Longjohn Prescribes A Different Healthcare Plan Than Upton

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Dr. Matt Longjohn is the Democrat challenging Republican incumbent U.S. Rep. Fred Upton in Michigan’s 6th congressional district on November 6th. In an interview with WSJM News Director Doug Cunningham, Longjohn lays out wha the says is a very different vision of healthcare than Rep. Fred Upton’s.

 

Doug Cunningham: Upton voted to repeal the Affordable Care Act and he voted for Trumpcare – the  American healthcare Act – which the CBO said would result in 23 million more uninsured people. So talk to me about how you would be different than Fred Upton on healthcare and what you would like to see happen.

 

Dr. Matt Longjohn: “I’m runnin’ for Congress for the same reason that I went to medical school. To help people live healthier lives, to help people have a chance at a higher quality of life. And you can’t live your healthiest possible life in a healthcare system that Mr. Upton is envisioning.

 

We need to look not just at what he says, but how he’s voted. – to your point. His votes on repealing the Affordable Care Act without having any real plan for replacing it, for watering down

insurance coverage requirements for pre-existing conditions and essential health benefits.

 

Essential health benefits  – the definition – are proven medical services that everyone basically needs at any point in their life. It might be an ambulance ride to the emergency room, that is an essential health benefit. It might be a mammogram, preventative services and other things that have been shown by science over decades to be essential to people’s health are essential health benefits.

 

The Affordable Care Act was actually called The Patient Protection and Affordable Care Act. PPACA was the official name of Obamacare. And we can all agree that health care costs have not been going down. The affordability in the Affordable Care Act has not been working. But the patient protections part of that law have been working. That’s where the essential health benefits and the pre-existing conditions  coverage was required.

 

And when the Upton Amendment was moving forward last year onto Speaker Ryan’s American Health Care Act – the Republican

Plan – he was willing to waive coverage for pre-existing conditions. He was willing to waive coverage for essential health benefits. He was willing for insurance companies to be able to sell junk to people.

 

And ultimately it was expected that 23 million Americans would lose their health insurance because of that bill passing. 40,000 people in this district alone would have lost their health insurance.

 

As I said at the beginning of this answer, I went to medical school to help people live healthier lives. I knew that what was being proposed last summer – what Mr. Upton took the lead on in drafting the Upton Amendment –  was wrong for people in this district, wrong for people across the country. And I’m standing up and running against him in large part because of what he was

willing to do on healthcare.”

 

Doug Cunningham: In terms of what was wrong – there was certainly a lot wrong with the American Health Care Act from the perspective of a patient or a human being who needs healthcare.

But in terms of what you would really support and vote for in Congress, or push for, or advocate for. Are  for a Medicare For All universal system or are you for maybe trying to improve the Affordable Care Act and something that’s not quite all the way to Medicare For All ?

 

Help us to understand more about what a healthcare plan that you would support would look like.

 

Dr. Matt Longjohn: First of all, I just have a hard time signing up to anything that’s a slogan or a logo. I think there’s a lot of confusion here when people use three, four word summaries of healthcare. It’s complex. It’s not something that we can just summarize by saying universal healthcare or Medicare For All. Those are not answers that actually mean anything when ti comes down to specific policy.

 

So let me be specific. The goals that I have in mind for healthcare reform – there are four of them.

 

The first is to improve healthcare quality. Medical errors are still the third leading cause of death in the United States. So we need better healthcare. That’s goal number one.

 

Goal number two – we need lower cost healthcare. How are we gonna bend the cost curve? How are we gonna decrease the cost of healthcare? Some of it can be through insurance reform.

But mostly we have to start paying for different things and paying for those things differently.

 

We need to invest in prevention. We need to make sure that people live healthier lives longer. And right now, if we are only interested in paying for things on the backend of healthcare after people get sick, we’re always goin to be dealign with the most expensive parts of healthcare and we’re not preventing illness in the first place.

 

The reason why I had been identified as one of the top healthcare innovators in the country is because I figured out how to – with my team at the YMCA nationally – how to unlock the value of community in helping keep people healthy.

 

We demonstrated in seventeen cities in eight states over a number of years that community health workers, community health jobs, can prevent up to 71 percent of new cases of diabetes. Providing a five to one  investment on Medicare if we focus on prevention.

 

Third is improving patient centered outcomes. And what this means is making sure that the patients is at the center of healthcare decisions. That means that if you’re looking at the quality of life of a patient as an outcome measure, that might be something like someone’s health 90 days after a procedure might determine whether or not a surgeon gets paid fully for a procedure done 90 days earlier.

 

We’re talking about healthcare now in a system that pays for volume. This is why we get a fifteen minute visit at the doctor’s office. And what I’m saying is we need to be paying for value. We need to be paying for outcomes that people care about.

 

And right now there’s a benefit that the Affordable Care Act helped pilot called the Comprehensive Joint Replacement  Benefit, which is one example of this. So if someone need a hip or a knee – a replacement procedure – in the old days in healthcare that orthopedic surgeon would be paid the same amount for every time anyone was getting that kind of procedure.

 

What I’d like to see happen is that those procedures get paid for

after someone has demonstrated an improvement in health. Not just kind of putting people on a conveyer belt through the operating room and seeing payment get paid for every time they’re done. But making sure that the outcomes are tied to the payment. So that’s a patient centered outcome.

 

If someone is unable to walk 90 days after a hip replacement then that procedure didn’t go well. And we shouldn’t be paying for it as taxpayers to the same degree that we’re paying for things that did go well.

 

The fourth thing is health equity. This means making sure that we aren’t leaving people behind in a health system that’s changing. We need to over-invest in making sure that the people who are most at risk for healthcare needs are served and served well.

So that it’s not just equally accessible to everyone – this healthcare system – but that we actually work hard to make sure that the people who are being left behind have a chance to catch up.

 

This quadruple aim has been recognized by healthcare reformers for over a decade as to what we’re trying to do with healthcare. I think we need someone in Congress who understands these things, who’s not just going to be voting on healthcare along party lines or who’s only going to be voting according to the interests of corporate lobbyists who are informing their view of healthcare.”