Minority Communities and Health Care Reform

Friday, March 12, 2010

Although the campaign for health care reform may be in its final stretch, even reform supporters are having to plan very carefully for how we would pay for the changes, should they happen. 

We’re joined by two experts in Massachusetts community health care who have worked in that particularly forward-looking system; they discuss how their programs could serve as either model or a warning to the Democrat's reform agenda.  Ann Eldridge Malone is a registered nurse in Boston as well as the executive director of The Alliance to Defend Health Care.  She says that, good intentions aside, the money isn't there to pay for all this care.

We’re also joined by Robert Pomales, executive director for the Latin American Institute who argues that we need to keep working toward health care coverage for everyone.


Ann Eldridge Malone and Robert Pomales

Comments [7]

Ann E Malone, RN, MSN from Boston MA

To Jeff:
From your diatribe it appears that you're very upset and I'm sorry for that but it does not change the fact that the U.S. urgently needs fundamental health system reforms of the type I have described here. You are right that the current Medicare program has problems but it appears that you are not open to learning about the various reforms that can directly remedy those problems. These reforms have the potential to put the U.S. on track to create a vastly improved Medicare-for-All national health program.

From Jeff's repeated mention of "counseling" I wonder what or who he's been listening to that's helped create such a diatribe.

For TakeAway listeners interested in the facts of the current health reform bill and an excellent overview of U.S. health policy I suggest the Health Beat blog by journalist Maggie Mahar.

The 3/2/10 entry "Obama’s Letter to Congressional Leaders: We’re Almost There" is a good place to start. Here's the link http://www.healthbeatblog.com/2010/03/obamas-letter-to-congressional-leaders-were-almost-there.html#more

Mar. 14 2010 05:00 PM

Why do you think Medicare will be the savior? Most doctors and hospitals in rural areas get paid so little, that putting even more people on Medicare will bankrupt the docs and hospitals. No one gets it....there is not enough waste in the system to pay for all healthcare...England and Canada are going broke as well. GLOBAL AGING POPULATION = MANDATORY RATIONING IN FUTURE....I say a mandatory level of care as a "right" with added tiers for people who can afford it/who actually "work" . Do you people want the entitled portion of our population to grow infinitely while the working part continues to get smaller? I can give you the stats from other countries...they are going broke, they ration care a lot more than we do. Broken bone sticking out of the skin...no matter what, has to be repaired....all the primary care /counseling/no surgery in the world will lead to infection/amputation....come on...waste is a small part. Lot of REAL PATHOLOGY THAT REQUIRES A LOT OF SERVICE, MEDICINE, AND TECHNOLOGY TO REMEDY... Cut out all the waste....there will still be tremendous shortfalls of money and docs and nurses won't work 90 hour weeks....with a lot of waiting by Americans. You all ready for your child to wait 6 months on a scan/ surgery when they have cancer? Or do you believe counseling will cure them?

Mar. 13 2010 03:59 AM
Ann E Malone, RN, MSN from Boston MA

Rick Evans makes important comments about wasteful spending in the current Medicare program. Medical providers (mostly specialists) and some hospital systems with expensive new technologies and layers of executive MBAs administrators with high salaries to pay for, knowingly perpetuate massive amounts over-treatment. As Rick mentions, this over-treatment includes both the legal and fraudulent kinds.

I'd add excessive use of over-priced prescription drugs to the cost-driver list, too. We can blame Congress in part for making this problem worse when they passed the law allowing Direct-to-Consumer drug advertising. Then under Bush and Co. we got the bogus Medicare Part D drug program that is largely a give-a-way to drug co's at taxpayer expense.

Why can't the federal government bulk purchase drugs for the Medicare program the way it does for the VA program (where it gets 30-50% discounts on the very same pills)?!

An improved Medicare-for-All program would let us correct most of the abuses in the fee-for-service part of Medicare and put us on course to pay for quality or value of care and not simply volume of care. And it would force us to do the logical thing and bulk purchase prescription drugs, like most other industrialized nations do for their populations. This speaks directly to the other comment Rick made about OECD health spending data, and how it is that the US spends so much while getting so little.

Putting people before corporate profits and fundamentally reforming the system must be our guiding principles in healthcare reform; anything less is merely dishonest tinkering (case in point the Mass. Plan).

Mar. 12 2010 11:00 AM
Rick Evans from Massachusetts

Ann E Malone, RN, MSN wrote: "Improved Medicare-for-All is the "gold standard" for real healthcare system reform."

I theory, yes. However Medicare for the Old is already one of the most wasteful fraud infested programs in the federal government. Even the legal spending is often wasteful with 'health care providers' gaming the system for gain.

Mar. 12 2010 09:32 AM
Rick Evans from Massachusetts

Hey, John,

What part of skyrocketing health care costs don't you understand? There are small businesses and unsubsidized Massachusetts residents facing 20,30,40% premium increases in 2010.

You ask the question 'What's wrong with spending MORE on health care'?.

How about from a recent Boston Globe article http://tinyurl.com/ybsm8wd: "Some cities now devote close to 20 percent of their budgets to health care costs."

Americans spend $7300 per person per year on the health care industry; double what other OECD nations spend.

They don't spend less because they force everyone to have insurance. They spend less because they limit spending with global budgeting. Yet their populations are no less healthy or even healthier than ours.

Mar. 12 2010 08:10 AM
Ed H. from Larchmont, NY

It looks like the pro-life Democrats might defeat the bill after all. Please don't accept a bill that includes taxpayer funding for abortion, which 70 percent of people don't want to see.

Mar. 12 2010 07:58 AM
Ann E Malone, RN, MSN from Boston MA

Improved Medicare-for-All is the "gold standard" for real healthcare system reform. This approach to reform would allow us to improve the system in the areas of cost, access, and quality. Other reform approaches safer politically but are piecemeal and do not address the root causes of our healthcare crisis. The Amercian people deserve better.

The current national bill, if it is to be real reform, must create a robust public insurance option. A mandate without a public option is a give-a-way to the insurance and drug industries.

A robust public insurance choice in the bill will move us toward an improved Medicare-for-All national program, for those who want that choice. This approach to reform gives us teh best tools to remedy the root causes of the crisis and to make needed improvements in the 3 major areas of our healthcare system: cost, access, and quality.

Moving toward Medicare-for-All will greatly simplify and streamline funding and payment mechanisms, hence it will bring down--and hold down--costs tremendously. It will provide for universal equitable access to comprehensive care for all. Thirdly, it will create systemic opportunities to improve quality of care across the board. This can be accomplished using comparative effectiveness research to reduce the large amount of unnecessary, often harmful care that exists at present. Medical overtreament is driving costs up and quality down.

I hope this additional information, together with my comments on today's TakeAway program, makes the case for a much better way to do healthcare reform than the Massachusetts individual mandate approach. The "Mass. Plan" is bankrupting our state, municipalities, our employers and many of our residents. It merely expands insurance coverage but does make the system reforms that are needed to bring true and lasting improvements in healthcare cost, access, and quality.

Meaningful and sustainable healthcare reforms are indeed achievable, but only if we can create the political will and courage to pursue improved Medicare-for-All. The people of this country in every state across the nation deserve no less.

Learn more at http://www.defendhealth.org

Mar. 12 2010 07:25 AM

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