, we deserve full authority over our health care system to provide the best and most effective services for our citizens. It is our goal to implement free-market initiatives aimed at improving quality, increasing access, and lowering costs of health care for all Georgians. With this compact in place, we are ensured that we can make the decisions best for every person in this state. I thank the House and Senate for their hard work getting this compact passed and I look forward to working with Governor Deal to have it signed into law.”

I along with my conservative colleagues believe that states deserve control over health care goods and services and this Compact will guarantee

The Health Care Compact is an agreement between participating states that restores authority and responsibility for health care regulation to member states. The compact allows member states to create laws that are better suited for the state’s needs, including amendments to the federal health care law passed last year.

Georgia is the second state to send the compact to their governor for signature. The Health Care Compact has been introduced in 12 states and has passed the State House of Representatives in Montana, Missouri, and Arizona and State Senate in Oklahoma and Arizona. In addition, more than 36 states, citizen groups and state legislators are actively considering the Health Care Compact with legislative activity expected in the coming weeks.

The Georgia House version of the compact was introduced by Rep. Rick Jasperse (R-Jasper) and was co-sponsored by Representatives John Meadows (R-Calhoun), Tim Bearden (R-Villa Rica), Terry England (R-Auburn), Roger Williams (R-Dalton), Delvis Dutton (R- Glennville) and others.

The Health Care Compact was introduced by the Health Care Compact Alliance, a nonpartisan organization dedicated to providing Americans more influence over decisions that govern their health care.

“The Health Care Compact gives the health care decision-making power back to the people instead of the bureaucrats in Washington. It allows greater citizen influence, more competition, and more options for health care for millions of Americans,” said Eric O’Keefe, Chairman of the Health Care Compact Alliance. “We would like to thank Sen. Bethel for introducing this important legislation that will provide the citizens of Georgia with greater control over their government and, ultimately, over their health care.”

For the Health Care Compact to become law it must be passed by both houses of the General Assembly, signed by the governor, and approved through Congress. The way health care works in a member state is not prescribed in the compact. Who and what is covered as well as the level of regulation are determined by each state after the compact is ratified.

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Governor Requests Attorney General Join Colleagues in Reviewing Constitutionality of Federal Health Care Bill

Governor Sonny Perdue on December 23 requested Georgia Attorney General Thurbert Baker join colleagues from around the nation in reviewing the Constitutionality of the health care bill under consideration in Congress. At least seven Attorneys General have confirmed that they are looking at several special deals made by Senate leadership to buy the votes of wavering Senators.

“The leadership of Congress, particularly Senate leadership, understands the financial devastation that is looming for states, which is clearly evidenced by the special deals that have been cut for states that have Democratic Senators with wavering support of the reform,” Governor Perdue wrote to Attorney General Baker. “In order to calm the concerns, Senate leadership has granted special exemptions with additional federal dollars to cover the substantial increases in Medicaid costs for a few states while leaving the rest of us to foot the entire bill.”

The special treatment that Senators have won for their states will cost the country’s taxpayers hundreds of millions of dollars, in addition to the billions in state costs that will skyrocket under this bill.

The full text of Governor Perdue’s letter to Attorney General Baker is below:


The Honorable Thurbert Baker
Attorney General of Georgia

Dear Attorney General Baker:

RE: H.R. 3590 - “Health Care Reform”

The debate over healthcare policy in Washington, DC has reached a critical juncture now that 60 Senators have agreed to support the latest bill unveiled by Sen. Harry Reid over this past weekend. Under the House and Senate proposals, state spending on Medicaid will increase dramatically and Governors of both parties have repeatedly objected to the path we appear to be rushing toward. One of my Democratic Governor colleagues even called this bill “the mother of all unfunded mandates.”

The leadership of Congress, particularly Senate leadership, understands the financial devastation that is looming for states, which is clearly evidenced by the special deals that have been cut for states that have Democratic Senators with wavering support of the reform. In order to calm the concerns, Senate leadership has granted special exemptions with additional federal dollars to cover the substantial increases in Medicaid costs for a few states while leaving the rest of us to foot the entire bill. Senator Reid’s recent compromise to obtain the support of Senator Ben Nelson of Nebraska is the most striking example where the federal government would cover one hundred percent of the cost of all newly eligible Medicaid enrollees in just the State of Nebraska. In addition, the health care legislation grants an additional $300 million in Medicaid aid to the State of Louisiana which secured Senator Mary Landrieu’s support – a deal many are calling the new “Louisiana Purchase.”

Yesterday, seven Attorneys General from across the country confirmed that they are looking at the constitutionality of these special deals. As I have considerable concerns over the constitutionality of these recent actions, I respectfully request that you join your colleagues from Alabama, Colorado, Michigan, North Dakota, South Carolina, Texas and Washington state in investigating the constitutionality of these special exemptions in the health care legislation and explore the availability of any legal challenges that Georgia could pursue to oppose this unconscionable scenario.

Congress appears to be on the cusp of making a decision that will have ripple effects for decades to come. Now is the time to ensure that any decision that is made has been thoroughly vetted and deemed to meet the intent and spirit of our country’s Constitution.

Thank you for your attention to this matter.

Sincerely
Governor Sonny Perdue

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CIGNA Offers Assistance to Customers Affected by Georgia Floods

(BUSINESS WIRE)--CIGNA (NYSE:CI) announced today that it is temporarily lifting certain medical and pharmacy restrictions in order to aid individuals impacted by severe flooding in Georgia.

People insured by CIGNA in the affected Carroll, Catoosa, Chattooga, Cherokee, Clayton, Cobb, Crawford, DeKalb, Douglas, Forsyth, Fulton, Gwinnett, Newton, Paulding, Rockdale, Stephens and Walker Counties can refill prescriptions early without prior approval and access care at any health care professional (in-network or out-of-network) at in-network rates.

“The health and well-being of the individuals we serve is our primary concern,” said Susan Gaca, Director, CIGNA Disaster Response Team. “We hope that during times such as this, these actions will provide some relief to those impacted.”

This temporary measure is in place until September 27, 2009 and may be extended if necessary.

Customers with questions or concerns are encouraged to call the customer service phone number on their CIGNA ID card or the CIGNA nationwide customer service telephone number at 1.800.CIGNA24 (1.800.244.6224) for additional information about the waivers.

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One Million Americans - and Counting - Come Out Against President Obama's Health Care Plan

/PRNewswire/ -- The National Center for Policy Analysis (NCPA) and Salem Radio Network announced today the 1 millionth signature on their joint "Free Our Health Care Now" petition calling on Congress to stop the nationalization of the American health care system.

The millionth signature milestone comes just over a week after President Obama reached a million signers on his health reform petition, funded and promoted by the Democratic National Committee's "Organizing for America."

"It seems we have a horserace," said NCPA President and Kellye Wright Fellow John C. Goodman. "This national debate over how best to repair a dysfunctional health care system has evolved into trench warfare between government vs. patient and doctor controlled health care."

The petition, available at www.freeourhealthcarenow.com, was launched on May 25 by Salem Radio Network, with the team of Mike Gallagher, Bill Bennett, Hugh Hewitt, Michael Medved, Dennis Prager and Janet Parshall, who reach millions of listeners each week and cover 90 percent of the United States. The NCPA, a leader in public policy research for over 25 years, provided the content and analysis on almost all facets of the debate, including educational guidance on the framing and substance of the petition itself.

"This is and continues to be an amazing response from a large segment of the American people," explained SRN president Greg Anderson. "Talk radio is at the epicenter of public opinion and citizens from all across the country are making their concerns known loud and clear."

"None of this could have happened without the expertise, acumen and dedication of the NCPA, and its CEO and President, Dr. John Goodman. His knowledge of health care, his experience in policy debate, and the great team he has built at the NCPA all were integral to this great educational success. The more our audience learned about the health care landscape, the more disenchanted our audience became with President Obama's desire for a so called 'public option,' and with his rush to get health care reform completed by the end of the summer."

"We are thrilled that our educational outreach with Salem Radio Network led to such a surge of interest in this topic," said Dr. Goodman. "Healthcare represents 17 percent of the economy, and the NCPA has long argued that placing government in control of health care would result in significant declines in access, choice and quality of care."

The Free Our Health Care Now petition will be delivered to Congress in late August, and at current signing rates, may become the biggest petition delivered to Capitol Hill since Newt Gingrich delivered 1.3 million signatures to Congress last summer as a part of American Solution's "Drill Here, Drill Now, Pay Less" campaign.

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NIA Says Health Care Will Cause U.S. Dollar Collapse

/PRNewswire/ -- The National Inflation Association today released the following statement to its http://inflation.us/ members:

"It is becoming increasingly likely that health care will be the straw that causes the U.S. Dollar to collapse. There is no doubt about it that health care costs are out-of-control in America. Unfortunately, most Americans are calling for the government to do something about astronomical health care costs, when the government is actually the cause of the crisis and will only make it much worse.

Medicare costs have increased from $3 billion in 1966 to an estimated $408 billion in 2009. This equals a compound annual growth rate of 12% and proves that inflation gravitates towards parts of the economy where government is involved in the most. Health care now accounts for 17% of the U.S. GDP, and by 2017 it is estimated that one out of every $5 spent in this country will be on health care.

Isn't it amazing that the one area of medical care that is going down in price is plastic surgery and other cosmetic procedures, because it is the area where the government is involved in the least? Free market forces dictate plastic surgery prices, because health insurance typically does not cover it.

Today we have a system where tax free health benefits from employers force Americans into expensive health insurance plans that encourage individuals to claim every small doctor's visit. This creates abuse of the system with Americans going to the emergency room for unnecessary reasons, knowing they will only have to pay a $10 co-pay.

If Americans were able to take home the cost of their health insurance plans, in the form of higher wages, they would then be able to purchase cheaper health insurance plans on their own that cover only bad accidents and major emergencies. If they wanted to see the doctor for something minor, they could pay for it out of pocket. With less people abusing the system, waits would be shorter and doctors would be encouraged to charge the least. Today, with doctors getting paid by a handful of third-party corporations, they are encouraged to charge the most.

Government intervention into health care has ruined the industry for doctors too. The government has made the industry less efficient by creating too many licenses and regulations. Doctors now spend half of their time filling out excessive paperwork while worrying about malpractice lawsuits. If somebody has a small bruise on their arm, instead of telling the patient to use ice, doctors now run multiple tests and fill out dozens of forms to comply with regulations and prevent themselves from being sued.

Obama's plan of socialized health care will wipe out the private sector and create less competition. No private health insurance companies will be able to compete with the government, which will be able to operate at a loss continuously. With any remaining efficiencies of the free market eliminated, costs will go up for all Americans in the form of much higher inflation, and the quality of health care will go down.

If we want the U.S. to remain the country where millions of people travel to for top quality medical care, we need to allow the free market to work for itself. Free market principles are the only way to drive costs down while improving the quality of health care."

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Secretary Sebelius Highlights Two New Reports on Health Care Quality, Says Improving Quality is Key Component of Health Reform

At a speech before the United Nurses of America's 12th National Nurses Congress, Secretary Kathleen Sebelius today discussed two new HHS reports on the quality of health care in America and challenged hospitals to work to reduce health care associated infections. Published by the Agency for Healthcare Research and Quality, the annual 2008 National Healthcare Quality Report and 2008 National Healthcare Disparities Report indicate that patient safety measures have worsened and that a substantial number of Americans do not receive recommended care. Upon issuing the reports, Sebelius also announced the availability of $50 million in Recovery Act resources to fight health care associated infections and improve patient safety.

"Today's reports show why we can't wait to enact comprehensive health reform," said Sebelius. "The status quo is unsustainable and we cannot allow millions of Americans to continue to go without the care they need and deserve."

The reports found:
* 40 % of recommended care is not received by patients.
* Only 40% of diabetic patients received three recommended diabetic preventive exams in the past year, and this rate has not improved over time.
* Only half of obese adults and children are given advice to exercise more and eat a healthy diet.
* Seven out of ten adults with mood, anxiety, or impulse disorders received inadequate treatment or no treatment at all.
* Disparities in health care persist. Minority patients receive disproportionately poor care compared to Caucasian patients. At least 60 percent of quality measures have not improved for minorities compared to Caucasians in the past six years.
* One in seven hospitalized Medicare patients experience one or more adverse event.
* Patient safety measures have worsened by nearly 1% each year for the past 6 years.
* Central line associated blood stream infections (CLABSIs) strike hundreds of thousands of patients each year.

Patient safety has declined in part because of this rise in health care associated infections (HAI), infections that patients acquire during the course of their stay in a healthcare setting, such as a nursing home or a hospital. HAIs are among the top ten leading causes death in the United States, and drive up the cost of health care by up to $20 billion per year.

Sebelius today announced that the Department of Health and Human Services plans to make $50 million in grants funded by the American Recovery Act available for states to help fight healthcare-associated infections (HAI). HHS plans to make $40 million available through competitive grants to eligible states to create or expand state-based HAI prevention and surveillance efforts, and strengthen the public health workforce trained to prevent HAIs. HHS is also allocating $10 million in grants to states to improve the process and increase the frequency of inspections for ambulatory surgical centers.

"Healthcare-associated infections can make illnesses worse, further debilitate patients who are already struggling and sometimes lead to death," said Sebelius. "Through the funding provided by the Recovery Act, we can help prevent these infections and improve the quality of care for all patients."

Sebelius also called on hospitals across America to commit to reduce Central Line Associated Blood Stream Infections in Intensive Care Units by 75 percent over the next three years. Research indicates that these infections strike hundreds of thousands of surgical patients and the percentage of patients acquiring these infections has steadily increased over the past six years.

Sebelius challenged hospitals to make use of a proven patient-safety checklist that can significantly and dramatically reduce the rate of these life-threatening infections.

"Patients expect to get better in a healthcare facility, not worse" added Sebelius. "The Recovery Act money will help protect patient safety, but we need hospitals to do more. Today, I'm challenging hospitals to take basic steps to fight infections that are weakening our health care system and threatening patient safety."

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Consumers and Employers Paying Almost $90 Billion Due to Under-Payments to Hospitals and Physicians by Medicare and Medicaid

/PRNewswire-USNewswire/ -- Low Medicare and Medicaid reimbursements to hospitals and physicians lead to significantly higher health insurance costs for consumers and employers, according to a study released today by Milliman Inc. The report found that annual health care spending for an average family of four is $1,788 higher than it would be if Medicare, Medicaid and private employers paid hospitals and physicians similar rates, with total provider reimbursement unchanged.

The continued underpayment of providers by public programs has devastating consequences for families and employers that are struggling to afford health care coverage. These underpayments create a payment gap to hospitals and physicians that privately insured employers and consumers must close through a "cost shift" or "hidden tax."

The Milliman study measures the cost shift as the difference between actual payment rates and average payment rates for Medicare, Medicaid and private payers; total payment to hospitals and physicians is held constant. The study does not assess appropriate levels of payment, but rather the disparities among current payment rates.

The study found that cost shifting:
-- Adds an estimated $1,512, or 10.6 percent, to the average premium for
a family of four
-- Of this amount, employers pay approximately $1,115 and the employee
share is $397
-- Families pay an additional $276 more in coinsurance and deductibles
due to the cost-shift


"As businesses struggle to cut costs to match sagging revenues, employee health benefits are increasingly at risk," said Rich Umbdenstock, president and CEO of the American Hospital Association. "The faltering economy makes fair payment by Medicare and Medicaid more important than ever."

In 2006, the hospital cost shift from Medicare was $34.8 billion and $16.2 billion for Medicaid. In 2007, the physician cost shift was $14.1 billion for Medicare and $23.7 billion for Medicaid. Taken together, the estimated annual cost shift is $88.8 billion.

Overall, the cost shift represents 15 percent of the current amount spent by commercial payers on hospitals and physicians. Stated differently, if there were no cost shift, hospital and physician costs for privately insured patients would be 15 percent lower.

Health plans have taken many actions to keep coverage affordable, but are challenged by the growing cost of the subsidy that their customers provide to public programs. In 2006, Premera Blue Cross, which provides coverage for 1.7 million consumers in Washington, Alaska, Oregon and Arizona, commissioned a local cost-shift study, the first of its kind, to examine how deficient payments by Medicare and Medicaid are affecting employers and hospitals in their area. Their work laid the foundation for the national cost shift study which examines the additional cost burden passed on to all employers and consumers nationwide.

"This new study shows that cost-shifting is driving up the costs of health care for all consumers," said Scott P. Serota, President and CEO of the Blue Cross and Blue Shield Association. "As our nation embarks on comprehensive healthcare reform -- and we collectively strive to extend coverage to all, improve quality of care and keep healthcare affordable for future generations -- cost-shifting is one of the areas where we should focus our attention."

"This study quantifies the 'hidden tax' that cost-shifting imposes on families and employers across the nation," said Karen Ignagni, President and CEO of America's Health Insurance Plans. "As Congress and the new administration focus on health care reform, they should confront this issue."

Also hospitals and physicians in some areas may not be able to offset low public payments with higher commercial payments creating additional financial pressures. In addition to this hidden tax, the privately insured also must bear the costs associated with bad debt and charity care provided to individuals without insurance, which is not separately quantified in this report.

"As we consider approaches to expand coverage nationally, we need to keep in mind the disparity among Medicare, Medicaid, and commercial provider payment rates, and the pressure that this disparity places on hospitals, physicians, and commercial payers," said John Pickering, Principal and Consulting Actuary at Milliman, Inc., who co-authored the report with Will Fox, also a Principal and Consulting Actuary at Milliman, Inc.

Milliman is an independent consulting firm that was engaged by AHIP, AHA, BCBSA and Premera Blue Cross to develop a best estimate of the cost shift in the United States. Hospital findings are based on analysis of the 2006 AHA Survey data. The survey includes data on the 4,927 short-term, community hospitals in the U.S. The data represent each hospital's fiscal year 2006 results. The physician findings are based on 2007 fee schedule levels for Medicare, Medicaid and commercial payers.

The American Hospital Association (AHA) is a not-for-profit association of health care provider organizations and individuals that are committed to health improvement in their communities. The AHA is the national advocate for its members, which include almost 5,000 hospitals, health care systems, networks, and other providers of care. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the Web site at www.aha.org.

America's Health Insurance Plans (AHIP) is the national association representing nearly 1,300 member companies providing health insurance coverage to more than 200 million Americans. AHIP provides a unified voice for the community of health insurance plans. A major policy goal for our members is to expand access to high quality, affordable coverage to all Americans. We have developed innovative proposed solutions to promote universal coverage, raise the bar on quality, and make health care services more affordable. For more information, visit the Web site at www.ahip.org.

The Blue Cross Blue Shield Association (BCBSA) is a national federation of 39 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 102 million individuals - nearly one-in-three Americans. For more information on the Blue Cross and Blue Shield Association and its member companies, please visit www.BCBS.com.

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CAGW Questions Healthcare Plan Options Presented to the Dougherty County Commission

PRNewswire-USNewswire/ -- On behalf of its 24,965 members and supporters in Georgia, Citizens Against Government Waste (CAGW) today called for the public release of the details related to how insurance broker Kirk Rouse made recommendations to the Dougherty County Commission on changes to the health care plan for county employees. CAGW President Tom Schatz sent a letter to the county commissioners expressing concerns and asking questions about the process.

Schatz wrote, "The Commission ... has an obligation to select a plan through an open, fair and competitive bid process that provides the best possible quality health care at the lowest possible cost. ... Mr. Rouse owes the Commissioners and the taxpaying public a full accounting of how he arrived at his recommendations. He should reveal all options that were available to him. Simply comparing various forms of exclusive deals for Phoebe Putney Memorial Hospital is not the kind of rigorous exercise that the county employees and the public deserve."

The letter questioned whether or not a formal request for proposal was issued, whether competitive bids were considered that did not require exclusive bids for Phoebe Putney or Palmyra Medical Center, what kind of criteria Mr. Rouse used, and how he reached his recommendation for the commission.

Mr. Schatz's letter added, "Basic free market principles dictate that identifying an alternative health care plan that offers a choice should provide better savings than an exclusive arrangement with either hospital. Dougherty County taxpayers deserve the benefit of any additional savings that can be achieved by identifying a plan that offers in-network choice. Mr. Rouse has not done his job until he has explored this option for the county employees and taxpayers."

The Dougherty County Commission is scheduled to meet Monday, November 17, 2008, at 10:00 a.m. at the Central Square Government Center, 222 Pine Avenue, Albany, Georgia to make a final decision on the proposed changes to the County employee health care plan.

Citizens Against Government Waste is a nonpartisan, nonprofit organization dedicated to eliminating waste, fraud, abuse, and mismanagement in government.

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Institute for Advanced Policy Solutions Receives $600,000 Peterson Foundation Grant

Emory University’s Institute for Advanced Policy Solutions (IAPS) has received a $600,000, one-year grant from the Peter G. Peterson Foundation to establish a Center for Entitlement Reform, the Institute announced today.

The new Center for Entitlement Reform is one of only a few university-based research centers in the U.S. focusing on federal health care entitlement reform.

The Center will conduct research and analysis in order to outline the factors responsible for the rise in federal entitlement spending, specifically focused on public health insurance programs; link new approaches in financing, payment, and care delivery for achieving better value (lower costs with the same or better outcomes) based on factors driving higher spending; and present the options to key policymakers in the U.S. Congress and White House, along with state-level governments, business leaders, the public and the media.

Public health policy researcher Kenneth E. Thorpe, PhD, will direct the new Center. Thorpe is also chair of the Department of Health Policy and Management, Rollins School of Public Health, Emory University, and IAPS executive director. Additional staffing for the Center will include faculty from Emory’s Institute for Health and Productivity Management, as well as a select group of IAPS fellows chosen from some of the nation’s foremost and emerging thought leaders in the public, private and not-for-profit sectors.

“Entitlement programs must be reformed to reflect current economic realities and longer life spans while also making them solvent, sustainable, secure and more savings oriented,” says Thorpe. “Spending cannot continue unabated without imperiling future generations. For far too long, needed health reform has foundered on ideology.

“The moment has come to set aside partisanship and, guided by sound research that explains both the nature and the urgency of the challenge, achieve real results,” says Thorpe. “The Center for Entitlement Reform will help translate research into action to avert the looming crisis.”

The rise in projected federal spending on health care results mostly from increasing costs per beneficiary but also because the aging of the baby boom generation will significantly raise the number of Medicare beneficiaries. According to the Congressional Budget Office, if health care spending grows as projected under current law, future budget deficits will rise to levels that will seriously jeopardize the nation’s long-term economic growth.

“Washington policymakers are continuing to put off tough choices by charging the nation's credit card and expecting our kids and grandkids to pick up the tab,” says Peterson Foundation President and CEO David M. Walker. “Social Security and Medicare must be reformed if we expect to maintain reasonable tax levels, invest in our collective future and deliver on the promises that the government makes. We are thrilled to be investing in Ken and Emory’s thoughtful leadership in this fight.”

The Center is expecting to complete its groundwork research and analysis and develop preliminary policy options—focused on reducing the rising prevalence of diagnosed and treated disease, more effective approaches for managing chronically ill patients and approaches for reducing the wide variation in per capita spending—by the end of calendar year 2008.

“America’s health care crisis was not created overnight, and won’t be solved immediately,” adds Thorpe. “The Center for Entitlement Reform will have a research agenda encompassing for long-horizon views. However, we also recognize the short-term opportunity to impact health care policy of the incoming administration and 111th Congress early in 2009. Our near-term agenda is to complete an analysis of the key drivers of rising Medicare and Medicaid spending.”

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Health Care Policy with New Administration, Congress to go Beyond Insurance Debate

President-elect Obama and Congress will undoubtedly wrangle with health care in 2009, but the action will go beyond the debate over health insurance coverage, according to a Georgia State University public health professor.

Reform will also encompass public health measures, prevention efforts, beefed-up regulatory enforcement, and investment in health care technology, said Russ Toal, associate professor and Distinguished Fellow in Health Policy at Georgia State.

“I want to be quick to note that there is much that can be done without expenditure of money. And much of it can be done quickly,” said Toal, who gave his remarks Nov. 5 Public Health Grand Rounds lecture. “Public health is far broader than health insurance matters.”

Even in the face of difficult financial times, the government can take measures to improve health care in the United States, including the improvement of health-related regulatory enforcement by agencies like the Occupational and Safety Hazards Administration, the Food and Drug Administration and the Environmental Protection Agency.

Peeling back the laws passed in recent years which make it harder for people to declare bankruptcy — an option considered by many who face huge medical debts — would also help, Toal said.

Prevention and education programs are essential in addressing chronic illnesses which run up health care costs, while changing rules which forbid the federal government from negotiating drug prices could reduce increasing costs for prescriptions, he added.

Other public health efforts which might be addressed next year include raising the federal excise tax on tobacco products — which has been done in several states to help discourage tobacco use — as well as improving nutrition labeling laws on food products.

However, parts of the debate will include the discussion of expense — including health insurance for the uninsured, as well as increased military health care expenditures, Toal said.

Health insurance is also a component of the policy debate, and Obama proposes a version of the health care plan enacted by former Massachusetts Gov. Mitt Romney that allows those with employer-provided insurance to remain in their plans, while giving those without insurance a chance to purchase subsidized coverage from a pool of private insurers. Proposals also include enacting “re-insurance” for people who face extremely high, catastrophic costs.

Getting any measures passed, though, requires policymakers and politicians to go through intense legislative wrangling.

When the 111th U.S. Congress and President-elect Obama take their oaths of office in January 2009, one party will control both the legislative and executive branches. But this does not mean that a new administration will be able to get all of its proposals through quickly, Toal said.

Not all Democratic senators will agree to certain proposals, and Republicans will maintain enough seats to allow for filibusters — a legislative maneuver which can let a minority party stymie or kill legislation.

And just as with this year, health care was a top campaign issue in the 1992 election, when Democrats took control of both the executive and legislative branches. That led many in public health to believe that reform would happen under the Clinton Administration, but Toal said reform was stymied by a commission that took 10 months to produce a 1,300-page bill that got nowhere.

“I hope that President-elect Obama understands that he needs to strike quickly,” Toal said. “The new administration must move to put people in place quickly, and send a message to those throughout the federal government about what we must do, and that people will be held accountable.”

Overall, Toal said that with a new administration, there could be a new spirit of service not seen since the Kennedy Administration, leading more people — including Georgia State health sciences students — to work for the public good, even though the hours are often long and the pay much lower than in private industry.

“The impact of a revitalized and energized work force cannot be underestimated,” he said.

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