Several weeks ago, after having it up to the eyeballs with all the myth making and distortion surrounding health care reform, I wrote a piece that was printed in one of the local paper's Viewpoint column. I made the arguments of which you are all familiar. A few days later I was contacted by the Sag Harbor Concerned Citizens for Healthcare Reform and asked to participate and speak at a march and rally that they were organizing. Happy to do the speech, but my arthritic knee said no to the march part.
Sag Harbor is a very pretty town in the Hamptons. If you just clicked on Sag Harbor you'll see a small ribbon of sand on the upper right part of the map (Long Beach), that is where the march started. In the lower center of the map are some moored boats which is where Marine Park is located and where the rally was held. (Just to give you geographic flavor.)
Now to give you some political flavor.
To make it easy, I'll call the group SHCCFHCR. They invited me to attend an organizational meeting, which I did. I was impressed with their organizational abilities and their sense of logistics. All the things you could imagine you might need for a 3 mile march they thought of: they hired a sign maker to make a big banner; they planned for water stops along the route, megaphones, speakers' platform, sound system, and last but least -- permission from the village govt to assemble at Marine Park. (Event permits are required if an event is larger than 150 people.) I helped out by giving them a list of local press contacts and some information to include in their press kit. The press was notified and a local radio interviewed the key organizer. (The organizer holds dual citizenship, here and Switzerland. He's appalled that our healthcare system is so dysfunctional and the motivation behind organizing the march and rally.)
They discussed speakers for the rally and this is where I learned my friend and current Southampton Town Dem Chair would be joining me on the speaker's roster. Some additional potential speakers they threw out at the meeting: Sen Gillibrand, Jon Stewart, Alec Baldwin, Richard Gere -- well, it is the Hamptons. None of these celebrities panned out, except, Sen Claire McCaskill's sister agreed to speak.
OK. Everyone contact their email list. So my friend the Dem Chair did and then the fun began.
The Sag Harbor Village government came back and said they didn't want an overt political event, and some of the members of SHCCFHCR were none to keen on the march and rally being "political." Huh!
Their main aim, they said, was to provide information to the public to counteract the distortions being made by the Teabaggers. So, they disinvited my Dem Chair friend.
They knew I was a former Dem chair, so I mentioned that I'm up to my eyeballs in local politics and was, in fact recently in the news over a ballot challenge that I made on behalf of the local Southampton Town Democratic Committee. I made the cut anyway. My 33 years in healthcare trumped my political animalness.
Meanwhile, rumors started flying that none other than President Obama would be appearing at the rally. (I chalk this up to Hampton's hubris, if he goes to Martha's Vineyard, surely he'll be in the Hamptons.) So the organizers had to go to townhall and squelch that rumor and be interviewed on local radio, WLNG, to set the march and rally record straight.
The evening before the event I get a call from the organizer asking if I know any lawyers who might be willing to intercede on a 1st amendment basis, just in case Sag Harbor Village loses its nerve and succumbs to Teabaggery and wants to close us down. So happens I do know an ACLU attorney and he lives on the march route. Check with him. OK. (Didn't need him.)
With all this going on, I'm writing and rewriting my speech: less political, more political, less political. Wait a minute, is Congress involved?
September 5th, the day of the event.
Sen McCaskill sister can't make it because of an illness in the family. She sends a message for the organizer to read. The speaker list is now me, a fully retired former health care administrator, and a semi-retired physician who practiced at Cornell-Weill Hospital in NYC. What more could you want.
The march was great. I drove by the marchers a couple of times beeping my horn in support. There were about 100 or so marchers, mostly all carrying signs, and the big banner they carried was impressive. I drove ahead to Marine Park and awaited their arrival. OFA folks set up an informational table. No signs of any protesters, and no sign of President Obama (and after his story at yesterday's AFL-CIO rally about Greenville, So Car, I am angry that he didn't come). Snark. Only discordent note the whole day was a couple of grumpy seniors who said that the HCR plan is a disaster. Got it. You got yours, to hell with everyone else.
To the speech(es)
I started out by informing the assemblage that I wanted to discuss the health insurance companies and then providers' role in the current system and then wrap it up with why reform is important to NY. But first, as a former hospital administrator, I must address the death panel issue.
Hospitals are accredited by an organization known as the Joint Commission on Healthcare Organizations -- JCAHO, or Jacko as we called it. I checked JCAHO's website to see what they say about Advanced Directives. Turns out that last April JCAHO called for an Advanced Directive Day and provided hospitals with advice on how to organize such a day. The organization that accredits hospitals calling for teach-ins on death panels. Imagine. I had to mention it.
(I Don't have a speech to copy in as I never completed one on paper.)
When I retired in Dec 2002, concerns were mounting that healthcare represented 12% of GNP, now it's 17% and growing. What does that mean in human terms?
* We pay 2x as much in annual premiums: $5800 vs $12,600
* Health Insurance profits up 4 or 5 times 2000 to 2008
* Unsustainable, we see employers dropping insurance
* Unsustainable, Individuals who need insurance dropping it as they can't afford it
* Insurance company greed results in no insurance due to pre-existing conditions, rescission or no insurance due to spendign thresholds.
What is the antidote: We need a public option in the healthcare reform bill(applause), a robust public option (more applause), a robust option that is -- please excuse the hint of partisanship -- A public option that is fired up and Ready to go on day one. What do I mean by a public option that is fired up and ready to go by day one.
* All Medicare providers enrolled in public option
* Payment rates at Medicare + 5%
* Large enough and powerful enough to negotiate drug prices
* Large enough and strong enough to establish cost benchmarks for the private comppanies to reach.
But, not all problems because of insurance companies, the medical profession, not just docs, need to rationalize the way care is provided. I mentioned the Atul Gawande New Yorker article where comparisons between 2 Texas systems were made: McAllen cost $14,700 per Medicare enrollee per year; in demographically comparable El Paso costs are $7500 per enrollee per year. Difference is that McAllen's system is proprietary. (Texas has tort reform, too, so no explanatory value there. And, Al Franken recently mentioned that Minnesota's Medicare cost per enrollee is half of El Paso's.
Much can be done to rationalize healthcare delivery. I mentioned the best health care policy minds are at work in the Agency for Healthcare Research and Quality and the Engleberg Center for Healthcare Reform at the Brookings Institute. Quality measures for cost and quality are being done, that comparative effectiveness research may be a new term for most, but these institutions have been conducting comparative healthcare research for a while and their ideas have found there way into the reform bill. I counted 25 such ideas in the 3 House bills.
Closed up by saying that in NY we provide $2 billion a year in uncompensated care, that the Bad Debt and Charity Care pool provides $857 million a year to make up some of the debt. My hospital drew down $40 million a year to keep the hospital afloat.
Wouldn't it be better to re-direct that money and use it for subsidies for people to buy insurance.
Wrapped up by saying when I walked out of my hospital when I retired 30% -40% of the emergency room patients were uninsured and a good portion of them were seking care for chronic health conditions (Asthma, diabetes, Hypertension). If I revisited the ER today, I would see the same payer and disease breakdown. It's time to insure everyone so we can get these patients a primary care doc and yreat them where they should be treated.
That's my speech.
I was followed by the Cornell doc who was terrific. He is a single payer advocate. The organizers let marchers speak and two people came from the crowd to speak: one of the the first african-american doctors out here and a young playwright who stole the show.
Good event, no teabaggers, the grumpy old men watched the festivities from the perimeter. And, we got good press coverage. (Can't find the LI Newsday article.) The press played up the lack of turmoil angle.
On the way out I was approached by a voter: Mike, Anna's position on the animal shelter is wrong and why aren't the Democatic candidates here.
Mike, are you heading back to Southampton? Yes. Can you drop of some food at the food pantry?
Ahh... healthcare expert one minute, Dem operative and community activist the next.