28 June 2009
Changes For Health Care Reform
I think this is my third or fourth post about changing the absence of a national health care plan in the US. As legislation is beginning to surface in Congress, you may want to send your representative in the House and your senators part or all of the bullet point opinions and recommendations.
I copied these from a letter I just faxed to Nancy-Ann DeParle, Counselor to the President and Director of the White House Office of Health Reform. I wrote to the President some weeks ago. I found Ms. DeParle's resume gave some insight into the several roles she has had that involve health care. She is Obama's advisor on these matters and her corporate, federal agency, private law practice, and investment firm experience and network are extensive. This can all be found by googling her name. The Business Week report of connections and the fact that she once headed HICFA, the predessor of CMS for Medicare. I think I have an inkling about the absence of public lobby organizations "at the table." And, yes, she is another lawyer in the White House.
Here is my input to her today:
HEALTH CARE REFORM
- We desperately need a federal, single-payer health care system, not a federal insurance program among private insurer plans based on employer-based procurement.
- We in this country do not have to reinvent the wheel for a national health service plan.
- The "donut hole" must go, entirely. Pharmacists should play a larger role in matters of policy and practice.
- All federal health care programs should be able to negotiate and receive the lowest prices for all procurement.
VETERANS HEALTH CARE
- Establish the Veterans Health Services (VHS) as a Medicare/Medicaid HMO to enable VHS to receive cost reimbursement and other financial payments the same as Medicare/Medicaid would to private HMOs.
- All veterans receiving Medicare and Medicaid would have the choice, without any means test, to enroll in VHS or in any other qualified HMO like Kaiser Permanente.
ENTITLEMENT PROGRAMS AND POVERTY
- The irony of Congress' requiring means tests, for limiting eligibility for federal programs, is that long-term, future federal entitlement expenditures will increase. We need a new paradigm not based on employment status or a means test.
- Create or require an operational auditing function for health care and entitlement program management of all public and private, public-funded providers.
FUNDING SOURCES
- Look into procurement activities while Cheney and Rumsfeld were in office. A governmental procurement activity deserves the lowest price of all customers. We have to raise taxes plus rearrange some budgets within the Administration.
I hope the current tweaking of the health care system's most visible injustices is only the beginning of full reform. Public health should include the means to keep the public healthy. We deserve better than what we have allowed to accrete into the current, complicated, complex fiefdoms of providers and insurers.
Iranian Political Reality and the US
Finally, on CNN's GPS with Fareed Sakaria today, a former CIA operative really explained the nature of "The Iranian Crisis." Mr. Bauer explained that the military, especially the elite units closest to the president, are trying to wrest control of the country from the rule of mullahs. He also said that this is an internal crisis that the people of Iran must settle for themselves. Paraphrasing him, the US should do nothing to interfere with these internal political matters. He also revealed how little intelligence information the US Government has about Iran. Bauer was last there, as CIA, in 2004. No one speaks or reads Farsi at the CIA anymore. To me, the lack of linguistic intelligence capability seems to coincide with Cheney and Bush's priority on Arabic while planning to invade Iraq. If any translators in training or in operation were identified as "gay" they were drummed out of the military, a stupid action by the Joint Chiefs of Staff, the Secretaries of State and Defense, that eliminated a key element in support of intelligence and of military combat forces. Certainly no one understood the histories of that portion of Asia or their social norms as evidenced by the US military actions and pronouncements in Afghanistan, Pakistan, the Caucacus republics that were part of the Soviet Union, in Iraq and in Iran.
It does not take much effort to read about the several civilizations as they came and went since the time of UR.
In Iran, the cycle of political leadership has been fairly consistent since the Seventh Century of the Common Era, often labeled A.D. Over the past 12 centuries, Persia or Iran has been ruled alternatively by the mullahs or by the secular forces like the military or a shah. Since 1979 CE, the mullahs have had control. Last weekend marked the beginning of secular political leadership. The mullahs will retain their resiliency, as always, because they are Shi'a, and because the Shi'a mullahs run their own public services for health clinics, education, welfare housing and food. [ Hezbollah uses the same methods to retain loyalists within the people of Palestine.] Each faction waits for the other to show weakness or vulnerability as its signal to resume political control of Iran.
Any threats to use military intervention for whatever reason, according to Mr. Bauer, are sabre rattling to appease Congress. In the meantime, by this coming Wednesday, all occupation troops in Iraq will have withdrawn from policing the cities. What might be happening in northern Iraq where the Kurds run things?
Change can happen. The problem with change is that the past tells us very little idea about the future. We overwhelmingly chose 'change' last November at the voting booths. I will wager that every voter had a unique idea about what "Change" would be like and how it would occur. Would continuation of the Bush/Cheney type of federal government, meaning 'better the Devil you know' reaction to fear of change, be better? All we know about the Obama/Biden initiatives comes from press conferences, television addresses and the position papers they have on their campaign web sites.
Labels: Attitude toward Change, control, cycle, history, intelligence sources, Iran, mullahs in charge, political, secular-mullah, translators
24 June 2009
Follow the Money - How?
Within the past month, I have received emails from a group called Organizing for America at "BarackObama.com." A small note at the bottom of the web site informs that this group is a project of the Democratic National Committee. An email on June 18, 2009, said:
Peter --
We've seen a tremendous response to President Obama's email this week and, as of today, an important milestone is within reach -- 100,000 donors to OFA's [Organization for America] health care campaign.
Many are new supporters who did not donate to last year's campaign but know how critical it is to end the broken status quo on health care.
Reaching 100,000* donors will send an unmistakable signal to the opponents of reform: the movement you built is prepared to knock on as many doors, call as many neighbors, and sacrifice as much time and energy as necessary to make health care reform a reality.
Please donate $5 or more today and put us over the top.
Thank you,
David Plouffe
---------Original Message---------
From: President Barack Obama
Subject: This is why
David --
Last year, millions of Americans came together for a great purpose.
Folks like you assembled a grassroots movement that shocked the political establishment and changed the course of our nation. When Washington insiders counted us out, we put it all on the line and changed our democracy from the bottom up. But that's not why we did it.
The pundits told us it was impossible -- that the donations working people could afford and the hours volunteers could give would never loosen the vise grip of big money and powerful special interests. We proved them wrong. But as important as that was, that's not why we did it.
Today, spiraling health care costs are pushing our families and businesses to the brink of ruin, while millions of Americans go without the care they desperately need. Fixing this broken system will be enormously difficult. But we can succeed. The chance to make fundamental change like this in people's daily lives -- that is why we did it.
The campaign to pass real health care reform in 2009 is the biggest test of our movement since the election. Once again, victory is far from certain. Our opposition will be fierce, and they have been down this road before. To prevail, we must once more build a coast-to-coast operation ready to knock on doors, deploy volunteers, get out the facts, and show the world how real change happens in America.
And just like before, I cannot do it without your support.
So I'm asking you to remember all that you gave over the last two years to get us here -- all the time, resources, and faith you invested as a down payment to earn us our place at this crossroads in history. All that you've done has led up to this -- and whether or not our country takes the next crucial step depends on what you do right now.
Please donate whatever you can afford to support the campaign for real health care reform in 2009.
It doesn't matter how much you can give, as long as you give what you can. Millions of families on the brink are counting on us to do just that. I know we can deliver.
Thank you, so much, for getting us this far. And thank you for standing up once again to take us the rest of the way.
Sincerely,
President Barack Obama
*If the figure is true, their goal is to raise at least $500,000 plus the donation is not tax deductible.
I do not appreciate such appeals for monetary support less than six months following a new President's election. I suspect the DNC staff found themselves about to join the ranks of the unemployed unless they could start a new fundraising project. In any event, the appeal assumes that Democrats want the Obama health care plan. This appeal also sends the message that reform will occur on the basis of financial dealings, not on principled policy changes.
I do not like the way the President and his staff have sought input to a plan that the President want to have bi-partisan support. Many of us, a significant number of progressives and liberals within the Party, and a large portion of the public (if polls are accurate) favor a major change and view a single-payer approach positively.
I decided to reply to this appeal without a donation and with my rationale for not answering my party's appeal for money.
David,My position on health care reform, is quite different from President Obama's. Further, it is my understanding that Candidate Obama received $45 million in campaign contributions from the health care and pharmaceuticals industries. My taxes, along with every other taxpayer, are my contribution to the President's reform plans, yet I or other taxpaying members of the public have not had a principal role in the development of the reform package. And we provide $trillions to the President's coffers. Why do we Americans have to reinvent the wheel in this? The Administration is accountable for the quality of the nation's public health, of which the current discussions represent only a means to achieve that public health entitlement implicit in the Declaration of Independence and in the Constitution of 1787.I want a single-payer health care system for all persons on our soil and for US citizens abroad. If private insurers want to offer supplemental products, more power to them, but they, the insurers, should not drive national health policy. As long as clinical standards and practices have to conform to multiple plans' rules, the administrative burden can only become greater due to normal inflationary wage increases. Also, the Medicare codes and its individual negotiations of acceptable payment rates with institutional providers continue to complicate efficient, effective and appropriate care and treatment.Many complain about the USPS and ask if we want out health care à la post office. I think that the USPS would do well, certainly better than our complex and needlessly complicated financing of health care. For $0.47, I can send a letter to the right recipient, even if that person lives in Manhattan or Coral Gables. One price for that service anywhere in the United States.The program being proposed by President Obama does not truly reform our health care system. Where are the price controls for treatment and care? Where are the price controls on pharmaceuticals prescribed by physicians? Where is the limitation on the indirect costs associated with providing health care? Where are the mandated appropriations for internal controls necessary for compliance by all providers and payers? It is in these areas that true reform must occur or else our health care expenditures will exceed the budget of the Department of Defense.Yours truly,
I wonder where these donations will go [to whom] and why are they needed? Other web sites using names that appeal to a targeted demographic, appeal for donations to save different endangered species, to implement or to support alternative energy and green building agendas. Because all of this fundraising occurs on the internet, the cost to ask for donations is minimal, especially if well-designed software keeps track of the addressees and the funds received.
My question still concerns the use of these funds donated over the internet and why an appeal for money is needed at all. The public can telephone, write and fax their views to the President, to the DNC, to our Congressional representatives and to the Secretary of Health and Human Services. If one must send money, find an organization that is already lobbying for your position, such as the California Nurses Association (CNA).
