Sen. Susan Collins gets AHA Honorary Life Membership Award
During the American Hospital Association's (AHA) 2018 Annual Meeting in Washington, DC, on May 7, Sen. Susan Collins (R-Maine) received the AHA's Honorary Life Membership Award for her contributitons to hospitals and healthcare in America.
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AHA board member Michelle Hood, president and CEO of Eastern Maine Healthcare Systems, and former AHA board member Kris Doody, CEO of Cary Medical Center presented Collins with the award.
Below are the Senator's remarks:
Thank you so much for such a warm reception. That’s the way I’d like to start every one of my days, if you could be around.
I want to particularly thank Michelle and Kris. I am deeply honored by this recognition and I’m delighted be here with so many dedicated health care leaders in Maine and across America, including Seema Verma, an extraordinary public servant.
It is especially significant to receive this award from Michelle and Kris. I am proud to live in Bangor, Maine, and I know first hand, from my time serving on the board of Eastern Maine Healthcare Systems before I was elected to the Senate some 21 years ago, that they continue to make great contributions to the health and well-being not only of people in the Bangor region but in other regions of our state as well.
As for Cary Medical Center in Caribou, well, as has been mentioned, I was born there. I still have the bib to prove it. It is truly a community hospital with an emphasis on “community.” And, two months ago, when my beloved father died at Cary, it was Kris who made sure that we had everything we needed, and it’s the kind of compassionate care that you see at hospitals throughout our nation. I’m also proud that Cary is the site of our nation’s first Community Based Outpatient Clinic for veterans, it has led the way in expanding access to quality health care for the men and women in uniform who have served our country so well.
The scope of the activities at these two institutions is replicated by AHA members throughout our nation. From primary and acute care to surgery, research, home health and wellness programs, America’s hospitals – both large or small, urban or rural – are essential to our communities, our patients, and our families.
The problem of ensuring affordable access to quality health care for all Americans is one of the most significant domestic challenges facing our country. There are still too many Americans today without affordable health insurance or with health insurance that has such high deductibles that it’s really like having no health insurance at all. Hospitals and other health care facilities in too many communities are under severe financial pressure, which leaves many wondering whether there will be convenient health care access in the future. And, as I know from the State of Maine, people want to be able to get their care locally as much as possible. They don’t want to have to drive long distances during a winter blizzard in order to get the care that they need. And it’s even worse when it’s an April blizzard to get the care that they need.
Successfully addressing these issues, however, will require us to overcome one considerable obstacle: and that is the excessive partisanship in Washington. That, my friends, is the single greatest impediment to health care reform.
In my work on this issue, I have always been guided by the central tenet of the Hippocratic Oath – “First, do no harm.” The current system is not working well for many Americans, but in trying to solve this problem, we must not make matters worse.
Unfortunately, there are a few in Washington that are guided by a different motto – “My way or the highway.” From the passage of the Affordable Care Act eight years ago to the ill-fated repeal and replace attempts last year, to the failure to pass common sense measures to stabilize our health insurance markets and bring down rates by as much as forty percent over the next two years, health care has far too often been used as a wedge rather than as a challenge that can only be met by our working together.
Now, I opposed the Affordable Care Act eight years ago because I foresaw many of the problems that are now apparent, such as skyrocketing premiums, limited choices, unstable insurance markets, and Medicare cuts to hospitals and other providers.
But I have been clear from the start, that we cannot simply wipe out the ACA with a stroke of a pen without having a well thought-out, workable, and better alternative in place. Last year, I was disappointed that the leaders of my party repeated the same mistake the Democrats leaders made in passing the ACA without a single Republican vote. The Senate health care bills bypassed the standard legislative process that, while, at times, is not pretty, and can be pretty messy, helps to ensure a better final product and one that has bipartisan support.
After these bills were defeated, it seemed as though there was finally a willingness among both parties to sit down and begin to have a serious discussion about the ways to fix our health care system. The Senate Health Care Committee, chaired by Senator Lamar Alexander with Patty Murray as the Ranking Member, convened a series of excellent hearings in which we received inputs from a variety experts, including actuaries, insurance regulators, insurers, governors, patient advocacy groups, and, of course, health care providers – including hospital administrators. These hearings and roundtables were widely attended by both Republican and Democratic members, and I began to believe that we really would come up with a series of bills that would improve our healthcare system.
Regrettably, there was a bill that was introduced that would’ve made widespread cuts in the Medicaid program without a proper evaluation of the impact and would have taken a trillion dollars out of the Medicaid program over the next decade.
Rural hospitals across the country are already eliminating services, such as obstetrics, oncology, pediatrics, and psychiatry. And I can just imagine what would happen if we treated all states the same with a per beneficiary cap. That might work well in a state with a very young population that is very healthy, like Utah perhaps. In my state, the oldest state in the nation, it would’ve been a disaster.
Last year I spoke with the marketing director of a small hospital in Greenville, Maine. If you haven’t been to Greenville, I recommend it. It has a beautiful lake, the largest lake in our state. That’s my one advertisement during this speech. And she pointed out to me that they were the biggest employer in town, with 180 FTEs. They rely on Medicaid for 65 percent of their revenues, so there was no way this vital hospital would survive the cuts that were in either the Senate or the House bills. Hospital closures unquestionably have ripple effects on the economic growth of the communities they serve as well as the convenient access to healthcare that they provide.
Rather than reshaping one-sixth of our economy in this fashion, I joined with HELP Committee Chairman Lamar Alexander and Energy and Commerce Chairman Greg Walden and many others to advance a legislative strategy that focused not on solving everything at once, but on targeting specific problems. Much the way a health care professional approaches an illness or an injury.
The first component was legislation based on the Alexander-Murray bill to fund cost-sharing reduction subsidies for three years. Contrary to the rhetoric that you hear, these are not a bailout for the insurance industry. What they do is help our lowest income Americans, those making under 250 percent of the poverty rate, to afford their co-pays and deductibles so that insurance is meaningful for them.
Second, we sought to improve the ability of the states to take innovative steps to lower insurance premiums to experiment with different deisgns while keeping in place the prohibitions against discriminating against people with preexisting conditions. It would revise what is known as Section 1332 of the Affordable Care Act, which authorizes state innovation waivers, and it would’ve given SEMA much more flexibility to do so.
Third, in my view the provision with the most impact, was a bill I authored with Senator Bill Nelson, a bipartisan bill, that would have provided $30 billion over three years for states to establish reinsurance or invisible high-risk pools by applying for a waiver under the Section 1332 program I just mentioned. According to leading health care experts, our bills would lower individual health insurance premiums in the individual market by as much as 40 percent compared to what people otherwise would have paid. I would note that Oliver Wyman also projects that our bills would’ve expanded coverage to an additional 3.2 million individuals.
So in considering this plan, the Senate, indeed the Congress, faced a fundamental question: do we want to take action to significantly reduce the cost of health insurance for millions of Americans who do not receive insurance through their workplace, or are we going to just sit back, say no, and let this opportunity pass us by? Regrettably, some were more interested in retreating to ideological corners rather than coming together in good faith to solve this looming problem.
And make no mistake about it - if Congress fails to act, insurance rates in the individual market will skyrocket this fall. And this will directly harm the nine million Americans who pay for their own insurance without government or employer assistance. A growing number of counties in our country are at risk of having no insurer or only one insurer, leaving hard-working individuals with few or no choices for health insurance coverage. Inaction will only exacerbate the premium spikes and market instability that we have already experienced.
So, my friends, I’m counting on you to make the case on Capitol Hill as you do your visits, as you communicate with your members of Congress. You are on the front lines. You have tremendous credibility. We must work together, across party lines, to develop health care reforms that work for all Americans. We must stop allowing partisanship to be a pre-existing condition that prevents meaningful health care reform. The American Hospital Association is such an informed and effective voice for action. Please keep up the good work that you do in your communities, in your states, and here in Washington. And, again, thank you so much for this prestigious award, it means a great deal to me. Thank you.