I heart Maine

How  about a shout out to the Senators from Maine, both of whom are Republicans and both of whom are showing the kind of logic and leadership I wish all leaders had. Nobody likes compromising. But these Senators have studied the health care issue, know what they want, and are willing to fight for a solution that suits  their philosophical leanings AND the needs of Americans.

They don’t like the Democrats’ plan as is, and they’re changing what they don’t like. I’m not arguing they should get everything they want, or even anything they want, but I am a big fan of leaders who listen and think, and who don’t feel the need to protect their original opinions to the death.  I’m not so ignorant that I think we’re going to convince the Maine Senators on a pure public option, though it’s what I’ve lobbied my Senators and Representatives for.  I’m also not a fan of forced bipartisanship, three of each bickering until they water things down enough. I like a couple of passionate people from each side choosing to come together with good intentions to make compromises that really work for Americans, not just for politics.

Though that’s not the situation here, I’m still bumping Maine further up our list. I was always a Masshole-New Hampster type, but if *this* is what being conservative in Maine means, I can actually abide a conservative-leaning home.

Plus, Maine seems to be doing fine work on the way to equality for all. You’ll move up further if you pass gay marriage. (You know you want to. Hubby Hubby is the best B&J flavor.)

Idealogues are pains in the ass. Those GOPers who genuinely prefer health insurer profits to a healthy nation, stick to your guns. Those who are terrified of change: take a deep breath and move slowly. Republicans who want to fix the system but can’t stand what it will cost: do the math on what we lose keeping things the way they are.  Sometimes you have to spend money to make money.  Those Republicans who want to help people but just can’t swallow the fact that Barack Obama is President: get new jobs. Because the fact that you put your fingers in your ears and vote “whatever is the opposite of Obama” are not leaders. You’re followers. Contrarian follwers, but followers nevertheless. Liberals who still want Universal health care or a single-payer system, keep fighting. But at a certain point, we’re all going to have to accept that the other side, whoever they are, have a point. We’re not getting single-payer, and we need to compromise on public option. So push all you want, but make sure it’s not counter-productive, or you, too, can get new jobs with the GOP ideologues.

Guest post

Not really a guest post. An email I got from the White House. Instead of forwarding, I’m pasting it here so we can debate the facts.

Health Insurance Reform Reality Check

8 ways reform provides security and stability to those with or without coverage

1. Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
2. Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
3. Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
4. Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
5. Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
6. Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
7. Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
8. Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won’t be allowed to refuse renewal because someone became sick.

Learn more and get details: http://www.WhiteHouse.gov/health-insurance-consumer-protections/

8 common myths about health insurance reform

1. Reform will stop “rationing” – not increase it: It’s a myth that reform will mean a “government takeover” of health care or lead to “rationing.” To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies.
2. We can’t afford reform: It’s the status quo we can’t afford. It’s a myth that reform will bust the budget. To the contrary, the President has identified ways to pay for the vast majority of the up-front costs by cutting waste, fraud, and abuse within existing government health programs; ending big subsidies to insurance companies; and increasing efficiency with such steps as coordinating care and streamlining paperwork. In the long term, reform can help bring down costs that will otherwise lead to a fiscal crisis.
3. Reform would encourage “euthanasia”: It does not. It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.
4. Vets’ health care is safe and sound: It’s a myth that health insurance reform will affect veterans’ access to the care they get now. To the contrary, the President’s budget significantly expands coverage under the VA, extending care to 500,000 more veterans who were previously excluded. The VA Healthcare system will continue to be available for all eligible veterans.
5. Reform will benefit small business – not burden it: It’s a myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses, provide tax credits to help them pay for employee coverage and help level the playing field with big firms who pay much less to cover their employees on average.
6. Your Medicare is safe, and stronger with reform: It’s myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform will improve the long-term financial health of Medicare, ensure better coordination, eliminate waste and unnecessary subsidies to insurance companies, and help to close the Medicare “doughnut” hole to make prescription drugs more affordable for seniors.
7. You can keep your own insurance: It’s myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.
8. No, government will not do anything with your bank account: It is an absurd myth that government will be in charge of your bank accounts. Health insurance reform will simplify administration, making it easier and more convenient for you to pay bills in a method that you choose. Just like paying a phone bill or a utility bill, you can pay by traditional check, or by a direct electronic payment. And forms will be standardized so they will be easier to understand. The choice is up to you – and the same rules of privacy will apply as they do for all other electronic payments that people make.

Learn more and get details:

8 Reasons We Need Health Insurance Reform Now

1. Coverage Denied to Millions: A recent national survey estimated that 12.6 million non-elderly adults – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years or dropped from coverage when they became seriously ill. Learn more: http://www.healthreform.gov/reports/denied_coverage/index.html
2. Less Care for More Costs: With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job. Americans pay more than ever for health insurance, but get less coverage. Learn more: http://www.healthreform.gov/reports/hiddencosts/index.html
3. Roadblocks to Care for Women: Women’s reproductive health requires more regular contact with health care providers, including yearly pap smears, mammograms, and obstetric care. Women are also more likely to report fair or poor health than men (9.5% versus 9.0%). While rates of chronic conditions such as diabetes and high blood pressure are similar to men, women are twice as likely to suffer from headaches and are more likely to experience joint, back or neck pain. These chronic conditions often require regular and frequent treatment and follow-up care. Learn more: http://www.healthreform.gov/reports/women/index.html
4. Hard Times in the Heartland: Throughout rural America, there are nearly 50 million people who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. Learn more: http://www.healthreform.gov/reports/hardtimes
5. Small Businesses Struggle to Provide Health Coverage: Nearly one-third of the uninsured – 13 million people – are employees of firms with less than 100 workers. From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%. About a third of such workers in firms with fewer than 50 employees obtain insurance through a spouse. Learn more: http://www.healthreform.gov/reports/helpbottomline
6. The Tragedies are Personal: Half of all personal bankruptcies are at least partly the result of medical expenses. The typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone. Learn more: http://www.healthreform.gov/reports/inaction
7. Diminishing Access to Care: From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. An estimated 87 million people – one in every three Americans under the age of 65 – were uninsured at some point in 2007 and 2008. More than 80% of the uninsured are in working families. Learn more: http://www.healthreform.gov/reports/inaction/diminishing/index.html
8. The Trends are Troubling: Without reform, health care costs will continue to skyrocket unabated, putting unbearable strain on families, businesses, and state and federal government budgets. Perhaps the most visible sign of the need for health care reform is the 46 million Americans currently without health insurance – projections suggest that this number will rise to about 72 million in 2040 in the absence of reform. Learn more: http://www.WhiteHouse.gov/assets/documents/CEA_Health_Care_Report.pdf
***end message***

Let’s debate the facts, not the propaganda.

Health care

The New Yorker has an amazing piece on health care. Read this article by Atul Gawande, a Boston surgeon if you are interested in health care costs, health care reform, and why we should talk about health care not health insurance. If you can only read one page (which I never recommend, but I’m realistic), skip to pp 6.

Short version: the point isn’t who’s paying. The point is whether profit or care is privileged. Comparing apples to apples of population demographics and socioeconomic factors, too many tests and surgeries, mean higher costs to everyone—insurers, patients, and government—which actually makes patients less healthy. The more we spend, the worse care gets. Sometimes because docs are padding their wallets. Sometimes because the medical culture’s priorities are wack. Not because of malpractice or technology.

And the best health care? Collaboration and best practices seem to be key. In one case, the Mayo Clinic, salaries help keep costs way down because docs focus on getting people well the best way possible. And their quality far outstrips those hospitals, towns, and cities that cost the most. Ditto elsewhere that docs simply come together and agree to collaborate and root out poor care, though they’re not salaried.

So are we going to focus on patients or revenue? Read the article and help your national representative decide.