[HCCN] Health Care Forum Oct 10 and perspectives

Judy_Robbins Judy at RobbinsAndRobbins.com
Mon Oct 1 06:28:53 EDT 2012


MaineAllCare is sponsoring a public forum and a discussion by a panel of four experts including doctors, administrators and business people on universal health care. The intent of this public discussion is to shine the light on a solution that has been ignored to date by both the political leadership and corporate establishment. The Forum will pay special attention to the plight of small businesses and their ongoing struggle to provide and pay the increasingly higher cost of health insurance for their employees and their families, yet remain competitive and profitable. Cosponsors of the event are Alliance for Democracy, Occupy Blue Hill and Peninsula Peace and Justice. This event is free and open to the public and everyone is encouraged to attend and participate.

The forum will be held October 10, 2012 at 6:30 pm in the Blue Hill Town Hall.

following are two OpEds which appeared this past week in the Bangor Daily News:
Affordable health care — invented by Republicans

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By Rufus Wanning, Special to the BDN
Posted Sept. 24, 2012, at 1:02 p.m.	
Last modified Sept. 25, 2012, at 9:10 a.m.
There are only three ways this country could move toward universal health care. We could extend Medicare to the entire population, having the government pay for it; we could require employers to insure their workers, with government picking up the bill for the rest, or we could have an individual mandate. The individual mandate is the most politically conservative plan, and it is the plan Obama and Congress chose when they enacted The Affordable Care Act.

The plan was first proposed in 1989 by the conservative Heritage Foundation. In 1993, a similar bill was proposed by prominent Republican senators. In 2005, another such bill was proposed by Mitt Romney as governor of Massachusetts, which became law the next year. All these reforms included an individual mandate, which somehow was never a big issue. Romney even said, in a 2008 Republican primary debate, “I like mandates.”

Now Romney calls the Affordable Care Act “an assault on freedom.” You explain this; I can’t.

The Massachusetts bill became the model for Obama’s Affordable Care Act, passed in 2009. From what I’ve heard, the Massachusetts bill has been fairly successful, although a little more expensive than hoped. Massachusetts is the only state in the Union where the individual mandate is NOT a big issue, because they already have it.

But with three choices, why did Obama choose the the Heritage Foundation plan with its requirement for individuals to buy private insurance? He really had no choice. Liberals, led by Ted Kennedy, had been trying to pass Medicare for All for at least 40 years, and got nowhere. Clinton had proposed an extremely complicated employer mandate, which got killed by heavy business lobbying and the famous Harry and Louise ads, sponsored by the insurance industry. The Heritage Foundation plan, with an individual mandate, was the only plan Obama had a chance of getting enacted.

The main part of the Affordable Care Act squeaked through the Supreme Court, while an important component was found unconstitutional. That was the part requiring the states to extend Medicaid to a larger population than before. Ironically, the Supreme Court held that Medicare for All would have posed no constitutional problems.

Medicare for All is not dead; the state of Vermont has passed a version of it. Perhaps this is how Medicare for All will come to America: state by state.

Meanwhile, Republicans are spitting fire and pledging to repeal Health Care for All if they come to office. What would that mean?

It would mean that children who are permitted to stay on their parents’ policies up to age 26 will be dumped, and left to find insurance on their own. Insurers will no longer be required to cover preventive services, such as mammograms. Likewise, they will once again be allowed to charge extra to women, and deny coverage to people with pre-existing medical conditions.

Most important, repeal would deny health insurance to 24 million people who now have the chance of getting it.

There is a great deal more in the law. For instance, there are provisions to slow the growth of Medicare costs, provisions that Republicans are calling a “tax on Medicare,” even though candidate Paul Ryan books the savings in his budget plan.

The plan does require a mandate, because otherwise people would be able to wait until they get sick, then buy insurance. How burdensome is that mandate?

First, the mandate does not apply if your income is too low. Second, If your income is low enough, you will qualify for expanded Medicaid, if you are lucky enough to live in a state that expands Medicaid, receiving a 90 percent federal match for it. Third, the government will give you subsidies if your income is below about $88,000 for a family of four. Fourth, if you still don’t get health insurance (and why wouldn’t you?), the penalty starts at only $95 per year, rising to $695 in 2016.

The Affordable Care Act represents a real health care improvement, not just according to Democrats, but according to wiser Republicans of the past.

Rufus Wanning is an arborist living in Orland.



ERIK STEELE

Health care reform — what do physicians think?

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By Dr. Erik Steele,
Posted Sept. 27, 2012, at 4:10 p.m.

Physicians agree on — maybe — two things. First, they agree they don’t agree on anything. Actually, some probably disagree about that. Second, they usually agree that everyone who disagrees with them is wrong. It should therefore come as no surprise that physician opinions about health care reform cover more territory than a bad rash.

That is reflected in physician opinions about President Obama’s Affordable Care Act, or ACA, in particular. Talk to five physicians and you get five opinions that sometimes overlap, sometimes don’t, and are almost always strongly held. And as we know, opinions are like bacteria — everyone has them and some of them are nasty. That’s why a Florida urologist who probably had a big prostate clouding his thinking put a sign on his office door telling Obama supporters to seek care elsewhere.

The difficulty understanding what physicians think about all of this is compounded by the fact there are few really good surveys of them on these issues, and results of them seem contradictory. One of those — a survey of 2,694 physicians commissioned by the Jackson Healthcare System — found 55 percent felt the ACA should be scrapped, but one-third of respondents felt the act did not go far enough and a single-payer health system was needed. That means some of those who felt the law should be scrapped did so because they thought it went too far, and others thought so because it did not go far enough.

On the other hand, a 2009 survey of 2,130 physicians found 62.9 percent supported universal insurance through public (government-sponsored) and commercial options. They differed on how to achieve that universal insurance, with 25 percent supporting commercial insurance as the only option, and less than 20 percent supported government-sponsored insurance as the only option.

Despite this diversity of opinion, general patterns of physician perspective have emerged. Perhaps two-thirds support some kind of insurance for all Americans, because most recognize that lack of insurance puts their patients in jeopardy. Just as there seems to be an emerging consensus among physicians, there is also one among their professional associations (such as the American Medical Association and the American Osteopathic Association) that all Americans need access to comprehensive, affordable health care, and that some kind of insurance is required to ensure that access. That evolution is part of what brought the AMA from its position in the 1960s opposing the formation of Medicare to its position in 2011 in support of the ACA.

In fact, the AMA’s website suggests continued advocacy on the issue; it has a banner running across its website policy page detailing some of the impact of the ACA since its implementation: 3.1 million Americans under age 26 insured under their parents’ insurance plans, 54 million Americans who have had expanded coverage of preventive health care, 5.1 million Americans on Medicare who have paid less for prescriptions, etc.

This growing consensus among physicians that all Americans must have access to ongoing, affordable health care has probably been driven, I believe, by the tremendous suffering that lack of insurance causes our patients. We cannot escape seeing it every day. Our experience is reflected in a painful avalanche of studies that has now proved beyond a doubt that lack of insurance kills thousands of Americans each year — friends, colleagues, family members, and other fellow Americans. You cannot watch this parade of preventable misery walk through your ER or office each day and not be moved to conclude that something must be done.

Despite the range of opinions among physicians, here’s my prediction: If most Americans are not insured in another five years, a large majority of physicians will support any means necessary to make that happen, even a single government insurance plan such as Medicare for all. We don’t agree on much, but most of us agree we cannot sit by and watch millions of our patients suffer, and thousands of them die each year, for lack of comprehensive, affordable care.

Erik Steele, a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems.
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