How many times have you said or thought that? Plenty, I'll bet. If you are like ACORN member Tamecka Pierce from Florida who suffers from lupus and serious gaps in her health care coverage, it's a regular thing.
If you are like the ACORN members I speak with regularly, the mother who worries about her son's asthma medicine, the partners who worry if their uninsured husbands get injured on the job, the families who face discrimination in the ambulances on the way to the hospital where a lack of insurance can take us 20 minutes farther away to a hospital that will provide care, then you know.
You are also sick and tired of being sick and tired.
What was Max Baucus thinking at his appearance at the "newsmakers" breakfast of the Kaiser Family Foundation Thursday when in the space of a few minutes he made the following two statements about healthcare reform:
"Everything's on the table. Everything. All proposals. All ideas that groups may have are on the table. And they're going to stay on the table. We are going to discuss them."
And, then two minutes later, pressed to explain why he continues to gag discussion of the option most favored by nurses, doctors, and tens of thousands of consumer activists, single payer, Baucus can say:
Truly, one of the strongest aspects of Healthy San Francisco (HSF) is its simplicity. The program allows participants to select their primary care provider from among dozens of local hospitals and clinics, both public and private. Our local system does not require lengthy HMO paperwork and there is no denial of treatment based on pre-existing medical conditions.
A recent study showed that Healthy San Francisco is dramatically less expensive than traditional insurance. And our experience in San Francisco is proving what most American's already know - it is much less expensive to keep people well than it is to treat their sickness, particularly when so much treatment for uninsured Americans is provided in costly emergency rooms.
There are currently more than 40,000 participants in HSF. We are enrolling approximately 600 new participants every week. We have already enrolled more than half of the previously uninsured San Franciscans and the vast majority will have access to health care by the end of next year.
I believe that administration and congressional leaders understand that we cannot wait for health care reform. Our health care crisis affects every aspect of our society - from making sure every child receives the health care they need to succeed in school, to decreasing the financial burden on business, both large and small, so our economy can get back on track.
I know there is pressure in Washington to wait until the economy improves before we act on health care reform. I faced many of the same pressures when I was working with allies in San Francisco to forge our universal health care delivery system.
But "waiting" in politics usually means never - and we simply cannot afford to wait any longer. The lessons we are learning in San Francisco shows that investing in health and wellness is its own kind of economic stimulus.
The time is now to tackle this problem and I applaud President Obama for promising to sign a national health care reform bill by October. We cannot wait for change - the President needs your help. Sign the petition to support President Obama's call for health care reform.
For my part, I was recently made Chair of the U.S. Conference of Mayors Task Force on Health Care Reform. Cities often have the most pressing health care needs and have had to adapt and innovate in lieu of national health care reform. I am looking forward to working with my fellow Mayor's to hear what they have learned in their cities and share what we've learned in my hometown through Healthy San Francisco.
In the end, the task force will identify urban health care priorities and advise the work of Congress and the Administration to help solve this crucial challenge we all share. As always, please feel free to give me your input and feedback in the comments section below.
With the final White House Forum on healthcare scheduled Monday, April 6 in downtown Los Angeles, advocates of single payer/guaranteed healthcare have one more opportunity to shake up what has become a dreary conventional wisdom about the presumed acceptable parameters of the debate.
Hundreds of nurses, doctors, healthcare and labor activists will rally at 9 a.m. outside the California Endowment, 1000 North Alameda St., Los Angeles.
It will mark the fifth time, at all five White House regional forums, that the single payer/Medicare for all message will come to the stage, outside and inside the forum. You can extend that to the town hall meeting at the White House last week where the President was asked why we can't have a national healthcare system like they have in other industrialized nations.
Haven't we heard this song before? It sure looks like the people who already control our healthcare system are framing the biggest issues of the present healthcare reform debate.
From the back rooms to the committee hearings to the White House summits to the front pages of the newspapers, the demands of the insurance industry are given enormous deference and accommodation.
Is it fear of Harry and Louise, the insurance campaign that some believe torpedoed the muddled Clinton health proposal? Is it the considerable influence of insurance industry contributions in the pockets of many legislators?
Hector De La Torre's bill, AB 1945, which would have forced health plans to seek approval from a third party before rescinding health insurance - a VERY common practice, unfortunately - was vetoed by Arnold today. Interestingly, Arnold was for it before he was against it as De La Torre noted:
Having the governor not engage in any discussions or negotiations for months, and then just veto the bill is astonishing," he said. "The issue was good enough to use as an applause line in his State of the State Address in January, but not to sign a good piece of legislation that would protect insured people in the individual market.
It's another sop to the HMOs, whose business model relies on preventing people from getting the health care they need. This is especially true on the individual health insurance market (the one John McCain wants you to rely on) - if you get sick, the insurance company is going to comb over your application, your policy, and your life with a fine toothed comb to find a reason to cut you off and watch you suffer.
Arnold has vetoed a lot of bills this session, but few vetoes will hurt more Californians than this one.
There are a lot of interesting things going on that should be mentioned, but that I couldn't quite generate whole posts out of - so here they are for your Friday reading pleasure.
Karen Bass will become the Speaker on May 15, meaning she will play a central role in the upcoming budget negotiations this summer. I'm guessing she won't be as frequent a guest in Arnold's smoking tent as was her predecessor.
Civil Rights groups have come out swinging against the redistricting reform plan - MALDEF, the NAACP Legal Defense Fund, the National Association of Latino Elected Officials, and the William C. Velazquez Institute held a news conference to explain their belief that redistricting reform will produce many fewer elected officials of color and weaken the voting rights of those communities. It's especially ironic that these criticisms are made against the backdrop of Fabian Núñez getting ready to hand off power to Karen Bass - redistricting reform is low enough on the state's list of priorities, and if it is going to reduce the representation of California's communities of color, it needs to not be passed.
The Department of Managed Care is going to reexamine thousands of "rescissions" of health insurance made by insurers AFTER the patients got sick. When 90 of these rescissions done by Blue Cross were sampled by the agency, all 90 were found to be flawed. While this process holds out some hope of recovery of costs and insurance by those victimized by this practice, it also simply reinforces the point that health insurers have no place in the delivery of health care in our state and in our country.
It's unconscionable that in the United States in 2008, one has to organize protests in order to save a life. But here we are. From the CNA's Guaranteed Healthcare website, where there are dozens of similar stories:
This is Nick's older brother, Ricky, and I want to ask all of you for a huge favor. Our insurance company, PacifiCare, denied Nick to go to Kansas City for a special treatment of radiation for his cancer (this could save his life). Nick has suffered with cancer for 4 years of his life and he has exhausted every avenue to get better, but nothing worked. This is our last effort and this procedure has worked before with people in Nick's situation. I think it is our duty to stand up for Nick and tell PacifiCare that what they are doing is wrong.
I am putting together a demonstration in front of the PacifiCare building at 5701 Katella Ave Cypress, CA 90630. Tuesday, March 25th, at 10:00 a.m. We are getting the media to step in and put pressure on (kcal9 and newspapers).
If we can at least get 300 people there I know they will have to say something about it. I know that my brother isn't the only one suffering because of America's poor healthcare system.
If you guys know anyone else that is suffering because of this, have him or her come out too. We need to let not only PacifiCare but America know that what they are doing is wrong and we need change.
Thank all of you so much.
Ricky Colombo
From Eve's diary at dKos:
Here are the emails I received from the California Nurses Association.
Just received a call from Ricky Columbo. His brother Nick has cancer, and the treatments thus far have been ineffective. The docs recommend cyberknife. Insurance won't pay.
He is organizing a protest outside the Pacifica Care building in Cypress, CA next Tuesday at 10. He heard CNA did this kind of thing, and would like CNA to come and support the effort. He says he has already rallied a bunch of people to come to it, thinks there is going to be a big crowd.
He has also spoken with Dave Lopez at Channel 9, who is supposedly covering it.
Here's another just received:
Just spoke to the young man, Ricky, 19. Nick, this boy with Ewing's Sarcoma (bone cancer) is only 17 - The mother works long hours preparing taxes for people and cares for the son before she leaves; the father then comes home earlier in the day to care for his son.
They have had a local TV reporter to their home to interview Nick and are hoping to get more attention to push PacifiCare.
Donna Smith
Communications Specialist
California Nurses Association
The contact information is PacifiCare at 714-828-1821 or Tyler Mason, the UnitedHealth/Pacificare spokesperson at 714-226-3530.
"I Am Not A Health Reform" appears in today's New York Times, an op-ed by two Harvard professors of medicine and members of Physicians for a National Health Program, a group of doctors working for single-payer health care. In it, they explain that the "individual mandate" approach that Speaker Núñez has now caved to is by no means a new or untested idea - that it has failed everywhere it has been tried. And it's been tried many places:
IN 1971, President Nixon sought to forestall single-payer national health insurance by proposing an alternative. He wanted to combine a mandate, which would require that employers cover their workers, with a Medicaid-like program for poor families, which all Americans would be able to join by paying sliding-scale premiums based on their income....
In 1988, Massachusetts became the first state to pass a version of Nixon's employer mandate - and it added an individual mandate for students and the self-employed....In 1988, 494,000 people were uninsured in Massachusetts. The number had increased to 657,000 by 2006.
Oregon, in 1989, combined an employer mandate with an expansion of Medicaid and the rationing of expensive care....The number of uninsured Oregonians did not budge.
They go on to describe how Minnesota, Vermont, Tennessee, and Washington all passed various forms of mandated insurance in the early 1990s, only to see the number of uninsured fail to decline and in many cases continue to rise. They then turn to Massachusetts' reform, which is failing:
As governor, Mitt Romney tweaked the Nixon formula in 2006 when he helped devise a second round of Massachusetts health care reform: employers in the state that do not offer health coverage face only paltry fines, but fines on uninsured individuals will escalate to about $2,000 in 2008....Yet even under threat of fines, only 7 percent of the 244,000 uninsured people in the state who are required to buy unsubsidized coverage had signed up by Dec. 1. Few can afford the sky-high premiums.
Why has this failed?
Each of these reform efforts promised cost savings, but none included real cost controls. As the cost of health care soared, legislators backed off from enforcing the mandates or from financing new coverage for the poor. Just last month, Massachusetts projected that its costs for subsidized coverage may run $147 million over budget.
Hmmm...no cost controls, rising costs of care, and a deficit that limits the availability of subsidized coverage. Sound familiar?
Fresh of one of the most family-oriented holidays of the year, I'm sure all of you will know exactly what I'm talking about with the following scene:
Half a dozen extended family members crowded in a small living room trying to accomplish a task nobody really knows how to do. At least twice as many proposals as people. And somehow everybody gets to thinking that if they just repeat their idea often enough, at loud enough volume, it will become the best idea. Total chaos. "Too many cooks," as they say.
Except we're not arguing about how to tell if the turkey is done, or what the best route to the movie theater is. We're arguing about how you're supposed to put an I.V. into somebody's arm.
The Employee Retiree Income Securtity Act of of 1974 means that only Hawaii can legislate employer mandates (10 steps down from Single Payer). Hawaii is unique for a whole bunch of reasons, but they have done better for decades than the rest of the states due to their excemption.
When the Fed didn't step up, Hawaii did. Now that the California has yet to step, San Francisco is trying (can't wait to see the author -- Tom Ammiano -- in the Assembly). Yet the same old ERISA complaint.
And the Consolidated Omnibus Income Security Act of 1985 pretty much means health care will suck (despite out of the best intentions) until we get real primary care.
ERISA did a lot of great things, but it should be amended. Of minimum, common sense revision would still not bring about single payer, but it would give local governments some parlay room.
This time, Moore is counting on the blogosphere to help promote his film and its "call to action" against the health care industry. Which might explain why when the movie opens in the United States over the July 4th weekend, Moore and his PR team are planning a premiere fundraiser in San Francisco benefiting -- what else -- the blogging community.
Kinda odd for Chris Lehane to release this to a newspaper, instead of...you know, the blogs. But we'll see who and what soon enough I'm sure.
Senator Leeland Yee has introduced SB 389, which attempts to take the patient out of fights between dueling medical groups and hospital associations. When a doctor from a non-contracting group ends up on your case at the hospital, the patient ends up getting stuck with a huge bill. Often times this will occur at a hospital that contracts with the insurance plan of the patient, but the patient may never know, or be given a choice, until after the service has been provided.
I haven't yet studied the law in detail, but from what I do know, it seems to be a common sense addition to insurance regulation in the state. Full press release over the flip.
Arnold Schwarzenegger's health care plan claims to be a takeoff of th Massachusetts plan. That plan requires every citizen to purchase health insurance. As I've written in the past, the individual mandate is not really a solution. It leaves the "insured" open to huge deductibles, and/or large premiums. Why can't we find good, affordable health insurance?
Why? Becuase health insurance sucks! It is a source of loss in the health care delivery system. Insurance companies are skimming ridiculous amounts of money off the top of our health care system. And Dr. Marcia Angell, a Harvard med school teacher and former editor of the New England Medical Journal, thinks there is a better system available now:
Private insurance companies offer little of value, yet skim off 15 to 25 percent of the health care dollar for profits and overhead. It would make much more sense to extend Medicare to everyone. That could be done gradually by dropping the eligibility age a decade at a time, while phasing out the insurance companies. The loss of insurance jobs would probably be more than offset by job gains in other industries no longer saddled with health costs.
Medicare is not perfect, but its problems are readily fixed. It is far more efficient than private insurance, with overhead of less than 4 percent, and since it is administered by a single public agency, controlling costs would be possible. Unlike private insurers, it cannot select whom to cover or deny care to those who need it most.(Boston Globe 1/29/07)
Governmental programs? Oh my golly golly gosh, it would send the conservatives into a tizzy. What is this? Yup, we have a single payer system for everybody over the age of 65. Why not for younger people?
I know others here disagree with my position that individual mandate is a step in the wrong direction, but, well, it's how I feel. And sure, I know there is something positive about a Republican governor addressing the health care issue. However, for me, there are just too many negative effects of the individual mandate. It takes a market based system (the regular insurance model) and tries to graft a non-market solution upon it by requiring everybody to buy in. It denies people the right to opt-out of the insurance system in the country. For all we know, it's more affordable for that person to just put aside the premiums that he/she would have been paying in a nice investment account and use that for the rainy day that will eventually come. In many ways, self-insurance would really make a lot of sense for most people, especially for those who are pretty healthy.
Of course, the people for whom self-insurance makes the most sense are the same people that the insurance companies really want. Their basic model is to make lots of money off of healthy people to pay for the sick people. Now, I really don't have a problem with that as long as everybody knows about, and agrees to, this deal. That's just the nature of insurance.
The individual mandate doesn't allow people to disagree with this bargain. They are forced into the insurance world and are denied the option of self-insuring. And, in many cases, the only insurance they can afford has outrageous premiums and/or ridiculously high deductibles. So, your healthy 25 year old who might have considered self-insuring or just considering "going naked" because they cannot afford the cost of insurance will no longer have a choice. "Going naked" really just spreads the cost of insurance to the state and to the creditors who you won't be able to pay, but that's for a different essay. If you go ask any "true" conservative (read: not a corporatist), they will tell you what the individual mandate really is: a tax on being healthy. Who gets the windfall? Insurance companies, who currently take up to 25% of every health care dollar, get rich off of the individual mandate plan. (Source: Health Affairs (Vol 24, No. 6)
In Massachusetts, which now has an individual mandate, it is becoming painfully clear that the individual mandate program is only really helping the insurance companies. Sure, you can buy a cheap insurance plan, but individuals buying their own insurance might still quickly end up $20K in the hole pretty quickly. From Progressive States:
The Massachusetts Health Care Plan, negotiated by former Governor Mitt Romney and the legislature, is proving to be expensive, just as critics warned, with the lowest cost plan costing state residents as much as $9,560 per year in out-of-pocket expenses if they suffer a serious illness. While the Mass plan has been pointed to as a model for other states, these new numbers make clear that the Romney model of individual mandates is not a reasonable approach.
{snip}
"We're talking about a plan that will take almost 1/6 of people's income in premiums alone. People could pay as much as 1/3 of their income into medical expenses. That simply is not affordable," said Thompson. "To penalize individuals who reject this expensive proposal by levying $1,000 fines borders on cruel."(Progressive States 1/22/07)
The individual mandate is a giveaway to the insurance companies. It legislates the ceding of health care discretion to for-profit industry. And as we can see from the example of Massachusetts, the insurance companies have given us no reason to trust them. Gov. Shwarzenegger, if you're looking for a model, look right past Massachusetts. There's nothing to see there.
Unbelievable! He doesn't get it. This is what the C student from Yale doesn't get:
Health Insurance DOES NOT EQUAL Health Care
His Plan make some "generous" employer provided plans taxable and allow those who have to pay for their own insurance tax deductible.
(I cross posted this diary on the Daily Kos, OrangClouds115 asked me to join your site here and cross post). I'm glad to help...if it helps. I'm new to your community, but not to kos, please forgive me, if my language is a little more direct than you are used to.
((this is reprinted, with permission, from a DailyKos diary by nyceve. Nyceve is one of the most astute advocates for universal health care in the blogosphere. You can read her many thoughts on the subject here. California will be a health care battleground in 2007, so it's important to keep the pressure on. - promoted by dday)
As I write this, the Republican governor of California lies in a hospital bed receiving V.I.P. treatment for a broken leg the result of a skiing injury suffered several days ago at his palatial estate in Sun Valley.
Schwarzenegger to undergo surgery in L.A. today on broken leg
By Peter Nicholas, Times Staff Writer
December 26, 2006
SACRAMENTO - Gov. Arnold Schwarzenegger was admitted to a Los Angeles hospital Sunday in preparation for surgery early this morning on his right leg - broken in a skiing accident in Sun Valley, Idaho, the governor's office announced.
Schwarzenegger's orthopedic surgeon, Dr. Kevin Ehrhart, said in a prepared statement that the surgical procedure planned for the governor was "relatively common" and was expected to last two hours. link
Allow me to contrast the treatment Mr. Schwarzenegger received to what you or I would get--if we were lucky, and if we had insurance.
The San Francisco Health Access Plan has gotten a bunch of national attention in the last few days. Newsom doesn't support the current plan that Ammiano proposed, but he supports the concept in general. I suppose he wants to work on the business aspect of it.
One day after announcing the proposal that would make San Francisco the first U.S. city to provide access to taxpayer-subsidized health care for every uninsured resident, Newsom pitched his ambitious plan during local radio and newspaper interviews -- knowing that the question of who should be required to pay for it is already generating controversy. ... The proposal would cost about $200 million annually, with more the half the money coming from city funds, about $38 million from local business contributions, and the remainder from monthly premiums paid by plan participants.
***
Newsom, who owned numerous local businesses before taking office in 2004, said he provided health insurance to his employees. He said he does not support Ammiano's legislation in its current form, but he nonetheless challenged the business community -- known for being strong mayoral allies -- and employers who do not provide health care to "step up."
***
"We have been at every public hearing saying one thing: affordability, affordability, affordability," Kevin Westlye, executive director of the Golden Gate Restaurant Association, told the supervisors. "It needs to be affordable. The way it's constructed, it's not." Westlye sat on a 41-member task force created by Newsom to study and develop the health care plan. (SF Chron 6/22/06)
So, I suppose that this is going to come down to a "progressives vs. businesses" thing like most other big efforts in SF. However, with the Mayor's support, I imagine that this one will happen. Funding seems in flux, and the exact parameters of the deal are a little sketchy right now. But, as I understand it, SF is essentially getting into the HMO business. They will provide orimary care providers and allow preventive care. However, the program participants will have no benefits outside of the county.
I think this is a great idea, at least as an experiment. We spend so much money on ER care that is essentially unnecessary. There is a reason that the U.S. gets the least value of our health care dollar of any major industrial nation. After the fact that we spend $0.35 of each dollar on the insurance complex, there is the fact that we spend way too much on emergency care. It's expensive and many of the cases could be handled a lot more efficiently in regular clinics.
So, there are details to work out, but I applaud SF for this grand gesture. We'll see how it works in the next few years.
