Westchester Guardian/Catherine Wilson.

Thursday, January 29, 2009

Catherine Wilson, Bureau Chief
Northern Westchester

We Need Health Care Reform

Westchester citizens are responding to the call for change from the Obama administration by hosting health care community discussions and offering their own personal ideas for reform. Led by Senator Tom Daschle, the new head of the Department of Health and Human Services, the purpose of these discussions is to gather information from the public.

Daschle said, “We have invited people from all over the country to participate in these discussions. We want people to share with us what
idea they have on how to improve the system. The idea is to put together the best list of proposals together – ideas from prevention to hospital care to chronic care management.

If we’re going to do this right, it’s going to mean that we’re going to have to involve the American people. We have to involve people who
have personal stories to tell, who have ideas to share, who have real experiences that they can relate to.”

Daschle believes that this approach is “the essence of good legislating”. On Friday, January 16, a group of Westchester residents braved the
near-zero temperatures to gather at the Dragonfly Café in Pleasantville to share their ideas for reform to the health care system. The moderator of the Pleasantville discussion, Dr. Susan Rubin, voiced her encouragement for local residents to attend, stating, “I know I’m not alone in believing that our healthcare system is not working as well as it could be to create better health. Now is the time to stop sitting on the sidelines and do something about it”.

As Rubin noted in her invitation to this event, “When our government talks about healthcare, they are generally referring to health insurance.
The term healthcare system is really a system of medical care. How can we make it more about caring for our health?”

The Obama/Biden “transition project” outlined their goals for these discussions:

1. Engage in discussions with your friends and neighbors about health care reform and draft a group submission with your findings and
conclusions. This will help the Transition Health Policy Team flesh out key issues around health care and give the Team fresh ideas about the
best ways to promote the President-elect and Vice President-elect’s vision of quality, affordable health care for all Americans.

2. Develop your group submission to the Transition Health Policy Team through a process that respects, empowers, and engages all attendees.

3. Identify particularly poignant stories about health care from participants that can be used to help emphasize the need for health care reform in our country.

The attendees at the Dragonfly Café were more than willing to share their views and stories to improve our healthcare system. Ten area residents attended, a mix of mothers who are involved in their local PTA wellness committees, self-employed individuals, small business owners, alternative health care providers, and seniors.

One participant set the tone up front by noting, “Insurance policies govern our personal health decisions. We do what the insurance companies tell us we are allowed to do, rather than what we want to do for our own health and our own bodies”.

The participants agreed that their insurance companies directed them to doctors and providers based on financial decisions, rather than
on what would work best for their health. One mother noted that she was put through a variety of useless medical tests and procedures
to diagnose her headaches which were eventually determined to be the result of her diet. “No one ever stopped to ask me what I ate and
drank,” she noted frustratingly.

The attendees agreed that the insurance companies “don’t pay for doctors to sit down and talk to you to see what the problem might be”.
The participants felt that doctors were pressured to do medical tests to get any payments from the insurance companies, rather than being
paid for their time with patients. Another mother voiced her frustration with the limited choice of the types of care that insurance companies offer, especially in the areas of alternative medicine. “I suffered from a problem with my rotator cuff and couldn’t move my arm.

I went to a doctor for treatments for months with no success,” this mother told the group. “Finally I heard of an acupuncturist who was highly recommended, but my insurance company would not pay for this type of treatment. I had to pay out-ofpocket myself to go to her. But one session with her did the trick!” The mom took off her jacket and swung her arm around in the air to show us the improvement. “Now why couldn’t my insurance pay for this treatment?” she asked.

The group agreed that one of the major issues with our health care system is access. One senior noted “The real problem is access; access to
alternative care. Access to any care at all because you don’t have insurance. Access to care because there are no doctors or hospitals”.

All of the participants agreed that we are fortunate to have an abundance of doctors and hospitals and other health care providers in Westchester, an advantage that many parts of the country, and even areas of upstate New York, do not have. As one participant noted at this
discussion, “How can we talk about health care in this country when we have parts of this country where there are no doctors?” The group recommended a program similar to the Peace Corps and Teach for America to encourage medical providers to offer their services in underprivileged areas of our country, a Medical Peace Corps.

They suggested forgiving medical school student loans to encourage participation in this program. Listening to the stories at the discussion, one participant noted, “We need a new definition of prevention. We need to outline all stages of prevention in life”. The group recommended education to encourage individuals to take charge of their own health and to prevent health problems. “We need to show how food, lifestyle, and environment affect health, and, educate people as to how to eat properly,” Dr. Rubin noted. “Our current system does nothing to educate people and does not encourage prevention,” she said.

One participant suggested making our health insurance programs similar to auto insurance, stating, “Why don’t health insurance companies
embrace the approach of the auto insurance companies? Why don’t we reward individuals who take proper care of themselves and charge more for those who smoke or don’t eat properly?”

The group discussed Governor Paterson’s proposed tax on soda but agreed that it did not go far enough since it did not cover diet sodas and
sports drinks, both equally popular with growing children and teenagers. “We need to subsidize healthy foods,” one mother stressed. “We
need to encourage healthy eating, especially for our children.” One frustration voiced by the self-employed individuals and the business owners was the high cost of their insurance and the high taxes they pay to subsidize the health insurance of government employees.

One mother, a self-employed worker, noted “The Blind Brook School District employees only contribute 15% of the cost of their medical insurance. They only pay in one year what I pay in a month for insurance!” The participants agreed that the current tax system had to change to allow small business owners and self-employed individuals to deduct the cost of their health insurance in full to be equal to government and school district employees who receive their subsidized benefits tax-free. “We have a system of double-jeopardy,”
one participant noted. “Those of us who pay for our own insurance pay twice. Once for ourselves, and again in taxes for government
workers’ insurance”.

Several mothers noted their frustration with the current privacy laws affecting family members of emancipated children who suffer from mental illnesses. “I cannot obtain medical information on my own daughter,” one mother said. “She’s over 18 so she’s an adult in the eyes
of the law and her medical information is governed by HIPPA laws.”

Family members told of instances where they could not locate which hospital their loved one was admitted to in an emergency because the
HIPPA laws prevented the hospital from releasing the information. Several participants expressed their frustration with the health care providers themselves, many of whom dismissed their knowledge of the patient or themselves. As one mother noted, “No one ever trusted
my own knowledge of my own body.” This reporter revealed to the group my own experiences with my elderly mother who suffers from
dementia, and how many providers never looked at the Alzheimer’s alert bracelet my mother wears with all of her medial and my contact
information, opting instead to quiz her directly for information that she is incapable of providing due to her condition! The group agreed that
providers needed more instruction on how to care for patients and how to involve and trust the entire family in the patient’s care.

Another frustration voiced by one participant is how the providers themselves are often the ones blocking access to care. A mother, an advocate for health care access for those who have no insurance, noted that Port Chester schools have an “Open Door Program” where medical providers come into the schools directly to provide care and health education to the uninsured.

“Port Chester even has dentists who come in on a regular basis. West Greenwich has many poor individuals similar to Port Chester but the
Greenwich schools are not allowed to offer the same program. Greenwich Hospital will not allow any of their providers to bring anyone into
the local schools to offer care to the children who are uninsured.” Dr. Rubin noted that she is currently working with Northern Westchester
Hospital to offer a “Healthy Kids Westchester” program in local schools. The group agreed that all kids are at risk for poor health based
on their diets and lack of regular physical activity. One mother asked, “We have a DARE program in our schools to prevent drug use, why don’t we have a similar program for fitness?”

The group suggested that President Obama resurrect the fitness program inaugurated by President Kennedy. “We have a young, healthy
President now with two young children,” one mother noted. “He could set an example for the kids in our schools by showing them how to
exercise regularly and take care of themselves.”

Older participants in the group shared their stories on President Kennedy’s “Presidential Fitness Program” in their schools and reminisced about the calisthenics they had to do as part of the exercise routines! The group did agree that President Obama could set a similar example for the nation and hoped more individuals would already be encouraged to quit smoking along with him.

One concern voiced by several members of the group involved how the Health Care Community Discussions have been Shanghaied by
the pharmaceutical industry who are hosting many of these discussions themselves with their own employees to skew the results to the
new administration.

The New York Times revealed last month, “Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, the main lobby for insurance companies, said the group was ‘mobilizing our grass-roots coalitions and encouraging industry employees’ to participate in meetings”. The Times also uncovered one of the health insurance industry’s goals to galvanize members of its Coalition for Medicare Choices, a group of 750,000 beneficiaries who like their private Medicare Advantage plans.

According to the Times, the health insurance industry is using scare tactics, “The industry-sponsored coalition recently told Medicare recipients that if the cuts occurred, ‘millions of seniors could see their benefits reduced, face higher out-of-pocket costs or lose their Medicare
Advantage coverage entirely’.” The Pleasantville participants were concerned that the results of these deep-pocket groups would overshadow the grassroots efforts of ordinary citizens.

The Obama/Biden team has clearly noted, however, that they are “committed to health care reform that comes from the ground up” and
specifically asked for these community discussions to gather “particularly poignant stories about health care from participants that can be used to help emphasize the need for health care reform in our country”. The new administration hopes that these stories will be an effective weapon to challenge the special interest groups.

The Obama-Biden plan for health care reform states that its objective is “To make health insurance work for people and businesses, not just insurance and drug companies”.

All of the views of the Pleasantville group, along with their recommendations, will be forwarded to Secretary Daschle and the Obama/Biden transition team. Information concerning these discussions can be found on the Obama/Biden transition team website, www.change.gov.

Additional information on the Obama-Biden health care reform plan can be found on the White House website, www.whitehouse.gov. The new administration is encouraging citizen participation through its Office of Public Liaison. Any local resident who wishes to have their views on health care reform heard can do so by submitting them to this office through the White House web site.

Citizen involvement for health care reform does not end with the community discussions. Any proposals to reform our laws will need
to be approved by Congress. The pharmaceutical and insurance companies are already gathering their lobbyists to fight any changes to the
existing system.

Area residents need to make sure their opinions are equally heard by contacting their local Congressional representatives. Local advocates are
also gearing up in response. As Dr. Rubin reassured the Guardian, “I think it’s important we do more of these discussions. We need to keep
getting our voices heard”.

THE OBAMA-BIDEN HEALTH CARE REFORM PLAN

On health care reform, the American people are too often offered two extremes -- government-run health care with higher taxes or letting the insurance companies operate without rules. President Obama and Vice President Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference.

The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors, and plans. Under the Obama-Biden plan, patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats.

Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year. If you don’t have health insurance, you will have a choice of new, affordable health insurance options.

Make Health Insurance Work for People and Businesses -- Not Just Insurance and Drug Companies.

• Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.

• Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.

• Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.

• Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.


• Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees' health care.

• Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.

• Ensure everyone who needs it will receive a tax credit for their premiums.

Reduce Costs and Save a Typical American Family up to $2,500 as reforms phase in:

• Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs, and taking on drug companies that block cheaper generic medicines from the market.

• Require hospitals to collect and report health care cost and quality data.


• Reduce the costs of catastrophic illnesses for employers and their employees.

• Reform the insurance market to increase competition by taking on anti-competitive activity that drives up prices without improving quality of care.

The Obama-Biden plan will promote public health. It will require coverage of preventive services, including cancer screenings, and increase state and local preparedness for terrorist attacks and natural disasters.

A Commitment to Fiscal Responsibility: Barack Obama will pay for his $50 - $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.