It does my heart good to say that our community meeting regarding health care reform was a wonderful success! This is the first time I have ever done something like this. I learned that people are passionate and hungry to be heard. We had 14 members participate, full of constructive ideas. It was difficult to keep things to an hour. It is clear that I need to make more of these happen. I received many phone calls and emails the two days after the event from people who could not attend but wished to give input and get involved. Participants of our meeting expressed a strong desire to band together and organize more of these forums, perhaps on a larger level. It is clear that people are ready to be heard and participate in formulating a plan. Thank you everyone, for standing up and taking responsibility for change!
I am posting my report to the Health Care Policy Transition Team, so anyone can see how this went and what we talked about:
January 1, 2009
To Tom Daschle, Secretary-designate of Health and Human Services and The Health Care Policy Transition Team,
Here is a summary of our group’s findings from our December 30th community meeting discussing problems within our health care system and how we might go about making positive changes under our coming administration.
We would like to sincerely thank you for the opportunity to add our voices as we tackle these problems together. Please know that the enthusiasm and passion for giving our input is large, and we are committed to helping you exact effective positive change in the future.
We focused on three main questions as a group:
1.) What is perceived as the biggest problem in the health care system?
2.) Sharing of personal experiences illustrating these problems, and
3.) How can public policy promote healthier lifestyles and preventative medicine?
#1). What do you perceive is the biggest problem in the health system?
Our group was in agreement that the biggest problem is our for-profit corporate health care insurance system. Individuals highlighted many salient points to illustrate this:
a) Our for-profit health insurance system results in lack of universal coverage in our country (with the number of uninsured children being of particular concern).
b) It creates a system where non-health care trained individuals are making bottom line decisions regarding access to testing and treatment.
c) It results in a poor and ineffective approach to preventative care by limiting access to health care execution and limiting time that health care providers are able to spend with their patients thereby eroding trust in the doctor-patient relationship.
d) For-profit insurance also provides inappropriate incentives, for example incentives reducing the time spent with the patient and incentives promoting utilization of prescription medication management for health problems that could be approached in a more preventative life-style/ education manner.
e) It causes severe systemic problems regarding unequal health care provider reimbursement, which leads to further inequity (i.e. some doctors choose not to see Medicare/Medicaid patients as a result).
Our group was in complete agreement that universal coverage and a single-payer system would go a long way towards ameliorating these primary problems.
Concerns were expressed from some participants regarding how a new system would be executed and regulated—specifically will there be adequate reimbursement to health care providers to facilitate universal acceptance of government insurance? Will we see similar problems develop as we have seen in the Medicare/Medicaid system where a financial burden is placed upon providers due to poor reimbursement forcing non-universal acceptance of this means of insurance? Will the quality of care be reduced as we enact a new more universal system with financial constraints? As a group, we felt that these concerns need to be clearly addressed as a single-payer or other universal coverage system is implemented…we did not feel that they are a valid argument to prevent implementation of this change.
#2.) Have you or your family members experienced difficulty paying medical bills?
a.) One participant shared that she was horrified to receive a $16,000 medical bill while still grieving the recent loss of her husband. Litigation ensued.
b.) Another pair of participants who work as Registered Nurses at our local Cancer Clinic shared their frustration that patients cannot afford their oral chemotherapeutic agents as insurance will only cover IV administration of chemotherapy (often the least cost-effective route). As a result, patients there who cannot pay out of pocket go without these life-saving or life-improving medications. These health care providers did not know how to explain this to their patients and felt frustrated and unable to help, rendered powerless by the system.
c.) One participant shared that he considers himself quite fortunate as he has had no major health issues yet and is uninsured. However he pointed out that he lives in a state of fear, knowing that should health care problems surface, it could lead to complete financial ruin and inability to obtain needed care. He also admitted that this results in his putting off prompt treatment of small medical issues as they arise.
d.) Yet another participant shared that her son pays so much for his insurance that it is a great burden financially, AND ironically he lacks coverage for his pre-existing condition of bladder cancer which is the most likely to arise as a major medical concern in his future.
#3.) How can public policy promote healthier lifestyles and preventative medicine?
Our group was in full agreement that implementing prevention and a healthier American lifestyle is KEY to reducing the rising cost of our health care. There was also firm agreement that this area needs massive improvement. Individuals highlighted the following points:
a) Universal Access to health care is a must to implement a healthy America focused on prevention. The uninsured currently have no effective means of obtaining preventative care.
b) There is a strong need for an increased number of small local primary care clinics to implement better prevention.
c) Implementing preventative care as a health care provider means having more time to spend with the patient and repairing the damaged provider-patient trust that currently exists in our system. Physicians and other practitioners are forced to rush through seeing their patients, prohibiting quality communication between provider and patient, prevention education of the patient or adequate time for the patient to bring up all concerns. Patients may no longer feel that their health care providers have their best interest at heart.
d) Incentives are needed to strongly encourage health care providers to focus on primary care (as opposed to existing incentives for treatment with medication, incentives to see largest number of patients in shortest time, etc).
e) Incentives are needed at a local level to promote healthy lifestyles (i.e. The Silver Sneakers Program for seniors which promotes health and fitness for the elderly).
f) Health Care Provider education focused upon prevention needs to be increased and the culture of medicine in our country needs to shift to this approach (less emphasis on pharmaceutical management, more emphasis on lifestyle management).
g) Financial incentives for employers are needed to promote prevention (i.e. Make it cost effective for employers to encourage sick days and days at home to care for sick children preventing spread of disease and resultant costs and decreased productivity).
h) Local access to health care providers needs to be considered (more local clinics and more transportation options to get there).
i) Increased transparency is needed in our health care system so that people are aware of their options for care and are also able to navigate the confusing process of clearing things through insurance, obtaining referrals, etc. This can be confusing to someone in good health with many resources…it is sometimes impossible for an ailing person with limited internet/telephone access to effectively navigate our current system and as a result they go untreated.
j) Consider a tax upon “junk food” as well as increased taxation on tobacco with these funds being directed at public health education and prevention.
k) An educator pointed out that the school needs to change from a place of academic only focus to a community center that fosters healthy living. He indicated a strong need for mandatory Physical Education and after school physical activities in all schools (funded by our government as “pay to play” models are failing). He referred to the large body of well documented studies that correlate obesity with decreased academic performance, depressed quality of life and decreased future success for our children. He suggested increased nutritional education in schools, evaluating schools not just upon academic performance but also level of health, and implementing more programs similar to the School Community Health program instituted by the Centers for Disease Control.
l.) Increase support for and utilization of local agriculture resulting in higher nutritional content of food, as well as environmental benefits (decreased use of fossil fuel transport of produce). Consider decreased government subsidy of corn and wheat agriculture and increased subsidy for more healthy alternatives.
m.) Government programs that provide very strong incentives for Primary Care Medical education and community service need to be increased and utilized (i.e. Loan forgiveness programs or scholarship programs for health care providers with attractive stipulations to practice at a local community level in primary care). While we discussed that these programs do already exist, we agreed that they are obviously too small, unattractive or being underutilized and not producing the desired effect.
These ideas are the result of a community discussion among 14 individuals from various walks of life and age groups. We limited our discussion to one hour. The potential for much more in depth discussion exists. Group members expressed wanting more opportunities like this to share their ideas and more community organization to band together in larger groups and communicate their wishes to legislators. We will be working on better community organization and providing more forums like this in the coming year.
Thank you again for this opportunity.
Sincerely,
Marjorie Alexander, meeting organizer
From left to right: Marjorie Alexander, Chet Gardiner, Mary Palma RN, Ann Dichov RN and Kristy Theiler (Tucson ACORN)
From left to right: Irma Perez (Tucson ACORN), Deborah Littman, Sol Littman
Marjorie Alexander next to meeting board
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Hi all! I just got off the phone with a wonderful woman who is visiting from Canada...she will be attending our neighborhood meeting tomorrow night.
She wanted to hear more personal stories about this amazing grassroots movement for Obama, as in her country she feels people have a need to understand what this was like for each of us on a local level.
She will be returning to Canada January 3rd and would love to talk with some of us on the phone before then. She is happy to cater to your availability.
If you would like to talk about what this experience has been like for you on a personal and local level, feel free to email me (marjorie_alexander@yahoo.com) or call me (520-240-2978) so I can take your contact info down and connect her with you. She is a delightful person with a sincere desire to bring a better understanding of our Obama movement back to Canada! There is nothing more powerful than our individual stories, emotions and even how we have changed as this grassroots movement has found importance in our lives. Please share yourself and your amazing journey!
Peace,
Marjorie
President-Elect Obama and his team have asked us to gather in our communities and share our ideas, stories and feelings regarding changing our health care system for the better. We are holding a small gathering here in the Blenmann neighborhood in Tucson. Please consider coming out on Tuesday, December 30th if you would like to contribute. Our gathering should only last about an hour and you are welcome to talk to me more afterwards if you have more to share. I will be summarizing and submitting what is shared at our gathering to the Office of the President-Elect. Meetings like this are happening all over our Country up until December 31st. At that time, Barack's team will begin reviewing what America has shared.
During the election, we all held on to our beautiful passion for change and together made an amazing difference. But we all know that the real work is just beginning...we are needed more than ever right now to step up to the plate and take responsibility for what we want to happen next! Can we do this? Yes we can!
