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Quote (as of May 13, 2009, 5:40 pm)

http://www.healthreform.gov/forums/whatpeoplearesaying.html

What People Are Saying

“Political momentum may finally be on the side of health reform.”
This week health reform took center-stage as President Obama hosted meetings at the White House with health care stakeholders and members of Congress. Reacting to a round of meetings with health care industry representatives on Tuesday President Obama said “this is a historic day, a watershed event in the long and elusive quest for health-care reform.”
In an article in TIME magazine this week, Karen Tumulty analyzes the difference between this year’s health reform effort and the failed attempt of the early 1990’s. The article also highlights some of the “big changes” that are seen as being key to reigning in the cost of health care.
In the early 1990s, the argument was all about covering the 37 million or so uninsured. In 2009, after much of the rhetoric on last year’s campaign trail focused on the growing ranks of uninsured, the major thrust of health-care reform centers on something that affects everyone: the staggering cost of a system that threatens to devour the rest of the economy. And as a result, political momentum may finally be on the side of health reform...
...So how do you actually bring medical spending under control? Health-care experts say it is possible to cut it significantly without reducing quality. Indeed, they say more efficient medicine would be better medicine. By some estimates, as much as $700 billion of the $2.3 trillion that we spend on medical care each year is on unnecessary treatment that is not doing anything to make us healthier - and could even be hurting us. Obama Administration budget director Peter Orszag notes that all sides now are starting to agree that four big changes are needed...
Time, Wednesday, May, 13, 2009
Why healthcare providers joined forces with Obama
Speaking about the prospects of health reform, Ron Pollack of Families USA said “there’s a context of cooperation that we’ve never seen before.” In her testimony before the House Committee on Ways and Means, HHS Secretary Kathleen Sebelius said, that at no point have we been better positioned to pass health reform than we are today. And recently President Obama said “that reform is not a luxury that can be postponed, but a necessity that cannot wait.”
It is clear that consensus is building around the urgent need for health reform. While no one is under the illusion that passing health reform will be easy, there are many reasons to be optimistic. Yesterday’s meeting at the White House between President Obama and representatives from the health care industry illustrates the fact that groups who were once opposed to health reform now acknowledge that the status quo is unsustainable.
There has been a sea change in the long struggle over healthcare reform in Washington.
The last time a Democratic president took office promising major health reform, 16 years ago, the effort crashed amid fervent opposition by key groups in the healthcare industry.
Today, many of those same groups have voluntarily come to the table, ready to deal. On Monday, President Obama announced a commitment from a half-dozen health-industry trade groups to reduce the growth of healthcare spending significantly, with a potential savings of $2 trillion over 10 years.
Industry groups see that momentum is building toward reforming the system – and they want to be inside the tent affecting the outcome, not outside having decisions forced upon them...
... “What’s brought us all together today is a recognition that we can’t continue down the same dangerous road we’ve been traveling for so many years; that costs are out of control; and that reform is not a luxury that can be postponed, but a necessity that cannot wait,” Mr. Obama said after meeting with representatives of the groups.
The Christian Science Monitor, Monday, May 11, 2009
“Reform is not a luxury that can be postponed.”
Today President Obama hosted a meeting at the White House with six leaders of the health care industry to discuss what can be done to bring down the rising cost of health care. During the meeting, health care representatives presented a letter to President Obama outlining their commitment to work with the Administration to slow the skyrocketing costs of health care. In the letter, the companies pledge to decrease the annual health care spending growth rate by 1.5 percentage points, which estimates suggest could save as much as $2 trillion over the next ten years. President Obama said that this voluntary effort by the groups represents an “unprecedented commitment” to bringing down health care spending. President Obama has said repeatedly that bringing about health reform will not be easy; rather it will require everyone making sacrifices. Today’s announcement is welcome news to the Obama Administration and represents a step in the right direction.
Doctors, hospitals, drug makers and insurance companies will join President Obama on Monday in announcing their commitment to a sharp reduction in the growth of national health spending, White House officials said Sunday.
The officials said the plan could save $2,500 a year for a family of four in the fifth year and a total of $2 trillion for the nation over 10 years. That could make it less expensive for Congress to enact comprehensive health insurance coverage, a daunting challenge facing the Obama administration…
In remarks prepared for delivery to health care providers on Monday, Mr. Obama says: “These groups are voluntarily coming together to make an unprecedented commitment. Over the next 10 years, from 2010 to 2019, they are pledging to cut the growth rate of national health care spending by 1.5 percentage points each year — an amount that’s equal to over $2 trillion.”
The New York Times, Sunday, May 10, 2009
Letter to Chairman Baucus and Ranking Member Grassley
During Secretary Sebelius’ confirmation process, she said that “action is not a choice. It is a necessity.” Days after her confirmation, HHS Secretary Sebelius sent a letter to two of the men who will play key roles in passing health reform: Senator Max Baucus and Senator Chuck Grassley. In the letter, Sebelius thanked the Senators for the steps that they have taken so far in advancing health reform and encouraged them to continue to work collaboratively with the Department of Health and Human Services to pass comprehensive health reform legislation.
Dear Chairman Baucus and Ranking Member Grassley:
I applaud your leadership as the Finance Committee continues to work in a bipartisan way toward our shared goal of enacting meaningful health reform legislation this year. You took an important first step this week, by announcingproposals aimed at improving the value and efficiency of health care and reining in the rising cost of health care. The policies you proposed will cut down on waste, fraud and abuse, reduce medical errors and improve the quality of care for patients. Among your proposals are ideas we have long supported:
Promoting primary care and prevention,
Realigning incentives to promote high-quality care,
Increasing transparency to empower patients and providers, and
Reducing waste, fraud, and abuse.
The Finance Committee, in partnership with other key Committees, is doing important work to address the public’s urgent need for health reform. We welcome your ideas as we continue working closely with the committees to explore the many ways in which we can achieve the goals of cutting health care costs and assuring quality and affordable health care for all Americans.
Sincerely,

Kathleen Sebelius
Secretary of Health and Human Services
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2009: The Year of Health Reform
On Tuesday, Kathleen Sebelius was confirmed as the Secretary of the U.S. Department of Health and Human Services. As HHS Secretary, one of her top priorities will be to work with the President, Congress, and Nancy-Ann DeParle to pass comprehensive health reform this year. In a recent WSJ story entitled, “Moment is Ripe for Obama to Fix Health Care”, writer David Wessel explains why this may be the “Year of Health Reform”
It would seem an unpropitious moment for President Barack Obama to renovate the American health-care system amid battles to prevent the collapse of the American banking system, conquer the worst recession in his lifetime, and defeat the enemy in Iraq and Afghanistan. But Mr. Obama is determined to try, and chances that he will have something to boast about by year’s end look surprisingly good.
…Unhappiness with the status quo is greater. Despite expansions of government health insurance, more Americans lacked health insurance going into this recession than in 1994, and the number has risen since. Health costs continue to rise faster than nearly everything else and now equal to 17.6% of total U.S. output, up three percentage points from 1994. (Each percentage point amounts to $140 billion.) Employers and the government’s Medicare and Medicaid are seeing unsustainable increases in health spending. And — this is politically important — so are American families, as premiums, co-pays and deductibles climb.
The White House heath-care summit in March was a visible manifestation that health providers, insurers and employers believe this may be the Year of Health Reform. Harry and Louise, the characters in the devastating commercials that the health insurers used to defeat Hillary Clinton in 1994, have decided it’s smarter to ride the train than lie down in front of it.
White House political tactics are smarter. The American health-care system is complex; any legislation to change it will be complex. So the Clintons offered a complex plan, and it was ridiculed and attacked at its vulnerable points even by Democrats. Counseled by Washington insiders and Clinton veterans, Mr. Obama will issue no detailed plan. He will offer elements, and work with Congress so whatever emerges will be as much their plan as his. The parliamentary move to allow health legislation to pass the Senate with 51 votes (instead of the 60 it usually takes in the Senate) gives Mr. Obama and his congressional allies added leverage.
The message is smarter too: If you like your current health insurance, Mr. Obama promises, it won’t change. White House polling finds that employed Americans worry more about the cost of their health insurance than the prospect of losing it in a layoff. So watch for the president to emphasize not how many uninsured he will cover, but how he will hold down ordinary Americans’ health tab.
Democrats in Congress want to do this — now. Mr. Obama and White House Chief of Staff Rahm Emanuel really want a deal this year, but so do Max Baucus, the Senate Finance Committee chairman; Teddy Kennedy, who sees this as the last political victory of his life; and the House and Senate leaders Nancy Pelosi and Harry Reid. To get a bill, they may even surrender on some elements long seen by liberal Democrats as non-negotiable. (For example: To cut costs, offer decent but bare-bones health insurance to those who lack it, rather than delivering on the promise to offer every American a plan as good as members of Congress have.)
The Wall Street Journal, Thursday, April 30, 2009
“With All These People Losing Jobs, A Lot Will Lose Their Health Insurance”
President Obama has said that health reform “cannot wait, must not wait, and will not wait another year.” Today the Wall Street Journal cited evidence that illustrates why so many Americans cannot afford to wait another year for health reform. Layoffs are causing thousands of Americans to lose their health care coverage, and as was reported today, insurance companies are seeing their profits shrink as they lose members.

Earnings from the nation’s big health insurers show them losing members at a rapid rate, suggesting the ranks of uninsured Americans are surging during the recession.

The latest evidence came from WellPoint Inc., the country’s largest health insurer with nearly 35 million medical-plan members. Reporting a 1.3% drop in first-quarter net income Wednesday, the insurer also said it had shed nearly 500,000 net members since the end of December.

While WellPoint had factored in a large decline, it said it was surprised by the nearly 325,000 members it lost to layoffs or workers otherwise opting out of employer coverage. “We haven’t run into something like this before,” said Ken Goulet, head of WellPoint’s commercial division, during the company’s earnings conference call with analysts.

Analysts and economists have said the number of uninsured almost certainly has risen by several million people since the U.S. Census Bureau in 2007 pegged it at 45.7 million. For every one-percentage-point rise in the unemployment rate, the number of uninsured has likely grown by 1.1 million, according to research by the Kaiser Family Foundation.

Kaiser estimates that of the nine million people expected to have lost employer-sponsored health coverage since December 2007, about four million of them currently are uninsured. An additional 3.6 million have likely enrolled in Medicaid or other public programs, estimates the foundation.

On Tuesday, UnitedHealth Group Inc., the second-largest insurer in terms of members, reported a 900,000 drop in the number of people enrolled in its commercial health plans in the first quarter, compared with the end of last year, many because of higher-than-expected layoffs at the insurer’s employer clients.

It is unclear how many of those people have or will find coverage elsewhere or qualify for government insurance such as Medicaid. “It’s probably not a surprise that with all these people losing jobs, a lot will lose their health insurance,” said Paul Ginsburg, president of the Center for Studying Health System Change, a Washington, D.C., health-policy research group.

Hospitals say they also are seeing some signs of more patients without insurance. The hospital chain Tenet Healthcare Corp. said earlier this week that its number of admissions of patients with private health coverage declined 2% in the first quarter from a year earlier, while outpatient visits of insured patients slipped 0.4%, when adjusted for last year’s leap-year effect. A study released by the American Hospital Association in November found that one-third of U.S. hospitals had seen a noticeable decrease in elective procedures, such as knee replacements, during recent months.
The Wall Street Journal, Thursday, April 23, 2009
“Do I really have to lose my home to save my son’s life?”
President Obama has resolved to ease the burden of health care costs on American families this year. Many Americans are experiencing layoffs and are left without affordable health care coverage, which can be devastating for families like Danna Walker’s. Danna’s son Jake was diagnosed with cancer three years ago. Then, she had a stable job and health coverage that helped her pay for his expensive treatment. Jake is now in remission, but Danna has lost her job and her family is no longer insured. She is desperate to find affordable health insurance for her son. Kevin Sack from The New York Times told their story.
When Danna Walker left the second-floor conference room and returned tearily to her desk — where someone had already deposited a packing box for her belongings — her first thought was not of the 14 years she had worked for DHL or the loss of her $37,000-a-year salary.
It was of Jake. In three months, once her benefits ran out, how in the world would she provide health insurance for Jake, her mountainous, red-headed 21-year-old son, who had learned three years earlier that he had metastatic testicular cancer?
Since the day she was laid off in October, Ms. Walker and her husband, Russ, co-owner of a struggling feed store here on the outskirts of Houston, have mounted a largely fruitless quest to find affordable coverage for Jake’s pre-existing condition. Their odyssey has become all too familiar to millions of newly uninsured Americans who suddenly find themselves one diagnosis away from medical and financial devastation.
The Walkers, both 46, are among nine million people who have lost employer-sponsored insurance since December 2007, according to projections by the Kaiser Family Foundation. Some have qualified for government insurance, and others have bought individual policies. But an estimated four million have joined the ranks of the uninsured, heightening the urgency in Washington to close the coverage gaps in American health care.
Like many others, the Walkers live on a knife’s edge of risk. Without insurance to cover her high blood pressure or his diabetes, they defer doctors’ visits when possible and obtain their prescriptions — nine between the two of them — for $4 apiece at Wal-Mart.
But their primary concern has been finding insurance for Jake, who, after four operations, two stem cell transplants and round after grueling round of chemotherapy, has been cancer-free for a year.
“You realize how vulnerable you really are,” said Ms. Walker, who exhibits the maternal ferocity of a black bear. “You just — not give up — but you just feel that you’re at a loss, that you’re at your wits’ end. I ask myself, ‘Do I really have to lose my home to save my son’s life?’ ”
The New York Times,Monday, April 20, 2009
“A Burgeoning Medical Crisis” in North Carolina
Thousands of Americans have participated in health care reform discussions in their own communities or submitted thoughts on healthreform.gov. Rising health care costs are a serious concern that many have asked the President and Congress to address this year. President Obama believes that health care reform is both a moral and fiscal imperative, especially in light of the nation’s current economic challenges. He has called on Congress to act quickly to propose comprehensive reform that will lower skyrocketing costs putting a strain on American families and businesses. On Monday, a story in the Washington Post reveals how the economic downturn is exacerbating the health care crisis in North Carolina.
Recessions are tallied in numbers — jobless claims, home foreclosures, plant closings and bailout dollars. Here at the HealthServe community clinic, [David] Talbot, the medical director, tracks the recession in days — the number of days that patients wait to see a doctor.

Just six months ago, the clinic delivered same-day care to most callers, the gold standard from a health perspective. But in October the delays crept to four days, then 19 in November and 25 in December. In January, HealthServe temporarily stopped accepting new patients, and almost immediately 380 people put their names on a waiting list for when the crunch eases.

In North Carolina, more than any other state, the recession has triggered a burgeoning medical crisis. A steep rise in unemployment has fueled a commensurate increase in the number of people who do not have health insurance, including many middle-income families.

“I used to be upper middle class,” said Amy, who called HealthServe every morning for weeks before getting in to see Talbot. “I’ve paid my taxes for 30 years.”

In the past two years, North Carolina’s number of uninsured has climbed 22.5 percent, the biggest jump in the nation, according to an analysis by the North Carolina Institute of Medicine, a quasi-state agency. Nationwide, about 22 percent of adults do not have health insurance. Here in North Carolina, 25 percent of adults — or 1.8 million people — have no coverage. An additional 9 percent are underinsured.

For most Americans, health insurance and employment are linked. Every 1 percent increase in the jobless rate translates into 1.1 million people losing coverage nationally, according to the independent Kaiser Family Foundation. North Carolina’s unemployment rate has doubled in the past year to 10.7 percent, making it the fourth-highest in the country.

Washington Post, Monday, April 20, 2009
It Demands Urgent Attention
President Obama and his health care team have spent the last two months bringing together Democrats, Republicans, doctors, nurses, business owners and insurance industry executives to talk about the need for health care reform that will cut costs and assure quality and affordable care for every American in collaborative meetings across the country. You can read about the health care forums that took place at the White House and across the country. Members of Congress around the country have expressed their commitment to enacting health reform that reflects the President’s principles this year. Several members of Congress held forums on health care reform in their districts in recent weeks and heard from constituents, health professionals and businesspeople about the need for reform. Below is a recap from one health care forum organized by a bipartisan group of lawmakers last week in Missouri.
More than 100 people gathered at Christian Hospital for a health care forum headed by three members of Missouri’s congressional delegation - Democrats William Lacy Clay and Russ Carnahan of St. Louis and Republican Jo Ann Emerson of Cape Girardeau. The panel also included insurance leaders, public health advocates, doctors and others from the industry.

Experts agreed that the nation’s health care system suffers from several problems: inadequate access for the poor, too few primary care physicians, skyrocketing costs. They also cited a need for greater emphasis on nutrition and disease prevention.

Carnahan said 1.5 million Missourians were uninsured at some point during 2007 and 2008, and nearly four-fifths of them were from working families.

“We all know our health care system is broken,” Carnahan said. “It has become a burden on families, the economy.”

“For so many years we’ve kicked the can down the road,” he said. “We haven’t made much progress. So I think this is squarely on the plate for us. It demands urgent attention.”

News Tribune, Saturday, April 18, 2009
A Small Miracle for One Maryland Community
Bringing down health care costs and ensuring Americans have access to quality health care are two key principles President Obama has communicated to Congress as they begin to craft health care reform legislation. Last weekend, the Washington Post highlighted how the Recovery and Reinvestment Act has helped preserve Community Health Centers, which help meet the critical need for affordable and accessible medical care for millions of Americans. Deborah Foerter’s health center is still open to the Nanjemoy, Maryland community thanks to funds from the Recovery Act. Clinics like Deborah’s are a vital source of medical care for Americans in rural communities.
In one of the world’s most advanced medical systems and one of America’s wealthiest states, Foerter and her clinic are a lifeline for hundreds of poor and working-class residents of Nanjemoy, an isolated peninsula in rural southwestern Charles County. Dozens of people here live without running water, some in unheated trailers or shacks, just 37 miles from Washington. There is no grocery store and no gas station, no Laundromat or restaurant.

This spring, Foerter told them that the clinic’s services almost certainly would be ending in the next few months. The recession has hit nonprofit health clinics hard. This one had lost $150,000 during each of the past 14 years, and other grants were drying up. The board of Greater Baden Medical Services, which runs the clinic tucked inside the Nanjemoy Community Center, decided it no longer could be sustained and voted to close it.

And then, just as some patients had given up on the idea of affordable medical care within their reach, they received word of a small miracle: Two weeks ago, the federal government announced that all but a handful of the nation’s health clinics would receive a total of $2 billion through the federal stimulus package. Greater Baden was awarded $270,372, enough to keep Nanjemoy Health Services open for two years.

“The fact that someone stepped in and did something about the crisis that this was going to cause is reason for celebration,” said Rick Campbell, a longtime patient who has multiple sclerosis. “It doesn’t solve Nanjemoy’s underlying issues, but it’s a start.”

Without the clinic, Foerter said, many people wouldn’t go to the doctor at all, whether out of stubbornness or a lack of transportation, or they would wait until they needed an ambulance. Without the clinic, patients tell her, they might as well start making funeral arrangements.

Washington Post, Saturday, April 18, 2009
Report to the President
The Health Care Community Discussions from around the country were analyzed and presented to President Obama.
View Report (PDF)

Health Reform This Year
President Obama is committed to working with Congress to pass comprehensive health reform this year in order to control rising health care costs, guarantee choice of doctor, and assure high-quality, affordable health care for all Americans.

Read our online reports on health reform
Hard Times in the Heart Land
Helping the Bottom Line: Health Reform and Small Business
The Costs of Inaction: The Urgent Need for Health Reform
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