January 24, 2010 - January 30, 2010 Archives

Communicator in Chief - Health Care Rx Panelists

Communicator in Chief

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In the hours that followed President Obama's State of the Union address, I received emails from friends, colleagues, and Doctors for America members who felt they had finally seen the leadership on health care that our country needs.

President Obama reminded Congress and all of us of a fundamental truth too often obscured by misinformation and political theater: that the need for health care reform remains urgent and is only growing with each passing day. He rightly urged Congress to move this contentious legislative process forward, not for political calculation or short term gain, but for the millions of lives which literally depend on it.

One of the most important jobs of the president is to be the Communicator in Chief. This is who President Obama was on Wednesday night. More importantly, that is who he must continue to be in the weeks and months ahead.

We know that support for health reform legislation increases significantly when people understand a few key concepts in the bills. But many people don't realize that the current legislation would make it easier and cheaper for them to get insurance or that it would protect them from losing coverage once they have it. Instead, they have been told that health reform will limit their choice of doctor and lead to delays in care - neither of these claims is true.

Communicating the reality of health reform to the American people and dispelling myths will require the visible and ongoing leadership of the President.

But it will also require something far more powerful: Us.

President Obama was right when he said he alone cannot bring the change we need. Neither can Congress. They need our help.

For those of us who see the urgency of our health care crisis in our clinics and for those who have been burned by the failures of the system, we need to stand up and speak out. We need to demand change from our Representatives and the White House, but we also need to talk to our fellow citizens and urge them to act. Apathy in the current climate is understandable. The rancor of the past year has turned off so many people. But the stakes in this debate are human lives - and this demands action from all of us.

A simple example: recently, I saw a 25 year old single mother in clinic. Her name was Elizabeth. A year ago, she had an abnormal chest x-ray showing nodules in her left lung. Her doctor asked her to get a CT scan of her chest to better define the nodules, which she did. Unfortunately, she lost her job and her health insurance soon after and was unable to return to see her doctor. It took her 11 very stressful months to find another job that offered health insurance after which she finally returned to the clinic.

I remember flipping through the papers in her chart with a sinking feeling in my stomach. "Number nodules are seen in the left lower lobe," the report noted. It was not an outright diagnosis of cancer, but the radiologist strongly recommended getting a repeat CT scan in 3 month and a biopsy if the nodules were still present. The tragedy of her situation is that her nodules may yet be cancer, and we may have missed the window to treat Elizabeth.

Had Elizabeth had insurance, she would have returned to the clinic earlier. She would have received her follow up. If this was in fact cancer, it would have been caught much earlier. Even if it wasn't cancer, Elizabeth would have been spared many months of anguish as she worried about her own health and the welfare of her young son.

Elizabeth's story does not stand alone. It is a single thread in a larger tapestry of good intentions mired in a broken system. Stories like Elizabeth's are the reason that I and many others are urging Congress to fix our health care system - because we believe that a young mother should never have to face the possibility of an early death from cancer just because she lost her job.

The political climate for passing health reform looks more challenging now than a month ago. But the only thing that is stronger than Washington gridlock is the collective will of the people. Civil rights supporters knew this. So did the brave men and women who founded our country against much greater opposition. If we let health reform be a political issue, it may fail. But if we reclaim it as our issue - a moral and economic issue that affects the lives of million of our fellow citizens, we will succeed in pushing Congress to act. This is what we are called to do now.

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A 2,000 page bill disguised as reform - Health Care Rx Panelists

A 2,000 page bill disguised as reform

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In his first State of the Union address, President Obama took a brief moment to mention what had been his number one legislative priority: health-care reform. Mr. Obama encouraged Congress to continue the year-long quest for a comprehensive bill, to which the American people are opposed. The Congressional Budget Office and other independent authorities have shown that both the House and Senate legislation will raise premiums and increase the federal deficit. They do virtually nothing to lower costs. The president's plan is simply not economically feasible, especially at a time when 1 in 10 Americans is without a job and struggling to make ends meet.

During the speech, President Obama chastised Republicans for not offering an alternative plan. Again, he is simply wrong. House Minority Leader John Boehner introduced a bill last year that would not break the bank and offered many commonsense reforms. The president and Democratic leadership simply chose to ignore it.

America needs and deserves smart reform that focuses on the needs of real people. That's what we at the Center for Health Transformation have been doing for years, from reforming our civil justice system and eliminating fraud and waste to paying for quality care and expediting scientific breakthroughs. That's what real reform is all about. It is not a 2,000 page bill disguised as reform. Instead of forcing through a flawed piece of legislation, President Obama and Congress should go back to the drawing board, start over, and work to craft smarter bipartisan policies that delivers better care at a lower cost for the American people.

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Hail to the Chief - Health Care Rx Panelists

Hail to the Chief

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I was greatly encouraged by President Obama's address. He made it clear that he is committed to health-care reform and what's more, he gets it. He gets how American families are feeling the burden from paying outrageous health-care costs and are at risk of losing their health care when jobs are cut. He gets that many families are one illness away from losing everything and he gets how health insurance is an important piece of economic recovery. His call to action was loud and clear.

The only thing that I found disappointing as I watched the State of the Union was how totally disaffected the Republicans were. They seemed disaffected by tax cuts, they did not react to education promises and they remained stone faced when the president addressed health-care reform. It's clear that the right doesn't get it. Their continued assertion that Americans don't want health-care reform is either denial or blatant disregard. The only people in America who don't want health-care reform are right-wing politicians, health insurers and Americans who have never had to worry about paying for it. The rest of us are concerned for our families, our friends and our neighbors, and apparently, so is our president.

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I believe reform is needed badly. But I would recommend single payer because of large savings and less confusion and paperwork for doctors and hospitals. Every doctor office I talk to says medicare is much simpler than private health insurance, and that there are less disputes than with health insurance. The health insurance companies get between the doctors and patients to try to get out of paying for things.

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Listen to Mrs. Obama - Health Care Rx Panelists

Listen to Mrs. Obama

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The remark that caught my attention most-- because I think it could have a swift and powerful impact on rising costs and our nation's health--was that the First Lady, Michelle, will start a national initiative this year to reduce childhood obesity in the U.S.

One in six children are obese, and children who are obese have a 70 percent chance of being obese as adults. Two-thirds of American adults are obese or overweight, leading to chronic diseases like diabetes and heart disease. Currently, obesity alone costs the health system $147 billion a year! What's more, obesity is one of the biggest risk factors for developing the six chronic diseases that drive the majority of costs, including diabetes ($218 billion), cardiovascular disease and stroke ($437.5 billion). Obesity is within our control to manage/prevent.

According to the CDC, the average American adult (age 20 and 74) is 5'6 ¾", weighs 177.65 pounds and has a BMI of 28 (Note: an adult who has a BMI between 25 and 29.9 is considered overweight and an adult who has a BMI of 30 or higher is considered obese). To achieve a BMI of 24, America needs to lose 29 pounds per person. With the U.S. adult population at 205,639,360, that means almost 6 billion pounds.

If we were to collectively lose this weight, we would have a direct impact on obesity and as a result, diabetes and other conditions. Healthier diet and exercise are things we can immediately start doing -- without legislation. Not to sound trite, but losing weight can be the "quick fix" for our health problems and rising costs. Walking half an hour a day, five days a week cuts the incidence of diabetes by 40 percent.

Imagine if we were to take all the TV time, print space and blogs consumed by the political debate and use it to advance an audacious goal like improving the state of our health. Imagine what we could accomplish with a big sustainable campaign across schools, employers, state governments and the media.

As many have noted, amongst the current legislative proposals, there isn't a "silver bullet solution" to bending the cost curve or improving the value we get from our spending. But by taking more responsibility for our own actions, we can impact the healthcare costs of our nation.

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We're ready to fight, too - Health Care Rx Panelists

We're ready to fight, too

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In his speech last night, President Obama brought the health-care debate back to where it matters most: the living rooms and kitchen tables of Americans struggling with the high costs of insurance - or the fallout of having to go uninsured.

By highlighting the real and continuing need for health reform - and recommitting to crucial components like ending pre-existing condition bans, dramatically expanding insurance coverage, and bringing down premiums - President Obama may have reshuffled the deck and brought us a step closer to real reform. But advocates who share the president's commitment need marching orders.

The president has repeatedly told us he is ready to fight for us - well, we're ready to fight, too. We need to know what is attainable - and what is sacrosanct - and we will fight day and night for it. We do not expect a perfect bill and we understand that politics is a compromise, but we are closer than ever to passing meaningful reform that will improve the lives of millions of low-income working families.

There is a crew of fighters ready to push for the reforms that are achievable. But we need a target. I hope the president's next step is to plant a bulls-eye wherever we can make the biggest difference.

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"I don't quit" - Health Care Rx Panelists

"I don't quit"

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In his address to the nation, President Obama made it clear: Jobs are now his No. 1 priority.

This is what most Americans wanted to hear. They fear that he has spent too much time on health care and has not paid enough attention to climbing unemployment. This does not mean that they oppose health-care reform legislation--it's just that they are tired of hearing about it. And the need for jobs is more pressing.

Hours before the State of the Union address, some believed that the President would save health-care reform for the very end of his speech. The pivotal question was this: would health care seem an after-thought or a climax?

It would be neither. Rather than turning to reform as he closed his address, the president tucked the issue into the middle of his speech. One might even say that he "buried" the subject in the middle of a 90-minute oration.

When he finally came to health care, the president began by going for the laugh-line: "Let's clear a few things up. . . . By now it should be fairly obvious that I didn't take on health care because it was good politics."

This set the tone for what he would say. Obama would be amiable, not angry and not confrontational. This president does not change his style.

He was striving for consensus: "As temperatures cool, I want everyone to take another look at the plan we have proposed." At that moment, it wasn't clear who he was appealing to: Republicans? Or House liberals who are reluctant to vote for the Senate bill?

If the president was asking Republicans to take another look at the legislation, he is misjudging their interest in helping his administration accomplish anything.

Throughout much of the State of the Union, Republicans sat glued to their seats, stone-faced and refusing to applaud. At other points, they were chuckling, smirking at each other as if to say: "Who does this guy think he is?" At one point, they laughed at him. I cannot remember either party ever showing as much disrespect during a State of the Union address.

I had hoped that the president would signal to Democrats that he expected them to come together: the easiest and surest way to pass the legislation would be if the House voted for the Senate bill. But the president did not say this. He came close to telling Democrats what they need to do: "Don't walk away from reform. Not now. Not when we are so close. Let us find a way to come together and finish the job for the American people. Let's get it done."

Most importantly, the president underlined the fact that according to the Congressional Budget Office, (which has a history of underestimating how much health-care reform plans will save) "our approach would bring down the deficit by as much as $1 trillion over the next two decades." This leaves opponents with something to explain: if the bill doesn't control spending, how is it going to reduce the deficit?

I hoped that, as he finished his speech, the president would return to the subject of health care and make it clear that if we want to save the economy, we must have health-care reform. He didn't do that.

But at the very end, he did show a moment of defiance, a flash of fire: "We don't quit. I don't quit. Let's seize this moment . . .."

As he said those words, I can only hope that President Obama was thinking of the Senate bill.

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A boring rehash - Health Care Rx Panelists

A boring rehash

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I found the President's State of the Union speech lacking luster, content and heart. It was a simple rehash of many past speeches with the emphasis changed from health care to the economy. Much of the slight of hand, designed to impress, is now becoming predictable. If only his erudite manner and oratory aptitude were used for the purposes of the country and the office instead of promoting his finely honed political agenda, they could be appreciated.

It doesn't matter how many times you say the same things. They are still not digestible. My problem is with the content. His goals and the goals of his cronies are not the desirable goals of the people of this country. We are not a nation that has ever embraced the idea of being ruled by a few. We are a nation of the people. Instead of tuning into the American people, he is consistently holding fast to those goals he brought with him from Chicago. The virtue of a good leader is the ability to change and to adapt to the needs of the office.

Mr. President, if you want to impress the majority of the American public, you have to stop talking and try to listen. It's really very simple. It's not about you. It's about us. We all agree you give a good speech but there's got to be more to holding your office than that. It's time to develop some other skills.

We want a better health-care system. We all agree the patient is sick but not just any old medicine will do. It takes skill, knowledge and a thoughtful approach to solve this problem. We have not seen this and have a right to expect the right medicine and accurate treatments in the future without your killing the patient in the process.

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The genie is out of the bottle - Health Care Rx Panelists

The genie is out of the bottle

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The dirty secrets and tragic failures of our broken health care system have been paraded in front of the American people for months. We've heard the stories. Many of us in the cancer community have lived them. Since last July, our hopes for access to affordable care and for justice and quality in the health-care system have been raised sky high. In recent days, those hopes have been in limbo, waiting for what comes next.

What we hoped to hear tonight was a call for Congress to get back to work on an issue that literally determines life or death for many of us.

And much to our relief, we did.

The President took the right approach, calling for a reexamination of the plan on the table but opening the door for other options. He renewed his commitment to Americans on health care and used his bully pulpit appropriately to call for action.

Americans don't care about the method, whether it's piece by piece or in an omnibus bill. What they care about is reform that creates affordable care and an end to unethical practices by insurers that wreak havoc on their lives.

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Telling it like it is - Health Care Rx Panelists

Telling it like it is

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The President gave a coherent defense of the need for health reform. He is right: the problem is still here and getting worse. It is complicated but solvable. Congress should pay attention and find common ground to get it done.

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Critical condition - Health Care Rx Panelists

Critical condition

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President Obama excels at motivating the human spirit. This is clearly important in difficult times. However, with the nation's health in critical condition, it will take calculated, well-articulated, decisive measures and not mere reassurances to save the patient.

Obama spent the first 50 minutes of his State of the Union address focusing on issues that are undoubtedly at the core of our nation's ills: jobs, economic stability and health care. Until last week, the order was quite different. We must recognize that the center of our economic paralysis is that businesses cannot afford to hire new people and be globally competitive because of the high cost of health care. If the focus of this last-ditch effort is to hold insurance companies accountable, drive down cost and improve choice, then the right thing to do is to provide incentives or even mandates for businesses to be able to hold insurance companies accountable.

The President took responsibility for not adequately communicating the health-care agenda. That is the root of why we have not succeeded to date. What is required to maneuver the current challenge is a deep understanding of the ills of the system in order to win bipartisan approach. What is required now in the 11th hour is more than inspirational rhetoric. We need hard, reliable facts to help chart a course of true success.

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Fortunately, Americans aren't nearly as stupid as our leaders think we are. We know who is responsible. It's us. For allowing a corporate influenced Congress do enormous damage to our country.
It's time to vote a lot of them out.
Republican rhetoric and comments from physicians that prostitute a profession they had little to do with does not change reality.

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The wrong focus - Health Care Rx Panelists

The wrong focus

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The President has the wrong focus on reform. He promises premiums can come down for everyone while covering those with preexisting conditions. This is only possible with a mandate for everyone carrying insurance. Health insurance reform is not the issue. The system of care and instituting evidence-based practice, reforming the administration and oversight of Medicare and Medicaid is essential. Obama spent five minutes on health care-- as his fifth priority-- while focusing on business, jobs, energy and a small program on education. This was a pro-business talk with a small, ineffective and poorly developed health focus. He doesn't even have a Centers for Medicare and Medicaid Services (CMS) nominee after a year. Is he really serious or knowledgeable about health care?

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The President needs our help - Health Care Rx Panelists

The President needs our help

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My charge is to say whether I agree with President Obama's comments about health-care reform.

Yeah, I do agree with him, particularly his admonition to Democrats: "We still have the largest majority in decades, and the people expect us to solve some problems, not run for the hills."

I do wish he had been more directive in asking the House to pass the Senate bill, and in asking the Senate to address that bill's major flaws through the reconciliation process. (I and 50 other health policy experts recently signed a petition that advocated this course.)

As I listened to the State of the Union, I was less impressed with what President Obama should do than I was with we--his listeners--should do to help get this done. He can't do this alone. Neither can Harry Reid or Nancy Pelosi. They need grassroots help.

Democrats have made impressive gains via an inside game that moved us closer to a final bill than we have ever been. Unfortunately, as political scientist James Morone reminds us in the Jan. 27 Los Angeles Times, Democrats have been less successful telling their story to the American public. All that legislative sausage-making was done for worthy purposes. These purposes were too often left unexplained. Surprisingly and inexcusably, health care proponents have been outworked and out-talked by conservative opponents, who were often able to frame public debate:

Every big piece of legislation is a contest of ideas about what the nation needs. The Republicans told their story with exquisite skill. "Death panels," socialism and "government takeover" were all colorful ways to opt for private markets over government policy.

Those of us who know better must provide a more compelling alternative, one that emphasizes the inherent shortcomings of any "private market" solution that lacks proper government backing and oversight.

My own family is connected by fate with many others affected by cognitive and developmental disabilities. Over the past six years, we have borne primary responsibility for a cognitively disabled adult facing multiple challenges arising from fragile X syndrome. He requires hundreds of thousands of dollars in medical and social services. Although I have an excellent job as a University of Chicago professor, we could not have cared for him without a lot of help from Social Security, Medicare, and Medicaid. We are very grateful for this help. Hundreds of thousands of others are intimately affected by fragile X and similar disorders. Many are effectively uninsurable.

There are many good arguments for health reform. The simple argument for social insurance may be the best: Acting together, we can protect each other from burdens that would crush any one of us, if we were forced to bear it alone.

That's a good message to deliver to your Senator and your Representative as you urge them to get this done. If you or a loved one has benefited from government help at a crucial life moment, make yourself heard. People need help.

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YOu know why they need your help? Because the sizable majority of Americans don't want this bill. I have gotten so sick and tired of those on the left asking the president and Congress to just ignore the obvious will of the people and their disdain for the current bill and instead just ram through the bill via reconciliation, a process that was designed for budget matters, not fine tuning massive entitlement programs.

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Let's get it done - Health Care Rx Panelists

Let's get it done

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"America prevailed because we chose to move forward as one nation, as one people," President Obama explained in his State of the Union address as he reflected on history.

He later said that Americans today perceive that Washington seems unable or unwilling to solve the middle class's problems.

Too right, Mr. President. Based on the latest polls, the American people want Democrats and Republicans to get to "yes" on jobs and the economy.

Don't give up. Don't quit, Congress.

Jobs are certainly the No. 1 focus, the President said. But we know that more businesses are dropping health insurance, and small businesses -- the engine of job growth in this country -- more often than not simply cannot afford to cover health care in today's insurance market.

The President wants to fix problems that hamper the nation's economic growth. One of the key constraints on growth is health care costs. The Congressional Budget Office said today that spending on Medicare and Meciaid are the "single greatest threat" to the nation's budget stability. Last year, higher unemployment drove up Medicaid spending by 9 percent. Outlays on Medicare grew by 10 percent. Both of these growth rates exceeded those seen in the past decade.

Our health care cost and access challenges must be dealt with, not next year, but now.

The President said, "Here's what I ask Congress: don't walk away from reform now that we are so close. Let us find a way to come together for the American people. Let's get it done."

Please, just do so. The dots directly connect between health care costs, jobs and the economy today, and for the health of the national budget in the long run.

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Dysfunctional Congress:
The President said, "Here's what I ask Congress: don't walk away from reform now that we are so close. Let us find a way to come together for the American people. Let's get it done."
I agree. Like many I have been appalled and shamed by many of the recent actions by our national Congress members, particularly on health care issues. I believe we need to provide health care for all our citizens. Presently, any legislation providing that seems to be in danger. Meanwhile, the US still ranks 31st among nations in life expectancy, although those over 65 and on Medicare live longer than the average in industrialized countries. Uninsured hospitalized children are still 60 percent more likely to die than insured hospitalized children. Uninsured, poor citizens are still dying for lack of health care.
The mandate that hospitals must admit and treat the severely ill uninsured is not health care; it is more like end-of-life care, simply unacceptable from both a moral and societal view. Real health care for these 30 million people should result in decreasing society costs. “An ounce of prevention is worth a pound of cure.”
The present senate bill costs about $90 billion per year, about 4% of the 2008 US total yearly expenditure of $2.3 trillion for health care (http://www.cms.hhs.gov). The whole game is to redistribute that other 96% so there is a net decrease in overall cost. It’s not rocket science. If that is too difficult, let’s streamline the bill and try a 2%-98% split. If that does not work, we should: vote against all incumbents in the next elections, refuse to contribute money to any political party or cause, and boycott any corporation that contributes to political parties.

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About this Archive

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