Our values: Health, health security, safety, protection, quality of life
Our vision: Every American should be able to get the health care they need, when they need it, at a price they can afford. But for years, insurance companies charged too much, their policies were full of holes, and coverage was easily denied or revoked. The Affordable Care Act changed that, providing families with a measure of health security. Now that the ACA is under attack, there is much to be done: (1) guarantee coverage to every American as a matter of right; (2) encourage healthy behavior and protect others from unhealthy behaviors; and (3) allow people to make their own health care choices.
Donald Trump and Republicans in Congress are trying to repeal the Affordable Care Act (ACA). The Congressional Budget Office estimates that such a repeal and the resulting market collapse for private insurance could take health coverage away from as many as 30 million Americans. Each state and locality needs to prepare to protect the health care of as many residents as possible. One step, already employed by Maryland, is to create a study commission to report on the likely healthcare and economic impacts of ACA repeal and recommend policies to help people become or remain insured.
Preventable behaviors such as tobacco use, poor diet and physical inactivity, and alcohol or other drug use are the underlying cause of half of deaths in the United States. A progressive government encourages healthy behaviors while leaving ultimate decisions to the individual. The biggest preventable killer remains tobacco, which claims more than 480,000 victims every year. Jurisdictions can discourage smoking by raising the tobacco tax, implementing workplace smoking and e-cigarette bans, increasing the minimum age to purchase tobacco, and offering smoking cessation programs. States, localities and school boards can improve nutrition and physical fitness programs available in schools and also increase opportunities for athletics, walking and biking in communities. States and localities can raise alcohol taxes, crack down on sales to minors, and rethink whether their drug laws and enforcement systems are an efficient way to discourage the use of dangerous drugs.
Too often, people who are sick or dying are not given choices that should be theirs to make. If a doctor thinks that a patient with glaucoma, multiple sclerosis, nausea from chemotherapy or chronic pain would benefit from medical marijuana, the patient should have that choice. If patients would benefit from palliative care, they should be told. And if a terminally ill person wants to have some control over the time of his or her own death, that should be their decision, not the government’s.
FEATURED POLICIES FOR 2018
Prescription drug prices rose about ten percent each of the past five years and drug costs are the fastest-growing component of health care in most jurisdictions. So, it is not surprising that the overwhelming consensus among Americans is that pharmaceutical companies are charging too much. In 2017, Maryland enacted first-of-its-kind legislation to directly address high drug prices. The Prohibition on Price Gouging for Essential Generic Drugs Act allows the state Attorney General to go to court to stop unconscionable price increases for certain medicines.
Pharmacy benefits managers (PBMs), on behalf of health insurance companies, often prohibit pharmacists from informing their customers about less expensive ways to pay for their medicines. Such contract provisions are unfair to both pharmacists and their patients. The No Gag Rule on Pharmacists Act prohibits health insurance companies and PBMs from using contracts to prevent pharmacists from telling their customers about cheaper ways to buy prescription drugs.
The Congressional Budget Office (CBO) estimates that repeal of the Affordable Care Act (ACA) and the ensuing market collapse could cause nearly 30 million people to lose health care coverage, especially those in working families. Each state and locality should prepare now to protect as many residents as possible. States and localities can follow the state of Maryland which enacted legislation to create a study commission to report on the impacts of ACA repeal and recommend policies to prevent the broad-scale loss of healthcare coverage.
Smoking is the leading cause of preventable deaths in our nation, killing more than 480,000 Americans each year. More than 90 percent of smokers start as teenagers and, therefore, young people are heavily targeted for advertising by the tobacco industry. Legislation increasing the tobacco age to 21 will cut the number of people who start smoking, and that will reduce deaths, disease and health care costs caused by tobacco use. Five states (CA, HI, ME, NJ and OR) as well as at least 275 localities (including Boston, Chicago, Cleveland, Kansas City and New York City) have raised the age for tobacco sales from 18 to 21.
E-cigarettes are battery-powered devices that mimic cigarettes. A heating element vaporizes a nicotine liquid, which is inhaled by the user. Both the benefits and risks of e-cigarettes are rather uncertain, but nicotine is certainly an addictive substance and some teenagers who were otherwise nonsmokers are using e-cigarettes. Nine states and more than 500 localities have specifically applied workplace smoking bans to e-cigarettes, in part because their safety is not established and because their use causes confusion as to where smoking is allowed.
End-of-life palliative care
All too often, terminally ill people are not provided adequate information about their physical condition or counseling about palliative care and end-of-life options. Too often they feel abandoned by the healthcare system and suffer unnecessary physical or psychological pain. People have a right to know when treatments offer only a tiny chance of prolonging their lives for a few weeks or months. And they have a right to know about palliative therapies which could make them feel a lot better for their remaining time. A few states now require healthcare providers to address the needs of the terminally ill. In New York, for example, when a disease is terminal and patients are unlikely to survive six months, doctors must inform them of this, and advise them of available medicines and treatments that comfort rather than cure. Palliative treatment can ease anxiety and pain, and can be administered at home, a hospice, or a specialized hospital unit. A good law also encourages the creation of interdisciplinary palliative care teams to provide medical, spiritual, psychological and practical support to patients and their families. And just incidentally, by eliminating medical procedures that patients don’t want, it also saves many millions of dollars.