On the campaign trail I've talked with many people very concerned about health care costs and asking what I plan on doing to help Kansans if elected to the Senate. This is an extremely important topic and as with so many things a complex one that will take some time to solve. We do need to improve health and health care in Kansas but this does NOT have to mean a big, expensive, government controlled program needs to be the solution. It does mean paying attention and doing a lot of things that will reduce the cost of health care and health insurance, making both more affordable for Kansans.

Here are some principles that guide me in looking for a solution:

1) The individual citizen chooses, owns, and controls his/her health coverage (insurance)
2) Health coverage is available, affordable and portable.
3) There is no government mandate placed on employers or individuals
4) No new taxes
5) Expands the private sector and shrinks government and the uninsured
6) It is stable and flexible over the long term (establish a Trust fund and apply one-time windfalls (like tobacco settlement money or the sale of nonprofits to go into a private foundation. Also dedicate portion of premium taxes to the foundation and encourage private resources give to the foundation.)

Let me provide some context of the problem and then I will give you my thoughts on a tentative approach to solving it.

Currently health care comprises at least 16% of the state economy and it continues to rise in costs. At the same time only about 25% of doctors in the community even accept Medicaid because government doesn't come anywhere close to reimbursing even their costs. Hospitals and doctors are doing well to get 8 cents on the dollar in reimbursement. And many of our hospitals-- including Providence Hospital in Wyandotte and Cushing and St John's in Leavenworth struggle with staying solvent because of the severe imbalance of paying patients to non-paying, a ratio averaging 25% paying to 75% not. That is unsustainable. So why doesn't government pay the cost? Because we would instantly bankrupt the state or our taxes would be 5 times what they are presently--and they are already too high. Clearly more government control is neither desired nor even a possible solution.

Many people go to the emergency room, because ERs don't have a significant co-pay and they can actually see a doctor (by law they can't be turned away). But ER care is the most expensive of all health care and many people don't see or retain a regular private physician for many reasons including job relocations, expense, or that they believe they can skimp on that part of their budget because they're mainly healthy until -they aren't and then they need help. What many people need and are looking for is healthcare insurance plans that are affordable and portable.

That's why the discussion by both Democrats and Republicans alike is really about Health Care Insurance coverage as the solution. Neither the government nor the taxpayer can afford the expense. The difference is in approach: I (and Republicans) believe that individuals ought to have choice and control of their health care and doctor relationships. My opponent (and Democrats) believe government should choose and control health care for you in what they call universal health care that government would control. Right now, the health care system in Kansas is like a wobbly, three-legged stool—divided unevenly between growing and costly government programs (23%), shrinking private health insurance coverage (65%), and the uninsured 10.9%. Government needs to get out and stay out of health care and safeguard your privacy by empowering you. It doesn't need to dictate to you what you can and cannot do nor should it get into rationing care.

There is no magic bullet or simple solution for this complex problem but there is an excellent one. Being a Republican I will be able to work closely with the Senate Republican majority to enact a bipartisan plan called KanCare. This plan was put together by a team of experts from medicine, insurance companies, and experienced health administrators.

KanCare builds on the strengths of the Kansas health care system and works to correct some major flaws.

KanCare has 4 parts:
1: Make Commercial Insurance more affordable by using Section 125 accounts
2: Transition Medicaid/uninsured patients to private markets using targeted approaches
3: Medicaid Reform (a new program to be called MediKan)
4: Strengthen Charity Care for a smaller pool of uninsured

KanCare's first priority is to make commercial insurance more affordable. This can be done by allowing consumers to pay for health care with pre-tax dollars and encouraging more insurance companies to operate in Kansas so costs are held down through competition. Section 125 plans allow consumers to use pre-tax dollars to pay for health care. Through tax credits and low cost plans we make Section 125 plans widely available, so every Kansan saves 15% immediately by using FSAs and HSAs. A secondary effect of individual accounts—similar to IRAs—is that coverage is "owned" by the individual and thus transferable between employers as well as states.

The plan's second part calls for transitioning Medicaid and uninsured patients to private insurance. As stated previously there are many different reasons people are uninsured or on Medicaid. Using targeted approaches we'll help them find stable health insurance. For example: Individuals who are in between jobs or have lost their insurance can use vouchers/tax credits to keep insurance. Or we could provide seed money to encourage association plans—sort of like Co-ops or credit unions—targeted on small communities, business groups, ethnic organizations. This effort would also target the forming of insurance buying pools, especially for small businesses and others such as Kansas teachers. Children with Medicaid could be placed on their parent's family plan with vouchers or credits.

KanCare's third part reforms Medicaid into a new state program called MediKan to preserve and stabilize the community's safety net. MediKan would comply with and use the National Governors Association recommendations and meet new federal guidance of the 2005 Deficit Reduction Act. HPAs works with the federal government for new programs to stop waste and fraud, helps seniors get more home health rather than nursing homes, wellness initiatives, and other waivers. MediKan expands choices of doctors and health plans and enables patients to choose from benefit packages with some specially designed for diabetes care, children, seniors, etc. It will use consumer driven health plans and Medicaid recipients would get a Health Opportunity Account. The state puts money into the account for the patient to use for co-pays, glasses, weight loss programs, etc. We can even reward patients if the quit smoking or who avoid costly ER visits. MediKan gives the state more options in case contractors have problems.

KanCare's fourth part strengthens "charity care" given by emergency rooms and clinics, including "free care" clinics like St Vincent's in Leavenworth. KanCare experts say that because the first three components would tremendously reduce the number of uninsured, the burden on hospitals, emergency rooms and clinics to provide care for those without insurance would be significantly reduced and therefore will help assure they remain solvent and open. Additionally it would provide incentives for providers to give more free care.

KanCare is an excellent plan but we as individuals and communities have other things we have to do as well. Obviously we must maintain a strong public health effort to reduce the spread of infectious disease. This is a form of preventive care and helps reduce demand for health care, ER visits and helps contain costs.

We must inspect and hold all clinics to high standards of cleanliness, staffing, and record keeping. This will help reduce malpractice and other related health problems and minimize lawsuits. Preventing excessive jury awards for medical malpractice while insuring that the right of Kansas citizens to use the courts to regain all appropriate damages and, if necessary, punitive damages will help reduce costs to the health care industry.

Health education needs to be improved in our schools and also in our work sites. Increasing public awareness of health related issues helps health consumers make wiser health care decisions. Additionally, we must encourage more education in the sciences so we have more doctors, nurses and other health care providers. We already have a shortage of trained personnel and this dwindling pool of medical and medical support personnel continues to shrink and age. More doctors and nurses helps contain costs while improving care and access.

Individually, we all must get more exercise and eat healthier diets. This not only improves individual quality of life and longevity but will reduce demand for health care and thus reduce costs. The old adage of an ounce of prevention saves a pound of cure is absolutely true in this case.

Please contact me if you have other ideas, suggestions or questions.