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Say fascism one more time, motherfucker!
Say it again! I DARE YOU! |
Okay, so, this is gonna be a long one, and I know it's dangerous ground, but I have girded up my loins, loaded my assault weapon, and fortified myself with a picture of Jules Winnfield because the shit is about to get real.
Health care Reform. There. I said it.
We need it, we have received pieces of it. It's a fair start, but it is not enough, and people need to stop crying about it. First, lets just get some things out on the table and out of the way.
1. Yes, there is a black man in the white house. Get over it.
2. Yes he won the election again. You were out-voted. We lived with your guy in charge for 8 years, now it's our turn. Suck it up and get over it.
3. No, the black man does not hate America. He is not a Nazi, a Fascist, a Communist, a terrorist, a black Muslim, or a radical Christian. He was born in the United States. He is not going to come take your guns, force you to gay marry, stop you from practicing your religion, nor would he stage the mass murder of 26 children and teachers so that the great gun ban could be set in motion, or any of the other wacko bullcrap that seems to spring up every other day, so can we stop with the conspiracy theories and stick to the facts please?
So where was I? Oh yeah... Health care reform.
Here is a little background:
United States citizens spend more per capita than any other developed nation on health care. We have less available hospital beds than every developed nation besides China, less doctors and nurses per capita, one of the highest rates of death by preventable diseases in the developed world, 48 million people without health insurance, with as many as 26,000 to 44,000 dying from illness due to lack of health coverage annually. As many as 1 in 3 children are uninsured for substantial periods of time, more than half of which are from families of moderate income. Basically, these families make too much to have their children covered under medicaid, and can't afford regular insurance. Now, granted, these numbers are reported in various sources and taken from census information from 2009-2010, however, experts agree that the numbers haven't budged much since these reports were written. Regardless of a difference in numbers, studies have shown that uninsured people are 40 percent more likely to suffer death from illness than those with coverage (Journal of National Public Health), that statistic alone should be enough to make us say "hey, this is serious!"
Then there is the myth that anyone can receive health care by going to an emergency room. Emergency rooms can address your acute symptoms, but their next step is to refer you to a physician to determine what is actually wrong with you. If you do not have insurance, that can be tough. Either you won't be seen, or you have to pay up front at the time of service. If you can't afford that, you remain sick. Up until last year insurance companies could deny coverage for children who had preexisting conditions. Even if you do have insurance you are at the mercy of your insurance company for which procedures they deem necessary and that they chose to cover.
How is it that this could be the state of affairs in the richest, most powerful, and by our own definition, most egalitarian country in the world?
According to Business Insider (among others) the countries that rate highest in citizen satisfaction and happiness are Denmark, Canada, Norway, Netherlands, and Switzerland, in that order. All have universal health care. Of the top 36 health care systems in the world, the US isn't even on the list.
I have heard the argument that letting health care be a part of the free market will increase creativity and innovation. Well, it has been part of the free market, and this has not proven to be the case.
Commodities should be a part of the free market. Human health and well being is not a commodity. It is something that a society should protect and nurture in order for that society to thrive. By allowing our health to become a commodity, to have a certain monetary value placed upon it, we have not created a health care system, we have created a disease and death management system.
Anecdotally, I have many friends in other countries and they are always astonished when I say that I can't afford to go to the doctor, or mention what medical care costs in this country.
I have heard the argument that President Obama is a socialist and he is trying to destroy America through health care reform. Well, if that is the case, then President Roosevelt, President Truman, President Nixon, President Johnson, and President Clinton all did the same thing. How have we as a nation survived such despots!?
Every president is a bad guy to the opposition.
So, back to conspiracy theories.
I could write pages and pages about each misconception surrounding the Patient Protection and Affordable Care Act, or, Obamacare. I only have the time and finger dexterity to address a few.
But don't take my word for it, read it for yourself-
Bill text:
http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf
Section-by-Section Analysis:
http://waysandmeans.house.gov/media/pdf/111/sbys3200.pdf
What? Still here? Okay, fine. Here goes...
SO the misconception I want to address today is the one I hear about the most -
Obamacare is an all out assault on the seniors in our country.
This conspiracy was obviously developed by someone who has never read the PPACA, and has no idea what they are talking about.
Since the
Health Reform Fact Check page has done all the research footwork I am going to put their info here, this page was put together by Campaign for America's Future, a progressive interest group. They do, however, site all their sources and keep to the facts, so here it is:
THE LIE- PART A: The cuts in care to pay for this bill come directly from seniors, about 500 billion dollars.
See also here .
TRUTH:
As a factsheet from the Ways and Means Committee explains, "By eliminating wasteful overpayments to private plans under Medicare, reforming how doctors are reimbursed, and creating new incentives for coordinated, high quality care we will extend Trust Fund solvency and improve Medicare for generations to come." The figure of $500 billion represents savings - not cuts - that will result from specific reforms designed to increase efficiency for Medicare and Medicaid.
PART B: The bill is effectively a repeal of Medicare.
TRUTH: The House bill strengthens Medicare and Medicaid by “reallocating U.S. taxpayer dollars already being spent on health care to achieving more efficiency, higher quality, and broader coverage.”
• $156 billion in savings by eliminating overpayments to private Medicare Advantage plans over 10 years. According to the Medicare Payment Advisory Commission, private Medicare Advantage plans are currently paid, on average, 14 percent more than traditional Medicare providers – and overpayments to certain plans exceed 50 percent.
• $102 billion in savings over 10 years by incorporating productivity adjustments into Medicare payment updates for hospitals. This adjustment will encourage greater efficiency in health care provision, while more accurately aligning Medicare payments with hospital costs.
• $110 billion in savings over 10 years by: 1) codifying the recent PhRMA- White House agreement, which provides that Medicare Part D beneficiaries will get a 50 percent reduction in price on any brand-name drugs they need while in the so-called “donut hole” where drug costs are not reimbursed at certain levels; and 2) requiring that drug companies provide rebates for individuals enrolled in both Medicare and Medicaid that are at least as large as the Medicaid rebates that were provided prior to the enactment of Medicare Part D.
• $100 billion in additional savings over 10 years through numerous other provisions, including incorporating productivity adjustments into Medicare payment updates for home health agencies; and key delivery system reforms such as incentives to reduce readmissions to hospitals and promoting accountable care organizations.
Source:
http://waysandmeans.house.gov/MoreInfo.asp?section=52
The bill requires hospitals, doctors, and pharmaceutical companies to achieve key efficiencies and eliminate waste in Medicare (including eliminating overpayments that are driving up profits for Medicare Advantage plans) and toughens our ability to root out fraud and abuse – but does not make cuts that hurt seniors. It also does nothing to take away choices for seniors.
On the contrary, the bill includes several key provisions that improve Medicare benefits for seniors, including the following:
Phases in completely filling in the “donut hole” in the Medicare prescription drug benefit (where drug costs are not reimbursed at certain levels), potentially savings seniors thousands of dollars a year.
Eliminates co-payments and deductibles for preventive services under Medicare.
Limits cost-sharing requirements in Medicare Advantage plans to the amount charged for the same services in traditional Medicare coverage.
Improves the low-income subsidy programs in Medicare, such as by increasing asset limits for programs that help Medicare beneficiaries pay premiums and cost-sharing.
Source:
http://waysandmeans.house.gov/MoreInfo.asp?section=52
PART C: WSJ: The House bill being pushed by the president...ensures that seniors are counseled on end-of-life options, including refusing nutrition where state law allows it (pp. 425-446). In Oregon, some cancer patients are being denied care by the state that could extend their lives and instead are afforded the benefit of physician-assisted suicide instead.
TRUTH: According to a
Section-by-Section Analysis of the bill (p. 18), Section 1233, on "Advance care planning consultation," "provides coverage for consultation between enrollees and practitioners to discuss orders for life-sustaining treatment" and "instructs CMS to modify "Medicare & You" handbook to incorporate measures on advance care planning into the physician's quality reporting initiative."
The legislation seeks to provide seniors with counseling that will educate them about all of their options. This provision does not mean that seniors will be denied otherwise available end-of-life care, nor does it mean they will be forced into "physician-assisted suicide."
As
Rep. Blumenauer's office explains, "Advance planning consultations are not mandatory; this benefit is completely voluntary. The provision merely provides coverage under Medicare to have a conversation once every five years if – and only if – a patient wants to make his or her wishes known to a doctor. If desired, patients may have consultations more frequently if they are chronically ill or if their health status changes." Additionally, "There is no mandate in the bill to complete an advance care directive or living will. If a patient chooses to complete an advance directive or order for life sustaining treatment, these documents will help articulate a full range of treatment preferences, from full and aggressive treatment to limited, comfort care only. Patients that choose to have these documents and can customize them so that their wishes are appropriately reflected." And finally, "There are no government-chosen professionals involved. The legislation simply allows Medicare to pay for a conversation between patient and their doctors if patients wish to talk with their doctor about end of life care preferences." The provision has been
supported by the AARP, American Academy of Hospice and Palliative Medicine, American Hospice Foundation, Consumers Union, Gundersen Lutheran Health System, Medicare Rights Center, National Hospice and Palliative Care Organization, and Providence Health System.
Compassion and Choices has more
here and
here, Snopes has more
here, and Media Matters has more
here.
PART D: WSJ: Comparative effectiveness research...is generally code for limiting care based on the patient’s age. The cost of a treatment is divided by the number of years (called QALYs, or quality-adjusted life years) that the patient is likely to benefit. In Britain, the formula leads to denying treatments for older patients who have fewer years to benefit from care than younger patients. Rep. Paul Ryan (R-Wisc), Sen. Tom Coburn (R-Okla), Rep. Ginny Brown-Waite (R-Fla.), Rep. Paul Broun (R-Ga.) have all made a similar argument, see here.
TRUTH: Comparative effectiveness research in reality is not an attempt to implement QALYs used by countries such as Britain and Canada. Rather, as columnist Paul Krugman stated in his column July 24, "the Obama administration and Congressional Democrats have also been emphasizing the importance of “comparative effectiveness research” — seeing which medical procedures actually work." Even conservative columnist David Brooks commended comparative effectiveness research as one of the ideas that "sounds good" in his column from the same day. Below is an explanation from the legislation's text of what comparative effectiveness research is, and its roll in fixing the nation's health care problems.
SUBTITLE A—COMPARATIVE EFFECTIVENESS RESEARCH
Sec. 1401. Comparative effectiveness research. Establishes a Center for Comparative Effectiveness Research within the Agency for Healthcare Research and Quality (AHRQ) to conduct, support and synthesize research relevant to the comparative effectiveness of the full spectrum of health care items, services, and systems. Establishes a public/private stakeholder commission known as the “Comparative Effectiveness Research Commission” to oversee the Center, determine national priorities for research, identify research methods and standards of evidence, support forums to increase stakeholder feedback, appoint advisory panels on specific national priorities to advise the center on research questions and methods, and make recommendations for the dissemination of findings. The 17-member Commission will be appointed by the Secretary with input from the Comptroller General and the Institute of Medicine and will include the Director of AHRQ, the Chief Medical Officer of CMS and stakeholders including clinicians, patients, researchers, third-party payers and consumers. Clinical perspective advisory panels will provide advice on specific research questions, methods and gaps in evidence in terms of clinical outcomes for priorities identified by the Commission in order to ensure that the research is clinically relevant. The Commission and the advisory panels it appoints will be subject to strict conflict of interest requirements. The Center and the Commission are prohibited from mandating coverage, reimbursement or other policies to any public or private payer. The Center and the research it conducts are funded out of the Comparative Effectiveness Research Trust Fund (CERTF) which will receive contributions from Medicare and
private health insurance plans.
PART E: CNS News claims that health reform will place seniors in "medical homes" without doctors.
TRUTH: First of all, CNS News' article on medical homes relies heavily on quotes from the Center for Medicine in the Public Interest, an institution that
receives funding from the pharmaceutical industry and has been
described as a "nest of ex-moles who served the industry in one capacity or another in the Bush Administration's FDA."
Visions of
"FEMA camps" and "government-enforced euthanasia" may dance in rightwingers' heads, but the truth about Section 1722 of HR 3200 is much more mundane. In reality, the concept of a Patient-Centered Medical Home is a mainstream medical practice that has existed since the
American Academy of Pediatrics developed the idea in 1967. Forty years later, a
joint statement by the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Physicians (ACP), and the American Osteopathic Association (AOA) explained the principles behind the Medical Homes concept, emphasizing that quality of care, safety, and coordination are key objectives.
Legislation proposed in America's Affordable Health Choices act merely builds on existing concepts and facilities. According to the
bill summary, HR 3200 "establishes a 5-year pilot program to test the medical home concept with high-need Medicaid beneficiaries. Including medically fragile children and high-risk pregnant women. The federal government would match costs of community care workers at 90% for the first two years and 75% for the next 3 years, up to a total of $1.235 billion."
Thank you for your research Campaign for America's Future.
It seems to me, reading this information, most of which came from the House Ways and Means Committee, that the Patient Protection and Affordable Care Act is doing exactly what it says. Protecting Patients and trying to make care more affordable. It baffles me when I see people rabidly opposing something that actually benefits them because they have no idea what the law entails.
Here are some things I like about the PPACA... I especially like that insurance companies cannot deny coverage to children with pre-existing conditions (as a parent of a child with a pre-existing condition who had been denied insurance in the past, I am ecstatic). I also love that insurance companies can no longer increase costs for pre-existing conditions, or in any other way jerk you around because you have an illness.
I love the fact that my kids can stay on my insurance until they are established and can afford insurance of their own, 3 million young adults have already gained insurance due to this policy. Oh, as a woman, I also like that many preventative procedures are now covered by my insurance 100%. Preventative care saves lives and reduces health care costs.. it should be free.
I like that over the next decade 30 million uninsured people will gain coverage.
I like that medicare beneficiaries now get a 50% discount on name brand drugs, a benefit that saved over 4 million medicare beneficiaries an average of $600 last year. I like that they can receive free annual wellness checkups and cholesterol screenings.
I like that Obamacare requires that insurance companies spend the majority of premium dollars collected (85%) on health care and improvement, and not administrative costs. if overspending on administrative costs does occur, they must pay a rebate.
I like that insurance companies can no longer set a lifetime or yearly maximum, so if something major happens I wont be out of luck.
I like Obamacare, and you should to. If you don't, it's most likely because you are misinformed, so don't take my word for it, or the fact check's word either. There are links up there that go right to the source. If you don't believe that, then I can't help you my friend and all I can say is this... in the words of Jules Winnfield... "BITCH, BE COOL!" cause this is good for the rest of us! It's not enough, not by a long shot... but it's a start. Its civilized, it's right, let's keep moving forward until we are at the top of the list, and instead of being an example to the rest of the world of how to misuse an assault weapon, we can be the example of how to take care of each other and do what is really and truly right.
