Agenda – Healthcare Assignment From Change.gov

Every couple of weeks since President Elect Obama formed the Transition Team, myself and others have received requests for information. This latest is is to make a discussion on our healthcare. 

Have you ever wanted the chance to have a “Real” voice in what our government needs to do with an issue?  Did you ever have an idea about how better to solve a problem and had to sit and watch on the sidelines as the Governemnt botched it up? Well, President Elect Obama is really interested and I am amazed at this approach.  The Transition Team is asking for all Americans to participate.  if anyone is interested in active participation, joining a local community action team or just writing about your own story, use   www.change.gov 

Go to AGENDA and you will see the various issues like Revitalizing the Economy ,  Ending the War in Iraq , Providing Health Care for All , or Renewing American Global Leadership  to name a few. 

I can’t form or attend a meeting because intenseness of my job won’t let me. However, I thought we could have a discussion here. With enough discussion of healthcare that included the who, what, when, where, and why, I feel comfortable that sending information to the Transition Team would get us read too.  So lets brain storm over the next 24 hours. My cyber friends and friendly lurkers.  

Fire away!

 

The Obama-Biden Plan For Healthcare

On health care reform, the American people are too often offered two extremes — government-run health care with higher taxes or letting the insurance companies operate without rules. Barack Obama and Joe Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference.

The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors, and plans. Under the Obama-Biden plan, patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats.

Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year. If you don’t have health insurance, you will have a choice of new, affordable health insurance options.

Make Health Insurance Work for People and Businesses — Not Just Insurance and Drug Companies.

  • Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.
  • Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.
  • Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.
  • Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.
  • Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees’ health care.
  • Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.
  • Ensure everyone who needs it will receive a tax credit for their premiums.

Reduce Costs and Save a Typical American Family up to $2,500 as reforms phase in:

  • Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs, and taking on drug companies that block cheaper generic medicines from the market.
  • Require hospitals to collect and report health care cost and quality data.
  • Reduce the costs of catastrophic illnesses for employers and their employees.
  • Reform the insurance market to increase competition by taking on anticompetitive activity that drives up prices without improving quality of care.

The Obama-Biden plan will promote public health. It will require coverage of preventive services, including cancer screenings, and increase state and local preparedness for terrorist attacks and natural disasters.

A Commitment to Fiscal Responsibility: Barack Obama will pay for his $50 – $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.

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83 Comments

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83 responses to “Agenda – Healthcare Assignment From Change.gov

  1. chefsheila

    Ok! I’ll start.

    WHY has our healthcare system forgotten Dental? WHY is Dental the only healthcare need that is not insured well enough and so expensive, as you become middle aged and need more dental, you practically bankrupt yourself?

    I had 100% health coverage at one time.

    I was having chest pains. BIG CHEST PAINS. Landed me in the hospital. the Cardiologist new I was not faking it.

    Long story short, with in a week of leaving the hospital a tooth imploded….just crumbled. I went to a dentist and found out that I actually had 8 absesses. The normal pain was manafesting in Chest Pain. The infection was working its way down to my heart instead of in my mouth.

    All of this was caused by TMJ. I was not actually aware that I had this. The amount of preasure my jaw took from the grinding and bitting down, put a toll on my entire mouth.

    The lack of dental insurance and the huge cost of dentel compared to my loss of wages, for ten year period of time, precluded me from seeing a dentist for many years.

    I needed a series of operations RIGHT AWAY. It was going to cost me anywhere from $15 to $20,000 and actually cost me $30,000. I was required to get a Medical Loan that had a 17% interest and I actually had no time and no choice in this company.

    the Cardiologist and the Dental Surgeon BOTH wrote letters to Blue Cross Blue Shield to no avail.

    Blue Cross Blue Shield said only the pulling of all of my teeth would have been covered…..

    AND, my treatment is still not finished and I can’t afford to complete it.

    So, here I am with an unplanned high interest loan that actually has been a major contributor in my financial ruin.

    AND in the year that I have been wressling with this embarassing process, I have found 6 other of my generation that have had the same problem and are suffering huge meidal costs because of it.

    I would have DIED.

  2. chefsheila

    We have to change the dental industry too. It has to be included in our health insurance.

  3. chefsheila

    Go JAY!

    Time’s Jay Carney will be Biden aide

    http://www.politico.com/news/stories/1208/16600.html

  4. horsedooty

    I never had dental insurance either Sheila. Do you qualify for VA care in any way? I was under the idea that vets (lifers really) were authorized VA med care.

  5. chefsheila

    I retired in the mid-90’s. There was a change in coverage at the VA Centers at that time. Anyone who retired during the draw down also lost the right to go to a VA Hospital unless they had a disability that was confirmed.

    Everyone before that was grandfathered in.

  6. horsedooty

    well that sucks big time. Maybe we can lobby General Shinseki to change the rules so that the US will actually honor promises they made to the public when they were asked to join.

  7. chefsheila

    LOLOL That would be a new one, wouldn’t it?

    Right now though, I can’t even get into Madigan here….I have a doctor assigned and I’m having a hard time getting an apiontment. Aparently, there is a shortage of doctors for the military too. The ones here are on tour in Iraq.

    We DO have a problem in the military. Shorage because they don’t make enough money on active duty to attract good ones.

  8. chefsheila

    You know Doots, I’m beside the point as a retiree. I feel guilty just thinking I deserve better healthcare, when all those young kids have brain injuries and lost limbs and they need the healthcare first.

    The VA is just as broken as the healthcare system. Its going to be a loooonnnggg time coming if Shinseki and Obama can fix it.

  9. dnd

    Dental plaque has been linked to heart disease (be sure to floss!). It’s stupid that health care coverage doesn’t include dental.

  10. chefsheila

    I’ve been a flossing mama from the beginning….

    Great advice though.

  11. dnd

    If we had universal health care coverage, it would solve a lot of VA problems. Vets who live far from VA centers could get treatment by local physicians.

  12. Nannymm

    Good morning, all!
    This is an excellent post, Sheila! Great information about Obama’s plan. I agree with you about dental care. I’m one of the few fortunate ones that has it. But for many years I didn’t so I can really understand where you’re coming from. Whatever
    plan is finally implemented must include dental, optical, and mental health at parity with medical/surgical. In other words, we need FULL health care coverage. We have to stop this piecemeal way of providing coverage that this country is mired in. We pick coverage options like we were ordering dinner from a Chinese menu. It doesn’t work. We need stem to stern coverage, head to toe.
    I also think we need to find a way to get people to accept routine wellness care. Perhaps, people who go for regular checkups would have no co-pays. But those who miss their annuals would be required to pay a small fee for any other care that year. Not sure that would work but we do need to find a way to get people in for regular checkups. Any ideas?

  13. chefsheila

    ooooo….Thats a good idea Nanny! Its worth passing on too.

    In order to get people in for regular checkups, there have to be enough doctors though. Malpractice insurance needs to take a hit.

  14. dnd

    Nannymm,
    I think if we reduced the cost of routine wellness care through clinics, more people would be motivated. Nurse practitioners can do 98% of what doctors do in routine care.

  15. chefsheila

    hmmm….maybe separate wellness clinics from real live illness.

    Not a bad idea. If we had a clinic to go to for our physicals….

    But what about the majority of coughs colds, and flue that take up a lot of clinic time?

    What about education in home therapy? Or is that going too far?

  16. Nannymm

    dnd, I used to think you were right. But even people who have excellent coverage and easy access don’t go for annual check-ups. Among some segments of society (younger and middle aged men, for instance) there is a feeling that you only go to a doctor if you’re really sick. The problem with that is that by the time many of these people get to a doctor, they really have serious issues such as hypertension, diabetes, elevated lipids, etc. Many of these conditions could have been caught early if the patient had come in for routine physicals. Then there are the patients who never return…. We need a way to make it advantageous to each person to get that well check each year. Some kind of carrot and stick approach might work,

  17. Nannymm

    Separate wellness clinics is not a good idea, IMO. People need a health care provider/team that they can get to know and feel comfortable with and that knows them and their history, a team that can recognize when something is not right with that particular patient. For instance, my doctor knows what my normal BP and BGL ranges are. So, if they are out of those ranges, she is alerted that something may be going on and can monitor it. Medical providers need to establish relationships with patients in order to give quality care. If you were to ask doctors, they would tell you that they don’t have enough time to get to know patients and to address their concerns. That’s why I favor a team approach.
    The team might include a doctor, a physicians assistant and/or nurse practitioner. It would allow continuous care both for the well patient and the sick one. It would ensure that a patient was known by the team and that the records would be maintained by the team.

  18. chefsheila

    So what about congested areas? In my brief encounter with one doctor, He actually had too many patients. He has two different offices and so if I had a problem and couldn’t catch him at the office I went to, then I went to a 24 hour critical care or the emergency room…..

    He got a read out of diagnosis, but he actually never got to know me anyway. He was always somewhere else.

  19. chefsheila

    Maybe one of the answers is less patients per doctor or team?

    I don’t know how it is across the country

  20. chefsheila

    And to get a person to go to a wellness check up, maybe an increase in their insurance or penalty if they miss one?

  21. Nannymm

    We do need alot of education for healthcare consumers. NO ONE needs to see a doctor for a cold, unless that person has a serious underlying medical condition that may be affected, such as heart disease, COPD, an immune deficiency, or severe asthma. We need to educate people about when to seek care and when they can safely treat at home. A quality team approach would allow for that. The team could accept off hours calls from patients. Many times just being able to discuss a situation with the team and receiving reassurances that a situation is not an immediate crisis is enough to keep people out of the ER. Like wise, some doctors are now doing email consults for minor issues. These are ideas we need to expand upon.

  22. Nannymm

    Perhaps. Or perhaps some other incentive to go. Something that isn’t a penalty but a bonus. Or maybe a combination of the two. But something!!

  23. Nannymm

    Part of the problem of the doctor shortage is the issue of money. We pay primary care physicians so poorly that most new Med School grads choose to go into the higher paying specialties. For many of them, they have no choice. They leave school so heavily in debt that they need to make more money just to pay those bills. So, any change in how we deliver healthcare must look at how we train doctors and how we reimburse them once they begin to practice.

  24. chefsheila

    hmmm…..Yes, I wonder if we start with penalties and go it an incentive while, teaching our children in class….like they used to do with us.

  25. Nannymm

    Darn you, Sheila! You picked my pet topic for today’s discussion and now I’m getting no work done! And I’m being today’s “Blog Hog.” 😉

  26. Nannymm

    Now THERE is a GREAT idea!! We need to spend more time teaching kids about their bodies, their health, nutrition, etc. We need to remember that they will be making the healthcare decisions in a few years and they will do a far better job of it if they are educated healthcare consumers.

  27. chefsheila

    LOL I’m so glad nanny! I supposed to be working too!!!! So intermittenly we will come up with something.

  28. chefsheila

    I was in the California Educational system in the 60’s. There was a Walt Disney partnership with the government about all sorts of education for children. I really looked forward to those films. Disney really knew how to draw in my attention.

    I mean healthcare, nutrition, nuclear detanation…earth quake drills….everything.

  29. Nannymm

    We saw those films in NYC, too!

  30. chefsheila

    I wonder if something like that could be developed for the children…..and why not for all of us?

    there’s a lot of health channels and PBS would be another place to find this stuff…or making a health update for wellness something that turns into a TV Special on all the channels…..hmmmm……

  31. dnd

    Nannymm,
    I think you’re right about a carrot and stick approach. Not sure what it’d be, but people need to have some skin in the game.

  32. chefsheila

    SO spending some money developing a National health and wellness campaign as a part of a new health care program….would it be worth it?

    Define what would be the parts of the populus most benefiting.

    What kind of educational subjects in your opinion would be most benefitial?

    How would you deceminate the education?

    What kind of Carrot and Stick?

  33. Nannymm

    Alot of education for adults should be done right at the doctor’s office. If I had my way, every office would have a nurse educator on staff and every new patient would have a consult with that educator. Additionally, when a patient received a new diagnoses of a serious or chronic disease, he or she would again consult with the nurse educator. That nurse could also be available for phone and email consults for quick questions and by appointment for other issues. He or she might want to conduct a series of small classes devoted to specific health care topics. There are many ways to do all this. But incentive must be there. I believe that when people are invested in their care, they get better care and they utilize care more effectively.

  34. chefsheila

    OOOOOO Good Idea Nanny! You have a lot to say!

  35. chefsheila

    A full service facility that educates adults as well as caring for them….What a concept.

  36. Nannymm

    When I was diagnosed with diabetes, my doctor set me up with two appointments right away. They were with a Nurse Educator who specializes in diabetes education and a Registered Dietitian. Although I am a nurse, I am not a diabetes expert nor a dietitian so I was glad to have a team that could advise me and help me plan for living with diabetes.
    The team provided me with written materials, took a history, helped me develop a care plan, a diabetic diet plan, and general oversight. Now, if I have a question or concern, I have professionals I can call to discuss the matter with. Other members of my diabetes team include an ophthalmologist and a podiatrist.
    With the help and encouragement of the team, as well as my family and friends, , I have gotten my diabetes under strict control. This should be the goal for every patient. It is a goal that would be so much easier to achieve if everyone got the same kind of care from a quality did like I have.

  37. Nannymm

    that last sentence should be “….from a quality team like I have.”

  38. chefsheila

    Cool. 😉

    Well done!

    If things were so simple, we might not have this problem.

  39. Nannymm

    It is a a good concept, IMO. People need to stop thinking about healthcare in the piecemeal way that we have become accustomed to. While we need specialists such as cardiologists, oncologists, surgeons, etc, they should be secondary to the team. The primary physician (as well as his or her support staff) and the patient must be the core members of the team, the ones responsible for ensuring quality care. Specialists should only be brought in when needed. But even then, care should be coordinated by the Primary Care Team. It is an effective model where it is utilized. I think it should become the model for all care.

  40. Nannymm

    OMG! Sheila!!! STOP!!! If we get into the reasons for why we’re in this mess, we’ll never get any work done!!

  41. chefsheila

    LOL I’ll see you later…..

    Not my fault you are so good at this!!! 😆

  42. Great post Sheila, and thorough too!

  43. Nannymm

    I’ll bet it’s delicious, Brian!

  44. chefsheila

    LOL Great Post Brian and enjoy!

    Thanks for the compliment.

    Whatever you want to bring up for discussion would be great.

  45. It’s yummy, 3 polyps removed, I’ve had them before and I’m sure the biopsy report will be a good one. My last colonospy was two years ago so these are new polyps and haven’t been there long enough to be cancerous.

  46. chefsheila

    Excellent!

  47. Nannymm

    Great news, Brian!

  48. Nannymm

    This is a terrific idea! And quite funny, too.
    Paying down the deficit with whizzing shoes.
    By Nicholas Kristof
    http://kristof.blogs.nytimes.com/2008/12/15/paying-down-the-deficit-with-whizzing-shoes/?8ty&emc=ty

  49. chefsheila

    I’ve been in with the Mrs planning Christmas dinner!!!!!! Brian.

  50. chefsheila

    By the way my friends, we ARE signed up and I’m going to be forwarding our thoughts on the subject of educating the masses in healthcare for provention.

  51. horsedooty

    at the risk of appearing somewhat more dense than I normally show, I will ask? Signed up for what?

  52. How I think health care should be covered. I’m a firm believer in that we have to go to a one payer system. And that our premiums should be based on our income and handled through taxes. This could easily be worked into the current tax code as another aspect of the progressive income tax we already pay.

  53. chefsheila

    Doots,

    If you reread my short post before the video,

    The transition team is looking for input on how we should re-invent healthcare. We were to choose a topic.

    By default Nanny led me into the subject on education and how to educate and structure it.

    What are you interested in?

  54. Nannymm

    Lol…you most certainly do not ever appear dense, Doots!

  55. horsedooty

    musta skipped over that part Chef Sheila. Sorry for that. Sometimes my reading skills are less than they need to be. Let me think on this for a bit.

  56. Well we could make the movie Sicko mandatory viewing!

  57. Nannymm

    Sheila, my point isn’t just about healthcare education. It’s about a comprehensive, team-centered approach to healthcare. I agree with Brian that we need a single payer system. I’m open to how that is accomplished, but I do think Brian’s ideas about premiums based on income and administered/collected through taxes is one possible way. Another might be to increase taxes generally, especially for those in the highest brackets, and then provide healthcare coverage to all.

  58. I really don’t see how you achieve universal coverage without it being funded through taxes and having the risk spread though out the entire population.

  59. horsedooty

    I can get behind a single payer system. I like what Nanna has to say about the team-centered approach to healthcare. Nearly every other country in the Friggin’ world has Universal Healthcare but the US. Reason is it is supposed to communist from what I hear.

  60. Nannymm

    Thanks, Doots. I come by my ideas after years as a member of the healthcare delivery system.
    Brian, I’m not disagreeing with you at all. In fact, I think your idea is the best one I’ve seen so far. In Canada, healthcare is provided through the tax system. Everyone has full coverage from birth to death regardless of income. It’s paid for out of tax revenues. We can and must do the same here.

  61. Nannymm

    Only those crazy right wingers think it’s wrong to provide health care to everyone. Until, of course, they need help. Then they sing a new tune. Given the state of our economy, I think we’re going to be hearing alot of that new tune in the weeks and months ahead,. That may help get universal coverage legislation through congress this time around.

  62. chefsheila

    Good job guys….so talk amongst yourselves and I’ll be back after gorceries.

    Tonight I’ll make a summary of what was dominant in our posting and after you see it, I’ll send it on off to the Transition team.

  63. Well right now I’m on my old win98se computer. I got everything moved in wait for my TV tomorrow.

    The store called me and told me someone would be calling me between 6:30am and 8:30am to give me a approximate time in a three hour window of when they would be coming.

    The lady also said that they then would call me about forty minutes before delivery so I’m already for them.

    The only problem is I still have not setup my other computer yet. It appears that I need to buy a 25′ network cable so it can reach the new area the computer is in.

    I also went out and bought a new battery for my APC Ups and kept the old one for backup since it was still good. Then I went to the store where I got my set and bought a new amplified antenna for it.

    I moved the box with the stand back into the living room and will see what the nic cable goes for at BestBuy since hhgregg don’t sell it.

    I also checked to see if Brian had removed the two comments from the post I mentioned earlier only to find the whole post missing.

    I see that everything went well for you Brian and I sincerely hope and pray your biopsies come back clean.

    Take care everyone as tonight is my night for NCIS and the Mentalist so I will have to get offline. Also there is no lamp in this room and its getting dark out. Unable to see the keyboard in the dark since I’m no cat.

    Hope this goes through since I have not used this computer to post here. Will copy and save in case it gets eaten so I can repost it again if it does.

    Take care and …

    God Bless all.

  64. Whole post missing? I think I’m missing something, I don’t know what you are talking about AP

  65. dnd

    I agree that health care coverage should be singer payer and should be covered by taxes. But this would require the tax code to be revised, as it is so unfair. And the right would never buy it. They start screaming “socialism” and “the Laffer Curve” and “Medicare.” They probably wouldn”t say much about the taxpayer supported VA….

  66. dnd

    Vilsack said to be top contender for Agriculture. This despite an article last month where he said it wouldn’t be him.

    Clearly Vilsack is acquainted with agricultural issues. But the Forest Service is under USDA. They have a huge amount of public lands, most of which are in the west, that are used for recreation, oil, gas, coal, mineral and agricultural leases. And wilderness. I don’t know how knowledgeable Vilsack is on these issues, but if he’s not, I hope he’s a quick study.

  67. The right will never buy any health care reform Obama wants to put through, that’s why it’s so important to proceed full speed ahead while the iron is still hot!

  68. Nannymm

    I agree, Brian. If we wait for the right wingers to hop aboard, the healthcare train will never leave the station. As far as I’m concerned, we can do this and do it better without them anyway.

  69. dnd

    Whatever health care plan Obama comes up with, it will have to be acceptable to the blue dog Democrats and moderate Republicans, as it will be congress that passes the legislation.

  70. Oh it’s not the blue dogs and moderate repubs I’m worried about, but wanna bet what the “toyota repugs” are going to be doing?

  71. chefsheila

    Well one things for sure. The legislation won’t look anything like it did when it first started. So it makes sense to get whats really important from the public so they know what to write.

  72. chefsheila

    you know Brian. I’ve been driving a Toyota since I was 16.

    Toyata is not the problem. The region’s politics that they have settled in this country is.

  73. I didn’t say toyota was a problem.

  74. Brian…

    From my 7:50am comment on the last thread.

    “The person who posted a comment last named web left a spam post on the I still don’t love him post as did the guy above his comment.

    The guy web’s name links to a porn site and the guy above him links to a drug site {prescription} drugs that is.

    Just thought I would let you know so you can delete them.”

    Unless I’m blind I could not find that post again or maybe I am blind.

    Anyway I’m back on the other computer again and just stopped in to see what was going on.

    Check in tomorrow. Take care and …

    God Bless.
    PS: Your tests came out okay didn’t they?

  75. Maybe Sheila caught it AP, yes things went pretty well, thanks for asking.

  76. Brian…

    Found it. Here’s the post.

    https://clistersbackchannel.wordpress.com/2008/09/26/shoot-me-i-still-dont-love-him-by-guest-blogger-jamie/#comments

    There the last two comments and they left it right after my last comment from last nights thread. I went to the post to see what the comment was and when I clicked on there handle the sites I mentioned came up.

    That’s why I brought it up this morning in my 7:50am comment to let you know so you could delete them if you wanted to since the comments were harmless, however someone might click on there handles to see who they are and end up on a porn site or a drugs for sale site.

    Catch you all tomorrow. Will let you know when my TV comes or at least when they call me to let me know.

    God Bless.

  77. got it, thanks, old thread, I’m off to bed, night.

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