Health care reform quote for the day 09/24/2009
No program will work unless people want it to work. Everyone must have a stake in the process. ... By sharing costs, consumers would have a direct economic stake in choosing and using their community's health resources wisely and prudently. From a speech given by President Richard M. Nixon on February 6, 1974, in which he outlines his plan to expand Social Security and Medicare benefits to include more Americans. To read the complete speech, go here. Add Comment Here’s an excellent explainer put up by the Department of Health and Human Services today, answering many questions many have about health care reform and how it will affect seniors. It’s clear, it’s presented well and it’s comprehensive. I urge you to take 15 minutes to read it. Then, send your thoughts about it to your elected officials. Health Insurance Reform and Medicare: Making Medicare Stronger for America’s Seniors For Congressional contact information, see the end of the blog post below. A look at the Baucus Bill 09/23/2009
Here’s a rundown of some of the highlights discussed yesterday in the conference call between senior health care legislative aides in the office of Sen. Harry Reid, and five blog publishers, including myself. You can read the entire bipartisan bill that came out of the Senate Finance Committee this week -- also called the Baucus Bill -- at: http://finance.senate.gov/sitepages/leg/LEG%202009/091609%20Americas_Healthy_Future_Act.pdf This is the long-awaited bill that is supposed to keep the costs within the framework mandated by President Obama, and be acceptable to both sides of the aisle, while keeping the spirit of reform. Note: It does NOT include a public option. In other words, it’s a compromise, from the start. Since the Baucus Bill was published over the weekend for Mark Up, nearly 600 amendments have been proposed. The amended version of the bill should be available for study in a few days. I’ll put up a link when I have one. During the conference call, we focused on priorities for seniors, and how the bill will affect Medicare recipients. Here are a few highlights: --This bill contains no benefit cuts to seniors on Medicare. NONE. --Those enrolled in a drug benefit plan will get a 50% discount on brand name drugs while they are in the so-called donut hole. That discount will not affect their ability to reach the next level in the drug program, however, because they will be credited for 100% of the cost of the drugs they buy at a discount. --Senior Medicare recipients will get a free annual physical. This is something new. --All prevention testing and immunization will be free. This will include flu shots, mammograms, colonoscopies and the like. One amendment under consideration would add bone-density testing to the list. --Physicians treating Medicare patients will get a 5 % increase in reimbursements beginning 2010, instead of the scheduled 21% payment cut. This should make it more likely that physicians will open their doors to new Medicare patients. I asked what the catch was for all this “free” stuff. After all, we know there’s no such thing as a free lunch. We were told money would be raised to pay for new benefits through revenue provisions (taxes and fees?), as well as by cracking down on waste, fraud and abuse. The Baucus Bill gives the Secretary of DHHS, FBI and Department of Justice new tools to monitor and increase penalties for fraud. One aide said we already spend billions every year on health care in this country that do not improve health one iota. For instance, a large part of the health care dollar goes to pay for consumer marketing and direct advertising by insurance and drug companies, or is lost to fraud or waste. All bloggers were urged to encourage their readers to voice opinions on this bill and other health care reform proposals through emails or calls to elected officials, or through blogs like our own. For more information, be sure to read the blogposts by the other bloggers on the call: George Phenix at Blog of Ages Nancy Belle at The Tempered Optimist Jan Adams at Happening Here Ronnie Bennett at Time Goes By Here’s a handy form Ronnie Bennett put together: Contact your senators and representative here. Nancy Pelosi Email form Phone 202.225.0100 Harry Reid Email form Phone 202.224.3542 A call from Washington 09/22/2009
 US Capitol Building, Washington DC Guess who called today? Are you sitting down? Birds on a Wire Blog was one of five chosen for a morning conference call with aides from the office of none other than Sen. Harry Reid, Senate Majority Leader, to answer questions and discuss elements of the Baucus bill for health care reform. Ronni Bennett of Time Goes By recommended us, as one of several blogs taking on health care reform issues in a serious and thoughtful manner. Its readers fall into that category as well. I'll get to the specifics we discussed in another post, but here's what I believe this call tells us: 1. At least some members of Congress have learned a lesson from the Obama campaign, which made very good use of social networking tools to build a viable base, deliberately and efficiently. If it worked for Obama, it can work for health care reform. Yesterday, I read on BlogHer that Reid's office would be using this technology for outreach to specific constituencies (seniors, women, etc.), in hopes of building a groundswell of public opinion in favor of the bi-partisan bill. I believe we were the first or among the first called. 2. Congressional outreach by way of the blogging community makes good use of aides' time. For every blogger they talk to, they have the potential to reach at least hundreds, maybe thousands, more. No travel and no fancy preparations are necessary. 3. Complex issues require serious study, thought and discussion. You're not going to be able to discuss nuances of various health care reform proposals through soundbites on talk shows or--heaven forbid!-- rowdy demonstrations. Our readers have the time and inclination to mull over ideas, read up on the details, compare and contrast content, and float their own ideas within a supportive community. 4. What better platform could there be than a blog, to provide a town hall-type forum? It's free, open and raucous-proof, by design. 5. Apparently, people working in the great halls of Congress read blogs. Even better, they read THIS blog. Just knowing that adds a lot of value--and responsibility--to what we do. All bloggers and blog readers (of every stripe) should take pride in the fact that this new media counts, and probably count even more in the future. 6. Your ideas can and will be heard through your blog comments, as well as your direct correspondence with Congressional leaders and and their staffs. WRITE today! Tell them you appreciate their interest in your comments through Birds on a Wire Blog, and other blogs. Here's a book I'd like to read 09/16/2009
Somebody had to do this and I guess I'm glad it was a Washington Post foreign correspondent. Reporter T.R Reid had a shoulder injury, so he sought medical advice -- in 10 countries! What he discovered may surprise you as much as it surprised him. Here are a few comments from a review in today's New York Times: One Injury, 10 Countries: A Journey in Health Care By ABIGAIL ZUGER, M.D. September 14, 2009 With all due respect to the seminar room, the boardroom, the hearing room and the Oval Office, a better vantage point than any of them for evaluating and redesigning our health care system is the hospital room (window bed, please). The chair next to the bed isn’t bad, either. Some of us perch on one or the other almost every day, observing the tangled mess that is our current system and mentally designing a dozen better alternatives. But for those who wind up in bed or a chair only when tragedy strikes, T. R. Reid’s new book provides an excellent substitute perspective ... A person’s last days can be spent in any number of ways. But on the phone pleading with an insurer, that’s only in America. For the entire review, see http://www.nytimes.com/2009/09/15/health/15book.html?em Time off from the debate 09/08/2009
I thought we'd take a little vacation from health care reform for a while, giving readers a chance to contribute, and me a chance to enjoy what you have to offer. Fear not, this issue is not going away. We'll return to it shortly, or even earlier if I believe more aspects need clarification. For those who can't get enough or simply want more facts, see Time Goes By, listed as a favorite blog on the right. Ann Sentilles, Dallas-based journalist and publisher of The Third Third, has kindly permitted us to republish one of her recent posts, My Rx for Health Care. Her thorough and thoughtful statement will move you, I guarantee. You can follow this important piece to the end by clicking on Read More, just below the line dividing this post from the next. Thank you, Ann. For more of her fine writing, visit her blog, which she calls an online journal for women engaging the third third of their lives. ~~~~~ My Rx for Health Care The Third Third June 25, 2009 I think that ancient Chinese curse has taken hold: we are indeed living in interesting times. These are, in many ways, the times my Dad has worried about his entire adult life. As a child of the Depression, he was always afraid of running out of money. And as a physician, he was terrified of “the government taking over” health care. (Instead, as I have pointed out to him repeatedly and to no avail, the insurance companies took over health care and made a real mess of it.) As the Obama administration takes on both challenges – the economy and health care reform – all the while linking them inextricably, I am feeling a huge sense of bystander’s responsibility. I’m heavily invested in the government getting this right. Yet I’m not sure I have a voice in the discussion, and I know I’m not a player in the game. What’s a bystander to do? I’m ready for the times to be a bit less interesting. Translating this at both the macro and the micro levels, that would mean something like steady 5 to 7 percent growth in the economy (and by extension, the stock market, upon which our retirement depends), and a dependably accessible and effective health care system (and for me and mine, one smart, attentive primary care physician with access to the best resources should we need them). Nothing too complicated, right? But, as the cliché of the week insists, “The devil’s in the details.” (Just as an aside, can one call a trillion dollars a “detail”?) For the moment, let’s leave the economy to the, ah, economists, and move on to health care. Oh, how they’ve muddied the waters. What exactly is health care today? (To read the entire story, click on Read More, below theviding line.) Health Care Numbers Don't Add Up 09/01/2009
1 + 1 = 5? According to University of Chicago economist Jon R. Gabel, over the past 30 years, the Congressional Budget Office has traditionally underestimated the savings Medicare tweaks would produce. In fact, they were off by billions. As a result, lawmakers work in the dark when they’re formulating new legislation, including the various health care reform bills now on the table. This, from his op-ed piece in the New York Times: “By underestimating the savings that can come from improved Medicare payment procedures and other cost-control initiatives, the budget office leads Congress to think that politically unpopular cost-cutting initiatives will have, at best, only modest effects. This, in turn, forces Congress to believe it can pay for reform only by raising taxes, which then makes reform legislation more difficult to pass.” For the full story, go to: Congress’s Health Care Numbers Don’t Add Up http://www.nytimes.com/2009/08/26/opinion/26gabel.html?_r=1&scp=1&sq=Gabel&st=cse My husband and I live in a state that already has health care reform. We live in Massachusetts. On April 12, 2006, our state legislature enacted a law requiring all residents to have health insurance. They could buy it themselves, they could buy it from their employer through a group plan or, if their income was below a certain level, they could buy it from the state at a reduced rate. This is the so-called public plan. If people are totally disabled and therefore unemployable, and have no assets to cover the costs, the state pays for it. Very few people fit the last category. Employers – even small-business owners – are required to provide basic minimum health care plans. If they do not, they are fined (a whopping) $295 per employee, per year. To date, the vast majority of employers – even small-business owners – have found a way to provide health insurance plans for their employees. Few have paid the fines. In fact, the number of small-business employers in the state that do offer insurance rose from 88% to 92% from 2007 to 2008, according to a recent story in Investors Business Daily. This program has been in effect almost three years. As far as we can tell, the world has not come to an end. When the law was enacted, my husband was already enrolled in Medicare and I was buying my own individual policy (a high-level HMO) from a business association group I joined specifically to buy insurance at a discount. The last year I had it, I paid $620/month, plus $175/year for association membership dues. Today, we’re both on Medicare, but buy a mid-level Medicare supplement HMO plan from Blue Cross/Blue Shield of Massachusetts. The supplement includes a drug plan and costs $119 a month, brining our total outlay for health insurance to $216 a month/per person. Thanks to Medicare and the supplement plan, we’re saving about $800 per month for the two of us. Thank you, US taxpayers and government bureaucrats. We weren’t sure we liked the idea of mandatory universal health care when it was first presented to the people of Massachusetts. We worried about reduced care, higher bills, and all the other things you worry about when you’re facing change. Here’s what has happened to us as a result of mandatory, universal health care: 1. We still go to the same doctors. 2. We’re still on the same medications. 3. We still use the same pharmacy. 4. All other medical facilities we use – imaging labs, hospitals, blood testing labs, physical therapy -- have not changed. 5. As far as we can tell, our insurance premiums have not changed or have changed slightly ($5, maybe, per month). 6. Our co-pays are lower, but we’re on Medicare. 7. If I had stayed in the same HMO plan I had before Medicare, some of my co-pays would have increased for things such as substance abuse treatment and prosthetic limb fittings, not that I used any of those benefits. 8. I have greatly reduced my drug regimen and we both have increased our weekly exercise, in part, because our insurance now encourages prevention by paying a nice benefit for going to the gym. 9. We feel more comfortable being in crowds at the grocery store, movie theaters, or in close quarters at the barber shop and hair salon, knowing everyone there has access to health care. That means everyone we deal with is less likely to be spreading infectious disease than they were three years ago. 10. We’ll feel even better when this year’s flu season comes around, since school children, teachers, bank tellers, store clerks and others dealing with the public can get the necessary vaccines or treatment to contain this year’s flu, no matter how rich or poor they may be. And that’s the truth.  For related stories, click on Health Care Reform, under Posts in the right-hand column.  If you’re listening to the health care reform debate, you’ll hear over and over again how great US health care is and how we don’t want to mess up a good thing. Well, I don’t know where those people get their facts, but they won’t find them in any US medical school or school of public health where real data rules, not jingoism. I learned this while covering stories at Harvard School of Public Health. Here are the facts: FACT: The US ranks 37th in overall quality of health care, in a world ranking published by the World Health Organization in 2000. WHO spent years collecting and compiling data, taking into consideration expenditure, efficiency, life expectancy and other factors. We’re behind Morocco in quality but ahead of Barbados! See for yourself. *The World Health Organization's ranking of the world's health systems Rank Country 1 France 2 Italy 3 San Marino 4 Andorra 5 Malta 6 Singapore 7 Spain 8 Oman 9 Austria 10 Japan 11 Norway 12 Portugal 13 Monaco 14 Greece 15 Iceland 16 Luxembourg 17 Netherlands 18 United Kingdom 19 Ireland 20 Switzerland 21 Belgium 22 Colombia 23 Sweden 24 Cyprus 25 Germany 26 Saudi Arabia 27 United Arab Emirates 28 Israel 29 Morocco 30 Canada 31 Finland 32 Australia 33 Chile 34 Denmark 35 Dominica 36 Costa Rica 37 United States of America 38 Slovenia 39 Cuba 40 Brunei 41 New Zealand 42 Bahrain 43 Croatia 44 Qatar 45 Kuwait 46 Barbados 47 Thailand 48 Czech Republic 49 Malaysia 50 Poland I cut it off at 50, by the way, to spare you the pain. Dollar for dollar, we're paying more and getting less than most of our friends and relatives in Europe, some areas of the Middle East and parts of Asia. Why is that? Those who think we don't need to improve quality -- just reduce expenses -- should think again. Look at our competition. Consider the countries -- such as Costa Rica and Saudi Arabia -- that, according to WHO, are doing a better job of meeting the health care needs of their citizens. Of course, this is little to do with the quality and quantity of our research, just delivery. Nor does it take into consideration the existence of something like the National Institutes of Health, or the National Library of Medicine, or the Centers for Disease Control and Prevention (all government funded and run). Here's a 2007 New York Times story that examines the significance of the WHO data. http://www.nytimes.com/2007/08/12/opinion/12sun1.html *Sources: WHO World Health Report 2000 See also Spreadsheet Details (731kb) See also: Healthy Life Expectancy By Country See also: Health Performance Rank By Country See also: Total Health Expenditure as % of GDP (2000-2005) See also: Main Country Ranks Page | Blogger Profile
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