The Debt Deal - with Rep. Ed Markey

Last night I was one of about 30 people attending a meeting with Representative Ed Markey (D-MA) to discuss the Budget Control Act and its likely effect on health care.  It was an information exchange, as he presented how the Budget Control Act is slated to play out and then listened to our concerns as to how that will most likely affect health care, ourselves, and our constituents/clients.

The Debt Deal (Budget Control Act) Basics
Markey laid out the "Debt Deal" as having 3 major steps, with Step 1 already complete: passage by the House and Senate and President Obama's signature on the Bill last Monday, August 1, 2011.

Step 1 is designed to trim $917 Billion from the budget over 10 years through spending cuts and caps.  $350 Billion will come from defense with the remainder from discretionary funds, which could include health care areas except Medicare and Medicaid.

Step 2 is the Super Committee, comprised of 12 members: 6 Republicans and 6 Democrats -- divided evenly between House and Senate from each party.  These legislators must hammer out an agreement by November 23, 2011 that reduces the federal deficit by $1.2 - $1.5 Trillion over 10 years and Congress must then pass that agreement as a Bill by December 23, 2011.

• In this step, nothing is off the table as far as spending cuts or caps or measures to increase revenues. 
• The Super Committee must reach agreement - i.e., reach agreement by simple majority (7 yes votes). 
• If they reach an agreement, that agreement goes to Congress as a bill they must vote on with no options for changes, filibuster, or other political maneuvering.  A simple yes/no vote is required.  
• The Bill then goes to the President for signature, with Presidential veto possible but unlikely. 

Step 3 kicks in only if Step 2 fails totally -- i.e,. there is no agreement --, Congress fails to approve an agreement, the President vetoes the resulting Bill, or it fails to reduce the deficit enough*.  Step 3 triggers automatic cuts in spending that are basically 50/50 between defense and non-defense budget items. 

• Defense would be cut by approximately 9%; this could include cuts to the VA (Veterans Administration).
• Non-defense would be cut by approximately 8%; these non-defense cuts would include a $2.5B cut to NIH (National Institutes for Health), a $525M cut to NSF (National Science Foundation), and a 2% cut (approximately $20B) to Medicare providers.  Medicaid, Social Security, and Medicare benefits are exempt in Step 3. 

*Note that Step 3 would kick in, at a reduced level, if Step 2 results in passage of a Bill that is significantly less than the expected $1.2-$1.5 Trillion.  The cuts in Step 3 would be amounts that would bring the total deficit reduction to the $1.2-$1.5T.

Super Committee
The 12 legislators chosen for this high stakes poker game have a great deal of latitude in how they slash the budget to reach $1.2-$1.5 Trillion in deficit reduction.  Nothing is off the table, according to the rules of the game. That includes Medicare, Medicaid, and other programs that are actually protected in Steps 1 and 3.

This step also includes the possibility of revenue generation.  However, when half the Super Committee has already pledged no tax increases, that immediately ties the other half of the Committee's hands.  As Markey pointed out last night, GOP leadership excluded any Republican leaders from the Super Committee who had indicated they were open to raising taxes**. 

Response from Attendees
Attendees included some people from Cambridge Health Alliance, two different Alzheimer's advocacy groups, Mass Senior Action Council (they were out in force with half a dozen attendees -- great advocacy!), Hallmark Health, myself from Tri-CAP (also representing the HealthMINT Network and the Heritage Tenants Association), a Mass Elders advocacy group, individuals representing themselves and their family members, and state senators Pat Jehlan (D-Medford) and David Linsky (D-Natick) and a representative from sate Senator Katherine Clark (D-Malden).  Some groups were represented but I just cannot recall their names, so if were there and I missed you feel free to comment on this post and add that you were there!

Concerns included fears that:

• the automatic deficit reduction strategy would decimate essential health research and that will result in far-reaching future medical costs that will only increase our debt, 
• cuts to medicare providers will result in increased health costs to everyone else,
• no one seems to be talking about increasing revenues to offset the deficit
• the GOP is playing hardball while we're caving in and that has to stop
• it's not a negotiation if one side comes to the table refusing to consider other options (i.e., the "no tax increases" stand by the GOP),
• defense cuts might unfairly reduce VA benefits, and
• fear that those already slipping over the edge into an abyss of depression, job loss or pay cuts, housing loss, stress, mental health issues, etc. are not finding any relief and this Bill makes that worse. 

Markey then asked us each to tell him which Step (2 or 3) we would "vote" for so he can go back to the House and talk to his colleagues.  Nineteen (19) participants voted for Option 2 as preferable over the seven (7) votes for Option 3.  He also reminded us that every legislator needs to hear from all of us.  If we want to have a say in the final outcome, we must mobilize and make our voices heard on the subject.  The Tea Party has been very organized and goal-driven; we must do so also if we don't want our worst fears to come to fruition. 

Congressman Markey, we appreciate your invitation for us to meet with you and give you our input on this critical matter and to represent our constituents' needs.

Additional information sources for this morning's article:

• "Quick Summary" of the bill by Keith Hennessey
• "The Debt super committee: who will serve on it,"by Paul Kane, Washington Post
• **"Deficit 'super committee' reflects party leadership," by Lisa Mascaro, Los Angeles Times
• Numerous articles on economics and politics by Paul Krugman, NY Times

Disclaimer:   I attended this meeting as part of my paid job with Tri-CAP and thus "reported" on it in this format.  My views do not necessarily reflect the views of Tri-CAP. 

Wrapping up the Week, 10/10/09

I've not posted much lately because so much has been the same thing over and over, especially on health care.  But this week was a little different and I'll give brief mention to a few items today.

NASA Rockets (in)to the Moon - Literally!

Being on the East Coast was a bonus on Friday, permitting me before heading to work to watch NASA launch twin rockets into the Moon surface in the search for water.  The experiment was designed to capture and analyze the plume of debris from the rocket impacts.  The debris, once ejected from the moon's dark side and exposed to the sun, will begin to break down into its basic components before vaporizing; any water-ice, hydrocarbon, or organic materials will be exposed to NASA's collection instruments.  It will be several weeks before NASA has all the data coordinated from the many sources collecting it and can state whether or not they found water.

If you've never explored NASA's website, here's a chance to do so.  There is a ton of "neat stuff" for all ages.

Health Care Indignities by CIGNA Just Keep on Coming

Cigna is a major health insurer with some major press issues.  Of course, that's not why I'm writing about them.  I'm writing because they do a terrific job of making the case for health care reform! 

Example 1:  Cigna is still experiencing fallout from a protest over the 2007 death of Nataline Sarkisyan who died needing a liver transplant that Cigna deemed too experimental.  After protests in 2007, Cigna reversed its decision, but Sarkisyan died hours later.  In 2008, Sarkisyan's mother and supporters from the California Nurses Association went to Cigna headquarters to confront the CEO and demand an apology.  Angry protestors were heckled by Cigna employees, with one employee literally "flipping off" (giving the "bird" or middle finger) to them.   Sarkisyan's mother left, feeling defeated and stunned by the employees' actions.  She also did not get to meet with CEO Edward Hanway.  Read the article on Huffington Post or this article on Los Angeles Times. 

Read more at: http://www.huffingtonpost.com/2009/10/08/cigna-employee-flips-off_n_314189.html

Example 2: Cigna has another battle on its front lawn and this fight is being supported by MoveOn.org and its supporters.  Dawn Smith is trying to fight a treatable brain tumor, but with Cigna as her insurer, it's not a battle with the disease that has Dawn in a fight - it's been a 2-year battle with Cigna which won't even tell her why they won't cover her treatment.  Cigna recently reversed its decision and says it will cover treatment, but they won't tell her why they denied it for 2 years or why it will treat her now.

Cigna only reversed its decision after the public spotlight was thrown on it; does this mean everyone has to go public with their medical conditions to get appropriate treatment?

Health Care Reform is Still a Political Game that Ignores What Americans Want

The above are just 2 examples of why our public health care system needs reform.  The large health insurers are the major voice that seems to get the attention of the Senate Finance Committee.  They continue to ignore the huge numbers of Americans who have signed petitions calling for a "public option" in health  care.  And my previous posts on health care tell that story pretty well. 

Current proposals to include the public option but permit states to opt out show that legislators are not listening; they are playing politics as usual.  They want to be able to say they support the public option and voted for it, so voted for this proposal to get the bill passed.  Others will say they didn't support it but voted for it because it will then be up to each state to adopt or not adopt it.  This is how Congress has its cake and eats it too.

On the Local Front...

Here's something I learned about this week.  Last month, a Massachusetts senior received notice that her October Social Security check was going to reduced by almost $200 (for that month only) and then subsequent checks would be reduced by almost $100.

How many of you can afford to have $200 taken from one month's income, and following that it would be reduced by $100/month?  Now answer that question again knowing that your monthly income was only around $1,100 in the first place!

You probably agree with me that this is a lot of money.  Seniors depend on Social Security for rent, food, medical bills, clothing, and more.  Getting a 10% cut like that hurts.  And getting 20% in one month hurts even more.  The senior was advised to ask Social Security about it, who informed her that MassHealth was taking the money out to cover her Medicare premiums.  Interestingly, the senior had received a letter from MassHealth in August stating that MassHealth was paying her Medicare premiums and that she should not have any money taken out of her Social Security check for it!

A phone call to MassHealth confirmed that the August notice was correct, so the senior brought the caseworker's notes on that call back to Social Security.  The person at Social Security again said they were taking out the Medicare premiums, but the senior argued back, showed her the notes from the previous day's conversation, and insisted that the worker check again.  A little further checking, going farther back into her Social Security computer record, showed that MassHealth was correct and Social Security was wrong.

This senior will get her money back and we hope this is resolved.  But it demonstrates how easily an agency can get something wrong, insist on maintaining what is wrong by not taking a look beyond the initial computer screen, and severely affect someone's life.

For anyone who is having this sort of difficulty, and for the advocates who assist them, documenting every phone call, getting the name of the person you speak with (& confirmation # of calls when they're available), and being politely persistent can make a difference.  We all have the right to question decisions that are made like this.  We also have the right to file an appeal.  Be sure to read notices to determine your rights to appeal and follow those instructions carefully and to the letter.  Meet those deadlines, even if you file a very brief appeal and then follow it up more details later.

Obama Awarded Nobel Peace Prize

People have mixed reactions to the news that the Nobel Committee has selected President Obama as the recipient of the 2009 Nobel Prize for Peace.  I'm pleased.  I think many people have not given Obama the respect he deserves for what he has accomplished and tried to accomplish in his first year in office.  Some talk as if he's been in office several years and cannot seem to get everyone behind his programs.  Some are seriously trying to derail anything he supports.  The Nobel Committee reflected on what he has done and is doing to stimulate peaceful talks and negotiations between and among several world communities and also what he's doing to try to reduce nuclear arms.

The award is recognition of the immediacy with which he tackled these tough world issues and has tried to lead by example in bringing people together to effect change on such important world issues.

Congratulations, Mr. President, and continue this important work.

Obama Must Not Back Down on Health Insurance Reform

Each day there are more articles revealing how some Republican leaders in town hall-style meetings are permitting misinformation, myths, and distortions about the health care reform bill to go unchallenged.  They're even furthering the "untruth" by tacking on additional editorial comments to the questioner's statement and taking the false scenarios even farther.

This is an intentional ploy to derail President Obama and is not about health care reform.  And it could work.  They pretend to discuss compromise but have no interest in forward movement.  These leaders are not serving the American public; they are serving a political party that wants its power back. Some of these leaders on the Senate Finance Committee, part of the "Gang of Six."  that is reviewing the bill for areas where they can compromise.  (See my Aug 29th post on this topic.)  

There are many people who have legitimate concerns about the costs and benefits of the reform bill under discussion.  Democratic and Republican leaders are among those with concerns.  This is not a bad thing.  Disagreement can lead to a better bill that serves us better.  Concern, discussion, and disagreement can lead to compromise.  But as I've discussed before, some of the dissenters are not interested in compromise.

These vocal opponents are interested only in derailing Obama's power.  Health care reform is their weapon. 

My message to the President, and to my legislators, is to stop playing "pretend compromise" and focus on what is best for the American public.  The Public Option is vital to true health care reform.  You knew that going in; now refocus and move forward.

The Democratic Party needs to find those Republican legislators who have the guts to vote on conscience, defying Republican leaders who are using this important bill to derail the President.  If there are areas where compromise makes sense without gutting the bill, then compromise.

Democrats and Republicans who have issues with the bill need to discuss those issues without distortion.  And they all need to tell the American public the truth, pointing out what the lies and distortions are when they surface so Americans can be informed and not lied to; the lies of omission must stop.

But overall, they must listen to the American public.  Our voices have been raised, loudly and clearly.  But it seems as if leaders in both parties are not listening.  Their ears are tuned elsewhere.

Tune in to us.

Listen to us.

We're talking to you...

Health Care Reform: One Argumentt -- Two Sets of Rules

Don't you just hate it when you are trying to understand an issue and someone comes along and starts talking about it -- but they're not really talking about it?  Instead, they're injecting a different topic into the conversation disguised as a position on the original topic?  It's like changing the rules in the middle of a game without telling the opponent.  The purpose, of course, is to derail the original discussion and get people talking about something else and never have to deal with the guts of the original.

The discussion was about health care reform.    Now Republican leaders are attempting to derail the conversation by introducing a senior health care bill of rights.  Republicans supposedly put this forward to ease seniors' concerns over health care "rationing" and cost-cutting under Medicare.  Now I wonder where that idea came from? 

"Under the Democrats' plan, senior citizens will pay a steeper price and will have their treatment options reduced or rationed," according to Michael Steele, chairman of the Republican National Committee, in an op-ed in Monday's Washington Post (subscription required to view most articles).  This is the same Michael Steele who, in 2006, called for cuts to Medicare to control runaway costs.   How convenient that the GOP has an answer ready to assuage seniors' fears, making a radical shift in position from 3 years ago.  How ironic that this "ready answer" deals with a concern that they created! 

In 2006, Steele felt that the way to reduce Medicare costs was to cut benefits to seniors.  In the current health care reform bill, H.R. 3200, Medicare costs are reduced by reduction of payments to providers.  Everyone seems to complain about runaway health care costs, but when there is a plan on the table to curb those rising costs while maintaining a level of coverage for vulnerable seniors, the Republication option is to derail the conversation. 

And that moves the discussion away from real health care reform.

More Immigrants Than Non-Immigrants are Uninsured

A memorandum by the Center for Immigration Studies finds that more immigrants than non-immigrants are uninsured. This would seem to contradict my post of yesterday that immigration is good for the economy, since providing medical care for uninsured residents tends to drive up medical costs for everyone else.

I'm looking at it a bit differently though. Many businesses that need low-skilled workers rely on immigrants to do these jobs. When there are fewer immigrants, the jobs go unfilled. Sometimes it's because citizens won't take those jobs. Immigrants tend to stick to these jobs to bring money home for the family while Americans will quit and go elsewhere to try to earn more.

But low-paying jobs mean people cannot afford to pay health insurance premiums. Oh, here's an idea! Why not develop a health care system that will provide low-cost premiums for people in low-paying jobs; get insurers to come down a bit in their premiums and partly subsidize the plan so the insured pays what they can afford. It will certainly cost less to subsidize premiums a bit, helping keep people healthy, than to pay the full cost of emergency care for serious illness brought on by lack of access to preventive health care. And this plan gets the insurance providers to share the burden.

Oh, wait -- that's what the current health care reform is all about!

Instead of seeing health care reform as government intrusion, let's look at it as another choice being put into the mix. Along with current insurance options and insurers, there would be an additional option for people who have low-paying jobs or may be long-term unemployed. Let insurers bear part of the burden, the government bear part of the burden, and the individual and company s/he works for bear part of the burden.

Small businesses could opt for a subsidized plan that covers their employees but is affordable for both the business and the individual. Why is that so threatening? Wouldn't it cost less, in the long run, to keep people healthy through preventive health care? Wouldn't business owners rather be able to say, "yes, we're small but we can provide basic health insurance."?

The current health care system has a lot of problems; rising costs -- skyrocketing costs -- among them. We need to work on containing those costs. Let's acknowledge first that among the reasons for those costs are several factors that don't improve health care (rewarding physicians for unnecessary medical procedures comes to mind) and a number of factors that are directly related to good health care or illness (research into diseases and treatments, covering medical costs for the uninsured, unhealthy lifestyles, etc.).

We need a health care system that provides preventive health care for all, shares the cost-burden among all the players as much as possible, provides incentives for good health care, eliminates excesses where they don't improve health care, and reduces costs by helping create a healthier society.

I don't know that any reform plan out there does all that. But I do believe that current reform efforts are a step in the right direction. If we move in the current reform direction, I believe we can help immigrants get health insurance, get better preventive health care, and reverse those numbers derived by the Center. And that would be good medicine in my book.

Word Cloud courtesy of Wordle

Who is Behind Health Care Misinformation?

I don't know whether these folks oppose health insurance reform due to true conscience -- and huge change of heart about government intrusion into our lives -- or if they are playing the same old, "I lost at my turn, so now I'll cheat and make sure you lose at your turn."

Either way, some of the champions behind spreading myth and misinformation are the same people who felt that Congress should step in and take over the life-or-death decision regardng Terry Schaivo about 4 years ago.

From the Huffington Post...
"Some of the same conservative figures taking potshots at Democrats for wanting to fund voluntary discussions about end-of-life decisions between doctors and their patients were leading the charge four years ago to contravene the decision by Schiavo's husband and guardian to remove the feeding tubes from his wife after she had spent 15 years in a vegetative state."
...learn more with wikipedia information on the Terry Schiavo case...

Once again, GOPers want to have it both ways. It's interesting to note, however, that their charges of government intrusion in the health insurance reform bill are actually made up, fictitious, as in not real. The language of the bill does not mandate any end-of-life decisions. The langauge does encourage and provide incentives for end-of-life discussions between physician and patient about every 5 years.

They are getting the headlines, though. And this is confusing the heck out of a lot of people, especially those with limited access to information from both sides of the issue. Who are the people with such limited access to information? Why, in many cases, they're the very people that health insurance reform is supposed to help! They're low-income elderly who don't have cable (yes, America, not everybody in America can afford even basic cable), they're homeless, or non-English speaking, and others who aren't digitally connected to high speed Internet or aren't computer savvy.

Another problem is that sorting out this misinformation takes time. I've spent many hours reading through different viewpoints and actual text of legislation. I've had the privilege of a summer intern who did some basic research for me, bookmarking websites and getting bill #s and references so I can do a more thorough review. Not too many people have that assistance. I'll do a separate post with many of those links.

Why is the GOP so intent on spreading myth and misinformation? Could it be that they have no valid reasons to fight against health insurance reform? Is this just a GOP tactic to make it difficult for Democrats to push through reform? It isn't a stretch for me to believe that. I just look at some of the other tactics they've taken over the years when it looked as Democrats might win. The "Swift Boat" attacks on John Kerry come to mind.

The GOP seems to find it easier to make things up rather than argue the facts. The sensational headlines are an easy grab, make for more media coverage, and give them air time when they have nothing real to say. Shame on them.

Health care and health insurance reform are needed. Now. Whether the President's plan is the best one to follow, it's a start in the right direction. It does not create socialized medicine, which is something so many people fear. It creates a multi-player and multi-payer system that extends health coverage to a great many people who don't have any coverage now.

Let's face it; staying healthy is less expensive than getting sick. If we can provide health care to more people, so they stay healthy, we'll have gone a long way toward fixing a broken system.

Debunking Health Care MISinformation, 2

Many people (many, many people) don't really know what's in the huge health care bill and will never read it. They rely on journalists and others to tell them what's in it and how that affects them. That's somewhat understandable. Legislation is really dry reading. And you've got to pay attention to what section and subsections you're in so that you can piece together which facts actually affect which other facts.

Which is why I'm steamed over the current health care bill. Actually, I'm steamed over the attempts by conservatives to distort the facts and misrepresent what's in the bill. The fear-mongering and scare tactics are especially cruel to people who are currently worried about health care costs and have medical issues that mean this bill will affect them very quickly when/if it passes.

A few places where you can begin fact-checking are Debunking Health Care Misinformation, which I mentioned in Monday's blog; The Washington Post (and be sure to click on related links so you can get updated articles; and the Huffington Post. You can search for more information and I'm sure you'll find many different stories out there.

That's what is so difficult about this issue; there's so many stories out there. But many of them are not true. Why is it that lies travel faster and farther than truth? Why does health care create such a ferver and bring out the worst in the GOP?

I'm going to single out Sarah Palin because she's getting a lot of attention with statements about fear of the government "pulling the plug" on her Downs Syndrome son. That's just so blatantly untrue and demonstrates her true nature. She's a sensationalist and will use anything, including her own children, to put herself into the spotlight. I'll wager that she hasn't even read the bill! And as a key figure in her state (before her resignation) and in her party (they'll use her for as long as she can grab attention), she should have read AND UNDERSTOOD every word.

We have a few more weeks that Congress is out-of-session. Let's use the time to actually research the facts about the health care bill, understand what it means for those we represent or our family members, and then expose the lies and distortions being played out across the airwaves, Internet, and newspapers. Let's help get the truth out to our families and seniors and those who don't have access to the truth. Let's talk to the staff of our legislators and find out their views on the bill.

And for those of you can stand it, get on those radio shows and debunk those myths that are being spouted by hateful, harmful people. Me, I can't stand talk radio and cannot listen for even 5 minutes, so I'd have a hard time listening long enough to call in! But if you can stomach it, go ahead and do that part.

Then, we need to inform our legislators on what we want them to do for us. We need to bring facts to them, not rhetoric. We need to bring voters to them, not lies. We need to gather the signatures of our families and people who have learned the truth and tell our legislators what we want them to vote on and how we want them to vote.

If we don't fight back, we lose; it's that simple.

Debunking Health Care Misinformation

I still have more reading to do, but this site is a great resource for getting behind the many rumors and misinformation regarding the Health Care bill.

Check it out for yourself and see what you think. I'll post more on it later, but wanted to get this resource out there, in your view.