Sunday, August 9, 2009

And Finally, What I Am Doing About All This Health Care Mess

So, after all my yipping, what am I doing besides blogging? Well, I'm trying to engage in realistic conversations with people who don't agree with me, for one. I've considered arranging a party for everyone I know who is on the left and claiming the only solution is single payer and people who are on the right and are claiming that single payer is what is currently being devised. My plan is to invite them all to one spot, without telling them the purpose, then I'm going to turn out the lights and whisper one word.

"Health Care"

Whichever side wins the scuffle wins the debate. If that doesn't end it, then I'm going to then retry the idea by simply whispering "War on Terror" while they are all catching their breath.

Short of the time to do that, I have expended my energies elsewhere.

I am writing all my legislators explaining to them my problems with the current health care legislation, and pointing out the growing concern over financing said reforms. I'm also pointing out that they are up for re-election, and that if such sweeping legislation does get passed and causes more economic problems, then I, and millions more, will certainly not vote for them. However, if some reforms are passed, don't work well but can be easily changed, then the likelihood of reelection for them is much greater. In my letters I am pointing out that reform is much easier to do through an existing system, and that those options have not been researched enough. I am also pointing out that if they can fix ONE thing in the system, see how that works, then fix another, there is a precise and measurable way to determine what is working and what is not.

Here is a link to a web page where you can find any US Senator and email them with your concerns.

In addition to that, I've looked at systems around the world that combine both public and private in order to ensure universal health care. I plan to continue writing to my senators and to the White House as I see systems that work well, pointing out to them what DOES appear to work and what DOESN'T work. I have also contacted Anthem about different policies I've seen that could be created to ensure coverage for people who are "at risk" for more expensive medical care.

In my daily life, I feel like I fight the health care battle as I challenge the status quo in how my daughter's disabilities are handled, turning down overpriced adaptive devices that are not necessary and using the ones that are necessary until they have outgrown them. I think critically about everything that is offered, asking myself if I would take said item if I was paying for it all out of pocket (saying I had the money), and considering if the item will actually help with something. We also routinely turn down additional government assistance that we qualify for because we believe that it's more important for our girls to grow up thinking that God will provide for their needs through their diligence and hard work, not that they get special perks for simply having joints that don't move right. Of course, I don't believe that it's always wrong to take government money when someone has a disabled child, but for us, we are choosing a different path because we believe that is where God has called us to be. So, please, don't anyone write me and tell me how judgemental I am. This is what we are doing because we are trying to follow God as we think He is leading us at this particular stage in our lives. This is not about how we think other people should or should not use the current system as it is set up. I'm not privy to the particulars of anyone else's life to make a judgement on how much state aid they need or don't need, should take or not take and I am not attempting to make that judgement.

If I had lots of money, I would look into establishing a private for-profit health insurance company that worked on the principal of equal risk pools. In other words, the higher risk people are spread equally among all the various policies, so that the cost to insure them is not any greater. I would also look at establishing wellness clinics and instruction through the company.

If I had lots of money, I would also look into establishing more private clinics and health services to promote health, early screening of diseases, and such. Right now, I think our YMCA is doing an awesome job at this -- promoting health. In addition to their workout equipment, they offer personal trainers, a diabetes management group, Autism inclusive preschool and are soon opening a family workout room with video games and other fun things. Now that's something proactive!

Since I don't have a lot of money, though, I'll just think those are good ideas.

Wednesday, August 5, 2009

Universal Health Care, A Thoroughly Christian Concept

In light of health care reform discussion, I think it's important to remember the passage in Romans that refers to government:

Romans 13

Submission to the Authorities
1Everyone must submit himself to the governing authorities, for there is no authority except that which God has established. The authorities that exist have been established by God. 2Consequently, he who rebels against the authority is rebelling against what God has instituted, and those who do so will bring judgment on themselves. 3For rulers hold no terror for those who do right, but for those who do wrong. Do you want to be free from fear of the one in authority? Then do what is right and he will commend you. 4For he is God's servant to do you good. But if you do wrong, be afraid, for he does not bear the sword for nothing. He is God's servant, an agent of wrath to bring punishment on the wrongdoer. 5Therefore, it is necessary to submit to the authorities, not only because of possible punishment but also because of conscience. 6This is also why you pay taxes, for the authorities are God's servants, who give their full time to governing. 7Give everyone what you owe him: If you owe taxes, pay taxes; if revenue, then revenue; if respect, then respect; if honor, then honor."

While I don't agree with the direction that our federal government is moving, it is legitimate government. The people in office were legitimately elected, reflecting the current overall majority of our nation at the time of the election. American government is not the Kingdom of Jesus, and it will not be perfectly run. However, it is legitimate authority. Therefore, as a Christian in this nation I am called to respect that authority, which I believe involves reading legislation and reacting intellectually to that legislation.

What does that mean?

Rather than reacting to what the pundits are saying, find the specific errors in the legislation and provide specific reasons those ideas will not work. For instance, it does no good to just make a blanket statement that "universal health care" doesn't work. For all intents and purposes, that's not true. Several European nations have successful systems that have a combination of private health insurance and a public option. It might not work in Canada, but that isn't going to convince lawmakers, or other citizens who can help to put pressure on lawmakers, here, when the plan on the table doesn't even compare with that system. It's like if someone was saying, "Eating an orange when you have a cold will give you enough vitamin C to stop the cold." And you respond, "It's obvious that eating that apple is not going to solve the problem."

We also need to keep in mind that as Christians, our hearts should be "broken by the things that break the heart of God".

Jesus' purpose in coming to earth was to give his life as a sacrifice for all of humanity's sins, and also to conquer death. Not a small agenda. Yet, a big part of his ministry was healing. He was moved to compassion for the people he saw suffering. While I believe that part of the reason for the inclusion of miracles in the Bible is to reveal Jesus' power, I think it also serves to show us his concern for people who were suffering or simply wanted to be healed. As someone who is trying, in a rather floundering and unsuccessful manner,to be like Jesus, I think it's important to care what happens to the health of everyone. As Christians we need to be very concerned for all of God's children, and our goal should be that every person has at least the option of accessing quality health care.

I think Christians need to reclaim the concept of Universal Health Care!

We've taken a concept that should belong to the church, abdicated our responsibility and allowed it to be delegated to the government. The church used to be salt and light in the area of providing health care to our citizens. Just a look at all the hospitals is evidence of how involved Christians were. However, when was the last time a new (new, not one that's being moved from one location to another) hospital went up in the name of Christ? Have you heard of any new clinics established in his honor? Health Insurance plans?

Universal Health Care does not need to mean socialized medicine. I think it's safe to say that no one wants to live in a society where people cannot access health care. Rather than letting those who want to socialize the system take a term and change it into what they want it to mean, I think we, as Christians, can push for true "Universal Health Care" by making sure that laws are fair and just, medical care costs are not skyrocketing, and private insurance is available as viable options for the vast majority of people who are willing to purchase it. Most importantly, launching ministries that serve the health needs of our fellow citizens, including those poor enough to not have other options, would go much further than anything the government could provide.

It also means being responsible with your own life choices. I've heard people yelling about how they don't want to be forced to purchase health care. That's fine. However, if you are not willing to pay into any system, then are you willing to be completely responsible for your medical costs? Are you willing to sign an affidavit stating you will not access emergency care at a hospital, or if you do, you will foot the entire bill? Part of what is fueling the current health care crisis is the irresponsibility of people who aren't insured showing up at hospitals needing emergency help and ultimately costing the government and the insured significantly more money. Sometimes, that's not irresponsibility -- people can't purchase health care under the current system. However, many people just want to go from job to job without a long term plan or would rather spend their money on cable TV, high speed Internet, newer cars, entertainment, convenience food, and new clothes rather than on health insurance. Paying for health care should be a part of your budget, just as the grocery bill or rent.

If you sincerely don't want to be a part of the system in any manner, then look for models of health care legislation that offer an "opt out" option and lobby your congressman and the White House to add that into the legislation. Currently, the Netherlands is one model that has an "opt out" clause. However, simply saying that you don't want to be forced to pay for health insurance isn't going to do any body any good. And, incidentally, it's now been a few days, but I remember nothing in the legislation that says you have to purchase health insurance.

Okay, I lied, this will not be a three part blog series. Tomorrow I'm going to blog about ideas I have about what Christians can DO about health care reform.

Tuesday, August 4, 2009

A Fool and His Money Are Soon Parted (Or Why I Believe the Current Health Care Reform Won't Work)

There is one reason, first and foremost, that I believe that this health care reform will not work. We don't have the money to do it. In a way, it's even more ridiculous to believe that we have the money for this than to believe we really had the money for all the bailouts and stimulus. At least, in theory, money shovelled out for the bailouts and stimulus would be either paid back or returned back into the economy by growing the economy. While professing to make health care less expensive in the long run, this legislation is going to cost us money without earning any new. Money that our government doesn't have.

The real insanity in this is that they are planning on running this health care legislation in addition to Medicaid. So, we already have a system in place that is running throughout all 50 states. This system is funded by both state and federal money, and in many states already is contracting with private insurances to provide managed care for it's participants. Why, in the name of all that is logical and reasonable, would we not look at reforming the Medicaid system, and allow the option for people to purchase policies through that? This very thing is, in fact, done in some states already as low-income people have the option of purchasing private insurance contracted by the state. Running a "health insurance exchange" -- which is not in itself a bad idea -- through each state, with federal law protecting the right to make it portable and limit premiums, just might actually work. Not only that, but it might help to fund Medicaid.
To run this public option from Washington creates the need to pay for:

Addition Federal Staff
Office Space to House Said Staff
Travel Expenses of Said Staff
Multiple Accountability Committees (not paid a salary, but requiring travel fees etc)
Administrative Costs with surveys and research on effectiveness
Staff for handling the actual public option (accountants, doctors, customer service, etc).

Then there most certainly have to be some type of liaisons at the state level.

Which leads me to another reason I know that this health care reform won't work.

It never works to fix something from the top down, and no big national social program has ever been truly effective. If our politicians are going to put forward legislation that is costing the US billions of dollars, it is reasonable to demand that there be evidence that 1) It is the most efficient way to solve the problem 2) that the proposed legislation has a chance of working

Consider social security... this is the same government that brought you this mess. Is there any evidence to believe they will do any better with a national health care option? For significantly less money, easier accountability, and solid health care plans, then there is much more hope that something can be designed on a state level. Countries that have had successful Universal Health Care programs have been countries that are much smaller than the US. Bureaucracy feeds on itself. Our federal government, because of it's size, will do nothing but create a bureaucratic mess with this. Switzerland doesn't create that mess because it's federal government is smaller than many of our state governments. Just the accountability portions of the legislation, alone, was hundreds of pages. It's really not rational to believe that any federal plan is not going to create a bureaucratic mess.

Unfortunately, our state governments are increasingly becoming mere puppet governments for the federal. I learned, recently, that 80% of our state budget is federally mandated and cannot be changed by our state legislature. Now, there is a law that people should be rallying to change. How can we have a voice in our government, when we, the people paying the state taxes, can't influence how that money is spent?

When I consider the quality of service offered through our current social programs, I don't believe for a minute that the public option that the national government is going to offer is going to be any better than Medicaid. I believe that because there is no evidence that it will be better. Ultimately, people with resources will purchase private insurance, and only people with no option will choose the public option, and the discrepancy between the care provided to the rich and poor will either be the same (at greater cost to each taxpayer because we're paying for both programs), or, possibly, worse. And, we're going to feel really stupid since we're already paying for that with Medicaid!

Anytime the government moves a program from the state and creates it on a federal level, then it has defied the concept of "We the people" as the people no longer have a viable voice in our own government. Washington is too big and too far away. I know that the White House is holding Town Hall Meetings, sending out communications and taking suggestions. That is all well and good. However, on a practical level, your voice is simply much more likely to be heard by your local state representative, who's hearing from maybe hundreds of people, than by the White House, where one of hundreds of aides is hearing from, probably 10,000 every hour. It will never make it to the right people, even if your letter is actually read by someone who's voice has finished changing and is able to grow a beard. And, having spent a fair amount of time contacting legislators' offices this past summer, I can tell you that I almost always had to ASK to talk to a grown up. But that's a different issue.

So, these are the reasons I believe that this health care reform will not work. I don't believe the sky is falling, and am hopeful that things can be changed (in part because of the 18 month survey period, and also because there is a clause in the legislation allowing for the development of state wide health care exchanges). Stay tuned for the "Christian" response to the US health care crisis...

Sunday, August 2, 2009

The Most Boring Reading in America Today: "America's Affordable Health Choices Act of 2009"

After getting incredibly tired of receiving emails and Facebook postings about how my life is going to come to an end if the health care legislation currently before the House passes, I realized that I needed to look into the issue and decide if all the apocalyptic rhetoric was founded. So, yesterday I spent the day reading the 1000+ pages of the legislation. This is not as impressive as it sounds, because it's not 1000 full pages. Most of the pages have, maybe, a paragraph of information. In fact, if they submitted this legislation to a high school English teacher, they would most certainly be busted for using large margins and large fonts to increase the size. On the flip side, it was hardly compelling reading. In fact, I now have a new definition for boring reading: any book, article or essay that invokes a feeling similar to the one which one feels as he or she reads the health care legislation.

I am going to write three blog entries based upon my reading. This first one, a second one detailing the reasons why I believe this health care plan will fail, and one on what I believe to be the Christian response to this legislation (which, no does not involve nominating Sarah Palin for the next presidential election).

I fully admit that I did not understand everything in the bill, as they, being politicians, used as much legalise as possible. However, I was able to understand the bulk of what I read. I also fully admit that I am not an expert at politics, civics, or predicting the future. I am, however, a fairly intelligent person who is able to read and comprehend. I have a solid faith in God's promise to meet my needs, and a belief that our country has made stupid decisions in the past and survived, so at this point don't believe that this here legislation marks the end of it all. Even if it does, I'm not very nonplussed by all this because my citizenship is actually elsewhere, and I'm just serving here until I can get there. I'm aware that He's coming back for me, and it will all be very good then.

I decided to read the legislation because I simply will not base my thinking on reading articles that are written by people who profit from creating panic and fear in the American public. The reality of the press is that the more sensational they make things, the higher the ratings and money. This is especially true of cable television media. I believe that each person is able to think on their own and does not need someone to filter and spin the legislation. And, if we don't, as engaged citizens, actually understand and discuss the legislation, but instead just make blanket statements about all universal health care plans, then we are failing to not only be salt and light, but we are forgoing our opportunity to shape society. There is going to be change in health care. The national push for it in our democracy is too great for nothing to happen. All the polls I've read had indicated that over 85% of all Americans believe something needs to change. If all we do is dig in our heals and refuse to dialogue about the change, then we will end up with no say in the matter. Like it or not, conservatives are the minority right now, and currently have a most disagreeable reputation (thanks to the likes of people such as Sarah Palin, Dick Cheney and Glen Beck). The more we react rather than engage, the less likely we are to have an effect. If however, we behave intelligently, find good candidates and stop ranting, then we have a chance to positively effect our country.

First and foremost, what is the general plan? New health care regulations are the start, and I will only detail a few. I'll say from the start, that this section of the bill, in my opinion, is good. The insurance industry needs regulation and over sight. I don't see how it can happen unless it's does on a federal level. Some of the regulations are as follows: Private Insurance companies will not be able to refuse to renew coverage on a person who has been diagnosed with a medical issue. Insurance companies will not be able to charge exorbitant amounts to people in higher risk pools. They will, however, be allowed to charge higher premiums. Also, people will have the option to "carry" their policies with them when they leave a job by paying into a pool that is not just based within their own company. When a person is denied a claim, the appeal process through the company will be the same appeal process that is used at every other insurance company.

As things stand right now, if someone loses their job, they lose their insurance. I know for our family, that is the most difficult issue we face if my husband is laid off in November. We both have chronic conditions, and if something doesn't change, I'm certain that I will NOT be able to get any decent health care coverage. This is a common problem. I know a family where the husband left his job as he was called to serve in Iraq. They lost their private insurance, and went onto the military's plan. When his service ended, they lost the insurance. In the meantime, their son was diagnosed with a condition that Anthem illogically considered a very high risk. Because of that diagnosis, they were unable to get insurance for their family without paying over $800 a month, in conjunction with what the employer was paying. This is the type of situation that not only punishes a family for doing something they had to do, but holds people back from leaving a larger company to start their own business.

Another fallacy about the legislation that I cannot understand is how people keep referring to this as a "single payer system". What I read was not a single payer system. Forced to somewhat change its structure, private insurance would continue. Instead, there would be options from which a person can choose to purchase, either individually or in conjunction with their employer, into a plan. The difference would be that there would be a public option -- a government run health insurance plan-- that people could also chose to purchase. There is about 200 pages of legislation limiting the scope of the plan, providing oversight and accountability to keep it competitive, if not quite as comprehensive, with private insurance. Considering the overwhelming success of such government systems as say, Social Security, I don't see much concern for the popularity of this plan causing the private insurances to be pushed out of business. And, that hasn't been the case in other nations where both a public and private insurance exist. I'm not saying I agree with this plan, but, again, if there is to be dialogue, people need to understand and speak realistically about what the legislation is.

Another point that has been misrepresented is end of life issues. I have read in multiple articles and listened to multiple talk-show people (who do greatly entertain me when I'm at the Y), that this plan will be coercive to people at the end of life. The myth is that there will be mandatory counseling sessions every 5 years after a certain age, and every couple years if one is in certain risk categories. Again, this simply not true. What is true is that the public option will pay for a patient to see their doctor to discuss end-of-life care (like: Do I want to go to hospice? Should I have a living will? What are my nursing home options?). Under the public option a person may visit their primary care physician up to 1 time every 5 years, unless a patient is at higher risk for needing those services, in which case they may consult every 2 years. There is no wording that makes that mandatory. Anyone who thinks this concept is new, is just simply wrong. Patients have been consulting with doctors for years on these issues, and all this legislation does is guarantee that the public option will pay for one of those consultations. My current insurance pays for a pap smear once a year. The gynecological police do not show up at my house and force me to and have a pelvic exam if I miss. That's a good thing, because gynecological police would be very scary. If I choose not to go, then I, unwisely, choose not to go. Patients across America are routinely discussing end-of-life-issues with their physicians even as I write (okay, maybe not right now because of the time of day I'm writing....), whether someone is coerced into hospice or any other situation will completely depend upon the integrity of the doctor.

Abortion is another thing that has been grossly misrepresented as well, both for sides of the abortion debate. Some people are saying it will limit funding for abortion. Not True. Some are saying it will increase funding. Again, not really true, although maybe a tiny bit true. The legislation does not mandate coverage of abortion. In fact, the writing specifically covers the right of private insurance NOT to cover abortion. In the case of the public option, it offers that abortion will only be covered in cases of rape and incest or life endangerment, which is how it is currently funded under Medicaid.

One final point that people have overlooked as well is this: There is an 18 month research period before any changes become final. Thus, if people will engage in dialogue (again, not rant: engage), then there is the opportunity to make changes in this system to come up with something that will actually work. Keeping in mind that if people behave themselves, congress could look very different in 18 months.