Responses to District of Columbia Political Action Committee (DOCPAC) questionnaire.

1) Bill 12-501, the “Health Benefits Plan Grievance Procedure Establishment Act of 1997”, establishes grievance procedures for members of health benefits plans in the District of Columbia. At the Council’s hearing on the legislation, the Medical Society testified in support of the legislation, but urged Councilmember Allen to expand the legislation. Please indicate your position on the bill. We would also welcome your comments on federal legislation on similar and related issues currently being considered by Congress. Do you have a position on the president’s Consumer Bill of Rights? If so, please describe it briefly.

“The Health Benefits Grievance Procedure Establishment Act of 1997”, which I co-sponsored, is a forward thinking piece of legislation. It places the District of Columbia on the cutting edge in regard to legislation designed to protect citizens enrolled in health plans when they believe that the care they received was inadequate. I take seriously the issues brought before the Council by the Medical Association. Regarding the issues raised in your testimony, I am inclined to support all three of your recommendations, but would also be interested in hearing other views before I would proceed. After weighing all the evidence and if it is determined that there is no adverse impact on other groups, I would be happy to support amending the current bill to include your suggestions. While much of what one hears regarding current health care plans is anecdotal, I do think we should put in place strong mechanisms to assure that the weakest of us — the ill — are protected. At first blush, the president's plan seems to meet that criterion.

2) In Council Period Xl, the Council enacted legislation to regulate HMO's, (Law I 1-235). The Department of Insurance and Securities Regulation is currently drafting legislation to implement the law. Do you have any comments regarding issues that should be covered by these regulations?

Your organization, like the Council, is still waiting to see the regulations that should have been forthcoming from the Department of Insurance and Securities Regulation three years ago. It is unconscionable that our government should leave its citizens hanging. This agency is one that is still under the purview of the mayor. I assure you that as your mayor these unreasonable delays will not occur. If we put laws on the books, we expect to see them enforced. We in government must monitor the laws and give our citizens an opportunity to have input on how they will be implemented. One reason I want to be mayor is because all too often as a Councilmember, I have sponsored laws and had them enacted; yet they were never implemented. When I am elected, I will see that this law and all others passed by the Council are implemented.

3) There are many parts of the city that are currently considered under served by physicians. Do you have a plan for attracting and retaining physicians to the District of Columbia and more specifically to these under-served areas?

Tax relief for our citizens is one of the cornerstones of my campaign. I am looking at various ways to give tax incentives to small businesses and professionals — including physicians. As part of efforts to increase care sources in under-served communities, tax relief can be an excellent incentive to physicians who locate their practices in these neighborhoods in much the same way that the Public Health Service offers incentives to young physicians who locate in out-of-the-way places. I am also thinking about ways in which development projects in under-served neighborhoods could serve to attract physicians; for instance, developers could be asked to assure that space is available for physicians in any new projects that they are putting up in these neighborhoods. Streamlining the process of doing business in the District is another cornerstone of the campaign and it is important to keep in mind that, while health care is an invaluable public good that must be maintained for the benefit of all, it needs to also operate as an efficient business. Today's health delivery system adds mountainous administrative costs to the delivery of high quality health care. In a Schwartz administration, we will find ways to help cut these costs and make the District a more attractive location for doctors and their practices.

4) What do you think needs to be done to ensure a viable future for the Public Benefit Corporation, including the hospital and its community clinics?

The District must enter into a fair and equitable contract with the Public Benefits Corporation (PBC). For many of the very poor in our city the PBC is the health provider of last resort. When HMO's will not take our Medicaid patients it is to the PBC that our poor residents must turn. They are not remunerated for these services. The Public Benefits Corporation has made strides since its inception in 1997. One such stride is the 96% rating it received on an on-site survey conducted by the Joint Commission on Accreditation of Healthcare Organizations (JACHO), which examined clinical and management performances of the hospital's lab services. I intend to see that our city hospital continues to succeed and as mayor, I will do battle with the Financial Authority and any other entity to assure that our public hospital can meet its goals and provide increasingly high-quality health care.

5) Do you support legislation to implement medical liability reform? Do you support limits on recovery of non- economic damages? Please elaborate as to your reasons why?

Yes, during my tenure on the Council in the 1980’s I co-sponsored legislation to bring this about. We must find ways to bring down expensive malpractice costs so that that money can be directed toward much needed patient care.

6) In your opinion, what are the biggest issues facing the physician community today?

Medical technology to improve patient care is advancing at a pace never before experienced in this country. We must ensure that physicians in the District are not hindered in their abilities to access the best technology. Unfortunately, physicians responsible for delivering that care face greater restrictions through the inappropriate intrusion of some managed care plans. Ultimately, it is costlier to the community and contrary to the best ethical medical practices for systems to rely on non-medical judgments to override those made by treating physicians. Responsible cost containment is consistent with sound medical practice and ethical patient care.

7) What message would you deliver to organized medicine in the District?

It is my intention to help bring about the responsible delivery of health care services in the public and private sectors to the citizens of the District of Columbia by ridding our delivery system of intrusive external practices that do not serve the best interests of patients. I will work with your organization and the D.C. physician community to address our mutual concerns as I always have in the past as a Councilmember.

8) If elected, what would be your top five priorities?

First and foremost, a healthy District economy helps to ensure a vibrant and robust health care community. Eliminating onerous taxes can help to lower the cost of health care and contribute to the long-term viability of small private clinics and practices. I have spent my entire legislative career working to reduce taxes for the citizens of the District of Columbia and I have had some success. As mayor, I will continue to work on this issue. Secondly, the elimination of burdensome and unnecessary regulatory requirements can also assist health care providers in better serving our residents through lowered costs. I fully intend to see that our regulatory processes are streamlined. Thirdly, we must realize the value to public health of having a high quality public educational system in the District. In addition to its medical aspects, public health also encompasses educational programs that promote the importance of such things as preventive checkups and frequent screening for basic diseases. Healthy living is the product of making educated choices about things such as diet, nutrition and exercise. As mayor, I can promote educational efforts about these and other health-related issues, including alcohol and drug abuse. Fourth, access to affordable health care is another of my priorities and we must assure that all of our citizens have the ability to take advantage of quality health care services. We must be especially concerned about the availability of essential medical care and services to pregnant women and their infants, seniors and youth. As a final priority, I would focus upon the importance of public safety. There are fewer public health concerns of greater import to our residents than public safety. Crimes of violence in our city, such as murder and robbery, oftentimes appear to outpace some medical diseases in terms of fatalities. Public safety must be viewed as a public health matter and I will search for ways to make our streets safer from crime so our citizens can enjoy longer and more rewarding lives.