Tuesday, August 18, 2009

Senator Kristen Gillibrand

ANGELICA: Two cars rolled up to the Angelica Sweet Shop just after 1 on Monday afternoon for one of Senator Kristen Gillibrand’s many stops across 10 of New York’s southern counties. With Gillibrand were her two small sons. Five year old Theo headed for the candy counter at the Sweet Shop while little Henry was content to peek around his grandmother’s neck. Gillibrand put her Senate office on wheels to move it from Chautauqua County eastward to her home in Columbia for what she calls “The Senate at your Super market” tour.
Several county dignitaries and an array of citizens from Wellsville, Andover, Alfred and certainly Angelica were on hand to greet the Senator offering her pamphlets and books to thumb through later hoping to build a concept of what Allegany County offers.
The visit started with Theo’s tour of the Sweet Shop candy wall where Gillibrand nabbed a quick Twizzler and then moved outside to take questions and define her position on a variety of topics. She is not holding town hall meetings but rather talking in small groups with constituents.
Health care is a huge concern. She’d like reforms to the health insurance industry that would end the practice of excluding people for pre-existing conditions. She supports preventive care and proposes that there be no co-pay for cancer screening tests. She also supports that there be a universal form to simplify office work and increase efficency.
Gillibrand supports a public option for which people would pay premiums of no more than 5% of their income. Along with that she would require a better reimbursement rate to the medical providers. In cities, the volume of patients helps the money flow into a service provider but in rural areas, the fee for service has to cover the cost of operating. There just aren’t enough people using the service to make up for low rates in rural areas.
Having said all that, she was doubtful that the legislative chambers would pass such an inclusive bill even though the end result would be lower costs for everyone. Right now insurance costs are increasing at four times the rate that salaries increase and it’s just not sustainable.
The average family income in Allegany County is $40,000 while basic insurance plans are $10,000. People can’t pay that. That makes people depend on the Emergency Room - the least efficient/ most expensive way to go.
Gillibrand is also looking at bringing alternative energy projects to the Southern Tier. She said we have the workforce, the education and the resources to get into cellulose ethanol, wind and solar power. There’s a history of manufacturing in this area and the country needs to make use of remaining expertise.
Gillibrand said that the anger over the cap and trade bill is really anger about the economy. In rural areas of New York the unemployment rate is 15%. She said that cap and trade allows clean industries to sell their carbon savings to dirtier industries that produce more carbon but said that what we really need is to clean up our air. In the Bronx, 25% of all children have asthma. The federal government might make money available to entrepreneurs to develop clean energy sources or to reduce air pollution and such small businesses could drive the economic engine.
“Our energy policy is part of the health debate when you look at air quality,” she said going on to voice concerns about obesity. The country spends $100 Billion a year on medical matters related to obesity and another $500 Billion on heart disease. She wants to ban trans-fats to encourage people to eat calories with more nutrition and to increase reimbursement rates for school lunches so schools can serve children actual chicken and not a frozen, processed item. She wants mandatory physical education for children for an hour a day in schools and she wants health insurance to cover dietary counseling for all.
At the end Gillibrand was asked to push for a public option while her party holds a majority in the senate. A robust, aggressive public option would drive prices down. She was also asked to make insurance companies subject to anti-trust laws. She said that the Senate just has to do something to help, to take a step forward and to start making changes.

Town Hall meeting

OLEAN, Sunday August 16

I went to the Eric Massa town hall meeting in Olean on Sunday night and then sent this Email to 6 people. On Monday, at the meeting with Senator Gillibrand I learned that my Email traveled to several other inboxes so I'm sending it to a few more.

It was exhausting.
In part it was bad because Eric let people go on and on. When I left I talked with some staffers to say that it might be better if he would give people 2 minutes to pose a question and let them come back a second time if there is time left. (A later Email from Eric said that he will continue to listen to every person's every word and try to understand them all.)

One guy wanted the government out of health care but he also wants the government to tell all insurance companies that they must become non profit. He doesn't want them to be not for profit because the profit motive is important but they should be non profit.

Another man said that money for women's health matters means for abortions because women are fornicators and abortions are the only women's health issue that there is. He wasn't the worst one but he said he was a retired doctor and that he knew what women are really like.

People railed against the left's plan to turn us into a socialist nation. Eric said that under socialism patients have no right to choose their doctor, doctors don't get to choose hospitals and there's someone else dictating what procedures would be allowed. That, he said, is what veterans face. Eric is on the veteran's insurance plan and refused to take the golden plan offered to all congressional members. He won't take it until all his constituents are covered by insurance. He also introduced an amendment that was accepted into the bill that would require congressmen and senators to be on the insurance plan created by whatever bill is passed.

I think that most of them were angry that they lost the election. I think the angry people at this meeting get their information from one or two right wing voices who enjoy manipulating people.

They would say that page such and such of the bill said this and that and Eric would turn to the page and read it to them and they would say he was lying. There were claims that the bill allows for the government to have full access to everyone's checking account when it actually says that it allows for e payments. Is that full access? They said that if the provision for an end of life directive wasn't about requiring death panels then it wouldn't have been rescinded.

Eric was patient and polite. He several times pointed out inconsistencies in the questions and demands put by an individual such as the person with the non profit/not for profit business but was repeatedly told that he was lying. He'd offer them the pages and insist he read the words on that page and they'd say, "Liar."

'there was yelling and booing. People would say they read the real bill on the internet.

He'd say that he really couldn't help them more than that and that he had to move on but I wished he'd said that more often.

I felt that the hall had about 1/3 mean spirited, nasty, loud people and 2/3 people interested in discussion. One man said that he knew he was speaking for 90% of the people in the hall and another woman said that he had no right to claim to know her feelings which differed sharply. That woman was great. Lisa someone.

One woman said she was being laid off and losing her health care but that she didn't want a public option,she wanted a job with health care. A public option wouldn't help her at all.

The air was full of anger and hatred. It was truly an awful place to be.

I was there with a supportive friend or I'd have sat in the car and sobbed afterward. We stayed for 3 hours. The meeting went on for 4 1/2 hours. The selfishness of the people speaking at the meeting who have insurance was astounding.

Monday, August 17, 2009

Canisteo town hall

CANISTEO: On August 12th the Canisteo Town Hall often filled with applause, sometimes with laughter, occasionally with frustration. Several citizens said that they had gone to the town hall meeting expecting to be annoyed and disappointed but instead they found that they appreciated and respected their Congressman, Eric Massa.
The meeting focused on health care with the majority of time spent with questions and answers. Because of several unpatriotic episodes at other town hall meetings Massa asked that people not boo or clap “because that intimidates people and that keeps me from accomplishing my job.”
Massa’s copy of HR 3200 (the Health Care bill) was spattered from his morning in Gowanda where he helped clear mud from basements. He described the flood water devastation in Gowanda and talked of the spirit of camaraderie experienced when strangers work side by side.
Massa has read HR 3200, a thousand page bill, 4 times- so far. He said that a lot of information going around the internet is just not factual. One segment he read was on Advanced Care Planning Consultation. That segment allows Medicare to pay for a doctor’s visit to discuss end of life care.
If a person wants every heroic measure taken to prolong their life, they can direct that in a document sometimes called a living will. If they want to have maximum pain relief or minimum pain relief or if they wish to die at home or in a hospital then each person can put their personal beliefs and preferences in writing so that when they can no longer carry on a discussion their family will know just what they want. Contrary to some discussion on talk radio, a living will puts end of life decisions clearly into each person’s hands, away from government reach.
Massa sees a living will an implement of self protection and has, for himself, a very detailed living will because 10 years ago he battled cancer. His living will tells people clearly his choices regarding pain medication, feeding tubes, respirators and other tools and procedures so that his voice can guide his doctors even if he is unable to talk.
One thing that Massa doesn’t like in HR 3200 is that it reduces Medicare payments to doctors and hospitals. That’s bad because if Medicare doesn’t pay enough, doctors won’t take Medicare patients.
There was a great deal of discussion about Medicare. Massa said that the promise of Medicare was that if people paid 1.5% of their earnings toward the program and then a monthly premium while they use this government-healthcare they would have medical coverage for life. That percentage hasn’t changed though costs have skyrocketed.
Some constituents pointed out that though the percentage stayed at the same level, the amount of money contributed increased. While that is true people paying health insurance premiums are spending 30% of their income on insurance- an amount that has exploded over the past 10 years. It has been suggested that changing the Medicare deduction to 2% could rescue the program long-term and still be a bargain compared with private insurance plans.
Another frequent statement was that people don’t want the government interfering in their health care and over and over it was pointed out that Medicare and the Veteran’s health care system are both government administered healthcare systems. When asked, about 40% of the audience indicated involvement in government healthcare now. Some people said that it was unconstitutional for the government to be involved in health care but it wasn’t clear whether they supported the continuation of government involvement by continuing Medicare and Veteran’s health programs or if they want those programs to end.
Massa said that there is no proposal to establish socialized medicine in that patients would continue to choose their doctors, doctors would continue to choose their hospitals and doctors and patients would choose procedures. He said that nobody was looking at adopting the Canadian system or the French system. Massa would like to blend existing good ideas into a unique American plan but at this time there is no provision for a public option in the bill.
There is a provision that would require that insurance plans have stable premiums, end the practice of excluding people because of pre-existing conditions and keep co-pays stable and predictable.
Someone asked why the bill was written to protect the insurance companies and someone else said that it was all kept in secrecy but Massa said that the entire bill can be read online by anyone. Massa would like the bill to include tort reform that sets a limit on payments for pain and suffering.
Massa reported that he attended a meeting with insurance company representatives who said that they did not want to compete with a public option such as Medicare because Medicare provides insurance cheaper and more efficiently than private companies can.
Massa feels that a for-profit insurance company provides an ethical conundrum because the insurance corporation exists to provide share holder value. The fewer payments made for health care, the more money paid to investors.
Should all Americans have health insurance? All Americans are required to have car insurance and few would argue with the wisdom of that.
Massa supports eliminating the Medicare prescription plan donut hole. He promised not to vote for any bill he wasn’t given time to read. He would like to stop pharmaceutical companies from advertising on TV. A billion dollars spent on ads is a billion less spent for medical benefits. Pharmaceutical companies spend more on advertising than on research and 50% of all the advertising dollars were spent on Viagra, Cialis and Levetra.
When people brought up the costs involved in giving medical care to people Massa said that the concerns about costs were really concerns about the explosion of the national debt in the last 8 years. He was against the bank bailout bill and the Iraq supplemental emergency bill which wasn’t used to fund the war in Iraq and didn’t address any emergencies.
“If we do nothing about health care reform we do so at our peril,’ Massa said. ‘Health care premiums have doubled in the last 10 years and will double again in the next 10. We can’t afford to do nothing. Only the insurance companies are excluded from the Sherman Anti Trust Laws. Insurance companies divide the territory so they don’t compete. This is called collusion.”
One older gentleman in the crowd told Massa, “You exude the code of honor. Thanks for being helpful. I came here to scoff but you have a lot of Navy in you and I’m pleased.”