Spotlight on Congressman Kenny Hulshof A Leader for Health Care Reform
ACRa staff recently interviewed Rep Kenny Hulshof (R, Mo) regarding his role in the House and how he views health care as a primary issue during the 109th Congress. Hulshof has been a leading advocate to improve the health care system. Elected to Congress in 1997, he has worked tirelessly on such issues as providing access to affordable health care, patient safety, and health insurance costs for the self-employed and small business owners.
Hulshof began his political career in 1996 when he was elected to the US House of Representatives from Missouri's ninth congressional district. He serves on the influential Ways and Means Committee.
Hulshof takes an active role in his fight for health care as reflected by his June 2005 site visit to a Missouri radiological practice in his district.
Following are excerpts from this interview:
Q. As a member of the Ways and Means Health Subcommittee, what would you like to see happen this Congress to better our health care system?
A. There are many issues that I personally hope Congress will address in the near future. Health Information Technology is certainly a hot topic. I think the government should encourage adoption of HIT in a manner that will lead to increased efficiency and cost savings in our health care system. I also have an interest in expanding telemedicine's potential.
Also, we need to improve our current reimbursement structure. The emphasis needs to be on the care of patients, rather than simply the cost. Furthermore, we need to explore payment inaccuracies that have been built into the Medicare program. It is estimated that Medicare payments are inaccurate nearly 65% of the time. In refining payment methodologies, payments can more accurately reimburse providers and improve overall health care.
Q. The MEDPAC report listed medical imaging as one of the bigger drivers of increased health care costs. Would you support efforts to reduce these costs by imposing quality and safety measures on all physicians to weed out those who are more profit-centered than patient-centered?
A. We must strive to find ways to reduce the escalating cost of health care in this country. According to the March MedPAC report, from 2002 to 2003, the imaging volume growth rate was 8.6%, while the growth rate for tests was 9.4%. Not only does this raise Medicare spending, but it adversely affects physician reimbursements through the SGR formula. This clearly demonstrates the need for Congress to be good stewards of taxpayer dollars as it applies to the Medicare program and to ensure that payment policies do not inadvertently encourage overutilization. However, as with other issues surrounding our health care system, the main focus should be on the patient. As a general principle, policies should ensure increased quality of care and patient access to diagnostic tools. I believe this can be achieved in an efficient and cost-conscious manner.
Q. What are the chances of Congress passing a Medicare pay-for-performance bill by the end of this year? Would such legislation include language to avoid the pending 4.3% cut for physician services in 2006?
A. There is much momentum behind averting impending reductions in the physician fee schedule and tying it to quality standards. In doing so, it is important to focus on patient outcomes, rather than simply clinical data. I am one of many members, both on and off of the Ways and Means Committee, who support addressing the physician payment issue. I have a good feeling that this will be addressed in the near future.
Most recently, legislation has been introduced to replace the SGR target with a MEI reimbursement formula. This legislation also sets forth a physician value-based payment system that will determine quality indicators based on input from the various specialty groups. Although many of us in Congress would prefer to see CMS implement administrative solutions to avert reductions in payment, it seems more and more likely that we will need to act through legislation.
Q. You have been a strong voice for patients. What do you feel is the biggest crisis with our health care system today?
A. There are many challenges we face regarding health care in the nation—45 million individuals lack health insurance during some portion of the year. Along with the increasing number of uninsured, the number of retirees in the future will nearly double. It is imperative to promote the purchase of long-term care insurance. The average individual living in a nursing home setting will spend approximately $70,000 a year, which many families will struggle to afford.
I also think that we have an impending physician shortage if changes are not made in the near future. Medical malpractice, coupled with declining reimbursements, may eventually limit access for patients. This is even more critical for those who live in rural areas.
Q. What can ACR members do to become more active in advocating their issues in Congress?
A. The most important thing is to let your voices be heard by your representatives. All members of Congress should be approachable—after all, we were sent to Washington to represent you. Never hesitate to pick up the phone and call your member's office.
I encourage you to schedule a meeting with your respective member, either in DC or in the district office. Let them know how federal policies impact radiologists and the patients you treat.