Health Care Advocates Call on Voinovich to Support Affordable Health Care for All
Wednesday, health care advocates gathered from around the state concerned that the affordability standards in the U.S.
Senate Finance passed version of health care reform do not go far enough. On the heels of the Senate Finance
Committee's historic vote, advocates delivered their message and hundreds of signatures on postcards to U.S. Sen.
George Voinovich urging his support of affordable health care for all.
At a Statehouse press conference and rally prior to a meeting with Voinovich, Cathy Levine highlighted the historic
importance of the Senate action on health care reform.
"No issue before Congress could be more important than ensuring that cancer survivors, those with chronic conditions,
and those whose wages are stretched to pay for food and shelter have access to the richest health care system in the
world," said Levine, co-chair of Ohio Consumers for Health Coverage (OCHC). "We ask Sen. Voinovich to support health
care reform that gives all Ohioans access to high quality, affordable health care."
Joining the rally and meeting with Voinovich were health care advocates from across the state, many motivated by their
own personal experiences. Anne Creech, a two-time cancer survivor, traveled from Toledo to share her story. After
dropping her employer-based insurance at her employer's request, Creech struggled to find affordable coverage in Ohio's
individual market as a cancer survivor.
"I pay $500 each month for a high deductible insurance plan that excludes coverage for cancer screenings and other tests
I need," said Creech. "I am putting off important preventive screenings because I cannot afford to pay for them out of
pocket."
The issue of affordability is especially important to the age group just below Medicare eligibility, advocates pointed out.
Those aged 50 to 64 often face coverage exclusions or higher premiums because of pre-existing conditions and
age. "That is a key reason why 13 percent of adults age 50-64, or 7.1 million adults, were uninsured in 2007 - a figure
that is growing rapidly in our current difficult economy. Even those with insurance often struggle with high premiums and
cost sharing obligations that can make health care unaffordable."
George Sonnichsen, an AARP volunteer, called for fair treatment for older Americans: "We must prevent insurers from
denying coverage or charging higher rates based on age or health status and subsidies must ensure that coverage -
including both premiums and co-pays and deductibles - is affordable for everyone."
Health care reform is also an important issue to the faith community. The United Methodist Book of Discipline calls health
care "a basic human right," and states that it is a "governmental responsibility to provide all citizens with health care."
Alicia Rivers, a commissioned deacon in the West Ohio Conference of the United Methodist Church and a member of the
leadership team of Ohio Consumers for Health Coverage spoke to the faith community's responsibility in the health care
reform debate.
"Health care for all is not an option from a faith perspective, but rather a necessity. We are called to care for persons as
God cares for them, providing out of abundance rather than scarcity. Access to care is not a privilege but a right for all,"
explained Rivers. She continued, "We call on Sen. Voinovich, who is known as a man of faith, to make affordable health
care for all Ohioans - and all Americans - his legacy."
According to OCHC, the Senate Finance passed bill includes the some safeguards for consumers but the coalition wants
the Senate to adopt affordability provisions that go further to protect consumers - such as those which provide premium
credits on a sliding scale basis to individuals and families with incomes up to 400 percent Federal Poverty Level.
Ron
Oct 12, 12:52 PM EDT
Seniors lobby challenges health insurance report
By RICARDO ALONSO-ZALDIVAR and ERICA WERNER Associated Press Writer
WASHINGTON (AP) -- Supporters of President Barack Obama's drive to remake health care are pushing back against a dire report from the insurance industry warning of hefty new costs for consumers from the latest legislation.
"I really don't think it's worth the paper it's written on," AARP Executive Vice President John Rother told reporters Monday. "If anyone believes it, that's a problem."
The study commissioned by America's Health Insurance Plans put the White House, congressional Democrats and their allies on the defensive on the eve of a critical vote in the Senate Finance Committee.
It marked a shift in strategy by the health insurance industry, which had been working for months behind the scenes to help shape health care legislation. With the Finance Committee set to vote Tuesday on a sweeping bill the industry fears could result in a loss of revenue, the insurers suddenly went on the attack, in dramatic fashion.
Late Sunday, AHIP sent reporters and its member companies a new accounting firm study that projects the legislation would add $1,700 a year to the cost of family coverage in 2013, when most of the major provisions in the bill would be in effect.
Premiums for a single person would go up by $600 more than would be the case without the legislation, the PricewaterhouseCoopers analysis concluded in the study commissioned by the insurance group.
"Several major provisions in the current legislative proposal will cause health care costs to increase far faster and higher than they would under the current system," Karen Ignagni, the top industry lobbyist in Washington, wrote in a memo to insurance company CEOs.
The industry said the cost increases result from new taxes and a weakening of the penalties for failing to get insurance that would let Americans postpone getting coverage until they get sick.
Democrats and their allies criticized the report as biased. Health economist Len Nichols of the New America Foundation contended that, among other problems, the study failed to take into account the impact of subsidies that would help low- and middle-income people buy coverage. He said it also left out a key expected impact of a proposed new tax on high-value insurance plans, which is a reduction in the use of health services.
"It was paid for by people who are not interested in an objective analysis of the truth but are interested in a particular point of view being inserted into the political process right now," Nichols said.
Spokesmen for the White House and for Finance Committee Chairman Max Baucus, D-Mont., attacked the report along similar lines. "It's a health insurance company hatchet job, plain and simple," said Baucus spokesman Scott Mulhauser.
The Senate Finance Committee is slated to vote on its 10-year, $829 billion bill on Tuesday, but more important to the industry are the steps beyond the panel's decision.
Senate Majority Leader Harry Reid, D-Nev., will be merging the bill with a companion measure from the Senate Health, Education, Labor and Pensions Committee, with the goal of a sweeping, affordable bill. In the House, Speaker Nancy Pelosi, D-Calif., and Democratic leaders have been pulling together legislation from three committees.
Unlike the 1990s, when it contributed to the failure of President Bill Clinton's health overhaul, the insurance industry has been attracted by the promise of millions of more people getting coverage. Translation: millions of new consumers buying policies.
The Baucus plan got a boost last week when the Congressional Budget Office estimated it would cover 94 percent of eligible Americans while reducing the federal deficit.
But the PricewaterhouseCoopers analysis attempted to get at a different issue - costs for privately insured individuals.
It concluded that a combination of factors in the bill - and decisions by lawmakers as they amended it - would raise costs.
The chief reason, said the report, is a decision by lawmakers to weaken proposed penalties for failing to get health insurance. The bill would require insurers to take all applicants, doing away with denials for pre-existing health problems. In return, all Americans would be required to carry coverage, either through an employer or a government program, or by buying it themselves.
But the CBO estimated that even with new federal subsidies, some 17 million Americans would still be unable to afford health insurance. Faced with that affordability problem, senators opted to ease the fines for going without coverage from the levels Baucus originally proposed. The industry says that will only let people postpone getting coverage until they get sick.
But the industry stopped short of signaling all-out opposition. "We will continue to work with policymakers in support of workable bipartisan reform," Ignagni said in her memo.
---
On the Net:
America's Health Insurance Plans: http://www.ahip.org/
Senate Finance Committee: http://finance.senate.gov/
There are special interest groups trying to block progress on health care reform by using myths and scare tactics. Like the notion that health care reform would ration your care, hurt Medicare or be a government takeover. Actually, these are false statements.
All of the health care reform plans currently being debated in Congress would ensure that you and your doctor are the ones making decisions about your health. The majority of working Americans will continue to receive their health care through their employer. In addition, health care reform will strengthen Medicare by eliminating billions of dollars in waste while lowering prescription drug prices.
Throughout the debate on how to fix what's broken about our health care system, AARP pledges to help you cut through the noise and find the facts about what health care reform means for you and your family. When we see special interests using scare tactics, we'll make sure you're given the facts so you can make informed decisions about health care reform.
The following are some of the most common myths being spread about health care reform and the facts that prove them wrong – click here to watch a video by AARP on the myths and facts of reform.
Fact: Health care reform will preserve the employer-based health care system, meaning an estimated 200 million Americans will continue to get their coverage through their employers.Fact: For people buying coverage for themselves, there would be a range of private health plans to choose from. Also, the so-called "public plan" option would seek to give American consumers another choice if they can't find affordable, quality coverage in the private insurance market. The goal of the "public plan" is to give consumers the best value for their money and force greater competition among insurance plans for our business.Fact: Every proposal that Congress is considering would allow people to choose their own doctors and hospitals.Bottom Line: Health care reform isn't about a government takeover. It's about guaranteeing all Americans a choice of health care plans they can afford.
Fact: Health care reform will preserve the employer-based health care system, meaning an estimated 200 million Americans will continue to get their coverage through their employers.
Fact: For people buying coverage for themselves, there would be a range of private health plans to choose from. Also, the so-called "public plan" option would seek to give American consumers another choice if they can't find affordable, quality coverage in the private insurance market. The goal of the "public plan" is to give consumers the best value for their money and force greater competition among insurance plans for our business.
Fact: Every proposal that Congress is considering would allow people to choose their own doctors and hospitals.
Bottom Line: Health care reform isn't about a government takeover. It's about guaranteeing all Americans a choice of health care plans they can afford.
Fact: None of the health reform proposals being considered would stand between individuals and their doctors or prevent any American from choosing the best possible care.Fact: Health care reform will NOT give the government the power to make life or death decisions for anyone regardless of their age. Those decisions will be made by an individual, their doctor and their family.Fact: Health care reform will help ensure doctors are paid fairly so they will continue to treat Medicare patients.Bottom Line: Health reform isn't about rationing; it's about giving people the peace of mind of knowing that they will be able to keep their doctors and that they will always have a choice of affordable health plans.
Fact: None of the health reform proposals being considered would stand between individuals and their doctors or prevent any American from choosing the best possible care.
Fact: Health care reform will NOT give the government the power to make life or death decisions for anyone regardless of their age. Those decisions will be made by an individual, their doctor and their family.
Fact: Health care reform will help ensure doctors are paid fairly so they will continue to treat Medicare patients.
Bottom Line: Health reform isn't about rationing; it's about giving people the peace of mind of knowing that they will be able to keep their doctors and that they will always have a choice of affordable health plans.
Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.Fact: Health care reform will lower prescription drug costs for people in the Medicare Part D coverage gap or "doughnut hole" so they can get better afford the drugs they need.Fact: Health care reform will protect seniors' access to their doctors and reduce the cost of preventive services so patients stay healthier.Fact: Health care reform will reduce costly, preventable hospital readmissions, saving patients and Medicare money.Fact: Rather than weaken Medicare, health care reform will strengthen the financial status of the Medicare program.Bottom Line: For people in Medicare, health care reform is about lowering prescription drug costs for people in the "doughnut hole", keeping the doctor of your choice, improving the quality of care, and eliminating billions in waste that is causing poor care and medical errors.
Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.
Fact: Health care reform will lower prescription drug costs for people in the Medicare Part D coverage gap or "doughnut hole" so they can get better afford the drugs they need.
Fact: Health care reform will protect seniors' access to their doctors and reduce the cost of preventive services so patients stay healthier.
Fact: Health care reform will reduce costly, preventable hospital readmissions, saving patients and Medicare money.
Fact: Rather than weaken Medicare, health care reform will strengthen the financial status of the Medicare program.
Bottom Line: For people in Medicare, health care reform is about lowering prescription drug costs for people in the "doughnut hole", keeping the doctor of your choice, improving the quality of care, and eliminating billions in waste that is causing poor care and medical errors.
Fact: The President and Congress have committed to producing legislation that will be paid for so it won't saddle our children and grandchildren with debt.Fact: If we do nothing to fix health care, families with Medicare or employer-based health coverage will likely see their premiums nearly double again in the next seven years.Fact: If we do nothing to fix health care, the share of your income spent on health care will nearly double in the next seven years.Bottom Line: When one in three Americans say someone in their family skipped pills, postponed or cut back on needed medical care due to the cost; when countless bankruptcies are related to medical expenses; when the number of uninsured approaches 50 million; when government spending on health programs rises so rapidly that it jeopardizes other priorities; and when employers struggle to pay for the costs of health care, the fact is, we can't afford not to fix health care.
Fact: The President and Congress have committed to producing legislation that will be paid for so it won't saddle our children and grandchildren with debt.
Fact: If we do nothing to fix health care, families with Medicare or employer-based health coverage will likely see their premiums nearly double again in the next seven years.
Fact: If we do nothing to fix health care, the share of your income spent on health care will nearly double in the next seven years.
Bottom Line: When one in three Americans say someone in their family skipped pills, postponed or cut back on needed medical care due to the cost; when countless bankruptcies are related to medical expenses; when the number of uninsured approaches 50 million; when government spending on health programs rises so rapidly that it jeopardizes other priorities; and when employers struggle to pay for the costs of health care, the fact is, we can't afford not to fix health care.
Fact: Health care reform will NOT give the government the power to make life-and-death decisions for anyone regardless of their age. Those decisions will be made by individuals, their doctor and their family.Fact: No one, including the government or your insurance company, will be given power to make life-and-death decisions for you.Bottom Line: Health care reform isn't about putting the government in charge of difficult end of life decisions. It's about giving individuals and families the option to talk with their doctors in advance about difficult choices every family faces when loved ones near the end of their lives.
Fact: Health care reform will NOT give the government the power to make life-and-death decisions for anyone regardless of their age. Those decisions will be made by individuals, their doctor and their family.
Fact: No one, including the government or your insurance company, will be given power to make life-and-death decisions for you.
Bottom Line: Health care reform isn't about putting the government in charge of difficult end of life decisions. It's about giving individuals and families the option to talk with their doctors in advance about difficult choices every family faces when loved ones near the end of their lives.
"I want to speak directly to seniors for a moment, because Medicare is another issue that's been subjected to demagoguery and distortion during the course of this debate.
More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years. That's how Medicare was born. And it remains a sacred trust that must be passed down from one generation to the next. And that is why not a dollar of the Medicare trust fund will be used to pay for this plan.
The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies -- subsidies that do everything to pad their profits but don't improve the care of seniors. And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.
Now, these steps will ensure that you -- America's seniors -- get the benefits you've been promised. They will ensure that Medicare is there for future generations. And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pockets for prescription drugs. That's what this plan will do for you. So don't pay attention to those scary stories about how your benefits will be cut, especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past and just this year supported a budget that would essentially have turned Medicare into a privatized voucher program. That will not happen on my watch. I will protect Medicare."
— President Barack Obama
Dear Friend,
The rising cost of health care is crushing families, business, and government. President Obama is working with Congress to enact urgently needed health reform this year, and every American has a stake in the outcome. On Wednesday, April 8, from 10 am to 12 pm ET, a diverse group of those stakeholders, from businesspeople to insurers to health professionals, will come to the White House to share their views with Counselor to the President and Director of the White House Office of Health Reform Nancy-Ann DeParle.
This Health Care Stakeholder Discussion is part of a continuing series of conversations that began last December, when roughly 30,000 Americans took part in 3,200 Health Care Community Discussions around the country. The stories of Americans across all walks of life will play an important role as the President and Congress work to enact legislation that lowers cost, guarantees that people have a choice of doctors and health plans, and assures affordable, quality health care for all Americans.
Please visit www.HealthReform.gov to watch this discussion, sign our statement of support, and learn more about the President’s commitment to enacting comprehensive health reform this year.
Jenny Backus
Deputy Assistant Secretary for Public Affairs
U.S. Department of Health and Human Services
C. Access Concerns
Among the Health Care Community Discussion reports that focused on access problems, 37 percent conveyed concern about being denied access to care due to pre-existing conditions and other non financial barriers to insurance; 27 percent reported challenges in access to care; 20 percent did not feel their coverage was adequate, lacking preventive care and mental health coverage; 18 percent pointed to provider shortages; and 16 percent disparaged a system where health care for many Americans is only accessible through hospital emergency rooms (see Figure 5). Most of the reported barriers to access are cost related, described in the previous section. A group in Bethesda, Maryland, stated, "Access to quality health care is determined by ability to pay rather than need." Many Health Care Community Discussion groups concluded that the large numbers of uninsured Americans drive access problems. The report from the Unitarian Universalist Congregation's Meetinghouse in Fort Wayne, Indiana, highlighted, "...the plain and simple truth that there are too many uninsured." A potluck gathering in Kingston, Rhode Island, agreed, stating, "The central health care issue of our time is access to affordable, high quality primary care."
Pre-Existing Conditions
Numerous participants cited pre-existing conditions as a significant barrier to accessing adequate, affordable care. In Wisconsin Dells, Wisconsin, one man spoke about his mother's struggles to acquire insurance coverage. He said: "My mother is epileptic; she has been all of her life. This is not a choice she made, this is a condition...but because of her condition she is denied coverage. It's not that she is just not covered for her epilepsy issues, she is denied for all her health concerns, prevention included. She is uninsurable. Yet I know of few people who are healthier or tougher. She takes excellent care of herself, but [is] still uninsurable."
Individuals also discussed the effect that being "uninsurable" has had on their lives. At a "coffee and talk" gathering in San Diego, California, one 61 year-old woman explained that she crosses the border into Tijuana, Mexico, to receive care because she "can't afford [insurance] due to pre-existing conditions." In West Lafayette, Indiana, at a "small gathering of friends and neighbors," another couple described their son's struggle to find employment with health insurance benefits because he had Hodgkin's Lymphoma at age 17. Now an adult, he "has trouble finding a job with insurance benefits, because of his previous disease, even though he has successfully recovered."
Other Health Care Community Discussion participants shared similar stories about insurance coverage denials due to conditions ranging from high blood pressure to asthma. In Birmingham, Alabama, insurance companies deemed one man uninsurable because he took medication to lower his cholesterol and high blood pressure. This man had sought out private insurance only after he was laid off and could not afford to pay $3,500 a month to insure his family under COBRA. In Missoula, Montana, a participant related her struggles to acquire insurance for herself and her four-year-old daughter. This piano teacher had "several health conditions, including asthma." After giving birth to her second daughter, she and her husband, who is a musician employed by a local music store, took a second mortgage on their home to cover their medical bills. At age 3, their daughter had open-heart surgery and, at age 4, "is now uninsurable." She lamented, "No mother should have to say her daughter is 'uninsurable.' We provide education to all children but not health care? It just doesn't make sense to me." The Missoula group report further explained, "The family's household income is just above Montana's SCHIP [State Children's Health Insurance Program] income limit. They are now in a situation where they will soon have to choose between paying health insurance or [their] mortgage."
Emergency Rooms
The shortages described above leave many Americans without a reliable primary care physician, which in turn leads more Americans to rely on emergency rooms for health care, even for non-urgent matters. At a local coffee shop in Keene, Texas, one individual described, "More people need to have proper medical care so they don't run to the emergency room when they have a medical problem that is not an emergency."
Health Care Community Discussion participants agreed that emergency rooms often became a primary source of care for both uninsured and insured populations. When discussing uninsured populations, participants characterized emergency rooms as "the norm." At a home in Milwaukee, Wisconsin, attendees lamented, "If one has no health insurance, one does not go until problems are so bad they require a trip to the ER, which could have been avoided. In Wisconsin, care cannot be refused at an ER. So people wait and go to the ER, which is more expensive a service in general." A school nurse in Prescott, Arizona, said she sees "so many kids at the school who have no insurance and just go to the ER for strep throat." Even insured participants spoke about having to use emergency rooms for non-urgent care because "people cannot get in to see their doctor." As a result, a group of psychiatrists in Tucson, Arizona, wrote, "Urgent Care and Emergency Room[s] [are] used for primary care or minor acute care. This also results in dangerously long waits for true serious urgencies/emergencies."
Comprehensive Coverage
Several participants who actually had insurance deemed it as inadequate and failing to cover additional "essential" services. A group at a local church in Bristol, Virginia, reported, "There was also general consensus that mental health cannot be separated from physical health and that some level of mental health care services should be available to all citizens." Further, the host of a Health Care Community Discussion in Port St. Lucie, Florida, recounted, "One attendee (ex-military) expressed [that] particular attention should be paid to the uninsured with mental health problems, and she especially worried about all the servicemen and women serving in various parts of the world." A participant in Albany, California, discussed dental care, noting that "Dental care is not included as part of health insurance, but it is just as important. The mouth and teeth are essential parts of the body!" About 5 percent of all group reports expressed concern regarding a woman's inability to obtain and/ or afford preventive health care. A group of friends from Planned Parenthood in Denver, Colorado, remarked, "Overall our group would like to see more coverage for women's health care. Some of my friends have stopped using birth control because it is too expensive. They literally are making decisions about birth control and pap smears and filling up their gas tank or buying groceries. It is so sad that these days women cannot protect themselves the way they should be able to. Women's health care is very preventative and if my friends had access to those services it would be a lot less expensive in the long run." A North Dakota women's group held a Health Care Community Discussion and reiterated this point by bluntly stating, "Preventative health care is an important part of being healthy and lowering money spent on health care for citizens and the state. The primary preventative health care services should be covered and routine: birth control, breast and cervical cancer screenings, sexual treatment infection screening and treatment."
Lack of adequate insurance for long-term care was mentioned in a number of Health Care Community Discussions. A group of senior citizens in Zephyrhills, Florida, described their fear that "providing long-term care can bankrupt a couple leaving the surviving spouse with no resources left." In Mountain View, California, a participant at a house Health Care Community Discussion of friends and neighbors "was concerned that her long-term care policy cost has doubled and she was unable to get information on what the policy covered."
Many participants agreed that their insurance should more adequately cover preventive services and alternative medicine. A Health Care Community Discussion group in Chesapeake, Virginia, reported that their group had agreed it was "costly to pay out of pocket for preventive health screenings" and that there was often a "long wait time for preventive health care appointments with primary care providers (over six month wait period for well exam)." The Chesapeake group also felt that "[p]rimary [c]are [p]roviders have limited education in preventive health care delivery systems, such as the many types of therapies: massage, physical, occupational, emotional, nutritional and non-invasive procedures." Several groups expressed their desire for a comprehensive system in terms of outcomes rather than benefits. "Health care reform must include as a goal the elimination of racial/ethnic health care disparities," declared one Dayton, Ohio group. Participants often spoke about difficulties in navigating the health care system due to linguistic and cultural barriers. A Health Care Community Discussion organized by a San Francisco, California HIV/AIDS health organization, explained: "[A]ccess to health care is not the only major issue with our health care system. Once you acquire access, you may still have to deal with cultural incompetence or a lack of quality health care, particularly if you have linguistic barriers, are part of the transgender community, or experience health issues that require special knowledge or training (such as survivors of torture)." Participants at a Health Care Community Discussion in Devon, Pennsylvania, described linguistic and cultural barriers as often "subtle, subjective and [e]mbedded in care," further explaining that, "As our society becomes even more multi-cultural and diverse, however, these issues will only increase."
Show Introduction
Americans across the country are demanding comprehensive health reform and cannot afford to wait any longer for Washington to act. Businesses and families are struggling as costs continue to skyrocket. More and more Americans find themselves uninsured. Those Americans fortunate enough to have health insurance often don't get the quality care they need and deserve. The Costs of Inaction highlights the flaws in the health care system and demonstrates the cost of maintaining the status quo. Organized into three sections - Escalating Health Care Costs, Diminishing Access to Care and Persistent Gaps in Quality - the report shows how the current system has failed millions of Americans and why we must enact comprehensive health reform this year.
Millions of Americans do not have health coverage, or have inadequate coverage. As our economic challenges multiply, the problem of health care access grows.
From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%.15
An estimated 87 million people - one in every three Americans under the age of 65 - were uninsured at some point in 2007 and 2008.16
More than 80% of the uninsured are in working families.17,18
Children without insurance have decreased access to well-child care, immunizations, basic dental services, and prescription medication. Uninsured adults similarly have less access to needed preventive care, and when sick, they are more likely to experience poorer health outcomes.19
This in turn leads to lost workplace productivity and greater risk of illness and death, at a cost of $65 to $135 billion per year.20,21,22
However, when the uninsured do obtain health care coverage, access to effective clinical services and health outcomes improve.23
In the current economic crisis, even people with insurance are forgoing needed medical care, including prescription medications and doctor visits, because of inability to pay copayments and deductibles.24
In the past 4 years, the number of people above 200% of the poverty line who spend more than 10% of their income on health care has more than tripled. About half of them report difficulty paying bills.25
People with insurance also report difficulty accessing care when they live in areas with high uninsurance rates, and physicians in these regions believe that they cannot make medical decisions in the best interest of their patients.26
Flashback: It Was Bush, GOP
That Opposed Executive Compensation Caps
By Sam Stein
It is a rather curious spectacle to see congressional Republicans express outrage at the exorbitant bonuses being handed out by bailed-out companies and blame the Obama administration for failing to curb the practice with AIG. Because when the first installment of the Troubled Asset Relief Program was passed it was the Bush administration and GOPers in Congress who were insisting that caps on executive compensation not be part of the legislation.
As the New York Times reported at the time that TARP was being crafted, "Congress and the administration remained at odds over the demands of some lawmakers, including limits on the pay of top executives whose firms seek help."
Former Treasury Secretary Hank Paulson said that while he was upset with the levels of salary afforded to top executives, any cap on such would dissuade companies from participating in the TARP.
"If we design it so it's punitive and so institutions aren't going to participate, this won't work the way we need it to work," he told Fox News Sunday on September 21.
Senator Richard Shelby, the top Republican on the Senate Banking Committee, told CBS news that: "It should be up to the board of directors of a private corporation to set the compensation of an executive; it shouldn't be Congress's role."
Senator Mel Martinez told CNBC that: "While it is very appealing to think about executive compensation as being a part of this, one of the drawbacks to that is perhaps that we would have fewer entities participate in what is essentially a voluntary act."
And House Minority Whip Eric Cantor, "outraged" over AIG's issuance of $165 million in bonuses, said he was not in favor of "the federal government be[ing] able to set salaries across the board," when the issue of executive compensation arose in September 2008.
The issue extended to when the Obama administration was tasked with writing its own version of the TARP. Senate Minority Leader Mitch McConnell, likewise dismayed over AIG's bonuses this past week, said back in early February that while he was "appalled" at some of the perks executives had received, he did want "the government to take over these businesses and start telling them everything about what they can do."
That said, the Obama administration too was pushing back against overly-strict caps on executive earning albeit still favoring some form of limitation.
Of course, a distinction could be made between executive compensation and issuance of bonuses. One being salary, the other being rewards. But in this and other cases, money is fungible. And back when the Troubled Asset Relief Program was being debated, it was the leadership of the GOP and the past administration that asked that the issue not be touched for fear that it would derail the legislation.
It was, after all, President Bush who warned lawmakers not to "insist on provisions that would undermine the effectiveness of the plan" while Barney Frank, chairman of the House banking committee, declared that there would be "no golden parachutes while we are the owners" of the bad assets of Wall Street firms.
(Hat tips to Think Progress and Dana Milbank)
Help Share TRUTH !
B4B
In December 2008, the Presidential Transition Team invited Americans to host and participate in Health Care Community Discussions to talk about how to reform health care in America. Over 9,000 Americans in all 50 states and the District of Columbia signed up during the holiday season to host a Health Care Community Discussion and thousands more participated in these gatherings. Friends, family, neighbors, and co-workers, representing the views of both health care patients and providers, came together in homes, offices, coffee shops, fire houses, universities, and community centers with a common purpose: to discuss reforming the health care system.
After each Health Care Community Discussion, hosts were asked to fill out a Participant Survey and submit a group report to the Presidential Transition Team's Web site, www.change.gov ("Change.gov"), summarizing the group's main concerns and suggestions. Committed to bringing all Americans to the table, the Health Policy Transition Team and a group of dedicated volunteers read and analyzed, line-by-line, the 3,276 group reports submitted to Change.gov. This extensive and intense engagement of the public in policy development by the Federal government is unprecedented and historic, as is this study, which systematically analyzed the information generated by the Health Care Community Discussions.
One of the most striking results from this analysis was the lack of differences in the concerns and solutions identified by participants: Americans who participated in Health Care Community Discussions were generally united in what they felt was wrong with the system and the general direction on how to fix it. The Health Care Community Discussions focused on concerns about a "broken" health system, access to health insurance and services, rising premiums and drug costs, being "uninsurable," medical mistakes, and the system not being "for them." In 30,603 Participant Surveys, the top concerns were cost (55%), lack of emphasis on prevention (20%), pre-existing conditions limiting insurance access (13%), and concerns about the quality of care (12%). Participants told stories about people who are bankrupted by medical bills, who cannot afford to see a doctor when sick, and who wind up in emergency rooms because they have nowhere else to turn. These stories, and thousands of similar ones, affirm that we must fix America's broken health care system, and that we must fix it now.
Many of the Health Care Community Discussions focused on the aspirations for the health system, suggesting that its performance would improve if it adhered to guiding values or principles. Among the reports discussing system solutions, participants expressed support for a system that is fair (36%), patient centered and choice-oriented (19%), simple and efficient (17%), and comprehensive (15%). The Health Care Community Discussions offered a wide range of specific suggestions for fixing the system, including making health insurance more accessible through a public plan, creating scorecards on quality and cost, improving the nutritional content of school lunches, implementing electronic medical records, and creating an AmeriCorps for health workers.
The Health Care Community Discussions are a first step in this Administration's commitment to an open and inclusive style of governance that allows all Americans to have a voice in our country's health reform efforts. This Administration recognizes that true reform comes from the grassroots up and promises that when Americans speak, the Administration will listen. These Health Care Community Discussions reflect the President's commitment to enlist the public in achieving a top priority: creating a health system that is affordable, accessible, and high-quality for all Americans.
Highlights
Concerns about the U.S. Health Care System: Health Care Community Discussion groups were asked to appraise the performance of the U.S. health care system through a Participant Survey and in their own words through group reports. Many commented that the system is "broken," particularly with regard to the adequacy, affordability, and accessibility of health insurance coverage.
Health Care Costs: Among the group reports that focused on the cost of health care, 28 percent focused on health insurance premiums with another 28 percent worried about the overall cost of the system. The cost of health care to individuals and families was a topic of discussion in one-fourth of the cost discussions; prescription drug costs were mentioned in 21 percent of such reports. Examples of these concerns included:
Access to Health Care: Among the Health Care Community Discussion reports that focused on access problems, 37 percent expressed concern about being denied access to care due to pre-existing conditions and other non-financial barriers, 27 percent reported challenges obtaining access to services, 20 percent felt their coverage was inadequate (such as lacking preventive care and mental health coverage), 18 percent pointed to provider shortages, and 16 percent disparaged a system where health care for many Americans is only accessible through hospital emergency rooms. This is in addition to the large fraction of participants worried about the cost of health care and health insurance.
Quality: Most of the quality concerns were with the overall system (47%), although 36 percent of reports that mentioned quality focused on overuse of services and 20 percent discussed medical errors.
System: A large percentage of the Health Care Community Discussion reports pointed to structural and systemic issues at the heart of the problems in the U.S. health care system. In 37 percent of the reports that focused on system problems, participants either praised or criticized the link between employment and health insurance. Additional common topics of discussion included concern about the system's complexity (27%), trepidation that it espouses the wrong values and emphasis (such as a lack of focus on prevention or the health system's market orientation) (29%), and its coverage gaps that result in a large number of uninsured (21%).
Solutions to the Problems in the U.S. Health Care System: Thousands of Health Care Community Discussions offered suggestions on the values, roles, and policies that should guide the effort to reform the U.S. health care system.
Principles for a Reformed U.S. Health Care System: Many of the Health Care Community Discussions focused on their aspirations for the health system, suggesting that its performance would improve if it adhered to guiding values or principles. Among reports discussing such principles, participants wanted a system that is fair (36%), patient-centered and choice-oriented (19%), simple and efficient (17%), and comprehensive (15%).
Fair: Participants seek an inclusive health system that does not exclude Americans who cannot afford it or cannot access it due to sickness or health risks. From Charleston, South Carolina: "The nation needs some form of universal health care. The failure to insure that every citizen has access to affordable health care is a major reason for the chaos and fragmentation of the delivery of health care in this country, and goes a long way towards explaining why our country ranks below many others in the overall health and longevity of its citizens. It is also a source of severe financial distress for millions of families and individuals across the country."
Patient-Centered and Choice-Oriented: Participants placed a high value on choice and orienting the health system around patients. From Scituate, Rhode Island: "We want a system that encourages engagement between people and their primary care practices and other health providers; that is patient centered, which means meeting people where they are, as they are, and giving them services that actually improve their health."
Simple and Efficient: Many Health Care Community Discussion participants suggested that a simpler health system would both improve outcomes and efficiency. From Merrick, New York: "The amount of increased paperwork and need for doctors to hire people to take care of it was cited as wasteful, a result of our present insurance environment, and the feeling that the money spent on that be put where it can increase the quality of care for everyone. Paperwork needs to be streamlined because it becomes the focus of care instead of the patient."
Comprehensive: The specific type of coverage was as important to some participants as whether they received coverage at all. From Bristol, Virginia: "There was also general consensus that mental health cannot be separated from physical health and that some level of mental health care services should be available to all citizens."
Roles in a Reformed U.S. Health Care System: Participants in Health Care Community Discussions frequently stressed the importance of collaboration in both fixing and operating the health system. The theme of "shared responsibility" was common. However, Health Care Community Discussion groups had differing views on whether the roles of the main actors in the health system – the government, private sector, businesses, and individuals – should expand or contract in a reformed health system.
Role of Government v. Market: The debate among participants was less about whether government should have a role in a reformed health system and more about the size of that role. A number of "single payer" advocates participated in Health Care Community Discussions. From Livermore, California: "This group was almost strident in its belief that we should simply adopt a single-payer system similar to what is enjoyed in Canada and much of Europe and take the burden off of individual employers and corporations altogether." Others expressed concerns about the approach. From St. Louis, Missouri: "[A] major concern with [a] public v. private plan was the quality of care received with a public plan." This debate took place within as well as across groups. From Bristol, Virginia: "Many argued that the insurance industry should be completely removed from the health care delivery system, but others saw how they acted as 'gatekeepers' to control costs, and to offer affordable coverage to some employers." Other groups supported a "hybrid" model that would include both types of plans.
Role of Businesses: Health Care Community Discussion participants expressed varying views on the role of employers in a reformed system. From Staten Island, New York: "All feel that all employers should be required to offer some health care plan to employees...." From Hillsborough, California: "Employers should be involved in paying for health care, but not providing coverage; health care itself should not be linked to employment; [there should be] seamless 'portability' of health coverage."
Role of Individuals: Most participants in Health Care Community Discussions stressed that individuals should take a primary role in health reform by leading healthier lives. From Leesburg, Florida: "Educate and prepare people, particularly youth, to take responsibility for their own health thereby empowering them to make healthy choices...." Other groups talked about the role of individuals in financing the health care system, including a sliding scale, income-based contribution.
Specific Suggestions: Health Care Community Discussions recommended numerous different solutions. The solutions clustered around several themes related to reducing insurance and drug costs, using information to improve the quality and efficiency of health care, promoting education and healthy behavior, and strengthening the capacity of the health care system.
Health Insurance Exchange: A number of groups suggested organizing health insurance choices for Americans through a purchasing pool or exchange. From Redondo Beach, California: "All individuals with employer-based package[s] seemed to like the idea of options to utilize [an] insurance exchange or public insurance, depending on the cost of the program(s)."
Reducing Prescription Drug Costs: Health Care Community Discussion groups recommended aggressive actions to lower the prices of prescription drugs. From South Trail, Florida: The government needs to "negotiate reasonable pricing for drugs with the pharmaceutical manufacturers." From Sebastopol, California: "Pharmaceutical costs should be standardized and decreased through a government acquisition program." From Welaka, Florida: "All feel there must be an overhaul of drug company marketing techniques and drugs from other countries should be easier to obtain."
Research, Standards, and Promoting High-Value Health Care: Participants suggested different options for using the power of research and standards to improve quality and efficiency. From Littleton, Colorado: "Public policy can create a data base to compare providers and their costs for basic services. In this data base can be a listing of their filed complaints or some type of review (maybe similar to the Better Business Bureau) where consumers can know if they are seeing a quality provider or not (rather than relying on the insurance company to tell them who they get the best rates from). Providers would ultimately benefit because patients would migrate to those more efficient/better outcome providers."
Simplification and Information Technology: Harnessing 21st century tools like information technology to make the health system perform better emerged as a common theme in Health Care Community Discussions. From Springfield, Missouri: "Health records should be...made electronic and secure. This will promote coordination of care, enhanced quality, and create a safer patient environment."
Education on Health and Wellness: Participants recommended education as a critical element of health reform. From New York, New York: "We further believe that meaningful health care reform must include an emphasis on health education − throughout the life course − focusing on prevention and wellness. The goal is to teach people what they need to know to stay healthy and give them enough knowledge to make informed choices when they need medical care."
Promoting Healthy Lifestyles: A number of reports recommended coupling education with incentives to promote healthy lifestyles. From Larchmont, New York: "The group agrees that the country needs to treat obesity as an epidemic taking over the nation. Every dollar we spend putting apples in the hands of our youth will translate into hundreds of dollars saved in diabetes treatments, etc." From Fort Worth, Texas: The government needs to "make neighborhoods safer so people can get out and walk; put in sidewalks in all communities; have community facilities aimed at teaching healthy behaviors."
Expanding Health System Capacity: Policy makers should invest in expanding the health care workforce and primary care clinics, according to some Health Care Community Discussion participants. From Valley Village, California: "Create a 'Health Corps' or 'AmeriCare' (along the lines of the Peace Corps) not only providing new jobs but also creating a network of health care providers across the country that can deliver affordable care, conduct community outreach for education, prevention, and wellness, and flag emerging health problems as they arise." From South Pasadena, California: "While there is a shortage of nurses in the country, we are a powerful enough force to effect change for the public good in a cost-effective way."
Suggestions for Future Engagement: The Participant Survey solicited more than just concerns and policy solutions: it also asked how policy makers should reach out to Americans, and how Americans want to remain involved in health reform.
How to Develop the Health Reform Plan: According to 30,603 participants, the most popular way to develop a plan for health care reform is more community meetings similar to the Health Care Community Discussions (37%), a White House Summit on Health Reform (21%), and surveys to solicit ideas on reform (18%).
How to Stay Engaged: Most participants (38%) wanted more information on health reform solutions as a means for continuing participation in the health reform debate, and nearly one-third of respondents (31%) wanted more opportunities to discuss the issues. All types of communities expressed interest in such opportunities. Further, 18 percent of respondents wanted more background information on the problems to stay engaged and 13 percent wanted more stories about how the system affects real people. Interest in continuing to stay involved was strong. From Green Acres, Washington: "We are extremely encouraged that President-elect Obama is reaching out to all Americans rather than special interest groups to come up with a solution. More than ever, we are optimistic that this solution will be reached."
Conclusion: President Obama has encouraged all Americans to have a direct say in the effort to reform the health system. Individuals who participated in the Health Care Community Discussions rose to this challenge. These Health Care Community Discussions brought together people in all 50 states and the District of Columbia from all walks of life – patients, doctors, business owners, and advocacy groups – who united around a common concern: the need to reform health care in America. The stories of hardships that emerged from the Health Care Community Discussions, and thousands of similar stories, affirm the need to reform America's broken health care system. The Health Care Community Discussions represent two related Administration commitments: to an open, inclusive style of governance that engages Americans in the policy process and to health reform that is directly responsive to the problems Americans face, the stories they share, and the solutions they offer.
Executive Summary and Highlights
I. Overview of Health Care Community Discussions
A. Introduction
B. Motivation
C. Logistics
D. Analysis
II. Participation in Health Care Community Discussions
A. Reasons for Signing Up and Participating
B. Who Participated in Health Care Community Discussions
C. Sample of the Health Care Community Discussions
D. Articles on Health Care Community Discussions
III. Concerns About the U.S. Health Care System
A. Prioritization of Concerns
B. Cost Concerns
D. Quality Concerns
E. System and Other Concerns
IV. Solutions to the Problems in the U.S. Health Care System
A. Principles for a Reformed U.S. Health Care System
B. Roles in a Reformed U.S. Health Care System
C. Specific Suggestions
D. Relationships between Concerns and Solutions
E. Suggestions for Future Engagement
V. Conclusion
Appendices
A. Analysis Team
B. Methodology
C. Figures, Tables, and Maps
Notes
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Health Care Community Discussion Participant Guide (PDF)
Health Care Community Discussion Moderator Guide (PDF)
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Current Financial Crisis Demands Health Reform
Now is the time to fix our broken system and spur economic growth
By Joanne Limbach
Skyrocketing health care costs have Ohio’s working families struggling to make ends meet and are pushing our employers to the brink. As wages tighten and unemployment rises across the state, soaring medical costs are squeezing individuals and families – forcing some into bankruptcy. We’re seeing major industries forced to close or impose drastic layoffs, finding the soaring cost of health insurance is putting their businesses (and our nation as a whole) at a global disadvantage.
Our current health care system costs too much, wastes too much, makes too many mistakes and returns too little value for our money. Still, some members of Ohio’s congressional delegation are telling us that we cannot afford to fix our broken health system, we need to wait. That doesn’t make sense. Now is the time to fix the system that if left unchecked will only worsen. We can’t afford the cost of doing nothing.
As state president for AARP Ohio, I can assure you that we will be working across the state and across the nation to convince our leaders to take on real health care reform now and ensure that all Americans have access to their choice of quality health care plans that they can afford. AARP believes we must:
● Make affordable health care coverage options available to everyone, especially people ages 50-64 who are among the fastest growing group of uninsured
● Keep Medicare affordable by rewarding doctors and hospitals for quality rather than quantity of care
● Promote prevention and healthy behaviors
● Eliminate fraud, waste and abuse
● Improve care coordination for people with chronic conditions, help them stay in their homes and out of institutions
● Cut administrative costs by replacing paper records with a secure online record system
● Use research to help doctors and patients determine the most effective treatment
● Reduce the cost of prescription drugs through bulk purchasing for Medicare and Medicaid
By making health care reform an important priority in his address to the nation and by providing funding for it in his budget, President Obama began building the momentum necessary to spur action on health reform this year. AARP believes that all of us – individuals, providers, purchasers, insurers, and government – have a role to play. We encourage you to join us in urging Congress to act now on comprehensive reform to bring down costs, improve quality, and ensure that all Americans can get affordable, quality coverage.
Please join us in telling U.S. Senators George Voinovich, a Republican, and Sherrod Brown, a Democrat, and all of our U.S. Representatives – including Democrat Zack Space and Republicans Pat Tiberi, Steve Austria, Jim Jordan and Bob Latta – to end partisan bickering, put their best ideas on the table, and work together now to make health reform a priority met this year. You can learn more and find contact information for your congressional representatives at www.dividedwefail.org
(Joanne Limbach, who lives in New Philadelphia, volunteers as state president for AARP Ohio and as a member of the AARP National Policy Council.)
A message from the Black Professional Network:
President Obama Launches White House Internship Program
Dear Colleagues:
On February 26, President Obama launched the White House Internship Program for his administration and announced that applications are currently being accepted for the summer of 2009. Those selected to participate in the program will gain valuable job experience and an inside look at the life of White House staff while building leadership skills.
“This program will mentor and cultivate young leaders of today and tomorrow and I’m proud that they will have this opportunity to serve,” said President Obama. “I look forward to working with those that are selected to participate and I want to commend all who apply for their desire to help through public service to forge a brighter future for our country.”
In addition to normal office duties, interns will supplement their learning experience by attending a weekly lecture series hosted by senior White House staff, help at White House social events, and volunteer in community service projects.
The 2009 Summer Internship program runs from May 22 to August 14 and the submission deadline is March 22, 2009.
Those interested in applying to the White House Internship Program must be:
· US Citizens
· Eighteen years of age on or before the first day of the internship · Enrolled in a college or university (2-4 year institution) or must have graduated from college in the past two years
Interns will be placed in a departmental office for their internship. Below is a list of departments in the Office of the President and the Office of the Vice President where interns could be placed.
· White House Department of Scheduling and Advance · The Office of Cabinet Affairs · The White House Communications Department · The White House Office of Public Liaison and Intergovernmental Affairs · The Office of the First Lady · The White House Office of Legislative Affairs (OLA) · The Office of Political Affairs · The Office of Management and Administration · The Office of White House Counsel · The Domestic Policy Council · The White House Office of Presidential Personnel · Office of the Vice President
More information on the White House Internship Program, including application instructions, can be found at: www.whitehouse. gov/about/ internships.
Social Inclusion
I'm a Red Cross Disaster Volunteer. Are you? If not , why not? Join today.
Thanks for an energizing discussion on health care. It was a pleasure meeting and talking with each of you. Let's do it again.
Hotel Room available Jan 16-20 (all five days only)
Airport shuttle, Metro, free parking, complimentary breakfast: less than 10 miles from DC.
Great location, Great price. Will not last.
Email wyler@att.net
January 19, 2008
Obama for Change Volunteer Victory Celebration at Zanzibar on the Waterfront 9pm-5am
700 Water Street, SW Washington, DC 20024 Tel: 202-554-9100 contactus@zanzibar-otw.com
$85.00
The space that was available in Alexandria has been taken. Thanks for your interest.
Gayle
