Organizing for America | Posts with the tag health care policy

Posts with the tag health care policy

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Positive Lessons Learned from Democratic Congressman Adam Schiff’s Healthcare Reform Town Hall on Tuesday 8/11/2009

By Michael from Santa Monica, CA - Aug 21st, 2009 at 1:03 am EDT

Also listed in: 10 groups

Please help me figure out how to get this to those that are preparing for future events...

Positive Lessons Learned from
Democratic Congressman Adam Schiff’s Healthcare Reform Town Hall
on Tuesday 8/11/2009

On Tuesday 8/11/2009, I attended a very well run Town Hall event that provided some very clear lessons on how to overcome the organized attempts at disruption and fear/hate mongering led by the radical right and corporate anti-reform supporters.

My thanks and congratulations go to Congressman Schiff and everyone involved in this event. This is the first such event that I have attended, and it was a very positive experience overall. (I was drawn to attend in an attempt to balance out the rowdy anti-reform crowds that I have seen on TV trying to dominate such events.)

The event had at least the expected 2000 people present, and despite the vocal attempts of anti-reform people, the event was kept relatively civilized and constructive.

A large part of this success is due to the obvious efforts of the event organizers to actively manage the event, rather than utilize a normal town hall format, which the anti-reform sponsors have recently managed so well to game to their advantage.

Below I list my observations, which I highly recommend that all Democratic legislators and town hall event planners study before/while planning their own events to discuss healthcare reform.

I also recommend that you contact Congressman Schiff, the event planners at his office and the City of Alhambra, the moderator Dr. Bruce Hensel, and the Alhambra Police Department for their own lessons learned.

Things done right to support a constructive dialog:

Don’t assume that this will be a normal town hall event. Treat this as a unique event with its own necessary preparation steps to ensure success.
The anti-reform sponsors have worked hard to game the format employed by normal town hall gatherings. Do not reward their efforts by passively playing along.
Be very clear on the goals of anti-reform sponsors…

· To agitate the radical right

· To prevent constructive dialog on this topic by disrupting and monopolizing the event

· To limit opportunities for reform supporters to spread their message

· To propagate intentional lies about reform goals/methods

· To intimidate supporters of healthcare reform from participating

· To wear down and intimidate pro-reform legislators

Do not limit attendance.
Attendance limits reward organizers who can bus in their supporters early during working hours so as to claim all available seats. Limits thus penalize people with jobs who find that by the time they can arrive after work and traffic the event is filled and they will not be admitted.
Hold the event outdoors.
This reduces the impact of people shouting to disrupt the event. During the first half of our event a number of anti-reformers attempted to shout non-stop to reduce dialog, but the open air dispersed their volume. They could not effectively compete with the sound system used by the podium speakers, and eventually they gave up and shut up.
An outdoor venue also supports the ability to avoid attendance limits.
Our event was held at a grassy area outside the library at the City of Alhambra Town Hall.
Use a high-quality sound system for the podium speakers.
The sound must be loud enough to be clearly heard by all in the audience, without distortion. Use a professional company for this and test it in advance.
Allow signs
Pro-reform audience members were obviously more polite and less likely to resort to out-shouting their opponents. Signs provided an alternative means for them to make their opinions known.
There will be many crazy signs from the anti-reform movement, such as pictures of Obama with a Hitler mustache. This is acceptable vs. the benefit of providing more civilized members of the audience with a means to communicate.
Use a professional moderator who is knowledgeable about healthcare reform.
Dr. Bruce Hensel, Medical, Health, and Science Editor/Reporter for NBC4 performed this role very admirably at Adam Schiff’s event. I recommend that organizers of similar events contact him to learn his own lessons learned.
The moderator should feel free to guide the discussion with the goal of providing constructive dialog.
Do not provide microphones for audience speakers, have the moderator restate their questions for the audience.
This reduces both the incentive for and impact of grandstanding and attempts to disrupt.
Not hearing amplified ranting also discourages other members of the audience from piling on with more shouting/chanting in an attempt to disrupt/monopolize the event.
It also allows legitimate, but nervous/awkwardly phrased questions to be restated in a manner that supports better dialog.
Have audience members line up to approach the front to ask questions
This is necessary for them to be heard by the moderator and legislator, since they will not be issued microphones. It also allows the moderator to more clearly call on people to come forward and speak.
At our event there was a pseudo line which formed as people moved forward to reach the front where they might be called on. This provided a cooling off period where people are required to behave in a civilized manner before speaking. Make sure that latecomers to the event are able to join the line as well as people that camp it before hand.
Using a line does not mean that the next person to speak is predetermined. At our event the line was a few people wide, and the moderator retained the right select the next speaker. This helps him/her try to balance the questions based on impressions of which side people may support, and to avoid calling on obviously disruptive people.
(I was able to move through the crowd, line up and eventually ask a question, even though by the time I arrived the event was just starting with over 2000 people present.)
Have sufficient room at the front for the selected speaker to step forward away from the line and speak.
Having the person separate themselves from the line makes it more clear who is to speak. It also reduces any potential intimidation from other people in line.
At our event a little girl was able to step up and ask a question without feeling intimidated.
Use a panel format
This allows the moderator to select appropriate experts to speak, and perhaps more importantly will avoid having the legislator get trapped in a cycle of having to continuously defend him/her self. The legislator remains free to speak up as desired though. It also supports the impression that the legislator is not the only person supporting reform.
Do not feel that the panel needs to be overly balanced so as to include people that do not support healthcare reform. The goal should be to support discussion of what type of reform, rather than having panelists attack the very concept.
Panelists should be warned though that due to the contentious nature of the anti-reformers, there may be limited opportunities to have a real debate, and much of the time may be spent simply defending the concept of healthcare reform.
Give the panelists a few minutes each at the beginning to state their positions once they are introduced.
At our event, the panelists were…

· Dr. Benjamin Chu, President, Southern California Region, Kaiser

· Dr. Richard Brown, Director, UCLA Center for Health Policy Research

· Jerry Flanagan, Health Care Advocate, Consumer Watchdog

· Leeba Lessin, President, CareMore Health Plan

Have a visible, but not overbearing, police presence for crowd control, especially near the front.
The Alhambra Police Department is to be commended for very successful crowd control which helped to protect the panelists and audience, as well as the spirit of the event itself. Their firm, but restrained guidance should be seen as a model of police support for civilized debate in a democracy. They were visible, but not at all overbearing. This helped lead to an almost carnival atmosphere where people were confident of their safety, without feeling intimidated by the government.
The 3-4 police between the audience and the podium helped ensure that the “line” of people moving forward to ask questions remained civilized. At one point they were required to step in and handle a minor disruption, but this in no way detracted from the event as it was handled firmly, but with restraint. Once I asked my question, an officer politely, but firmly asked me to step back if I was done with my question. I happily thanked him for his efforts and rejoined the crowd.
Perhaps most importantly, keep a sense of humor, and don’t allow yourself to be intimidated
Congressman Schiff was very good at this, including occasionally joking in a friendly manner with the crowd about their “passionate debate”. He began the event by specifically asking everyone to act in a positive manner, which also helped. He also clearly stated that he was not going to be able to please everyone, while making visible attempts address anti-reform questions. A very impressive balancing act during a challenging event in my opinion.

Potential improvements:
A few minor points might be improved upon…

When asking how many people in the audience are for or against healthcare reform, know that the second side asked will typically be louder than the first.
This is because they have time to prepare themselves, and have the ability to gauge how load they are willing to shout to surpass the first asked side. If you want to even out the chance for the more polite pro-reform side to present their numbers, I recommend that you ask first how many oppose healthcare reform, and then how many support it. At our event, the Congressman’s final question of how many people were undecided produced a predictable, but humorous response of only a handful of people.
Have the front area specifically reserved for people in line to ask questions,
Allowing people to remain in the front area allows more aggressive anti-reformers to crowd the more valuable positions towards the front where they can more effectively disrupt and intimidate.
At our event the crowd was allowed to be a little too close to the podium, which allowed a small mob of anti-reform shouters to have more than their fair share of influence.
Have police expel people that obviously attempt to disrupt the event
As mentioned above, at least one person as able to stand near the front and shout at the top of his lungs non-stop for about half the event.
Obviously the desire to address this has to be balanced with any potential for actual or perceived police intimidation. As stated, at our event, the open air venue and excellent sound system used by the podium speakers eventually caused this person to quit yelling, so perhaps this is not always necessary.
Try not to call on any one panelist too frequently
Mixing it up keeps all panelists involved and reduces the impression that any “pet-panelist” is being given too much attention.
Set the crowd’s expectations by clearly stating that there will be a period of at least ½ hour for the legislator and panelists to introduce themselves and give their positions before questions will be taken from the audience.
This will help control the anti-reformers’ desire to go straight to questions so that they can dominate the event. (It obviously won’t reduce their desire for this, but it will make their chants for questions to begin sound more rude, which will encourage the rest of the audience to discourage them.)
Possibly use a lottery to decide who is initially allowed to be up front for questions.
Assuming that the lottery is held immediately before the event, instead of well in advance, this would keep people from being able to camp the front.
The challenge here would be to come up with a method that would allow this to be done quickly and fairly, so it doesn’t become a distraction.

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Disappointed in President Obama's Organizing for America Health Care Forum

By Michael from Santa Monica, CA - Aug 20th, 2009 at 5:37 pm EDT

Also listed in: 10 groups

Billed as a strategy session and “an incredible opportunity to huddle with the President and discuss how we're going to pass real health insurance reform this year”, what we got was preaching to the choir by our Professor in Chief, rather than a discussion of strategies to actually move this forward.

I was ESPECIALLY disappointed to hear the President refer to the select panel as a legitimate negotiating method, and to hear him praise the Republicans on it, including Senator Grassley who has promoted the lies about death panels, as acting in good faith.

Surely Obama can’t be this naïve!!

First of all, how can that panel be legitimate when half of the members are Republican in the first place. This is not the proportion that was elected. Voluntarily giving them equal weight has only prevented any real reform from moving forward. A perfect example of this is how the single payer option was never considered, because these Republicans would never go along with it. This freed them to target any public option as socialized medicine, which it now sounds like we are moving away from as we try to compromise with them.

The American public elected a Democratic majority to get the job done. In giving away our majority to do so, I can only assume that enough Democrats have been bought out by special interests so that no intent to actually deliver effective healthcare reform has ever been intended. Instead apparently we only wanted to sound like we are trying to accomplish it, while at the same time stacking the deck against ourselves.

Secondly, the actions and comments from these three Republicans have shown that they have no interest in passing anything. Grassley himself, after warning people to be afraid for grandma, recently said that he would never support a bill that a majority of Republicans would vote for. Given the underhanded tactics that they and their pundits use, it should be obvious that they have NO interest in a dialog in good faith, and are only negotiating as a means to drag out the process with a series of endless compromises, while they foster an environment of hatred and intolerance for reform.

Wake up Mr. President!!!

Quit letting the Republicans and Blue Dogs play you for a fool.

It’s time to show less compassion and understanding and instead more backbone and righteous indignation.

Call out the liars as despicable and unpatriotic.

Quit trying to convince the Blue Dogs to support reform by watering it down, and instead make it politically impossible for them to act against it.

Stop portraying the anger in America as legitimate debate and instead demonstrate how it is manufactured astro-turf.

If you don’t feel like you can do this and be a nice guy, assign a senior hard-ass to do it for you. The movement desperately needs someone to lead the counter charge.

It also needs more clear organization...

Your discussion today only vaguely stressed the need for people to talk to their friends and neighbors, and offered a couple of talking points in response to a couple of questions.
Lame! We need someone who is actively providing clear instructions on what and how to help.

At a minimum, there should be a 3-5 point bullet list of talking points that everyone is pushing. Shorter, sound bite length talking points, which you can then lecture on to your heart’s content.There needs to be clear instruction on who to contact to help.We need to take the tactics of our opponents, refine them so they are morally acceptable, and then deploy them in a clear fashion.This movement needs a General to guide it.

Now unfortunately, I missed the beginning of the Forum due to internet issues, so maybe the initial speakers provided this leadership and guidance.
If so, I’ll be very, very happy to see more information coming from them in the future.

So far though, this effort seems like a weak, half-hearted attempt to capitalize on the exact same volunteer structure used during the election, without realizing that it needs more focus and clarity to work for an issue-specific movement. And for God’s sake, don’t think that we will win in the end based on the pattern of the election! A lot of the reason that we won convincingly is that the Republicans imploded towards the end of the election.We can’t count on that now, especially given that there are such powerful special interests whose profits are directly threatened by the reform movement.

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SOLUTION: AFFORDING BASIC HEALTHCARE FOR ALL

By Jennika - Aug 12th, 2009 at 12:12 pm EDT

Also listed in: 8 groups

Under a basic universal healthcare system (or public option), all Americans would be entitled to receive preventative and necessary healthcare by creating a program whereby recent graduates from all medical fields would be encouraged or required to serve 2 + years as "universal plan" providers (or "public option providers"). In other words, individuals choosing to enroll in a basic, public option plan would receive care primarily from younger, less experienced healthcare providers. Within these participating clinics/hospitals, there would be senior clinical supervisors overseeing and consulting with their younger associates. A monthly premium and/or copays could be determined as a percentage of annual income, with a cap.

KEEP SUPPLEMENTAL INSURANCE IN THE PRIVATE SECTOR
Those individuals who wished to receive more specialized and expanded care could purchase supplemental plans that would be privatized and outside of the government subsidized public option, just as we do today with employer or individual financed private insurance plans.This option is integral to ensuring that those who want their medical care to be more aggressive and intervention-based get that assurance.

For example, under the Universal Care plan (the public option), end of life care/prevention would have limitations so that elderlies' lives are not extended indefinately with various forms of life support. Many of us do not wish to have our lives extended in this artifical and costly way. However, for those who want a more aggressive approach to end of life care/extension, a supplemental policy could be purchased that would guarantee such care.

Healthcare providers who opted into the universal system would be rewarded by student loan forgiveness programs and subject to contracted wages/salaries negotiated between healthcare providers and states/federal government. One way of making this more affordable to the government would be to have the government provide government-backed malpractice insurance that would have stricter caps on what and how much patients could sue for.

Admittedly, this proposal does set up a two-tiered system, whereby public option recipients receive care from younger, less experienced practitioners. To me, this is the unavoidable way to provide lower cost healthcare to all, and it is superior to the current system where many go uninsured and without any healthcare whatsoever.

Non-Profit Healthcare Co-ops
This idea is quite intriguing to many healthcare providers in Boulder County. I am interested in legislation that includes such clinics as an option to compete with private insurance plans, as long as the rules and fees for setting them up are not overly restrictive. These types of co-ops would require government assistance to help set-up in order for them to become a viable alternative to traditional employer-based healthcare. In my opinion, both the Public Option and Non-profit Co-ops should be included in healthcare reform legislation. It appears that Republicans are proposing this option in lieu of the Public Option because they know it will be much more difficult to establish on a large scale, in a way that would really compete with for-profit insurance companies in the same way that the Public Option would. That being said, if these co-ops are to be included in reform legislation, please ensure that these co-ops are designed to compete and succeed in the new system.

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THE HEALTHCARE DEBATE: FOCUS ON PREVENTION

By Jennika - Aug 12th, 2009 at 12:10 pm EDT

Also listed in: 8 groups

Along with valuable screenings, check-ups, and other disease-detecting methods, an emphasis on nutrition, exercise, and natural-based, noninvasive therapies are needed as part of a "first resort" emphasis (i.e. acupuncture, myofascial release techniques, chiropractic, and various rehabilitative exercise therapies). If these therapies were covered benefits, they would no longer be the exclusive domain of the wealthy and privileged. And, if there were more interface between allopathic medical providers and "alternative medicine" practitioners, physicians, nurses, and other medical specialists would gain the ability to recognize when it would be valuable and appropriate to refer patients to these "first resort" treatment options.

This would be most efficiently implemented by establishing integrative clinical settings, where patients could travel to the same facility for all their healthcare needs, and where providers worked as a team to provide customized treatment plans for each patient.

We can and must find a solution to the healthcare crisis our people are facing. We must also acknowledge that under a single-payer universal system, it will be impossible and unaffordable to provide the most advanced, cutting edge diagnostics and treatments for everyone. The solutions offered in this proposal are pragmatic and attainable, though it requires us to shift our thinking about what constitutes preventative and basic healthcare.

Thank you for considering my proposal. Although I am primarily a healthcare provider, I am also and active citizen, especially when it comes to healthcare reform. I am interested in serving as a citizen advisor on healthcare policy. Please utilize me in any way you see fit. I will continue to seek pragmatic solutions to our nation's challenges.

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THE HEALTHCARE DEBATE:TYPE OF CARE NEEDS CONSIDERATION

By Jennika - Aug 12th, 2009 at 12:09 pm EDT

Also listed in: 8 groups

As an acupuncturist who has had the privilege of working in a community that is relatively integrative, my concern about the state of our healthcare crisis is somewhat unique. Healthcare is a basic human right, and all citizens should have access to healthcare, regardless of their ability to pay full market price. I believe that basic human needs such as water, energy, and healthcare should not be subject to profit-making or the unregulated domain of "Free Market Capitalism". I also believe that people who take responsibility for maintaining and enhancing their health should be given incentives, such as reduced premiums / copays or even better, including these healthy habits as a covered medical insurance benefit that is available to everyone.

NATURAL MEDICINE as FIRST RESORT

I work in a field (acupuncture and Chinese Herbal Medicine) that has become most people's "last resort", when I believe our work is better suited as a "first resort": If we, as healthcare providers, must first pledge to do no harm, should we not proceed by offering the least invasive treatments first, before turning to the more risky options of surgery and drugs laden with potential side effects? If natural-based medicine and exercise therapies were covered insurance benefits, we would be able to reach many more people before they become so ill that they have no other options besides surgery and life-long drug therapies. Let me also clarify that in some cases, surgery and life-saving drugs are a godsend, and the most appropriate treatment for the patient. My patients are sometimes shocked to hear me say "I think you should go for the hip replacement", but I am committed to helping them choose medical solutions that work, and you can't "cure" bone-on-bone hip degeneration with needles and herbs. Some of the most enthusiastic proponents of hip replacements and other surgical procedures are themselves acupuncturists and providers of natural-based medicine.

In sum, I believe that the type of care covered by insurance is as important as the issue of universal coverage. I urge my fellow healthcare professionals and legislative advocates to adopt this issue alongside the very noble and worthy goal of universal healthcare.

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As Obama Continues Push for Healthcare Reform, House Committee Approves Kucinich-Sponsored Measure to Keep Single-Payer Option Alive

By Jason M. Christos - Jul 23rd, 2009 at 3:24 pm EDT

As Obama Continues Push for Healthcare Reform, House Committee Approves Kucinich-Sponsored Measure to Keep Single-Payer Option Alive Kucinich-web

On Capitol Hill, Democratic leaders say they’re open to paring down a healthcare reform bill in order to sway “conservative” Democrats who’ve threatened to oppose the measure that would create a government-run public insurance option. We speak with progressive Democrat, Rep. Dennis Kucinich (D-Ohio). A House committee recently approved his amendment that would allow individual states to adopt a single-payer system. [includes rush transcript]... http://www.democracynow.org/2009/7/21/as_obama_continues_push_for_healthcare

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Health Care

By John_Q_NY - Jun 28th, 2009 at 1:38 pm EDT

Health Care service day Sat. June 27 ,.... Locally, good productive activites to raise community awareness and identify potetial volunteers. Now what's next ?

What would be effective community activities to build momemtum for reform? Since thie isn't an election, phone calls to voters doesn't seem a productive use of time.

How can support be put to use without getting mired in legislative details that will remain a moving target as the process proceeds?

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C-SPAN page focused on health policy

By No longer active - Jun 21st, 2009 at 1:30 pm EDT

Also listed in: Citizens Concerned about Healthcare | SiCKO (Universal Health Care - HR 676)

C-SPAN now has a web site page focused on health policy. It has some great information resources for those interested in healthcare reform: http://www.c-span.org/Topics/Health-Care.aspx

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Action for Health Care Reform Service Day

By Susanne B - Jun 17th, 2009 at 10:46 pm EDT

Also listed in: 4 groups

I'm interested in forming a group at the Beaches that will take action on June 27th. There are events all around Florida and the country. I'd like to see us have a forum to discuss health care reform right here in our community. We could get speakers from the health care professionals we all ready know...our doctors, physical therapist, pharmacist, dentists, alternative health care professionals, ER nurses, etc.
It would take some planning but it should be fairly simple if we can use our local library or if there is another public venue.
It's time for us to act now! We need Congress to know that all of us are fed up with costly insurance and poor health care.
Please talk to your friends and lets do something now!

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the ongoing debate

By Maria B. - Jun 11th, 2009 at 8:47 am EDT

Also listed in: Middletown CT for Obama

"Health care system" in this country is an oxymoron. We must begin to call it what it is: a "medical-insurance syndicate." Too harsh? Try listening to the millions of horror stories about death and financial ruin. We have to directly confront the AMA and Congress with the truth, and force them to stop using euphemisms. It's a profit making syndicate built on the suffering of people without (and with) medical insurance. For years, American auto manufacturers were able to delay including seat-belts with a simple tactic: "whoever owns the name, owns the game." They used "accidents" in their lobbying; implying inevitability. It worked for years. We must change the name of this issue.

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Health Care Discussion

By Fernando from San Antonio, TX - May 23rd, 2009 at 12:21 pm EDT

The Mexican American and Hispanic Physician Association (MAHPA) will be hosting a discussion on health care at Alamo Heart Associates on June 6th from 9 am to 11 am. Please consider coming to interact with other health care providers and community leaders and hear their thoughts on the current health care debate.

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Health care

By Lorne Runge - May 15th, 2009 at 6:23 am EDT

I hope our new health plan emphasizes proven affordable treatment so that no one is denied effective medication or procedure. Once a condition is determined to be beyond affordable effective treatment and the person is still symptomatic then clinical research protocols should be encouraged to manage the situation and/or palliative treatment made available. We need to make hard choices as otherwise we will bankrupt ourselves attempting the impossible.

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DR. RUDY'S UNIVERSAL HEALTH CARE THAT PAYS FOR ITSELF

By Dr. Rudy - May 13th, 2009 at 9:29 am EDT

The Saber Tooth Tiger!

The reality and stress of health coverage for everyone is running straight at us. What should we as citizens do, if we wish to participate? What is Possible? What is Realistically achievable?

Medicare For All

I have never had a medicare Patient give me a serious complaint about it in 40 years. Numerous other doctors told me the same thing. It is an existing system that works.

Advantage

Everyone would be covered with insurance. "Biggest ADVANTAGE " employers can compete better in US and World market with no cost of health insurance on their backs. Choice of doctors and hospitals.

Advantage

Veterans should be covered-they could use local hospitals or any Dr. or hospital of their choice in the country-they deserve it. Less overhead than insurance company-6% versus 20%- huge savings. Most Medicare patients are satisfied customers.

Advantage

Once everyone is covered with Medicare, basic heath-care reform could be carried out. Orientation to wellness-holistic medicine, the achievement will be huge health-care dollars savings. Procedure orientation of medicine could change under this program, giving some amount of control.

Disadvantage

Does not pay health-care providers very well-that can be improved. Cost relatively unknown-estimates usually wrong. Increase government control of health care-although it's already the 800lb gorilla.

How To Pay For It?

A mini health surcharge-"MHS"- It's not a Tax. " The Hook"-you now have a health care card-you are covered. Applying the MHS on all unhealthy food.

Advantage

Would raise trillions of dollars-the MHS could be on hundred of bad foods. Precedent-Alcohol and Cigarettes. People who eat the right food-choice-no MHS. Illegal immigrants would pay the MHS-Now get free treatment. Uninsured would pay the MHS when eating the wrong food-that cause most of the diseases.

Advantage

Everyone would have health Insurance. This would lead to healthier lifestyle. Less sickness and diseases.

Western Illnesses

We lead the world in heart attacks, we lead the world in strokes, we lead the world in diabetes, we lead the world in cancer, we lead the world in metabolic syndrome, we lead the world in hypertension, we lead the world in obesity and we lead the world in children obesity.

Health Implications

Changes in diet began with the introduction of agriculture and animals. Diseases of civilization have emerged. Food processing-stripping nutrients from the food and fattening animals. Who eat the animals that are fat we do. Seven crucial nutritional characteristic of ancestral human diet that changed. Glycemic Load-sugar content of food changed tremendously-increasing glycemic load. Fiber content decreased-lack of complex carbohydrates leading to obesity. The nutritional qualities of recently introduced foods underlies many of the chronic diseases of Western Civilization-tremendous cost and health money. Fatty Acid composition of-US diet now 40% Fat-Asian diet 10% at one time. Micronutrient composition-fat, protein,carbohydrates-tremendous changes.

Macronutrient density-less raw vegetables, Beans and fruits. Acid base balance has changed-animals protein content is up-strain on the liver and kidneys. Sodium-potassium ration has changed- tremendous increase in sodium consumption from manufactured foods.

Chronic disease incidence

64 million Americans have cardiovascular disease, 50 million Americans are hypertensive, 20 million have diabetes, 37 million maintain high risk total cholesterol concentration over 240, 40 million have metabolic syndrome, 40 million has osteropenia-leading to osteoporosis and fractures.

Sample list of unhealthy food

Trans fats-hydrogenated oils, sugar,salt,manufactured foods-cereals and grains-high in sugar, meats-most beef is 80% fat, fish-40% to 50% fat, cheese-80% fat, polyunsaturated fats, plant oils-100% fat including olive oil. Lots of fast food-not fall. Huge list of invented and manufactured food.

I DO NOT AGREE!

Probably hundreds of foods with poor nutritional value could received the MHS-Mini health surcharge, trillions could be raised to pay for health care for everyone. Contrary to popular thought, healthy food in general is not more expensive than unhealthy food. I studied it, I do not agree that healthy food is more expensive.

I am Devon L Wilson Writing for Dr. Rudy Kachmann MD.

http://www.kachmannmindbody.com

http://drrudy.myblogsite.com/

https://twitter.com/DrRudy1

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Countering Misinformation about Health Care Reform

By Kate from Coupeville, WA - Mar 14th, 2009 at 2:28 pm EDT

Also listed in: Coupeville For Barack Obama

Private insurers and health care corporations are spending truckloads of cash to slow down health care reform -- by any means possible. The distribution of fake news analysis and misinformation is the wedge of a large, coordinated campaign to defeat health care reform at any cost (I'll be going over medical bills with a fine-tooth comb for a long time to come!). Read More »

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COBRA is Not a Viable Option!

By Elyssa Durant - Feb 11th, 2009 at 4:54 pm EST

Also listed in: Nashvillians for Obama

Please be sure to get the word out quickly while we still have a voice in how the money will be spent as they put finishing touches on the economic recovery package. We need to stay informed and in contact while congress decides how and where the money will be spent.

COBRA is not a viable option for most people losing coverage. We need a alternative transitional plan to help those who are at risk of losing coverage in the midst of chaos resulting from the economic crisis.

In our efforts to provide an expedient response to an urgent and growing problem, let’s not be too hasty by falling back on those systems already in place that have been not worked for us in the past.

We need a BIG fix to a broken system, and the economic recovery stimulus will not be enough. Consider the options carefully… http://healthcareforamericanow.org

Elyssa Durant
Nashville, Tennessee

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Another Health Care Conversation: 12/30/08

By olddockeller - Jan 24th, 2009 at 11:45 am EST

SUMMARY OF HEALTH CARE DISCUSSION
December 30th, 2008
Westborough, MA

All participants (listed omitted) agreed on an ultimate goal of achieving universal high quality health care at a cost commensurate with the health value provided to the individual and to society.

Two key challenges were identified: Excessive costs inherent to the current system and uneven access to health care. Universal health care will remain unfeasible unless costs are contained, and unless access both to insurance and health care provision are improved.

The Obama administration has a tremendous opportunity to demonstrate its commitment to solving the difficult problem of health care reform by agreeing to an ethical value-driven construct. We suggest announcing in the Inaugural Address a commitment to universal health care for children 0-18 years of age by the year 2010. Moreover, as a non-earmarked economic stimulus, it should immediately provide the NIH with the funds to support the research proposals that already exist and have been deemed meritorious through peer review.

The main problems identified and discussed were that of COST and ACCESS.

A. PROBLEM OF COST: On the issue of cost the key question identified was, what drives increasing medical costs? Two factors were identified:
1. Medical care is reimbursed for procedures done and tests conducted, not for health outcomes achieved. This leads to a technology supply-driven demand with no accountability for value.
2. Medical care is being increasingly provided for diseases that arise from societal behaviors that can and should be prevented.
Recommendations on cost control:
1. Medical care reimbursement should be commensurate with health value achieved, rather than with procedures or tests conducted. However, there are no appropriate metrics for health value. For example, we don’t know how to measure health outcome as a function of disease severity. Thus, the NIH must support research into, and disseminate information about:
a) The definition of value in health care (e.g. how does the physician’s time spent with a patient translate into improved health outcome, versus the prescription of yet another new drug or the request for yet another test? How is health improvement quantified? What makes sense to patients and their families as a positive outcome in a chronic or terminal disease?)
b) The design and integration of coordinated systems of care. Health care is provided by a team of providers not physicians alone. The concept that all health care is provided by or managed by physicians alone is part of the problem. The most effective healthcare is provided by teams of healthcare professionals. In community health centers in rural or inner city areas effective health management teams may not always need to include a physician. The future of healthcare is going to need a broader vision of the healthcare team and a significant amount of workforce development at all levels to create the providers who are most successful in these settings. The federal government should provide direct support for the development and analysis of systems that encourage collaborative multidisciplinary approaches to chronic disease reimbursed as disease management bundles
c) Understanding the relationship between cost and quality of care.
2. The federal government should aggressively intervene to promote lifestyle changes to prevent lifestyle-linked diseases. These include smoking-related diseases, obesity-relate diseases and AIDS. The federal government should immediately:
a) Require all food packages to prominently display calorie count per serving.
b) Provide tax incentives to all restaurants and fast food establishments that prominently display calorie counts per serving.
c) Require all buildings receiving federal funds to prominently display the location of stairwells, and encourage their use.
d) Provide tax incentives for health-promoting workplace designs (e.g. mini treadmills, pacers, etc)
e) Require and fund a minimum number of hours dedicated to physical education and sports in public schools. Exercise is linked to improved scholastic outcome, thus this promotes academic and physical well-being.
f) Implement a counter-marketing strategy against unhealthy food consumption pressures (e.g. “super-sizing”).
g) Ban the incorporation of high fructose corn syrup into products
h) Enact a uniformly high federal tax on cigarettes.
i) Enact routine testing for HIV.
j) Require the public school system to incorporate into the science curriculum the scientific basis of diseases such as diabetes, cancer and AIDS, and their links to lifestyle choices.

2) PROBLEM OF ACCESS
On the issue of access, there was agreement on the notion that uneven access leads to health care disparity. Both access to health insurance, as well as access to health services need to be enhanced. Several key issues hampering access to health services were identified:
1. Access to services is hampered by economic, racial and linguistic barriers.
2. Access to services is hampered by a current reimbursement system that does not encourage the development of relationships between primary care physicians and patients.
Recommendations on Access:
1. Support the integration of the public school system into the solution to healthcare. Teachers are often the first to identify health problems in children of diverse backgrounds, but mechanisms should be developed to help teachers direct children and their families into the health care system.
2. Support the creation of community health centers that incorporate into their creation input from patients as well as teams of care providers in the community. This patient-centered approach can help overcome barriers to care.
3. Implement a marketing and public information strategy to enhance recruitment of students into primary care health care team professions.

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Our Health Care Tea Party: 12/28/08

By olddockeller - Jan 24th, 2009 at 11:34 am EST

12 citizens in a room, talking health care: how does that influence the flow of change? Our group was certainly not representative of America. For one thing, we were mostly all invested in the development of a single payer system, and acutely aware of the economic forces that are working against the change that we all need. For another, we all thought that there were major systemic reforms that need to be put in place to complement the change in the way in which we think about health care. A few great quotes:

"The Obama folks haven’t thought this through- a soft sell for a needed revolution. This stuff is pap for the common people."

"Why aren't employers out in front of this stuff? This is costing them so much..."

"We need to build systems which actually provide health care, rather than focusing on who should get insurance."

""Health care for profit" is just doesn't work"

"We need to get away from talking about health insurance and talk instead about health care."

"We shouldn’t be apologetic to spend more money to help people do better."

Like Paul Krugman, our group seemed to feel that the real danger in this current move to reform is that the action will not be bold enough. I'll try to get more notes up soon, but the commentary is too fast and too passionate. We really need this change. (The Obama folks suggested a 6o minute discussion, and we are at 90 minutes with no sign of stopping.)

So, here's my first draft of the report back to the Obama folks. Not live, but close to it:

Health Care Community Discussion
Group Submission
28 December 2008, 3 PM
Home of David Keller and Julie MeyersPawtucket RI 02860
General Questions:
How many people attended your health care community discussion? Thirteen. We had a mixture of physicians (3 pediatricians, an internist and a family practitioner), a nurse, a speech pathologist, an attorney, an architect, 2 small businesspeople (one profit and one non-profit), a poet, a legal services attorney and a teacher.
Please summarize compelling personal stories from attendees about the need for health care reform in our country and provide their contact information.
Central point of the stories was that the current healthcare system is too complex, and that we need to develop a system that is built around the needs of the patient and family.
PA: Spoke of an elderly couple who could not coordinate their care
because of the separate systems of care for veterans and non-veterans.
CM: Spoke of the need for coverage for the immigrants seen at the hospital where he volunteers.
SD: Spoke of her struggle to get coverage for testing ordered by her physician and not covered when her health insurance was changed by her employer.
JM: Spoke of the needless complexity of the system, which would be poorly comprehended by anyone without a medical degree.
Summary of Responses from Discussion Questions:
What does the group perceive as the biggest problem in the health system?
1) Value received for money spent: “The biggest problem is the amount of money that we spend on health care. As an employer, each year we got a shocking increase in the cost of health care. Nothing can be done until the cost per person is reduced.”
2) Cost of pharmaceuticals: This was seen by many are a major area that needs to be addressed. Pharma is really influencing decisions of physicians in order to maximize profits. All of the physicians in the room can recall talks designed to promote the idea that a disease was prevalent, needed to be treated and required urgent treatment. Direct to consumer advertising puts doctors on the spot by asking people to “Ask your doctor about this or that?” Most of the new drugs that are developed are “Me too” drugs, that are not as needed in many circumstances. Detailing gets doctors to forget about generic drugs. Federal regulations need to: Ban direct marketing to consumers. Include efficacy in the FDA approval and test drugs against existing ones. Create a registry of all clinical trials through the FDA. Make it illegal to “datamine” physician prescribing habits.
3) Lack of systems thinking: The solo practitioner does not allow for adequate monitoring of patient safety or use of evidence based approaches; we need to encourage the creation of systems that are family friendly, the work effectively, and that use a primary care model to focus families on appropriate levels of services and help them coordinate care. In retrospective, this seems to be the “medical home concept” long championed by the AAP and recently endorsed by the AAFP and SGIM. In addition, we need to find a “no fault” way of dealing with medical mistakes besides the malpractice system as currently structured. Currently 25% of our healthcare budget is administrative, which is terribly wasteful.
4) Inter- and intra-systems communication: Compatible electronic medical records are part of the solution, but also need to be incentives for the various parts of the system to talk with each other. Within systems, various parts (doctors, nurses, allied health folks) need to talk to each other. Lack of communication between doctors and hospitals and PTs and schools is even more complicated because of the privacy laws. The difficulties that families have are extraordinary, especially for those with special needs. This business of dumping it all onto the school and the parents is unconscionable. How to help the underserved? The system is just too complicated; if you are not a medical person, it is really hard to navigate the system.
5) Access to care remains a problem for many people: Medicaid (Rite-Care) frequently cuts people off for no apparent reason and many poor folks don’t have the energy or resources to fight back. In Rim, poor people have rouble getting specialty care; some hospitals set up obstacles for care. Care for poor people is just not adequate, and they can’t fight their way through the system, because of a lot of little obstacles. In Rhode Island, access to health services is also in danger for low income residents by the pending Medicaid waiver, which we think should not be permitted to go through.
6) Training and workforce issues: Medical education system needs a lot of fixing: Primary care is denigrated as a field, especially family medicine and the provision of mental health services. How can we make the curriculum match the needs of the community? Mental health and primary care are the most important parts of the system, and yet get the least attention in the curriculum.
How do attendees choose a doctor or hospital? Where do attendees get information in making that decision? How should public policy promote quality health care providers? One participant choose her doctor through her health plan (Fallon) and was very happy with that choice. Others used word of mouth. Concern was raised regarding the “lone wolf” solo practitiotioner- efforts should be made within the Federal government to encourage doctors to practice according to guidelines and in concordance with “best practice”. Government should play a larger role in workforce management- coordinate decisions with medical schools, including loan forgiveness, incentives to go into the areas of medicine that we need such as psychiatry and primary care. Currently, the salary structure drives the market in the wrong direction. If there are no guidelines, then the public is vulnerable. Information systems that hype “lack of lawsuit” as a criterion for quality are not useful. In RI, primary care doctors get paid even less than in other states, driving down supply. There just aren’t any Primary Care doctors in RI. Medicaid waiver will drive us further down the tube.
Have attendees or their family members experienced difficulty paying medical bills? How can policy makers address this problem? One member of the group is currently fighting with a health plan over covered labwork- it was approved by her original healthplan, but when she changed plans in mid-treatment, suddenly it was not covered.
In addition to employer-based coverage, would the group like the option to purchase a private plan through an insurance-exchange or a public plan like Medicare? Employer purchased insurance is a major source of the problem. Employers in Canada and Denmark don’t have these sorts of problems. Doctors are pushed around by the industry. We can’t just shut it down, but we need to work out a way to make it change and to get employers out of the health care market. People in the room really wanted a single payer system, most thought that we needed to get their incrementally..
Did attendees know how much they or their employer pays for health insurance? What should employer’s role be in a reformed health care system? Single payer is the only way to get a handle on the cost of medical care. The beauty of the European doctors and dentists are that they have a guaranteed income, and are not driven to crazy practice styles by the economic demands of the practice. We should have done it 70 years ago. Doesn’t think that employer has no role in paying for health care. Most people don’t know how much is actually costs. People don’t look at they paychecks.
Were attendees familiar with the types of preventive services Americans should receive? Had attendees gotten the recommended prevention? If not, how can public policy help? HMO gets her a primary care doctor. EMR helps them to track the needs for screening and preventive care. There were many other comments in support of protable, usable electronic medical records.
How can public policy promote healthier lifestyles?
Some of this will take a culture change: we will need a massive campaign promoting “slow medicine” in the same way that we are promoting “slow food”. We need to focus on preventive things that are outside of the hospital. In Europe, they are much more aggressive about restricting exposure t

General Comments:
Some folks were concerned by the lack of detail in the Obama health plan: “Did I misread this, or is there not a lot of information about children with disabilities?”
“I am not sure that this is a major priority for the administration.”
We directed people to read the website for more information (www.change.gov)
Others were concerned that the change was not bold enough: “Why are employers not clamoring to change this?”. “The Obama folks haven’t thought this through- a soft sell for a needed revolution. This stuff is pap for the common people.”
Other countries have done this better: “We should look at Taiwan- how do they cover everyone in a for profit model?” This requires that we look at ourselves and at society in a different way. “It needs to be part of a societal campaign.” We cannot forget the poor among us “ How can we care for ourselves if we don’t care for the immigrants, legal and otherwise, in our midst?
All wanted the Health Care Transition/Reform Team to know that they need to involve us in the change, and that they need to include incentives for us to change. This has to be a win-win for all of us.
Final thoughts: “We shouldn’t be apologetic to spend more money to help people do better.” In regards hospital care, the nurse-patient ratio is a problem. At least part of the nursing shortage is caused by working conditions: people don’t want to work in the hospitals because of the quality of the workforce.” Finally, don’t forget quality: Many of the folks in solo practice have marginal qualifications and would benefit from the support of a group.
----------------

That captures a lot of it. I actually audiotaped the session and will try to get it transcribed. DOne- it is in the extended part

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Call for Referendum On Universal Single Payer Health Care

By PDSimic - Dec 29th, 2008 at 1:39 am EST

Please help build momentum for Single Payer Health Care system by following the link below and voting:
http://www.change.org/ideas/view/call_for_referendum_on_universal_single_payer_health_care

Universal Single Payer Health Care system is an idea whose time is come. Yet, there are powerful special interests to overcome; they are already at work behind the scene, distorting the idea and diluting the enthusiasm for it among the lawmakers. We can't let this happen, not this time. We need a powerful political tool in our hands, a definitive signal to Washington that this time people will be heard, that this time people will not be deceived, that this time people will take their destiny and the destiny of this country in their hands and will demand nothing less then the Universal Single Payer Health Care system.

So the idea is to press our representatives and the Obama administration for a national referendum for or against the Universal Single Payer Health Care system. If we win, and win we will, for the first time in history there will be an explicit democratic mandate to our president and our lawmakers that will empower them enormously in their fight for Universal Health Care for every American.

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Change is coming! Health Care on Brighton, NYC

By Jan Berkmans - Dec 29th, 2008 at 1:04 am EST

We were privileged to participate in the first Obama-Biden event on Brighton, NY. Because of its Russian speaking population, Brighton Beach is known as "Little Russia by the Sea". The team discussed how the health care can be improved:

· We propose to make limit for HealthyNY higher so it would make scene to earn, survive in NYC and be able to get an affordable health insurance.· We propose to establish, for health-care professionals, mandatory peer control of treatment decisions concerning surgical operations or any major invasive procedures. When such decision is taken solely by the health-care provider who is about to perform this procedure, for example, a surgical operation, a chance is present that the surgeon is not disinterested regarding the actual need for an operation, or the magnitude of the operation required. Two other congruent professionals should have to “sign off” on the treatment plan involving highly invasive procedures, for the plan to be green-lighted.· Legalize payment by insurance companies for preventive medicine and lectures in Russian. · Allow and encourage physicians in the area concentrate on prevention instead of post fact treatment.

Make requirement for all press and information systems and sources to promote community outreach 10-15% of the time. Time must be in a table schedule where pick amount of the viewers can be reached. (We propose to give local and federal authorities powers to partially regulate content of local/community, as well as mainstream, media. Public service TV/radio programming, and printed materials, such as disease prevention education, community service announcements, and so on, should be made a mandatory part of content, for all broadcasters and publishers, as a condition for their licensing renewal. Public officials, health-care professionals etc. should be obliged to participate in such programming and announcements, again, as a mandatory part of their professional practice).

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Healthcare Discussion 12/21/08

By TxNerd - Dec 22nd, 2008 at 12:08 pm EST

Also listed in: cowtown for obama | Obama - Tarrant County, Texas | Veterans for Obama

From Meet 2

During the Healthcare discussion held at my home on Sunday, December 21, 2008 6 people attended. We had a very good discussion about healthcare and agreed that the new administration should:

Identify healthcare as a basic need. Healthcare should be a partnership between the government, medical community, insurance companies, education and individual participation in fitness and preventative care. We believe that the government should provide a basic form of healthcare coverage to all American citizens that would include medical, dental, vision and mental health care. This basic coverage should use the current Medicare system as a model to best meet America’s basic needs and manage cost. This basic coverage could either be provided through a non-profit or limited profit insurance provider. We believe that the current burden on companies to pay for healthcare could be reduced but should not be eliminated entirely. While many employers do not contribute to the overwhelming cost of insurance for their employees we would recommend that all employers be required to pay a tax for each employee to help pay for universal basic healthcare coverage. Individuals who are self-employed would be required to pay this tax for themselves. To offset the cost to small business and self-employed individuals a tax credit could be given based on revenue. Individuals, who are elderly, medically handicapped or under the age of 18 would need to be automatically covered regardless of employment status. Qualified veterans would seek care through a local VA medical facility. We recommend that Individuals wanting or needing additional coverage could turn to private insurers at their own expense. Private insurers would only offer coverage above and beyond that already provided under the basic plan. To maximize the efficiency of this basic coverage, citizens would need to actively participate in preventative medical care such as annual physicals, well woman visits, mammograms, colonoscopies, etc plus work to reduce their weight, stop smoking, reduce alcohol consumption and be drug free or risk having to acquire additional private insurance. Policy should also require public and private schools to provide additional education concerning preventative healthcare to students prior to graduation from high school. A national campaign would be needed to improve understanding and awareness for the general public concerning their responsibilities to ensure their own care. We also feel that it is imperative that all medical records be computerized as quickly as possible to help reduce cost and improve the speed and quality of medical care regardless of the patient's location. We would like to see government policy to encourage drug makers to either offer a generic version of a drug or pay a higher fee for filing for a new drug patent.

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