Thursday, August 20, 2009

The emotion you are feeling is “Frustration”

Are you frustrated with our current health care system? Does health care reform address your frustration?

Let's get real! Here is a run down on what people are frustrated about, and what the facts are about proposed reform!

  • Frustration: I can lose my insurance if I am out of work or my company cannot afford the benefit.
  • Frustration: I may not be covered due to a pre-existing condition, even though I have insurance. They can decide not to pay after I get sick!
  • Reform includes health coverage for all US citizens regardless of age, employment, wealth or pre-existing conditions.
  • Frustration: I can't find a primary care doctor to be my partner to focus on prevention, health and coordination.
  • Reform includes support for primary care, in order to train more specialists in this area to meet this need.
  • Frustration: I do not have a choice of who I see with my current insurance.
  • Reform includes assurance that you will have a choice of plans, providers and hospital, both public or private plan.
  • Frustration: The system is so complicated, I do not understand my insurance, and there is so much paper work.
  • Reform includes simplified regulations and uniform rules for you and your doctor, so that it is user friendly and understandable.
  • Frustration: Costs keep going up too fast! I struggle to meet my share of the bills.
  • Reform includes a change in the rules of the game, in order to help you get the best care the first time with the best quality results. This can lead to better care and lower costs for all of us.
  • Frustration: We are losing jobs because of the high cost of American products due to expensive insurance, and this makes me worry I may lose my job.
  • Reform will take away the extra costs that insurers must pay for those who are not covered. America will become more competitive.
All of us will benefit from reform. Even those of us who have good coverage right now. We need to get real. We need to do this.

Monday, August 17, 2009

Thanks to David Horsey at the Seattle Post Intelligencer for today's commentary in the form of this cartoon.

Originally published on Sunday, August 16, 2009 in the Seattle PI.

Saturday, August 15, 2009

Ugly Spectacle Endangers Reform

During the 2008 presidential campaign, Nobel Prize winning journalist and economist Paul Krugman warned that upon assuming office, President Obama would face “an unending procession of wild charges and fake scandals, dutifully given credence by major media organizations that somehow can’t bring themselves to declare the accusations unequivocally false.” In his column in the New York Times, Krugman now asks, "So, how’s it going?"

Sad to say, Krugman has hit the nail on the head, and the scurrilous attacks on the president over health care have no relationship to anything he is actually doing or proposing.

Take for example the claim that health care reform will create “death panels” (according to Sarah Palin) that will send the elderly off to an early grave. It’s a complete fabrication. Grossly and maliciously untrue. The provision actually provides that Medicare will pay for end-of-life counseling requested by the patient was initially introduced by Senator Isakson, a Republican from Georgia. No one screamed at him about this, and he continues to say that it’s “nuts” to claim that it has anything to do with euthanasia. Before this current campaign, some of the current peddlers of the euthanasia smear, (for example, Mr. Gingrich and Mrs. Palin) were both on the record as being supporters of “advance directives” for medical care in the event that you are incapacitated or comatose. Not only that, but legislation to establish the Part D Medicare drug program during the Bush Presidency also established counseling for advance directives. No false outrage was seen at that time.

The smear continues to spread, and I am saddened to see that so-called moderate Republicans, such as Senator Grassley, (R) Iowa, have endorsed the lie. As Krugman notes, "his role in the health care debate has been flat-out despicable". Senator Grassley claims that Senator Ted Kennedy’s brain tumor would not have been treated properly in other countries because they prefer to “spend money on people who can contribute more to the economy.” This week, Grassley told an audience that “you have every right to fear,” that we “should not have a government-run plan to decide when to pull the plug on grandma.”

Right now the politics of opposition are an ugly spectacle. When the distorted paranoia of some worried citizens is cynically manipulated by Republicans and special interest groups to fuel the mistrust with out right lies, is a very worrisome trend.

Those of us who support reform also need to tap into our sense of passion and outrage. Passion to achieve a family doctor for every family, lower cost, freedom to choose and coverage for all Americans, and outrage at the lies and fear-mongering that are being used to block that goal.

Now is not the time to shrink from the debate.

Thursday, August 13, 2009 is A Place to Find out the Truth! is a project of the St. Petersburg Times, the same newspaper that won the Pulitzer Prize for outstanding coverage of the 2008 presidential election.

This web site is the place for you to check the truth about claims made in the US health care debate. Reporters and editors from the Times fact-check statements by members of Congress, the White House, lobbyists and interest groups and then rate them on the "Truth-O-Meter". Amazing! Someone in the press doing actual journalism. The ratings range from "Pants on Fire" (recent winner Sarah Palin) all the way to "True". Check out these recent "Pants on Fire" rulings and enjoy yourself.

Sunday, August 9, 2009

Report from a Town Hall Meeting, Mt. Vernon, Washington

The news had been full of reports of angry crowds with rude and obnoxious behavior, harassing members of Congress who were attempting to discuss health care reform with constituents, so it was with a little trepidation that I set out for the 2nd of 3 meetings hosted by Congressman Rick Larsen for Washington's 2nd Congressional District. Could the normally respectful and open minded people I live and work with behave this way? Turns out, I need not have worried!

So many people came to the meeting that the large auditorium was completely filled, and a crowd of thousands spilled over into the outside lawn. Speakers were set up so that all could hear, and Larsen made a point of coming out on to the lawn area to take questions. Congressman Larsen treated everyone with patience and respect. Oh, to be sure, there were some who seemed bent on stoking ill will, such as the guy who had a picture of the President defaced to look like Hitler. These folks were far outnumbered by those who came to listen and have true dialog, and when the Congressman singled out the picture of President Obama as Hitler, to say it was not reflective of true and honest criticism and debate, there was a loud and prolonged applause from 90% of those in attendance. To those who complained that the house bill was rushed through by people who did not understand it, he made it clear that he had read the entire bill, and had a copy with him to refer to if there were specific questions. And the questions did come!

One of the most interesting things I learned at this meeting is how confused and misinformed some worried people are about the truth contained in the recent bill passed by the House of Representatives. For example, one woman thought that payment for care would be limited to $5,000. The Congressman explained that no, this figure was a cap on expenses for her to be responsible for, and not a limit on benefits. Another thought that illegal aliens would be covered, and was told that they are explicitly not covered by this bill. There were many other examples.

Larsen made it clear that he is not approaching reform as an ideolog, but rather, he wants to accomplish practical change by keeping the following principles in mind:
  • Ban discrimination for pre-existing conditions, age and gender;
  • Don't try to fix what isn't broken. If people have insurance and doctors they like, they should be able to keep them;
  • Eliminate fraud, waste and abuse in government health programs;
  • Invest in prevention and pay for quality of care, not quantity of tests;
  • And get reform that works for Washington State.
He particularly took pains to explain that Washington state currently is penalized for providing higher-quality, lower-cost care by Medicare because reimbursement rates are so low that many local doctors do not accept Medicare patients. Under the original health care reform bill introduced in the House, this problem was not fixed, and was expanded, so that the same unfair, wasteful reimbursement policies would have been expanded from Medicare to the public insurance option. As he said, "What good is an insurance card if you can't find a doctor who will treat you?" That was his reason for opposing the "public plan" option as presented. To improve this situation, Larsen has worked with colleagues from Washington and other states with the same problem to secure an agreement with House leadership to agree to reform Medicare payments, reward high-quality, cost-efficient care and remedy geographic disparities that hurt access to care for local patients.

All in all, I was very impressed. Congressman Larsen should be commended for working hard on our behalf, with clear principles of reform. He is obviously very knowledgeable and energized about this issue. Residents of our area should be commended for their attention and respectfulness of the town hall process. I was glad that I went.

One disappointment I do have is with our local newspaper, The Bellingham Herald. I could not find a report of our local meeting, but there were 2 articles with old news about how meetings are being disrupted. What a missed opportunity by our media to set the record straight!

Thursday, August 6, 2009

$ The cost of Health Care reform

You've probably heard it said by critics that health reform will cost taxpayers at least a trillion dollars. This sounds scary, which is the intent of the critics, but it turns out not to be true!

The quoted figure is not a trillion dollars a year, but rather a trillion dollars over 10 years. On a yearly basis, the cost equals approximately $140 billion dollars. To put this in perspective, the Part D Medicare Drug plan passed during the Bush presidency is about 600 billion dollars for drugs alone.

$140 billion dollars a year still overstates the cost, however. That is because other parts of the reform plan result in savings for Medicare, such as the reduction of subsidies to private insurers, reform of payment rates for doctors and a decrease in payments to hospitals for providing "free care" to the uninsured. When all of this is taken into account, the net increase in government spending for health care will likely be about $100 billion a year, which is a one-time increase equal to less than 1 percent of US national income, which has historically grown at an average annual rate of 2.5 percent every year.

While criticizing, right wing critics have stood against ideas to improve care and lower costs. For example, a plan to fund research which gives doctors, patients and health plans better information on what works and what doesn't, Republican critics have claimed a sinister plot to have the government decide what treatments you will get. Using this kind of perverted logic, a proposal that Medicare pay for counseling on end-of-life care is transformed into a secret plan for mass euthanasia of the elderly. There are many other examples.

Please, don't take hysterical criticism at face value. The truth is more complicated, but also reassuring.

Sunday, August 2, 2009

What's In It for Me? What are our obligations to each other?

As what passes for a health care debate rages all around us, I have come to realize that between the polarized extremes there exists a very important group of people who are the key to what will happen this fall, and that is the large group of Americans who have health insurance and who are worried they may lose advantages in any reform. All of the noise in our media is an attempt to reach this group, who are likely asking, "What's in it for me"?

I believe that those who currently have health insurance and good access to medical care would be well advised to support proposed health care reform for the following reasons:
  • They may lose their insurance coverage! Right now, 14,000 insured people lose their coverage every day when they lose their job or the employer cannot continue to afford benefits, and that number is expected to increase greatly with current trends.
  • Business can't afford the increasing costs! Under the current system, costs are expected to double during the next 10 years.
  • Young people are priced out of the system! Those looking for work at the beginning of their careers are most likely to get jobs without benefits, leaving them uncovered and raising the cost for all others.
  • Insurance often does not work when you need it, even if you have it! The for profit system is full of people who work hard to "ration your care" by figuring out how not to pay for things.
  • The payment system must be reformed! Our current mess of a non system is caused by the payment incentive and lack of incentives we now have.
  • Quality is often lacking! A sad and poorly understood fact is that even people with good insurance get the recommended care they should have only about 1/4 of the time. The care is not organized in a way that allows most doctors to manage their patients the best way possible.
  • They may lose their doctor! Very few medical students are going in to the primary care disciplines, due primarily to the fact that they cannot afford to. Retiring family doctors are not being replaced. Reform which supports primary care is crucial to attracting the best and brightest into primary care.

When all is said and done, however, thinking just about ourselves misses one of the most important reasons for reform. Perhaps the most important thing to consider is, what are our obligations to each other? Our entire American society is engaged in global competition with all the countries on earth for the innovations, jobs, products and benefits of the world to come. We must have a society with well educated, healthy and productive citizens to secure the benefits of the future. Our companies need a level playing field that does not saddle them with the unequal and exorbitant costs of a failed system.

If the the future is scary to you, it is really not because of the risk of changing, but because we might not change. Don't be fooled.