Posts Tagged ‘president Obama’

March 25, 2010

Health Reform Shows Government Cares About People

President Obama is on the road selling health reform and showing the leadership that many Americans expected of him much earlier in his presidency.  You have to sell the American people not only on the value of health care for the individual but also the benefits of caring for your neighbors, friends, communities, and the nation.  Sometimes Americans forget the values and principles upon which we built this country.

At a recent International Forum in Washington,  health leaders from around the world were congratulating me and other Americans because our nation finally made the grade, so to speak, with regard to health care.  The U.S. finally recognized that health care is national issue–that translates into security economic growth and prosperity for the nation.  Most of all, it means that our nation has finally learned that the role of  government is to protect and take care of  all the people who believe in justice and democracy.

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Posted in Health Reform, News, Policy, health insurance, president Obama | No Comments »

February 27, 2010

Obama’s Health Summit: Not a Quadruple or Even a Triple Lutz

Was anything accomplished at President Obama’s health care summit on Thursday? Some policy wonks did not even turn on the TV, so interest is apparently lagging at this point.  Who calls a summit in the middle of the Olympics, when any accomplishment pales in comparison to the thrill of watching  snowboarders, skiers, Apolo Ohno  or the South Korean skating queen?  

Much time was spent on niceties and posturing on bipartisanship (mostly that health care costs money), and very little on substance (except that health care costs money).  The president is still not clear on what he stands for (except that health care costs money) even though he put forth a slightly modified version of the Senate bill as his plan.  Americans want to know about being cared for–not about money.  The President did not have a clear message about why the Congress should pass legislation  that is not a true overhaul of the system. 

 The President has a messaging problem; the Republicans do not.  The Republicans  are saying “start over.”  The other simplistic Republican answer–medical malpractice reform– also came across  more clearly than the President’s analysis of the costs of insurance premiums.   The President spent too much time on the intricacies of  lawmaking, turning the summit into a  high school civics class. 

The American people want the President to be stronger–to say that health care is a right and that the President will not negotiate on that issue and will only work toward legislation that covers and protects all Americans and does not put money in the pockets of health insurers.  Only Senator Jay Rockefeller of West Virginia, with his analogy of insurers to sharks, brought clarity –and some emotion–to the day.

Americans don’t want to hear about the market based approach to health care, words that the  President used too often. Americans know that’s what got us to the place where we are today. Such rhetoric breeds fear not favor in the hearts of most Americans.  The President is having a hard time with the message because his legislation does not back up the promise of the campaign.

Some credit must be given to the summit participants who sat for 7 hours in THOSE CHAIRS–typical uncomfortable seating for weddings or bar mitzvahs when half the time is spent on the dance floor.  No wonder nothing happened.

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Posted in Health Reform, president Obama | 4 Comments »

February 5, 2010

President Obama: Focus on Jobs in the Health Workforce

President Obama –and the Congress for that matter–need to focus on JOBS in the HEALTH WORKFORCE.  The Bureau of  Labor Statistics reports that the health sector ranks high among the areas that will provide the greatest number of new jobs over the next decade.  Four million jobs will be created in the health care sector will be a leader in producing new jobs,  including high-skill, high-paying jobs like doctors and nurses.  Among the top ten occupations needed will be:  Registered nurses, home  health aides, personal and home care aides,  and nursing aides, orderlies and attendants. 

With the aging baby boomer population, the need for a greater number of trained people in the health professions goes well beyond nurses and home care workers.  Shortages across the professions will be exacerbated by the retirement of physicians, nurses, pharmacists, dentists and other professionals.  In 2004, 23 percent of licensed pharmacists, for example, indicated they were leaving the profession within the year and 80 percent of pharmacy directors said they would leave within the decade. Substantial retirements of faculty in all schools of the health professions add to the problem.

With the overwhelming need for a health workforce for the nation, President Obama should be focusing his Jobs Initiative on education and innovative training programs for the health workforce.  President Obama should be looking for ways to provide incentives to academic health centers and their health professions schools for new ideas and innovative ways to develop a quality health workforce in a short time frame. 

One way is to receive funding and other incentives to create new career ladders for those people who are already employed within the health system and want to raise their skill levels and receive education in one of the more-skilled professions (and this can include the myriad allied health, imaging, medical records and IT jobs that are critical to the system).

There should also be funding to health professions schools to create innovative, perhaps fast tracked, retraining programs for the thousands of people who are losing their jobs in America’s dying manufacturing industries. 

The Obama Administration needs to look beyond small business and the green industries with regard to JOBS.  The health workforce should be the priority when it comes to jobs.

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Posted in News, Policy, health workforce, jobs | 3 Comments »

December 17, 2009

Bernie Sanders and George Will Got It Right on Health Reform

Two people recognize the health reform bill is not reform and are signaling that we need to start anew. 

Sen. Bernie Sanders,  the Independent from Vermont, is telling the world that the proposed legislation is not good.  Yesterday, he said that he could not accept the health reform bill in its current form because it does not control costs or rein in health insurance companies.  More important,  Senator Sanders showed the courage of his convictions and brought a real answer to the Senate and the American people.  He proposed a single-payer amendment to the current bill.  In calling up his amendment, Sanders said, “For the first time in American history, the Senate will debate a proposal to create a single-payer, Medicare-for-all health care system.” Unfortunately, Senator Tom Coburn (R-Okla.) objected to Mr. Sanders’s request to dispense with the reading of the 767-page amendment (as called for earlier by  Coburn).  After nearly three hours of listening to a team of Senate clerks read the proposal,  Mr. Sanders gave up and withdrew his amendment (Why,  Bernie? There’s nothing to fear but fear itself.)

(Of course, Coburn knew that would be the outcome because the dealy would prevent a vote on a funding bill for the Department of Defense. The current funding provision expires at midnight tomorrow).

George Will reflects today in The Washington Post on the latest CNN poll showing that 61 percent of the public oppose what the Democratic Senate is trying to do to health care.  “It is clear what the public wants Congress to do: Talke a mulligan and start over.”

Bernie and George are both saying that what we have is not good enough.  President Obama should say the same and ask for the creation of a “super special” congressional committee to start anew in January.  Health reform before the holidays may not make the season jolly.

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September 30, 2009

Baucus Tells America: No Public Option, Horatio Alger is Role Model

Long live Horatio Alger, the Congress said yesterday.  The Senate Finance Committee, by its vote against a public option in health reform legislation,  told the American people  that  if you can’t be Horatio Alger–if you can’t suffer and persevere and make it on your own when it comes to health care– tough luck.  Senate Finance Committee Chairman Max Baucus lives too much on the frontier.  He  obviously still believes in the Horatio Alger myth–that is,  that America can be sustained by  rugged individuals who, like the boys glorified by the 19th century dime-store novelist  Horatio Alger,  can go from rags to riches on their own solely by hard work and clean living. 

Without a public option, Baucus is saying that if you get sick, don’t have a job, lost your job, can’t pay your bills, get insurance coverage, figure out the insurance system, there must be something  wrong with you.  You’re not living right. You didn’t follow the Alger rules. The government will not help you.

 Shame on Senator Max Baucus. Shame on the Finance Committee. Shame on President Obama for letting the Congress act on its own on health care.  Shame on  America for not protesting in favor of a public option.

 This is the 21st Century.  Horatio Alger is not the role model we should be admiring. Did Horatio get an inherited form of cancer? Did Horatio lose his job because thieves on Wall Street were “too big to fail?”  There are forces at work beyond the control of any one person.  No one can make it on his  own these days—and no one should be blamed for that.

Horatio Alger  can no more protect his health in the modern world than he can provide for his own defense with a musket in the corner of his room in the boarding house!

 The government should protect its people with a health care program just as Horatio Alger –in the end– was saved from poverty with the help of a wealthy benefactor.

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Posted in American culture, Health Reform, News, Policy | 1 Comment »

September 17, 2009

Insurers Celebrate Baucus Health Reform Proposal

Wake up America!  Now you can learn who controls the U.S. health care system. Read the provisions of the  new health reform proposal by Senator Max Baucus (D-Mont.) and you will understand why for months there has been a smear campaign against the U.S. government promoting the myth that the federal government will control access to and dictate  choice within the health care system. While America was diverted in a riotous way from a rational approach to health care reform, the insurers were busy making hay with Senator Baucus to ensure that they maintained their stranglehold on the health care sector, the American taxpayer–and, of course, the U.S. Congress.  

With the Baucus proposal, we can truly say that  the federal government does not control health care but the insurance industry does? When and how often you see a doctor–and whether or not you get the necessary lab tests you need–and even which provider you see—are all determined–and will continue to be determined– by the insurers. 

Yesterday, I heard about a patient who was on the verge of a heart attack.  He saw his cardiologist who determined he needed a nuclear stress test immediately.  Did I say immediately?  According to  a top cardiologist he did?  According to his insurer, he had to wait two weeks for the test. Was this the government intruding in health care?  No, way. 

The government is not in your doctor’s office–but the health insurers are.   And now they will be in every house in America–like roaches, they are taking over.  Break out the Combat.

 Insurers broke out the champagne last night, knowing they succeeded in getting Senator Baucus  to allow them to make a killing with provisions for  U.S.  families to pay 13% of their income for healthcare coverage or pay a fine. A family of four with annual income of $65,000 would be asked to spend $8,450 on health insurance premiums before receiving any federal subsidy.  

 Certainly, Senator Baucus has been receiving too much  money from health insurance lobbyists to be in touch with the reality of the average American who cannot pay out 13% of their income on health insurance premiums.  The insurers are already raising premiums to cushion any blow that would come from doing away with non-payment for preexisting conditions.  After all, who is there to stop–or regulate– them?  The government?  With leaders like Baucus, I doubt it.

Where’s the reform?  Where’s the coverage?  Where’s the safety net? Where are the promises of President Obama?  The rising stock prices tell us who is benefiting from reform.  Perhaps Wall Street is also telling us that we learned nothing from the scandals of last year.  If the profits are only benefiting some big companies, something is very wrong.  It is time for Senator Baucus to recuse himself from the debate given that the first reaction to his health reform bill was mild pandemonium on Wall Street.

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Posted in Health Reform, health economics, health insurance, president Obama | 3 Comments »

September 10, 2009

The Time for Games Has Passed, Says Obama on Health Reform

The President  brought new energy and enthusiasm  to Congress last night as he tried to reignite action on health care reform.  Overcoming my anger at a joint session of Congress during a  BIG GAME –a quarterfinal match at the U.S. Open with 1 of only 2 Americans left in the tournament — the speech showed the President taking a firmer stand on reform, attacking the false claims on reform options, and talking of “my plan.”

Obama exhorted Americans to believe in their power—and the power of government—to do good.  He called on Americans to address health care as a moral issue, emphasizing that social justice and the character of the nation are at stake.

That said, what did we learn?  The President said that if we do nothing to slow the costs of Medicare and Medicaid, they will eat up the entire budget.  On the other hand, Obama made of point of saying that if you’re enrolled in Medicare, Medicaid, or the VA, or have employer based health insurance, nothing will change. Does that mean that the government will not cut Medicare and Medicaid payments? 

 The President’s plan will provide more security and stability to those who have insurance, provide insurance to those who do not, and slow the growth of health care costs.  His plan is to “make insurance work better for you.”  Will the insurers just pay for less (especially since they will have to cover pre-existing conditions)? How much will insurers change their pricing with academic health centers?

For those individuals without insurance, they will be required to get insurance (like auto insurance, said the President). The interesting thing is that some states do not make motorists show proof of insurance on routine traffic stops. Insurance is required, but only in the event of an accident. While fines can run to $5000, most are in the $500 range and only a few states impound your car—or send you to jail.  How will the government enforce the mandate?

As for the new insurance exchanges to be established, “customers will have leverage with the insurers,” said the President, who added that he will hold insurers accountable. The President did not say how that would happen.  I hope you’re right, Mr. President, but it sounded a bit like Shangri-la.  

Most importantly, the President will end fraud and abuse in Medicare.  While a worthy goal, it raises concern for academic health centers. The government does little now to evaluate providers (many fraudulent) who apply for a Medicare provider ID and run off with millions of dollars in payments for services never rendered.  So where is there money to be found?  The government is able to collect money by establishing Recovery Audit Contractors and other vehicles to search for supposed billing errors by academic health centers.  Is this the “fraud” the President is talking about?  Will we see some RAC clones established or a new wave of billing regulations? 

The President said the details of the plan are yet to be worked out.  The coming days will show the true impact of the speech and whether we see any change in attitude or action on Capitol Hill.

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September 3, 2009

Obama Trying to Salvage Match Point in U.S. Health Reform Open

What should have been a “love game,” with Obama easily cruising to victory in the U.S. Health Open, has now turned  into a grueling last set, last game battle, with the President having to save match point.  The President will address a joint session of Congress next Wednesday night to add specifics to his vision of health reform, according to media reports.   If conversations with White House health advisors are any indication, it is difficult to discern anything new in the messaging.  If the President tells the nation we need more primary care, health IT, and research to find out what treatments work and don’t work, America will not be enthused.

 America wants to know what systemic changes the President wants in a health reform bill. Will he stand for a strong public option?  Will he provide the roadmap and transition time for changing the current health insurance industry? Will he ensure that the health workforce is a priority and address workforce issues now—not later?  Will he go beyond primary care—and provide a new vision for how to deliver primary and specialty care to all segments of society or will he be satisfied with a 19th century view of the primary care doc going off alone to the rural regions of the country to solve the workforce crisis? 

Will the President explain to the nation that whatever happens in the delivery of services will ultimately affect  the nation’s research enterprise because of the unique  role that academic health centers play in the nation’s health system?  Will he explain how health reform must take account of how the clinical monies help to support the nation’s biomedical research through these institutions?  If the answers to these questions are what is meant  when the White House says  “specifics,” then America will listen.  If not,  the  President will be forced to make a quick exit from Center Court.

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Posted in Health Reform, News, Policy | 1 Comment »

August 3, 2009

On the Road With Health Reform: Where’s the Next Exit?

Speaker of the House Nancy Pelosi and HHS Secretary Kathleen Sebelius are using their August vacations to try to sell health reform.  Unfortunately, no one really knows what they are selling.  President Obama was elected in part because millions of Americans wanted health reform.  They wanted change and a NEW health care system.   What the Congress now has to offer—and Pelosi and Sebelius are trying to sell– is a warmed over version of the dysfunctional system we already have.  It’s reasonable to expect that buyers might be leery. 

Americans are attracted to all that is  shiny, new, high tech, and different.  But what are they getting with health reform? The proposed public plan is warmed over Medicaid, not Medicare—and no one is buying that.  The insurers still get a big piece of the action—and no one is buying that.  The timeline is too long for people out of work now—or fearing a layoff–and no one is buying that. People are wondering why the President is asking them to buy a clunker. 

 Mr. President, it’s time to  take the next exit—turn around– and tell the Congress you want something better to sell on the road.

 

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July 23, 2009

Mr. President: Provide the vision, take command of health reform

Mr. President. The press conference usurped the time slot of So you think you can dance? but you did not command the dance floor. You did not command the attention of the American people by telling them why health care is important to the future security of this nation. You provided no vision last night. You talked about the costs of health care as if you were the director of the Congressional Budget Office. Yes, health care may an important part of  the economic recovery –which you are taking extraordinary steps to address. And the costs of health care are a worry for the government.  But you forgot to tell the people that there are costs that go beyond the numbers on some CBO balance sheet.  There are also the costs of greatness. Without health care, the greatness of the nation is at risk. Health care reform relates to life, liberty ,and the pursuit of happiness for the American people who still believe that the U.S. should be the shining example of what is good in the world.

You did not call  upon the nation last night to think about a new and better way to live, as you have done in the past. Where was the orator last night? You are capable of raising the nation’s heart and soul. It is about the economic future that comes from good health care for each individual. You should be telling us how health care is about individual and national security–about freedom from worry about your child’s health or your mom or dad’s Alzheimer’s disease. Tell us that the nation is only secure if the health of its people is secure–that American greatness is built upon caring for each other.

Mr. President, we want you to  provide the vision that is so lacking in this health care debate. You talked about insurance premiums, employer coverage, and insurance exchange programs. You talked about passing reform at the “lowest cost.” How can health and security be equated to the “lowest cost”? I am not sure the nation wants to hear that, Mr. President.

What can you do Mr. President? Here is my short list. #1. Give us new vision on health care–one that’s about health–not just money and costs. #2. Reframe the debate by getting some new voices in the mix–including the single payers. Don’t close them out. #3.Make sure the nation knows what health reform will mean for the health workforce–and for biomedical research in this nation. Those are real issues for the future. Open the door to new thinking on all fronts. #4. Take control of the debate. The Congress is pushing many agendas and may not be doing what is best for the nation. #5. Take a stand. Tell the nation that the government is a good guy and can solve this problem. #6. Tell the nation that the bureaucrats making decisions about health services do not work for the government but for the insurance industry. It’s time to get creative to find out how the insurers can contribute in new and different ways to the economy. There may be a new world out there for them in job retraining. #7. Be strong and be confident that the nation is behind you.

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