Wednesday, August 26, 2009

Watch. Listen. Never forget. is asking that we all light a candle in our windows for Senator Kennedy tonight. Look this way. You will see my candle. Jennifer

Rest in Peace -- We'll Take it From Here

There are so many reasons to mourn the death of Edward M. Kennedy, one of the longest-serving and most effective Senators who ever served our country. The passage of the Americans with Disabilities Act is one whose presence is felt in my life every single day, as well as in the lives of millions of Americans with disabilities.

I needn't repeat the long obituaries, or catalogue his accomplishments. The press is doing a very good job of that.

No, I sit here in tears this morning because I know that the Lion's life's work was left undone -- and I know that it is up to us to see to it that the Edward M. Kennedy Health Care Reform Act is passed.

There's a lot of speculation about whether we can do it without him. I believe we must do it FOR him. He gave us the dream of a day when no person would be in pain because they were denied care, when no person would be too sick to be a good enough risk to insure. Despite his advantages, he somehow knew what it was like to be on the bottom of the heap, and he dedicated himself to raising up those who could not rise alone.

So today, in honor of Edward M. Kennedy, I re-commit myself to doing all I can to make his dream come true. After all, his whole life was about fulfilling our dreams. It seems the least we can do. Jennifer

Monday, August 24, 2009


I received this email today -- I'm also recording my responses:

To Jennifer C. Jaff, Esq.

I disagree with your statement about the "lies" in regard to the healthcare bill.

Please explain the following: P.50 Section 152 "HC will be provided to all non-US citizens."
Response: The word "citizen" doesn't appear on page 50. Section 152 is about nondiscrimination in health plans. In fact, the plan does cover LEGAL immigrants, but not ILLEGAL immigrants.

P. 85 Line 7 "Specs for Benefit levels for plans" Isn't this rationing?
Response: These are minimum levels of health plans, not rationing. Plans can provide basic, enhanced, and premium packages.

This isn't a heath care bill, but a bill for the gov't to control. For example P. 59 Lines 21-24 "Government will have direct access to your banks accounts for electronic funds transfer."
Response: This is direct deposit if you want it, not government access to your bank account. Do you use direct deposit for your paycheck? Or pay bills online? Does that give your employer or vendors access to your bank account?

and P. 195 "Officers & employees of HC Administration will have acess to all Americans' financial and personal records."
Response: This is government access to your tax returns, which they already have.

And P. 425 Lines 15-24; P.429 Lines 1-25 certainly sound like the government deciding "end of life."
Response: This allows doctors whom you consult about your end of life care to be reimbursed by Medicare.

All lies. I understand that not everybody can read the l000 page legislation for themselves, but to just buy this nonsense? I bet the person who emailed me about this is still not going to buy my responses. What will it take to stop these lies from circulating?


Friday, August 21, 2009

Do Unto Others . . . .

Taped to the frame of my computer monitor is a quotation that helps me every day to remember why I am working so hard for the rights of people with chronic illnesses: "Of all the forms of inequality, injustice in health care is the most shocking and inhumane." Martin Luther King, Jr.

This, from a man who knew inequality and injustice when he saw it.

I watch the debates over health insurance reform and wonder. Why is it that we have to pitch its advantages to the people who already have insurance because otherwise, they will oppose reform to help the uninsured? Why is it that seniors are lining up in opposition to reform because they are afraid that -- although the draft legislation does not include cuts to Medicare -- they will lose out? Why is it that President Obama was critiqued for telling faith-based groups this week that health care reform is our moral responsibility?

When Social Security was passed, and then Medicare, they received strong bipartisan support. There was a need. We as a country did not want the elderly and disabled to be without income and health care. We would all make the sacrifice, we decided as a nation. And we do the same for veterans, whether they saw combat or not. Indeed, we provide free health care for all prisoners, regardless of what they did to land themselves in a federal penitentiary.

So why isn't it enough to say health insurance reform simply is the right thing to do? There are 46 million people in the United States with no health care. Some of them choose not to buy insurance -- they are young and healthy, and not thinking about the what ifs that we who are older and wiser know will become a reality for many of them, especially if you consider that half of all Americans have a chronic health condition. But many of them either cannot afford insurance or they have pre-existing conditions that make it impossible to find insurance. Why is it okay to leave them to fend for themselves?

Is this the kind of country we want to be -- one that is inhabited by people who make their decisions about what policies and programs are important based solely on what is best for them and them alone?

The person in agony, turned away by insurers because of a pre-existing condition, given pain meds and shown the door by the hospital emergency room, left with nowhere to go, nobody to help them -- I talk to people like these every day. There are no solutions for them. They have been left to fend for themselves, and they cannot. They are living on the street, in their car, in shelters where they can't sleep for fear of their few meager possessions being stolen by others. No medicine, no doctors, no family, no friends, no support.

There but for the grace of whomever/whatever go we all. If you think it can't happen to you, think again. All it takes is one catastrophic bout of illness and you lose your job, your health insurance, your home -- it is happening to people every single day. You could be one of the unlucky ones tomorrow, no matter what your status is today.

But I don't want to have to sell health insurance reform to you by appealing to your self-interest. I want you to think about what America means, who Americans are. I want all of us to recognize that, "of all the forms of inequality, injustice in health care is the most shocking and inhumane." And it must stop. Now.

If you care about equality, dignity, community, respect, you must be in favor of health insurance reform. Jennifer

Thursday, August 20, 2009

Loss . . . and Loss

It turns out not all loss is so bad.

For example, I promised you months ago that I was going to go on a diet and lose weight. If I'm going to set an example for others with chronic illness, I have to live a healthier lifestyle, and for me, that starts with food -- what I eat and how much. What I can eat is very limited by my Crohn's disease, gastroparesis, and lactose intolerance. I went to a nutritionist recently who told me to eat several small meals per day, and address sugar cravings with unsweetened apple sauce. If I eat all day, I'm in the bathroom all day -- and anybody who's ever had a sugar craving knows that unsweetened apple sauce is no solution! But I've cut way back on the sugar, and I'm trying to add cooked veggies and yogurt (soy) and, yes, apple sauce to my diet. Three pounds so far this week -- and with all the barium I drank yesterday (I had an MR enterography, and anybody who tells you it's just like an MRI is lying!!!), I'm content with that as a start. I know I'm going to make it. When have I not kept a promise to you?

But sometimes loss just plain sucks. We've been working since day one with an organization that represents lots of patients with Crohn's disease and ulcerative colitis. It's been a great relationship. For a small monthly fee, not only have we provided services to their members, but we've worked with them on public policy issues, and I've traveled the country speaking to their members. It's never been a whole lot of money, but it's been income we've counted on -- and in this economy, any loss of income is scary -- but it's been a relationship that mattered a lot to us, to me. Apparently, it didn't matter as much to them. They had to make some brutal budget cuts, and we ended up in the cut pile. It makes me very sad. It's an organization of which I've been a member for 35 years, to which my family has given many thousands of dollars, and in which I've invested a lot of energy and heart. Losing that relationship is a mourning process. As an organization, with the help of people like Pearl Jam's Mike McCready and his amazing wife Ashley, as well as a handful of others who have been steadfast supporters of Advocacy for Patients, I suspect we'll survive. But it's terribly sad.

The real risk, though, is that one loss will undermine the other. My first reaction when I'm feeling sad and lost is to eat a bag of jelly beans! And that cannot happen. I'm holding onto the good loss regardless of the bad.

And life goes on, the good with the bad. Jennifer

Tuesday, August 18, 2009

Why I Support a Public Option

Finally, the health insurance reform debate has graduated from fictitious death panels to something that really matters: Should we have a public option that can compete with the public plan? I think so.

One of the massive problems we face are escalating health insurance premium. Ours went from $450 four years ago to $1000 now. That's per person per month. We can't afford premiums that double every four years. That's as big a reason to reform the system as any.

A public plan would have lower administrative costs because it wouldn't pay fat cat bonuses, and it wouldn't spend so much time trying to figure out what care it could deny. We know this from the Medicare experience.

Co-ops don't get us there, I think. Just setting up health care coops -- groups that form a nonprofit to provide care within a network of doctors, hospitals, etc. -- is too difficult, too cumbersome, and is likely to trap people in small networks. Those of us who need to see a doctor outside of the coop will be out of luck. Coops won't really compete with private insurance because they will be unattractive to most people.

Bob Herbert in today's NY Times is right when he says there's a problem when the health insurance companies and pharmaceutical manufacturers are happy with the reform we're headed towards. No way to force down insurance costs, no way to negotiate drug discounts for Medicare -- they're getting off scott free, to continue to do what they've been doing all along -- milking the system without having to change their ways one bit.

Indeed, health insurers will get millions of healthy individuals who are required to enroll, while not giving up a single thing.

A public option changes this dynamic. It is the only way consumers can really win. It will drive down the cost of premiums so the private plans can compete with the public plans. There's simply no other way to get there.

If you agree, please speak up. Jennifer

Sunday, August 16, 2009

The President Speaks

August 16, 2009
Op-Ed Contributor

Why We Need Health Care Reform

OUR nation is now engaged in a great debate about the future of health care in America. And over the past few weeks, much of the media attention has been focused on the loudest voices. What we haven’t heard are the voices of the millions upon millions of Americans who quietly struggle every day with a system that often works better for the health-insurance companies than it does for them.

These are people like Lori Hitchcock, whom I met in New Hampshire last week. Lori is currently self-employed and trying to start a business, but because she has hepatitis C, she cannot find an insurance company that will cover her. Another woman testified that an insurance company would not cover illnesses related to her internal organs because of an accident she had when she was 5 years old. A man lost his health coverage in the middle of chemotherapy because the insurance company discovered that he had gallstones, which he hadn’t known about when he applied for his policy. Because his treatment was delayed, he died.

I hear more and more stories like these every single day, and it is why we are acting so urgently to pass health-insurance reform this year. I don’t have to explain to the nearly 46 million Americans who don’t have health insurance how important this is. But it’s just as important for Americans who do have health insurance.

There are 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.

We will put an end to these practices. Our reform will prohibit insurance companies from denying coverage because of your medical history. Nor will they be allowed to drop your coverage if you get sick. They will not be able to water down your coverage when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime. And we will place a limit on how much you can be charged for out-of-pocket expenses. No one in America should go broke because they get sick.

Most important, we will require insurance companies to cover routine checkups, preventive care and screening tests like mammograms and colonoscopies. There’s no reason that we shouldn’t be catching diseases like breast cancer and prostate cancer on the front end. It makes sense, it saves lives and it can also save money.

This is what reform is about. If you don’t have health insurance, you will finally have quality, affordable options once we pass reform. If you have health insurance, we will make sure that no insurance company or government bureaucrat gets between you and the care you need. If you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan. You will not be waiting in any lines. This is not about putting the government in charge of your health insurance. I don’t believe anyone should be in charge of your health care decisions but you and your doctor — not government bureaucrats, not insurance companies.

The long and vigorous debate about health care that’s been taking place over the past few months is a good thing. It’s what America’s all about.

But let’s make sure that we talk with one another, and not over one another. We are bound to disagree, but let’s disagree over issues that are real, and not wild misrepresentations that bear no resemblance to anything that anyone has actually proposed. This is a complicated and critical issue, and it deserves a serious debate.

Despite what we’ve seen on television, I believe that serious debate is taking place at kitchen tables all across America. In the past few years, I’ve received countless letters and questions about health care. Some people are in favor of reform, and others have concerns. But almost everyone understands that something must be done. Almost everyone knows that we must start holding insurance companies accountable and give Americans a greater sense of stability and security when it comes to their health care.

I am confident that when all is said and done, we can forge the consensus we need to achieve this goal. We are already closer to achieving health-insurance reform than we have ever been. We have the American Nurses Association and the American Medical Association on board, because our nation’s nurses and doctors know firsthand how badly we need reform. We have broad agreement in Congress on about 80 percent of what we’re trying to do. And we have an agreement from the drug companies to make prescription drugs more affordable for seniors. The AARP supports this policy, and agrees with us that reform must happen this year.

In the coming weeks, the cynics and the naysayers will continue to exploit fear and concerns for political gain. But for all the scare tactics out there, what’s truly scary — truly risky — is the prospect of doing nothing. If we maintain the status quo, we will continue to see 14,000 Americans lose their health insurance every day. Premiums will continue to skyrocket. Our deficit will continue to grow. And insurance companies will continue to profit by discriminating against sick people.

That is not a future I want for my children, or for yours. And that is not a future I want for the United States of America.

In the end, this isn’t about politics. This is about people’s lives and livelihoods. This is about people’s businesses. This is about America’s future, and whether we will be able to look back years from now and say that this was the moment when we made the changes we needed, and gave our children a better life. I believe we can, and I believe we will.

Barack Obama is the president of the United States.

Thursday, August 13, 2009

Info on Reform from the White House

8 ways reform provides security and stability to those with or without coverage
  1. Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
  2. Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
  3. Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
  4. Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
  5. Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
  6. Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
  7. Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
  8. Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.
Learn more and get details:

8 common myths about health insurance reform
  1. Reform will stop "rationing" - not increase it: It’s a myth that reform will mean a "government takeover" of health care or lead to "rationing." To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies.
  2. We can’t afford reform: It's the status quo we can't afford. It’s a myth that reform will bust the budget. To the contrary, the President has identified ways to pay for the vast majority of the up-front costs by cutting waste, fraud, and abuse within existing government health programs; ending big subsidies to insurance companies; and increasing efficiency with such steps as coordinating care and streamlining paperwork. In the long term, reform can help bring down costs that will otherwise lead to a fiscal crisis.
  3. Reform would encourage "euthanasia": It does not. It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.
  4. Vets' health care is safe and sound: It’s a myth that health insurance reform will affect veterans' access to the care they get now. To the contrary, the President's budget significantly expands coverage under the VA, extending care to 500,000 more veterans who were previously excluded. The VA Healthcare system will continue to be available for all eligible veterans.
  5. Reform will benefit small business - not burden it: It’s a myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses, provide tax credits to help them pay for employee coverage and help level the playing field with big firms who pay much less to cover their employees on average.
  6. Your Medicare is safe, and stronger with reform: It’s myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform will improve the long-term financial health of Medicare, ensure better coordination, eliminate waste and unnecessary subsidies to insurance companies, and help to close the Medicare "doughnut" hole to make prescription drugs more affordable for seniors.
  7. You can keep your own insurance: It’s myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.
  8. No, government will not do anything with your bank account: It is an absurd myth that government will be in charge of your bank accounts. Health insurance reform will simplify administration, making it easier and more convenient for you to pay bills in a method that you choose. Just like paying a phone bill or a utility bill, you can pay by traditional check, or by a direct electronic payment. And forms will be standardized so they will be easier to understand. The choice is up to you – and the same rules of privacy will apply as they do for all other electronic payments that people make.
Learn more and get details:

8 Reasons We Need Health Insurance Reform Now
  1. Coverage Denied to Millions: A recent national survey estimated that 12.6 million non-elderly adults – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years or dropped from coverage when they became seriously ill. Learn more:
  2. Less Care for More Costs: With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job. Americans pay more than ever for health insurance, but get less coverage. Learn more:
  3. Roadblocks to Care for Women: Women’s reproductive health requires more regular contact with health care providers, including yearly pap smears, mammograms, and obstetric care. Women are also more likely to report fair or poor health than men (9.5% versus 9.0%). While rates of chronic conditions such as diabetes and high blood pressure are similar to men, women are twice as likely to suffer from headaches and are more likely to experience joint, back or neck pain. These chronic conditions often require regular and frequent treatment and follow-up care. Learn more:
  4. Hard Times in the Heartland: Throughout rural America, there are nearly 50 million people who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. Learn more:
  5. Small Businesses Struggle to Provide Health Coverage: Nearly one-third of the uninsured – 13 million people – are employees of firms with less than 100 workers. From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%. About a third of such workers in firms with fewer than 50 employees obtain insurance through a spouse. Learn more:
  6. The Tragedies are Personal: Half of all personal bankruptcies are at least partly the result of medical expenses. The typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone. Learn more:
  7. Diminishing Access to Care: From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. An estimated 87 million people - one in every three Americans under the age of 65 - were uninsured at some point in 2007 and 2008. More than 80% of the uninsured are in working families. Learn more:
  8. The Trends are Troubling: Without reform, health care costs will continue to skyrocket unabated, putting unbearable strain on families, businesses, and state and federal government budgets. Perhaps the most visible sign of the need for health care reform is the 46 million Americans currently without health insurance - projections suggest that this number will rise to about 72 million in 2040 in the absence of reform. Learn more:

Hagerstown Town Hall

A friend of mine went to the Hagerstown Town Hall yesterday and interviewed several people on both sides of the health care issue. His report is here. I hope you will check it out.

A woman who earns too much to qualify for Medicaid can't afford insurance for both herself and her child. Her child doesn't qualify for any publicly funded healthcare due to her income and to her state's plan for SCHIP (Maryland). A man who opposes reform tells her to take her son to the ER if he needs care because it's free.

See, now that's just plain wrong. Emergency room care is only free if you qualify for charity care because you earn right about the federal poverty level -- about $15,000 for a family of two. Since this woman earns more than that, her ER care would NOT be free.

How are we going to get anywhere when people refuse to listen long enough to hear the truth? Jennifer

From today's NY Times

Great essay by Atul Gawande, Donald Berwick, et al. Ten Steps to Better Care here. Jennifer

New Ads Promote Health Reform

Wednesday, August 12, 2009

More Debunking

CBS News asked Brooks Jackson,'s director, and Wall Street
Journal reporter Alicia Mundy to address six top health care myths: (1) Does
the bill encourage euthanasia? No. (2) Will health services be rationed? Not
really, and besides, it happens already. (3) Will reform be "deficit neutral?"
Probably not. (4) Will reform mean the government could pay for abortions?
Possibly, the bills are neutral on the issue. (5) Will there be Medicare cuts?
Democrats want to cut expenses, but not services. (6) Will people be able to
keep their current insurance? You can keep your plan, but reform may mean your
plan changes over time.


Is Health Insurance Regulation Socialism?

I saw a woman on a video of one of the unruly town hall meetings who was truly, genuinely distraught. She fears that President Obama is a socialist, and health insurance reform is moving us towards socialism. There are enough people scared by this that it's worth some time and analysis.

First, let's separate the fears of people who genuinely feel that ensuring that everyone in the United States can afford health insurance will lead us away from capitalism from the views of the crazies, whose wacko views don't deserve a response.

In my opinion, the personal attacks on President Obama -- the so-called birthers movement of people who don't believe he was born in the USA despite his Hawaiian birth certificate, people calling him a Nazi, drawing Hitlerian moustaches on his photograph -- these are largely, in my opinion, fringe groups that really hate the fact that we have an African-American President. These are the militia groups, and people like the guy who thought it made sense to bring a loaded gun to President Obama's town hall meeting in New Hampshire earlier this week, the guy who was arrested for advocating killing President Obama.

According to the Southern Poverty Law Center, which monitors what they consider to be hate groups, things haven't yet gotten as heated as they were before the Oklahoma City bombing, but there's a definite up-tick in the activities of militia groups, organizing and training for the next apocalypse -- bank bailouts, the stimulus package, and now health insurance reform.

I have nothing to say to these people. They will always be there. They are nuts. They are Sarah Palin on acid. They scare me, but I know better than to try to argue with them. They are a lost cause. The only way to change them is to deprogram them! And since we don't do that in America, they will remain.

But what of the people who are not just attacking Obama and railing against any form of income tax, who stockpile guns and supplies and advocate the overthrow of our government, but who genuinely are afraid that health insurance for all means socialism, and that somehow means the deterioration of the fabric of America?

We have Medicare and Social Security already. These programs didn't turn us into socialists. We have Medicaid for the poor. We have the State Children's Health Insurance Plan or SCHIP. Still no socialism. Your tax dollars finance the VA health system, and health care for everyone in an American prison. No socialism.

But that's the easy response. Let's take this more seriously for a moment.

According to Wikipedia,

refers to various theories of economic organization advocating state, public or common worker (through cooperatives) ownership and administration of the means of production and distribution of goods, and a society characterized by equal access to resources for all individuals with an egalitarian method of compensation."

So a socialist system would mean we the people would own the health care system. I've read the 1018 page House Bill and the Senate HELP Committee bill with all amendments, and there's nothing in them that says the people will own the health care system. I promise.

But the latter part of the definition -- "equal access to resources for all individuals with an egalitarian method of compensation" -- I suppose Medicare meets that definition, as does Social Security, VA health care, and prison health care. But that doesn't seem to bother folks like the young woman at the town hall.

What bothers her and many others isn't really health insurance reform in and of itself. If you ask them if people should have health insurance, most of them will say yes. Most of them are against pre-existing condition exclusions and the ability of insurance companies to drop people because they get sick. No. Before we dismiss this argument that health care reform is socialism simplistically, by pointing to Medicare, we really need to understand what these folks are saying.

The thinking goes like this: first we bailed out the banks, then we took majority ownership of the automobile companies, then there was the stimulus package, and now health insurance reform including subsidies for those who can't afford to pay on their own. We the people are handing out money left and right, and that's leading to government regulation and ownership of banks, auto companies, and now, a publicly run health plan.

Of course, we've yet to see whether there will be a public insurance plan that will serve as an option that people can choose as an alternative to commercial insurance. The core of what I believe will be passed will eliminate pre-existing condition exclusions, create a central marketplace where people can compare and choose a health plan to purchase, and probably a requirement that everyone must have insurance and, thus, subsidies for the middle class who can't afford the premium payments. There may well not be a public option. So no government ownership of the health care system other than what we already have -- Medicaid, Medicare, the VA, federal employees, the active military, and prisoners.

But really, this issue, the socialism argument, is about the size of government for some people, and about the size of the deficit for others. If health insurance reform weren't following on the heels of bank and auto bailouts and the stimulus package, I'm not sure you'd get so much of this socialism fear frenzy.

So let's unpack this.

Last September, BEFORE President Obama took office, the stock market went into a freefall and huge banks and financial services companies began to fail. I and most everybody lost about 40% of my retirement savings. The first bank bailout happened under George Bush, if you recall correctly. But it quickly proved to be insufficient to stop the economic melt-down, as bank after bank came to the brink of disaster.

Today, the stock market is relatively stable. It even has recovered a little bit. Some of the banks have paid back the money they were given. Have we fixed the problem? No -- as long as financial institutions continue to give huge bonuses to people regardless of their performance, the battle has not been won. And so the President urges Congress to pass financial institution regulation. We'll see how that goes. But I don't see how anybody can argue that, when President Obama took office, he shouldn't have done anything to save the banks. We might be in the midst of a depression right now if we had done nothing. So yes, it's distasteful. I hate the fact that my tax dollars are funding irresponsible institutions that have learned nothing from their failures. But I'm glad I lost only 40% of my retirement savings rather than all of it.

The auto companies. We're seeing unemployment at 9.4% and it may still get worse before it hits bottom. If GM and Chrysler had completely gone under, the job losses would have been extraordinary, not only for GM and Chrysler employees, but all the parts manufacturers and dealerships and everyone else that has a role in the auto industry in the United States. So yes, we gave them a lot of money and we took, in exchange, a large portion of ownership. I hope that, as these companies exit bankruptcy and begin to come back, our ownership in those companies will be worth more than what we paid for it. I hope that there comes a time when we can sell our shares of these companies. It remains to be seen. But letting them go under would have been worse, I believe.

The effects of the stimulus package have yet to be fully felt, but again, I believe it kept us from falling off the cliff. The COBRA subsidy alone has kept many thousands of people insured. We are starting to see public works projects get going. And in states without budgets like Connecticut, the stimulus funding is what will allow schools to open on time this year.

So for each step that President Obama has taken, there is a good rationale, and so far, pretty good outcomes. However, taken together, these programs are fodder for conservative advocates to use to scare people into believing that health insurance reform is a government take-over of the health care system, just like we allegedly took over the banks and the car companies. Regardless of how necessary these steps were and are, we've had to print a lot of money in the last 6 months, and our deficit has grown. This is enough for Glenn Beck and FOX news and Rush Limbaugh to make the argument that we are turning socialist. And people believe them.

And therein lies the problem. People believe them.

Those of us who are political and news junkies, and who are fighting for health insurance reform because we believe it truly is life and death, know that these fear-mongers are deliberately distorting the facts and fomenting revolution by the right. Limbaugh says the President's health insurance reform symbol looks like a swastika, and the next thing you know, there's a swastika painted on a Congressman's office. The Washington Times and Palin talk about death panels and you truly have senior citizens in hysteria. We know these charges are false and misleading -- indeed, deliberately so.

But it's also the case that most people aren't going to read the actual draft legislation. They don't spend hours each day reading newspapers or researching the truth for themselves. And they buy the claim that there's a liberal media elite that supports anything the Democratic President and Congress do, blindly, while they blindly believe that FOX news is a real news channel even though it refuses to cover things that are as important as a Presidential prime-time news conference.

So how do we calm these folks down? I have to tell you -- I'm feeling quite desperate about this. I have this little blog that is read by maybe 50 people if I'm lucky. I do all I can here to set the record straight, but truly, the Palinites would assume everything I'm saying is a lie anyway.

So I don't know the answer, but I know that these aren't all bad people. They assume Rush Limbaugh doesn't lie. They watch FOX news and think that's the truth. The only difference between me and them is that I take the time to do the research to learn the truth myself, and having learned the truth by reading the draft legislation, I am then in a better position to judge which news outlets are telling the truth. And since we can't expect every day Americans to do all that work, how do we resolve all of this?

Again, I don't know the answer, but I know that I'm scared. I'm scared for the young woman who is beside herself because she thinks we're turning socialist when what we're doing is addressing very critical problems -- the collapse of our economy, the crisis in health care. I'm scared that she and others like her aren't listening, can't be told the truth, can't hear it. And I'm scared that we will lose a once-in-a-lifetime chance to reform our health insurance industry because people believed the lies.

None of what President Obama has done makes us socialists. He's stopped us from sliding into a depression. He stopped the auto makers from going under entirely. And now, he wants to make sure that everybody can get and afford health insurance. Yes, it's been a lot, and it's been fast. But if the President moved slower, our country could be bankrupt.

As for health insurance, here's a fact. Four years ago, our insurance cost $450 per month. It now costs $1000 per month. Every day, I talk to people who can't get insurance because of a pre-existing condition, or who have to drop their insurance because of the cost. Something has to give; this is a crisis. And if you're really worried about socialism, remember that we all pay for the cost of care at free clinics and hospital ERs when people can't pay. It will help us all if everybody has insurance.

Socialism is a word. We've needed big, bold solutions and we've gotten them. As a result, the recession is starting to ease and there's the promise of health insurance for all down the road. I, for one, don't care what you call it as long as it works. Jennifer

Tuesday, August 11, 2009

More Truth-Telling

Sarah Palin says health care reform will result in death panels who will decide when to stop providing care to the elderly. In fact, the House draft legislation includes a provision inserted BY A REPUBLICAN (according to President Obama) that says that if a doctor spends time counseling you on end of life care -- whether it's time for hospice, whether you have a living will, what your intentions are -- the doctor can be reimbursed by Medicare. That's all -- it lets a doctor be paid to do something she's not paid to do today. No death panels. No euthanasia. Just the counseling you already want and get, but with payment to your doctor.

Health care will be rationed. If you think this isn't already happening, you're a very lucky person because you aren't one of the millions who've had services, treatments, or medications denied by an insurance company. Are you really happier with insurers rationing care than you are with a panel of doctors and scientists studying various treatments to see if the expensive ones really work better? Frankly, yes, I would guess that coverage will be denied of some things -- no different than today.

Today in New Hampshire, though, the President took the question of rationing in a different direction. He said we may not need to cut costs by eliminating expensive treatments if we are more efficient about what we're spending now. For example, did you know that private insurance companies are paid billions of dollars to administer Medicare at a cost that greatly exceeds the cost of the government providing the same care under traditional Medicare? Medicare Advantage Plans are private insurers administering Medicare. The government also administers Medicare. But we pay Medicare Advantage Plans more. The President said he'd rather subsidize people who can't afford insurance than subsidize insurance companies. I'm with him.

The President did make a small error today, though (with all due respect to the President). A gentleman asked him why his Medicaid program wouldn't let him stay on Lipitor until he had tried other drugs first. The President assumed he'd been forced to try a generic before being allowed to stay on the brand name. Instead, this man was talking about what's called step therapy -- I had one case in which the patient was on a proton pump inhibitor called Protonix. His insurance company had negotiated discounts with the manufacturer of other proton pump inhibitors like Prilosec, Prevacid, and Nexium. So every year, they were making him try the other drugs to save a little money because they couldn't get a discount on Protonix. I had to document the fact that the man had done this dance three years in a row, with the same outcome, so his insurer would let him have his Protonix long-term. The President said that, since generics are fine for most people, he didn't really have a problem with them making this man try the generic first, as long as they were willing to give him back his Lipitor if the generic didn't work as well. But what the man was really talking about was being forced to take an entirely different drug. To be perfectly honest with you, I expect that insurers in the post-reform world will still do these same sorts of things -- but NOT because the government has anything to say or do with it.

So those are today's truths. I'll keep on telling these truths as long as I have to. We need health insurance reform now. The people who are against it are either invested financially or they're misinformed and scared. I can't stop the corruption, but maybe I can get you some good information.

Indeed, if you have questions, post them as comments and I'll gladly research and find the answers for you. Jennifer

Monday, August 10, 2009

More Health Reform Truth

AARP has put up this website to give you the truth on health care reform.

White House Reality Check

Because of all of the lies being told about health care reform, the White House has launched a Reality Check Website that contains explanations and truths. So if you have questions or doubts, go here for the truth. Jennifer

Wednesday, August 5, 2009

More Lies About Reform

Having a living will or advance directive, which tells your family and medical providers what you do and do not want when you reach the end of your life and are unable to make your own decisions, is a smart thing to do. None of us wants to be Terry Schiavo, having courts and even Congress butting in telling us whether we get to live or die. Having a living will is the best insurance there is to make sure that your wishes are known and carried out.

So when members of Congress negotiating on health care reform added a provision that would ensure that people who want living wills would have help writing them out and making sure they were legal, they thought they were doing a good thing, GIVING the patient autonomy, not taking it away.

That was until the opponents of health care reform got ahold of it. I got an email last week from a woman who said her sister has COPD and is on oxygen, and she had been told that, if health care reform passed, the government would come and take her oxygen away and let her die. This is similar to the story that is being reported in the press, that people think the government is going to personally visit everybody at the end of life and talk them into dying because it costs less.

As best I (and anybody else who's written or talked about this) can tell, this all comes from the provision reinforcing the right to a living will. A provision that was intended to GIVE autonomy has been reinterpreted as if it would TAKE autonomy. Nonsense!

Think about it, really. Is there any indication from anything you've read or heard that President Obama is in favor of euthanasia for senior citizens? He talks lovingly about how his mother died too young, and he left the campaign trail to visit with his grandmother as she was dying. He's compassionate, he cares about family -- there's absolutely nothing I have ever heard or read about him that would allow me to believe that he would support killing old people because they're too expensive.

And even if he wanted to do it, do you really think a majority of Congress -- Democrat or Republican -- would be able to pass such a law, and you would only hear about it by rumor? Think about it. If Congress proposed legislation to kill us all off when we reach age 75, it would be the lead story on the nightly news. There would be hysterics. And it would be challenged in court, probably successfully. We don't legalize suicide; what on earth would lead someone to believe that we would legalize euthanasia?

It's rumor, and you and I both know who started it -- the people who don't want health care reform to succeed. And you're going to hear a lot more about it before this is over.

Rather than sitting down and having a rational debate -- because really, there aren't too many people out there saying we don't need some sort of reform of our very broken system -- they are telling lies. They are organizing protests. They are behaving like children, disrupting events around the country where people are trying to have real conversation about the merits of health care reform and other issues that are on our minds, like the economy. They are doing it to kill reform -- period.

Is there a place in our society for civil disobedience? Yes -- after all attempts at talk are exhausted and have failed. But we don't even have a final plan yet. If there are opponents out there who really don't want any kind of reform at all, let them speak.

But stop the lies. Stop the disruption. Let us have our social conversation about health care. That's the best chance we have to get it right. Jennifer

Tuesday, August 4, 2009

Here's a Lesson For You

The doctor's office called today to tell me that my tests were all fine. I said "what tests?" She said "biopsies." I asked if she would fax them.

They say "chronic active ileitis." That is not fine. That is active Crohn's disease. I never would have known had I not asked to have them faxed to me.

So there's a lesson for us all. ALWAYS gather your records as you go and read them. If they say something different from what the doctor told you and you don't understand the discrepancy, ask.

It's your right. Jennifer

Me and Mary J

No more drama. That's my motto for the moment. Ping-ponging from a loony doctor to a lying one (the written reports of the scopes say they monitored my airway throughout and there was no incident -- yeah, right) and back again is too much activity for me. I'm sick of being sick.

So I'm the new normal. The new normal goes to the bathroom 10 times a day, takes 12 prescription drugs every day, and doesn't eat solid food. That's me to a tee.

You know how 50 is the new 40? Well, I'm the new normal.

No more drama. Just normal. Jennifer

Monday, August 3, 2009


The lovely Dr. G actually gave me a hard time when he finally called after 2 pm. Although the endoscopy center nurse and anesthesiologist called me this morning as the day-after-scopes check in call, he blamed me for calling all these people -- just not true, and though I told him, it didn't seem to matter. Then he wouldn't let me have the next test near my house -- I had to go an hour away, and wait more than a month for an opening. I got no apology for the bruises on my neck or for not telling me on Friday that there had been a problem during the scopes -- he said he thought the anesthesiologist told me. In the end, I fired him. I don't know what I'm going to do next, but I know I'm not going to be in the hands of someone who thinks bruising is okay, no apology or explanation required.

I kept thinking today about what I would say to one of you if you called and told me this story about scopes and bruises and waiting a month for an MRI when you're sick. I'm pretty sure I'd have told you to find a new doctor. So I will. Jennifer

New Doctor

As you know, I have decided to try a new doctor. What a disaster.

I met with Dr. G last Wednesday and he seemed very nice, understanding, and determined to get to the bottom of things. He said the first step would be scopes, which didn't surprise me. He happened to have an opening on Friday, so I grabbed it, thinking the less time I had to anticipate it, the better off I would be.

After three sticks, they got an IV in me. That was the easy part.

They use propofol for scopes, which knocks you out. I've never been asleep for scopes before, but they seemed to know what they were doing, and so they did it.

When I woke up, I told them my neck hurt. I remember a nurse laughingly saying I have sleep apnea. Celeste, who was with me, said the anesthesiologist, as he was leaving the room, said "by the way, you have sleep apnea. You might want to get it checked out." That was the whole discussion.

By Saturday morning, I had fingerprint bruises on my neck. It looked like someone strangled me. I faxed the doctor a note, but since it was Saturday, I didn't think I'd get an answer, so I called the doctor on call. I told him about the bruises. Then I told him someone mentioned sleep apnea. He proceeded to give me a long explanation for the need to move my head so that my airway would remain clear. Frankly, in my book, that doesn't justify bruises. You can handle someone without injuring them, I'm sure.

It's now almost noon on Monday. I've been waiting for a call back from the doctor this whole time. In my mind, bruises around one's neck is the kind of thing they should really care about. They did call to ask where I had my prior surgeries because they want to get copies of the operative reports. I told my doctor's secretary that I'm waiting for a call from him. That was about 2 hours ago. She said she was going to track him down and tell him.

This is SO not okay.

And now I don't know what to do. At least Dr. S responded to me, usually in a reasonable amount of time. But to have had a problem with my airway and not tell me after the scopes is outrageous! They sent me home with reports of the scopes and nowhere mentioned a problem with the airway. The anesthesiologist told me in passing, quickly, when I was still on drugs from the scopes, and that was the only mention of it. The gastroenterologist didn't mention it at all.

And yesterday, I was in complete agony at my hernia site. I was literally writhing in pain, sweat dripping off me -- the whole deal. Since I have nobody to call, I tried to resolve it and finally took a vicodin so I could sleep.

Here I am, as educated a patient as a patient can be, and this stuff can happen even to me. What kind of doctor ignores bruises around the neck? And in a lawyer? He must be out of his mind. How am I ever going to trust him again?

He better have something really good to say when he calls because I'm getting angrier by the minute. This is not the level of communication I expect, especially when I'm injured at his hands. Jennifer