Medical experts differ with Gov. Perry on Medicaid policy

Last week's edition of the Dallas Business Journal published a front page article explaining why Dallas area hospital leaders disagree with Texas Governor Rick Perry's opposition to expanding Medicaid care with increased federal funding.  Here's what they had to say:

Hospitals say Medicaid expansion is critical

by Bill Hethcock, Staff Writer and Matt Joyce, Staff Writer

Date: Friday, August 3, 2012, 5:00am CDT - Last Modified: Thursday, August 2, 2012, 1:16pm CDT 

Gov. Rick Perry’s rejection of Medicaid expansion in Texas will shift costs to the privately insured, increase uncompensated care expenses and raise mortality rates, all while more uninsured patients crowd North Texas emergency rooms.

That’s the consensus of hospital industry leaders in the Dallas-Fort Worth area about the impact of Perry’s decision to spurn $70 billion from the federal government to expand Medicaid in a way that would make more Texans eligible for the program.

Click here to read the entire report.

Health Insurance and employers

Paul Krugman offered up this data set last week in The New York Times. 

Sobering facts. 

For years I've wondered how long American corporations and business can continue to foot the bill for the nation's health care strategy.  The time is coming when thoughtful business leaders will join with consumers to drive forward a more comprehensive, sane plan for providing the health care benefits we all need. 

The Collapse of Employment-Based Coverage

Reed Abelson at Economix points us to a startling study on the effects of the Great Recession on health insurance. You can see similar trends in the Census data, but for whatever reason this survey — carried out by a highly reputable group — is even stronger. Here’s the key picture:

What this says is that the system that has provided workable insurance coverage to many (but not enough) Americans is coming apart at the seams. And this in turn means that if health reform goes down, we’re going to be looking at a wave of misery spreading across the land.

Why is health care so expensive in the US?

The good folks at MedicalBillingandCoding.org created an infographic laying out many of the exact reasons why costs are so insane in the American medical industry.

To view their work cleck here.

As always, reactions welcomed.

Waiting for care?

Sooner or later in just about every debate over national health care reform the issue of waiting times for services comes up.  A widely held belief is that in the U. S. we don't have to wait for our care, at least not as long as citizens of other developed nations who have some form of universal health coverage.  In light of that notion, I found this report from Ezra Klein enlightening. 

America’s waiting times are the worst in the developed world

By Ezra Klein

Any discussion of waiting times must begin with the observation that France, Germany, Switzerland and many other developed nations manage to combine universal access to care with rapid access to care. It’s an unfortunate quirk of international health-care policy that Canada and England, the two countries that do struggle with waiting times, happen to be the two nearby, English-speaking countries in the sample, and so our impressions of government-run health-care systems are disproportionately influenced by their experiences.

That said, it’s important to understand that America also struggles with waiting times. Someone who can’t afford to go to the doctor, or can’t afford to purchase an elective surgery, waits. In some cases, they wait forever. In some cases, they’re killed by the delay. But we don’t count them as having “waited” for care, and so they don’t show up in measures of American waits. But which would you prefer? A three-month delay for an elective surgery? Or no surgery at all?.


To read the entire report click here.

Reactions? 

Help getting in the water. . .

Not long ago I received the following note from a friend I've known for a long time. He is a father. His oldest son is battling cancer of the brain.

I found his note moving. His awareness of others around him, even as he assists his own son in the fight of his life, is inspiring.

As I read his words and got in touch with his heart, it occured to me that health care reform is all about making sure everyone has what they need to "get in the pool."

John 5 tells about the healing at the pool of Bethesda. I know exactly what that must have looked like. When you sit in the lobby of the MD Anderson Brain and Spine Cancer Institute, you see men and women, boys and girls of all ages and races from all over the world professing every belief imaginable. They are being pushed in wheel chairs by family. They are being helped on canes and crutches by friends. They all have in common a deeply held belief that they can be healed if they can just get into the “pool”. How sad to have waited 38 years because he didn’t have someone to help him into the pool.

I now know some of what the Father in Luke 15 felt: “… we had to celebrate and be glad because this brother of yours was dead and is alive again; he was lost and is found.”

A good way to spend part of this day might involve my spending time remembering those who still need a hand toward the healing they desire so very much. 

Texas Big Winner in Health Care Reform. . .

This from the Center for Public Policy Priorities following the passage of the health care reform bill on Sunday night in the U. S. House of Representatives:

TEXANS ARE AMONG THE BIGGEST WINNERS IN LAST NIGHT’S VOTE FOR HISTORIC HEALTH CARE REFORM

Texans are among the biggest winners in last night’s historic vote by the U.S. House of Representatives to enact fundamental health care system reforms. With more than one in four Texans currently lacking health care insurance and runaway premiums adding daily to that 6.1 million count, relief cannot not come too soon for our overburdened health care system. In addition to providing new economic security to millions of Texas families, the national health reform bill will also bring billions of dollars back to Texas each year through health insurance tax credits for middle class and low-income Texans, and Medicaid coverage for our poorest citizens.

“Medicaid expansion to cover working poor parents of children on Texas Medicaid today will be 100 percent federally funded for three years, with the state getting nine federal dollars for each state dollar from 2020 on forward said CPPP associate director Anne Dunkelberg. “Twice as many now-uninsured Texans will gain coverage by purchasing affordable private insurance through the new Health Insurance Exchange as will gain Medicaid, bringing even more federal dollars to Texas with no state matching dollars required.”

This reform keeps in place our large and robust private insurance and health care delivery sector, while filling the gaps that have left too many Texans lacking care or overwhelmed by debt. Our state leadership should move promptly and in good faith to facilitate the implementation of health insurance reforms. Texans can look to the establishment of the Children’s Health Insurance Program (CHIP) and our response to Hurricane Ike as recent examples of the excellent performance of which our state government is capable when it has the backing of leadership.

Providing equal access to affordable health care will remove a crippling barrier to real equality of opportunity for Texans and Americans. CPPP applauds Congress for taking this long-overdue step forward. We pledge to help Texans learn about this legislation, and about what we need to do here in Texas to ensure the maximum benefits of reform for our citizens.

The Center for Public Policy Priorities (CPPP) is a non-profit, non-partisan policy institute dedicated to improving economic and social conditions of low- and moderate-income Texans.

Mean is simply mean. . .

Video needing no comment. . .

Side-By-Side Comparison Tool for Health Reform Bill

The Kaiser Family Foundation provides a very helpful "side-by-side" comparison tool for the House and Senate versions of the current health care reform legislation that may be voted on this Sunday. 

Check it out here.

Evidenced-based care

On Thanksgiving day, while walking down a very uneven sidewalk toward the park with the grandchildren, Brenda tripped and fell.  She broke her fall by stiff-arming the sidewalk.  She bumped and scratched her face and badly bruised her hand.  She shook off her injury and went on to the park! 

The next day, after a short visit with her doctor, she went to a local hospital emergency room to have her hand checked out.  After a lengthy wait and a couple of rounds of X-rays, she learned that no bones were broken.  During the exam, the examining nurse practitioner (she never saw a physician) questioned her about the scratch on her face, finally suggesting an MRI to make sure there were no broken bones in her face.  Brenda assured her that such a procedure was not necessary and that another X-ray would suffice, if even was really necessary. 

She left glad to know that there were no broken bones and with her hand and arm wrapped up to the elbow.  She also wondered if the attending staff was guilty of over prescribing treatment. 

In a "fee for service" health care system like we now experience, her suspicions make a lot of sense. 

Then, on Sunday morning, The Dallas Morning News carried a front page story on evidence-based medicine and cost sharing and the move of the Baylor Health Care System to such a strategy for providing care to its patients (by the way, the ER Brenda visited was not a Baylor hospital!). 

No one wants to talk rationally about health care realities these days.  But, in view of rising costs and our return in health and wellness benefits for what we pay, the time has come for serious discussions.  From the report it sounds as if Baylor will lead the way in that much-needed conversation.  Good for them! 

Be sure and read the story, "Baylor will try new Rx," by clicking here.

My young friends and "health insurance"

On Thursday, October 15, my young friend, David Null appeared before a U. S. House of Representatives committee considering health care reform.  David, Sherry and little Tatum experienced the failure of our current system of caring for one another's health as a people.  I decided to post David's comments in their entirety. 

United States House of Representatives
Committee on Energy and Commerce
Subcommittee on Oversight and Investigations

Testimony of David Null

My name is David Null and my family’s insurance story begins in 1999. My best friend and I finally came to realize what we considered the American dream; we started our own company together. Our baby, Tatum, was now two and my wonderful wife, Sherry, quit her job teaching so we could raise our family at home.

We employed 12 and had group health coverage sponsored by the company. We were doing well, life was good. But like many Americans, 9/11/2001 hit our company hard. Contracts got cancelled, our business plummeted and we were forced to discontinue our group coverage within 6 months. That’s when we had toswitch to the individual policy market. Business was bad but we knew the value of insurance and didn’t want to go without, although sometimes we did. Three times in 5 years we were unable to continue coverage without lapse because of decreased business in the 9/11 aftermath. We’d lose coverage for a few months and then we’d get a good contract and get a new policy.

January of 2005 I found myself shopping for health insurance again. We had been without insurance for about 3 months when our youngest daughter, Hannah, fell in the bathtub and split her chin. A quick trip to the ER for a liquid bandage cost us almost $800. It served as an excellent but costly reminder for the need to be insured. So I began the search for another policy.

Sherry and I spoke at length to an insurance agent at our dining room table. I explained an event in detail to the agent when my mother had become deathly ill suddenly. Her intensive care had cost nearly $200,000. I explained to the gent, “I don’t mind paying for the doctor’s visit for the head cold. We can handle that out of pocket. It’s the big “Oh, no!” like what happened to my mother that I need to protect my family from financially. Something like that could bankrupt us.” The agent told us, “You’re a very savvy shopper and this is the policy for you. By the time you factor our negotiated rates and what the policy pays out, you’ll hardly have to pay anything.” The way he explained it, it sounded like we were getting what we asked for, protection from being bankrupted by the $200,000 example I gave him. Our premiums were affordable at $320 a month, about $100 less than what we paid just before for insurance. I was under the impression my savings were due to not having significant office visit coverage like I asked. We felt relieved to be protected again.

March of 2005, just three months later. We started out for Sea World for Tatum’s first spring break, she was seven. Tatum had been sick to her stomach a little but we left thinking she’d be better the next day. She was a quick healer and always the picture of health. We had been in the hotel only hours when she looked at us with canary yellow eyes. We knew something was very wrong and immediately headed home to see the doctor the next morning. We didn’t realize until we arrived home that Tatum’s condition had deteriorated so much that her peaceful sleep in the truck was actually her slipping into a coma. We rushed her to the hospital and before the sunset that day we were told she would require a liver transplant within days to possibly save her life, if they can keep her alive that long.

Tatum laid in the ICU clinging to life. Her brain swelling from the poisons accumulating that her liver normally removes. The doctors told us she was the sickest kid in the hospital and they struggled constantly just to keep her alive. She had only days at best to live. In the midst of all this, the transplant department administrator came to me and said we needed to talk about insurance and walked me to a council room. As we walked I thought to myself, “Aren’t I glad we picked up that policy when we did. Wonder what he wants to talk about”. We sat down and he proceeded to explain that my insurance had a 25,000 max and Tatum had reached that after the first night. She had no more insurance from this point forward and its hospital policy to collect a $200,000 deposit to proceed. I couldn’t believe this was happening. Could this be true? Surely it’s a mistake because this is the big oh no I was buying protection from. Now my precious child lies just down the hall struggling for her life. Suddenly, not only were we facing the possible death of our child but now the financial death of our family at the same time. How could this be happening to us when we have insurance for this?

Thankfully, the hospital CEO agreed to proceed without any guarantee of payment. Tatum’s life is most important to the hospital and we’re grateful for that humanity. Miraculously, within two days a donor had been located. A loving family, who lost their daughter Angela, graciously donated her liver to Tatum so she could keep living. Tatum received her transplant with probably less than 48 hours to live.

Once Tatum was stabilized, the hospital helped me apply for Medicaid and we were narrowly approved. The coverage was retro active so they covered the entire transplant. Tatum’s bill for the first stay of 21 days approached $600,000 and our so-called hospitalization policy only covered about 1/10th of that cost.

Even with insurance, this left a balance we could never bear to payback, it would have bankrupted us. Our insurance had failed us. We were clearly relieved that Medicaid covered the entire cost. Tatum and our finances both had near death experiences. Although, we didn’t know at the time what going on Medicaid was going to mean to our family. Our daughter had been on total life support for a week and now our finances would be going on life support for the next two years.

Post transplant is also medically expensive. Her blood labs were $4,000- 6,000 a month. Her medicine over $1,000. CT scans and liver biopsies were the norm. The first sign of rejection was cause for 3 days inpatient for IV treatment. Nine months post she developed a complication of the anti-rejection medicine and developed a cancerous like infection. That required 7 weeks in the hospital with IV treatments daily. That treatment caused her to need another monthly IV treatment that was several thousand dollars for each bag. We never knew what the next day would bring but we knew for sure we can’t afford even one day without insurance.

We began to look for insurance that would help cover her post transplant expenses so we could get off Medicaid. We thought Medicaid was there to help people who couldn’t afford insurance or their medical bills. Then I was told by insurance agents to “not waste the time, paper or ink filling out an application with Tatum on it because they won’t even accept it.” We were learning Tatum was blacklisted from individual policies. Getting a corporate sales job for group coverage didn’t seem like an option for me. I’d make too much during the waiting period for company insurance and we’d get dropped by Medicaid, leaving a gap we couldn’t cover. Sherry is a teacher and schools do most their hiring just once a year. Additionally, our family was instructed by the hospital to self quarantine from public for infectious reasons. Teaching is a sure way to bring home a virus that could put Tatum’s life at risk due to high immuno-suppression. We now had no where to turn. We were somehow stuck on Medicaid. Not because we couldn’t afford insurance, we thought we had insurance when this started. It was simply that the insurance industry would not make a policy available to us in the individual market.

So, in order to keep receiving health care for Tatum we had to voluntarily drop our income to near poverty to satisfy Medicaid requirements. The allowed monthly income limit on Medicaid was a shocking $1,613 a month for a family of 4. This barely allowed us to cover our mortgage, most utilities and some food bills. That’s under $20,000 a year. This meant I would frequently have to pass on work because I’d make too much for Medicaid. It was even suggested that we might fair better financially if we got a divorce.

Those were tough times and we found ourselves in the red every month. Many expenses went on credit waiting for a day when we could afford to make the money to pay it back. Interestingly, with Medicaid we never incurred any cost for her healthcare. We’re very lucky; we actually have no debt related directly to medical bills. The high cost of staying on Medicaid is on the backside, trying to survive financially on less than $20K a year. We took on tremendous debt, eliminated our savings and retirement and put our growth on hold trying to survive while she got the healthcare she needed. All because we didn’t get the insurance coverage we specifically asked to have.

After two years Tatum began to reclaim her new normal life. Her immune system and new liver were getting along much better and she was on a bare minimum of immuno-suppression. There were now more good days than bad so her mother could return to teaching, group health coverage and an entirely different insurance experience.

I found it interesting when we transitioned to group coverage; Tatum was accepted with open arms and without question. They wouldn’t give us the individual application and yet on the group application, all we had to do different was check a couple ‘yes’ boxes and write ‘liver transplant’ in a blank. Next thing we knew we had insurance cards in hand. The insurance cost deducted from Sherry’s paycheck is actually reasonable and identical to other co-teachers. Our rates have remained that way for three years now. Under group coverage we’re treated like we don’t have a preexisting. It would appear individual policies and group policies exist in completely different universes.

Her mother and I are thankful Tatum’s physical recovery is quicker than our finances. She’s growing, thriving and giving back. She regularly appears on behalf of Children’s Medical Center, the Southwest Transplant Alliance and is active in supporting her favorite charity, Make-A-Wish. Her life has been a joy and inspiration to many. We’d do it again for her sake. We’re thankful Medicaid was there for us to provide the protection that nobody else would. We’re equally thankful to be off Medicaid.

We do hope our testimony illustrates for you how the Hospitalization and Surgical policy in question here today was obviously worthless at actually protecting anyone from financial disaster with its ridiculously low maximum caps. Through all this, we’ve learned the languages of policies and agents can be confusing. In spite of both being college educated, we didn’t recognize or understand at the time that $25,000 maximum for “Misc Hospital Expenses” meant the total of the medical bill. We thought it literally meant misc hospital expenses. Even today we still find the wording a little counter-intuitive and misleading.

While policy language can be confusing, we asked in very simple terms, for a policy that would protect us from the big “Oh, no!” We ended up with a policy that would do no such thing. We trusted the agent was matching our needs to his product. He was not. His policy was saving us only 25% compared to our last policy but the $25,000 cap was 1/40th the coverage ($1million). No college degree is needed to see that’s not a good deal. Obviously not a policy with the consumer in mind.

While our testimony should be labeled “Grossly Under-insured”, we’ve since learned that even traditional $1 million policies are sometimes no challenge for long-term life threatening illnesses. Maybe 10 years ago it was sufficient. Today it’s very possible that $1 million will still leave you under-insured. They estimate that transplants, nationally, average somewhere in the ¾ million dollar range, plus post transplant expenses. Had we started our experience with a million dollar policy, we’d be close to maxing it out now, if not already. If that ever happens, my wife will be forced to move to another school district with a different insurance
provider or I must give up self-employment and take a corporate job. Only time will tell.

Most importantly, we’ve learned that being under-insured really is the same as being uninsured. They both lead to the same end. Unfortunately, we’ve learned that if your American dream is to be self-employed, the insurance companies can make it your nightmare. Under-insurance certainly impacted our lives. God has carried us through and we trust He will continue to do so, and we’re glad. We’ve certainly learned from this experience and are trying to move on.

It would seem like the story ends here but it’s actually just the beginning for Tatum.

Under-insurance isn’t the biggest tragedy of our story if you ask me. Tatum’s story encompasses another shortcoming of the health care system that you need to do something about so people like Tatum can be truly free. Without health care reform from Capitol Hill there will be more challenges for a grown up Tatum and those like her.

What will continue to sadden Sherry and me is the issue of blacklisting on the individual market, for life. That carries a lot of ramification behind it that most of us never consider. We’re lucky because Sherry’s dream has always been to teach and with that career choice we have access to group coverage. But that’s not every bodies dream. Does this mean Tatum and those like her, will be required to dream of corporate work for group coverage or marry into it. What if they get laid off? Small companies will certainly find reason to not hire her, or her husband, if they find out she’s transplanted because it will torpedo their insurance rates. Will
Tatum and her husband be forced into the Medicaid trap too, not because of finances but because of policy unavailability? Her career options to access affordable health care in the future are tremendously effected simply because the industry has designed it. Is that really fair? Is that American?

Consider this. When Tatum was four, she and her mother went to New York City. Tatum visited Ellis Island and stood transfixed on Lady Liberty, our American symbol of freedom and beacon to the world. Tatum even got herself a Lady Liberty costume. She was told Lady Liberty stands and invites the world to come to the land of opportunity, where anyone can follow their dreams. And yet Tatum, a born and bred American citizen, might not get to share in this dream through no fault of her own. Simply because the insurance industry has developed a system that won’t allow it. Our Tatum has so much potential, but for now, she doesn’t have full access to Lady Liberty’s promise to pursue her dreams. She can’t pursue little girl dreams to be an artist, or have a dress shop, a restaurant or self-employed in any fashion that requires individual coverage.

When she asks me what she should be when she grows up, I can’t tell her the same thing you probably told your kids. Right now I can’t tell her she can be anything she wants and you need to fix that. Do I tell her Lady Liberty does not stand for her too because the insurance industry has made it so with underinsurance and preexistings? Do I tell her the government before her today, a government for the people, by the people, refuses to take the steps to also protect her rights to life, liberty and the pursuit of happiness?

What do we tell her? Tomorrow our family plans to see with our very own eyes our Declaration, Constitution and Bill of Rights. A true privilege and honor as an American. These documents were bought and upheld with the blood of men for all of us. What do we tell about her place in those? What do we tell her?

In closing, while my purpose today is to testify and answer your questions as an American citizen, I also come to pose just one question to the very distinguished committee as a father. Which of you, will commit yourself today to be able to look Tatum in the eyes and tell her, that you will be helping lead the way and you will see to it that when she grows up she’ll have affordable access to adequate healthcare, regardless of her occupation, and that today she too can start pursuing all her American Dreams?

We sincerely pray that God bless you and guide you. And God bless America.
Thank you.

To read a story on David and Tatum's powerfrul testimony click here.
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Very useful resource on impact of health care reform

If you would like to evaluate the impact of Congressional bill, H.R. 3200, America's Affordable Health Choices Act of 2009, on a congressional district-by-district basis click
here.

The imformation that you'll find is amazing!

Here's what I found about U. S. Congressional District 5 represented by Jeb Hensarling (R-TX).

America’s Affordable Health Choices Act would provide significant benefits in the 5th Congressional District of Texas: up to 13,400 small businesses could receive tax credits to provide coverage to their employees; 8,600 seniors would avoid the donut hole in Medicare Part D; 700 families could escape bankruptcy each year due to unaffordable health care costs; health care providers would receive payment for $84 million in uncompensated care each year; and 167,000 uninsured individuals would gain access to high-quality, affordable health insurance.

• Help for small businesses. Under the legislation, small businesses with 25 employees or less and average wages of less than $40,000 qualify for tax credits of up to 50% of the costs of providing health insurance. There are up to 13,400 small businesses in the district that could qualify for these credits.

• Help for seniors with drug costs in the Part D donut hole. Each year, 8,600 seniors in the district hit the donut hole and are forced to pay their full drug costs, despite having Part D drug coverage. The legislation would provide them with immediate relief, cutting brand name drug costs in the donut hole by 50%, and ultimately eliminate the donut hole.

• Health care and financial security. There were 700 health care-related bankruptcies in the district in 2008, caused primarily by the health care costs not covered by insurance. The bill provides health insurance for almost every American and caps annual out-of-pocket costs at $10,000 per year, ensuring that no citizen will have to face financial ruin because of high health care costs.

• Relieving the burden of uncompensated care for hospitals and health care providers. In 2008, health care providers in the district provided $84 million worth of uncompensated care, care that was provided to individuals who lacked insurance coverage and were unable to pay their bills. Under the legislation, these costs of uncompensated care would be virtually eliminated.

• Coverage of the uninsured. There are 188,000 uninsured individuals in the district, 27% of the district. The Congressional Budget Office estimates that nationwide, 97% of all Americans will have insurance coverage when the bill takes effect. If this benchmark is reached in the district, 167,000 people who currently do not have health insurance will receive coverage.

• No deficit spending. The cost of health care reform under the legislation is fully paid for: half through making the Medicare and Medicaid program more efficient and half through a surtax on the income of the wealthiest individuals. This surtax would affect only 1,990 households in the district. The surtax would not affect 99.3% of taxpayers in the district.

Visit the website and check out the impact of this comprehensive plan for health care on your own congressional district. Let us hear your reactions. There is so much misinformation and fear out there. We need more factual analysis.

The Moral Code of the Health Care Debate

Thoughts to ponder, especially for people of faith:

With all of the shouting, the fear, and now what often looks like hatred -- we are in danger of losing the moral “core” of this health-care debate. That core, quite simply, is that many people are hurting from a broken health-care system. They include the 46 million who have no health insurance, but also the many who do but don’t get what they need and simply can’t afford good health...

People of faith need to be the steady, moral drumbeat driving the debate and keeping our politicians accountable. This is a critical and long-overdue opportunity to fix a broken and inequitable system, which must not be derailed either by powerful special interests or by those, on any side, who just want to score political points. It is up to all of us to make sure that doesn’t happen.

Jim Wallis
Sojourners

Read the entire text of Wallis' comments from 8-20-09 here.

Central Dallas Ministries, along with a number of other organizations and churches in the Dallas Metroplex, will be sponsoring the Justice Revival with Jim Wallis, November 10-12, 2009 in Market Hall. Watch for more details!

A must read on health care reform. . .

What follows may be the best, most succinct thing I've read during the current health care reform debate. Thanks to my good friend, Randy Mayeux for sending me the link. I encourage you to read it all.

And, of course, I hope to read your reactions after you've done so.
________________________

I'm safe on board. Pull up the life rope
By Roger Ebert on August 20, 2009 4:44 PM

Having read through some 600 comments about universal health care, I now realize I took the wrong approach in my previous blog entry. I discussed the Obama health plan in political, literal, logical terms. Most of my readers replied in the same vein. The comments, as always, have been helpful, informative and for the most part civil. My mistake was writing from the pragmatic side. I should have followed my heart and gone with a more emotional approach. I believe universal health care is, quite simply, right.

Read the entire post here.

Unbelievable!

When I saw the report, that's all I could say or think.

Unbelievable!

Why would anyone carry an assault rifle to a political event, to a town hall meeting or to a speech? Who would do such a thing at an event where the President of the United States was to speak?

And to speak about health care, the nation's health and wellness?

Nothing new here though. Last week guns started showing up in the hands of people at other meetings and rallies dealing with health care reform.

Last week, at a town hall meeting in Portsmouth, New Hampshire where President Obama spoke, a man carried a sign that read, "It is time to water the tree of liberty." The same man had a pistol strapped to his leg.

Have a look at the story here.

Or, the video version here, reporting the presence of more than one person carrying assault weapons.

Maybe we need a holiday. You know, everyone go home, take a week off, calm down and decide to come back to the conversation or even debate with a bit of reason and maturity.

Lots is going on here.

What do you think?

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Neo-natal mortality

At one point during Meet the Press on Sunday, August 16, 2009, the hour-long discussion on health care reform in the United States turned to the "quality of our health care system." Every time that subject come up, the opposing sides begin talking about two very different issues.

On the one hand, someone will quote the comparative negative public health outcomes for the U. S. versus those of a number of other nations that spend far less per capita on health care. The fact is, in terms of overall public health, we are behind.

On the other, someone will point out that the U. S. enjoys the best system in the world in terms of treatment, innovation and research for those who can afford to access these benefits.

And from here the debates rage on.

But, back to Sunday's program.

At one point, Medicaid, the public health insurance program for the very poor, was blamed for our nation's terrible neo-natal mortality statistics when compared to other developed nations.

It was then that I almost turned the television off. I had done a good job, up until then, of trying to give both sides a fair hearing.

But, the Medicaid comment changed the entire subject and focus of the conversation for me. And, because no one on either side talks about poverty on any of the Sunday morning news programs (or much anywhere else today for that matter), no one raised any objection.

I wanted to reach out and pull the Congressman who made the comment through the television screen and into my den. I wished that I could give him a driving tour of the "Medicaid" neighborhoods here in inner city Dallas, Texas. I wanted to tell him that these neo-natal statistics would be far worse without Medicaid and that their origin won't be discovered in the existence of this public benefit for the poor.

No, our discouraging neo-natal outcomes aren't the result of Medicaid.

They are a cruel outcome of poverty itself.

Mark it down, anyone who says otherwise does not understand poverty today.

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Speaking of the health care debate--a word from Great Britain

Again and again, critics of any health care reform plan that further involves the U. S. government point across the pond to England as undeniable evidence of the folly of a national health care system that would provide care and coverage for all Americans.

I guess the Brits have tired of being made the straw man in our debate.

They are beginning to fire back.

For some interesting reactions to our debate and to the use some are making of their system in it look here and here for starters.

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What some United Methodists are doing concerning health care reform. . .

Go here to check out what groups of United Methodists are up to in regard to the health care reform debate.

Love to know what you think!

Waiting for a doctor's care. . .nothing new here

Forgive me for not being too sympathetic. But, I find the barrage of TV ads concerning the evil health threat posed by the Obama health care reform plan laughable.

For the past 15 years I've been surrounded by countless friends who have had to wait and wait to receive the health care they needed to stay alive. Due to delayed treatment and diagnosis, many of my friends died.

Why?

Simply because they were poor, uninsured and unable to pay for the care their conditions demanded. Too young for Medicaid, too poor for private insurance and too sick to be effectively treated by the MASH approach of the Emergency Departments of local hospitals, my friends had to wait.

They waited on charity--on folks like me to beg for free treatment.

They waited on disease severity to reach a point where the ER might lead to hospitalization.

They waited for admission to Parkland where everything is over crowded beyond belief.

So, you'll understand if I'm not moved by the concerns of the well off, like myself, who get the best of care because we can pay to buy private health insurance. I'm certainly not concerned with the pain of the insurance lobbyists.

I say provide coverage for everyone. Let all of us pay something based on ability. Let everyone receive the care needed.

Frankly, if I have to wait on my brother or sister to go first, I'm ready to do so.

In every other developed nation on the planet this willingness to share and to wait, just a bit, results in far better national, public health outcomes than are realized in the USA at a fraction of the per capita cost.

We need to read the Golden Rule as we consider what is needed in health care reform. And, even more, we need to remember one another.

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Health care challenges concern communities

If you read The Dallas Morning News, you may have seen the articles in Sunday's edition (May 17, 2009) addressing the health care challenges facing the nation and our communities.

Included in the newspaper version of the report was a interview with several of us who work in the health care space. You can read the "virtual roundtable" discussion here.

Also, in the feature report were the stories of individuals in our community and how they are handling their particular challenges with gaining access to affordable health care options. One of our Project Access Dallas patients was featured. Read this story here.

Health and wellness challenges affect our communities all across the Metroplex and shape our work as we attempt to make things better for individuals and neighborhoods.

Your ideas welcomed.

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