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Whitehouse’s first bills focus on health care

01:00 AM EDT on Tuesday, May 22, 2007

By Felice J. Freyer

Journal Medical Writer

Sen. Sheldon Whitehouse outlines his plan to introduce three bills focused on health care, while U.S. Rep. Patrick Kennedy, center, and Cranston Mayor Michael Napolitano listen.

The Providence Journal / Kathy Borchers Kathy Borchers

CRANSTON — U.S. Sen. Sheldon Whitehouse yesterday gave the first glimpse of his legislative priorities as Rhode Island’s newest senator, announcing that the first three bills he plans to file will focus on health care.

One bill would provide grants to local agencies devoted to improving health care. Another would establish a private not-for-profit corporation to develop a nationwide network for electronic health records. The third would empower states to define “best practices” in health care and to require insurers to reimburse for all care that follows those guidelines.

“The legislation that I’m going to put forward comes out of personal experience … the stories I’ve heard from Rhode Islanders,” said Whitehouse, who took office in January. He said the daughter of a constituent’s fiancée nearly died because her paper medical records were lost on the way from Providence to Boston. All the tests had to be repeated, delaying her care.

The proposals also emerge from his experiences as attorney general of Rhode Island, where he founded the Rhode Island Quality Institute, a not-for-profit agency that has worked to promote electronic prescribing and electronic health records.

Whitehouse’s announcement drew a standing-room-only crowd of reporters, Cranston officials, representatives of the state’s health-care industry and U.S. Rep. Patrick J. Kennedy to a small waiting room at the Cranston Community Action Program’s health center.

Behind him were two bookcases stacked with paper files. Joanne McGunagle, executive director, explained that the health center recently spent $25,000 on renovations to make room for such paper medical records. Switching to electronic health records would cost more than $1 million, an amount “not on the radar screen for community health centers,” she said.

“We are almost desperate for this program,” McGunagle said, of Whitehouse’s proposal.

Whitehouse said that the RAND Corporation estimated that “if we can get health information technology up to snuff,” the nation’s health-care system could save anywhere from $81 billion to $346 billion a year. “That’s a trillion dollars every three years,” he said. “That solves the uninsured.”

Whitehouse’s bills do not yet have any cosponsors. “I’ve spent a lot of time shopping the idea around Washington,” he said. The grant program, because it is simple and straightforward, has the best prospects, Whitehouse said.

These are Whitehouse’s proposals:

•The Quality Reform Expansion and Savings Act. The bill would create a $100-million grant program to support local, regional or statewide organizations that are working on improving the health-care system with such projects as developing electronic records, promoting prevention and detection of illness, changing the reimbursement system, or expanding health-care coverage. Whitehouse said that nationwide, there are about 30 such organizations, like the Rhode Island Quality Institute, which are performing “the R&D function” for health-care reform.

•The National Health Information Technology and Privacy Advancement Act. This bill would create a private, not-for-profit corporation to build a nationwide system to electronically connect doctors, hospitals and pharmacies. The corporation would design, own and manage the information technology network for the health-care industry, and would ensure that all electronic medical records are confidential, secure and compatible. It would be financed with user fees that providers and insurers would pay to access it.

Whitehouse acknowledged that this corporation would be doing essentially the same work that is now assigned to the federal Office of the National Coordinator for Health Information Technology. But that office, he said, lacks the resources and the leadership to move as quickly and comprehensively as needed.

•The Improved Medical Decision Act. This proposal allows state health departments to require health insurers to pay for the best quality care, according to guidelines recommended by medical groups and established in a public process.

This bill is a different approach to efforts already under way, by private insurers and the federal Medicare program, to reward doctors and hospitals for providing the best care. But Whitehouse said that Medicare’s efforts are too small and slow moving, and that for-profit insurers are “not motivated in the right ways.”

Although these “pay for performance” measures are controversial among doctors, Steven R. DeToy, spokesman for the Rhode Island Medical Society, said his group supports the premise, as long as the standards used are scientifically based. But he said a national approach makes more

ffreyer@projo.com

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