Question 1 1. Which of the following statements best describes your view of our current health care system?

Our health care system is broken and needs a complete overhaul.

Overall, the health care system is working and needs only some minor adjustments.

Significant changes are needed to make our health care system work much better.

Candidate's Comments The biggest problem with the American health care system is that it costs too much. Businesses and families pay more and more every year to get what they often consider to be inadequate attention or poor care. And those who want to buy insurance are often unable to afford health insurance because of the high cost. The growth of costs affects everyone: family budgets, government overspending, and business costs. We need to make health care more affordable for all Americans by ensuring that every aspect of the health care system competes vigorously to respond to their needs. I believe that every American should have access to quality and affordable care of their choice. I will provide American families with a $5,000 refundable tax credit ($2,500 for individuals) to purchase insurance of their choice. I strongly support Americans keeping their existing coverage. If you want to keep your employer insurance, you can. But you also have the option to investigate other policies. If you already buy insurance on your own, you now get the same tax break as those who have employer insurance and can use the added income to invest in your business and grow. If you didn’t have insurance, you now have some help in buying insurance. When coupled with my reforms to spur innovation and flexibility in insurance options, this will permit everyone to have the opportunity to buy insurance. We need to strengthen health care quality by promoting research and development of new treatment models, promoting wellness, investing in technology and empowering Americans with better information on quality, treatments and costs. We need to ensure that coverage is portable and follows every American from “job to job” or “job to home,” and protect Americans’ economic security from unforeseen health events by expanding coverage and savings options.

Question 2 2. In a recent survey, a majority of Americans (81%) say they are dissatisfied with the cost of health care in this country. As President how will you address health care costs for Americans?

Candidate's Comments Within a decade health spending will compromise twenty percent of our economy. This is taking an increasing toll on America’s families and businesses. It is imperative that we demand more for our health care dollar instead of simply throwing more taxpayer dollars into a broken system. First, we need to inject competition into all aspects of health care—in insurance, in procedures, in cost of treatments—to turn innovation loose on the 16 percent of our economy that is currently health care. Second, we need to do a better job of taking care of our citizens with chronic illness—70 percent of health care costs—to give them better health and reduce costs. We need to reduce the use of hospitals and nursing homes and support research on the care and cure of chronic illness. Third, we must also renew and increase personal responsibility for our health. Many of our chronic diseases are caused or aggravated by our behavior. Obesity in the young and old contributes to diabetes, heart disease and high blood pressure. Getting screening exams can lead to early and often complete cures. And following the appropriate treatments after we are diagnosed can produce better health, longer life, and lower costs. Finally, we need to undertake more common sense reforms like rapid deployment of health information technology to increase quality and reduce errors, allowing for more affordable drugs through safe re-importation and faster introduction of generic drugs and by facilitating a more coordinated and transparent health care delivery system.

Question 3 3. Do you agree or disagree that it is the responsibility of the federal government to ensure all Americans have basic health care coverage?

Agree

Disagree

Don't Know

No Opinion

Candidate's Comments I believe that all Americans should have access to quality and affordable health care of their choice, including keeping their current coverage. We can build a health care system that is more responsive to our needs and is delivered to more people at lower cost and higher quality. The "solution" isn't a one-size-fits-all-big government takeover of health care.

Question 4 4. How well do you think the Medicare prescription drug benefit for seniors is working?

Working very well

Working well

Working somewhat

Not working well

Don't know

No opinion

Candidate's Comments Rising drug costs continue to present a challenge for our nation’s seniors. We need to ensure that our nation’s seniors have access to affordable drugs. I will look to bring greater competition in drug industry through safe re-importation of drugs and faster introduction of generic drugs. I also support greater competition in the biotechnology market by allowing safe and effective follow-on biologics (FOBs) to enter the marketplace while ensuring that future research and development is not hindered. This will ensure that all Americans, especially our seniors, have access to more affordable life-saving medications. We also need a more fair system of cost-sharing for the Medicare drug benefit, so we don’t have middle class Americans subsidizing the benefit for the rich. It is only fair that individuals like Warren Buffet should pay more for the drug benefit than a retired school teacher.

Question 5 5. What strategies would you use to increase the focus on prevention and wellness in our health care system?

Candidate's Comments Focusing on prevention and wellness is an important aspect of my health care plan. Prevention and maintenance should be included as part of the basic qualified insurance proposals so that when individuals are shopping for health coverage of their choice they are able to find an affordable plan that offers access to important preventable measures. Wellness plans should be encouraged that reward and encourage healthy behavior. Plans should be allowed greater flexibility for providing financial rewards including reduced premiums for healthy lifestyle behavior as well as surcharges for individuals who continue to elect proven unhealthy lifestyle behaviors. I have authored comprehensive legislation reducing the sale, distribution, and marketing of tobacco products to minors and educating the public about the dangers associated with tobacco use, particularly cancer. I am also a strong supporter of wider implementation of smoking cessation programs to promote a healthier lifestyle for all Americans. We also need to invest in the habits of future beneficiaries. It is imperative that we use educational tools and proven strategies to affect the behavior early in the lives of children. The challenge of childhood obesity is very serious. And there are many things that schools can and are doing to create a healthier environment for our children. Current strategies include removing vending machines, providing healthy, low fat menus in school cafeterias, and providing more physical education and recess opportunities for children. However, each school has unique needs and challenges relating to the general physical health of students and decisions regarding how to address child obesity concerns should be made at the local level to ensure they reflect the needs of their specific students. Intervention prior to the onset of chronic disease is an important contribution to prevention. We also need to invest in a strong and diverse workforce, especially with a focus towards primary care, to ensure that Americans have access to basic care that will prevent onset of more serious illnesses. We also need to strengthen community health centers and promote medical homes, and encourage innovative treatment settings like walk-in clinics that provide convenient access to basic affordable care.

Question 6 6. Most agree that the use of standardized electronic health records (EHRs) will make the health care system more efficient and reduce medical errors. As President, do you think the cost of implementing EHRs should be paid for by the public sector, the private sector or some combination of the two?

Public

Private

Combination

Don't know

No opinion

Candidate's Comments Rapid and widespread deployment of electronic health records for all Americans is an important priority for me. Electronic records will not only lower health care costs through better coordination of care but also increase quality of care by preventing medical errors. EHRs will also provide us with information to develop new patient-centric treatment models that promote quality and efficiency. I will work in a partnership with the private sector to develop greater incentives to promote its adoption throughout the provider community.

Question 7 7. The National Institutes of Health (NIH) is the agency that funds most of the medical and health research paid for by U.S. taxpayers. Since 2003, funding for the National Institutes of Health (NIH) has been outpaced by inflation. Which of the following statements comes closest to your view on funding for NIH?

Funding for NIH is not a priority.

Current U.S. funding for medical and health research is sufficient and other budget items are higher priorities now

The U.S. must increase investment in NIH as a critical strategy to improve health care

Candidate's Comments I strongly support funding for the NIH. NIH plays an integral part in ensuring that America is on the leading edge of medical innovation against devastating diseases like cancer, Parkinson’s and Alzheimer’s.

Question 8 8. The Centers for Disease Control and Prevention (CDC) is charged with protecting the health and safety of Americans. In recent years, funding for core programs (such as chronic disease and injury prevention, tobacco control and environmental health) at the CDC has been cut. Which of the following statements most accurately reflects your view?

Funding for CDC core programs is not a priority

Maintain current funding levels for CDC core programs because other budget items take precedence.

Increase funding for core programs at CDC to improve public health

Candidate's Comments I strongly support funding for CDC. CDC plays an important role in not only promoting better health for Americans through better management of chronic care diseases and encouraging healthier lifestyle habits but also strengthens our homeland security by combating bioterrorism threats, pandemics and promoting emergency preparedness.

Question 9 9. The Agency for Healthcare Research and Quality (AHRQ) is the lead federal agency charged with funding health services research, which seeks to rapidly translate discoveries from research into medical practice and improve the quality, safety and effectiveness of health care. Since 2002, funding for AHRQ has been cut or remained flat. Which of the following statements most accurately reflects your view?

Funding for AHRQ is not a priority

Current funding for AHRQ is sufficient and other budget priorities exist

AHRQ funding should be increased as a strategy to improve health care quality and safety in the U.S.

Candidate's Comments I strongly support funding for AHRQ. AHRQ in partnership with entities from both public and private sectors can play an integral role in the development of new treatment models and better practice guidelines that provide more coordinated and high quality care in a more effective and efficient manner.

Question 10 10. The Food and Drug Administration (FDA) is responsible for protecting the public health by assuring the safety and effectiveness of human and veterinary drugs, biological products, medical devices, our nation's food supply, cosmetics and products that emit radiation. Which of the following statements best reflects your opinion?

Funding for FDA is not a priority

Current funding levels are sufficient for FDA to fulfill its mission

Current funding levels for FDA are not keeping pace with accelerated drug and device creation or the increasing globalization of food supplies and should be increased

Candidate's Comments I strongly support FDA funding. We need to ensure that FDA has the proper resources to maintain its duty as the guardians of our nation’s drug and food supply in an era of growing global economy. FDA can also play an important role in promoting greater market competition, especially in drug sector, by having more streamlined processes for drug approval.

Question 11 11. How important would you say it is that the U.S. work to improve health globally? If important, please describe how you plan to increase our nation's role in promoting and improving global health. If not, please explain why.

Very important

Somewhat important

Not too important

Not at all important

Don't know

No opinion

Candidate's Comments By continuing to build on our role as a global leader in helping provide medical care and public health interventions in areas of need, we will contribute to a more peaceful and stable world and foster a more positive view of the United States while safeguarding our nation’s health and strengthening our national security. We need to have a stronger focus on disease prevention and wellness through increased co-operation, improved global disease surveillance, better nutrition and medical care around the world.

Question 12 12. Do you support or oppose increasing federal funding for state/local health departments and hospitals across the country that are expected to prepare for and respond to threats to our health?

Support

Oppose

Don't know

No opinion

Candidate's Comments I have been a strong supporter of state and local health departments since they are our first line of response against public health threats, both natural and man-made – everything from a flu outbreak to bioterrorism. They also play an important role in disease prevention and promoting wellness that can significantly reduce health care costs for all Americans. We need to ensure that there is an important focus on developing a strong regional and national strategic plan that focuses on better coordination, improved communication capabilities, and greater accountability to handle the challenges of the 21st century.

13. Current evidence suggests that the U.S. is experiencing shortages and/or poor distribution of certain health care professionals. How high a priority would you say it is for policy makers to create more incentives to encourage individuals to pursue careers as: Physicians?

A top priority

High priority

Somewhat of a priority

Not too much of a priority

Low priority

Not a priority

Don't know

No opinion

Nurses

A top priority

High priority

Somewhat of a priority

Not too much of a priority

Low priority

Not a priority

Don't know

No opinion

Question 13 Dentists?

A top priority

High priority

Somewhat of a priority

Not too much of a priority

Low priority

Not a priority

Don't know

No opinion

Candidate's Comments To ensure that we have an efficient health care delivery system that provides high quality care to Americans at affordable prices, we need to ensure that it is staffed with qualified health care professionals like doctors, nurses and dentists. Addressing the health care workforce crisis is an important priority for me. I will ensure that there are proper incentives in place to address the workforce shortage. First, we need to encourage more public and private sector scholarship programs and loan repayment incentives. Second, we need to ensure that the workforce of the 21st century is diverse and equipped to provide culturally component care. Third, we need to ensure appropriate funding for programs National Health Service Corps and HRSA Health Professions Programs to ensure greater participation in areas of critical shortage like primary care, especially in rural areas. Finally, we need to start recruiting young by offering more internships and fellowships at renowned institutions like NIH and CDC and enhancing leadership training programs.

Question 14 14. Do you support or oppose expanding federal funding for research using embryonic stem cells?

Support

Oppose

Don't know

No opinion

Candidate's Comments While I do support federal funding for embryonic stem cell research, I also believe that clear lines should be drawn to reflect a refusal to sacrifice moral values and ethical principles for the sake of scientific progress. Moreover, I believe that recent scientific breakthroughs raise the hope that one day this debate will be rendered academic. I also support funding for other research programs, including amniotic fluid and adult stem cell research which hold much scientific promise and do not involve the use of embryos. I strongly oppose the intentional creation of human embryos for research purposes. I voted to ban the practice of “fetal farming,” making it a federal crime for researchers to use cells or fetal tissue from an embryo created for research purposes.

Question 15 15. Do you agree or disagree that mental health services should be part of all health care plans in the public and private sectors?

Agree

Disagree

Don't know

No opinion

Candidate's Comments Mental health is a necessary complement to physical health in all aspects of our daily lives. Fortunately, the path to greater quality and lower costs is to recognize this fact and provide incentives to treat physical and behavioral health together. I support mental health parity to ensure that mental health coverage is on par with medical and surgical benefits.

Question 16 16. Comparative effectiveness research compares two alternative treatments for the same condition to see which works better for the average patient. Many feel Medicare and private insurers should only cover the most effective treatment. Others feel, since comparative effectiveness only determines which treatment works best on average, the ultimate decision as to what treatment to be used should be left to doctors and not the government or insurance companies. Which is closer to your own view?

Comparative effectiveness research should be used by insurers and government to deny coverage for treatments that are less effective on average

Comparative effectiveness research should be used to inform patients and doctors but the decision on which treatment to use should be made by patients and doctors, not government or insurance companies

Don't know

No opinion

Candidate's Comments We need greater efficiency in our system to ensure that Americans are getting better value for their health care dollars. Although comparative effectiveness research holds great promise in helping us achieve this goal by better informing us about effectiveness of treatments, we need to ensure that this does not stifle the spirit of innovation in our medical sciences that has made America a world leader and maintains patient choice.

Question 17 17. Do you agree or disagree with the following statement? "The U.S. is in danger of losing its global competitive edge in science, technology and innovation." If you agree, what approach would you take to change this trend?

Agree

Disagree

Don't know

No opinion

Candidate's Comments I believe we are standing on the threshold of a new era: the innovation age. New information and communications technologies are the leading edge of technology innovations that will permeate every aspect of our society, and I am committed to federal policies that ensure America’s competitive edge in technology and innovative. Maintaining our tech edge requires robust basic research and sustained development efforts. I will support innovation by funding basic research and reforming and making permanent the R&D tax credit. We also need to keep the Internet tax-free. I recently sponsored legislation that extended that tax ban for seven years, and seeks to permanently ban taxing access to this source of innovation and growth. I also continue to be a strong supporter of H1-B expansion, but mere expansion is not enough. Reforms should eliminate the artificial limits, and allow the Department of Labor to set a level of visas appropriate for market conditions.