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- Imagine an American health care system where consumers have the freedom of choosing the health insurance plan that’s best for themselves or their families, a system that covers all Americans, a system that encourages true free-market competition to drive down costs and increase quality of care across the board. Imagine a one-stop shop allowing consumers to compare both private and public insurance plans, including a robust Medicare buy-in option.
- This is Dr. Hiral Tipirneni’s vision for our health care system – not a Republican one or a Democratic one, but an American one. It’s based on the nonpartisan goals of expanding health care coverage and choices, lowering costs, and delivering the highest quality of care possible.
- As a physician, I’m trained to follow the facts, diagnose the problem, find a solution. It’s a fact that our healthcare system remains broken, with both rising costs and deductibles, and 28 million Americans still uninsured. While significant reform may have begun with the Affordable Care Act (ACA), it by no means ended there. Despite the tens of millions of people who’ve benefitted from the ACA, its serious flaws must be addressed if we are to improve access to healthcare today as well as for generations to come.
- We need a collaborative approach that addresses the twin pillars of expanded coverage and cost containment. Such a plan is only possible with ideas borrowed from both sides of the debate. I have seen firsthand the struggles of the uninsured as well as the direct, tangible benefits the ACA has brought to real peoples’ lives, and it’s too valuable to simply toss aside. Here are ways to strengthen and further improve the current state of our healthcare system.
- Protect the current, most beneficial and popular ACA provisions:
- Children can remain on their parents’ insurance plans until age 26;
- No higher premiums or deductibles imposed because of pre-existing conditions;
- Prohibit imposing annual and lifetime caps on healthcare benefits; and
- Maintain requirement that all marketplace plans cover basic healthcare services.
- Secure payment of cost-sharing reductions. This should help stabilize the healthcare marketplace by enhancing insurance companies’ confidence in their ability to optimally cover their insured customers’ needs. Encouraging insurance companies’ participation in the marketplace will help spur private sector competition as well.
- Expand Medicare. Medicare has proven to be a highly-effective, efficient, and well-liked plan to both consumers and healthcare providers. We should allow people under age 65 to buy into Medicare. This true public option is an affordable buy-in, not a handout, and does NOT impact people currently eligible for Medicare. Furthermore, allowing people to purchase Medicare does not cost taxpayers a dime. This idea is especially important in areas of our country, such as most of Arizona, where choice of private insurance carriers is highly limited. Additionally, this helps people nearing retirement while lowering costs for those in the private insurance markets. And, it strengthens Medicare’s ability to negotiate lower drug prices for its customers as well as better rates with hospitals and medical practitioners.
- Drive healthcare coverage competition. We must look for innovative ways that have previously not existed, such as competition between the private sector and Medicare. This encourages creative solutions for cost containment as well as best practices for better patient outcomes.
- Healthcare is a moral obligation, but it is never “free.” Everyone eventually needs healthcare, so everyone should have health insurance. The bottom-line is that a solution must be developed that includes expanding the risk pool with healthy individuals. Fiscally responsible, efficient practices within our healthcare system which lead to healthier Americans must be our goal, not scoring political points.
- Progressives are concerned that too many people either remain uninsured or can’t afford good, quality healthcare. Conservatives say that too much regulation exists without enough private, free-market competition to keep costs down. There is truth to both perspectives, and good ideas can come from anywhere. Stop the partisanship. Stop administering Band-Aids. Face head-on the issues plaguing our healthcare system.
- Arizona is widely recognized for its business-friendly climate and low operating costs. In the modern economy, however, it seems more families are trying to actually live on a minimum wage, which had once been a starting point. Furthermore, it seems that in this dynamic economy, workers are asked to change jobs more frequently than in the past – which also means robust unemployment insurance, easily portable health care plans, and making sure that those who are self-employed, freelancing, or starting/operating small businesses do not fall between the cracks.
- So, how can policymakers address long-term economic growth and stability without jeopardizing Arizona’s competitive advantages? How can our community promote wages and salaries that actually sustain a family? How can struggling workers be empowered to better their positions? What can be done to encourage entrepreneurs and support small businesses?
- The answers include focusing on human capital and cultivating an innovative, knowledge-driven economic ecosystem. The following concepts are stepping stones along that path:
- Build upon and retain natural talent by cultivating the region’s various economic clusters; for example, healthcare, aerospace and defense, cyber-security, software and microelectronics
- Expand workforce development and apprenticeship programs; maintain and promote their alignment with secondary and post-secondary education
- Develop training and re-training programs for the jobs that are coming, not only the ones already here
- Expand and protect programs that can help build the economic ecosystem, such as effective incentives, creative funding sources and tech-transfer from higher education
- Fulfill the healthcare promises of the Affordable Care Act
- Develop access to affordable childcare
- Guarantee equal pay for equal work so women earn the same as men for doing the same job
- Ensure an employee’s job is protected in the event that a medical or family emergency requires time away from work
- Simplify the tax code and close loopholes so that tax reform benefits the middle class most
- The goal for federal policies should be to help expand opportunity, not penalize success.
- Retirement Security and Veterans
- Congress must protect the Social Security and Medicare benefits that retirees have worked a lifetime to earn. They are earned benefits and not entitlements and should never be cut or taken away.
- The VA (U.S. Dept. of Veterans Affairs) must be held accountable to reduce wait times and improve care for all our veterans.
- In a word, opportunity is the reason my family came to the United States from India nearly 50 years ago. Education – public education – was the foundation of that opportunity and the pathway to progress for my family. This has been true for our three kids, who attended Arrowhead public schools, just as it is true for all American families. That is why we must make sure every child has a quality education regardless of their zip code.
- Our economy rests upon the commitment we make to quality, public education for people from all our communities. Indeed, for Arizona and the United States to remain competitive in the 21st century, global economy, we need a higher level of educational achievement than we are delivering today. Our jobs require knowledge and technical preparation extending beyond our current K-12 school system.
- We must establish and maintain a relevant, nimble public education system that invests fairly in the educational needs of all our residents. That is why local, state, and federal governments as well as the private sector should support Arizona’s goal of raising the level of postsecondary attainment to 60 percent by the year 2030.
- A strong public school system has been instrumental in America’s history and modern economic success, and we must be vigilant against efforts to erode or undermine it. I stand firmly against the privatization of public schools, and against defunding public schools through alleged “choice” programs like vouchers. Data should help drive our education policies, and there is no current, consistent evidence of the benefit of voucher programs. Vouchers only offer real “choice” to higher socioeconomic families, most of whom can already afford private schools. This essentially gives them a publicly-funded discount while working- or middle-class families remain with schools receiving even less support going forward. We should be narrowing the inequities and disparities in our educational system, rather than growing that gap.
- Generally speaking, charter schools can play an important role in our public school system, like being incubators of innovative strategies that can be implemented in other schools. But as we’ve seen in Arizona, they can be fraught with failure and fraud without proper oversight. Many charters appear to simply be for-profit organizations. I believe that any school receiving public funds should follow the same guidelines and have the same oversight as public schools. This includes laws and transparency regarding student entrance criteria, performance benchmarks, and teacher qualifications.
- While Arizona’s K-12 public education system receives approximately 85% of its funding from state and local sources, the 15% that comes from the federal government plays a critical role. For example, Title I funding is essential to schools in communities with low financial capacity, and helps to level the playing field for all students. This funding can also include other important policies, such as requiring schools to provide adequate mental health services or help with funding vital after-school programs.
- Our commitment to higher education must include alternatives to the traditional, four-year college tract so that students can pursue highly valuable technical and career training and certification. Federal support for higher education must include cutting-edge trade and professional schools as well as career and technical education (CTE) programs in middle and high schools.
- Finally, we must address the alarming rise in student loan debt. In Arizona, this also hits us hard in our fight to address the teacher shortage.
- Nationwide, all student loan debt exceeds $1.5 trillion, an astronomical increase over the past decade. The reality is that student loan debt is dragging down the potency of a college degree or CTE program for Arizonans in all kinds of professions. It is time to recalibrate our nation’s commitment to funding higher education. For the past ten years, Congress has consistently reduced federal grants and need-based aid relative to what is needed, which has allowed unsustainable loan debt to take its place. Ironically, this has occurred at a time in which Americans need higher education more than ever.
- Arizona schools are facing a teacher shortage of epic proportions. While horrifically low teacher salaries are a local issue, the problem is aggravated by new teachers coming out of college with piles of student loan debt. In addition to addressing the larger problem of student debt, the federal government should look at ways to provide incentives, such as loan forgiveness or national service opportunities, for people to enter the teaching profession. Studies show a direct correlation between a higher investment in K-12 public schools and better student outcomes. But simply throwing money at the problem isn’t enough; we must be thoughtful in our approaches, and that may be the toughest part – the place where great minds can disagree. So let us at least start from a common place by recognizing that we must do better by our kids, and that our communities’ futures rely on the commitment we make today to give our children a solid foundation in life.
- Government Accountability
- Protecting taxpayers’ hard-earned dollars is key to helping keep government accountable to the people, and that includes reducing the influence of Washington special interests that work against the public interest.
- Congress should also continue to increase transparency, and prevent members of Congress from wasting tax dollars on personal benefits like first-class airfare.
- Immigration and Border Security
- Immigration and border security are truly personal issues for me. When we came from India, my father had $8 in his pocket despite having a civil engineering degree. My mother had a degree in psychology, no small feat for an Indian woman at that time. We struggled. Yet America gave my family a chance to rise and thrive, the very reasons that brought us to the United States in the first place. Eventually, we settled in a working-class suburb of Cleveland where I grew up in the shadow of a Ford plant. I passionately believe that we must remain a land of opportunity for those who are willing to work for it.
- We ALL deserve an accountable immigration system providing a clear, affordable path to citizenship for those who qualify and have earned it. We also need secure borders. While those two ideas should not be mutually exclusive, our current climate politicizes an issue that, at its core, has real lives at stake.
- Most immediately, the U.S. needs a ”clean” DREAM Act that provides a fair pathway to eventual American citizenship for this unique segment of the undocumented population – no strings attached. DACA (Deferred Action for Childhood Arrivals), which President Obama pointed out in 2012 was never meant as a permanent solution, acknowledged more than 51,000 hardworking Arizonans without criminal records, most of whom only know the US as home, who were brought to the U.S. as children by their parents. DACA brought these folks out of the darkness, so to speak, so that they could be accounted for in the U.S. in a climate of trust that is currently being betrayed.
- DREAMERs are our neighbors, friends, colleagues, and even family members. They are productive members of our society, academic stars and teammates, paramedics and teachers, small business owners, even soldiers and sailors. Perhaps that is why 400 CEOs signed a letter in 2017 urging President Trump not to end DACA without addressing DREAMers’ situation.
- In the bigger picture, the U.S. does need comprehensive immigration reform. The conversation must move beyond the present binary choice offered by Washington between enforcement (i.e., border security) and legalization (i.e., pathway to citizenship). We need a conversation that moves our immigration policies into the 21st century by recognizing modern immigration patterns, economic realities and national security threats. Americans deserve an honest dialogue about such issues as family immigration categories, worker programs and employer verification systems, and how to fairly and humanely address refugees and asylum seekers.
- Finally, in securing our borders we must avoid easy symbolism and take a real look at the situation and our options. Front and center in this discussion at the moment is a border wall between the United States and Mexico, estimated in February 2017 by the U.S. Dept. of Homeland Security at $21.6 BILLION. I am firmly opposed to “the wall,” and believe that even a fraction of those funds would be better spent towards securing our borders in other ways. For example, technology and staffing, especially at our ports of entry – through which the U.S. Drug Enforcement Agency recognizes most of the marijuana, cocaine, heroin and methamphetamines are smuggled into the U.S. – would be more effective. Furthermore, data suggests that the wall would have a negative effect on our economy, with potentially more significant effects on border states such as Arizona. We can do better than building a wall.
- In the long arc of history, America’s immigrants have contributed culturally, economically, and academically by continually adding vibrant threads to that great American quilt. I am proud, thankful, and honored to be an American, and will fight to keep the American dream alive.
- As an ER doctor, I’ve seen the trauma, suffering and devastating loss of life from gun violence up close. The destruction it causes to the victims, their families and communities is heartbreaking and, oftentimes, avoidable.
- I also support Second Amendment rights overall for law-abiding Americans to obtain firearms through legal channels to protect their homes, themselves and their families, and for hunting and sport. I do not see supporting both the Second Amendment and commonsense gun safety reform as mutually exclusive, though, and I find it increasingly difficult to follow arguments justifying the possession of military-grade weapons and similar accessories by the general public.
- America, the only industrialized nation with this degree of violence, should address it as a public health issue. The U.S. has a history of using data-driven policies to make us safer – seat belts, child car seats, airbags. We should restore funding for gun violence research so that our policies actually have a positive impact on public safety. Are current laws effective? If not, why and what can be done to improve their implementation, or should the law itself be completely reformed?
- The discussion should include innovative technologies, such as biometric locks and affordable, safe storage solutions.
- I believe commonsense gun safety reform can ultimately be accomplished while protecting the rights of lawful gun owners. There is already consensus between households with firearms and those without, which include:
- Closing the Internet and gun show “loopholes” by requiring background checks;
- “No-fly, no buy” so that those on terrorist watch lists have harder access to firearms;
- Ensuring that purchasers have passed necessary background checks, properly registered their firearm(s), and received appropriate gun safety training.
- Finally, mental health must also be part of equation. Mass shootings are truly horrific and instantly capture our attention. However, suicides and homicides make up nearly 90% of gun-related deaths according to 2016 data available. When addressing the issue of gun violence, we too often ignore the contributing role of mental health issues, including substance abuse and addiction, to our regrettable detriment.
- Women's Reproductive Rights
- I fervently believe our elected representatives should support policies reflecting clearly established women’s reproductive health rights.
- In short, abortions should stay safe, and legal. And, for the record, no one is “pro-abortion” – one is essentially either pro-choice or anti-choice.
- The heart-wrenching, deeply personal decision to end a pregnancy should be between a woman, her partner, her doctor, and her faith. There is no role for politicians in that decision. We cannot go back to the days, which are not so far in the past, of coat-hanger abortions and women bleeding to death in alleys. In Roe v. Wade, the Supreme Court has set clear precedent in the “law of the land,” and policy decisions should be in accordance with that principle.
- It should also be noted that late-term terminations, which can be particularly traumatic, are less than 1% of all terminations, and only done in cases of risk to the mother’s health or life-threatening developmental issues with the fetus.
- Of course, avoiding an unwanted pregnancy is the BEST way to reduce the number of terminations. Data has definitively shown that abortion rates drop when there is simple access to contraception and sex-education. We should have comprehensive, age-appropriate sex education in the classroom and ensure unhindered access to effective contraception.
- Women’s reproductive health is an issue of civil rights, economic freedom, and religious freedom, and it is an issue I will fight fiercely to protect.
- For the Internet to remain free and open, the U.S. must support net neutrality. That is why I support policies that maintain a level Internet playing field and protect our personal freedoms, as well as nurture America’s competitiveness and innovative spirit. We simply cannot promote rules which allow “speed bumps” or “fast lanes” to play favorites with what we watch, read, or purchase by influencing how we access all that information.
- Furthermore, without net neutrality, we simply cannot ensure a society in which there is true broadband equality throughout our communities. As the Internet has become more like a utility – for example, we all use water and electricity – this equality is so important to adequate access for everyday activities, like academic work, economic opportunities from e-commerce to job applications, and even the delivery of healthcare, particularly for more rural areas or to tap into expertise over long distances. Net neutrality is also key to the widespread delivery of essential high-speed broadband, which is increasingly key to our communities as we share larger and larger amounts of data.
- You don’t need to be a scientist to see the real effects of climate change. Around the world, we’ve seen record high and low temperatures and other extreme weather conditions. According to NASA, the hottest five years on record have happened since 2010. The question is not whether the climate is changing, it’s what are we going to do about it? Fortunately, Arizona is ideally situated to become part of the solution. We have the potential to become an epicenter for renewable energy and clean jobs.
- According to the Intergovernmental Panel on Climate Change (IPCC), “Scientific evidence for the warming of the climate system is unequivocal.” The IPCC states that according to a number of studies, there is “over 95% certainty” that the current climate change trend is the result of human activity since the 1800s. Ice cores drawn from Greenland, Antarctica, and tropical mountain glaciers show that the current rate of “warming is occurring roughly ten times faster than the average rate of ice-age-recovery warming.”
- This is alarming, but we have the tools to address this crisis. We need to invest in protecting our planet and ourselves. That involves a pragmatic approach, including reasonable regulations on pollutants as well as market-based solutions like “carbon credits,” and – especially here in Arizona – investment in proven alternative energy, like solar power.
- There’s no reason Arizona shouldn’t be the solar power capital of the world! Investing in renewable solar energy would be a tremendous economic asset, too. The face of energy production has changed significantly in recent years. The US Department of Energy stated that in 2016, solar energy employed 43% of the energy workforce, while traditional fossil fuels only employed 22%. Several studies say that the solar industry now employs more folks across the United States than the oil and coal industries combined. It only makes sense for us to lead the way and be the engine driving the train of the energy revolution.
- This not only serves us economically. Climate change is also a concern for national security, since countries in great environmental distress are more susceptible to extremism and the rise of terrorist organizations. Adelphi, an independent think tank focusing on climate, the environment and development, reports that in four case studies, natural disasters, economic despair, and environmental degradation all allow for extremist, terrorist groups to flourish. Climate change makes us more fragile and vulnerable to violence. If we don’t address this issue now, it’s only going to create bigger problems for us and future generations down the road.
- As one of the only nations in the world to opt out of the Paris Climate Agreement, we no longer have a seat at the table guiding the global fight on climate change. This weakens our ability to gain support from the nations pivotal in delivering truly impactful reforms. While other nations are contributing to climate change with their own pollution, it’s important for us to use our leverage and set a positive example. Moreover, industry standards for emissions and other toxins are increasingly strict, which means that we could get left behind if we don’t keep up. Sticking to our own standards could lead to tremendous economic disadvantages for the automobile industry, among others. We must work together. Our world depends on it.
- There is no “Plan-et B,” so let’s protect the one we’ve got.
- Our country was founded on the ideal that all people are created equal. We must ensure that our LGBTQ+ communities are afforded all the rights and privileges any other member of our society is granted. No American should face discriminatory practices based on race, gender identity, religion, sexuality, or any other immutable characteristic. I have always been fully committed to fighting to see the day that all of our LBGTQ+ friends, families, and community members can live a life free of hate, prejudice, imposed restrictions, and discrimination.
- Whether in schools, the workplace, the military, housing, public accommodation, or in the eyes of the law, all Americans must be free to live their lives safely and authentically – as they are meant to be and loving who they choose to love. In Congress, I will always work to uphold that principle, which should start by fully passing the Equality Act into law.
- And in my most important role as a parent of a LGBTQ+ young adult, I am not just an ally in this fight, I am proud to be a vested stakeholder.
- Hiral believes it is our duty as a nation to address the systemic racism and generations of inequities and discrimination that have held back our Black and Brown communities. This includes not only reforming our criminal justice system to end racial profiling, discriminatory policing, and police brutality, but broader initiatives that work toward a level playing field that ensures equal economic and educational opportunity, access to quality and affordable housing, eliminating health disparities, and so many other critical issues.
- Law enforcement reforms will not only lead to better public safety, but will keep police themselves safer. By building a partnership based on mutual trust and respect between communities and law enforcement, we make communities safer, make law enforcement more effective at fighting crime with the community’s help, and make law enforcement’s job less dangerous as well. This benefits everyone.
- Similarly, ensuring that Black and Brown Arizonans have an equal shot at quality education, a good-paying job, affordable housing, and effective healthcare is a long overdue fulfillment of the values on which this country was founded and will strengthen all of our communities.
- Ensure equal access to credit for small businesses in underserved areas to help them grow, and stamp out illegal and discriminatory banking practices
- Fight for effective investments in affordable housing in underserved communities, and focus efforts to reduce disparities in home ownership
- Boost Title 1 funding to improve our public schools so that every child has an equal shot at an outstanding K-12 education, while expanding career and technical education opportunities as well as ensuring affordable accessibility to community colleges and 4-yr universities
- Stabilize and strengthen the Affordable Care Act, protect key provisions such as pre-existing condition coverage, and create a public option that allows anyone to buy into a Medicare-like plan so all Arizonans have access to quality and affordable healthcare
- Ensure quality health care options in all our communities, including addressing disparities in healthcare delivery as well as investing in Federally Qualified Health Centers to boost care in underserved areas
- Push all police departments to adopt and fully utilize body cameras funded through federal grants
- Transition to community policing where officers are a part of the community to build mutual respect and trust
- Require better training in appropriate use of force and critical de-escalation tactics
- Develop and implement an adjunctive social resources/mental health team to be deployed in non-criminal situations
- Incentivize increased oversight measures, including community representation and citizen review boards[1]
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