History in the Making

I am breaking out the blog in honor of the pending passage of historic health care legislation. When I wrote to John Barrow last night, I asked him to be on the right side of history today. While he did not agree to change his vote, he does get credit for a prompt and personal response. This evening, when the House votes, he will not, I suspect, be on the right side of history, but his Party will be. This is not a perfect bill, but it is a toe in the door, and it will make it possible for more Americans to purchase health care and makes it more likely that one day, all Americans will have access to the health care that they need.

Passage is good policy and good politics. Just ask David Frum who sees this vote as the Republican party's Waterloo.

Update: Just heard Rep. Deal take the well to vow to keep Georgians from being subjected to the "unconstitutional" mandates in the bill. Sound to me a lot like what some said about the Civil Rights Act.

Update at 7:50: John Lewis is in the well. "We cannot wait, we cannot be patient. The American people need health care and they need it now." Dynamic, historic, vintage John Lewis.

Update at 9:30: Watching my sister's Rep, John Spratt run the debate for dems. At least her rep is voting for this. I am struck by all the references to back room deals, especially given that I have now been watching this debate for five hours. What secrets could possibly be left? Did someone make the Republicans swear a blood oath not to tell about the nasty secrets tonight on teevee?

Update at 10:15: Watching as the first female speaker of the house brings it home for health care. Go, Nancy! Your stock just jumped.

Update at 10:47: 219 to 212, Health care reform, the Senate bill, passes the U.S. House of Reps. with NO Republican support. Please, please, let them keep calling this the Democratic Bill. We will be calling it that for decades, and we will have a generation of "Health Care Democrats" just like my daddy was a "FDR Democrat."

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Since I've Now Earned the Right

Since the MCCG was kind enough to phone this afternoon to let me know that the estimated after-insurance-discount price of the heart cath I have scheduled for Wednesday is just over 19K, this seems especially ridiculous.

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Gee, I wonder what Georgia will do?

Sen. Reid has indicated that he will support a health care reform bill that includes a public option, but that allows states to opt out. Unfortunately, since our congressional delegation has already opted out, there's little question that Georgians, whose health and access to health care can be correctly categorized as the least, the lost and the last, will find ourselves watching as the public option parade passes by.

Here's a question for you. Talk to a Republican about health care reform, and to a person, they will say that people and businesses should be able to purchase plans across state lines. That's code for "purchase plans from states that have the least regulation and the fewest mandates for coverage." Your health insurance policy could end up being worth approximately as much as old Confederate dollars. But, what they don't want is for people in their state to be able to purchase insurance from the federal government. If you can make that make sense, please, have at it.

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More Mail from the RNC

Not having had time to purge their database after creating a mini-firestorm with their mailing masquerading as an official census form , my husband got yet another RNC mailer, this one in an envelope marked "Official Business," "To Be Opened By Addressee Only, Under Penalty of Law," and "2009 Future of America Health Care Survey." I did laugh because on postage paid return envelope, they wrote "By using your own first class stamp to return this envelope, you will be helping us save much needed funds."

From the inside, here's my favorite "survey" (read: push poll) question:

8. Rationing of health care in countries with socialized medicine has led to patients dying because they were forced to wait too long to receive treatment. Are you concerned that this would be inevitable in the U.S. under the Democrats' plan?

Fear and deception seem to be the only weapons left in the Republican arsenal. Where were all these RNC surveys about health care when Bush was in office? Why now, do they suddenly give a damn?

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"Marshall Disappoints Again"

I am sure that Jim Marshall could not care less what I think about his recent interviews on Fixed News or this piece in the Telegraph where he not only bashes all of the health reform plans before Congress, but at the same time manages to slam President Obama and draw a comparison to the Soviet system. How great of him to attack the President's leadership and evoke images of socialism in the same statement. It was a trifecta, only this time, the losers are his Georgia constituents whose health and ability to access care remains among the poorest in the nation. Let me be clear, I was never under any illusion that Marshall would support health care reform. We couldn't even get him to vote for the expansion of children's health care. But, does he have to toss the whole damn party and the President under the bus while doing the bidding of Houston County Republicans? I'm just asking. Folks who read the piece emailed me suggesting that perhaps he is posturing for a move to the minority party. Not a chance of that, I think. Someone else summed it up well in the subject line of her email, "Marshall Disappoints Again." When it comes to health care, that about says it all.

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Obama Stand Up for Women's Health: Lifts Global Gag Rule

Thanks to President Obama, the Bush legacy of the "Global Gag Rule" is now His-Story.

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Health Care Open Thread

Vic asked for it, so here it is. I invite you to share your very own health/care/insurance nightmares. Mine is pretty simple. There isn't a single child and adolescent psych inpatient bed in Bibb County. Not one. I don't need them often, for my patients, but when I do-the child is really, really in crisis. I hate telling the family to head to Atlanta.

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What Women Want

What do women want? It's not diamonds or pearls, but instead, shorter work days, more free time, a vacation. A chance to see their doctor when they're ill would be good, too.

We may have a female Speaker of the House and a viable female candidate for President, but the typical women in the workforce badly needs some time off. Even when women work, they still tend to shoulder a greater share of the household, childcare and eldercare responsibilities than men do. Even when we're not working, we're working, and even when we have "leisure time," we worry about what we ought to be doing. No wonder more women than men suffer from chronic illnesses like diabetes and depression. And how sad that, despite all this working, a substantial percentage of women cannot afford to go to the doctor or get prescriptions filled.

According to the U.S. Department of Labor, only one in five women take a vacation once every six years. Plus, researchers from Ohio State University have found that even when women do get a break from work, they have trouble relaxing and tend to combine leisure activities with other tasks and responsibilities. The co-author of the study, Liana Sayer, said, "The meanings of free time for men's and women's lives are quite different. Especially for wives and mothers, it appears free time is still combined with other activities or responsibilities."Interestingly, married women with children were twice as likely to feel rushed than single women without children. But men who are married with children do not feel any more rushed than single men without children." That will come as a surprise to no women I know.

And, women are worse for the wear. The Kaiser Family Foundation's report, Women and Health Care: A National Profile nearly four in ten women (38%) have a chronic condition such as diabetes, asthma or hypertension that requires ongoing medical attention, compared to 30% of men. One in four women (23%) reported they have been diagnosed with depression or anxiety, over twice the rate for men (11%). When it comes to quality of care, over one-third (37%) of women in fair or poor health say that they delayed or went without medical care in the past year due to costs, and one-third (34%) did not fill a prescription because they couldn't afford it. Nearly 12% of women not only care for children, but also for their sick and aging relatives. Among those, a whopping 46% have a chronic illness of their own and 29% provide more than 40 hours per week of care. And 20% of these caregivers have no health insurance.

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The Worst Sort of Push Poll

Someone is push polling on the issue of Elizabeth Edwards' health. Ick. Ick. Ick. From Politico.

Two bloggers today reported receiving calls last night from a pollster testing whether John Edwards’ failure to drop out to take care of his ailing wife could damage his campaign.

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MCCG to Suspend Issuing New Clinic Cards

As she approached the window in our front office, "Ann" said, "Can you give this to Mr. Morton, and ask him can he do anything?" She looked frail and scared. "Mr. Morton" is my husband, and he represents disabled people-people who cannot work, do not yet have Social Security income or the accompanying health benefits. Like many of his clients, Ann has few resources and relies on the Anderson Clinic of the Medical Center for medical care. There wasn't much Mr. Morton could do about the piece of paper Ann handed him. The Anderson Clinic, the Family Health Center and the Neighborhood Healthcare Center will suspend issuing new clinic cards this Friday.

According to the notice, these clinics provide primary care to 15,000 uninsured and under insured residents of Middle Georgia-approximately 40,000 clinic visits per year. The cost of providing this care has grown by 37% over the last two years-more than 1.3 million in new costs. Despite this, they have experienced significant reduction in funding from the state and federal government. Most recently, Bibb County reduced their funding by 2 million dollars.

So, Ann, who does not have a current clinic card, will have to get one before Friday, or she and others like her will simply not be getting primary care, and instead, they will be showing up at the emergency room for the most expensive and least effective health care available-and you and I, the taxpayers, will be footing the bill. What sense does that make? I'd rather pay a little to help provide preventative care than foot the big bill generated by people not having access to it. It's like not painting your house and then having to replace the wood siding. Dumb.

Now, according to this, the new Federally Qualified Health Clinic will open in Macon on November 1. I'm not sure that date still holds, but this clinic is a great idea, and thank God for those who made it happen. Is it actually opening tomorrow? Will it fill the gap for people like Ann? I'll be asking those questions.

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John Edwards : We Didn't Get Healthcare, We Got NAFTA

Today, addressing the Laborers Leadership Convention in Chicago, John Edwards pressed Hillary Clinton on her newly unveiled health care plan. Today, Clinton became the third Democrat to unveil a plan for universal health care. Sen. Edwards led on this this issue by being the first of the candidates to announce a plan and provide the details. Today, Edwards took Clinton to task for continuing to take money from some of the same interests who help derail her 1993 plan. Edwards said:

"The cost of failure 14 years ago isn't anybody's scars or political fortune, it's the millions of Americans who have now gone without health care for more than 14 years and the millions more still crushed by the costs."

Edwards was referring, of course, to Clinton's typical "I have the scars to prove it" retort when challenged about her failed efforts on health care in 1993 and her advocacy for inviting special interests to the table now. To the labor union audience, Edwards pointed out that in 1993, the President (Clinton) strongly supported universal health care, none the less, thanks to the influence of lobbyists and special interests, we didn't get health care, but we did get NAFTA.

Edwards attempted to put bite in his growl today by saying that when he is elected, he will submit legislation that ends health care coverage for the president, all members of congress and all senior political appointees on July 20, 2009, unless we have passed universal health care. I don't imagine he's going to find a whole lot folks in Congress lining up to support that legislation....but, he made his point. What's good enough for the rest of us, is good enough for politicians in Washington.

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And This is a Problem, Why?

Today, Sen. Edwards made it clear that health care for everyone does not imply responsibility for no one. Today in Tipton, Iowa, he told a crowd that people would be expected to see their doctor for preventative health care. He said that if Americans choose to be in the health care system, they cannot choose to not see their doctor for twenty years. Regular checkups and a healthier lifestyles would drive down health costs in American. That makes sense, but, alas, the words had hardly left his lips before the rightwing bloggers started in. The same crew that preaches personal responsibility thinks expecting people to go to the doctor is just too much to ask. Okay, how about we compromise and let you drive your SUV to the doctor??

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Teilhet: "Bankruptcy of Vision" in Health Care Debate

Progress on Health Care Will Require Reason, Political Courage
By
State Representative Rob Teilhet (D-Smyrna)
Chief Deputy Whip-House Democratic Caucus

More than a million and a half Georgians do not have access to health care that they can afford. The vast majority of these Georgians work full-time, yet they and their children are one major illness or accident away from bankruptcy and the loss of everything they’ve worked for, including their home. Imagine losing everything you have so you can pay for the medical treatment of a spouse or child. For too many people in our community, this doesn’t have to be imagined because it’s a reality. And these ranks are growing.

These Georgians are not abstractions. They are our neighbors. We talk with them every day at the grocery store, gas station, and at the office. They are the ladies who print and fold church bulletins for Sunday service. They are the men who fix our car when it won’t run, and who repair our air conditioning when summer has taken its toll. They are the people who serve political leaders their steak dinners at fine banquets, who top off the wine glasses at a $1,000 per plate fundraiser, and who keep the grounds neat and clean at the members-only golf course. They are parents and they are children. These people would never think to mention it, but they are carrying a burden. And we can choose either to help them, or do nothing.

What can we do? Two years ago, I introduced HB 1212 (or PeachKids) to ensure that every child in Georgia would have access to quality health care their family could afford. The plan was affordable, had been tested in other states and proved successful. It never received so much as a public hearing. This year, Democratic State Representative Pat Gardner (D-Atlanta) and Republican State Representative and Committee Chair Judy Manning (R-Marietta) introduced HB 625 (or PeachCare for All Kids), designed to make sure every child in Georgia could have access to a family doctor. PeachCare for All Kids builds on a system that works, the current PeachCare system, and does so in a fiscally responsible way, constituting an investment Georgia can easily afford. Both plans demand responsibility and buy-in from families in the form of tiered but affordable premiums and leveraged millions in available federal matching funds to help people help themselves and obtain the coverage they need. Yet PeachCare for All Kids met a similar fate to PeachKids, mired in committee while the General Assembly did battle over the pressing issues of payday loans, where to buy beer on Sunday and what kinds of pictures to put on our license plates.

There are other promising proposals by members of both parties, including more aggressively pooling the uninsured to increase their bargaining power and lower their available premiums. Another possibility is to use refundable tax credits similar to the federal Earned Income Tax Credit to help working people of modest income generate enough money to obtain health care coverage for their families. The problem in dealing with health care in Georgia isn’t a lack of policy alternatives, it’s the lack of political will to think and act boldly.

Recent comments by the President Pro Tempore of the Senate, who dismissed my call to do more on the issue of health care by pointing out that, after all, people can go to the emergency room if they really have to, show the dangers of obedience to caution and the status quo. While I agree with parts of the Republican mantra that controlling the cost of health care is important, it will not help the husband who has worked hard his entire life, played by the rules, and lost everything to pay for his wife’s unexpected cancer treatment. A bankruptcy of vision is as much a threat to health care in Georgia as a bankruptcy of dollars.

No doubt, the bipartisan alternatives that have been laid out will be attacked by some political hacks with the poll-tested language of “socialized medicine” or “Hillary-care.” They are, of course, no such thing. They are affordable and rational extensions of existing policies that have bipartisan support to meet a pressing need of our people, one that is not being met by the current health care system. Helping to make health care access more affordable isn’t “socialized medicine” any more than HOPE scholarships are “socialized education,” the state’s partnership with Kia is “socialized car building,” or OneGeorgia grants are “socialized rural economic development.”

It doesn’t have to be this way. Other states have made strides in making health care more accessible and done so in a bipartisan way. There is no good reason Georgia cannot do likewise. The funding and policy proposals are there. But what will be required is not timidity, not focus groups or poll-tested sloganeering, or weak gestures that are more symbolic than substantive. Rather, solutions will require courage and the expenditure of political capital.

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