Pelosi Sticks With Public Option

Speaker Nancy Pelosi at a gathering of interfaith leaders in San Francisco today (Justin Sullivan/Getty)
Speaker Nancy Pelosi at a gathering of interfaith leaders in San Francisco today (Justin Sullivan/Getty)

House Speaker Nancy Pelosi held a press conference in San Francisco this morning at which she reiterated her commitment to a public option in the health reform bill and expressed hope, though with somewhat  lowered optimism, for coverage of end-of-life conversations. She did get in a dig at opponents of the latter: In response to a question about whether voluntary reimbursement for discussion of end-of-life care would stay in the bill, Pelosi said, “You know, the language is almost exactly the same as what the Republicans put into the prescription drug bill.”

The press conference, hosted by the San Francisco Interfaith Council, was an apparent reinforcement of the Democrats’ strategy of  broadening health reform support among members of religious communities. With leaders from the San Francisco Bay Area Christian, Muslim and Jewish communities arrayed behind her, the Speaker made repeated references to health care for all being a moral issue. Responding to the above question, she said, “People of faith, people in healthcare” and others know that “it makes life better if a person has expressed his or her own wishes. The key to this is that it is voluntary; it serves the purpose of saying what is your wish, rather than someone else having to make a decision you might not want. I don’t know what will happen (to the provision); I surely hope it will stay in.”

Pelosi was unequivocal, however, in her response to questions about the public option and to one reporter’s comment that “some Democrats and liberals are frustrated because it seems you are caving in to the far right.” “Is that you?” she repeated, pointing to herself. “The public option is the best way to go. If anybody can come up with a better alternative we’ll consider it. But the President is not backing off. The co-op might work in some states and that’s fine.  There is no way I can pass a bill on health reform without the public option.”

Pelosi was equally emphatic about her intention to retain the 400% of poverty measurement. Hesitantly using the term “seniors,” she said that many people between the ages of 50 and 65 have lost jobs, or may be making just $30,000 to $40,000 per year, and cannot afford needed medical care or prescription drugs. “I believe we have to have the 400% of poverty for them.”

Would the Democrats accept a scaled-down version of health reform? Pelosi repeated her litany of what is needed: reduced costs, improved quality, expanded coverage, affordable care for all; “What are you going to give up? At the end of the day, this is what we must have. And we must have reform of the insurance industry.”

In the small, carefully selected audience assembled at St. James Episcopal Church where her children attended preschool, Pelosi was on her own turf and among friends.  And she was characteristically upbeat. “Have we lost control of the debate? I disagree. I have 218 votes, and expect to have more. I am optimistic, and the President is committed to change.”

Rallying the Faithful for Health Reform

President Obama sought to strengthen support for health reform among one of his core constituencies Wednesday afternoon, the community of believers. He served as keynote speaker of sorts, in a conference call with some 140,000 members of faith communities around the country. The call sponsor’s title, 40 Days for Health Reform, suggests those communities are mobilizing for action. 40 Days for Health Reform includes progressive interfaith groups PICO National Network, Sojourners, Faith in Public Life and Faithful America; and Catholics in Alliance for the Common Good. Web sites of the first four list members as adherents of faith traditions including Christianity, Judaism and Islam.

Urging his listeners to “spread facts and speak truth,” Obama said social change has always involved “a contest between hope and fear.” He reviewed some of the more glaring misrepresentations that have been made by opponents of reform — government take-over, “death panels,” funding for abortions — labeling them “ludicrous,” and said the response to “not wanting government bureaucrats meddling with your healthcare” is that “we don’t want insurance bureaucrats meddling with your healthcare.” There were no surprises, or new ideas floated. Director of White House Policy Council Melody Barnes fielded a few pre-selected questions from listeners but dodged any, such as one direct query about a public option, of substance. Still, among a small group of listeners surveyed after the call everyone was enthusiastic about the happening. “Nobody’s expecting policy pronouncements on a conference call,” said one; “what we need is just the recognition of how many good people want good health reform now.”

The call was clearly designed to rally and encourage the troops of the faithful. And those troops, many weary of watching debate co-opted by the religious right, may indeed now be reinvigorated. Most of the call was taken up with prayers or comments from religious leaders, or stories of tragedies caused by the current healthcare disarray. There were plenty of Biblical touchstones — the call lasted for 40 minutes — for listeners of Abrahamic faith traditions, and more than one of the speakers expressed the certainty that it is God’s will for all of His (or Her) creatures to have affordable, quality healthcare. Sponsoring organizations and participating individuals are gearing up for action in the weeks ahead toward that end.

The call can be heard on the 40 Days for Health Reform site. It may not change any Republican minds, but it does indeed claim a pretty powerful ally for the cause.

Counseling Improves Life's End. Surprise!

Knowledge, care and compassion really do bring peace. Why should this be a surprise? And why should a few strident opponents prevent those approaching life’s end from having this benefit?

A study appearing in today’s Journal of the American Medical Association points out the benefits of end-of-life counseling, although the widespread misinformation loose in the land may have doomed what should be a significant piece of health reform.

As a political uproar rages over end-of-life counseling, a new study finds offering such care to dying cancer patients improves their mood and quality of life.

The study of 322 patients in rural New Hampshire and Vermont also suggests the counseling didn’t discourage people from going to the hospital.

The Senate bill provision axed by Finance Committee chair Charles Grassley would have allowed coverage for conversations with physicians about things like hospice care, advance directives and treatment options.  But to opponents of reform, it was a handy attack mechanism. They enlisted a few standard bearers like former Alaska Gov. Sarah Palin and media darling Rush Limbaugh to twist the issue into menacing “death panels,” and in no time at all Sen. Grassley had his excuse to excise.

Losers in this are all of us. Eventually, 100% of us will die. Aggressive treatment and expensive, futile procedures are common today to that experience; compassion and peace are harder to come by.

In the new study, trained nurses did the counseling with patients and family caregivers using a model based on national guidelines. All the patients in the study had been diagnosed with terminal cancer. Half were assigned to receive usual care. The other half received usual care plus counseling about managing symptoms, communicating with health care providers and finding hospice care.

Patients who got the counseling scored higher on quality of life and mood measures than patients who did not.

Could someone please get this information to Sarah Palin?

Study: End-of-life advice aids terminally ill.

Public Option Dead? Barbara Lee Says No

You think the public option for health coverage is dead? Try telling that to Congresswoman Barbara Lee. Never known for going along (she was the lone member of Congress to vote against giving President Bush a virtual blank check to go to war after 9/11) or for mincing words, she wants it known that no health reform battle — other than that for single-payer — is over.

“It’s all about give and take,” she said tonight; “we gave single payer.”

The Representative from California’s 9th District was at San Francisco’s Commonwealth Club to talk about her new book, Renegade for Peace and Justice.  But the conversation with KQED TV host Belva Davis and the Q&A session with a largely friendly audience tilted immediately, and  heavily, toward health reform. Has the Administration lost control of the debate? Not in Lee’s opinion. “Mainstream media coverage has been very biased,” she observed in opening the Q&A session. “The focus has been on the ruckus made by a small percentage of people, who probably didn’t vote for President Obama. I didn’t see CNN covering my Town Hall meeting.”

Because “we spent over a trillion dollars on this war that didn’t have to be fought,” Lee said, the issue of health reform is now “all about choice, and about competition.” And before either of those get to the public, congressional give-and-take will lead to a final bill. As current Chairwoman of the Congressional Black Caucus and member of several powerful committees, Lee expects to play an active part in that process. “We will insist on a bill that has a strong public option,” she says. “At least 60 members are saying the public option is key to their support.”

The new book was enjoying brisk sales, but health reform comments drew the loudest applause. One audience member told me at the end of the event that “Congresswoman Lee won’t ever get medals for moderation, but I’m not throwing in the towel if she’s not.” We were both leaving a few minutes before the final gavel; he said he was on his way home to start sending out more e-mails.

Insuring the Uninsured: A No-Brainer

I’ll call her Joan. She is 61 years old, working in real estate and living comfortably in an upscale rental apartment thanks partly to rent control. She has a small 401k and a small, steady income from shared family ownership in a stable investment property. But the real estate business, you may have heard, hasn’t been wonderful lately. Joan lives frugally, gives of her time and resources to community nonprofits and is highly respected in business and social groups. She has no health insurance.

“I would if I could,” she told me some time ago. “But it’s either buy insurance or buy dinner. I’m fond of eating.” Twice in the past year Joan has had to have medical treatment; once for a nasty wound in a bike accident, once for an infection that required an overnight hospital stay. She went to the only place available, the understaffed emergency room of a crowded public hospital. Who picked up the tab? You and I. I am happy to do so, for Joan and everyone else who winds up in these predicaments. But come on, it’s not exactly cost-effective.

Expanding coverage to those currently uninsured is only one segment of this moving-target health reform; I hope it doesn’t get lost the way other key elements seem to be straying from the scene. People like Joan would be the first to purchase insurance through any reasonably-priced plan. Unfortunately, I don’t see many insurance companies eager to offer such a thing, and I don’t know where many of the currently uninsured will go if the public option comes off the table.  There were some 47 million uninsured at the latest count. Add to those the swiftly-rising numbers of independent contractors and freelancers of all sorts.

Getting non-emergency care out of the nation’s emergency rooms seems an enlightened thing to do… if we could just have a little more light and less heat in the discussion.

A Life-or-Death Decision in Australia

Australian Chief Justice Wayne Martin ruled Friday that quadriplegic Christian Rossiter has the right to end his life, if he chooses, by starving himself to death. Of all difficult medical-ethical issues, this has to be close to the top. I do not applaud the decision, do not support suicide (though I strongly support the right of a mentally competent, terminally ill adult to hasten his or her own dying) and hope Mr. Rossiter changes his mind. He may well do so now.

A series of injuries combined to make the 49-year-old a spastic quadriplegic last year. Mr Rossiter, once a keen rock climber and adventurer, told the Supreme Court his life was once exciting and enjoyable.

But the reality of his situation is far from that now.

Unable to move other than wiggle one finger or toe, unable to take nourishment except through a feeding tube, Mr. Rossiter asked his caretakers, Brightwater Care Group, dozens of times to remove that tube. They went to the court for an answer, and the answer has now come. But Mr. Rossiter is talking to his doctors and says he may change his mind. Should he stick with the decision to remove the feeding tube he will not, in truth, be “committing suicide;” he will be allowing natural death. (In the U.S. he would qualify for hospice care.) Either way, the choice should be his.

There are no winners or losers in this tragic tale. But there is something heroic in one man’s determination to keep control of his own destiny. I admire his gumption, and wish him well.

Quadriplegic Christian Rossiter now has control of destiny | PerthNow.

Fitness & Health Reform: Stay Flexible

Flexiblility is the new necessity. Political flexibility if one is to make the loop from truth to Sarah-Palin fiction, emotional flexibility if you’re following the market from day to day, mental flexibility just to stay sane with it all.

So maybe we’d better look at the physical. If you can just acquire and maintain a little physical flexibility you’re on the way to fitness, health and inner peace. At least, that’s what the yoga people tell me. Plus a lot of gym people, personal-trainer people and public park people. It is these last whom I tend to believe. I failed yoga (tried and just flat-out failed; I was too itchy for sunlight and speedier movement) and can’t afford a personal trainer. But parks! What a gift to the flexibility and fitness of the world and may we please not be closing them.

In our nearby urban park there is a par course. An array of exercise stations installed usually several hundred feet apart along an outdoor trail, the par course is the Everyman/Everywoman route to flexibility, especially for Boomers and Beyonders. It features a number of stretching posts (each station comes with illustrated instructions about what to do and how many times to do it) plus a variety of sturdily-equipped stations for things like chin-ups and sit-ups and other ups. I am addicted to the par course.

For the first five decades, fitness and flexibility aren’t all that hard to come by. Thereafter, one needs encouragement in this obesogenic (my new favorite word) society in which we live. Par courses are all about encouragement. You can’t manage to hand-walk more than halfway on the parallel bars? Last week you couldn’t get past one-third! Or you’re near despair at the chin-up station, and the hunky twenty-something at the adjacent bar applauds as you master a tiny new fraction of an inch.

By the time the final health reform bill is hammered out the issue of preventive medicine may be hopelessly lost in the shuffle. “Takes too long to produce results.” “Isn’t really worth the cost or the effort.” I don’t buy any of those arguments. Until we tackle the need for lifestyle changes like quitting smoking, losing weight and getting fit we’ll just keep pouring money down the drain of preventable illness. E-mail your senator. Write your representative.

Meanwhile, I recommend staying flexible.

Tracking Down a Rumor

Rumors come, and don’t seem to go. Jim Rutenberg and Jackie Calmes of the New York Times have weighed in again today with a few facts… just in case anyone is interested in facts:

The stubborn yet false rumor that President Obama’s health care proposals would create government-sponsored “death panels” to decide which patients were worthy of living seemed to arise from nowhere in recent weeks.

Advanced even this week by Republican stalwarts including the party’s last vice-presidential nominee, Sarah Palin, and Charles E. Grassley, the veteran Iowa senator, the nature of the assertion nonetheless seemed reminiscent of the modern-day viral Internet campaigns that dogged Mr. Obama last year, falsely calling him a Muslim and questioning his nationality.

Rutenberg and Calmes point out that the doggedly persistent rumor “was not born of anonymous e-mailers, partisan bloggers or stealthy cyberconspiracy theorists.

Rather, it has a far more mainstream provenance, openly emanating months ago from many of the same pundits and conservative media outlets that were central in defeating President Bill Clinton’s health care proposals 16 years ago, including the editorial board of The Washington Times, the American Spectator magazine and Betsy McCaughey, whose 1994 health care critique made her a star of the conservative movement (and ultimately, New York’s lieutenant governor).

This is the core of what all reasonable people know:

There is nothing in any of the legislative proposals that would call for the creation of death panels or any other governmental body that would cut off care for the critically ill as a cost-cutting measure.

But as T/S Contributor Andy Geiger points out, the real issue in health reform is that people are suffering because they don’t have health coverage. Opponents to any reform at all have found a handy way to create this smokescreen by keeping everyone riled up with an utterly false rumor.

I’ve spent much of my adult life working for better end-of-life care, including being forever on a soapbox urging everyone, not just seniors, to consider their end-of-life options, have conversations, create advance directives and then get on with living. I strongly, fully support the good provision in the health care bills that may indeed now get cut.

But we need not to lose this forest for a tree. Rational people have got to continue fighting for a decent system, a decent bill.

False ‘Death Panel’ Rumor Has Some Familiar Roots – NYTimes.com.

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