If that’s what you took away from this, you have a chronic need to have your ass kicked.

Will,

A touching, enlightening post. Thank you.

This entry really touched me. Thank goodness for survivors of chronic disease, like your mom, to be able to tell their story and inspire others to start living a healthier lifestyle and address the issues for those already afflicted. I am a health promoter, former nurse, author, and speaker. My own trials have been having cancer and not being able to afford treament or insurance for the last two years. College educated, hard working, a voter, and still fell through the cracks. Thank you for raising awareness.

I had the pleasure of speaking in front of the Myrtle Beach Mended Hearts on Monday- great group and we have set a date for me to volunteer for the health fair booth. With all of this in mind, I wanted to pass something I received in the mail to you. It has had a powerful impact on how I will be walking into the polls and knew you would appreciate it, too.

I’ll have your mom in my prayers.

A G U I D E T O T H E
2008 Presidential Candidates’
Positions on Chronic Disease
1

PFCD South Carolina Voter Guide |
The Partnership to Fight Chronic Disease (PFCD) is a national coalition of
more than 80 patient, provider, and community organizations, business and labor groups, and health
policy experts committed to raising awareness of the number one cause of death, disability, and rising
health care costs in the U.S.: rising rates of preventable and treatable chronic diseases.

The PFCD believes that rising rates of chronic health problems pose a significant and unsustainable
burden on the U.S. health care system, and that the viability and strength of the system—presently and
in the future—relies on a willingness to enact policies that help Americans better prevent and manage
chronic illnesses. It is our hope that the PFCD policy platform has helped to focus our nation’s leaders—
including the 2008 presidential candidates—on the crisis of chronic disease and highlight common-sense
reforms that will help the nation to address this challenge.

The PFCD has created grassroots networks in Iowa, New Hampshire, South Carolina, and Ohio. These
networks consist of partner organizations and volunteers working together to send a message. Chronic
disease accounts for 75% of every health care dollar. All candidates running for president in 2008
must address chronic disease in their health care proposals and platforms.

Any healthcare reform must:
1) Advance sustainable “Next Generation” chronic disease prevention, early intervention,
and management models throughout the health care system and public health infrastructure.

2) Promote healthy lifestyles and disease prevention and management in every community.

3) Encourage and reward continuous advances in clinical practice and research that
improve the quality of care for those with prevalent and costly chronic diseases.

4) Accelerate improvements in the quality and availability of health information
technology (HIT) throughout the health care system.

5) Reduce health disparities by focusing on barriers to good health.

PFCD South Carolina Voter Guide |
2008 Democratic Candidates
2008 Republican Candidates

Advance sustainable “Next Generation” chronic disease prevention, early intervention, and
management models throughout the health care system and public health infrastructure
Promote healthy lifestyles and disease prevention and management in every community

Encourage and reward continuous advances in clinical practice and research that improve
the quality of care for those with prevalent and costly chronic diseases

Accelerate improvements in the quality and availability of health information technology
(HIT) throughout the health care system
Reduce health disparities by focusing on barriers to good health

TABLE OF CONTENTS

PFCD South Carolina Voter Guide |

Candidate: HILLARY CLINTON
http://www.hillaryclinton.com
Chronic Disease Position Summary: Focuses on preventing and detecting chronic diseases
as well as managing care. Plans to streamline and coordinate chronic disease care to
increase quality and decrease costs.

Candidate: JOHN EDWARDS
http://www.johnedwards.com
Chronic Disease Position Summary: Focuses on bettermanagement of chronic conditions
among insureres and Medicare, improved communication between patients and other
physicians, and establishment of a “medical home” within Medicare.

Candidate: MIKE GRAVEL
http://www.mikegravel.com
Chronic Disease Position Summary: No response given.

Candidate: DENNIS KUCINICH
http://www.dennis4president.com
Chronic Disease Position Summary: No response given.

Candidate: BARACK OBAMA
http://www.barackobama.com
Chronic Disease Position Summary: Plan recognizes chronic disease prevention as
one of three primary needs facing the healthcare system. Believes that promoting
and protecting health is a shared responsibility among individuals and families,
school systems, employers, the medical and public health workforce, and federal and
state governments.

Candidate: BILL RICHARDSON
http://www.richardsonforpresident.com
Chronic Disease Position Summary: Plan recognizes that a strong, coordinated
national effort is needed to prevent and manage chronic diseases like cancer, diabetes,
and heart disease. Plans to substantially increase funding spent on chronic disease
prevention research.

2 0 0 8 D E M O C R A T I C C A N D I D A T E S

PFCD South Carolina Voter Guide |

Candidate: RUDY GUILIANI
http://www.joinrudy2008.com
Chronic Disease Position Summary: Plans to promote access to preventive care and
healthy lifestyle education. Many of his reforms focus on empowering individuals
and families to make health care decisions that work best for them.

Candidate: MIKE HUCKABEE
http://www.mikehuckabee.com
Chronic Disease Position Summary: Will encourage states to address chronic disease
and prevention and to use as models many of the changes that he implemented as
Governor of Arkansas.

Candidate: DUNCAN HUNTER
http://www.gohunter08.com
Chronic Disease Position Summary: No response given.

Candidate: JOHN McCAIN
http://www.johnmccain.com
Chronic Disease Position Summary: Plans to hold physicians and health insurers responsible
for adhering to standards of care for patients. States that everything should be done
to prevent chronic disease, promote appropriate tests for early detection, and ensure
patients follow treatment guidelines after disease develops.

Candidate: RON PAUL
http://www.ronpaul2008.com
Chronic Disease Position Summary: No response given.

Candidate: MITT ROMNEY
http://www.mittromney.com
Chronic Disease Position Summary: No response given.

Candidate: FRED THOMPSON
http://www.tommy2008.com
Chronic Disease Position Summary: No response given.

2 0 0 8 R E P U B L I C A N C A N D I D A T E S

PFCD South Carolina Voter Guide |

ADVANCE SUSTAINABLE “NEXT GENERATION” CHRONIC DISEASE PREVENTION,

EARLY INTERVENTION, AND MANAGEMENT MODELS THROUGHOUT THE

HEALTH CARE SYSTEM AND PUBLIC HEALTH INFRASTRUCTURE.

2 0 0 8 D E M O C R A T I C C A N D I D A T E S

CLINTON
Proposes to advance prevention by:
• Requiring coverage of preventive services deemed proven and effective.
• Rewarding physicians who improve their patients’ outcomes.
• Ensuring streamlined, coordinated care of chronic illnesses.
• Establishing a Best Practices Institute that would fund research on effective treatments—including chronic care
prevention, detection, and management—and help distribute this information to doctors and patients.
• Coordinating public spending on prevention across public programs.

EDWARDS
Proposes to advance prevention by:
• Requiring insurers offering health plans through health care markets and other public plans to manage chronically
ill patients’ health across all their product lines.
• Changing reimbursement rules to emphasize primary care.

GRAVEL
No response given.

KUCINICH
No response given.

OBAMA
Proposes to advance prevention by:
• Requiring that plans that participate in the new public plan, Medicare or the Federal Employee Health
Benefits Program (FEHBP) utilize proven disease management programs.
• Accelerating efforts to develop and disseminate best practices, and align reimbursement with provision of high
quality health care.
• Implementing care management programs and encouraging team care through implementation of medical home type
models.

RICHARDSON
Proposes to advance prevention by:
• Expanding research funding on chronic disease, including translational research that helps evidence-based programs
and treatments reach Americans more quickly.
• Boosting research efforts associated with obesity, and improving coordination between the National Institutes
of Health, Centers for Disease Control, Food and Drug Administration, US Department of Agriculture, and others
inside and outside of government.

PFCD South Carolina Voter Guide |

2 0 0 8 R E P U B L I C A N C A N D I D A T E S

GUILIANI
Proposes to advance prevention by:
• Expanding access to HSA plans and allowing for plans that are designed to cover preventive care and carecoordination
services.
• Permitting more flexibility in employer contributions to “disease management” accounts so workers with chronic
illnesses and anticipated long-term expenses will be able to receive employer funds more tailored to their
situation, while also facilitating care coordination.

HUCKABEE
Proposes to advance prevention by:
• Encouraging states to create innovative programs to get better disease management information to diabetics.
• Ensuring that diabetes centers are located throughout the country.

HUNTER
No response given.

McCAIN
Proposes to advance prevention by:
• Promoting competition throughout the health care system between providers and among alternative treatments.
• Making patients the center of care and giving them a larger role in both prevention and care.
• Reforming the payment systems in Medicare to compensate providers for diagnosis, prevention, and
care coordination.
• Dedicating federal research on the basis of sound science resulting in greater focus on care and cure of
chronic disease.
• Giving states the flexibility to, and encouraging them to experiment with: alternative forms of access; risk-adjusted
payments per episode covered under Medicaid; use of private insurance in Medicaid; alternative insurance policies
and insurance providers; and, different licensing schemes for medical providers.
• Building genuine national markets by permitting providers to practice nationwide.
• Fostering the development of routes for safe, cheaper generic versions of drugs and biologic pharmaceuticals and
developing safety protocols that permit re-importation to keep competition vigorous.
• Protecting the health care consumer through vigorous enforcement of federal protections against collusion, unfair
business actions, and deceptive consumer practices.

PAUL
No response given.

ROMNEY
No response given.

THOMPSON
No response given.

PFCD South Carolina Voter Guide |

PROMOTE HEALTHY LIFESTYLES AND DISEASE PREVENTION
AND MANAGEMENT IN EVERY COMMUNITY.

2 0 0 8 D E M O C R A T I C C A N D I D A T E S

CLINTON
Proposes to promote healthy lifestyles by:
• Establishing a Best Practices Institute that would ensure that healthcare professionals and patients receive up-to-date
and accurate information about diseases, including chronic illnesses, and ways to prevent and manage them.
• Increasing access to screening tools that have proven to work.
• Enacting the Family Smoking Prevention and Tobacco Act that will restrict tobacco advertising to children, stop
illegal sales of tobacco to children, promote smoking cessation programs, and provide coverage for comprehensive
smoking cessation in Medicaid.
• Putting physical education and sports programs back in schools.
• Removing junk food from schools.
• Increasing funding for the Carol White Physical Education program.
• Implementing a healthy schools program the provides funding for schools that commit to replacing all
unhealthy food with healthy food by 2012.

EDWARDS
Proposes to promote healthy lifestyles by:
• Requiring health plans offered through health care markets to encourage people to stay healthy by offering primary
and preventive services.
• Redesigning federal insurance programs to include appropriate incentives for families to use wellness programs.
• Requiring government programs to cover education efforts that help beneficiaries understand their health so they
can help take better care of themselves and stay healthy without costly hospitalizations.
• Investing in public health promotion and improving coordination among local, state, and national public health departments.
• Addressing school nutrition guidelines and emphasizing healthy food options.
• Improving funding for physical education, healthy lifestyle programs, and after-school programs that promote
physical activity.
• Supporting tax incentives to support businesses that promote healthy living programs.
• Establishing a nationwide healthy lifestyles campaign to promote individuals’ healthy choices.

GRAVEL
No response given.

KUCINICH
No response given.

OBAMA
Proposes to promote healthy lifestyles by:
• Expanding and rewarding worksite intervention/health promotion programs.
• Working work with schools to create more healthful environments for children.
• Expanding funding—including loan repayment, adequate reimbursement, grants for training curricula, and infrastructure
support— to improve working conditions.
• Increasing funding to expand community based preventive interventions.
• Aligning funding mechanisms to support an effort to develop a national and regional strategy for public health.

RICHARDSON
Proposes to promote healthy lifestyles by:
• Instituting a nationwide ban on workplace-smoking.
• Removing junk food from schools and putting physical activity back in.
• Supporting improved infrastructure for exercise such as biking and walking trails, increased physical activity in
schools, and policies that promote access to more affordable healthy foods.
• Promoting health literacy.
• Promoting healthy lifestyles through employers and community-based programs, including incentives to businesses
to implement worksite wellness programs.

PFCD South Carolina Voter Guide |
2 0 0 8 R E P U B L I C A N C A N D I D A T E S

GUILIANI
Proposes to promote healthy lifestyles by:
• Moving towards a new patient-centered health system that encourages healthy lifestyles and facilitates preventive
care and wellness programs.
• Educating seniors about their coverage options and encouraging more seniors to take advantage of Medicare Part D.

HUCKABEE
Proposes to promote healthy lifestyles by:
• Encouraging states to provide smoking cessation programs and eliminate co-pays and deductibles for PSA
tests, mammograms, and colonoscopies for those covered by state health insurance and Medicaid.
• Encouraging states to provide clinical breast exams, diagnostic services, surgery, chemotherapy, and radiation to women
below certain income levels who do not have health insurance or whose insurance does not cover these services.
• Encouraging states to remove/reduce vending machines in schools.

HUNTER
No response given.

McCAIN
Proposes to promote healthy lifestyles by:
• Teaching children about health, nutrition and exercise.
• Undertaking public health initiatives to stem the obesity and diabetes epidemic and to deter smoking.

PAUL
No response given.

ROMNEY
No response given.

THOMPSON
No response given.

PFCD South Carolina Voter Guide |

ENCOURAGE AND REWARD CONTINUOUS ADVANCES IN CLINICAL PRACTICE
AND RESEARCH THAT IMPROVE THE QUALITY OF CARE FOR THOSE
WITH PREVALENT AND COSTLY CHRONIC DISEASES.

2 0 0 8 D E M O C R A T I C C A N D I D A T E S

CLINTON
Proposes encouraging and rewarding advances by:
• Offering higher reimbursement rates to doctors who participate in qualified Maintenance of Certification programs
and whose patients have improved health outcomes.
• Recognizing care models that use teams of providers that meet consensus-based quality measures.
• Increasing the NIH budget by 50% over 5 years and doubling it over 10 years to support research and innovation in
the fight against the most prevalent and costly chronic diseases.

EDWARDS
Proposes encouraging and rewarding advances by:
• Promoting evidence-based medicine.
• Requiring Medicare to develop new payment systems to help make sure that beneficiaries have a medical home
with a doctor who knows them and coordinates their care.
• Rewarding high quality care and penalizing plans that fail to meet critical, quantifiable goals.
• Changing reimbursement rules to emphasize primary care (for health plans participating in health care markets).

GRAVEL
No response given.

KUCINICH
No response given.

OBAMA
Proposes encouraging and rewarding advances by:
• Requiring full transparency about quality and costs.
• Requiring hospitals to collect and publicly report measures of health care costs and quality, including data on
preventable medical errors, nurse staffing ratios, hospital-acquired infections, and disparities in care and costs.
• Establishing an independent institute to guide reviews and research on comparative effectiveness.

RICHARDSON
Proposes encouraging and rewarding advances by:
• Incentivizing health care providers and insurers to further meet state of the art delivery of the best clinical
practice models.
• Requiring that all health plans cover a standard set of evidence-based preventive services such as well-child visits,
cancer screenings, and chronic disease management programs.

PFCD South Carolina Voter Guide |
2 0 0 8 R E P U B L I C A N C A N D I D A T E S

GUILIANI
Proposes encouraging and rewarding advances by:
• Fostering innovation and continuing to fund research in advanced medical technologies and medications and
facilitating affordable access to them.
• Streamlining FDA mechanisms and ending regulatory excesses without compromising safety.

HUCKABEE
Proposes encouraging and rewarding advances by:
• Supporting the new model proposed by the National Committee for Quality Assurance which encourages patients
to visit primary care physicians identified as the best and paying those doctors more per visit.

HUNTER
No response given.

McCAIN
Proposes encouraging and rewarding advances by:
• Supporting innovative delivery systems that provide greater market flexibility in permitting appropriate roles for
nurse practitioners, nurses, and doctors.
• Employing telemedicine and community and mental health clinics in areas where services and providers are limited.
• Passing tort reform to eliminate frivolous lawsuits and excessive damage awards.
• Providing a safe harbor for doctors who follow clinical guidelines and adhere to patient safety protocols.

PAUL
No response given.

ROMNEY
No response given.

THOMPSON
No response given.

PFCD South Carolina Voter Guide |

ACCELERATE IMPROVEMENTS IN THE QUALITY AND
AVAILABILITY OF HEALTH INFORMATION TECHNOLOGY (HIT)
THROUGHOUT THE HEALTH CARE SYSTEM.

2 0 0 8 D E M O C R A T I C C A N D I D A T E S

CLINTON
Proposes to accelerate improvements in HIT by:
• Financially incentivizing doctors to adopt health information technology.
• Facilitating adoption of a system where better quality care and better patient outcomes can be rewarded.

EDWARDS
Proposes to accelerate improvements in HIT by:
• Investing in programs that encourage doctors to communicate with each other and in technologies that allow
them to quickly and easily gain access to all relevant patient information
• Requiring all health plans who want to participate in federal insurance programs to use interoperable information
technology that protects privacy.
• Providing resources that hospitals need to implement information systems that improve patient safety and
hospital efficiency.

GRAVEL
No response given.

KUCINICH
No response given.

OBAMA
Proposes to accelerate improvements in HIT by:
• Investing $10 billion every year over the next five years to move the U.S. health care system to broad adoption of
standards-based electronic health information systems, including electronic health information systems.

RICHARDSON
Proposes to accelerate improvements in HIT by:
• Providing grants, loans, and financial incentives for the widespread adoption of health information technology.
• Making personal health records available as an option to those who sign up for any federal health plan.
• Supporting incentives that encourage providers to use health IT in preventive and chronic health care management,
as well as track costs, outcomes and the quality of care provided.

PFCD South Carolina Voter Guide |

2 0 0 8 R E P U B L I C A N C A N D I D A T E S

GUILIANI
No specific proposal to accelerate improvements in HIT.

HUCKABEE
Proposes to accelerate improvements in HIT by:
• Supporting funding for the Nationwide Health Information Network that will link state, regional, and other networks
and make individuals’ medical records available anywhere.

HUNTER
No response given.

McCAIN
Proposes to accelerate improvements in HIT by:
• Making public more information on treatment options and requiring transparency by providers regarding medical
outcomes, quality of care, costs, and prices.
• Facilitating the development of national standards for measuring and recording treatments and outcomes.
• Promoting rapid deployment of 21st century information systems.

PAUL
No response given.

ROMNEY
No response given.

THOMPSON
No response given.

PFCD South Carolina Voter Guide |

REDUCE HEALTH DISPARITIES BY FOCUSING
ON BARRIERS TO GOOD HEALTH.

2 0 0 8 D E M O C R A T I C C A N D I D A T E S

CLINTON
Proposes to reduce health disparities by:
• Covering every American with health insurance.
• Requiring the development and testing of quality measures for use by doctors, hospitals, nursing homes, and other
providers targeted at eliminating racial and ethnic disparities in health care.
• Requiring DHHS to develop a uniform reporting format for the collection of quality information on race and ethnicity.
• Providing $50 million in federal funding for the development of culturally and linguistically competent clinical care
programs.
• Providing opportunities and incentives to encourage greater diversity in the health care workforce through recruitment
initiatives, scholarships, and loan forgiveness programs.

EDWARDS
Proposes to reduce health disparities by:
• Supporting medical research into disparities.
• Reducing the pollutions and toxins.
• Investing in translation services to address language barriers.
• Addressing disparities in health caused by disparities in insurance by implementing universal coverage and
guaranteeing that all Americans get high quality health care by encouraging all providers to implement
evidence-based medicine.

GRAVEL
No response given.

KUCINICH
No response given.

OBAMA
Proposes to reduce health disparities by:
• Addressing differences in access to health coverage and promoting prevention and public health.
• Requiring hospitals and health plans to collect, analyze and report health care quality for disparity populations and
holding them accountable for any differences found.
• Diversifying the workforce to ensure culturally effective care.
• Implementing and funding evidence-based interventions.
• Supporting and expanding the capacity of safety-net institutions.

RICHARDSON
Proposes to reduce health disparities by:
• Ensuring access to affordable, quality health care coverage for every American.
• Supporting increased training for minority health professionals.
• Supporting efforts to increase the number of minorities who have medical homes.

PFCD South Carolina Voter Guide |

2 0 0 8 R E P U B L I C A N C A N D I D A T E S

GUILIANI
No specific proposal to reduce health disparities.

HUCKABEE
Proposes to reduce health disparities by:
• Encouraging states to reduce the number of uninsured children.
• Encouraging states to find ways to require better, more consistent management of disease and early detection for
those in poverty.

HUNTER
No response given.

McCAIN
No specific proposal to reduce health disparities.

PAUL
No response given.

ROMNEY
No response given.

THOMPSON
No response given.