Last month over 4000 health care discussions were held around the country at the request of the Obama transition team.
One of those discussions was held in my office in Burlingame, California. This posting is a report on that meeting and a call for action
Eighteen people attended, including a videographer who filmed the event and put together an edited ten minute video which captures the feel of the discussion.
The event was covered also by the local press and an article appeared in The San Mateo Times a few days later.
Although it is gratifying to see the work that I and others have done to push for fundamental health care reform become available for more to see, what really matters is whether these efforts are going to be heard by those who will soon have the power to bring change.
Obama has told us that his administration will be listening. The Change.gov website declares and beseeches:
Health Care -- Of the People, By the People
Tell us your story, why health care is important to you, or what you'd like to see an Obama-Biden administration do and where you'd like the country to go.
Presumably, that is part of what these discussions were all about.
After the discussion, a report was prepared, complete with video and photographs and including the text shown below (edited for brevity here). I submit this posting today because I believe that we need to take Obama and Daschle at their word, that they want and will use our input to help formulate policy.
Please.
It is fun to talk among ourselves, but let's get going. Write to the President-elect and Daschle. Call your Senators (now, with Franken, there is a clear supporter of single payer in the Senate) and members of Congress. Go to Change.gov and tell them what you think. Write letters to the editor (I was shocked to see that one of mine hit the New York Times). Join with others in advocacy groups like Physicians For a National Health Plan or Healthcare Now. Go to Change.org and vote to add your voice for real change on another forum.
Politics, and political change, has been described as the art of the possible. Remarkably, in the election of Barack Obama, and in his solicitation of our input, we may be seeing the seemingly impossible happen. We have a new President, a man who has inspired our hope. We must turn hope into change.
Documentation of Obama-Biden Health Care Discussion
Date: December 31, 2008
Location: Burlingame, CA, 94010
Host: Aaron Roland, M.D.
Contact: doctoraaron@pacbell.net
Video Link: http://www.youtube.com/...
News: http://www.insidebayarea.com/...
Attendees: 18, including independent videographer and reporter from local press
Fundamental messages of this meeting:
o End private health insurance
o Single national health plan, a la H.R. 676
o Employers should be involved in paying for health care, but not providing coverage; health care itself should not be linked to employment; seamless "portability" of health coverage
o Enhance primary care access and primacy in the system
Compelling stories:
- Change in insurance coverage resulting in denial of preventive medication for asthma which had worked for years;
- Patient with poorly controlled diabetes for many years finally getting his diabetes under control only after moving temporarily to the kingdom of Tonga, where medication is free;
- Patient double covered by both employer-provided and workman’s compensation insurance nevertheless struggled for six months to get in to see mental health provider due to petty barriers set up in the system.
Biggest problem: cost
involvement of profit-making insurance companies in health care
lack of access, particularly to primary care
Difficulty paying: Although all attendees were covered by insurance, a number have had some difficulties, particularly when between jobs or in paying for medications. There was 100% support for single payer Medicare for All, with several emphasizing the need for including coverage for mental health and oral health
"In addition to employer-based coverage": Our group felt strongly that there was no fundamental reason for providing coverage linked to employment except that it seemed reasonable that employers and employees should share the expense of coverage. Instead, there was universal support for --"a single system" --"a public plan" --"universal health care" --"nationalized health care, like social security". Many observed that "employer based health care coverage sucks" –"an ideal system would remove employer from the process" –"employer should pay the government, not the insurance company"
Preventive services: We did not go into detail about this, but there was a very strong outcry for improvements in primary care access with calls for greater payment to primary care doctors, support for education of primary care doctors, greater emphasis on the use of allied health professionals (especially nurse practitioners), support for "disease management" and in-home support to keep people with complex medical problems on their treatment programs.
Policy to promote healthier lifestyles: Government involvement was supported though media promotion, greater provision of classes about treatment and prevention of chronic disease (some supported requiring patients with certain conditions to take classes). There was a burst of support for one suggestion that the government sponsor a comprehensive online resource for patient self education.
Additional suggested roles/goals for government: Promotion of a universal electronic medical record (although participants were dubious of the cost savings this could produce); require all research findings (including "negative" studies) be published, eliminate advertising for drugs, support various ways to increase access to and number of providers in primary care.