Background

Since its inception in 1991, the National Breast Cancer Coalition (NBCC) has been committed to guaranteed access to quality health care for all. The Coalition’s mission is to eradicate breast cancer. We believe the only way to achieve our mission is to ensure access to comprehensive, quality care for all. NBCC believes that patient advocates will play a key role in achieving this goal and in reforming our health care system.

In 2007, the NBCC grassroots Board of Directors approved a Framework for a Health Care System Guaranteeing Access to Quality Health Care for All which builds on Principles it adopted in 2003. Throughout the process of developing the Framework, NBCC applied its longstanding commitment to advancing evidence-based medicine and training consumers to strive towards systems change.

History of NBCC’s Efforts to Expand Health Coverage

NBCC has succeeded in making targeted changes to expand access to health care. Through passage of the Breast and Cervical Cancer Treatment Act (P.L. 106-354), NBCC successfully secured Medicaid coverage for low-income, uninsured women diagnosed with breast or cervical cancer through a federal screening program. While thousands of low-income women now have coverage for their treatment, that Act alone has been just one step in ensuring access to quality care for all.

NBCC’s Principles for Guaranteed Access

The NBCC Framework offers one approach to the issue of coverage but is based on several core principles that NBCC believes are central to any health care reform effort. We believe that each of these Principles is essential to creating a fair and effective health care system.

• Health care is a basic human right.
  
  
• Health care is fundamental to maintaining a productive society.
  
  
• Health care coverage must be guaranteed for everyone.
  
  
• The health care system must provide the same comprehensive benefits to everyone and must meet the public’s expectations.
  
  
• The health care system must be redesigned so that treatment and coverage decisions are based on evidence and best practices.
  
  
• All individuals must financially contribute to the system, based on ability to pay.
  
  
• The new health care system must be easy to use for patients and providers, and easy to administer.
  
  
• Any system of coverage must include these core values:
  • Access.
    Individuals must be able to get all the care they need when they need it. This must include meaningful access to evidence-based interventions.
    
    
  • Information.
    Individuals must receive information that is evidence-based, objective, complete and correct.
    
    
  • Choice.
    Individuals must have some choice of doctors and care.
    
    
  • Respect.
    Our health care system must treat the whole person, not just a person’s disease.
    
    
  • Accountability.
    Standards regarding care must be clear, uniform, and enforceable. Patients must have a right to sue if their basic human right to health care is violated.
    
    
  • Improvement.
    The health care system must have methods for measuring what is and is not working so that the quality of care can continuously be improved. Individuals must have access to well designed and efficiently run clinical trials, and the system should facilitate and support all efforts at improvement.

Key Points of NBCC’s Framework

• Coverage and Benefits.
  A Federal-level board should determine the benefits package. The basic benefits package should be equivalent to the most comprehensive plan available to members of Congress through the Federal Employees Health Benefit Plan. The benefits package guarantees coverage for care that is based on scientific evidence and is continuously reviewed and updated based on available best practices. Coverage should provide access to care that is medically effective and cost efficient.
  
  
• Patient Participation.
  There must be a significant number (the NBCC Framework calls for at least 25%) of educated patient/consumer members on all board, committees and panels established to review and assess the best evidenced-based treatment options, their cost effectiveness, decide the level of benefits and determine effective methods for communicating health care information to consumers, providers and plans.
  
  
• Quality.
  Health reform should integrate into our health care system a process by which tools and methods for measuring what is and what’s not working so quality of care can be improved continuously.
  
  
• Continuity.
  Our health care system should be such that no one is ever without coverage, regardless of their employment status.
  Insurance Reform: The health care system should provide guaranteed access to coverage and should not discriminate or deny coverage for any reason, including pre-existing conditions.
  
  
• Financing.
  The system will be financed in part through cost savings and shared responsibility:
  • Everyone – individuals, employers, and government – share responsibility to support the system.
    
    
  • Individuals will be required to financially contribute to the system based on their ability to pay.
    
    
  • All employers will be required to contribute to the system. The Framework would phase out employer-sponsored health insurance. Subsidies or a sliding scale should be implemented to ensure that small businesses are not disproportionately affected by these payments.

Action Requested

NBCC is committed to achieving guaranteed access to quality health care for all. NBCC calls on Members of the 111th Congress to work with us to advance health care reform proposals that will give all individuals access to comprehensive, high quality health care.

For more information on this or NBCC’s other legislative priorities, please contact NBCC’s Government Relations Department at (202) 296-7477, or refer to NBCC’s website at www.StopBreastCancer.org.