Saturday, August 29, 2009

Griffith’s August Town Hall Meeting in Florence

Monday night, August 24, my daughter and I drove to Florence to attend another Town Hall Meeting with our Representative, Parker Griffith. We had attended his Town Hall Meeting in July in Huntsville and were anxious to see if his stance had changed on anything. We had hoped to arrive much earlier than we did, especially after having missed out on getting into Senator Sessions' Town Hall Meeting a couple of weeks ago because of the size of the crowd (and the inadequate size of that facility). Parker Griffith's words, as best as I could record them that evening, are in bold below and my thoughts are italicized.
I have also underlined some of the key points.

Kudos to Congressman Griffith and/or his staff for choosing a large enough facility to hold this event, and for the three microphones which were placed in easy to get to areas of the auditorium. The auditorium at UNA is big enough to hold over 1600 people, so even though it looked like 1300 or so turned out, there was plenty of room for all of us! Promptly at 6:00 p.m. it started, with a brief invocation, which included the request that the Lord grant us "a productive meeting" here tonight. The invocation was followed by applause from much of the audience.

Then Griffith was introduced; he began with an introduction of his own: "First of all, I appreciate so much…the number of people here…this is truly what America is all about and needs to get back to…we need to have such meetings in the future about education and illegal immigration…" From there he launched into a story about one of his patients (Patsy) from his days as a doctor. Of course, the story was being used to indicate to us that something needs to be done to our Health Care system: "Had she had insurance…and I seen her earlier…she would have had a 95% cure rate…saw Patsy late…spent over 1 million dollars….that's why we're here." I don't want to take away from the tragedy of that situation, and I hate to be disagreeable so early on, but no, I don't believe that's why most of us were there that night!

Griffith continued, "…Judeo-Christian ethic wants to make us do better…one of the best Health Care systems in the world – if you can access it…we are doing something right in our Health Care system, but we want everyone to be able to benefit from it."
Again, I have to disagree with the Congressman. The Judeo-Christian ethic is what makes US want to do the best we can – but we are not asking that of our government! As Dr Lappert pointed out in his talk last week, hospitals as we know them were started by Christians. Charity is to be a work of individual people, not something done by the government.

From there, Griffith started talking about the specific bill that is currently working its way through Congress. So far, the bill has been voted out of committee, but not onto the floor. Griffith assured us that he is opposed to the current bill – Waxman's bill. (Yes, that would be the same Congressman Waxman who recently co-authored the Cap and Trade bill, and who is almost single handedly keeping last year's toxic bill, CPSIA, from being fixed!) Waxman's bill started at 875 pages, and has already grown to 1017 pages, and weighs 40 lbs. At that point he held up his copy of the bill. (I don't think anyone asked him during the evening if he had read.) He continued, "We are discussing this at the right time – we don't want to have the same thing happen as the Cap and Trade…hoping and praying the Senate will shelf or gut." (Major applause at that point.)

Parker Griffith pointed out that he is vice-Chair of the Blue Dogs Health Care Committee. (Blue Dogs came up many times in the next 4 hours….) He also pointed out that there are several bad parts of Waxman's bill – including that it includes a federally sponsored Insurance company (commonly called the "public option"). At this point there were a couple of shouts of "yeah" and lots of boos. There is also a proposal on the table to do a public – or insurance – exchange – all wanting to sell would have to put their proposals in – with the federal government's proposals. (The audience reacted negatively at this point, and Griffith had to wait to speak again.) The difference is that the public one would be based on a similar idea to Medicare, which is financially unstable at this point. Several people in the audience got very rude here, and probably should have been excused from the auditorium. Griffith continued, the proposal is to remove money from Medicare to support the new public option (many boos) – Not a good idea. (applause)

The discussions continue about where to get billions and billions of money from – money from "Medicare savings", but would put Medicare further at risk, not a good solution. (An audience member yelled out, "been borrowing from for 40 years") So then Griffith told us, "Here's what I want to do. It is a fact that there are 4.6 million in Alabama, 1 million are on Medicare, 700,000 are on Medicaid (and yet later he would tell us how difficult it is for people to get on Medicaid), and 600,000 have no Health Care Insurance. At this point, I was still waiting for what exactly he was proposing we should do, but he finally got to his "suggestions": All insurance companies have to compete across state lines (much applause); no "pre-existing" refusals; small business be able to bid together; Health Care Insurance companies will not be allowed to "overrate for age". These should be the conditions to sell insurance in the U.S. Additionally, we need Tort Reform which is not in this bill (much applause at this comment).
Currently there is a doctor, patient, and a lawyer in every examining room and emergency room…It's not the amount of money in the suits, but the existence of the threat at all…He has to protect himself from suits…extra tests, etc. (more major applause).

Griffith said he asked Congressman Waxman,
why isn't there Tort Reform in this bill? Waxman's response: "Not time to talk about it." (Guess we can only wonder whether he needed more than 1,000 pages…or more than a few months…or…?) What else isn't in this bill? No increase in nurses/doctors in more than two decades, and the shortage of doctors isn't addressed…Less than 2% of medical students going into Primary Care…47 million Americans are uninsured – 10 million are under 19 and 20 million are under 40, not hard for us to insure. (I had to ask myself, on what does he base that claim?) Griffith than claimed that Medicaid in Alabama is the most restrictive in the U.S., we could liberalize Medicaid and cover more of the above. (And how would we pay for this small miracle?)
Additionally, the VA needs to be more liberal with care and take care of more Vets. (My husband, father, and father-in-law are all Vets, so I'm all for that in principle, but again, who pays how much for this?)

Griffith told us that the current Health Care bill contains many, many pages that are fine. (I've apparently missed those pages when I've read through the bill…I haven't seen ANYTHING that looked good to me!)
Appreciate folks who want Public Option, even though I'm against it, that's why we're Americans…I will do what I think is best for my constituents…We are in a very trying time…easy to knee jerk…I will take on the leadership of my party, the other party, the executive branch, to protect this district…

By this time dozens of people had lined up at the three microphones to ask Congressman their "brief" questions:

  1.     "Remind you that government should never be in the place of competing with Private Enterprise." (applause) Where do you stand on COLA adjustments going down for Social Security and Medicare?" Griffith: "Sorry about that…little Congress can do…will get worse if this bill passes." (Congress can't prevent COLA Adjustments? They make sure they get their own adjustments!) Questioner: "Before you pass the final bill, give us the chance to read it!" (Should have added, and be sure to read it yourselves!)
  2.     "Like Public Option…My daughter aged out of my insurance in high school…in college used infirmaries…sick over the summer…Mom's doctor wouldn't see her. What in your plan will take care of that?" Griffith: "Final bill we write, your daughter will be covered…our 5 children became uninsured when they finished school…let them stay on parents' insurance longer." (I have to wonder at where all this money is supposed to come from when liberals come up with this type of stuff…)
  3.     "…an opponent to Public Option…Christian…6-year-old diabetic grandchild, 6 month wait could prove fatal to her…want system that won't create long waiting lines and care that doesn't leave out elderly." (applause) Griffith: "Thank you."
    (Yes, that was his entire answer to this "question".)
  4.     "What bill would cover questioner number 2's concern…What would your bill do to lower my insurance rates for employees?" Griffith: No bill yet…No amendments offered to #3200 yet.
  5.     "1978…wife Margaret with breast cancer given about 6 months to live…state of the art Health Care under Blue Cross…$750,000 bill over 10 years…she lived 10 years, not 6 months…What we have is better than we realize…We have a Mercedes with a bad transmission, and the President wants to put us in a Hugo, I want to fix the transmission." (applause and standing ovation at this point in his speaking) "Will future Margarets die under care like Canada and England?" Griffith: "We have to be careful..can't take away from what we have…have to improve access for 47 million."
  6.     "Retired medical technician…used to be $3 for throat culture…until insurance started paying $12 for throat culture…all prices raised…bottom line is money…Try to get those people to understand you can't spend money you don't got!" (more applause) No answer from Griffith.
  7.     Woman with AARP: "What do you see as some of the most misunderstood and divisive portions of this bill?" Griffith: (a) "Comparative effectiveness" – originally to compare 1 treatment with another…Danger in bill like this to put things like that in law…used as standards for treatments…takes decision away from Physicians. (b) "End of life care counseling" scaring our elderly unnecessarily. At that point it wasn't clear to me whether he was saying that we were overreacting to the "end of life counseling", or whether it shouldn't be in the bill…. Then Griffith continued: If Physician gets graded on amount of end of life counseling…Needs to be taken out of bill…not a government responsibility.
    (applause)Look at that, Griffith and I agreed on something! "Hospice happened without the government…Polio Vaccine happened without the government, without one federal dollar…Less government in Health Care the better off we'll be. And for that he got a standing ovation – it's a shame that some of us have trouble taking him at his word on this – maybe it has to do with all the other things he's been saying about Health Care!?!
  8.     An Anesthesiologist spoke next: "Thanks to the Blue Dogs for getting this delayed until after recess so we can have Town Halls like this. Individual Responsibility and Lifestyle choices have to be addressed…" I always get a little agitated when I hear people talking about individual responsibility and lifestyle choices in this context – is he suggesting the government needs to address those issues?!? No thanks! Griffith liked that topic: 2,000 deaths/year in Alabama from various cancers --- and 3,000 deaths/year from smoking-related diseases alone…Lifestyle issues leading to Diabetes…no bill can fix that… Well, then please don't try!
  9.     My friend's husband, Chad, spoke next, bringing up the "Empowering Patients First Bill" by Dr. Price, and asked about making Health Savings Accounts simpler. Griffith: "Dr. Price…good bill, not much support for…Health Savings Accounts are good – if you have a job. I think that was one of the most obnoxious things I heard Congressman Griffith say all night! Chad continued: "…Lawyers/Hospitals can do Pro Bono as tax write off, but not Doctors…" No response from Mr. Griffith on that last idea.
  10. The next person was someone I recognized from last week's talk at the Liberty House. He made three points: Alabama rates second to last in using Nurse Practioners; 37% of budget goes to Health Care (in Europe 50% of budget goes to Health Care; do not support illegals receiving Health Care benefits…thousands of illegals registered to vote in Alabama (Alabama hindered by federal government for fixing that). Griffith responded that Emergency Rooms are overrun by illegals. (Is that a fact, or just a "truism" everyone likes to throw out there? I would love to see the stats on that.) Griffith got into a story about a friend being rear-ended by an unlicensed illegal…Until federal government has backbone to shut that border down…(He was cut off by cheers and applause)…Plenty of blame to go around – R's and D's in power – not dealing with… The questioner then mentioned that Parker Griffith should talk to Dr. Lappert – who has some great ideas.
  11. "Nine trillion dollar debt we have…federal government has stolen everything I've made and my children will make…didn't just start…going on for decades…Do you support term limits?" Griffith: Absolutely – that's an easy one…more important than term limits – have to stop begin disinterested in our government…have to stop losing our children…
  12. Older woman: "My concerns with Public Option: Lack of choice/rationing…husband using VA services…happy at first…chest pains…nitrate pills…went to another doctor through private insurance – ended up in Huntsville Hospital with 80-90% blockage in arteries…" Griffith: Great concern…danger in a system and we hear a lot about cost…many things Americans spend on that are much less important than Health Care (this was another one of the most obnoxious things Congressman Griffith said – so the Federal Government can tell us that we need to spend more of our money on Health Care?!?)…don't want to see that type of care marginalized by this bill…Why we're here…" No, sir, that is not why we are here – we want to make sure you understand that we don't like this bill!
  13. Respect to have Town Hall Meetings and hear all sides…bill up there doesn't need to be modified, doesn't need to be tweaked, it needs to be trashed. (Standing applause from audience) Portability – why can't we do that now? Griffith: State law. Her: "So it's a government-created problem."
  14. One of my favorite questions: Where do you find authority in the U.S. Constitution for the Federal Government to get involved in Health Care?" Griffith: "That's the second time you've asked me that…" Older gentleman: "Still no straight answer." Griffith: In our Congress, 1965, we decided to develop Medicare. Gentleman: "No better case." Then Griffith went on about Medicare increasing life expectancy since 1965. (Interesting claim, Congressman, it's a shame most of us aren't buying it!) Then Griffith made annoying remark #3 – Not a constitutional scholar…rabbit trail with you. Excuse me, Congressman, you don't have to be a constitutional scholar, you just have to read it and believe it! And it is not a rabbit trail!
  15. "I do support a public option…no doubt would lower costs of Health Care. (Audience was a little rude here...booing him)…Poor college student… Griffith: Massachusetts is proving Public Option not working. (applause)
  16. "Working for Pharmacy Call Center…83-year-old woman, her insurance would cost her $800…you are a blue dog…will you support closing the gap in Medicare…?" Griffith: Absolutely.
  17. Next we heard from a 13-year-old: "I do not want nationalized Health Care – neither do many of my friends…if you get nationalized Health Care, and its being rationed, still telling her to die, happens in nations like Canada and England. (applause) Not much Griffith could say at this point, so he didn't say anything.
  18. "Member of Labor – you promised would be an advocate for Labor…also said would be advocate for health reform…would do everything you could to get Health Care for everyone in the country (booing in the audience…which part were they booing?)…You have not voted for one thing for Labor in D.C….In 2001, U.S. down because of deregulation…This Economy is turning around, even though you didn't vote for Stimulus. Griffith: No, I didn't (at this point the audience was getting pretty riled up). Labor guy: "Are you Democrat or Republican?" Griffith: I'm a good Democrat.
  19. We finally moved on: "Member of NRA" (applause) …Broke college student…but opposed to Public Option…News…a lot of ruckus about Democrats in Congress pushing bill through in spite of concerns.
    Griffith: With a technique called reconciliation…Obama will be a one-term president…we are a polarized nation and can't afford to get more… Then Griffith said something about what stimulus will do… (I missed most of the answer, but there was lots of applause.)

  20. "Esther (Old Testament)…there at the proper time…surprise to me, but the Blue Dogs may be there at right time…Waxman typical of politicians in D.C….salespeople… 'gotta be done now'…We're not ignorant...we know way socialized medicine care goes..these salesmen are the reason bill weighs 40 pounds…thank you it has not been voted on yet…if Blue Dogs will go back to D.C. and hold a bonfire on the mall and burn every one of them you would do our children and grandchildren a great favor…We don't have enough doctors and Health Care people going through our system…what's to encourage them when looking at a bureaucrat deciding what they can make…constitutional authority…but when it comes down to reality…very dangerous thoughts to us." No answer from Griffith, though I'm not really sure what he could have said at that point…
  21. The next question was very off topic – about Congress declaring war, not what happened in Korea, Viet Nam…Moving right along…
  22. Good questions: "…correct earlier person…People who made mess of mortgages were Barney Frank and Chris Dodd…Constitution…Declaration…government is based on consent of government…" Griffith: "…We the people have got to make our voices heard."
    I'm sorry, when I hear that from a Democrat, I have to shake my head. No, Congressman Griffith, WE the people, have to have OUR voices heard…" Back to questioner: "Retired for 22 years…How do we as individuals make those idiots in Congress show us what they are doing and do what we want?" Griffith: "Doing it right here…the more hollering the better…Need to do more often."
    Implication being that he is listening to us? Time will tell!
  23. "…Moved here from California…Type 1 Diabetes is NOT based on lifestyle…need to figure out way to cap insurance profits…if can afford premiums can't afford co-pays…Health Care costs up because Clinton's bill requiring all facilities taking Medicare money must take all who show up wanting/needing care…" While I think this questioner made some good points about Medicare, I'm still not so sure that insurance companies are raking in outrageous profits…No response from Griffith (but I don't think a question was really asked.)
  24. "Not from this district (originally from New Jersey)…Great tax system here in Alabama…(we're trying to figure out what his point is…) …More like medical control…end of life – don't like direction that is; don't like taxpayers paying for abortions a moral issue there); other problem we have…Federal Reserve…" (Audience started yelling, "Ask him a question."…He finally stepped down without having asked a question.)
  25. "How do we keep abortions out – since every attempt to exclude abortions has been shut down?" Griffith: Co-sponsored bill that would exclude abortions…promise not to vote for ANY bill that does not EXCLUDE abortion…lost some votes here, gained some.
  26. College student at UNA: "Why do you associate yourself with leadership of your party like Pelosi and Obama?…we have reached a tipping point." It looked like he turned to an audience member at this point, and said, "Sir, you are in a minority in this building today". Back to question to Griffith, "Will you stand firm in our principles, or will you fold to pressure of Democrats?" Griffith: "Practically speaking, Conservatives couldn't have stopped this bill, don't have vote…Someone asked me earlier whether I'm a Democrat or a Republican, I'm an American…What we have watched for last two decades, enough blame to go around…we need to change our attitudes and stop stereotyping people…worrying about jobs…"
    My question for the Congressman at this point would have been, if you are worried about jobs, why are you willing to sacrifice the Economy for the sake of any type of Health Care "fixes"?
  27. From Huntsville: "Cap and trade – sitting on a shelf – and you hope and pray it stays there. I hope and pray you are doing more than hoping and praying…You're saying all the right things…but you seem to be divorcing yourself from fact that your party is ramming this through…Need more than good words…You need to fight your leadership…biggest bait and switch ever, will create the biggest bureaucratic takeover of Health Care, all will be set by standards of BOARD appointed by President…willing to go and fight your party, haven't seen that." Griffith: Have you seen my voting records? Her: "Safe votes because party had votes without you…we need you to go and fight, not just vote NO! Take the leadership down and stop this insanity!" Griffith: Nancy Pelosi promised vote on floor before August Recess – Blue Dogs told her it would fail if she did.
  28. I missed the next question, it was something about Medicare. Griffith: 435 Congressman – a lot of competing views on Medicare.
  29. Next speaker started by commending the 13-year-old for speaking. "…Against the Public Option…Brother-in-law dentist with health issues, insurance because of wife's job…would get pushed aside under this bill…260 million Americans DO HAVE insurance!...Those vets didn't fight for socialized principles, they fought for democratic principles." Griffith: Very opposed to Waxman's bill…but believe that we as Americans want to preserve our Health Care while keeping what's good about it!...we don't want a bureaucrat even thinking he is in a position to make those decisions.
    How does he think we can possibly keep what's good with our Health Care and do even a portion of what ANY of the Democrats are proposing to do?!?
  30. "Some Congressmen won't face constituents at Town Halls, but willing to send our boys to harm's way..Have seen where Obama has said (in past) he was FOR single payor nationalized system….House Bill backway path to socialized Health Care…we will lose all control if makes it to Conference Committee between House and Senate. My question, why are things happening so fast? …Why does it have to be done in such a short period of time? (members of audience getting rude…) Griffith: We're losing some audience here. Questioner kept going, without saying much. There was applause when he finally stopped, and Griffith didn't even try to answer. Not much he could have said at that point.
  31. "…you made me proud I voted for you…Obama said, 'If you like your doctor and your insurance you can keep it." Griffith: Mistake to think if Waxman bill passes, will be able to keep… Questioner: "How much do doctors have to pay in malpractice premiums?" Griffith: $50,000 - $300,00/year or more…When I'm sued by a patient, my house, everything I own, goes on the line…not how many suits, only takes one for hospitals and Doctors to practice defensive medicine…Told Waxman had to have Tort Reform, ignored me. Questioner: "Pelosi might not let you back in chambers if she hears what you said here tonight." Griffith: …I'll have a gift certificate to a mental institute for her…
  32. Long drawn out story with the next person…Audience getting tired, taking too long to get to question: "How many would have to be in Co-op to work?" Griffith: Don't think state co-op would work, would have to be a regional. Questioner: "Trying to get insurance in Tennessee, joined affiliation of contractors to get better rates, no significant difference in costs, with 600,000 members. Why couldn't get better discount?" Griffith: You're asking me? I have no idea. Questioner: Paying 10% in insurance, raise my taxes 9% with Single Payor, and I'll still be better off." Griffith: If could get seen! He got it better than she did! Griffith continued: Cannot reform a system around a shortage…have to reform system fundamentally, not just an insurance question…If you had a pure Medicare hospital it would close… (She still thinks Single Payor will be better!) Griffith: It won't feed the bull dog, it won't pay the bill. (audience is getting rude again; getting restless) But I still don't see how anything being proposed will accomplish Griffith's grand goals!
  33. "If we got the government option, it would be subject to change at any time." Griffith: If we enact Health Care reform in a partisan way, it will be reversed in the next four years...too important to be decided along partisan lines. (We might add that it's too important to have the government deciding!)
  34. "…Need more people in D.C. like you…since both parties suck…Adding 47 million to Health Care without adding more doctors – rationing will become a reality.
  35. 36-year-old single mom: "How long will this arguing take…What is it going to take? What can we do to help hear other's… Griffith: You are exactly what we need… (Audience member yelled, "Give her a job.")
  36. Now, we're all getting emotional: "Not what will happen to my care, but what will happen to her." (Audience members telling him to go help her himself…) "One question, will you work as hard for her as for cheerleaders here?" So now, we've been relegated to the status of "cheerleaders"! Griffith responded with another non-answer: Need to see our children early and our ill early!
  37. Minister: "For the public option…Vietnam Vet…fought for black folks to have same rights as white folks…One daughter in college, went to Emergency Room, charge $1560…Ask these people what planet you live on? … When you Blue Dogs going to get behind a winner like Barack Obama? (boos from the audience) My question is: "When are you going to read the bill and stop listening to Rush Limbaugh?" Griffith didn't answer.
  38. "My husband and I both voted for you." Then she asked the audience, "How many of you have read the bill? Many hands, including mine, went up. "Got to fix the problems…Pre-existing has been a monster for years…bill deals with it….Illegals…what about companies who knowingly hire illegals? Griffith: Stimulus bill took out the E-Verify system. Her: "Why can't you guys look at the bill and see what we can agree on?" Griffith: This bill weighs 40 pounds. It was completed on Thursday, they wanted to bring it to the floor on Friday – we blocked it from coming to the floor without ANYONE reading it…A government that can give it to you can take it away!
  39. Christie: "I want to correct one thing about Blue Dogs, didn't stop the bill – just slowed down. If had all stuck together, wouldn't have come out of committee." Griffith: We wanted the American people to see the bill.
    Christie: "Pelosi one of the front runners of this bill, would you vote again for her as Speaker of the House?" Griffith: No (audience member yelled: "Best thing you said tonight…she needs to go home.") Griffith continued: Someone that divisive cannot bring people together.
  40. "We have a lot more in common than I would have realized…Do you feel the most significant thing in Health Care is cost?" Griffith: It's access.
    That is a common theme we hear from Griffith – that the biggest Health Care problem is access, not cost. And yet, only real complaints we're hearing from people is the cost! He tried again: If costs were reduced significantly, would take care of some of the issues. Griffith: We need more providers. Questioner: "How do we get those?" Griffith: Medial School in North Alabama…System trying to change here didn't grow out of a mandate from government…as plans grew, became more and more expensive…companies becoming international, without loyalty to American workers… Questioner: "…eliminate tax incentives for employers paying for Insurance so employees can get own insurance…We need you to fight for us…Pharmaceuticals gauging us… (Why is it so often assumed that because the price of something is so high, that it is because we are being gauged?!?) Griffith: Big pharmaceuticals made deal with President…no competitive bids. (If that's true, there the government goes, interfering with the Free Market again.)
  41. "…carry on to next generations…(hard to hear this gentleman, and he was having trouble getting to his question) …Social Security…cover most of your Health Care." (I had no idea what he was saying, and I don't think the Congressman did either…We finally moved on)
  42. From Huntsville area: "Very opposed to any government insurance…have read most of the bill…What can we do to help you keep this bill from passing?" Griffith demonstrated how his voting card works and then said:
    What I can do for you is listen to you…people in our Congress that don't think like we do…something fundamentally flawed as that…not against reform our Health Care system…not way to do it.
  43. "You say availability is biggest issue…I agree with others that cost are biggest issue…big difference between taxation and charity – an act of free will – want everyone including YOU to understand the difference (applause)…with other reforms put in place don't need government to subsidize doctor's education. Griffith: Existing schools… Questioner doesn't earn himself any brownie points at this point: "I'm against government education." Griffith: Greatness of America has come out of Public Education (Personally I think that's as big a stretch as crediting Medicare with our increased life spans...)Then the questioner really goes over the edge: "This is the Constitution. You said this is a theoretical document. (Checking notes from first 42 questions/comments and answers, don't see that comment anywhere!) Griffith: I didn't say that. Then they get in a nasty fight about public education and I stopped listening (thankful that the questioner never mentioned homeschooling in his arguments!)
  44. Business owner in Huntsville: "Lady from AARP had asked about misconceptions about this bill…misconception is that this can be free or affordable…a bill that forces transparency in insurance companies…and some type of cap on costs." (I guess he was saying that was what we needed a bill to do?!?) Griffith:
    A scarcity…increase supply, reduce costs. (So the earlier fight over scarcity versus costs boils down to both – if we increase supply, the costs will go down, and there will no longer be a shortage…but government intervention will decrease supply and increase costs!)
    Griffith: Agree that Pharmaceuticals are out of control…only country in the world that allows them to push drugs on TV.
    (So pass a law forbidding that and be done with it!)
  45. Linda: "It's been said that the President, Senators, Congress have insurance that will not be effected by this bill, is that true? Griffith: Introduced a resolution that would require Congress to be on the same Health Care plan. Linda: "What doesn't Congress understand about 'No'? Get your hands out of my pocket and your nose out of my business!"
  46. "You have people in need…people don't mind helping people in need, mind being taken advantage of…" Griffith: No system someone won't try to take advantage of…people in financial world taking advantage of the system… Questioner: "Difference when people buying dog food with food stamps…. Griffith: We can cure diseases today that we couldn't dream of curing 25 years ago…lifestyle choices…we decided as a country to fix best Health Care system in world.
    Excuse me, Congressman Griffith, Mrs. Difficult here again to argue with you – No, WE didn't decide that! Absolutely not! Some of the more liberal minded folks in D.C. decided that – it is not the will of most of the people!!! Questioner: "Take a message back to DC. About the Health Care plan… (I missed the message somehow…) Griffith: I didn't take the Government Health Care option, paying for my own.
  47. "Vietnam Vet, been on Medicare and on Blue Cross/Blue Shield…How are we going to defeat that bill…We need to take the U.S. back."
  48. "Earlier you equated Medicare with increase life expectancy; don't believe one has anything to do with the other." Griffith: We have people living today…that would never have lived…if we hadn't accessed system… (Oh yes, clearly because of Medicare! AARGH!) Questioner: "…bill that's a complete overall of Health Care in U.S. and I'm just trying to figure out why…go about it slowly, one issue at a time…give our Congress time to figure out where money is going to come from." Griffith: That's why we slowed it down…One of things we can do is require any new drug on market be cheaper and more effective… Okay, let me see if I have this straight, Congress will declare that only new drugs can be developed that are cheaper AND work better…Yeah, just like they declared that bicycles and ATV's for children will suddenly be made without lead – because they said so – Say goodbye to new drugs!
  49. An elderly gentlemen, over 80: "WW2 Vet, Medicare has been a blessing to me and my wife…reading about specific pages in bill…we Americans are benevolent people…"
  50. "Do you currently have enough votes to kill that bill?" Griffith: Yes, why it hasn't been voted on yet…and they have fewer votes than they did before, after these Town Hall Meetings.
  51. "Walking, without Hugo…If you're against it, where do I go?" Griffith: Let you have a choice of Insurance Companies…Let them compete…Ability to get Health Insurance will go up, like term life insurance, and home insurance…Will always be people who need to be on Medicare/Medicaid…Need to expand SHP…or will spend fortune correcting what could have corrected earlier…
  52. "How in the world did Democrats put someone like Pelosi in Chair…sounds like regardless of what American people want, they'll pass it." Griffith: If they do reconciliation (only need 51 votes in Senate, not 60), end of Democratic power – including President Obama…
  53. Vet from Iraqi Operation Freedom: "…didn't come back same…30% connected to VA…How am I going to be taken care of?" Griffith: Don't have to worry, VA getting better, not worse! (not a repeat of post-Vietnam) We have 486,000 Vets in Alabama, just under 80,000 in this district. We owe it to you and your family that you get the care…
  54. "Are you willing to oppose all Public Options?" Griffith: "All I've seen so far, I've opposed – don't know what's coming down the Pike.
  55. "Are Blue Dogs willing to pull Obama to the middle where most America is?" Griffith: If he doesn't separate himself from ones like Pelosi, he'll be a one-termer…Hasn't transitioned from a Campaigner to a President.
  56. "…How about a gift certificate to Dr. Kevorkian? …Ronald Reagan warned about socializing medicine."
  57. "Said earlier, 'no turning back Medicare'…almost had bill rammed down our throats…need time for public to see bills…ALL legislation should be approved by us…Medicare/Medicaid have raised the costs of Health Care…How will Single Payer reduce costs of Health Care?" Griffith: It won't! …Access to Health Care…It's outcomes we're interested in… Questioner: "Nothing in that bill that leads to positive outcomes." Griffith: Exactly! Questioner: "Bill gives employer incentive to drop Health Insurance…8% tax less than cost of Health Insurance currently providing." Griffith: Fewer people in private will pay higher, until private insurance goes away…leads to Single Payer Government Plan…
  58. Widow of proud Marine; brother was Marine… "Dad would have been exterminated under this… She has Blue Cross/Blue Shield…It works. Don't exterminate our parents and our Vets."
  59. Medical technologist for 37 years: "…will be shortages in ALL areas of Health Care… We (lab) did VA hospital inspection, found problems, no longer allowed to do inspections…Our VA system needs to be overhauled!"
  60. "So many Congressmen holding Town Halls…arrogant…not going to listen to his constituents…bothers me…" Griffith: Bothers
    me too. Questioner: "How do we know who to trust in D.C. anymore?" Griffith: Many honest people in D.C…Representatives are people's reps! You best pay attention to your constituents. Questioner: "You yourself said we can't undo Medicare, so how do we undo this?" Griffith: Best just not to do it!
    Then Griffith started using Great Depression as example of good government. Gag! Griffith: Some people need help, they truly do… (But our argument isn't against people needing help, it's about whose job it is to provide that help – individuals or the government?) Our strength is we can come together to solve…We can't get too close to a problem…We have a track record second to none…we cannot be defeatists!
  61. "All questions about Health Care have been answered…immigration is transforming our country overnight…what angered me…when they asked Barack Obama whether English should be official language…divides our country…angers me…We can send our solders to harm's way, but we can't secure our borders?!?" Griffith: Complete agreement…No backbone… Questioner: "Health Care is a problem…Immigration will rip our country apart! (If he is referring to illegal immigrants, I agree with him, but he almost sounded to me like he wanted ALL immigration ended!)
  62. "Knee replacement coming up…9 providers to find someone who will do…VA limit is 600/year…Tort Reform in Health Care will be handled, but still make Doctors more accountable?" (Something about an ad on TV that mentioned Congressman Griffith, as if it had his support, he didn't know anything about it in advance, or approve it…) Griffith: Tort Reform doesn't mean we don't want doctors sued… Questioner: "…Competition across state lines, if we bought insurance in California, and that Company went bankrupt, who bails them out?" Griffith: Health Insurance is regulated, reserves required… Questioner: "Most I can stay in hospital with knee surgery is 7 days…"
  63. "Paid taxes 47 years…I have a vested interest in what happens…resent being called a Radical…Make sure abortions are left out of any Health Care bill…" Griffith: Will do! (Okay, we've all heard it. Griffith has promised repeatedly now to vote against any bills that do not EXCLUDE abortions!)
  64. "…Courageous gentleman to say what said about Pelosi…Dr. Price of Georgia set up day to go over bill with Barack Obama; please take a day too." Griffith promised to do that.
  65. One of the last speakers of the night was a 16-year-old Eagle Scout whose Mom was diagnosed with breast cancer in 2005. "We won the battle…like the Health Care we have…greatest in world." Griffith: You need to run for Congress.
  66. "Would like to see something pass…my brother has been laid off for 8 months…he has no insurance…there are people being laid off daily – Blue Cross/Blue Shield is great, I love my insurance, but what is in there for them?" Griffith: We are not saying NO to improving our Health Care system…you would not still have Medicare under…No one in Congress I've spoken to is against Health Care Reform, but want DIFFERENT bill! …No one wants to avoid that, we want to improve the system….Well-meaning individuals in Congress… (Well, as they say, the Road to Hell is paved with good intentions! And frankly, most of us don't care how "well-meaning" they are, we care what they DO!)
  67. "Illegal immigration, moment you bring it up you will be a bigot, a racist…this has to stop…the Schumers, the Pelosis…" Griffith: McCain got thrashed by his own party, over amnesty... Questioner: "Open Door into this country…."


And with that off-topic comment, an hour late, the 4-hour Town Hall had come to an end! All in all, I was glad we went. (Didn't realize then that we would be in Athens just a few days later listening to Congressman Griffith discuss Health Care yet again, but those notes have to wait for another blog post!)











Monday, August 24, 2009

Health Care Talk

I enjoyed the Health Care Talk last week at Liberty House.
Dr. Lappert gave a wonderful talk that he called, "Taking Our Medicine: The Government Takeover of Medicine and its Consequences for Human Dignity". I went expecting a talk on the ins and outs of the current Health Care bill (since Dr. Lappert is one of the few I've heard of who has read more of it than me). But this talk was so much more than that. In fact, my biggest frustration was that the group present to hear him was so small! As is my habit, I took notes throughout his presentation, but he talked very quickly, and shared much good information, so this is just the highlights of what he covered last week (his comments are in bold, my thoughts are italicized).

Right away, Dr. Lappert was changing the tune of today's debate, at least for me; spelling out clearly that this is not the first time liberals have tried to take over the Health Care system; the battle has been running for over 70 years (he explained that further, later in the evening). I really liked what he said next:
"If we are arguing about the details of the current legislative effort, we have already lost. It is NOT a question of too much, too fast. We need to get away from any argument that makes it seem like we're just unhappy about portions of the bill – even large portions of it." He then pointed out that we are living with a government manufactured crisis (which he also explained further at a later point). And he explained that most of the current Health Care problems could/should be solved at the State level, not the National level (which many of us have been saying throughout this argument!)

Dr. Lappert explained that the role of government in private lives is unparalleled! (I don't think there was much disagreement in the room that night!) And he talked of the collision of interests in this "crisis" – private, corporations, state, and federal. (Depending on which figure you believe, Health Care equals ~14 – 20% of our Economy.)

Meanwhile those in the Government complain that the crisis is worsening because the population is getting older, the number of workers paying taxes is going down, the rising costs of high technology, fraud, poor patients abusing the Emergency Room, and Insurance Company abuses.

But then Dr. Lappert pointed out that we need to look at our Health Care "Crisis" in the context of the History of Western Medicine, which cannot be fully understood without understanding the Christian Worldview (a connection I'm sure that most of us had not made before!) He spoke of: Faith (in an eternal destiny),
(our actions have meaning and affect our destiny), and Charity
(perfection in the love of God is best action for affecting our destiny).
And that right there summed up much of what has happened in Western Medicine, and what we have strayed away from today, in ways that I had never thought of before!

From the earliest days of Christianity, Christians have believed in caring for the sick, the poor, the forgotten, and the impoverished! In fact, hospitals were started by Christians because of those beliefs…In the third century hospitals first appeared, run by Christians, for the care of the poor, the stranger, and pilgrims. (Before that, the Romans had clinics in wealthy homes for the care of the rich, their families, their servants, etc.)

Julian the Apostate, nephew of Constantine, who had renounced his faith when he came to power, saw the effectiveness of Christian medical care and ordered a state version, based on taxes. (Sounds familiar…)

The Christian methods of caring for the sick and the poor worked well for centuries, until:

The rise of materialism during the Age of Enlightenment; which put faith and reason at odds with each other. The myth of progressivism claimed that man today is superior to those from 1000 years ago, and that science is "based on reality". Dialectical Materialism comes out of this belief and was the foundation of Marxism.

Meanwhile, in America public and private efforts in Health Care had grown in parallel. For instance, the Mayo Clinic was started by the Sisters of St Francis and the two Mayo brothers… But, charity is not obtained at the point of a gun – that kills charity….the Government has no business "doing charity". And under this system, who got care? Everyone who needed it – No one went without medical care. (And until the 1960's it was understood that all doctors gave 10% of their time to pro bono work.)

But even before then the Federal Government started to get involved in Health Care: In 1934, with FDR's Committee on Economic Security's Social Security Bill came the promise that a "health insurance plan would be forthcoming"… and it was violently rejected by the voters of the time.
Bills were presented to give the government more control over Health Care starting in 1943 – and President Truman was the first president to publically support the idea – costing his party the 1950 mid-term elections.
(Hopefully, the same will happen in 2010!)

In 1956 the Disability Act, a "necessary prelude to universal health care", was passed. And in 1957 the AFL-CIO came out in support of the idea. In 1965 65% support was garnered for Medicare – with the idea of shifting dependency away from family and charity to the state. Claims were made that elderly would be ruined by catastrophic illness – even though there was no catastrophic coverage in Medicare. Among other things, they misrepresented the poverty level of the elderly in the U.S. The AMA fought the idea of Medicare idea (the last intelligent thing they ever did?)

In the beginning of Medicare, the bills were paid in full – and there was no incentive to cut costs. (We were in the midst of a booming economy, since Kennedy had cut taxes recently.) The generous Medicare payments skewed the valuation of services, and resulted in 30% of spending on the last three years of people's lives. Before this government interference, less than 40% of Americans had any insurance at all! Medicare caused a rise in the prices of Health Care for all. And it led to an explosion in malpractice and product liability lawsuits. It also led to a dramatic rise in private insurance with the promise of "Pay a little, get a lot" (Actual result: "Pay a lot, get a little.")

With all this government intervention, we have gotten to a place where insurance companies pay only an average of 9% of the total bills that hospitals submit to them…And doctors average 40% payment on the bills they submit. (And yet, a private payer, with no insurance, is expected to pay 100% of the bill!)
And then these billed prices are the ones used to calculate "Health Care costs", even though they are inflated, and not generally paid in full!

Our system has become nothing more than a
protection racket. But the threat has been createdby the Government – those that are now offering to solve it for us!

What are the top reasons most of us think Health Care is as expensive as it is? Inflation? Litigation? Technology? Bureaucracy? And of those, technology is often believed to be the worst culprit – but technology makes goods and services less expensive and more available to more people.
No, the real reason is the implementation of the "Soviet Model" of Federal Government with central planning, unmanageable complexity, and the denial of basic human motivation…

And now those who are trying to get the current bill rammed through over our protests are changing the terms – referring to the bill as the "Insurance Reform Bill" rather than the "Health Care Reform Bill",
as if that would make it more palatable! And they've started calling for "medical co-ops", blending market forces with collectivism…but the result will still be central planning, federal start up money; cherry picking of the lowest risk patient pool, and entry into "Medicare for the young"….none of which those of us who believe in liberty/free markets can endorse!

There are a couple of truisms that will hold up well in this argument against the socializing of our Health Care: (1)
"The most efficient place to control costs is at the point of sale" and (2) "People are most frugal with their own money!" If we spend our own money on Health Care – we reduce the cost at the point of sale; remove issues of "injustice" (who's paying for what and who's receiving what); and get rid of morality issues (like "end of life decisions").

We need to make incremental changes – we didn't get here overnight; tort law is mostly state law; insurance law is mostly state law; we need to keep hammering the MORAL TRUTH – not the TECHNICALITIES – of Socialism (including this bill!) A
good starting point would be: States should mandate that those using Health Care Savings Accounts must get the same discounts as the insurance companies…And we do need tort reform: caps on punitive awards; caps on product liability awards; and jury of peers …

In summary: What is the central issue that makes this an unjust system? The use of other people's money! (He who pays the piper calls the tune)
Medical care is the current battleground between forces of liberty and forces of statism! It is an Invented Crisis! And they are trying to nationalize a state problem.

And finally: Remember 1950 – Keep them on the run! We need true champions of liberty!

Monday, August 17, 2009

Les Phillip – Health Care Reform Town Hall

My notes from last week's Town Hall Meeting with the next Congressman from our district: Les Philip.

The meeting was very refreshing after the one I attended in July. Most of the people in attendance were well behaved, and most asked reasonable questions.

Les' Campaign Manager reminded us that "this a dangerous time for our country" and that "now is the time for all good men to come to the aid of their country." Les was introduced to us – an immigrant to our country who pursued his dream to be an aviator for the Navy, then joined Industry, and now runs a small business with his wife – the kind of credentials we need in D.C.

Les pointed out that: "These are difficult times…and one of the most important things today is Health Care…and our Representative is out of the country…When I hold this position, you'll know where I'm at when I'm home…"

Les also pointed out that "most of our representatives have not read the bill…and if they need a team of lawyers to read a bill, they need to get a new bill….Health Care will touch every one of us, it is the one thing that touches every single life in the United States."

And then he asked, "Why do we want to get rid of the best system in the world? Who thinks we need to overhaul the entire system?" Apparently only one hand went up from the 150 – 200 people present in the room, so Les graciously gave that gentleman the opportunity to ask the first question.

  1. "…people are going bankrupt because of Health Care…people who oppose it are offering NO plan" Les: "Not true that there are no alternative plans. One of areas looking at is competition…Competition equals zero…The federal government can break down barriers to competition, efficiencies/profits will be increased." Les went on to say that the "reason no competition is roadblocks the federal government needs to get out of way." And he pointed out the need for "Health Savings Accounts with catastrophic policy – Young People should at least have = responsibility (prevents bankruptcy and burden on society)…Portability: Insurance policy goes with you; not attached to your job." And "Tort Reform…OB in my family – she pays half a million dollars/year in liability insurance….For the last 100 years incidents at birth have stayed steady (attorneys also know, and will take any case to exploit tragedy)…Risk/Balance Ration is out of whack."

Les went on to point out that he was against this Health Care Reform because "It is not in the Constitution" and "It is not the Government's responsibility." (Much applause). Les also mentioned that he has travelled to England extensively…their Nationalized Health Care is causing too long of waits – so they make people wait outside the Emergency Room to reduce official "waiting times". He repeated his conviction that the "Government needs to get rid of roadblocks and increase competition…We as citizens need to get engaged – use our religious institutions and community organizations to help the poor."

  1. Because of…doctors…catering to those who can afford this…poor people are dying in Emergency Rooms. Do you have anything to refute that?" Les: "One of the reasons people are dying in Emergency Rooms because we have an illegal alien problem. Dozens of hospitals have closed in California because of illegals…California's debt…because of illegals."
  2. I missed much of what the next person said, but it seemed to be more a comment to the effect that "I think the American Dream is being destroyed socially and economically…$0.46 of every dollar the Federal Government is spending is borrowed."
    To which Les responded: "I agree 100%. We cannot afford this Health Care bill – costs for it are expected to be between 1 – 1.6 Trillion dollars. He then when on to point out that "other countries are taking our corporations because they charge them less or no taxes: Ireland and Hong Kong, for instance, are good countries for businesses, and Hong Kong is the most prosperous country in the world: When everyone has a job, you don't need social programs." The doctor on the panel then spoke up: "On the issue of people not being taken care of: People come in time and time again that can't afford care – they get it – they are being taken care of. The myth that patients are not being taken care of is nothing but a myth."
  3. The next question came from a Doctor/immigrant who had worked in England under their socialized medicine. He eventually got to his question for Les, "America is a land of opportunities…not one size fits all…do you support that dream?" Les: "Yes, because that is the American way!"
  4. "There has been a crackdown on Medicare and Medicaid fraud – how can giving government more to do…help…Do you have any ideas?" Les: "Regular audits of Medicare and Medicaid."
  5. Next person was a retired military person…He never got to a question. He spoke of poor who can't get coverage and tax incentives for those who give benevolence service…Very few people who can't get medical care in this country…He spoke of a free Medical Clinic – private with volunteers…
  6. Two questions from the next person. Can you document your earlier statement about the long waiting periods in England? And who will provide for the poor? Les: As far as the first question, personal observation – and you can Google it." And the Doctor spoke up to answer the second question: "Those coming from outside America to work say Americans are the most generous in the world."
  7. Understand you want to give examples of other countries, but it is a shame that our elderly cannot afford to pay for their medicines and a majority of Americans don't have Health Insurance. What are you… Les: "Most Americans DO have Health Insurance." She then claims that 2/3 don't have appropriate insurance. Les said: "84% have Insurance, and 85% are happy with their insurance…We need competition in the insurance industry. She then said that competition isn't good, that the only thing working is Medicare and Medicaid. Then she added that the majority of us are NOT happy with our insurance, even though we are claiming we are. Les just had Dale go on to the next person at that point…
  8. This young woman was 23-years-old, married and expecting her 2nd child. She is uninsured, but did not go to the government aid to get help, her husband is working overtime. She is concerned about page 167 in the bill that says they will tax individuals like her who choose not to have "acceptable coverage". She feels infringed upon with this bill. Les: "The choices you have now will be taken away." The gentleman from question #7 yelled at him "Not true", to which the audience yelled at questioner #7 – "Read the bill".
  9. A cancer survivor: "Our right to be able to choose…what comfort can you give me?" and "When I was on Medicaid I got punished for working." Les: "One thing I want to say about that – the government's job is to provide opportunity, not equal outcome – that will just bring everyone down."
  10. "Our representatives are to listen to us…we must stop this bipartisan voting…we have to have a change in attitude in Congress." Les: "Absolutely, right. Elections have consequences…didn't just start 6 months ago…started over 100 years ago when politicians figured out could tax one group to buy votes from another." At this point Les help up a pocket Constitution: " signed a pledge to govern by it…We are human beings, we are imperfect, but we got her because of…constitution…rights come with responsibility…until we elect people who understand what's in this document…It's not 1000 pages..why do we want to go away from this? I do not understand."
  11. "62,000 people trying to insure with this bill…yet could cover them with one fourth that cost and cover everyone – they really want government control!" Les: "Government is to promote the general welfare, not provide for it and protect us! … Socializing medicine…has failed everywhere else."
  12. "America is great…and a light in a world full of darkness….Our Health Care system helps many do you persuade those who have private insurance, but can't afford it…how do you persuade them that we need to improve what we have, not completely overhaul?" Les: "Events like this and personal conversations – not media!"
  13. "Cancer death rates are much higher in Canada and England…How would my 56-year-old family member get help? Les: "Probably wouldn't (if we get this "reform") I was brought up to respect my elders – to take care of the very young and the old…"Type of people we are – we don't ration food and we shouldn't ration health care."
  14. Another comment, not really a question for Les: "Only one part of medical care that is not controlled by government, and the costs have gone down. Do you know what that is?" (someone in audience answered "Plastic Surgery")
  15. Will Doctors stand up against AMA and resign from the organization and start their own? The doctor answered: "Many have already left AMA. Medical students have to be part of it, but many doctors drop immediately…and many doctors ARE leaving AMA over this bill."
  16. "The financial state of U.S….we're close to bankruptcy…if there was nationalized Health Care…What are your feelings about the National Debt? And I'm a third generation Hispanic – my parents came here legally – Are you familiar w/ E-Verify? What is your stand on it? Les: "The National Debt needs to be reduced – government has to reduce its output – need to reduce the corporate tax rate." And "The federal government's job is to protect our borders, but it is so bad now, need to implement E-Verify."
  17. Question from two teachers: "Our health insurance is currently provided by the state – we are concerned we will lose benefits if Health Care bill passes. Les: A website with this information….One thing we have to realize is we aren't helpless…we have to remember who we are and where we came from."
  18. How can we get info out there (on these plans) so people can get the truth? Les: "Heritage Foundation is one of the best sources."
  19. Just an example this time: "My mother-in-law moved back to England when her husband died, but kept her insurance here. She came back to the U.S. had a stress test which found two of her arteries were blocked. 5 years later she is still alive."
  20. What do you think of the Fair Tax? Les: "For it"
  21. "Life, liberty, and pursuit of happiness..What its all about, not what the government provides….Paul said, "If you don't work, you don't eat. Questions: If they pass this plan, what are our options? And "Problem with Health Savings Accounts – some lose unspent portion at end of each year." Les: "If it passes, your job is to vote the bums out…Reason I want to go to the House because that's where the money is…Health Savings Accounts are not a choice under this plan."
  22. "Do any of the bills address tort reform or portability?" Les: "No." Back to questioner: "Afraid of public option – false competition – government will undercut private industries, and start rationing care." Les: "Agree."
  23. Comment: "Believe our Health Care should be reformed…Congress should be forced to follow."
  24. More comments: "Health Care is distorted by Government…Medicaid and Medicare both pay less than 100% of costs, causing Insurance Companies to pay more…Individuals can't deduct cost of their Health Care, companies can."
  25. "I'm not an immigrant; I was born here….Blue Cross/Blue Shield lobbies in Montgomery to keep out competition…Why haven't Republicans addressed earlier?" Les: "Get rid of the 50 state Health Commissioners; make it interstate….You hire people who govern by the Constitution, not party."
  26. "What's going to happen to Senior Citizens?" and "How can we pay for all these illegals?" Les: "Agree with you…foundation of all societies is a family – mother, father, children…Have to go back to the foundations of this country?"
  27. "…Cost of medicine will become unsustainable in 25 years if limits not put on…cost control…more than 20+ cardio doctors here now and 30+ ortho docors here now (increased consumption) How can we afford unlimited access to medical assets? How will we pay for it? Doctor Ed answers: "At some point, providers, citizens, have to say, can't do everything for everybody…battle in Medical Community. We do Cardiac CTs here than can now reverse heart disease. It costs less than $1,000 to do scan. Blue Cross doesn't want to pay for it – though Heart Attack could cost $100,000 later….We have all sides out here tonight, we didn't shut anyone out here…"



Les: "Thanks for coming out. Whoever you vote for, make sure they believe our governing document is the Constitution."

And with that, an hour and a half Town Hall Meeting on Health Care ended. I was very impressed with Les Philip's thoughts on the subject, and the way he handled the questions. I was also impressed with the way the majority of the audience behaved themselves.


More on the House version of Health Care bill

I'm slowly making my way through this Bill… I wonder how much of it our representatives and their staff have read at this point!?!

Page 125 continues with information on the "Modernized Payment Initiatives and Delivery System Reform: (a) The Secretary may utilize innovative payment mechanisms and policies to determine payments for items and services under the public health insurance option."
(That part doesn't sound so bad, right, but later on the page it continues…) (b) …The Secretary shall design and implement the payment mechanisms and policies under this section in a manner that (1) seeks to improve health outcomes; reduce health disparities (including radical, ethnic, and other disparities); provide efficient and affordable care; address geographic variation in the provision of health services; prevent or manage chronic illness.
(How are they going to accomplish all of that?)

On page 130 the bill makes an interesting comment: "..the Commissioner shall establish effective methods that ensure that individuals with limited English proficiency are able to apply for affordability credits."
I have numerous relatives who immigrated to this country legally from Mexico – they took the responsibility to learn English very seriously. Why does the government need to take that away from them?

Then we get into State Medicaid Agencies: "If the Commissioner determines that a State Medicaid agency has the capacity to make a determination of eligibility…"
So, the Commissioner working for the Federal Government will be determining if State agencies have certain abilities? Does anyone else see a 10th amendment issue here?

On page 132 we get to another interesting part: "Access to Data-In carrying out this subtitle the Commissioner shall request from the Secretary of the Treasury consistent with section 6103 of the Internal Revenue Code of 1986 such information as may be required to carry out this subtitle."
So they'll have access to our financial information? Certainly sounds like it to me.

Section 246, Page 143 clearly spells out that "No Federal Payment for Undocumented Aliens: Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States."
At first I thought this meant that none of the Health Care bill provisions would be going to pay for illegals, and that may still be true, but the 10 pages or so leading up to this have specifically been dealing with "Individual Affordability Credits" (starting on page 128) Those pages are dealing with what income levels people will be getting help with paying for their health care insurance – so that is more likely to be the only portion they are clearly saying here does not apply to illegals.

On page 143, we get started on the Employer's Responsibility. On pages 144 and 145 the details begin: An employer meets the requirements of this section if (1) Offering of coverage… (2) Employer Required Contributions… (3) Provisions of Information… (4) Autoenrollment of Employees… On page 146 the Government informs employers that they will be required to cover at least 72.5% of the premiums for their full time employees and no less than 65% of their spouse and children. My question here is what about employers who cannot afford to pay those amounts, or to employees who cannot afford to pay the remaining amounts? There is an opt-out option for the employee mentioned on
page 148. It looks like employees will have 30-days to opt out of the insurance being offered by their employers…

So what happens to those employers who cannot afford to provide insurance? We start to get the answer on pages 149 and 150, where we see that an employer of a "large" company will have to pay an 8% "contribution" if they are not providing acceptable insurance to all of their full-time employees. Companies with payrolls under $250,000 will not have to pay the "contribution, and it slides up to 2% for up to $300,000 in payrolls, to 4% for up to $350,000 and 6% for up to $400,000.

Page 162 lets us know how serious the government is about this: "The Secretary may assess a civil penalty against the employer of $100 for each day…beginning on the date such failure first occurs and ending on the date such failure is corrected." Now, to be fair, they do go on on pages 163 and 164 to say that "No penalty shall be assessed…if such failure was due to reasonable cause and not to willful neglect and such failure is corrected during the 30 day period… But they go on to say: "In the case of failures which are due to reasonable cause and not to willful neglect, the penalty assessed…during any failures during any 1-year period shall not exceed the amount equal to the lower of 10% of the aggregate amount paid or incurred by the employer during the preceding taxable year for group health plans or $500,000."

And on page 167 we get to "Tax on Individuals Without Acceptable Health Care Coverage" In the case of any individual who does not meet the requirements…during the taxable year, there is hereby imposed a tax equal to 2.5% of the excess of the the taxpayer's modified adjusted gross income for the taxable year, over the amount of gross income specified in section…"

On Pages 171 - 173 we get the Government's definition of "Acceptable Coverage": "(A) Qualified Health Benefits Plan Coverage… (B) Grandfathered Health Insurance Coverage; Coverage Under Grandfathered Employment-Based Health Plan… (C) Medicare…; (D) Medicaid…; (E) Members of the Armed Forces and Dependents (including Tricare); (F) VA… (G) Other coverage – Such other health benefits coverage as the Secretary, in coordination with the Health Choices Commissioner…"

We start seeing more about how they plan to pay for this starting on page 197, "Surcharge on High Income Individuals: In the case of a taxpayer other than a corporation, there is hereby imposed in addition to any other tax imposed by this subtitle) a tax equal to 1% of so much of the modified adjusted gross income of the taxpayer as exceeds 350,000 but does not exceed $500,000, 1.5% of so much of the modified adjusted gross income of the taxpayer as exceeds $500,000 but does not exceed $1,000,000, and 5.4% of so much of the modified adjusted gross income of the taxpayer as exceeds $1,000,000." (Remember, this is on top of all the other taxes these folks are already paying!)

On page 215 the section on Medicare and Medicaid Improvements begins. This is an oft-touted section for "saving money" in this overall bill, but if it's so easy to safe money in Medicare and Medicaid, without disrupting the benefits, why are they waiting until this 1000 page bill passes to do it? Details that interested me didn't start until pages 228 and 229 when they start discussing Payments to Skilled Nursing Facilities. There is talk of "Change in Payment for non-therapy ancillary (NTA) Services and Therapy Services." Congress has decided that it its necessary to "increase payment by 10% for non-therapy ancillary services" and to "decrease
payment for the therapy case mix component of such rates by 5.5%." I looked up what non-therapy ancillary services include – drugs, medical supplies, oxygen, and those types of things…As a non-medical person, I read these types of things and wonder how we can just arbitrarily make these types of decisions…Are non-therapy services being underpaid? If so, who decided a mere 10% would correct that? Are we paying too much for the therapy portions? Somehow I doubt it! Aren't these the types of legislative decisions that will result in the closings of more Skilled Nursing Facilities?


More commentary to come…

Wednesday, August 12, 2009

My 1st Attempts at Dissecting the Health Care Bill

Everyone is talking about the Health Care Bill these days – but very few are reading it – beginning with those who may soon be voting on it. That seems to me to be about as effective as deciding a trial based solely on hearsay.

I'm not really interested in what ANY of our elected officials have to say about the Bill at this point, especially if they haven't actually read any of it – I want to know what IT says. I have found time to skim over the first 125 pages or so, and hope to work my way through the next set sooner rather than later. (10% down, 90% to go!) I figure at this point I've read more of it than most of those in the House of "Representatives"!

So, for what it's worth, here's my brief look at an incredibly complex bill:

I didn't have to look further than the title of the bill to get concerned about how realistic this idea can be:
"To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes."
The "for other purposes" may be the most honest part of the bill! But, besides that, how can we provide quality affordable health care for all AND reduce the spending – only through rationing! And yet they are all telling us this is not about rationing.

Page 15 Under this bill it seems fairly clear that the government is going to decide what is an acceptable Health Care plan, instead of the Consumers: "A Health Benefits Plan shall not be a qualified Health Benefits Plan under this division unless the plan meets the applicable requirements…relating to affordable coverage…relating to essential benefits…relating to consumer protection."
So apparently, we, the Consumers, are not capable of deciding whether coverage is affordable or what benefits we might consider essential.

Page 16 explains what coverage will be grandfathered in under this plan: "Subject to the succeeding provisions of this section…means individual health insurance coverage that is offered and in force and effect before the first day of Y1 (explained on page 14 to mean 2013, the first year of this bill's effect) if the following conditions are met: In General…the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1…shall not affect the subsequent enrollment of an individual who is covered as of such first day." (So yes, if we like it, we can keep it, at least as long as we have it – just don't expect to change to anything except the public option.) And then it goes on, "…the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1."

Pages 21 and 22 deal with Insurance Rates that will be permitted to be charged, and then with a study that the Health Commissioner will be required to conduct that looks at those who self-insurance. I was most troubled by the parts on page 21 that are telling insurance companies what they will be allowed to charge: "The premium rate charged for an insured qualified health benefits plan may not vary except as follows:" (and there are only 3 exceptions listed). While this sounds "fair" it seems like the first indication that the government will in fact be telling those "big, bad insurance companies" what they can charge us, "the poor, abused consumers". (Expected result: the government will allow insurance companies to continue to exist – until it just prices them out of the market…)

Pages 24 & 25 continue the theme of the Government dictating the prices. (Does anyone know ANY situation where that has worked well?)
Section 116 is entitled "Ensuring Value & Lower Premiums". I'm already nervous. It starts out by telling us that, "A qualified health benefits plan shall meet a medical loss ratio as defined by the Commissioner." Help, what's a "medical loss ratio"?

Pages 27 & 28 list the minimum coverage for these policies and then pages 28 & 29 seem to set the amounts that Consumers will be paying: "Requirements Relating to Cost Sharing and Minimum Actuarial Value" It begins with good news for Consumers but not necessarily for those who will be paying the bills: "No cost sharing for preventative services…"

Let's look at some of the highlights on Section 123 Health Benefits Advisory Committee, which begins on page 30: "There is established a private-public advisory committee which shall be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans." Let's start there: What's a "private-public advisory committee"? And I don't have to be a legal or a medical expert to read that they just said a panel of "medical and other experts" will be making recommendations on health benefits. Medical and other experts? Now, who exactly might they be – and if they are not medical experts why do they have any say in what health benefits any of us might or might not be receiving? And by the way, most of the members of this committee will be appointed for 3-year terms by the President. Sorry, I don't see that as being the Constitutional right/responsibility of the President – this one or any other.

Pages 31 and 32 spell out requirements for the membership on this critical committee: "The membership of the … Committee shall at least reflect…experts in racial and ethnic disparities
(say what?)…and at least one practicing physician
(oh good, at least one member will be a doctor!)
or other health care professional (nope, spoke too soon, not necessarily even ONE doctor on this committee to make medical decisions!)…"so that no single sector unduly influences the recommendations of such Committee." So, of the up to 26 members of this committee, 1 may or may not be a doctor.
Then we get to one of the roles of the committee: "The Health Benefits Advisory Committee shall recommend to the Secretary of Health and Human Services..benefits standards…and periodic updates to such standards." (Remember this is a committee that may not even contain ONE doctor on it!)

Page 42: "The Commissioner is responsible for carrying out the following functions…The establishment of qualified health benefits plan standards…including the enforcement of such standards…(all this in the hands of an appointed "Health Czar")

Pages 57 & 58 "Goals for financial and administrative transactions…enable the real-time (or near real-time) determination of an individual's financial responsibility at the point of service, and to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card…I don't even know where to go to comment on that portion, other than to say it makes me really, really nervous! And then it goes on, on Page 59: "…enable electronic fund transfers in order to allow automated reconciliation with the related health care payment and remittance advice…" (So who's going to be transferring money, and from where to where?)

Page 61: "…programs to provide incentives for, and ease the burden of, health care providers who volunteer to participate in the process of setting standards for electronic transactions…an estimate of total funds needed to ensure timely completion of the implementation plan…" (Another nice sounding idea, to set up electronic records – but we don't know yet what it will cost…)

Oh, and I just loved this portion: "There is established within the Health Choices Administration and under the direction of the Commissioner a Health Insurance Exchange in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option." Let's see, they promise us a transparent process, a variety of choices of affordable, quality health insurance, and a public health insurance option. Nope, I don't think we're getting any of those with this bill, starting with transparency!

Page 84: The Commissioner shall specify the benefits to be made available under Exchange-participating health benefits plans…" Again, where do we even go with a statement like that? And then
Page 85 we start learning about "3 levels of Exchange-participating health benefits plans: basic, enhanced, and premium…" There isn't much more about these 3 levels, at least not in this section.

Page 89: For some reason, the decision has been made here that: "The provisions of the Federal Acquisition Regulation shall not apply to contracts between the Commissioner and QHBP offering entities for the offering of Exchange-participating health benefits plans under this title." So, I hope the concept of FAR wasn't overly important to anyone!

And pages 89 to 91 explain the Standards to offer an Exchange-Participating Health Benefits Plan, including (1) Licensed…, (2) Data Reporting…(including information necessary to administer the risk pooling mechanism…and information to address disparities in health and health care, (3) Implementing Affordability Credits, (4) Enrollment – The entity shall accept all enrollments…subject to such exceptions (such as capacity limitations)…, (5) Risk Pooling Participation…, (6) Essential Community Providers…(6) Culturally and Linguistically Appropriate Services & Communications. The entity shall provide for culturally and linguistically appropriate communication and health services. (So apparently translators will be required…)

I guess this is where we start getting into the funding portion of this idea: Pages 109 & 110: "There is created within the Treasury of the United States a trust fund to be known as the "Health Insurance Exchange Trust Fund"… "Payments from Trust Fund – The Commissioner shall pay from time to time from the Trust Fund such amounts as the Commissioner determines are necessary to make payments to operate the Health Care Exchange, including payments under subtitle C…Transfers to Trust Fund – Dedicated Payments – There is hereby appropriated to the Trust Fund amounts equivalent to the following: (A) Taxes on Individuals not obtaining acceptable coverage… (B) Employment Taxes on Employers not providing acceptable coverage…(C) Excise Tax on failure to meet certain health coverage requirements…So, am I missing something, or are the taxes mentioned in A, B, and C going to pay for this mandatory Health Insurance? How big are these taxes going to be?!?

Page 111 mentions the role of states in Health Care – and seems to ignore the 10th amendment: "If a state (or group of States…) applies to the Commissioner for approval of a State-based Health Insurance Exchange to operate in the State (or groups of States); and the Commissioner approves such State-based Health Insurance Exchange…(So states can participate in this game, but only if they play by Commissioner approved rules…)

Page 121 shows how payments will work under this plan: "In general – The Secretary shall establish payment rates for the public health insurance option for services and health care providers consistent with this section…"

Pages 124 & 125 have the disturbing news that: "There shall be no administrative or judicial review of a payment rate or methodology established under this section…." (I guess the Commissioner has the last word on all of this…at least that's the way it sounds to me.)

So, for what it's worth, that's what I have seen in the first 125 pages or so. And it's not that I don't think we could improve our Health Care system – I just don't see the government doing it, particularly through a bill such as this.

If we want to look at ways to improve our Health Care, why don't we start by removing the restrictions that keep Health Insurance from looking more like Car Insurance, that can be purchased across state lines, with less government restrictions? And then we should make Health Care Savings plans more accessible – why can't those be offered by banks, and insurers, and NOT have to be used in the same year? That simple change would make those more useful to the Consumers.

Sunday, August 2, 2009

My latest comments on a Health Care blog

Health Care is not the same as Health Insurance even though so many use the terms interchangeably in these discussions. Several of my adult children do not currently have Health Insurance. That is a choice they have made. But they DO have access to Health Care. The fact that millions of people do not have Health Insurance does not mean they are without access to Health Care...

This bill consists of over 1,000 pages - over 1,000 pages that our Congressmen have NOT read (I bet most have not even SEEN it -- BTW, I have a copy of the House version sitting on my counter and I've started going through it) If you want to see it yourself, check it out on

...This bill would increase the number of abortions in our country, it would increase the rationing of medical care, and it would decrease the care given to our Senior citizens, our handicapped and other weaker members of society. How can anyone think those are good ideas?

Additionally the supporters in Congress don't seem to be concerned about the high costs of this idea...Where is this money supposed to come from? This bill would put our economy into a downward spiral that we would be hard pressed to recover from.

And a final point of clarification: We are a Representative Republic, we are NOT a Democracy. Even if President Obama HAD won by an overwhelming majority - it would not make it proper for him and his liberal buddies in Congress to pass this massive Health Care Legislation.