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.”

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