July 25th, 2009 by Emergiblog in Announcements, Better Health Network, Health Policy, Opinion
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This is Congressman Paul Ryan of Wisconsin, speaking at the Better Health “Putting Patients First” event in D.C.
I should talk about how passionately he spoke about health care reform (he did), about why he does not believe government should be running health care (he doesn’t) or that he took the time to come and speak at 8 am even though he had been up until 2 am working on the health care bill (he did) or that he spoke right up until he – literally- had to run back to the House to vote (he did).
And I will talk about these things.
But first, let me state the obvious and get it out of the way so that I can go on to discuss the serious nature of the health care reform debate before us.
Whoa.
Seriously, is it just me or are politicians getting better looking?
There. Now I can move on to the meat of the matter.
(I had to say it because you all know I was thinking it!)
*****
This event marked my first time in Washington, and just being there is awe-inspiring. Seeing the White House from the car window took my breath away, literally. I felt like Ellie May Clampett marveling at the ce-ment pond. The National Press Club is a museum in and of itself. Mother Jones and I were hoping we’d catch a glimpse of Sanjay Gupta, but he must have been off doing neurosurgery or something.
*****
By now, you’ve probably read who was on the panel (Dr. Wes, DrRich, Dr.Rob, Dr.Kevin, me, and Better Health contributors Dr. Alan Dappen, Valerie Tinley, NP and “token” – his words, LOL – surgeon Dr. James Herndon).
I will tell you straight up that I learned much more than I contributed.
The panel shot from the hip and spoke from the heart. Some of us had notes, some of us illustrated our comments with anecdotes and one of us (*cough*) had no clue what was going to come out of her mouth until that moment.
I’ll give you a hint….it wasn’t Valerie…..
*****
For the record, those of us on the panel were not told what to say, how to say it or what to believe, nor were we chosen based on what we do believe. Some discussed concepts that should be taken into account no matter what plan we end up with, others were definitely against a single payer plan run by the government (*raising hand*).
The inefficiencies of national health plans of other countries were illustrated/discussed. This hit me later: we should look at what works in those plans, not just what is wrong with them. We don’t have to emulate them, just learn from them, and that includes the good and the bad. It also applies to any universal form of coverage, not just a government-run plan.
Wish I had said that at the time.
So much for thinking on my feet (or on my butt, as the case may be).
*****
There was some controversy about not having any patient bloggers on the panel. There should have been. I hope that, as a nurse, I spoke for patients, but it was not the same as having someone there who navigates the system as a patient every single day.
The patient bloggers were in the audience, though, and if you go to Twitter you can find the live tweeting at “#patientsfirst”. There was a pretty healthy debate going on in the Twitterverse while the panel was up on the dais.
Here I am with Lisa Emrich (Brass and Ivory) and Kerri Morrone Sparling (Six Until Me). Duncan Cross was also there, but my pic was blurry!
*****
While health care reform has been a hot topic for awhile, it was especially acute this week as the President was actively promoting a government run health care system and there seemed to be a huge sense of urgency to get what is called “Americas Affordable Health Choices Act of 2009″ passed ASAP.
The bill is over 1000 pages long.
I just downloaded it.
And Congress has not read it.
Folks, our representatives are being asked to pass legislation they have not had a chance to read.
While I will admit to being a bit unsure of exactly what happens in the Beltway (Civics classes and Schoolhouse Rock’s “I’m Just a Bill” notwithstanding), that can’t possibly be business as usual.
Can it?
*****
I’ll say one thing: no matter what we believe, why we believe it or what our role is in the health care system, it is a conversation rife with strong opinions and passionate debate.
And, in the end, because we are all patients in one form or another at some point in our lives, the conversation is about us.
So, when you hear the phrase “putting patients first”, think of it as “putting me first”.
That may help you get a foothold in the morass of information that is the health care debate.
It worked for me.
*This blog post was originally published at Emergiblog*
July 25th, 2009 by Emergiblog in News, Opinion
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I was honored to receive an unprecedented opportunity to hear a Senior Advisor to President Obama speak about his health care reform efforts at BlogHer 09.
Valerie Jarrett, Senior Advisor and Assistant to the President for Public Engagement and Intergovernmental Affairs, spoke to an intimate group of bloggers at a luncheon today.
And I was 15 minutes late.
How humiliating! This was definitely not the event where one should be “fashionably late”.
Ms. Jarrett was totally cool though, and said “Come on in and tell us who you are!” Apparently I had just missed intros; the discussion was just starting.
(Photo credit: Wikipedia)
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Now I’ve been pretty clear about not wanting a government run health care system, and I attended the luncheon knowing I did not have a clear grasp on the President’s proposal. (I have downloaded the Bill, have not had a chance to finish it.) I wanted to keep an open mind; I wanted to learn as opposed to opine.
The best way to learn is to keep your mouth shut and listen. That is exactly what I did.
It was not easy.
*****
Ms. Jarrett is warm, sincere and truly passionate about the President’s efforts at health care reform; Ms. Jarrett has full faith in the ability of the President to positively reform our health care system.
Now, if I heard and understood correctly, what the President wants is a public plan as an option; a choice to obtain health care coverage through the government should you find yourself unemployed/without any health care coverage. Ms. Jarrett was adamant that the goal is not a single-payer government run plan, but there was some group questioning of (1) why the idea of a government plan is perceived as scary and (2) whether or not it would be tantamount to socialism and indeed, what would be wrong with that anyway. One blogger noted that she knew many Canadians who were happy with their health care.
These questions were more rhetorical in nature. Honestly, I don’t think time would have permitted in-depth discussion.
*****
There was discussion on how bloggers can get out the message of health care reform and ideas on how the President can best communicate his ideas to the public. It was noted that the President is holding press conferences for which he is asking full coverage because he wants the entire story told, not just sound bytes. (Side note: I found this interesting because just recently ABC News encamped in the White House for an entire day – and the topic was health care reform.)
I actually did have a question enter my mind, as I was intrigued by the idea that the public plan was an option: I wanted to know if one could move in and out of the public plan as desired, or were you stuck in the public plan once it was chosen.
I didn’t get a chance to ask, as the discussion moved forward with two bloggers sharing stories of their personal experiences with the health care system. Very personal, heart wrenching stories. Their frustration and anguish was palpable. Ms. Jarrett listened with empathy; she truly cared about what my fellow bloggers had/were enduring.
I found out later that both bloggers left with her personal business card with her office number for them to call her directly after the conference. That was impressive.
*****
So, some final thoughts.
I like Valerie Jarrett. It was amazing that she took time to come and speak to us, and it was informative. She speaks straight, she is sincere and she seems very passionate and compassionate regarding health care reform. I’m a bit more informed about what the President is looking for. This was the advantage shutting up and listening. I don’t necessarily agree but I’m starting to at least get a hold of the concept.
Gratuitous political commentary: I think a little too much time was spent decrying the last administration. It’s over; time to move on.
Now for my totally off-the-cuff observation. I could not help but notice this was the exact opposite of my experience in DC last week. This was a full-on Obamafest, last week seemed like an “anything BUT Obamafest”. This week the “opposition” was putting out misinformation, last week the “opposition” was trying to cram a bill through before Congress could read it.
Is there no middle ground? Does it have to be this contentious? Maybe it’s the way of politics and I’m just now realizing it.
Between the two events, I guess I have now been exposed to a “fair and balanced” view of health care reform by Washington insiders.
So….why does it still feel like I have vertigo?
*****
This post was written from my own notes and memory. It was actually live-blogged in real time and if you would like to read the entire transcript, it is written here: Valerie Jarrett/Health Care Reform Live Blog BlogHer 09.
Valerie Jarrett, White House Senior Advisor Talks to Bloggers at BlogHer09
*This blog post was originally published at Emergiblog*
July 17th, 2009 by Emergiblog in Better Health Network
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What is this?
An illustration from “Physical Therapy for Zombies”?
Seriously.
The crutches are way too long and there is no banister on the stairs.
Actually, I don’t even see a second crutch.
Is the nurse is standing by or running up to rescue this guy?
If he is trying to elope, he isn’t going to get far!
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I figure if you are trying to understand something, begin with how it affects you. Make it personal, and it’s easier to grasp.
So I took on my health insurance coverage. I am covered through my employer, but surely I could get comparable coverage as an independent buyer.
Right?
*crickets*
*****
I am covered by Anthem Blue Cross. You know, Blue Cross. The company that used to be the Gold Standard of health insurance? The one my physician no longer accepts because of their reimbursement rates? I figured my best bet was to check out and compare coverage from the same company, so I hit the Anthem Blue Cross website to try and get a quote.
You can get an overview of policies, but they make you put in your phone number so a representative can call you. I didn’t mind, as I had some questions. I spoke with Danny, who was very helpful.
But before I go any farther, you should know one thing. Just in case you are looking to purchase a private plan.
If you have insulin-dependent diabetes, Anthem Blue Cross will not issue you a private policy.
Whoa. Found that out when I asked about pre-existing conditions. I had always heard that folks were denied coverage for pre-existing conditions, but to actually hear it coming from a representative floored me.
*****
If I wanted to quit my nursing job tomorrow and make my living blogging (offers accepted), I would need to purchase insurance. I could go with COBRA and buy through my hospital for 18 months, or I could buy my own policy.
The payment for COBRA coverage for a family of three adults (ages 55, 52 and 19) is $2157.00 per month. That is $25884 per year, and includes everything from pediatric well-baby checks to maternity coverage.
Twenty Five Thousand, Eight Hundred and Eighty-Four dollars a year.
Pardon me while I go take a meclizine, just typing that number gave me vertigo.
Private PPO insurance for the same family of three, through the same company, with coverage for brand-name medications is $897, or $10,764 per year.
Huge difference.
On the surface.
*****
To get the private-pay plan you must be vetted. Screened. They will take you if you have high blood pressure, but only if you are controlled and have been on meds for a certain amount of time. Same with high cholesterol. Same with GERD. I’ve already mentioned the diabetes. If you don’t meet their criteria, it’s “buh bye”.
My friend in Human Resources told me that our insurance coverage was “more robust” than what was offered in the private plan. Our deductibles are less, our out-of-pocket per-year expenses are less, our co-pays are much less.
She was right.
But I am still confused.
And I have a lot of questions.
- Why is my employer paying for coverage I no longer need? I’m long past needing the services of a pediatrician and maternity coverage is not an issue (been there, done that, may my ovaries Rest in Peace). Why can I not opt out of these things, saving my employer money? What if I did not want coverage for mental health, for example? The private pay plan is available without maternity care.
- Why can’t I have the money that is spent on my health insurance premiums (more than some people make in an entire year!) put in a savings account that allows me, as an individual, to choose what type of coverage I want to have? And have whatever is left available to pay co-pays and deductibles? They are paying the money anyway – why not put it in the control of the patient/employee.
- Where the hell does the private insurance industry get the authority to decide who they will and will not cover? Is that not discrimination?
- What happens when/if I develop an illness that would have denied me private coverage to start with? Am I dumped? Is the illness covered? For how long?
And I still don’t understand…
- Why my doctor charges $140 for a visit, I pay $15 and the insurance company pays another $40, and my doctor winds up with only 39% of his fee? No wonder he doesn’t take new patients with Blue Cross. What other profession has no control over their reimbursement?
- Why, with my background as a nurse, I still am unable to make sense of an “Explanation of Benefits” report. There is an actual fee, a negotiated fee, a deductible, a co-insurance portion and then what is left is for me to pay. And trust me, the amount paid by either the insurance and/or myself never, ever amounts to the actual fee. Ever.
- Why I have a bill for lab tests and screening exams that far exceeds what my deductible is for the year, and yet the deductible is not yet satisfied. Seems to me I’ve paid out the deductible-times-five and yet it is still not satisfied.
I don’t even know where to start to try and get an handle on this.
Either I’m an idiot or the system is way out of control.
Maybe both.
But I do know this. I am a 52-year-old woman who is welded to her employment solely for the medical benefits. I’m getting older, I am going to need coverage for conditions and diseases that I did not have to worry about in my 30s. Every decision I make, whether it be a new job or attending school full-time at a university will be decided by the availability of health insurance and what it covers.
Thank god I have that coverage.
I just wish I had more control over how it was applied.
Lord knows I could do it more efficiently.
*This blog post was originally published at Emergiblog*
July 7th, 2009 by Emergiblog in Better Health Network, True Stories
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Why shouldn’t we have to pay for our health care?
Why….we don’t have that sort of money!!! How dare you even suggest that we should pay!!!!
We manage to buy cigarettes. We manage to buy fast food. Often. We manage to get all the channels we want via cable or satellite television. Some of us even have satellite radio in our cars. And GPS. Our cell phones are really nice, but all that texting costs a pretty penny. We drop a few bucks at Starbucks every week without thinking twice.
And then we roll our eyes when we have to pay for….god forbid…..health care!
*****
Think I’m heartless? Think I’m an elitist?
Think I’m talking about the Medicare patients in my ER who bring in a super-sized number 8 from McDonalds for the entire family and hold out their right arm for a BP while they text rapidly with their left hand?
I could be.
But I’m not.
The patient rolling their eyes at having to pay was me.
*****
Yeah.
Me.
Showed up for a colonoscopy yesterday and the receptionist went over what would and would not be covered by my insurance.
My out-of-pocket payment would be $216.
And my first thought was “why the hell am I paying anything out of pocket for this? I have insurance!”
I was ticked.
*****
But why was I ticked?
Why shouldn’t I have to incur out-of-pocket expenses?
I have insurance. Good insurance. Insurance I don’t pay a single penny for. It’s a benefit I get from my employer for working 24 hours a week.
Did I think I was entitled to full coverage because I was insured?
Entitled?
Me?
*****
Isn’t that term used to describe some patients who get their health care for “free” through a public plan?
Well, I get my coverage for “free”, too, and god help me, the emotion I felt in that office yesterday was “entitlement”.
Now I understand.
And I won’t use that term again.
Ever.
*This blog post was originally published at Emergiblog*
June 28th, 2009 by Emergiblog in Better Health Network, Health Policy
4 Comments »
Well, apparently they call a nurse!
Either that or Nurse Nellie caused the headache.
But we know that nurses never cause doctors to have headaches, so that can’t be what’s happening.
Ha!
Trust me, there have been a few doctors over the years that have given me major headaches and I have no doubt that I have been the impetus behind a few MD migraines myself!
**********
The guy in the Anacin ad must be doing what I’ve been doing for the last two days.
Trying to get a grip on healthcare reform.
That alone is enough to give you a migraine.
There is so much information and conjecture and opinion and debate, it is difficult to know where to start.
Who gets covered? What gets covered? Who pays? Who decides the charges? Who decides the fees? Who has an agenda: political, financial or otherwise? Private or public plan?
And the most important question of all: Who is fighting for what is best for the patient?
Because, when all is said and done, WE are “the patient”.
*****
Okay, so I’ve come up with some foundations; these are things that I feel must be at the heart of any health care reform debate:
1. Every citizen must have health care coverage.
2. Every citizen needs to own their health care coverage.
3. There should be a choice between private and public plans.
4. Every citizen must be able to choose between a private or a public plan and switch between as necessary.
5. Each plan must cover basic health care: physicals, screening, immunizations, well care.
6. Each plan must cover chronic or catastrophic illnesses. (Diabetes, asthma, MS, cancer – just a few examples)
7. After basic health care and chronic/catastrophic illness, each citizen should be able to choose how they want to be covered. I have heard this called the “cafeteria plan”.
*****
Gee, I don’t ask for much, do I?
We don’t have to invent the wheel here. Other countries have gone before us; there are models of universal coverage we can study.
The operative word here is “study”. Take what is good, understand what does not work and use that knowledge to form a unique form of universal health care that meets the needs of the citizens of the United States.
*****
Probably the easiest way to tackle health care is from a personal angle.
I just found out what my COBRA payment would be if I left my job tomorrow.
I’m hoping my jaw heals before I go to work on Thursday.
But that’s a topic for the next post.
*This blog post was originally published at Emergiblog*
