Showing posts with label health care reform. Show all posts
Showing posts with label health care reform. Show all posts

Thursday, December 10, 2009

Reform Debate Continues To Be Dishonest - Business As Usual

I don't watch the Senate and House debates on C-SPAN much anymore because it only frustrates me to listen to the dishonest arguments.

Yesterday the Senate was debating Health Care Reform.  One of the Republicans said that the Democrats wish to reduce the Federal income tax medical expense deduction.  Unreimbursed medical expenses in excess of 7.5% of your adjusted gross income are currently deductible.  The Democrats propose raising the limit to 10%.  The senator stated that this would result in a tax increase that would affect middle income families the most.  He stated that the tax increase for a family with an income of $57,000 would be more than $3,000, which is a gross overstatement.

A family with an adjusted gross income of $57,000 can currently deduct unreimbursed medical expenses in excess of $4,275.  The Democrats propose to raise this to $5,700 (10% of $57,000).  The maximum difference between the current and the proposed is $1,425 if the family's unreimbursed expenses equal or exceed $5,700.  A family with a taxable income of $57,000 will pay federal income tax at the rate of 13.54%.  Therefore, the maximum impact of the Democratic proposal is 13.54% of $1,425 or $193.

The typical family of four earning $57,000 doesn't have unreimbursed medical expenses exceeding 7.5% so most families will not be affected by this change.  The families and individuals that do have unreimbursed medical expenses exceeding 7.5% are likely to see those expenses reduced by far more than $193 due to positive affects of health care reform - reduced insurance premiums, increased coverage, lower costs for service and drugs.

The good senator's misinformation is not going to cause any Democrats or Republicans to vote against the proposal as long as they have a basic understanding of the tax laws and middle-school mathematics.  Therefore, the senator had no expectation of impacting the results of a Senate vote on reform.  Was he trying to mislead the C-SPAN audience?  I think the number of C-SPAN viewers who could be mislead by the senator's false statements is very small.  If responsible news media reported on the senator's statements, I hope that they recognized that the statements were false and reported them as such.

So... the good senator has perhaps only delayed voting on the bill, which was probably his sole purpose - keep talking to delay a vote.

Sunday, November 08, 2009

The House Passes The Affordable Health Care For America Act!!!!!

I'm pleased but amazed that the House passed their health care reform bill.  I was beginning to think that Congress would not enact health care reform and we still lack a Senate bill and reconcilliation between the House and the Senate.  So there may still be a long way to go and we don't know what the final reform will include if Congress passes it.  I expected the House vote to be more strongly in favor of passage but it was close, passing with only a 2 vote margin.

The following is the content of an e-mail from my US Representative Chris Murphy (D-CT), which is his view of the process leading up to the passage.

Dear Friends,


Decades from now, I think I will look back on Saturday, November 7th, 2009 as one of the most important days I spent in public service. That is the day the House passed the Affordable Health Care for America Act, marking an historic step in the hundred year fight to bring health care coverage to all American citizens. The bill will extend health coverage to millions of Americans, end the practice of pre-existing condition discrimination by insurers, lower health insurance costs for small businesses, and eliminate the Medicare drug donut hole for seniors. It’s a good bill, and Saturday was quite a day.


I thought you might enjoy a short behind-the-scenes look at a few of the more interesting moments over the last 24 hours.


Helping a New Congressman Get Started


On Election Day, New York’s 23rd District elected Bill Owens as their new Congressman. Bill ran as a pro-health care reform candidate in a district that hasn’t elected a Democrat since the Civil War, so he was preparing to cast one of his first votes for the health reform bill. One of my responsibilities here is to help oversee freshmen legislators as they navigate their way through Congress, so I started Saturday with a 9am meeting with Owens. For a guy who hasn’t slept in three weeks, Bill seemed remarkably chipper! We spent a little time walking him through the schedule of votes for the day so he wouldn’t be caught off guard by any of the amendments. He seems like a really sharp guy, and even has a nice Connecticut connection – his son is in his first year at UConn Law!


One Last Push for Votes


I firmly decided to support the bill this week, but as of Saturday, it was still unclear whether we had the votes to pass the bill. I offered my help to persuade the few remaining undecided Members, and I found that one of my close friends was on the list. At about 10 a.m. the first round of votes were called (on non-health care related bills), and I found him in the cloakroom off the House floor. He was forlorn. In his gut, he said, he wanted to vote for the bill, but he worried his constituents would not support a "yes" vote. This is always the toughest position for a legislator. I made the case for the bill, but I could tell his mind was made up. My constituents are in a different place than his, and so he needed to go his own way.


President Obama and Fox News


President Obama was scheduled to speak to the Democratic Caucus at 11am, which was timed well for me since I committed to do an interview on Fox News at noon. But President Obama was late, and he didn’t start speaking until 11:45am. Even worse, the producers at Fox News couldn’t get their act together, and every two minutes, they would e-mail to change the location for the interview. Finally, they agreed to do the interview right outside the Caucus room at 12:15pm. Unfortunately, President Obama was just hitting the high point of his speech when I had to run out. I thought to myself as I snuck out the back door, "What would President Obama think if he knew I was walking out on him to do an interview with Fox News!" Luckily, the interview went off without a hitch – a good conversation, and I know people were watching because they immediately called the office to let me know their thoughts on the bill.


My Speech on the Floor


I hate when this happens! When you speak on the House floor, especially on major bills like this one, the Chairmen of the relevant Committees divide up the debate time between people who want to speak. Friday night I was told I would have two minutes to speak, so I wrote a two minute speech. But as I was sitting on the floor, a few moments away from speaking, and an aide approached me to tell me that they were running short on time, and I needed to cut my remarks down to one minute. Argh! I furiously scratched out half of the paragraphs of my speech and hoped that what remained flowed. I scurried down to the well of the House at around 3pm and got my speech in just under the minute mark. I immediately got a text message from a friend: "Fabulous!" Whew.


The Vote


I spoke early in the debate, so I went back to my office to get some work done in the late afternoon. But as the debate continued, I felt like I had to be on the floor, to witness history in person. As the vote neared, more Members came to the floor, and by 10:30 p.m., when the votes were to begin on amendments and the bill, the chamber was jammed with 435 Members and seemingly just as many staff and guests in the gallery.


As the final vote approached, around 11 p.m., the atmosphere was simply electric. The word was out that we likely had the votes to pass the bill, but no one was celebrating yet. As the clock began, people didn’t waste time casting their vote, and quickly we were up to 214 in favor, four short of passage. But strangely, the total stalled here. Aides were rushing around with the list of missing votes, and it turned out the people that hadn’t voted were in favor of the bill. Where were they? With about five minutes left in the vote, we hit 217, and as the deciding vote was cast, the place erupted in sustained applause. Three more people, including one Republican, made it a 220-215 final.


As I write this final paragraph, the hour is nearing 12:30 a.m. This was a truly amazing day. The legislation certainly isn’t perfect, but it will extend health insurance to millions more Americans, lower costs for small businesses, and decrease the deficit. I was proud to vote for it, and play a role in its passage.


Now, just for that small matter of the Senate…


Every best wish,


Christopher S. Murphy

Thursday, November 05, 2009

Bush Tax Cuts Cost 2.5 Times As Much As Proposed Health Care Reform

The Republican Party has been complaining that Health Care Reform proposed by the Democrats is too expensive.  The cost has been estimated to be as much as $1 trillion over 10 years.  The GOP didn't complain when President GW Bush asked them for tax cuts that cost almost 2.5 times as much as Health Care Reform.  The Bush tax cuts (including interest) cost $2.485 trillion.  More than 30% of that benefitted the top 1% of wage earners.  That's worth almost $500,000 to each taxpayer in the top 1% compared to $7,200 to each taxpayer in the middle income category.

Health Care Reform will benefit everybody, whereas the Bush tax cuts benefitted the rich much more than the middle class and the poor.

The AMA and AARP both strongly endorsed the proposed health care reform but Eric Cantor, House Minority Leader, discounted both endorsements.  Cantor said the AARP is a Washington DC based organization that is not in touch with the people and the AMA does not reflect the opinion of its membership.  Congressman Cantor is more than willing to say anything in his effort to defeat health care reform.

Remember who the GOP is representing the next time you go to the polls to vote.


Thursday, October 29, 2009

Senator Mitch McConnell Says "Public Option May Cost You Your Life"

The man in this picture is warning the citizens of the United States that the Public Option for health care insurance coverage "may cost you your life."

Please note that this is also a picture of a lying jackass.  He goes by the name Mitch McConnell.  He is the senior United States senator from Kentucky and the senate minority leader.  God only knows how this jackass gets re-elected to the U.S. Senate but I bet that the good folks of Kentucky will re-elect him again.

McConnell is not representing the interests of the voters who elected him.  He has a history of representing the special interests that contribute generously to his campaigns.  Citizens for Responsibility and Ethics in Washington named McConnell one of the 15 most corrupt members of Congress in 2009.

McConnell's concern for the health of Americans is demonstrated by his support of the tobacco industry, which makes products that kill people.  In exchange for his support the tobacco industry has donated $419,000 to McConnell's campaign fund.

Apply the Rule of Common Sense when you listen to our elected officials.  Forrest Gump's mother would explain McConnell statement by saying "stupid is as stupid does."

Sunday, October 25, 2009

Fools And Liars Should Be Excluded From The Health Care Reform Debate!

Recently, I participated in an online discussion about whether it is ever reasonable to refuse to debate with somebody and whether a tolerant person would refuse. I'm of the opinion that it is sometimes reasonable for a tolerant person to not debate.

We all know to "never argue with a fool" but, fool or not, we also should not bebate with anybody who is not acting in good faith.

The current health care reform is one such occasion when refusing to debate is reasonable.  Most, if not all, of the legislators who oppose health care reform are in my opinion either fools or not acting in good faith.

Representative Michele Bachmann is an excellent example of a fool with whom we should not debate.  Bachmann assures us that the government will establish death panels under the proposed reform legislation and, in my opinion, only a fool could believe in death panels.

Senator Jon Kyl is an example of a person who will not debate in good faith.  Although 60% of the health care insurance providers will not cover maternity care, Jon Kyl disagrees with requiring all health care insurers to cover maternity care.  Why?  Jon Kyl stated that he does not personally require maternity care coverage and therefore does not want to pay for it.  I say that Jon Kyl is not debating in good faith and does not deserve to participate in the health care reform debate.

The Senate and the House should ensure that their members are acting responsibly and should censure its members when they do not.

I do not doubt that some people will claim that Michele Bachmann's speech is protected under the Constitution but I argue that Congress is responsible for representing the People accurately and fairly and any other conduct is a corruption of our government.

Monday, October 19, 2009

Utter Lack Of Compassion, Willing To Say Anything To Prevent Health Care Reform Or Both?

When Senator Kyl of Arizona was asked on Meet The Press if it is "a necessity to tackle the fact that there are more and more Americans who die because they don't have access to health insurance?"  Senator Kyl replied, "I'm not sure that it's a fact that more and more people die because they don't have health insurance. But because they don't have health insurance, the care is not delivered in the best and most efficient way."

Amazing!  Amazing that such a person continues to be elected to the Senate.  Amazing and very disappointing.

I assume that Senator Kyl is aware of the recent Harvard research study that estimated that 45,000 Americans die each year because they lack access to health insurance.  Can it be that Kyl is so uninformed on the key legislation in Congress?  Does he not read?  Does he not hear?  Does he not care?  Ah, yes!  Perhaps he simply does not care.

Is there other evidence that Kyl doesn't care?  Yes, indeed!  Kyl recently joked that he doesn't need maternity care while he was arguing that insurance companies should not be required to provide certain types of coverage.  Really?  Do you think any of the women, whose insurance providers will not cover maternity care, thought Kyl's remark was as funny as he did?  Since 60% of the insurance companies do not provide maternity care coverage, this is no laughing matter to a lot of women.

Kyl doesn't seem to care much about women's issues.  Kyl (and Arizona's other senator, John McCain) recently voted against an amendment that would have provided legal protection for women who are sexually assaulted in the workplace.  Protection against sexual assault, like maternity care, is not a personal issue for Senator Kyl so as far as he is concerned it's not an issue worth addressing.

Who in blogdom will offer a defense for Senator Kyl?  Is Kyl's perspective regarding health care reform fair to his constituents?  I should ask is it "fair to all Americans" since his vote on reform will impact all of us.

Wednesday, October 14, 2009

Healthy 4-Month Old Infant Denied Health Care Insurance Because Of His Size

Alex Lange, infant son of a Grand Junction, CO TV news anchor, was denied coverage by his family's insurance company, Rocky Mountain Health Plans, only because the baby's height and weight put him in the 99 percentile of his age group.  The baby's father says that Alex is breast-fed only.  "We can't put him on the Atkins diet or on a treadmill," said his father.

After the denial was made public the insurance company quickly reversed their position and said that they have modified their guidelines so that this will not recur.

Call me a cynic if you will but I suspect that Baby Alex would still be without coverage if his father wasn't a TV news anchor with the ability to broadcast the insurance company's denial across Colorado.

If you are one of those "folks" who still believes that health care reform is an un-American assault on your freedom for the benefit of the undeserving or a socialist take-over of a benevolent insurance industry, think about Alex Lange and then think again about your opinion of reform.

Read more at: http://www.huffingtonpost.com/2009/10/12/alex-lange-denied-health_n_317337.html

Friday, October 09, 2009

My Insurance Company Has Denied Further Coverage Of Interferon

I've been on interferon for 6 months.  My physician submitted a prescription renewal to continue treatment for another 6 months but my insurance company denied it for clinical reasons.  I can't determine from the customer agent what the clinical reason is.  The medication costs $500 per week.  Maybe that is the clinical reason.

I need to take my shot today but I have no medication, it isn't approved yet and if it is approved it will be a few days before it arrives.  I wonder if a gap in the treatment will be a problem.

Sure, we don't need no stinking health care reform.  This is working well for me.

UnitedHealth CEO Is Paid $57,000 Per Hour

This is incentive to deliver large profits not necessarily effective affordable health care. How much is the CEO willing to pay his lobbyists and our representatives to protect his salary?

If the shareholders of public companies set compensation instead of the board we wouldn't be thinking about regulating company salaries.

Wednesday, October 07, 2009

Betsy McCaughey On Health Care Reform: Lies and Name-Calling

Betsy McCaughey and Representative Anthony Weiner (D-N.Y.) debated health care reform with Dylan Ratigan yesterday on Dylan's Morning Meeting show on MSNBC.  Dylan challenged some of McCaughey negative statements about reform.  Like any liar when cornered with facts, McCaughey refused to answer Dylan's most revealing questions, and finally complained that he was an "unfair moderator."  She was no less unhappy with Rep. Weiner and called him "ignorant."

McCaughey said that the Democrat's proposal for paying for reforms included cost cuts in the Medicare system, which she said would result in higher premium costs and/or reduced services.  Dylan Ratigan and Rep. Weiner both disagreed that cost reductions would require increased premiums or reduced services.  When asked how she proposed to cut Medicare costs to ensure its survival she said she would increase the minimum age to qualify for Medicare from 65 to 70!

That's an ingenious plan.  Everybody that I know who is retired or considering retirement but is not 65 is very concerned about how they will pay for health care insurance until they qualifiy for Medicare.  Most of these people will be or are receiving a monthly retirement benefit from their past employer but health care coverage is not provided.  The cost of non-group health care insurance is $9,000 to $12,000 per year.  Some of these people may not retire until they are covered by Medicare but many others were recently forced into retirement by their employers after the collapse of our economy late last year.  Without Medicare they will be spending a lot of their retirement savings or retirement checks for insurance for the 3 to 5 years until they reach age 65 and some will risk not having insurance for those years.  If the minimum age is increased to 70 it will be a financial hardship to many of the senior I know who are under the age of 70, retired or will be retiring soon.  Many who lost their jobs due to the economy or fear that they will be and some of those who were already retired may have to find full or parttime jobs until they are 70.

Oh by the way, McCaughey was also a major opponent of the Clinton reform bill when Bill Clinton was president.  She has made a mini career out of preventing health care reform.

American Academy of Family Physicians - Health Care Reform Recommendations To Its Membership

The AAFP, which supports the Health Care Reform Bills and the Public Option, provided the following FAQ for their membership.

Why would family physicians support the bills in Congress?

The legislation in the House of Representatives contains numerous provisions that are designed to support primary care physicians. There is a bonus payment to primary care physicians of 5 percent (10 percent if the practice is in a physician shortage area – usually rural areas). The SGR is eliminated (which is good for all physician practices) and the replacement system has higher conversion factors for E/M and preventive care services, which are the ones that most family physicians provide. Primary care services in Medicaid are paid at least at the Medicare rate, which is a substantial increase in some states. The legislation invests in a broader pilot-testing of the medical home practice model. And payments to departments of family medicine and to family medicine residencies are increased, and there is increased tuition assistance for medical students who choose family medicine (or other primary care specialties). The legislation is the first major investment in primary care that the federal government has made in years. Finally, the bill is consistent with our long-term policy of supporting health care coverage for all – and this legislation is a step in that direction.

Many of my elderly patients are concerned that Medicare is going away. What should I tell them?

There is nothing in the current bills that would take away Medicare. Please tell your patients that Medicare will still be there for them – even if health care legislation passes Congress. The legislation does not eliminate the program, nor does it eliminate benefits.

Why is the AAFP supporting a so-called “public plan?” I think that will lead to a single-payer system or socialized medicine.

The legislation preserves the private insurance market, so medicine will not be socialized. But what it is intended to do is to provide some competition for insurance companies, especially in areas where one company is dominant or a monopoly, which are often rural and where many of our members have no leverage in negotiating with the major plans. Members have been asking for years to find some method to give them some bargaining power with the major plans. While this is not the best mechanism, it is a start.  In addition, it is not at all clear whether or not a public plan will be part of any final bill. Many Members of Congress – particularly in the Senate – are discussing the idea of a “co-op,” which would be a non-profit entity run by the members at the state or national level. However, the AAFP Board of Directors discussed public plans at length, since this option has been part of the discussion for quite some time. The Board came up with principles on a public plan option, consistent with those set forth in the New America Foundation document “A Modest Proposal for a Competing Public Health Plan” (12-page PDF file; About PDFs).  These principles are:

  • administrators of the public plan must be accountable to an entity other than the one identified to govern the marketplace -- in other words, the authority overseeing the marketplace and responsible for enforcing its rules should not have an incentive to favor a public plan compared with private plans;
  • the public plan cannot be Medicare;
  • the public plan must be actuarially sound;
  • the public plan cannot leverage Medicare or any other public program to force providers to participate;
  • the public plan should not be required to use Medicare payment rates;
  • insurance market rules and regulations governing the public plan must be the same as those governing private plans;
  • the public plan cannot be granted an unfair advantage in enrolling the uninsured or low-income individuals, who presumably will be eligible for subsidies in the new marketplace;
  • public and private insurers should be required to adhere to the same rules regarding reserve funds; and
  • the public plan would need to contribute to value-based initiatives that benefit all payers.
We have used these principles as a yardstick to measure the public plans in the House and Senate bills. We have found that the bills are consistent with our policy. The bills do not force providers or patients to participate and plans will negotiate rates with providers.

 Do these bills change how I will get paid?

 The House bill includes language that replaces the current SGR formula with another volume-control payment method. This includes better payment rates for cognitive services, like office visits and preventive health services, than for procedural services. The new formula is GDP + 2 percent for E/M and preventive services and GDP + 1 percent for all other services.

This does not benefit primary care physicians exclusively, since most physicians provide at least some cognitive health care services. It encourages the effective use of a physician’s training and skills. Whether it is sufficient is always an open question until the data is in. Our early review of the revised payment structure suggests that it is a step in the right direction for our members and is a good down payment for better enhancement for primary care.

And, without the House bill, physicians get a 21 percent cut in Medicare next year and cuts in the 5 percent range annually for the foreseeable future. This bill is a major step forward out of a failed Medicare formula that has plagued us since 2001.

The Senate Finance committee has not yet released their legislation so we cannot review it at this time.

 Why is my Academy supporting bills that will increase the deficit?

The cost of health care reform may be significant, but part of the reason is that we have postponed dealing with the problem. As significant as the cost is now, it will only get higher if we continue to put off the necessary decisions. Paying for health reform will require a combination of measures like tax increases, reductions of tax benefits, and efficiencies in the health delivery system.b

The goal of the legislation is not to increase the deficit. Specifically, while the House legislation would rebase the SGR, and this money would be added to the deficit, members of Congress continue to seek various means to pay for the reform legislation.

Won’t the comparative effectiveness research give federal bureaucrats the power to make medical decisions for your patients and force rationing of health care?

We do not believe that more knowledge about how various treatments, procedures, and products compare with each other will lead to rationing. Instead, we believe that the more objective information physicians and patients have about health care issues the better their choices will be. It is valuable to have a respected agency like the Agency for Health Care Research and Quality as a disinterested moderator of this information.

How come I’m not hearing anything about medical liability in these bills? Wouldn’t medical liability reform cut costs?

There are clearly additional costs due to defensive medicine. The AAFP’s policy has called for a cap on non-economic damages, and we have signed a letter to Congress, along with several other physician groups that calls for medical liability reform. There are many alternatives that Congress has considered from time to time. For example, we have supported bills that would give some states authority and resources to try out alternative methods of dispute resolution and liability settlements.

Right now, the bills do not contain medical liability reforms, but we know that many Members of Congress are interested in including different reforms. We are advocating that these reforms be added later as the legislation works its way through the process.

What about nurse practitioners? I heard they now will be treated the same way as physicians.

No. Members of Congress are keenly aware of the differences in training between physicians and nurse practitioners. Nevertheless, in an effort to help provide health care access to some rural areas, the House bill does make some changes.

While nurse practitioners are potentially able to head primary care medical homes, this is only in pilot programs and only in states where they have independent authority to practice. In addition, their payment rates under Medicaid – like physicians’ – are increased, but the differential between NPs and physicians is maintained. Finally, both physicians and nurse practitioners are eligible for Medicare payment incentives – 5 percent for selected primary care services. This language is part of the House bill’s overall goal of providing more funding for primary care.

Why won’t employers simply “dump” their employees into any public plan?

In the House bill, employers are prohibited from selecting the public plan for their employees. They are required to provide coverage or pay a payroll tax. Specifically, their options are to continue to buy a group policy as they do today; set up a self-funded plan, or make a defined contribution so that their employees may purchase a plan through the Exchange.

In the HELP bill, there is a requirement that if someone is offered employer sponsored coverage they cannot enter the gateway and thus the community health insurance option unless that offer is unaffordable to them (using a rigorous test). CBO has estimated no net loss of employer-sponsored coverage.

Isn’t the Patient-Centered Medical Home just another version of the failed “gatekeeper” model run by the HMOs many years ago?

Good question and here’s the difference. The medical home model is on which patient care is an integrated team with the primary care physician at the center.

Patients are active participants in their own health and well-being. They are cared for by a physician who leads the medical team that coordinates all aspects of preventive, acute and chronic needs of patients using the best available evidence, appropriate technology, and referrals to sub-specialists when needed.

But, aren’t you taking away the individual’s freedom of choice through a Patient-Centered Medical Home?

The short answer is no. In the medical home model, the primary care physician and the patient decide together which path to take. If they decide that the patient would benefit from a particular treatment provided only by a subspecialist, then the primary care physician would work with the patient to make that happen. Importantly, however, the primary care physician would stay involved, i.e., after a particular treatment, both physicians would discuss next steps, in conjunction with the patient.

What about sub-specialists? What financial incentive is there for them to participate if all money goes to primary care?

As physicians who all have take the Hippocratic Oath, we clearly believe that our sub-specialist colleagues will continue to see patients, even under a reformed health care system that places more emphasis on primary care. In addition, our sub-specialist colleagues will be able to treat those extraordinarily complex cases, in conjunction with the primary care physicians, for which they have been trained.

Nevertheless, there is no simple way to predict how physicians – or the market – will react. Our goal in supporting health care reform simply is to establish the best system that provides the right kind of care for the patient at the right time.

I’ve heard a lot of about “insurance reforms.” What sort of reforms are in the health reform bills?
  • Protects patient choice  
  • Prohibits pre-existing condition exclusions  
  • Requires guaranteed issue and renewal for insured plans  
  • Requires parity in mental health and substance abuse disorder benefits consistent with AAFP policy  
  • Ensures adequacy of provider networks.  
  • Ensures value and lower premiums  
  • Requires coverage of essential benefits package including prevention  
  • Requires fair marketing practices by health insurers  
  • Requires fair grievance and appeals mechanisms  
  • Requires information transparency and plan disclosure  
  • Requires timely payment of claims c 
  • Requires administrative simplification  
  • Closes the Medicare Part D donut hole is also big for our patients.  
  • Eliminates annual and lifetime caps on losses.
How do these bills help family physicians, like me?

The AAFP is strongly committed to health care reform legislation that will increase the number of family doctors and boost your Medicare payments. c

The House bill offers strong support for primary care in a variety of ways, including medical home demonstration projects, improving Medicare payment for primary care physicians, expanding scholarships and loan programs for those who choose careers in primary care, and reforms the way that Medicare updates physician pay rates that recognized the value of primary care.

The bill that was passed by the Senate HELP committee also includes a number of primary care provisions. While the committee does not have jurisdiction over Medicare – that is handled by the Senate Finance committee -- the HELP bill supports training for family medicine; gives priority to programs that educate students in team-based approaches to care, including the patient-centered medical home; Increases the supply of qualified health care workers by providing low-interest student loans and loan repayment programs and creates a Primary Care Extension Program to provide assistance to primary care providers about evidence-based therapies, preventive medicine, health promotion, chronic disease management, and mental health.

It also funds Community Health Teams to support the development of medical homes and to ensure a patient’s care is coordinate by a team that includes primary care providers.

Wednesday, September 30, 2009

GOP Outrage Over Dem's Speech: The Kettle Calling The Pot Black

The Congressional GOP is outraged that Rep. Alan Grayson (D-FL), in a speech to the House stated, “The Republican heath care plan: "don't get sick" -- and if you do, "die quickly.”

The GOP wants Grayson to apologize to the House and the House to punish Grayson.  It's hard to believe that the GOP could be outraged after they spent the summer name-calling in Congress and in townhall meetings across the country and warning that the Democrats would establish a Death Panel.

Does the GOP think that the American people are so stupid that they won't be immediately reminded of all the GOP death talk???  No voter with common sense, Democrat, Republican or Independent, could re-elect this bunch of self-serving obstructionists.

The following are some of the statements made by the GOP in Congress:
  • Rep. Joe Wilson (R-S.C.): "You lie!"
  • Rep. Ginny Brown-Waite (R-Fla.): "Last week, Democrats released a health care bill which essentially said to America's seniors: drop dead."
  • Rep. Paul Broun, MD (R-Ga.): Reviewed the Democrats public health insurance option stated that it is "gonna kill people."
  • Rep. Virginia Foxx (R-N.C.): Suggested on the House floor that Congress "make sure we bring down the cost of health care for all Americans and that ensures affordable access for all Americans and is pro-life because it will not put seniors in a position of being put to death by their government."
  • Rep. Louie Gohmert (R-Texas): "One in five people have to die because they went to socialized medicine...I would hate to think that among five women, one of 'em is gonna die because we go to socialized care."
  • Rep. Steve King (R-Iowa): “They're going to save money by rationing care, getting you in a long line. Places like Canada, United Kingdom, and Europe. People die when they're in line."

Friday, September 18, 2009

Bill O'Reilly Supports A Public Option For Working Americans

I applaud Bill O'Reilly's support of a Public Option within Health Care Reform.

The Huffington Post  9/17/09:  Bombastic Fox News host Bill O'Reilly made a rather notable policy pronouncement on Wednesday's show: he supports the creation of a government-managed health care plan if it provides working Americans with an affordable option to other private insurance plans.

In other words, he supports the public option now being hotly debated in Congress.

As noted by DailyKos' Jed Lewison, O'Reilly had the following exchange with the Heritage Foundation's Nina Owcharenko:

O'REILLY: The public option now is done. We discussed this, it's not going to happen. But you say that this little marketplace that they're going to set up, whereby the federal government would subsidize insurance for some Americans, that is, in your opinion, a public option?

OWCHARENKO: Well, it has massive new federal regulation. So you don't necessarily need a public option if the federal government is going to control and regulate the type of health insurance that Americans can buy.

O'REILLY: But you know, I want that, Ms. Owcharenko. I want that. I want, not for personally for me, but for working Americans, to have a option, that if they don't like their health insurance, if it's too expensive, they can't afford it, if the government can cobble together a cheaper insurance policy that gives the same benefits, I see that as a plus for the folks.
Indeed, supporters of the public option do so for the very reasons O'Reilly notes. A study by the nonpartisan Commonwealth Fund found that "a public coverage program similar to Medicare would reduce projected health care costs by about $2 trillion over 11 years, and reduce premiums by about 20% on average. Within about a decade, 105 million people would be enrolled in the public plan, and about 107 million would have private insurance, according to the Commonwealth Fund."

See Video and full post.
Read more at: http://www.huffingtonpost.com/2009/09/17/bill-oreilly-backs-public_n_290658.html

Wednesday, September 09, 2009

Birther Will Deliver GOP Response To Obama's Address To Congress

Louisiana Rep. Charles Boustany has been selected by the GOP to deliver their response to President Obama's address to Congress on health care reform. Relatively unknown, Boustany may have been selected because he is a medical doctor. The GOP is obviously unconcerned that Boustany was a cosponsor of "The Life Sustaining Treatment Preferences Act of 2009" that would require Medicare to pay doctors for providing end-of-life counseling, which the GOP has labeled the "death panel" in its argument against health care reform. The GOP must also be unconcerned that Boustany is one of several Congressional Republicans who do not accept that President Obama was born in the United States and thus qualified to be the president.

The GOP's choice to respond to Obama's first address to the nation was Bobby Jindal who, prior to his speech, was a 2012 GOP Presidential hopeful. Jindals's disappointing speech, among other things, quickly ended his presidential aspirations. But, this selection seems to be an even poorer choice than their first. The majority of Americans are smart enough to believe that Obama is a natural citizen of the United States. How many of them will question Boustany's qualifications because he is a Birther?

Why does the GOP feel that Boustany is the best choice? Will Boustany testify that reform legislation does provide for a "death panel" because HE proposed it? Will Boustany also deny Obama's citizenship?

Is the GOP a piece of "work" or what? This fine group of quasi-racist, bible-quoting, corruption-riddled obstructors of all Democratic legislation is hell bent on doing anything to restore their majority position in Congress in 2010 and defeat Obama in 2012 as soon as they identify who in the RNC is the best choice to be their Great White Hope, to quote Republican congresswoman Lynn Jenkins of Kansas. And while they accomplish these self-serving goals they MUST also defeat health care reform for the health care industry that so generously contributes to many GOP members of our Congress. What will they be doing for the American people? Nothing!

Tuesday, September 01, 2009

Michele Bachmann Wants Us to Slit Our Wrists

In a speech at a Denver fundraiser on Monday, Michele Bachmann, congresswoman from Minnesota's 6th District, said in regard to the effort to defeat health care reform,

"What we have to do today is make a covenant, to slit our wrists, be blood brothers on this thing. This will not pass. We will do whatever it takes to make sure this doesn't pass. Right now, we are looking at reaching down the throat and ripping the guts out of freedom and we may never be able to restore it if we don't man up and take this one on."

I guess that the praying and fasting that Michele called for last week didn't pay off as soon as she expected. Did she only lose her patience with God or did she lose her faith?

Bachmann is indeed the Queen of the Wingnuts. It's hard to believe that anybody not in a straight jacket would believe anything that Bachmann says, anymore, but it appears that as long as Bachmann has a spot for fishing along the shallow end of the gene pool, she'll be able to hook plenty of supporters.

Monday, August 31, 2009

Healthcare Reform Misinformation From The Church

My in-laws attend the St. Lawrence O'Toole Catholic Church in Brewster, NY. This past weekend the church distributed with its bulletin a two page warning about specific New York State and Federal proposed legislation. NY State bills are the Marriage Equality Act and the Reproductive Health Act. The Federal bill is Health Reform. Part of the misinformation distributed by the church appears to have been generated by the United States Conference of Catholic Bishops, which has distributed multiple letters and videos (YouTube.com) attacking health reform.


Any church and its members have the right to disagree with any legislation and to publicly oppose it. However, it is very disappointing that this church has chosen to disseminate misinformation. Apparently this church is willing to break one commandment in order to defend another.

Wednesday, August 26, 2009

Michele Bachmann Calls For Prayer and Fasting To Defeat Healthcare Reform

Representatives Michele Bachmann of Minnesota and Virginia Foxx of North Carolina jointly held a townhall meeting via telephone to discuss healthcare reform. Bachmann and Foxx repeated all the lies about the healthcare reform bill being developed in the House, such as the Death Panel. Bachmann stated that the Death Panel is real since Sarah Palin said it is so! Bachmann suggested that it was Religious Destiny that put her and others like her in congress at this critical time. Bachmann then called for prayer and fasting to defeat healthcare reform.

Shall we all pray to God that congress does not pass legislation to reform our ineffective and increasingly unaffordable healthcare insurance and services? Here's some online responses to Michele Bachmann:

"Praying so some Americans won’t get any health care insurance? Does Mrs. Bachmann’s God accept such petitions?"

"I strongly support Rep. Bachman’s call to fast. I think she should begin, NOW! Under no circumstances should she stop until Obama is deposed and Bachman’s vision of righteousness rules this fair land. We’ll be sure and let Rep. Bachman know when she can quit. Maybe she could also hold her breath? Let the countdown clock begin…."

"Fasting is quite easy when one’s foot is already filling one’s pie hole."

"What does this say about the constituency who elected this nut job to Congress."

"Interesting that this chat was sponsored by a “pro-life” group. They will fight tooth and nail to bring every child into this world, at the expense of a mother’s health or the child’s safety, but as soon as they breathe life outside the womb, they’re on their own, including the mother. Interesting…"

Wednesday, August 12, 2009

GOP & Right Wing - Corruptors Of Our Democracy

A Right Wing fanatic showed up at the president's townhall meeting yesterday carrying a gun and a sign declaring that "The tree of liberty must be refreshed from time to time." The complete quote continues with "the blood of patriots and tyrants." The message is clear: this fanatic is prepared to use violence to force his opinion on the People.

Under the most peaceful circumstances it is irresponsible to bring a gun and a sign that threatens to use it to a public forum. Townhalls, thanks to the GOP, healthcare industry paid activists and Right Wing thugs, are not an opportunity for All to speak their mind in a respectful manner - respectful of the rights of those with whom they do not agree.

These activists are corrupting our democracy. They don't believe that "government of the people, by the people, for the people" applies to each and every citizen of the United States. They don't believe in majority rule and respect for each citizen. GOP leaders and spokespersons are publicly promoting this undemocratic conduct. When the GOP has controlled congress and the presidency they did nothing to reform healthcare. Now that the Democrats and Obama are in the position to reform healthcare the GOP says NO. They want to defeat any proposal for reform but can only do so by making false accusations about the proposal. Although some of the accusations are outrageously unbelieveable, many, many people are accepting them as fact.

I support everybody's right to present their opinion and differ with all others but it must be done responsibly. Physical intimidation and violence are not acceptable means for persuading others to accept one's ideas.

I believe that tactics like this will ultimately destroy the GOP. Responsible Republicans - fiscal and moderate social conservatives - will abandon the GOP which has committed itself to far right social conservatives and racists. However, in the process I fear that the United States will not reform its healthcare system.

Finally, what somebody calls the person that shows up at a townhall meeting with a swastika sign or paints a swastika on the office of a U.S. Congressman is not the issue. These acts of Hate and Intimidation are the issues. These are acts of a THUG. Why don't the conservatives who take exception to calling out-of-control protesters THUGS, complain when Palin and Limbaugh call their opposition un-American, un-Patriotic, socialist, communist and Nazi?

Monday, August 10, 2009

Sarah Palin Is Lying About Healthcare Reform

Sarah Palin is lying about Obama's healthcare reform because she is surely not stupid enough to believe what she has said. "The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care. Such a system is downright evil."

I believe Palin is familiar enough with the reform proposal to know that it does not propose a Death Panel or anything like it.

My son Jon has Down Syndrome. Jon's life has always been and continues to be significantly better because of government funded programs from Early Intervention before he was one year old to the adult employment program through which he has a job. In Jon's life the only significant cut in the Department of Mental Retardation funding occurred under the administration of Ronald Reagan - the same administration that reduced the maximum income to qualify for assistance thus creating a new class called the Near Poor and defined ketchup as a vegetable to reduce the cost of Head Start school meals.

As Alaska's governor, Palin reduced funding of The Department of Education and Early Development of Special Needs by more than 60%.

Palin isn't interested in the truth about healthcare reform. She knows that she must lie to defeat beneficial reform. With much regret I concede that there might be enough voters who are stupid enough to believe her.

Consumer protection laws require truth in commercial advertising. Why don't we require truth in political advertising? Is it only because we cannot find enough people who are able and willing to render an honest opinion that is free of ideological bias? They don't have to judge the opinions they only have to determine if the claims are supported by facts. I believe there are many people who could fulfill this role, however, since they must be appointed by politicians, unbiased candidates don't have a chance.

Don't listen to the political rhetoric. Read the reform proposals and judge them for yourself. We won't all agree about the reform. But, we should agree to be honest with each other.

Friday, July 31, 2009

Texas Governor Plans To Secede From The Federal Healthcare Program

Texas Governor Rick Perry wants no part of the Federal Healthcare Reform. He doesn't want the federal government to screw up healthcare in Texas. Perry thinks that Texas is doing better and will continue to do better on its own. Perry has been the governor of Texas for 9 years. Let's see how Perry is doing with healthcare in Texas.

1 in 4 Texans is uninsured; 25% of its population. Only 15% of all Americans are uninsured.

Texas employers insure fewer of its residents than 45 states.

Texas spends less than 44 states for healthcare per Texan.

Texas spends less than 36 states for healthcare per "insured" Texan.

Texas receives 10.4% of all Federal funding for the SCHIP program which pays healthcare expenses for children of low income families but SCHIP enrollment in Texas is only 7.4% of the U.S. enrollment. Therefore, the "Federal" cost per child in Texas is 40% higher than the national average.

Healthcare in Texas is poor.

Why then does Governor Perry feel that Texans will get better healthcare if Texas is not involved in the Federal Healthcare program? Is Governor Perry concerned that all Texans have access to affordable healthcare or is he more concerned that the healthcare industry continues to make a good profit?