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In today's highly partisan environment, one of the few things that politicians seem to agree on is that healthcare is in crisis. Premiums are rising 12 to 20 percent a year and from 1994, to 2004 healthcare costs have doubled. In 2004, the healthcare tab for our country was 1.9 trillion dollars, almost 4 times our budget for national defense. Unpaid medical bills are the number one cause of bankruptcy in this country, and if you are married and retiring, you'll need $200,000 in savings to cover your healthcare costs. Most agree that this has a tremendous impact on employees and employers. Medical News asked both candidates how he would address this crisis as a U.S. Senator.

Corker:I want to encourage changes in our health system that give patients, not government or insurance companies, more power. I want to encourage innovation and use information technology to bring down administrative costs and develop standardized platforms for billing. Much technology has already been used for the diagnosis and treatment of diseases, but we still have enormous opportunities to improve health care delivery with the application of information technology to the administrative side. Reforming the medical malpractice system will reduce health care costs and increase access, particularly in rural areas. I support allowing small businesses to pool together to purchase more affordable insurance for their employees. I support the use of health savings accounts to give people the option of using cheaper, catastrophic coverage. I support increasing individuals' ability to deduct their health insurance from their federal income taxes.


Ford: As a nation, we spend $2 trillion each year on healthcare. Yet, 45 million Americans and more than 700,000 Tennesseans – 1 in 9 of our neighbors – are uninsured, and the problem keeps getting worse. We spend enough money. We just need to manage it better.

The next American healthcare system should be guided by 4 principles:

· Access to healthcare for all. No Tennessean – rich or poor, young or old – should be without healthcare. And no business should be bankrupted for taking care of its employees. When you buy a house, you are required to get homeowner's insurance. When you own a car, you are required to get car insurance. It is time to apply the same rationale to health insurance. Instead of the current system – where the insured are paying for themselves and the uninsured – we need to move to a system where adults to accept responsibility to obtain coverage for themselves and their children. To help accomplish this, we need to make insurance more affordable.

· A redesigned primary healthcare system. Doctors understand more than anyone how the system is broken, which is why they are coming together to figure out ways to fix it. Primary care is critical because it helps fix small problems before they grow into something bigger. Understanding this, family physicians have developed the Future of Family Medicine Project, which advocates a new model of patient care to address the healthcare crisis. We need to encourage this kind of problem-solving and give doctors the tools they need to put their answers into practice.

· Tort reform. Guaranteeing fundamental access for all requires fair and proportionate compensation to patients and families injured by doctors. Too many frivolous claims are filed against doctors who did nothing wrong. We need to set up tribunals with qualified review boards in our court system to screen claims for legitimacy before they go to trial. This will help decrease costs and ensure that all Tennesseans have access to the care they need, whether they live in Unicoi, Maury or Dyer County.

· Use Technology to Improve Healthcare Quality. It is not enough to change how we pay for healthcare; we also need to change how we deliver it. That is why I join Former Speaker Newt Gingrich in calling for the use of health information technology to transform the health care system by preventing medical errors, improving the use of best practices in medicine, reducing unnecessary duplication, streamlining administration, creating vast new research and public health monitoring opportunities and radically change quality reporting.

Covering the uninsured is critical. But we must also lower the cost of care for everyone. Three specific steps will help achieve this goal:

· Association Health Plans. Small businesses in every community are being driven out of business by the high cost of healthcare. We should reverse this trend by allowing small businesses to pool their resources and buy health insurance for their workers at a lower price. Congress passed a bill – that I voted for – that would allow Association Health Plans, but the Bill Frist-led Senate has not even voted on it. Small businesses have always driven our economy and led in innovation. Helping them to achieve the same kind of negotiating leverage as large companies will promote entrepreneurship and keep our nation competitive.

· Tax Credits for Employers. We should give incentives to employers who assume responsibility by providing minimum levels of coverage to their employees. I have supported efforts in Congress to do this. Tax credits in exchange for coverage will help make sure companies do not shirk their responsibilities and look to Medicaid to cover their employees' health needs. Government should be in the business of rewarding business leaders who encourage and incentivize their employees to maintain healthy lifestyles. In the end, it will save lives, reduce costs and make us more competitive.

· Allow Medicare and Medicaid to Negotiate Directly With Drug Companies. It is inexcusable that we do not allow Medicare – the country's biggest purchaser of prescription drugs – to use its negotiating power to get cheaper prices for our seniors. Companies like International Paper, Eastman Chemical and Nissan here in Tennessee buy their supplies in bulk; why should the federal government be any different? We already allow the Veterans Administration to negotiate with drug companies, and it is long past time to let Medicare and Medicaid to the same. By letting Medicare and Medicaid use their negotiating power to get lower prices, we can reduce the burden of prescription drug prices on our healthcare system. I did not vote for the President's Medicare prescription drug program, also known as Part D, because it did not allow Medicare to negotiate with the drug companies. That needs to change.



Medical News: GM has asserted that health care costs are so out of control that it cannot remain price competitive with companies in countries whose health care systems are heavily subsidized by taxpayers. Do you buy that argument, or is GM just making excuses? If you do buy that argument, at least in part, is there a role for government to play here in addressing the competiveness issue?

Corker:As someone who has built a business from my own savings, I understand the competitive pressure in the marketplace and the difficulties of competing against countries that do not depend on employer-based health care systems. Many employees are trapped in jobs they don't like in order to maintain health insurance coverage. We need to work toward more patient control of health resources and more portability. As individuals change jobs more often and as more are self-employed, options like health savings accounts and small business health plans become more important. I want to be sure that the tax code gives equal treatment to health insurance purchased by individuals for themselves and health insurance purchased by employers for employees.


Ford:Traveling across Tennessee, I have met countless small and large business owners who are struggling to remain competitive in the face of rising healthcare costs. Our nation's automakers spend more on healthcare than they do on steel to make their cars. For the men and women working at the General Motors plant in Spring Hill, this is troubling news; it means our companies have a harder time competing with their foreign counterparts.

Of course, the problem is not limited to businesses. The average yearly health insurance premium for a family of four is more than $10,000. If companies are unwilling or unable to pick up the tab, too many Tennesseans cannot afford to keep their families healthy.

Small businesses in every community are being driven out of business by the high cost of healthcare. We should reverse this trend by allowing small businesses to pool their resources and buy health insurance for their workers at a lower price. Congress passed a bill – that I voted for – that would allow Association Health Plans, but the Bill Frist-led Senate has not even voted on it. Small businesses have always driven our economy and led in innovation. Helping them to achieve the same kind of negotiating leverage as large companies will promote entrepreneurship and keep our nation competitive.



Medical News: What do you think about Massachusetts law making health insurance mandatory? Would this be something you would pursue on a national level?

Corker:I would prefer to see greater consumer control rather than increasing the role of government through new mandates.


Ford:Absolutely. Of course, forcing people to buy health insurance makes no sense unless we make it affordable. With increased personal responsibility to ensure that everyone obtains coverage comes shared responsibility to ensure that everyone can afford coverage. My plan features a multi-tiered strategy to lower costs for the three basic groups of uninsured who need our help:

· Those who are eligible for Medicaid but don't sign up. We should set up low-cost portals at hospitals and health centers to register them and begin addressing their needs. When someone eligible for Medicaid comes in for treatment, they will automatically be registered.

· Those who can afford coverage but decline it. Usually, these people decline coverage because they are in good health and consider coverage too costly. But this means when they get sick, the public safety net picks up the tab for them. This cycle should be stopped. Insurers claim they can provide insurance plans at less than half the rate of today's standard $500 a month for an individual. The federal government should work with insurance companies to design high-deductible, low-premium plans to serve these people. States like Massachusetts and New York are already doing this. We need to take this successful program to the national level so the people of Tennessee can benefit as well.

· Finally, those who cannot afford health insurance but who do not qualify for Medicaid, either. These people deserve a system with sliding scale subsidies to provide affordable coverage with smaller subsidies as incomes rise. For people making three times the poverty line (individuals earning more than $30,000 and families of four earning more than $54,000), the subsidies would phase out.

In Massachusetts, a Republican governor and a Democratic legislature put their political differences aside for the greater good. It is this kind of bipartisan leadership that we need more of in Washington.



Medical News: One of President Bush's key healthcare emphasis is on Health Savings Accounts, introduced 2 years ago. Since then, 3 million have signed up. In your opinion, are HSAs working and if so, how would you expand the program?

Corker:I think there is an important role for HSAs to play in expanding options for individuals and for small businesses. Health Savings Accounts have the potential to produce some consumer-driven changes in the way health services are provided and in the information available to consumers.


Ford:I support President Bush in promoting Health Savings Accounts because they help many Americans get the healthcare they need more affordably. But HSAs are only part of the answer; they are not a complete solution. For example, they do not address the 45 million Americans and 700,000 Tennesseans who don't have insurance.

On top of the appalling number of uninsured and the tens of millions more underinsured, our current system fails patients by subjecting them to limited access to care and layers of burdensome paperwork and inefficiencies. Patchwork fixes will no longer do the job. Instead, we need to completely reform our current healthcare system.



Medical News: Some have suggested that a major solution to the healthcare crisis would be a national electronic medical records system that would be engineered much like the U.S. Highway system. Would you support such an initiative? How?

Corker:The revolution in information technology can help us drive down the administrative costs of health care, reduce errors, and improve the continuity of care. Electronic medical records and more standardized platforms can create a more efficient system that will be cheaper and easier for patients and physicians to use.


Ford:It is not enough to change how we pay for healthcare; we also need to change how we deliver it. That is why I have joined Former Speaker Newt Gingrich in calling for the use of health information technology to transform the health care system by preventing medical errors, improving the use of best practices in medicine, reducing unnecessary duplication, streamlining administration, creating vast new research and public health monitoring opportunities and radically change quality reporting.



Medical News: Our readership is made up of almost exclusively of physicians and other healthcare decision makers, why should we in the healthcare industry vote for you?

Corker:I recognize that Washington has failed to address two large problems facing health care professionals and I am committed to working on a solution in the Senate. First is the need for medical liability reform to cap non-economic and punitive damages. My opponent in this race has voted against legal reform five times; I will vote for reform. Secondly, I consider the Medicare reimbursement system currently in use for physicians' reimbursement to be totally unacceptable and will work to provide an improved system. While our federal budget pressures are severe, there is no reason for the Medicare system to base physician pay on a formula that in no way reflects the value of physician services or the demand for their services. In the Senate I will be an energetic and effective voice for practical solutions that recognize the key role of health care in our economy and in our lives. By supporting free market, consumer-driven care I will work to ensure that our health care dollar is spent on health care rather than on litigation and administrative costs.


Ford:As physicians and healthcare decision makers, you know better than anyone how urgent the need is for complete reform. You also understand what kind of change is needed. If elected to the U.S. Senate, I will listen to you and make sure that the system works for everyone – doctors, patients and healthcare providers.

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