Clinton promised Thursday that as president she would
improve health care quality by raising standards for
providers, educating patients, and requiring insurers
to reward innovation.
Barack Obama and John Edwards have proposed detailed health
care overhaul plans, Clinton is taking an incremental
approach. She started with a speech in June on
reducing costs, followed by Thursday's address on
quality, and will outline her plan for universal health care
coverage next month.
''My order here
is deliberate,'' said Clinton, a New York senator. ''In
order to forge a consensus on universal health care, we need
to assure people that they will get the quality they
expect at a cost they can afford.''
''Too often and
in too many places, our health care system hurts us
instead of helps us,'' Clinton said at Dartmouth-Hitchcock
Medical Center. ''It hurts doctors, who aren't
rewarded for providing the best care and are often
punished for it financially. It hurts nurses who are
asked to work longer hours, caring for more patients with
fewer resources. And it hurts patients, who are forced
to make complicated medical decisions without basic
information about their conditions and options.''
quality, Clinton said she would promote physician
certification programs that help doctors keep up with the
latest advancements, increasing Medicare
reimbursements for doctors who participate in them.
Nursing care would get a boost in the form of $300
million to expand enrollment in nursing schools, create
mentoring programs for recent graduates, and recruit
more minorities into the profession.
shortage has become a nursing crisis, and that means it is
a crisis for everyone,'' Clinton said. ''Our nurses are
truly the eyes and ears, and in many ways the heart
and soul of our health care system. When we've got
fewer nurses working longer hours and serving more
patients, the result can be worse outcomes.''
Patients can also
play a role in improving the quality of health care
they receive, she said, if they are given more information
about their treatment options. She praised
Dartmouth-Hitchcock's Center for Shared Decision
Making, saying she would like to see similar programs
called for overhauling a reimbursement system that she said
often punishes doctors for doing the right
thing--spending time with patients or working
with their colleagues to take a collaborative
approach. She proposes higher payments to providers who use
teams to provide coordinated care and ending payments
for preventable infections and injuries sustained
during hospital stays.
''We need a
system that encourages instead of discourages quality,'' she
Speaking later in
Manchester, Clinton said her universal health care plan
would not involve a single-payer government system. Instead,
she said, she would consider expanding Medicare and
allow people to join the federal employees insurance
''I think you
don't want to take choices away from Americans. We're big
on choice here. But you've got to have some framework so the
choices work better,'' she said.
Clinton said she
also would consider allowing people to purchase health
insurance from companies outside their states.
''There is no
really strong argument anymore why you couldn't buy
insurance across state lines to get better deals,'' she
said. ''Why should you be limited to what companies
want to come into New Hampshire?'' (AP)