Please Dont Blame Me for the Length of this Post About Health Care Reform

I sent the following note to Cong. Paul Ryan-

I will support any health care plan that will:

* Restore a friendship. A few years ago, I loaned a friend (without health insurance) several hundred dollars so his fiance (without health insurance) could receive medical treatment. Finally, I was tapped out financially, and after declining his requests for more help; we haven’t spoken since.
* Treat a child with Crohn’s disease. This child is home-schooled by mom. Dad works full time with no health insurance. I have this disease; and saddened thinking of what this family is going through.
* Health insurance for graduating college students. Too many students are terminated from their parents’ health insurance shortly after receiving their diplomas. On top of whatever education debt they may have, they are facing the possibility of financial ruin if a medical disaster occurs and have no coverage.

The health care challenge is personal. The solution- provide health care for everyone in the United States.

Chet

The congressman’s response:

Dear Chet:

Thank you for contacting me to express your concerns about our health care system. I appreciate you taking the time to let me know your views on this important issue.

The call for fundamental health care reform has never been so loud and as necessary as it is right now. The third-party-payer model that serves as a framework for the financial underpinnings of our existing health care system no longer meets the needs of patients, doctors, hospitals, and governments. It has undermined the doctor-patient relationship and removed individuals from the decision-making process. Transforming America’s fractured and antiquated health care system demands wholesale and fundamental reform.

Unfortunately, Congress has gotten off to the wrong start. The recently passed American Recovery and Reinvestment Act. H.R.1, does nothing to address the systemic problems affecting existing health programs, such as Medicare and Medicaid, and creates new entitlements that will exacerbate mounting health care costs. Among the bill’s most troubling provisions:

o Increases the Number of Americans Dependent on Federal Health Care – H.R. 1 increases the number of those dependent on the Federal Government for health care by about 8.2 million. Rather than reform a broken health system that handicaps state budgets and denies patients access to medically necessary treatments, such as dental care, this bill promises more of the same while forcing millions more people into one-size-fits-all government run health programs.

o Puts Washington in Control of Health IT – The bill spends $20 billion on a new government-run health information technology program for health care providers, punishing those who have already adopted technology measures and refuses to acknowledge that no consensus has been reached on interoperability standards, the nucleus of any health information technology program. This will stifle the innovation and entrepreneurship that are the envy of other country’s health care systems and allows the government to dictate to both patients and doctors what medical information must be shared and how that information is to be reported.

o Shifts Control of Health Care Decision to the Federal Government – While innovation is the hallmark of the American health care system, H.R.1 provides $1.1 billion for a new “Comparative Effectiveness Research” program. The purpose of this “research” is to allow the Federal Government even more leverage in deciding which medical treatments are worth paying for and which are not. This will inevitably impose government control over physicians’ medical decisions, and cause private-sector insurers to limit coverage in line with the government’s choices – all of which put American health care on the fast-track toward a nationalized health maintenance organization.

This lack of real reform is also reflected in the President’s recently released budget for fiscal year 2010. While I applaud the President’s commitment to health care reform, I have serious concerns about the direction he has chosen. Without providing any specifics, his budget proposes to spend $634 billion on health care of which half is paid for by increasing taxes. Leaving aside the problems that already exist within programs such as Medicare and Medicaid, it is irresponsible to propose massive expansions of deeply flawed government bureaucracies without requiring any reforms in return. I believe in the promise of health care security that Medicare and Medicaid offer and I believe it is Congress’ job to make sure these programs meet that mission. Unfortunately, the President’s proposed budget falls dramatically fall short of that goal.

That is why I have proposed an alternative approach to reforming our health care system. My bill, the Patients’ Choice Act would put patients and doctors in control of health care decisions. It fundamentally changes the mechanics of Medicaid while strengthening the promise of health care and security for all Americans.

The Patient’s Choice Act

Preventing Disease and Promoting Healthier Lifestyles

Each year, five chronic diseases (heart disease, cancer, stroke, chronic obstructive pulmonary disease, and diabetes) cause two/thirds of American deaths; treatment of these largely preventable diseases makes up 75 percent of total health care expenditures. Critical investments in public health and disease prevention will go a long way in restraining health care costs and improving the quality of Americans’ lives. The Patient’s Choice Act of 2009 would:

o Encourage increased coordination of federal prevention efforts and bring long-overdue accountability to these programs

o Require CDC to undertake a national campaign highlighting science-based health promotion strategies

o Equip recipients of Supplemental Nutritional Benefits with easily understandable information about nutritious food options and target the use of food stamps to healthy food choices

o Invest $50 million annually for increased vaccine availability and bonus grants to states that achieve 90 percent or greater coverage of CDC-recommended vaccines

o Provide incentives for states to reduce rates of chronic disease like heart disease and diabetes

Creating Affordable and Accessible Health Insurance Options

Our health care system should be easier to navigate and provide integrated care in a more equitable manner. A vibrant market for health insurance that is consistent and fair will allow all Americans access to health coverage. The Patient’s Choice Act of 2009 would encourage states to establish rational and reasonable consumer protections, including the following:

o Creates State Health Insurance Exchanges to give Americans a one-stop marketplace to compare different health insurance policies and select the one that meets their unique needs

o Gives Americans the same standard health benefits as Members of Congress, so all Americans have a wide range of choices

o Protects the most vulnerable Americans to ensure that no individual would be turned down by a participating Exchange insurers based on age or health

o Creates a non-profit, independent board to risk adjust among participating insurance companies to penalize companies that “cherry pick” health patients and reward insurers that encourage prevention/wellness and cover patients with pre-existing conditions

o Helps States expand coverage through auto-enrollment at state and medical points of service, for individuals who do not select a plan at the beginning of the year

o Gives states the ability to band together in regional pooling arrangements, as well as the creation of robust high risk pools, reinsurance markets, or risk adjustment mechanisms to cover those deemed ‘uninsurable’

Equalizes the Tax Treatment of Health Care, Empowering All Americans with Real Access to Coverage

Economic analysts across the political divide agree that the tax code is stacked in favor of the wealthy and those who get their health coverage through their employers, discriminating against the self-employed, the unemployed, and small businesses. The Patients’ Choice Act of 2009 would restore fairness in the tax code and give every American, regardless of employment status, the ability to purchase health insurance by:

o Providing an advanceable and refundable tax credit of $2,300 per individual or $5,700 per family

o Improving the operation of Health Savings Accounts [HSAs] by allowing health insurance premiums to be paid with HSAs without a tax penalty

o Allowing preventative services to be covered by High Deductible Health Plans

o Increasing the amount of money an HSA owner may annually contribute to their account

Modernizing the Medicaid Benefit and Protecting Medicare Beneficiary Choice

The health security for low-income families and American seniors is threatened by the outdated formulas and exploding costs of Medicaid and Medicare. These vital programs require significant reforms to better balance value for those beneficiaries in greatest need and protection for U.S. taxpayers. The Patients’ Choice Act would make important improvements to both programs without limiting eligibility or benefits by:

o Integrating low-income families with dependent children into higher-quality private plans through direct assistance

o Removing the stigma of Medicaid and providing access to the same coverage options available to all Americans

o Realigning responsibility between federal and state governments in order to better coordinate benefits by requiring the Medicare program to assume Medicaid responsibility of premiums, cost-sharing, and deductibles for low-income seniors

o Rebalancing long-term care services to ensure choice between institutionalized and home-based care

o Empowering Medicare beneficiaries with more choices and more power by reforming Medicare Advantage

o Allowing for the creation of Medicare Accountable Care Organizations that would improve payment to physicians, hospitals, pharmacists, and nurses for demonstrable improvements in quality and patient satisfaction while reducing costs

o Requiring wealthy Medicare beneficiaries to contribute a little more for their care under Medicare Part D

Ensuring Compensation for Injured Patients

Our current legal system does a poor job at compensating patients for medical mistakes in a fair and efficient manner. Instead of nurturing an environment where medical professionals can openly learn from their mistakes, our legal system often forces doctors and patients into contentious courtroom disputes. The Patients’ Choice Act would reform this broken system that helps drive health care costs out of control by:

o Encouraging states to adopt a number of legal alternatives entirely run by the state that would include the establishment of expert medical panels to resolve disputes, creation of health courts, or a combination of both

Establishing Transparency in Health Care Price and Quality

For a vibrant health care market to function properly, patients must know what services cost and who provides the best service. Uniform and reliable measures of reporting quality and price information should be designed by the stakeholders in health care rather than the heavy-hand of government. The Patients’ Choice Act would bring this much needed transparency into the health care market by:

o Creating a Healthcare Services Commission that relies on a public/private partnership to enhance the quality, appropriateness and effectiveness of health care services through the publication and enforcement of quality and price information

o Empowering the private sector – rather than Washington bureaucrats – to set standards on price and quality with the input from all major stakeholders in health care, as well as the general public

o Ensuring that measures of effectiveness keep pace with innovation

I believe this comprehensive approach will provide patients and taxpayers with real solutions to the problems they now face. In the meantime, if you wish to share additional information with me concerning this issue, please feel free to contact me by calling, emailing, writing, or faxing me. Please be advised that mail sent to my Washington office is subject to an additional two-week delay due to increased mail security. I thought you might also be interested in receiving regular updates on what is happening in Congress and the 1st District delivered directly to your e-mail inbox by signing up for my Instant News Updates. To receive the updates, visit my website at http://www.house.gov/ryan and click on the Instant News Updates graphic on the right side of the screen for this free service.

Thank you again for contacting me on this issue. If I can be of further assistance to you regarding this or any other matter, please do not hesitate to contact me. I am always happy to respond and be of service to you.

Sincerely,

Paul Ryan
Serving Wisconsin’s 1st District

Come on Paul, You Need to Do a Better Job Convincing Us

Paul Ryan and the GOP should have compared their ‘Budget Alternative’ to the Bush budgets of the last eight years, not Obama’s proposal. By clearly articulating their differences from the Bush budgets of the last eight years, Paul Ryan and the GOP will establish credibility with the fiscal responsibility issue. Without clear differentiation, the American people have no reason to take the GOP proposal seriously.

Someone please explain this to me

In Wisconsin we have a Supreme Court election coming up. The candidates are incumbent Shirley Abrahamson and challenger Randy Koschnick. From what I can tell, there has been a fair amount of press coverage on the race. My perception  is not scientific; just my observation of the quantities of articles in  the Milwaukee Journal-Sentinel, and various headlines I see online.

Honestly, while I plan to vote and I know who I am going to vote for, I haven’t really been dialed into this race other than what I glance at in the papers and online.

Out of boredom really, I took a look at the finance reports (as of mid February 2009) of the two candidates. The incumbent has about a million bucks for her campaign and Koschnick about 40 grand.

Money-wise, this race looks like it will be a cakewalk for Abrahamson. But why is Koschnick getting coverage? At best, he appears to be a fringe candidate. We always hear about the importance of fundraising. We’re told that candidates need to have significant amounts of campaign cash for viability. This is not the case with Koschnick.

For a comparison, I took a look at the financial reports of the recent congressional election in the Wisconsin 1st  District. In that race, incumbent Paul Ryan pummeled challenger Marge Krupp. Now this is a race I did have interest in , because I was hoping that this was the time that someone put a dent in Paul’s armor. Krupp raised and spent about 120 grand; a pittance compared to Ryan’s money, about 2 million. That said, can anyone say they saw or read any significant media coverage about this race? Maybe part of that was Krupp’s fault. As I was reflecting back to the last election, I am not really surprised and, frankly, found the media coverage of the 1st CD race appropriate. While Krupp worked really hard, she did not approach the financial numbers that warranted top tier candidate status.

Now we look at Koschnick. I don’t understand why one drop of ink is printed about his campaign. It seems all that this race, and the Koschnick campaign, deserves is the obligatory article about the candidates prior to the election.

Maybe this guy is getting top tier status because of some support he may receive from special interest groups. Who are they? It was widely reported one of the major players in the last two supreme court elections, the Wisconsin Manufacturers and Commerce trade association, was sitting this race out.

Does this now mean that the local media will take every elective contest seriously, regardless of how much money is involved?

The GOP FAX Machine at Work

Interesting…as I was driving home from work the other day I heard a local talk show radio host blasting President Obama for filling out out an NCAA bracket and for his appearance on Jay Leno’s show on Thursday. I wasn’t surprised as the host is a right wing, conservative Republican water carrier.

 

Obama was elegantly defended by this guy, Casey Gane-McCallum in a blog post I spotted.

 

His response was written as if he was listening to the same radio program….

 

From what I can tell, he doesn’t live in the same market as I do, but the media where he lives are getting the same faxes.

Partisanship

In article published in the Washington Post, it was reported that President Obama was going to start pointing the blame at America’s economic problems on the Bush Administration.

Good. But that is is a different discussion, perhaps left to economic experts.

When Obama took over, he was restrained with his criticisms of the Bush Administration because he didn’t want to ‘appear too partisan’. One of his campaign themes was to ‘rise above partisanship’.

Obama needs to remember something he said a while back….”I won.”

When the Republicans were in power, they had their chance, and they screwed up the country. However, it is still necessary to be reminded of their errors so we don’t make the same mistakes.

If being a partisan means that it provides the strength to fix what needs to be fixed,  so be it. Maybe we need more partisanship. 

Bipartisanship is being able to work with folks in the other party. ..Embrace and acknowledge new ideas…. All that has been offered by the GOP is the same old stuff, so what is the incentive to be bipartisan.

There should be no fear in being called ‘partisan’. What it really means is that your priorities match the values of your political party; it is not an insult… or weakness, no matter what your party affiliation.

Just Say No

 President Obama challenged the GOP to stop saying no to proposals designed to get America out of its economic rut unless they come up with alternative solutions (here is the story: Obama challenges critics to do more than say no ).

Who cares if that is all that they can say? Its just as an important to see exactly what the Republicans are saying no to.

For example, these are some issues the GOP say no to:

Health insurance for kids

Unemployment benefits

Protections for the environment

 Improving education

Increasing mass transit options

These are issues that the American people feel are important. The results of the November election reflect this. The Republicans campaigned on more tax cuts (Obama proposed tax cuts too, but for citizens that need the help, not the upper 5% of the income ladder) and they lost.

Why does the GOP keep saying tax cuts are the only answer to our problems? In November, America said NO!!

GOP and Jobs

This was reported in Milwaukee Journal-Sentinel All Politics Blog about the creation of a high speed rail line in Wisconsin:

Mark Jefferson, the state GOP’s executive director, noted that federal stimulus money would pay only for the first stages of the project. He questioned where the state would get the rest of the money to build and operate the system, and whether this was an appropriate use of stimulus money.

 

“First and foremost, Wisconsinites need their jobs back, and others need to feel assured their jobs are safe,” Jefferson said in a news release. “A passenger rail system is a huge financial commitment and will do little or nothing to bring jobs to our state when we need them most — now.”  (here is the link for the full article: Larry Sandler post)

 

I guess there will be no jobs created building the railroad cars or jobs for people to maintain the system. Or there won’t be any new jobs for people to work on the rail line. And I guess businesses won’t get any new non-driving customers or employees. Or customers who are sick of driving.

 

And heck, there just may be a few less cars on the road because of high speed rail. But I guess that’s not a good thing.

 

I get confused, just how should we spend money to create jobs Mr. Jefferson? Clearly, tax cuts for the wealthy didn’t do any good. Look at where we are now with our economy.

Return on Investment

The GOP spends a lot of time complaining about what they feel is excessive government spending. That’s fine, its what they do, and sometimes they bring our attention to some questionable expenditures. But the Dems do that too. And part of the process is to argue about what to spend tax dollars on.

Obama wants to spend a lot of money. The GOP objects to it. That ‘s their job….but we don’t hear from them their objections as to what Obama wants to spend the money on. Things like health care reform, protecting the environment and improving education. This is all stuff that needs to be worked on now, and we will see a return on our investment. And the public supports it.

During the last administration our country went from surplus to deficit. And what did we get for going into the red?… nothing but wall street going into the toilet, more unemployment, home values sinking, banks collapsing……

A lot of people have already said that the GOP is no position to talk abut fiscal responsibilty. As far as I’m concerned let ’em keep talking….

Remember, it was George Bush and Paul Ryan who wanted to put social security investments into wall street. Pretty smart guys, huh?

A Way for Paul Ryan to Lead

WI Cong. Paul Ryan opposed the recently passed stimulus plan. Fair enough.

His hometown of Janesville took a hit when GM announced that the local auto plant is closing. This plant was a major engine for the Janesville economy.

This is what Ryan should do…Call WI Governor Jim Doyle and work out a plan to invest stimulus money to retrofit the Janesville plant to build mass transit railroad cars. Like or not, Wisconsin is going to need to expand its mass transit system.

I for one won’t call Ryan a hypocrite for opposing the stimulus and then suggesting ways to use it. Its all just politics; now is the time to think of ways of getting people back to work and helping stressed cities like Janesville.

Outsmarting the Loyal Opposition

Obama gets passed a $700 or so billion stimulus package to help the USA’s struggling economy.

The GOP (so-called loyal opposition…yea right, loyal to who? BTW) says the package is too expensive, they were shut out of the process and it will raise the deficit….and therefore mortgaging the future of our kids and grandkids (passing SCHIP when Bush was in charge is way to help kids, which they didn’t do).

Obama comes out with a plan to pay down the deficit (inherited from the previous adminsitration, BTW) by half by letting tax cuts for the wealthy expire and drawing our troops down from Iraq.

You have to admit, a brilliant move on Obama’s part. If he made these moves in reverse, the GOP would be crying….”deficit be damned….we can’t raise taxes,….. it will hurt economy…..”

Now that they are deficit hawks, what do they say to Obama now?