Monday, December 29, 2008

Part Two: Health Care forum report for Obama-Biden Transition Team

[This is Part Two of the report from Dec. 15 Health Care discussions by the North Beach for Progress group]

• Is it fair to ask insurance companies or taxpayers to take care of the consequences of people refusing to take care of themselves? An example is the prediction that 1/3 of children today will end up at some point with diabetes. We KNOW that lack of exercise and a diet high in refined sugars and carbohydrates causes this disease, yet the fast food industry thrives and most products in our children’s cereal boxes, lunch trays, snacks and drinks are poison to people with this condition. Should society, in the form of taxes or health care insurance costs have to be obligated for this lack of personal care?
• In fairness, many people don’t have the education, time, money, or incentive to either understand the choices that are available, or the ability to make the changes.
• We need to stop Cola ads the same way we stopped cigarette adds.
• We need to curb the fast food industries’ reliance on highly processed nutritionally deficient foods and provide more vegetables and whole grains.
• We need to have a public advertising campaign that makes healthy food and exercise and health choices a “cool” thing, and find some way to create incentives for people to make better choices.

• An excessive 20% to 30% of time is spent on paperwork & billing & other non-patient activities, significantly reducing the amount of time available to spend with patients.
• The high costs of medical education (about $160,000) and malpractice insurance limit the kinds of care they can offer and creates an imperative of choices doctors have to make to stay in business. There is a need for more primary care physicians, but they are dwindling in number as it becomes difficult to afford to pay back school costs.
• Due to legal, insurance and administrative costs, doctors are in a position where they must practice defensively, rather than what is in the best interest of the patient.
• No reason or consistency in denial of claims from insurance companies, good Drs. are leaving practice, can’t afford to cover costs on what insurance companies will pay, and their whim of when they will pay or deny, even on pre-approved items.
• Large uninsured population in Florida
• We need to make a decision about what part money plays in the type of services available. Here, cost is paramount in decision making as opposed to human care.

• Procedures, tests and referrals are limited or disallowed to provide cost savings. Drs. are paid far below UCR per patient visit, necessitating overfilling of treatment slots. Quality of care is often inferior.
• Consider efficacy of eliminating managed care.

We applaud Obama’s vision of expanding promotion and coverage of preventive medicine, but the understanding of what is prevention needs to be greatly broadened. Early screening for cancer is a great idea, but early detection in the fight against a disease is NOT prevention. Broadly speaking, prevention is about building our health, not fighting disease. It is building our immune system, keeping our body strong and cleansed of toxins; about dealing appropriately with stress and working to bring our lives into balance: physically, mentally, emotionally and spiritually. We perform regular maintenance on our cars so they won’t break down, but wait until we are sick or ailing before we take care. Western medicine is great at fighting disease, but it is complementary medicines such as Acupuncture, Homeopathy, Massage Therapy and Chiropractic that are best at helping people stay well by maximizing optimal balance and function, and relieving stress. If we brought ourselves in for seasonal “tune-ups” like our cars, the “machine” of our body would have far fewer breakdowns. Lifestyle choices like the food we eat, type of exercise, cleanliness of our environment, how we deal with stress, how we balance our personal, professional and spiritual lives; all of these are what we must look at if we are going to promote preventive medicine. And we need prevention inculcated from elementary school onwards so children learn how to keep themselves sound of Body/Mind/&Spirit.
Another aspect of understanding what preventive medicine is about is the screaming child. When our child starts screaming we are alerted to their being in distress, that something is needed to help them, and maybe we look and see a big red hot swollen bump and realize that’s where they fell and that’s the place that needs the icepack. We respond with what they need, they feel better and the crying stops. No one would think that an appropriate intervention would be to tranquilize their vocal cords to stop the screaming, yet that is in fact what much of our accepted standard of care does in suppressing symptoms. We need to learn to reach for the natural remedies that support our body first before we turn to the big guns of drugs and invasive procedures. A cup of chamomile tea often works to calm an upset stomach and nerves and is certainly worth a try before reaching for the medications with their higher costs and side effects.

• Must be very careful to make sure policy is not unduly influenced by self serving motives of pharmaceutical companies, lobbyists, legal profession, providers with special interests (AMA) to the exclusion of other forms of care that serve patient and public needs.
• Confusing health insurance with health care: we are paying for insurance, not treatment.
• Reduce technology where it causes excessive time away from actual patient care and evaluation, and where it removes the ability for human oversight and individual response. And…
• Make technological resources available to practitioners, including those in smaller private practices not associated with hospitals or institutions.
• Stress public plan option to force existing companies to promote health rather than stockholders.
• Revamp how providers are going to get paid.
• Provide universal health care with tight transparency and accountability. Our citizens should neither fear ill health due to horrendous bills nor should they feel alienated from the health care facilities due to impersonalness, excessive emergency care waits.........poorly trained or exhausted nurses and doctors.
• Use lottery slush fund resources to fund community health projects.
• The pharmaceutical industry needs to be made into a tool of a health care system that provides safe and totally proven effective remedies.
• Since medical school costs are prohibitive and the ability to take loans is shrinking, provide medical school training to qualified students in exchange for their working in community based not-for-profit clinics for a certain number of years upon graduation and licensing.

• Feedback from administration on these community conversations that this participation has a chance to create effect will increase motivation for continued involvement.
• Support Health Care Freedom lobbyist in Tallahassee
• Watch congressional hearings, call and write to representatives
• We need a spirit of volunteerisms and a toppling of laissez faire mentality for health matters.

[MORE in following blog post]

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