Tag: Health Reform

Health/Money/Politics & Causes/USA
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Obama plays the Medicare card

by Fran Johns
President Obama, with Vice President Biden and Speaker Pelosi behind him, delivers a joint address to Congress on September 9 (Alex Wong/Getty)
President Obama, with Vice President Biden and Speaker Pelosi behind him, delivers a joint address to Congress on September 9 (Alex Wong/Getty)

For almost anyone over 50, the central issue of health care boils quickly down to Medicare. Will I keep it? Will it be there when I need it? Will it change?

In his address to a joint session of Congress Wednesday night, President Obama looked straight at the camera while saying he wanted “to speak directly to seniors: Medicare has been here for four decades, and is a sacred trust that must be passed down” to future generations. Then he pointed out to those seniors that the legislators opposing his reform plan are the same “folks who voted against Medicare in the beginning” and this year voted for a budget that would privatize it. He said also that much of the plan will be paid for by reducing waste and inefficiency in Medicare and Medicaid. Anybody who’s had (and thank you, I have) Medicare coverage for more than 15 minutes knows about waste and inefficiency. So cut those, and leave the system, and we should all be happy.

We should all be happy, that is, if such care extends to everyone. And if Mr. Obama’s references to the U.S. being the only developed country that lets its citizens suffer daily for want of adequate health care didn’t communicate the moral wrong that reform will attempt to right, you weren’t listening. What we heard was outline, and the president’s throw-away line about a few details yet to be worked out got an expected congregational chuckle. Some of us are more optimistic than others about whether any substantive change for the common good will remain by the time the final bill is drawn.

The details are ahead for the devil to be in, and he/she is surely ready. Whether public support will be forthcoming seems likely to boil down to a whom-to-believe game. Obama repeatedly stressed that “nothing in our plan requires you to change what you have.” But in delivering the Republican response immediately after the speech, Representative Charles Boustany of Louisiana promised listeners that they would be in for “replacing your family’s current plan with government-sponsored healthcare.” Boustany also tossed in references to “rationing care” and to general “fear and anxiety,” giving a distinct impression that battle lines are still drawn.

About those battle lines: Republicans sat on their hands as Obama once again proclaimed the rumors about bureaucrats who would kill off senior citizens — he skipped dignifying Sarah Palin by using the death-panel words — to be “lies, plain and simple.” And although he got the other side of the aisle to stand when he insisted there must be reform of medical malpractice laws, there were no smiles when he pointed out that the cost of health reform will be less than the tax breaks for wealthiest Americans passed during the previous administration.

Somehow, what truths and certainties do exist must be kept alive in the fray: Medicare is not going away. End-of-life conversations won’t kill off grandma. (Sadly, this provision may be already dead anyway.) The plan’s not going to cover illegal immigrants or pay for abortions. Medical malpractice laws must be reformed. Nothing will adequately replace the public option. A health care plan that offers access to all, imperfect or not, is only common decency.

This senior’s trust is still in Barack Obama.

Health/Money/Politics & Causes/USA
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New Way to Count Old Poor

by Fran Johns

As if there weren’t enough bad news to go around, a new(ish) formula for calculating the national poverty rate could boost the number of over-65 poor from 9.7 percent — or 3.6 million of us — to 8.6 percent, or a hefty 6.8 million. Just like that, the poor get poorer; or in any event they get to be more of us.

It’s not really a new formula, it’s a revision of the half-century-old National Academy of Science’s formula…

which is gaining credibility with public officials, including some in the Obama administration. The original formula, created in 1955, doesn’t take account of rising costs of medical care and other factors.

If the academy’s formula is adopted, a more refined picture of American poverty could emerge that would capture everyday costs of necessities besides food. The result could upend long-standing notions of those in greatest need and lead eventually to shifts in how billions of federal dollars for the poor are distributed for health, housing, nutrition and child-care benefits.

Using this formula, overall poverty in the U.S. would rise to an estimated 15.3 percent, or 45.7 million.

The current calculation sets the poverty level at three times the annual cost of groceries. For a family of four that is $21,203. That calculation does not factor in rising medical, transportation, child care and housing expenses or geographical variations in living costs.

I’m not at all sure my current family of two could eat (OK, and drink too, with an occasional dinner out) on $21,203. It may certainly be time for a re-calculation. And a little more help.

via New measure doubles number of elderly poor.

General interest/Health/Money/Politics & Causes/USA
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Health Reform: The Mystery

by Fran Johns

Facebook friends of mine in the past few days have been turning up with a status line that reads, “No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree please post this as your status for the rest of the day.”

Well, I do agree. I haven’t posted it as my status yet, mainly because my True/Slant posts get posted as my status, and enough is probably enough. But I’ve been curious because friends who are not even Friends of friends have been posting it, some with additions (“I’m just sayin’…”) or (“E-mail your representatives!”)

So I just checked out Open Salon, and there’s OESheepdog’s blog reading “From my friend Leigh Bailey: “No one should die because… etc” followed by a long list of affirmative reactions. My personal favorite was John Blumenthal’s comment, “You’re right, of course, but I wouldn’t lose any sleep if someone took Glenn Beck’s insurance away. Pre-existing stupidity.”

But the question remains, Did OESheepdog’s friend Leigh Bailey start the whole movement? Kathleen Sebelius? Nancy Pelosi?

I’m just askin’.

Reforming US health care is not the end of the world – OEsheepdog – Open Salon.

General interest/Health/Money/Politics & Causes/USA
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Healthcare: Sorting Fact from Fiction

by Fran Johns

House legislation on health reform is a win-some-lose-some proposition for those over 65. Especially, as outlined in The New York Times yesterday, when it comes to Medicare drug benefits.

Medicare beneficiaries would often have to pay higher premiums for prescription drug coverage, but many would see their total drug spending decline, so they would save money as a result of health legislation moving through the House, the Congressional Budget Office said in a recent report.

Premiums for drug coverage would rise an average of 5 percent in 2011, beyond the level expected under current law, and the increase would grow to 20 percent in 2019, the budget office said.

“However,” it said, “beneficiaries’ spending on prescription drugs apart from those premiums would fall, on average, as would their overall prescription drug spending (including both premiums and cost-sharing).”

The Congressional Budget Office report set off an immediate battle between Republicans and Democrats, each side eager to convince seniors — those vocal voters — that the other was representing the devil incarnate. Republicans swear the House bill will threaten Medicare beneficiaries in order to cover the uninsured, Democrats say the bill will help them by eliminating a gap in Medicare drug coverage.

On this particular segment of the impossibly complex bill, maybe seniors would do well to listen to their own purported champion:

Nancy LeaMond, an executive vice president of AARP, the lobby for older Americans, welcomed the report as evidence that “health care reform will lower drug spending.”

“Opponents of reform may use today’s projections to try to stall reform,” Ms. LeaMond said, “but we hope they will look at all the facts before jumping to a false conclusion.”

And there, some would suggest, is the problem. The facts have been virtually obscured by misstatements, misrepresentations and outright lies. Death panels? A lie that served its scary purpose. Rationing? It’s already here, folks; it’s done by insurance companies that deny coverage in sometimes arbitrary ways. Socialized medicine? Hello? Does anyone over 65 remember those screams before Medicare was signed into law in ’65? When half the population over 65 had no insurance coverage at all?

Set aside the fact that providing healthcare for all is simply the right thing to do. Millions of American seniors (whether you begin that definition at 65, 60 or — to their horror as it sometimes happens — 55) were motivated to support President Obama by not only their hearts but also their brains. If those brains can be called into play to sort fact from fear-mongering, we may yet get the health reform common decency requires of this otherwise civilized nation.

Health Bill Would Cut Drug Spending for Many on Medicare, Budget Office Says – NYTimes.com

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General interest/Health/Money/Politics & Causes/USA
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More on Health Care: Where the Costs Are

by Fran Johns

A few interesting factoids were dropped into the health reform debate by New York Times writer Amanda Cox Tuesday:

In 2006, health care expenses among half the United States population totaled less than $800 per individual, according to the federal Agency for Healthcare Research and Quality.

For openers, that seems entirely reasonable. Would that we could actually care for the citizenry at $800 a pop. Keep reading.

But the expenditures were not uniformly distributed throughout the overall population. Spending was far higher among the elderly, the obese and people who identified themselves as unhealthy. Median spending in those groups totaled $2,300 per individual. Although these patients represent just one-third of the population, they accounted for almost 60 percent of health care spending.

I hate to stomp this nearly dead — oops, bad metaphor — horse even further into its grave, but a lot of us, given the chance to talk to our doctors about aggressive, invasive, often futile end-of-life treatments that are going to make our ends horrific might choose to go home and spend our remaining time with palliative care, at peace. A nifty way to cut that $2,300 back down to $800. But Senator Grassley and others think we should now allow those conversations.

The truth may be too obscured by the cleverly promoted lies, but the issue is about choice. Compassion. Comfort. Peace. Sanity. If anyone could get this truth across to seniors, that one critical segment of reform might still survive. And personally, I’d like to have the option of saving the rest of you taxpayers my $1,500.

via Making Sense of the Health Care Debate – Prescriptions Blog – NYTimes.com.

General interest/Health/Money/Politics & Causes/USA
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Health Policy: Is Altruism Dead?

by Fran Johns

Recently in this space the me-first word was brought up. (It does not abbreviate well.) Might as well say it out loud: health reform could surely be sunk by the Me-Firsters, those who would put personal desires above the greater good, whether those desires are for better pharmaceutical or insurance industry bottom lines or for some corner of personal coverage, senior or otherwise, that might be sacrificed in the future.

I am not above having those desires. My husband and I actually have a tiny bit of stock in a drug company thanks to some mergers and buyouts I do not pretend to understand (I also don’t mess with the family stock portfolio) and thus a decline could cost household income we can ill afford. Plus, I would hate having the excellent care I get from Kaiser (thank you, Medicare) curtailed and would be seriously bummed if suddenly stuck with paying 100% of my post-cancer meds. But if that, or something equally draconian, is what it will take to get health coverage for my currently-uninsured friends, I would like to go on record as supporting whatever we must do to get access for all. This is not noble, just minimally humane.

There are noble people out there, however. They sign up for Teach for America, they volunteer in nursing homes and day care centers and hospice programs, put in long hours at food banks or take to the streets in other, similarly un-chic endeavors.

Re the current health reform brouhaha, there are also noble people, or at the very least altruistic people, all over the country; you just don’t hear a lot about them. On August 19, for example, President Obama urged supporters of health reform to “speak facts and truth” in what he said was a “contest between hope and fear,” and tried once again to refute some of the misrepresentations still widely circulating. His comments were themselves fairly widely circulated. But unless you happened to run across them in this space you would not have known they were made to 140,000 members of faith communities and/or supporters of community-organizing nonprofits. The people of Sojourners, Faith in Action, PICO and other groups that put together the 40 Days for Health Reform conference call are not in it for personal gain; they happen to believe everyone in this country should have access to health care. The next day, Nancy Pelosi held a press conference reiterating her determination to keep a public option in the final health bill. But again, unless you happened to see it here you would not have known the event was sponsored by the San Francisco Interfaith Council with a lot of help from its friends in the San Francisco Organizing Project.

When the religious right goes on a tear against abortion or end-of-life choice (or for that matter, when the religious left goes head-to-head with its ideologically-opposed brothers and sisters) it makes news. When community organizers stage high-profile protests, the same thing happens. What does not make news is the enormous effort made by people of good will just to promote the common good — most recently, health reform.

Some opponents of Obama and his reform bills even have an altruistic bone or two. The reportedly calm, if badly misinformed, Bob Collier, featured in a front page New York Times article August 25, allowed that “we’ve got to do something about those people who can’t get insurance.” He qualified that later: “There has to be a safety net there. But I don’t want that safety net to catch too many people.” Somehow, Mr. Collier wants to separate out the “truly needy” from the “lazy and irresponsible people who play the system” and wouldn’t we all. The Times said that Mr. Collier gets his information from Fox News, Rush Limbaugh and Matt Drudge, none of whom I see as particularly altruistic. I would surely welcome him to True/Slant.

But the people cited above, people in faith communities (including many I disagree with and some I can’t pronounce), progressive nonprofits, community organizing groups and others just roaming the streets being kind, these people seek access to health care for everyone without worrying about who deserves it and who does not. A great many of them worked hard to put Obama in office, and are now working hard for health reform for no reason other than it is the right thing to do for someone else. Might be unrealistic but they keep at it.

My money is still on those people.

Politics & Causes
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Pelosi Sticks With Public Option

by Fran Johns
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.”

General interest
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Rallying the Faithful for Health Reform

by Fran Johns

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.

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