What is Left?

Last night, for about the millionth time I stood with a small group freezing our garbanzos in front of the State House at the ‘Cost of Delay’ vigil sponsored by Moveon.org. There were about forty of us, some doctors, nurses, business owners, parents. We were standing up for, essentially, universal health care. We were standing up for something better than the current mess that excludes so many Americans from access to lifesaving medical care. A FUBAR system that is heavy on technology, profit-driven, deficient in staffing and in the human touch. I adore computers, but if they’re used to keep things limping along while essential workers are laid off there will be no savings of life or even money in the long run.

We held candles, that was pretty. I always love looking at the city lights downtown. A brand new building dominated the skyline. Blue Cross/ Blue Shield. The corporate logo, while not exactly the Eye of Mordor, radiated power. It was visible from both the front and the back of the State House, our legislators can’t miss it.

We held candles. We vote.

In Louisville, Kentucky, where my in-laws live, Humana has a tower even higher than Blue Cross. Money flows in this direction. On the floors, at Rhode Island, or Roger Williams, or Miriam or Memorial, people walk fast, multitask, try to keep everyone safe, get everything done. In the natural course of things, it helps profit to cut the payroll. We hate government intervention, but we love our lawsuits. So corners are cut until someone sues.

I wish that the death of the public option was some sort of sleight of hand. Maybe I’ll wake up and everyone will be able to buy into Medicare at a cost based on income. We’d all give a little, and everyone would have access.

Maybe I’ll look at the ProJo and see that Congress has passed a Star Spangled Keep America Healthy and Strong Act. Who could vote against that?

I’m fine with not letting the perfect be the enemy of the good. But are we settling for the mediocre? Are we letting fear of backlash kill all the energy and daring that could have really reformed health care? Are we going to pay a series of middlemen for a roll of duct tape, and let Americans continue to die unnecessarily?

The only remedy for the stagnation and despair we are feeling is to show a better way. A bandaid is not going to do it.

Is there a ray of hope? Is there a chance of a program– minus the odious ‘public’ label, or the liberal folly of giving people an ‘option’– might make affordable health care attainable for ordinary working people?

Does sausage taste better if you call it tube steak? Is this sausage wholesome? Some think so at the Washington Post.

Public Option

health care demo daylight
Providence City Hall

At least 50 Rhode Islanders came out on a chilly evening Thursday, October 29 to show support for a strong public option for health insurance.

Rallying on the steps of City Hall we sang, waved signs and got lots of support from passers-by. The rally ended with a march to Blue Cross, and then back down Weybosset St. past Johnson and Wales and back to Kennedy Plaza.

There were costumes– a giant screw, a red-tape mummy, and drums. I spotted nurses and doctors in the crowd, as well as a woman who had lost her hair to chemotherapy. This affects us all. Anyone can find themselves cut off from access to care if we don’t reform the system now.

The scariest thing looming over this Halloween is the prospect of a weak bill masking as reform. The insurance companies are ready to cash in if they have no competition. So don’t expect your congressmen to receive your psychic projections. Call or email today.

Contacts for Senators Reed and Whitehouse here.

Congressman Kennedy here.

Congressman Langevin here.

Re-brand It

I think some of the resistance to the Public Option is the name. Kind of drab and prosaic. Like public school. Or public parks. Or public streets. Or public libraries, or public safety. Yeah, these things provide essential services, but they sound so darn dull. ‘Public option’ after all, is a generic term. If it were a package it would be white with a bar code on it.

Take a hint from the insurance companies. They spend millions on branding, and come up with cute names like Tenet, and Blue Cross, and Cigna.

We want something that says medical, but feels caring…I’ve got it–Medicare! We can let people opt-in to Medicare. Medicare is a popular, well-tested insurance program with a good record of keeping administrative costs down.

You can color the logo red, white and blue. I think it will work.

Last year the insurance industry spent almost 500 million dollars lobbying against the public option. So you can understand that they can’t afford to let sick people latch on to their plans. Let’s make everyone happy. Drop the public option, open Medicare to everyone, let the insurance companies keep on doing what they do, and let people have a real choice.

House Moves on Public Option

The dawn of reason…

House members leaving an evening meeting with House Speaker Nancy Pelosi said a “robust” public option was gaining support, buoyed by preliminary estimates from budget analysts putting the cost of a bill with the option at less than President Barack Obama’s $900 billion target.

“The robust public option clearly outperforms the others,” Representative Robert Andrews said after a two-hour meeting to discuss the choices. “Members are searching for the best way to reduce the cost of the bill and this is the best way.”

Think about it. The principle of insurance is creating a large risk pool, so that the cost per subscriber is kept low. Then, to best serve the public, keep administrative costs down and put most of the money into care and services. That’s the public option. Of course it saves money.

Another Terry Schiavo?

(Second thoughts on this post– The left blogosphere has picked this story up, but the source is the Washington Times, a hard-right organ of Reverend Moon’s Unification Church. The story concerns cancellation of private insurance for a disabled man, and the family considers the alternative, Medicaide, to be a death sentence. I’m not buying that at all. However, I can understand their desire to maintain the home care that has kept Ian Pearl well, and I support them in that. Expensive? Yes, but so is institutionalization. Home care is the future of health care, if we want to keep costs down and give people autonomy and choice.)

Another Terry Schiavo? Don’t count on Senator Bill Frist to ride to the rescue. Frist doesn’t need to divine from video that Ian Pearl is neurologically intact. Ian Pearl can speak for himself.

Rather than continue to pay for Ian Pearl’s million dollar medical treatments, one insurance company has decided to end certain lines of coverage altogether, reports William Ehart of the Washington Times. Pearl, 37, suffers from Type II spinal muscular dystrophy, and has been using a wheel chair and connected to a breathing tube for most of his life. Patients with his type of muscular dystrophy rarely live past infancy, but Peal credits his vitality to the care he has received all his life.

On December 1 his insurer, Guardian, is discontinuing a portion of its coverage, which will effectively kill him. Without his extensive coverage Pearl will be admitted to a state hospital under Medicaid, with less treatment. Pearl’s mother said that in a state hospital her son would be lucky to live more than a few weeks. Pearl’s plan, as of now, covers 24-hour home nursing, which Medicaid, and the vast majority of plans, do not.

Ian Pearl’s treatment is expensive. And I’m very concerned about the assertion that people who go into the state hospital just die. If the state hospital in Fort Lauderdale, Florida is that bad then there are many more Ian Pearls who are not lucky enough to have fierce advocates.

Where does the money go? I’ve never met Ian Pearl, but I do work in home care so I can give an educated opinion. A better one than Doctor Senator Frist gave in the Schiavo case. I’m betting that Ian Pearl has home health aides who get him out of bed, wash him and keep him from getting bedsores. I’m betting that Ian Pearl has nurses who can manage his tracheostomy, visible in his photo, and all the breathing equipment that keeps him alive. They don’t teach that in nursing school, it’s usually learned on the job in Med Surg or ICU. I’m guessing that Ian Pearl has some very skilled nurses on his team.

So somewhere in Fort Lauderdale tonight there are some very unhappy medical workers who have kept Ian alive and well for years. They might be terminated. For what?

“This is attempted murder” said his father, Warren, “the insurance companies are cheating in order to have obscene profits.” Last year Guardian reported $437 million profits, up 50 percent from 2007.

Interesting that this story was reported by the Washington Times. A newspaper that was bought by Reverend Moon. A newspaper with an agenda, to be carried out in this world or the next, who knows? The coverage of this story on left-wing sites may be another case of politics making strange bedfellows.

The Washington Times was a good friend of the Bush administration, but they are eternally an organ of the Unification Church. I have no idea what the Times is up to.

I’ve observed that it’s easier to love those who are silently unborn than those who are not only born, but in need of expensive care to keep them in this world. Hey, a lot of wingers don’t even support prenatal and pediatric care. Every time I drive past those ‘Prolife Across America’ billboards, with the cute babies, I think about the Rhode Island children who could be insured if the governor made it a priority.

All Ian Pearl wants is to live with some security and dignity. And the money spent doesn’t go down the drain. It goes into wages for the workers who care for him, and they pay taxes, buy groceries and care for their families. This kind of hands-on labor can’t be outsourced, so it cycles back into our economy.

But a young guy with a goatee, who can speak for himself is a problem, isn’t he? Not as much of a blank slate as poor Terry Shiavo, whose autopsy revealed an atrophied brain. This is a man who is alert and oriented and can speak for himself. What will we do for him?

A public option for a Medicare-type insurance that will use less money in administration and won’t drop you arbitrarily would give some security to patients like Ian Pearl. Some of the Tea Party believe that we should let God decide. And God’s agents on Earth are named Tenet and Blue Cross. But they have a vital interest in unloading people who really need the help. So what is left?

What is left is ‘We the People’ deciding to walk the walk when we say that we value life. Ian Pearl’s condition was not predictable or preventable, but with financial support he can manage. Taking care of our own requires investing locally, in a way that cycles back into the local economy. Letting the insurance corporations do their financial triage is a disgrace and a waste. Let them reform, or get out of the way for a better system.

More on this, with a picture of Ian Pearl, here.

In Burnside Park–Rally for Health Reform

If I had a dollar for every time someone yelled at me–‘Get a job!’ I would not be working two of them. But a flexible schedule is a luxury that never gets old. I wondered who on earth else would be free to come downtown at noon on a weekday to rally for health care.

I made a last-minute decision to take the bus, hoping the driver would let me on with my sign. A woman was waiting at the stop, we got talking and it turned out she was going to the same demonstration. She told me that she is a psychotherapist and spends many hours on the phone with insurance providers, being shuffled from department to department, just to get paid. Since there were two of us I turned my sign to face the oncoming cars, and I was getting honks and waves just waiting there.

Downtown, a small crowd was assembled in front of the monument in Burnside Park. Sen. Whitehouse has an office nearby, perhaps someone spoke for him before I arrived, but my first impression was of a group huddled around a statue. Speakers were using a bullhorn on the monument steps but you had to strain to hear them. I would not have minded making the message more visible. I turned my sign outward toward the people waiting at the bus stops in Kennedy Plaza.

Back to the job thing. I was amazed at the professional people who had taken time out to attend this rally. Among them, Hanna Watson, from Brown Medical School advocating for her patients, Claudia Gregoire, a lawyer, speaking on behalf of small businesses, a nurse who lost coverage for needed care when her insurance changed, a man whose sick wife was evicted from her hospital bed when her insurance denied her. Perhaps we were preaching to the choir. Perhaps not. There was one man who shouted, ‘Who’ll pay for all this?’

‘I’ll tell you,’ I said, trying to be helpful. ‘You see, we’re all paying for it when costs are passed on to…’

At that point he got surly, said a few things about illegals and they can just go to the emergency room and left in a trail of alcohol fumes.

I noticed that a reporter from WPRO followed after him, perhaps disappointed at the lack of action.

Recently I heard a story on the radio, about a woman who went up to Franklin Delano Roosevelt with a list of important reforms.

‘We elected you,’ she said, ‘you need to do all these things.’

He looked at her and said, ‘You have to make me.’

It’s true. The insurance corporations are talking through their lobbyists, and we have to try ten times as hard to be heard. And that’s a reform for another day. But this is a crucial time, the health system is broken. Only we can build a better one.

Real Competition

Even the AARP says that the insurance industry report that came out this week is a piece of propaganda. And here’s Robert Reich on why we need a public option…

It’s an 11th-hour bombshell.

But the bomb went off under the insurers. The only reason these costs can be passed on to consumers in the form of higher premiums is because there’s not enough competition among private insurers to force them to absorb the costs by becoming more efficient. Get it? Health insurers have just made the best argument yet about why a public insurance option is necessary.

Another good idea would be to extend Medicare to everyone over age 55. That saves money because they don’t come into the system with huge problems that could have been prevented.