Sunday, 13 April 2014

Vermont's Answer to the Affordable Care Act: Treat State like a Big Buisness

In 2011 Vermont passed a bill creating Green Mountain Care, the first State run health insurance.  Its passage ushered in a new chapter in the health-insurance debate.  Asking for the first time in a long time, why is health insurance connect to employment?

From Vermont.gov:
"Green Mountain Care will use the federally-mandated Health Benefit Exchange infrastructure as a springboard, but it will be a completely new type of system.  The goals of Act 48 are to:

  • Improve the health of Vermonters
  • Reduce the rate of growth of Vermont’s health care costs         
  • Enhance the quality of care and experience of patients and providers
  • Recruit high-quality health care professionals to practice in Vermont
  • Simplify and streamline administrative and claims processes to reduce overhead and enhance efficiency"
Basically, Vermont is breaking the link between employment and health-insurance.  It is a great opportunity to see what American Single Payer Health might look.

Their big question is how to you raise the $2B needed to pay for it.  They know that Vermonters pay well over $2.3B/yr in insurance premium, yet they are afraid to ask Vermonters to pay some type of similar insurance premium/subsidy to a government run insurance program.  

One of leaders behind the bill explained how much more cost effective it would be for a company of the size of Vermont to self-insure and how every actuary and consultant would advise the move. Ironically, many health business executives shutter at the thought of a single-payer system.  Mainly due to the economy of scale that adjust the cost-benefit scale away from illness and towards health.  When the system is large enough and payed for in a closed loop, an increase in population health means decrease in overall health spending.  

As we enter the next generation of the fights in health-equity, Vermont might prove to be a great lab. The bill, in the very least, brings into clear view some of the hypocrisy of the current system.  

A great video explaining the current debate:


for a super wonky video:

 

Tuesday, 25 March 2014

Leaving it all on the ... table

My office is all a flurry with the upcoming deadline for folks to get insured. (hint, hint) We are following a mantra of "leaving it all on the field".  Last night, I fear I took it all a bit too far.

I was at a friend's house (Mike) about to have dinner, noshing on bread with super delicious olive oil (from costco, by the way), I used one of his super sharp bread knives (also from costco) and amputated what is known in some circles as my LI-01 in others the side/tip of my left index finger.  Oddly enough, as it was happening, I felt this feeling that it was happening for a reason.

Mike left to get bandages, then returned for more, only to finally admit the need for an ER.  During that time, I hung out with the pain.    Hanging out with pain is interesting.  Not the easiest friend, but sure teaches me a ton!  This pain vacillated between a super hot burn, throbbing, that horrid "bending your fingernail back" pain, severe paper cut, and a weird hand contraction.

We rushed up to Washington Hospital Center, the hospital nearest my house.  With a flesh wound like this, I thought better because their MRSA rates have been higher than other hospitals.  But decided that I didn't want to trouble Mike too much and it is "just right there".  Well...

We were diverted due to the construction of McMillian Park construction.  I took us 10 minutes just to get back on track towards the hospital.  Then due to unfamiliarity and because the signs are ridiculously unhelpful, we ended up at 4 different no ER entrances, before I got out at the ER. What I saw was terrifying.

It was a crush of people.  At least 100, probably more.  Heaps of children. People just looked so in pain and sick: miserable.  It felt like a den of agony and despair.  I felt compelled out and literally ran out calling out to Mike to stop him. (Big flesh wound.  + MRSA = please bless never me!) I told him I what I found and we went to Sibley.

The flags are the perimeter of the property
and the rusted metal roofs are the slums.
The hotel's water wasn't potable, but
a waiter with top-hat and gloves would bring bottled water
Addis Ababa, PEPFAR Annual Meeting 2005
90 minutes after the accident, I'm in the Sibley ER and its like violins are playing. Oh wait, there was classical music playing.  It was a completely different experience. Even just the smell upon first entering the building smelt completely cleaner. Wonderful care, happy pleasant staff.  I was in a fixed up in less than an hour and I never once felt anything other than care.

Any ideas on how these stark differences are allowed to exist in a moral society?


I've written about the staggering inequality I experienced in Addis looking out the Sheraton Hotel across my 7-Star balcony to the slums.  Well, it isn't so far away.  Its blocks from my house.

Witnessing the inequality in such an intimate way has been the most painful part of this whole thing.  It is the only part that makes me cry about it.  There is something really immoral in our society if this is how things are.  And it is so.

In acupuncture the point I amputated has been described as:

Large Intestine 1 Merchant Yang
mike took this photo and is owed a medal
for being such a good friend last night!
Merchants know the value of things. Their success depends on their acquisition and sale or exchange of things people want and need, as well as the elimination of what is old, stale or unnecessary. A "yang" merchant is one who is vibrant and active. There will be no accumulation of rubbish in this merchant's shop. What will be found there will be of the highest quality, impeccably fresh and clean.
Many patients have accumulated so much rubbish – physically, mentally and spiritually - that they have lost touch with what is innately pure, incorruptible and eternal. Using this point on the metal-imbalanced patient in such a state is akin to cleaning layers of debris from a stone and revealing a dazzling diamond beneath.   
My my diamond be dazzling!  :)

In the meantime, I will be visiting a hand surgeon to get the nerves healed up.

Please, make sure you have health insurance.  I believe that everyone having insurance is the first step in getting things more humane.  (Next is disconnecting insurance from employment ... a-whole-nother story.)


closer look at slums.


Thursday, 6 March 2014

Conference Call with President Obama with Faith Leaders on Health Insurance


 
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Friends –
 
The White House Office of Faith-based and Neighborhood Partnerships invites you to join President Obama for a conference call on Monday, March 10th at 1:30pm ET.

President Obama wants to thank all of the faith and community leaders across the country who are working hard to help millions of Americans access affordable, quality health coverage.  As you know, one of the President’s top priorities is to ensure that Americans get covered by enrolling in the health insurance marketplace before the March 31
st deadline, and he looks forward to discussing these issues with you.

Thank you for your work and continued support. Please feel free to share this invitation with other community contacts who would be interested in this work.  We hope you will be able to join us.

*This call is off the record and not for press purposes. 

WHEN: 
Date: Monday, March 10, 2014

Time: 1:30pm ET
 
HOW:
To accept this meeting invitation, please RSVP to AT&T Executive TeleConference.
When can I RSVP?
- You can begin registering upon receipt of the invitation and up to the scheduled start of the call.
How do I RSVP?
- Phone: 877-471-4350; 402-516-0110 for international callers
To RSVP, what do I provide?
- Conference ID: 321632
- Name, Organization, and Email Address
To participate on the call on Monday, what will I need?
- Dial-in number provided when you RSVP to AT&T. Please print or write down the call-in number for your records.
- Conference ID: 321632

Peace

Sunday, 19 January 2014

Dawn of a New Day in American Governance



I take umbrage with what Michael Aron's dismissiveness about this as just a extreme use of "political juice". The rest of the panel gave to much deference to him, someone should have pointed out that Mayor Zimmer had just demonstrated that those days of corrupt politics were supposed to be over, and that the behavior was not normal but totally absolutely abusive.

I hope most Americans believe that government works with integrity and for the their best interest. If we have lost this, then it is time to remake the government as one that does represent you, because, democracy is by the people and for the people.

This behavior is reprehensible and many who are in our very dysfunctional government live by much higher standards as evidenced by Mayor Zimmer.
May many more Mayor Zimmer's stand up against this tide of corruption!

I can't figure out how to embed iframe in blogger so instead of video here, i can only paste a link.  but check out this video ... if you know the story skip to 6:10 when the panel kicks off.  Mr. Aron makes his old timey comment there.


Deconstructing the power structure of New Jersey 
The Chris Christie bridge scandal could go beyond just a traffic jam and instead reach far into the whole power structure of the governor’s office, and the politics of New Jersey itself. Brian Murphy, Michael Aron, Josh Barro and Dafna Linzer discuss.

*whole thing smells to me of organized crime.





Monday, 6 January 2014

Webinars on the Health Care Law

The HHS Partnership Center has updated webinars on the health care law for faith and community leaders. All webinars are open to the public and include a question and answer session.
 
To participate in one of the webinars, please select your preferred topic from the list below and submit the necessary information. Please click on the title of the webinar and fill out the registration form. After registering you will receive an e-mail confirmation containing information about joining the webinar. Please contact us at ACA101@hhs.gov if you have problems registering or if you have any questions about the health care law.
 
You may also join the webinar by telephone only. The phone number, access code and pin (the pin is # for those connecting by phone only) are listed below. All webinars are one hour.
 
Please note that the first 1,000 people who join each webinar at the start time are able to attend. If there is significant interest in a webinar, we will do our best to schedule another session. If possible, please use your computer speakers to listen to the audio portion of the webinar. .
 
 
 
January 8 at 7:00pm ET
(6 pm CT, 5 pm MT, 4 pm PT)
Special Wednesday Night Session!
 
To Join By Phone Only, Dial: 877-309-2074 or 415-655-0069, Access Code: 198-993-183,
The Pin Number is # with no numbers when connecting by phone only
 
According to the Census Bureau, nearly 16 million Hispanics are uninsured. When key parts of the health care law take effect in 2014, there will be a new way for individuals and families to get health insurance. This webinar is co-sponsored by the Administration for Children and Families and the HHS Center for Faith-Based and Neighborhood Partnerships. Please send your questions toACA101@hhs.gov by noon on January 8.
 
 
January 11 at 3:00 pm ET
(2 pm CT, 1 pm MT, Noon PT)
Special Saturday Afternoon Session!
 
To Join By Phone Only, Dial: 866-901-6455 or 646-307-1001, Access Code: 533-109-083
The Pin Number is # with no numbers when connecting by phone only
 
 
According to the Census Bureau, nearly 16 million Hispanics are uninsured. When key parts of the health care law take effect in 2014, there will be a new way for individuals and families to get health insurance. This webinar is co-sponsored by the Administration for Children and Families and the HHS Center for Faith-Based and Neighborhood Partnerships. Please send your questions by 3 pm on January 10 to ACA101@hhs.gov.
 
 
*en español*

Organizado por el Centro para las Asociaciones Religiosas y Comunitarias del Departamento de Salud y Servicios Humanos de los Estados Unidos
 
Sabado, 11 de enero 3:00 – 4:00 pm ET
(2 pm CT, 1 pm MT, Noon PT)
 
To Join By Phone Only, Dial: 866-901-6455 or 646-307-1001, Access Code: 533-109-083
The Pin Number is # with no numbers when connecting by phone only
 
 
Para inscribirse para participar en la presentaciόn, haga clic aquí
 
Después de inscribirse usted recibirá un correo electrόnico de con más informaciόn sobre la presentaciόn.

Por favor envίe sus preguntas, comentarios y sugerencias a ACA101@hhs.gov
 
 
January 15 at 1:00 pm ET
(Noon pm CT, 11 am MT, 10 am PT)
 
To Join By Phone Only, Dial 702-489-0008, Access Code: 892-455-196
The Pin Number is # with no numbers when connecting by phone only
 
We are in the open enrollment period for health insurance in the Health Insurance Marketplace. We will explain the health care law, show you how to shop for plans using our new window shopping tool, explain how to enroll, and answer your questions. Open enrollment ends on March 31, 2014. Please send any questions to ACA101@hhs.gov prior to January 15 at 10 am ET.
 
 
 
January 30 at 3:00 pm ET
(2:00 pm CT, 1:00 pm MT, Noon PT)
 
To Join By Phone Only, Dial 314-627-1518, Access Code: 685-210-347
The Pin Number is # with no numbers when connecting by phone only
If you have questions about the health care law, the Affordable Care Act, this is the webinar for you! We will answer questions that have been submitted in advance as well as new questions asked during the webinar. Please send your questions by January 30 at 10 am to ACA101@hhs.gov.
 
 
February 4 at 3:00 pm ET
(2pm CT, 1 pm MT, Noon PT)
 
To Join By Phone Only, Dial 702-489-0008, Access Code: 217-541-652
The Pin Number is # with no numbers when connecting by phone only
 
We are in the open enrollment period for health insurance in the Health Insurance Marketplace. We will explain the health care law, show you how to shop for plans using our new window shopping tool, explain how to enroll, and answer your questions. Open enrollment ends on March 31, 2014. Please send any questions to ACA101@hhs.gov prior to February 4 at 10 am ET.
 
 
 
February 20 at 1:00 pm ET
(Noon CT, 11 am MT, 10 am PT)
To Join By Phone Only, Dial 702-489-0007, Access Code: 457-547-210
The Pin Number is # with no numbers when connecting by phone only
 
If you have questions about the health care law, the Affordable Care Act, this is the webinar for you! We will answer questions that have been submitted in advance as well as new questions asked during the webinar. Please send your questions by February 20 at 10 am ET to ACA101@hhs.gov.