Getting Back to a Real Discussion on Health Care Reform

I’m hoping with President Obama and other Democrats taking the offense that we can finally get back to talking about health care and health insurance reform.  First they had to, unfortunately, address the “death panels” issue, as President Obama did at a town hall forum in Grand Junction, Colorado yesterday. 

The President’s abridged comments from the Huffington Post (which includes a video from CNN that I can’t seem to post here):

“What you can’t do, or you can, but you shouldn’t do — is start saying things like we want to set up death panels to pull the plug on grandma.” President Obama paused and grew emotional, “First of all, when you make a comment like that, I just lost my grandmother last year… I know what its like to watch somebody you love, who’s aging, deteriorate… When you start making arguments like that, that’s simply dishonest. Especially when I hear the arguments coming from members of congress in the other party, who, it turns out, sponsored similar provisions!”

I did find AP video of the Grand Junction town hall of President Obama taking the discussion back to how current insurance industry practices hurt the American public, however.

Back to the alleged “death panels” for a moment, Secretary of Health and Human Services, Kathleen Sebelius, noted on ABC’s This Week with George Stephanopoulos (as reported by the New York Times) “all the administration was thinking about was reimbursing doctors who would engage in bedside consultations with families whose relatives are near death and who are ‘conflicted about what to do next.’ “

Unfortunately, she added, such a provision “is off the table” for now in the Senate Finance Committee because of the outcry.

“I think it’s really horrific that some opponents of the health reform bill have used this painful, personal moment to try and scare people about what is in the bill,” she said on “This Week with George Stephanopoulos.”

So, now this help for patients and families won’t be in the bill (even though it was included in medicare reform passed by the Republican congress a few years back, as President Obama noted).

As President Obama did Saturday by recalling his grandmother’s death last year, Ms. Sebelius spoke of her mother, who spent 10 weeks in three hospitals at the end of her life. Only relatively late in the process, Ms. Sebelius said, did the family have a consultation with a doctor about what could and could not be done for her mother.

“It was the most agonizing, most painful, most terrible time for not only me and my siblings, but for my dad,” she said. “And what every family wants is good information and an ability to make a decision that suits their loved one the best way that the family is involved and engaged.”

So, what will be included in the legislation?  The problem is, it is still being hammered out and as both Katha Pollitt in The Nation and former Secretary of Labor Robert Reich pointed out on his blog last week, it’s hard for the public to get behind health reform when they don’t know what’s going to be in it, or what compromises will be made.

 In his Why We Need Health Care Reform op-ed in today’s New York Times, the President lists “four main ways the reform we’re proposing will provide more stability and security to every American.“

First, if you don’t have health insurance, you will have a choice of high-quality, affordable coverage for yourself and your family — coverage that will stay with you whether you move, change your job or lose your job.

Second, reform will finally bring skyrocketing health care costs under control, which will mean real savings for families, businesses and our government. We’ll cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies that do nothing to improve care and everything to improve their profits.

Third, by making Medicare more efficient, we’ll be able to ensure that more tax dollars go directly to caring for seniors instead of enriching insurance companies. This will not only help provide today’s seniors with the benefits they’ve been promised; it will also ensure the long-term health of Medicare for tomorrow’s seniors. And our reforms will also reduce the amount our seniors pay for their prescription drugs.

Lastly, reform will provide every American with some basic consumer protections that will finally hold insurance companies accountable. A 2007 national survey actually shows that insurance companies discriminated against more than 12 million Americans in the previous three years because they had a pre-existing illness or condition. The companies either refused to cover the person, refused to cover a specific illness or condition or charged a higher premium.

President Obama has made his case for the last item especially through American’s personal stories, as noted in another New York Times article, following his visit Saturday to Grand Junction:

At a town-hall-style meeting in a high school gymnasium here on Saturday, Mr. Obama was introduced by Nathan Wilkes, whose family nearly lost their health coverage after costs to care for his 6-year-old son, Thomas, who has severe hemophilia, approached the $1 million lifetime policy cap.

On Friday, in Belgrade, Mont., Mr. Obama was introduced by Katie Gibson, who was dropped by her insurer after she received a cancer diagnosis. On Tuesday, in Portsmouth, N.H., Lori Hitchcock introduced the president; she cannot find insurance, she said, because she has a pre-existing condition.

“If you think that can’t happen to you or your family, think again,” Mr. Obama said here Saturday, adding, “This is part of the larger story, of folks with insurance paying more and more out of pocket.”

The President talks a good talk, and so do many of his allies in Congress.  How many compromises will need to be made to get the bill through (if the ultra-conservatives don’t succeed in derailing it like they’re trying to?

Robert Reich, among others, raises concerns about the deals the President has apparently already made with the pharmaceutical industry for their support (even while talking tough about them at town halls).

Last week, after being reported in the Los Angeles Times, the White House confirmed it has promised Big Pharma that any healthcare legislation will bar the government from using its huge purchasing power to negotiate lower drug prices. That’s basically the same deal George W. Bush struck in getting the Medicare drug benefit, and it’s proven a bonanza for the drug industry.


To be sure, as part of its deal with the White House, Big Pharma apparently has promised to cut future drug costs by $80 billion. But neither the industry nor the White House nor any congressional committee has announced exactly where the $80 billion in savings will show up nor how this portion of the deal will be enforced. In any event, you can bet that the bonanza Big Pharma will reap far exceeds $80 billion. Otherwise, why would it have agreed?

The New York Times reported today that “The Obama administration sent signals on Sunday that it has backed away from its once-firm vision of a government organization to provide for the nation’s 50 million uninsured and is now open to using nonprofit cooperatives instead.”

Once again, because the administration feels it needs to compromise.

Rahm Emanuel, the White House chief of staff, has fought to retain the government insurer in the Obama health plan but conceded last week that the White House might not have a choice.

“We have heard from both chambers that the House sees a public plan as essential for a final product, and the Senate believes it cannot pass it as constructed and co-op is what they can do,” he said in an interview. “We are cognizant of that fact.”

But what are insurance co-ops?  Katha Pollitt is still checking on that for the Nation:

Maybe it won’t even have a public plan; it will have insurance co-ops instead. And then, maybe, I should say those will be just as good, as Rahm Emanuel’s brother, Ezekiel Emanuel, the MD/PhD bioethicist, says.

OK, but what are insurance co-ops? I poked around online for fifteen minutes and discovered that they’re untested, small, unregulated, that they exist in twenty states and that Senator Kent Conrad of North Dakota really likes them–but I didn’t discover what they actually are.

I don’t know what all these compromises are going to mean, and hope at the end of all this debate we’ll have adequate coverage for everyone, especially the poor and working class, children, the elderly, those with disabilities or already ill or injured.


Official White House Photo by Pete Souza

I know none of these negotiations are easy, and think the President and my members of Congress are trying to work for the best deal possible.  I also think those of us who care need to keep pushing them, so they have the support to do the right thing.  Especially with so much of a push on the other side – both for pro-insurance industry “reform” and total fear-mongering nonsense like “death panels.”


2 thoughts on “Getting Back to a Real Discussion on Health Care Reform

  1. all the administration was thinking about was reimbursing doctors who would engage in bedside consultations with families whose relatives are near death and who are ‘conflicted about what to do next.

    No, the administration was quite clearly thinking of setting up death panels to coerce “conflicted” families into killing their relatives to cut costs.

    How obscene of Sebelius and Obama to exploit their own relatives’ deaths in this context. Neither of them played any role in caring for their mothers or grandmothers. Obama wasn’t even around for his mom’s death, and he only flew in to see his grandmother on her deathbed so he could run out the clock on the last few days of his presidential campaign.

    And Sebelius? She expects us to believe she didn’t give serious thought to all of her mom’s medical options until it was too late? If that’s truly the case, how is she remotely qualified for her position? When the parent of anyone I know gets seriously ill, they hit Google, the medical library and every resource available to track down the best doctors, the best treatment and every other conceivable option. What did Sebelius do, sit around with her stupid tongue hanging out of her mouth?


  2. No, what is obscene are the lies about “death panels” and Sarah Palin trotting Trig out once again for political gain. As I’ve pointed out in previous posts, the so called death panels have not only been thoroughly discredited, Palin and others have actually supported end of life planning, including advance care directives, which they’re now pretending are “death panels” in the past themselves.

    Politifact’s Pants on Fire rating on their Truth-O-Meter for Sarah’s claims of “death panels”

    Think Progress breaks the story that Palin endorsed end of life counseling as Governor:

    Grassley and many other Republicans voted for end of life counseling in Medicare legislation in 2003:

    Last, but not least, Newt Gingrich wrote a column in the Washington Post advocating advance care directives:

    Either all these Republicans were for “death panels” at one time themselves, or they are lying. What is obscene if for them to now be making up lies that President Obama and the members of congress working on the health care bill would create such “death panels” to kill the elderly or disabled and it’s especially obscene knowing that Obama just lost his grandmother last year. If there is anything resembling “death panels,” it’s the insurance company bureaucrats deciding who’s covered and not (and the only people they really want to cover are those who are healthy, so they can make their obscene profits).


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