Bucks Voices members will be speaking at a number of Bucks County Senior Centers this week to highlight the proposed health care reform impact on Medicare and to answer seniors’ questions. The first panel was held this morning at Ben Wilson Senior Center in Warminster. Please come with your questions to one of the remaining panels:

Tuesday, December 8, 10:30 am
Morrisville Senior Center
Borough Annex
31 E. Cleveland Ave
Morrisville, PA 19067

Thursday, December 10, 10:00 am
Lower Bucks Senior Activity Center
301 Wood St (Wood and Mulberry)
Bristol, PA 19007

Go to the Action page of our web site and check out the full page “Health Care Security” ad Bucks Voices ran last week in the Bucks County Courier Times, Doylestown Intelligencer and the Bucks County Herald: http://www.buckshealthcare.org/hc_action.html

If you haven’t done it yet or it’s been a while, please write, email or call your senators today to urge them to pass a strong health reform bill.

With the endorsement of AARP, American Medical Association, the American Cancer Society, President Obama, and millions of Americans, House Bill 3962 is scheduled to be voted on by the full House of Representatives on Saturday, November 7. The vote is expected to be very close as opponents are pulling out all the scare tactics to try to stop reform of a broken unaffordable system. This is an historic event. Never in our history have we come this close to having the first of two houses of Congress committing our nation to guaranteed needed health care for everyone.

We need you, your friends and family to call or e-mail your congressman before the vote on Saturday in support of this legislation. (click here)

Bucks Voices believes this hybrid bill, that includes both public and private roles, goes the farthest yet toward including the principles for reform the residents of Bucks County outlined over two years ago. (click here) We acknowledge that there is no perfect way to provide health care for 300 million people living in our country. What has become painfully clear is that our history, traditions, and jumble of laws have produced an oversized and inefficient machine that consumes resources disproportionately to what it produces. Millions of heartbreaking human stories resulting from our broken system have been publicly recorded during this debate. The picture is clear. Failure to make reforms now is not an option if we want a strong country and citizenry for the future.

Over the past year, these weekly updates have brought our readers straightforward explanations, analysis, innovative ideas, and resources surrounding the complex issue of health care in America so that they can be informed voices among the fog of disinformation. Our guiding vision and principles have kept us on track. Now we need to make our voices heard again in these final hours before the House of Representatives votes.

This is what HB3962 bill will do (with gratitude to www.faithfulreform.org for the update of the merged bill):

• Expand Medicaid to 150 percent of the federal poverty level could cover one third of those currently uninsured, including uninsured adults without children who were previously ineligible.
• With the individual mandate, it is estimated that 96 percent of us will be insured - if sufficient subsidies are made available to make premiums truly affordable, and if equitable out-of-pocket caps are enacted.
• An employer mandate will require that all businesses of certain sizes provide health insurance or pay into a fund through which workers could purchase their own insurance through an insurance exchange.
• An insurance exchange will be created to make standard affordable policies available for small business owners, for self-employed persons, and for those who are not insured through employers, Medicare, or Medicaid.
• “Guaranteed issue” will ensure that insurance companies will no longer be able to deny persons coverage because of pre-existing conditions, health status, gender or age. In addition, the ratio of premiums in these categories of coverage will be regulated.
• The proposed public health insurance option in the insurance exchange will provide a standard benefit package in an alternative to private for-profit insurance for small business owners, for self-employed persons, and for those who are not insured through employers, Medicare, or Medicaid. The public option will make affordable insurance available during job transitions.
• Coverage of young adults on parents’ policy until age 26.
• Increased funding for community health centers will improve access to health care among under-served populations.
• Minimum services to be covered include:
  −    hospitalization
  −    outpatient hospital and clinic services
  −    emergency care
  −    services of physicians and other health professionals
  −    prescription drugs
  −    rehabilitative and habilitative services
  −    mental health care
  −    substance use disorder services
  −    preventive services
  −    maternity care
  −    well baby and well child care, including oral health, vision and hearing services, equipment, and supplies at least for children under 21 years of age

• Provisions regarding the Indian Health Service will include improvements to facilities, attention to health and wellness promotion, and recruitment of Native Americans for health professions.
• The bill is entirely paid for, and will somewhat slow the growth of costs.
• Out-of-pocket expenses will be capped at $5,000 for individuals and $10,000 for families.
• Medicare recipients will see the elimination of cost sharing for preventive services and the reduction in the gap/doughnut hole in prescription drug coverage.
• Federal regulations will impose greater responsibility upon the insurance and pharmaceutical industries and medical providers to control costs.
• Individuals will be required to have insurance. Federal sliding-scale subsidies will be available to workers who earn too much for Medicaid eligibility, but are too young for Medicare, and cannot afford to purchase insurance. An individual mandate which will put millions more people in for-profit insurance policies.
• Tax credits are projected for more small businesses to help make premium costs for workers’ insurance more affordable.
• Annual and lifetime coverage caps will be eliminated.
• Employers with payrolls over $500,000 per year must offer coverage with certain benefits or pay a fee equal to a percentage of their payroll. (86 percent of employers would likely be exempt.)
• The penalty on individuals for not having insurance is 2.5 percent of adjusted gross income, with the penalty waived for households with hardships based on their individual circumstances.
• A 5.4 percent surcharge will be assessed on incomes over $1,000,000 for households and $500,000 for individuals.
• Insurers in the group market will be required to spend a minimum of 85 percent of their premium dollars on health care (called the medical loss ratio), rather than on profit, administration and advertising. Currently to some insurance companies spend just 60 percent [Source: Families USA].
• A health insurer may rescind health insurance coverage only upon “clear and convincing evidence of fraud” with action subject to notification and independent third-party review.
• Competition in the insurance marketplace will be increased by eliminating the antitrust exemption for health insurers, which previously allowed price fixing and the creation of monopolies in particular markets.
• New tools will address waste, fraud, and abuse with the entire health system.
• Research will be conducted, supported, and synthesized to identify best practices in preventing, diagnosing, treating and managing diseases, disorders and other health conditions.
• Incentives for providing care will change. Instead of over-payment for services rendered, doctors and hospitals that demonstrate improved health outcomes will be rewarded.
• Investments in advancing health information technology and other efforts to coordinate care will improve the provision of complimentary treatments and significantly reduce errors.
• Public reporting on health care-associated infections in hospitals and ambulatory surgical centers will be required and coordinated within new protocols.
• Whistleblower protections will be implemented.
• Reform will establish federal rules for health insurance, which is now regulated mainly by states.
• Standard benefits will be defined by federal regulation and plans will be offered through an insurance exchange to help purchasers fully understand the benefits and costs of their choices.

Robert Reich speaks directly on what the ‘public option’ is and why it is so important to health care reform.

• Big Insurance: Sick of It Rally for Health Insurance Reform
  Tuesday, Sept. 22, 4:45 pm
  Dilworth Plaza, NW corner of City Hall in Philadelphia
  Speakers include former Cigna Executive, and insurance company whistleblower, Wendell Potter, AFL-CIO Executive Vice President Arlene Holt Baker, and Pennsylvanians who have suffered at the hand of Cigna.
• Several organizations, such as HealthCare4AllPA, are sponsoring a rally on Tuesday, Oct. 20, from 10-12 noon, called “Single Payer - The Economic Solution: PA 2009 / The United States 2010,” at the State Capitol, Harrisburg, PA. Former CIGNA Executive Wendell Potter, California Nurses Association organizer Donna Smith, and HealthCare4ALLPA Executive Director Chuck Pennacchio are confirmed speakers. For more details, see http://www.healthcare4allpa.org/rally.htm.

• Weekly vigil, Wednesdays, 5:30-6:30 p.m., corners of State and Main Streets in Doylestown.
• Rally to send Congressman Murphy back to D.C. to get health care reform done! Saturday, September 5 beginning at 10:30 a.m., Lions Park, Mill and Radcliffe Streets, in Bristol Borough.
• President Obama’s address to Congress Wednesday evening, September 9.

Congressman Patrick Murphy will hold two Congress on Your Corner events tomorrow, Saturday, Aug. 1:

• 1 p.m. at Concerto Fusion, 2 South Delmorr Avenue in Morrisville
• 3:30 p.m. at the Acme on New Falls Road in Levittown

The Intel and the Courier Times are to be there. It’s very likely that people opposed to health care reform will show up to try to derail the chance of a good bill passing this year (Teabaggers are mobilizing and Rep. Murphy is a target). Penn Action is encouraging a calm, peaceful presence that supports a strong public option, regulations on the insurance industry and quality, affordable health care for everyone.

Seats usually start to fill up an hour before the event. Please invite people to join you at one of the sites tomorrow. Please take the time to come out yourself - remember, Democracy is not a spectator sport.

J.D. Mullane’s column in the Bucks County Courier-Times has been promulgating the latest bit of right-wing, anti-health-care-reform propaganda, namely that the current House Bill promotes “suicide for seniors.”  He calls Section 1233 of the proposed legislation the “Angel of Death” clause, claiming that it mandates that senior citizens will be denied “pricey” medical treatments under any government run health care program.  Of course, this nonsense–which is widely circulating in GOP circles and has cropped up on “conservative” news programs–is totally false; and it is designed solely to scare senior citizens into opposing reform.

In fact, Section 1233 of the proposed House Health Care Reform Bill does only one thing:  it authorizes Medicare to pay for an “Advance Care Planning Consultation” between a patient and the doctor of his or her choice once every 5 years.  Such a conference is entirely voluntary; and its purpose is to ascertain the patient’s wishes as to the treatment the patient wants if he or she is comatose or unable to communicate with relatives or medical providers, e.g., the Terry Schiavo situation.  At such a “Consultation,” the patient is to be advised of his or her right to have a Living Will, a health care power of attorney or other written instructions which would become part of the patient’s medical records and insure that treatment is in accordance with the patient’s own wishes.  Contrary to the “suicide” screamers, the language of Section 1233 (or “Page 425″ as it referred to in some of propaganda e-mails) does not in any way require the patient to adopt a Living Will, or to choose to “pull the plug” in the event of brain death.  As I pointed out to Mr. Mullane, under this Bill, the patient could just as easily specify that he or she wanted to continue life support no matter what–so it could become an “Angel of Life” clause for those that want that outcome.

Moreover, Section 1233 of the proposed act says absolutely nothing about denying medical care to seniors because of cost (or any other reason other than a patient’s choice in a Living Will).  That is a claim invented by anti-reform zealots, led by the American Association of Physicians and Surgeons–an organization that opposed Medicare and attacks any and all forms of government provided health care. However, the issue of cost of senior care has arisen in a different context, not from the health care legislation being debated in Congress, but from recent medical studies published in professional journals.  For example, several studies have shown that coronary by-pass surgery–one of the most common major surgeries in the US–does not extend patient lives, and in the case of seniors, may shorten life (due to the deaths and complications from surgery which by-pass operations entail for the elderly).  Similarly, some major studies on prostate cancer treatments have established that the currently available treatments, like radiation, chemotherapy and prostate removal, are probably unnecessary for men over 60 because they are more likely to die from other causes before the slow-growing prostate cancer can kill them.  Since prostate surgery has serious and frequent side effects–like incontinence, impotence and perpetual pain–this is information that men need to have before agreeing to surgery.

The House bill does not, as its opponents claim, mandate that senior citizens even get current information on the efficacy of expensive drug and surgical treatments, as compared with other alternatives which might provide a better quality of life without sacrificing the potential for maintaining the patient’s life.  This is something that should be added to the reform legislation as patients should be provided with all alternatives before agreeing to some treatment plan which could kill them or destroy their ability to enjoy their last years.  So rather than mandating that seniors be denied any treatment on “price” grounds, the real hole in the current bill is that it does not do enough to promote “evidence-based” medicine, by giving patients the results of recent studies which would affect their free choice of treatments.

Medicare: Made in America – DC Lobby Day and Single-Payer Rally
Celebrate Medicare’s 44th Birthday by showing Congress and President Obama the people, unions, doctors, nurses, seniors, faith groups, and Americans of every stripe support a single-payer system.

Polls consistently show that the public supports a Medicare for All system, and 59% of physicians support it. In the face of inadequate reform to our health care system, we want Congress to make sure our voice is heard.

Rally starts at 1 pm - 2 pm in the Upper Senate Park on July 30.

9am - 11:30 am Volunteers needed for morning drop to all Members of Congress. Meet in Room 2138 Judiciary Committee Room of Rayburn House Building for materials to deliver to every member of Congress! Email info@healthcare-now.org if you plan to help with the morning lobby visits.

2pm onward - Activists will take to the hill for meetings with Members of Congress. If you need help in setting up a meeting with your Member, please email info@healthcare-now.org. Lobby materials will be available in the Judiciary Committee Room for pick up on the day of the meetings. They will be posted here shortly to download in advance.

For more information and a map, click here.

Former Senators Bob Dole (Republican), Howard Baker (Republican), John Daschle (Democrat), and, until he became special envoy for President Obama, George Mitchell (Democrat) got together in 2008 to start a process of developing a bi-partisan solution to our health care crisis. They began their work by setting a vision and establishing principles for reform. The report entitled, Crossing Our Lines: Working Together to Reform the U.S. Health System aims to provide quality, affordable health coverage for all Americans and includes recommendations to improve quality and controls cost. The Leaders’ Project plan centers around four key “pillars” for reform:

• Promote high-quality, high-value care;
• Make health insurance available, meaningful and affordable;
• Emphasize and support personal responsibility and healthy choices; and
• Develop a workable, sustainable approach to health care financing.

The report covers key, and often controversial, issues including:

• The need for strong insurance reforms that require guaranteed issue;
• Elimination of medical underwriting for pre-existing conditions and rating limitations;
• New state and regional coverage options through exchanges;
• Reforms that constrain cost growth; and
• Financial assistance through Medicaid and tax credits.

Each side made compromises.  In the end, they found common ground for comprehensive health care reform that is budget neutral and commits to quality and value-instead of quantity and volume-to improve medical outcomes and constrain unsustainable cost growth.
In the news release announcing the plan, Senator Baker said, “Health reform can be achieved. But in order for that to happen we must work beyond our points of disagreement and focus on reaching bipartisan solutions to create the health care system that the American people deserve.”

Addressing the compromises the Leaders made in developing this report, Senator Daschle said, “A number of proposals would have looked different if they had been crafted by only Democrats or only Republicans. But in the spirit of our bipartisan effort, my colleagues and I agreed to this compromise in the hopes that we can begin to bridge any rifts in the debate and move forward with achieving our common goal of reforming the health care system.”

Senator Dole stressed the need for preventive care and personal responsibility. “We need to improve health care delivery, while providing individuals with the knowledge, tools and choices they need to be accountable for their health,” he said. “These and other reforms are needed to fix the nation’s ‘sick care’ system.”

Now if only the current congress would work in the same spirit, we could really have systemic reform in the coming legislation this fall. Read the report here.

As the drive for health care reform moves forward, Bucks Voices for Health Care Reform is supporting Organizing for America, Central Bucks Chapter, in a community blood drive to be conducted by the American Red Cross.

Join us for a
Blood Drive, Story Collection, Art Display, Tab Collection

Wednesday, July 1
2 - 8 p.m.
Buckingham Green Shopping Center
Route 202, Buckingham

• It takes less than an hour of your time to give blood. Our community needs your donation, and summertime is traditionally one of shortage.
• Tell your health care story. Make a written record of your story.
• See some examples from an amazing artwork project by Theresa BrownGold, who is documenting people’s health care stories with their portraits and a brief summary of their circumstances.
• Bring tabs from aluminum (soda, soup, beer) cans. They will be donated to the Ronald McDonald House.

Come for any or all of these components, but come.

Please reply to Anne Marie Jordan (amjordan99@comcast.net or 267-265-1540) with the time you can come to give blood. You will receive a confirmation. Appointments are set for every 15 minutes.