First, a little background. Last weekend, I went to see SiCKO, the most recent film by Michael Moore, with some friends. I've read a number of diaries on DailyKos about health care, mostly by nyceve as her diaries frequently make the Recommended list. I can't wait to meet her at YearlyKos. So I had a fair amount of knowledge of the current state of our health care system before the movie. I can't say that my friends were similarly informed prior to the film. But, we all left the theater shocked, angered, and saddened at the stories presented and the system we in America get to deal with.
Getting from here to the Town Hall Meeting after the jump...
I've discussed numerous issues with my friends as I've spent time on the lefty blogs and become more active in politics. The Bush administration's Iraq debacle was the impetus that led me in search of answers and to see if there was anyone else out there who thought, as I did, that this country was getting crazier by the day. But neither the war nor numerous other issues lit a similar fire in my friends' bellies. Until we watched SiCKO, that is. After the movie, one of my friends decided they could no longer stand idly by knowing for-profit health corporations continue to choose profits over care.
Thus, when I invited my friend to accompany me to Sen. Brandon Shaffer's (D-Longmont) Town Hall meeting at the Lafayette Public Library yesterday to discuss Colorado's attempt to look into the current state of health care and how it should change, my friend decided to join me.
State Sen. Brandon Shaffer (Senate District 17) hosted the meeting and I want to thank him again for taking time out on a Saturday to do some work. He was the Prime Sponsor of S.B. 06-208, which set up the Blue Ribbon Commission for Health Care Reform. Sen, Shaffer joked that he inherited the bill from the previous legislative session when a similar attempt to create the Commission failed. Two Commission members were also present to provide some information and answer questions from the attendees. Those two members were Dr. Mark Wallace (Founder, Northern Colorado Health Alliance) and Elisabeth Arenales (Healthcare Program Director, Colorado Center on Law & Policy), both of whom were appointed to the Commission by Speaker Andrew Romanoff.
The initial chair set-up would have supported an audience of maybe 20-30 people. That number was quickly filled and approximately 80 people showed up. The group was made up of citizen-activists, a wide variety of health-care workers, politicians and candidates.
The charge to the Commission is to come up with 3-5 proposals by Jan 1, 2008 (originally Nov 2007). The Commission holds a number of meetings, all of which are open to the public. Involvement in those meetings by the public varies according to each meeting, we were told.
Dr. Wallace provided some of the numbers the Commission are operating with: ~785,000 uninsured in Colorado, ~180,000 of which are children; an estimated $30.1 Billion will be spent on health care expenses in Colorado this year: 33% of which will be spent by taxpayers and 15% of which will be paid by out-of-pocket expenses. He noted that contrary to the free-marketeer crowd's argument, that means 48% of our health care is already being spent by public sources. It wouldn't take that much of a shift to make publicly-financed healthcare a majority in our state.
Elisabeth pointed out that just as important, the cost shifts found in the current system represent a hidden tax* to un-/under-insured. As many of us are aware, this makes private insurance more expensive every year. (* Their presentation had the hidden tax in quotes. I prefer calling a spade a spade and don't think there should be much watering down of the message.)
Dr. Wallace and Elisabeth continued to present information such as the Commission timeline, guiding principles, and then a little information about the proposals themselves. 37 proposals were whittled down to 11, then again down to just 4 recently.
I will spend the remainder of this diary discussing the principles. I will discuss the proposals themselves in a second diary. There were a number of good questions asked post-presentation and I will spend time on those in a third diary. Questions asked during the presentation are interspersed throughout.
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So the principles:
The Commission's goal is to increase coverage and reduce cost and has adopted the following principles to guide its work:
* Protect and improve the health status of all Coloradans.
* Expand coverage of essential health care services for all Coloradans, with an emphasis on the uninsured and underinsured.
* Align incentives to provide high-quality, cost-effective and coordinated care.
* Support a system that is financially viable, sustainable and fair.
* Provide opportunities for meaningful choice and encourage personal responsibility.
* Emphasize wellness, prevention, health education and consumer empowerment.
The second principle came under fire quickly. "What does 'expand coverage' mean to the Commission?" was brought up, followed by the observation that increased access to care does not equal increased access to insurance. Beyond that, what does "essential care" entail? No direct answer was given.
'Align incentives' was questioned next. Are they going to be positive or negative incentives? A combination of the two, and to what degree? Positive for whom and negative for whom was a large worry voiced by a few folks.
Then the fifth bullet was discussed. My reaction turned negative when I read 'personal responsibility'. If it's the kind of responsibility that Republicans like to push around, I'm not even close to interested. Dr. Wallace took time to explain that the four proposals under consideration discussed personal responsibility on a "range from individual to collective", which I thought was interesting. To me, personal responsibility evokes responsibility of one person at a time. The principle did not read 'collective responsibility' which evokes something quite different (at least to me). IMO, our system right now emphasizes individual 'responsibility' and that's one reason why it's failing to deliver that which it should: care.
There wasn't much discussion about the last principle aside from most of the attendees emphasizing preventive medicine as an effective way to begin bringing costs under control. I personally would rather have seen this principle emphasized earlier in the list.
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It was acknowledged that health care is a very complex issue and than attempts to 'fix' small parts one at a time were destined to fail. I was glad to hear this viewpoint expressed by the two Commission members.
By the time they present their recommendation to the General Assembly next year, they will have spent over a year talking to Coloradans, which I hope includes other Kossacks and SquareStaters and the people you all know. This is an incredible opportunity to enact real change on an issue that affects us all. Find meetings that you can attend. Then show up and ask hard questions. Write to the Commission. They won't pass along our desires if they don't know what they are.