Note: Lieberman withdrew from the presidential race Feb 3.
Access to health care
How do you propose to provide health care for the uninsured?
Lieberman: My plan for health care will cover more uninsured Americans -- more than 31 million -- than any other competing, non-single-payer proposal. Better yet, it is the most cost-efficient: According to an independent economic analysis, my plan will cost an average of $53.4 billion for the first five years and will cost less per newly insured person than any other Democratic plan over 10 years.
My plan calls for a step-by-step approach to universal care. To help the nine million uninsured children, my plan includes an immediate expansion of the State Children's Health Insurance Program. It also includes the gradual phasing in of a new universal health insurance program for kids, called MediKids, and a national network of school-based health centers.
My plan will also enable all Americans who don't have access to affordable, conventional health insurance to buy into new MediChoice health insurance pools, modeled on the health care program for federal employees. The MediChoice pools will be open to all workers who currently fall through insurance cracks. This includes self-employed, part-time, seasonal and temporary workers. It also will give stay-at-home moms, early retirees over 55 and workers in small companies with less than 50 employees access to affordable health benefits.
Additional programs in my health care plan to provide health care to the uninsured include: expansion of the Medicaid program, provision of insurance premium assistance to moderate income Americans and provision of tax credits to subsidize COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) insurance premiums for workers who lose their jobs.
Health care costs are rising steadily. What specific measures do you propose to address this?
Lieberman: I believe that the only way to afford universal health insurance is to make health care universally affordable. In addition to the overall health care savings predicted from universal coverage (less uncompensated care, better prevention, fewer emergency room visits), the Lieberman plan would also improve overall efficiency of the health care system. Care quality improvements, reductions in medical errors, broader use of electronic medical records and decreased disparities in care will all help save health care dollars. And the combination of better prevention, cures and optimized chronic disease management will sharply reduce the $750 billion per year burden posed by chronic illness.
Medicare
How do you propose to correct the Medicare physician reimbursement rate formula?
Lieberman: Reasonable physician compensation is an important aspect of ensuring that Medicare beneficiaries have access to high-quality care.
As president, I would convene a panel of experts to review the recommendations of the Medicare Payment Advisory Commission. I would ask the panel to come up with proposals for a long-term fix of problems with Medicare physician reimbursements.
How would your proposal address disparities in payments to providers in rural areas?
Lieberman: I supported the Boswell pledge (from Rep. Leonard Boswell, D-Iowa) to end inequities in payments to rural providers. I believe that correcting disparities in payments is critical to ensuring that providers will be available to deliver care in rural communities.
Medical liability
What is your position on a cap on noneconomic damages in medical liability lawsuits?
Lieberman: I support medical malpractice reform and am one of the few Democrats who has introduced bills about tort reform. I believe that good physicians should not be driven out of business by skyrocketing malpractice premiums and should not practice medicine timidly for fear of litigation. I feel that the Medical Injury Compensation Reform Act provisions in California are illuminating and worth studying as one possible approach.
What plan would you propose to reduce medical errors?
Lieberman: Building on my leadership in the Senate, I would launch MERCY, the Medical Error Reduction Campaign, which would require mandatory, anonymous reporting of deaths and serious injuries caused by medical errors; establish a Center for Patient Safety to conduct research on medical error reduction; and create public-private partnerships to eradicate mistakes.
Electronic medical records
What is your position on the development and use of an electronic medical records system?
Lieberman: Today, the local McDonald's may have a more sophisticated computer system than the local doctor's office. As president, I will promote and facilitate expanded use of electronic medical records to help doctors do their jobs and help patients receive the best possible care. Unfettered communication will reduce duplicate tests, prevent dangerous drug interactions and deliver critical information in an emergency. And to improve efficiency and guarantee privacy of individual records, I will give every American an electronic "medical home" where their medical records are securely stored and accessed by their physicians. Patients, not health care providers, own their medical histories.
How would you help physicians get the technology they need to implement an effective electronic medical records system?
Lieberman: I am very aware of the problem of unfunded mandates. In terms of EMRs, I have proposed using tax deductions to help support infrastructure technology improvements.
Training primary care physicians
America faces a shortage of primary care physicians. What would you do to address this?
Lieberman: I have supported increases in training grants for family practice physicians. More importantly, I will be a president who emphasizes prevention and management of chronic diseases and who builds respect for primary care physicians and the invaluable services that they provide for Americans.
What role do you see community health centers playing in addressing this shortage? How would you fund them? How would you staff them?
Lieberman: For the past several years, I have requested increases in funding for community, migrant, public housing and homeless health centers. The Lieberman health care proposal calls for revitalization of community health centers, including an increase in funding and school-based care.
The staffing of community health centers should be multidisciplinary, including physicians, nurses, social workers and health educators. The role of family practice physicians on these teams cannot be overemphasized. The medical leadership and expertise of family physicians is crucial to providing the highest level of quality care.
NIH/AHRQ
What is the appropriate funding level for basic medical research at the NIH?
Lieberman: I have been an adamant supporter of increased funding for the NIH. The Lieberman health care proposal calls for at least doubling the funding that is in President Bush's budget. In addition, the Lieberman proposal for an "American Center for Cures" would bring $150 billion over 10 years to support clinical and translational research.
What is the appropriate funding level for the Agency for Healthcare Research and Quality and for other agencies that sponsor applied medical research?
Lieberman: I have sponsored several bills that have called for strengthening AHRQ and evidence-based medicine. An important part of the Lieberman health plan is that as president, I will direct federal health agencies, including AHRQ, to partner with health care leaders and organized medicine to better develop evidence-based medicine guidelines and disseminate them to health care providers.
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