Wednesday, August 26, 2009

Farewell Teddy

Watching and listening to the tributes to Senator Ted Kennedy, I realized that with his death, I am saying goodbye to a representative of a time on which I cut my political teeth.

When I was in college, John F. Kennedy ran for president, and I went on my first door to door canvassing dollars for Democrats. When he won, his inauguration message resounded: what could I do for my country, not what could it do for me. Martin Luther King was preaching a message of equality and dignity, and I was proud to be part of a new generation emerging from the South.

After that first assassination, I was heartbroken but recommitted to the dreams of the time -- I marched in sympathy with Selma in New Jersey, I worked on Lyndon Johnson's campaign against Goldwater in 1964. And I worked in a civil rights group to open segregated housing in the surburbs of Washington in the mid-60s.

But the Vietnam War interrupted, and our country became more and more bogged down in a war we couldn't win. We protested, we marched, we wrote letters. In short, we organized.

Then Martin Luther King was assassinated and 2 months later, Bobby Kennedy. So much sadness, such deep divisions within our country.

(In a different way, I feel those divisions again, paired with an uncontrolled anger -- especially in the town hall meetings over health care reform. )

As part of his legendary family, Teddy Kennedy suffered through personal tragedies that seem the stuff of myths. His own personal shortcomings led to a terrible death of a young person, and subsequently to more anguish and dysfunction in his own life..

But Ted Kennedy had a third act -- In the last 30 years, he rose to become the greatest of our senators. He became not only the voice of the poor and the dispossessed but one of the most respected senators (by both parties). He forged friendships and alliances with people whose views diverge greatly from his -- Orrin Hatch of Utah, John McCain of Arizona. And I know of at least one situation in which his personal attention helped a grieving family settle their affairs. Someone said he was a generous man, and indeed, he was generous in spirit.

Losing Teddy, then, is a huge loss for the Congress and our country. For me, it marks the end of the era that he represented. Yet as it said so eloquently in 1979 when he gave up the presidency:

"For all those whose cares have been our own, the work goes on, the cause endures, and the dream shall never die." Sphere: Related Content

Health Care Myths Exploded by White House

Reform will stop "rationing" - not increase it: It’s a myth that reform will mean a "government takeover" of health care or lead to "rationing." To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies.
We can afford reform: It's the status quo we can't afford. It’s a myth that reform will bust the budget. To the contrary, the President has identified ways to pay for the vast majority of the up-front costs by cutting waste, fraud, and abuse within existing government health programs; ending big subsidies to insurance companies; and increasing efficiency with such steps as coordinating care and streamlining paperwork. In the long term, reform can help bring down costs that will otherwise lead to a fiscal crisis.
Reform would not encourage "euthanasia": It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.
Vets' health care is safe and sound: It’s a myth that health insurance reform will affect veterans' access to the care they get now. To the contrary, the President's budget significantly expands coverage under the VA, extending care to 500,000 more veterans who were previously excluded. The VA Healthcare system will continue to be available for all eligible veterans.
Reform will benefit small business - not burden it: It’s a myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses, provide tax credits to help them pay for employee coverage and help level the playing field with big firms who pay much less to cover their employees on average.
Your Medicare is safe, and stronger with reform: It’s myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform will improve the long-term financial health of Medicare, ensure better coordination, eliminate waste and unnecessary subsidies to insurance companies, and help to close the Medicare "doughnut" hole to make prescription drugs more affordable for seniors.
You can keep your own insurance: It’s myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.
No, government will not do anything with your bank account: It is an absurd myth that government will be in charge of your bank accounts. Health insurance reform will simplify administration, making it easier and more convenient for you to pay bills in a method that you choose. Just like paying a phone bill or a utility bill, you can pay by traditional check, or by a direct electronic payment. And forms will be standardized so they will be easier to understand. The choice is up to you – and the same rules of privacy will apply as they do for all other electronic payments that people make. Sphere: Related Content

Tuesday, August 25, 2009

Moran and Dean Participate in a Lively Town Hall on Health Care in Reston, Va

I was surfing the TV after the News Hour tonight when, from the comfort of my living room, I discovered Congressman Jim Moran introducing former Governor and Dr. Howard Dean to an audience of screaming people. The meeting was a live town hall meeting on health care reform in Reston, Va. on C-Span.

This show was better than any of the other fare on TV tonight. Drama: anti-abortionist Randall Terry and followers were shouting "Dean is a baby killer" and "We won't pay for murder." Moran explained Terry had announced his intent to disrupt the meeting, and that he would be escorted from the meeting unless he wanted an opportunity to ask a question and be part of the process.

Terry obviously opted not to be part of the process, and he was removed. The meeting remained lively, noisy and chaotic -- with a vociferous group vying for attention among the several hundred people there.

Moran persisted, laying out a number of myths about the health care reform bills. (Most of these were covered before I found the meeting but I hope he will publish them on his website.) Howard Dean made three points: Health care in the US is 70% more expensive than it is in other countries; many people have no health care; and the way to pay for health care is to eliminate the unnecessary procedures.

After that, Moran drew names out of three boxes (for, against and undecided about health care reform) to get questions from the audience. A pharmicist asked if the Governor supported medical therapy services, and Dean responded yes, and that using pharmicists and nurse practitioners was one way to reduce costs.

Several people asked Moran if he was willing to go on a public plan. He kept responding that, as a federal employee, he is on a public plan for which he pays about $6,000/year. People seemed miffed at this answer.

One man asked whether a system of medical cooperatives would be an acceptable compromise to a public option. Moran responded that this was not a substitute for a public option although there was nothing wrong with the idea. He said a coop would need 500,000 people and start up monies, and that there would be no private incentives for cooperatives to operate.

A woman saying she was the questioner asked "why don't we take $23 million out of bailout?" and then Moran realized she was not the questioner.

Moran answered a question about Part D saying that the pharmaceutical companies agreed to a deal with the bill negotiators that they would reduce the "donut hole" gap in coverage if the government would not require negotiation with drug companies for coverage. Moran said he preferred negotiation as users of Veterans Administration had been able to pay one third to one half of the drug costs because VA was able to negotiate with the companies.

Another person asked why not have a universal coverage without a public land. The response was that the Netherlands and Switzerland, which has no public plan but universal coverage, treats insurance companies like public utilities governing rates strictly.

Another person asked why is medicare so much in the red. Moran responded that medicare costs are rising slower than privately insured costs even though it is true that over time, medicare will run out of money. Medicare spents only 3% on administrative costs; private companies, 30%.

Tort Reform: The issue is how to stop frivolous lawsuits while still allowing people who have been injured by a doctor or hospitals to redress their grievances in court. Both politicians acknowledged that the congressional bill writers didn't want to take on the anti-tort reformers in this legislation. But they agreed tort reform was needed. Dean suggested a plan whereby people would go to arbitration, and the results of the arbitration - while not binding - could be evidence in a tort trial.

Moran claimed that the public plan would be paid for by the revenues coming in, although he did not explain how Congress would fund the subsidies for those who are unable to pay for the public plan and receive the sliding scale subsidies.

At the end of the meeting, Dean pointed out that this had been a good forum in the "spirited American tradition," and that both sides had behaved "pretty well."

After listening to this I tried to find the C Span feed; at the time of writing there was no feed but an announcement of the next time the event would be re-shown on C Span 1 -- several times on August 26, for example: Sphere: Related Content

Monday, August 17, 2009

Health Care Reform

For weeks I’ve been reading the articles on health care reform and grousing because there are so few summaries of the 1000+ page bill. But I’m happy that some writers are finally talking substance rather than the politics of the bills or the uproar at townhall meetings (often over misinformation or dis-information, by the way).

Steven Pearlstein in the Washington Post last week wrote about the Republicans propagating falsehoods in the attacks on health care reform. He pointed out several main points of the bill, especially notable the “exchange” idea:

The health insurance exchange that individuals and small businesses could purchase insurance at lower rates than now available. It is this exchange in which the question of “public option” arises. Although the public option is in the House bills floating around, it appears that the bi-partisan Senate bill will probably opt for a “nonprofit cooperative” to take on the role of the public option, and the Obama Administration signaled in a number of press outlets this weekend its willingness to consider such alternatives to the public option.

The Sunday Washington Post had a “handy health care cheat sheet” by Alec MacGillis, although I think it needs to be honed down a bit more. In short McGillis points out that 47 million people are uninsured; and that health care costs have been surging. The proposed solution is making Medicaid available to more people and helping others to purchase insurance through the “exchange.” Everyone would be required to buy insurance. At the outset, large businesses and people receiving coverage from employers probably wouldn’t be able to buy on the exchange.

The cost of expanding coverage, according to MacGillis, would be around $1 trillion over 10 years ($140 billion/year). The funds would be raised by squeezing money out of Medicare and Medicaid from subsidies that go to private Medicare Advantage Plans and some other Medicaid funds.

The bills would set a federal panel to establish Medicare rates free of pressure from providers.

From the House Committee on Energy and Commerce there are a number of other provisions in their fact sheets:
* Guaranteed coverage – Insurance companies will not be able to refuse to sell or renew policies or exclude pre-existing health conditions. Prohibits lifetime and annual limits on benefits. Premiums can vary based only on age, geography and family size.
* Over time a minimum quality standard for employer plans will include preventive services with no cost sharing, mental health, oral health and vision for children.
* Caps on amounts person must pay out of pocket in one year
* Sliding scale affordability credits for low and moderate-income families and individuals.
* The exchange and inclusion of a public health insurance option (or cooperative option) will open many markets in area to new competition.
* Expansion of Medicaid to persons and families with incomes at or below 133 percent federal poverty level and will be fully federally financed.
* Filling of "donut hole" in Part D drug program, eliminating cost-sharing for preventive services and improving low income subsidy programs in Medicare, fix physician payments.

An excellent column by Paul Begala in the Thursday Washington Post warns against Progressives dumping the health reform effort because of compromises such as no single-payer plan or perhaps no public option. Bergala points out that every other major piece of social legislation had to make compromises in the beginning and gives some excellent examples of groups excluded from Social Security initially (agricultural workers and domestic workers) but who later have been included. Although we can be appalled that these workers were not initially included would we have wanted Roosevelt to veto the legislation?

Begala was part of the White House group advising President Bill Clinton in the early 90s urging him to veto any legislation that didn’t meet idealistic goals of real reform – Of course health reform did not get out of Congress in the 90s – it was dead on arrival. Bergala says, in effect, that this time we need to be willing to accept the half-loaf. I agree.

Everyone needs to write their Congressmen and Senators and express their views – however idealistic they may be.

But the bottom line should be: We need health care reform now. We cannot postpone this issue for another generation to decide. Let's begin the reform in 2009.

Sphere: Related Content