The Health Care Debate the Media Missed

Dr. Jon LaPook Attends A Town Hall And Finds Holes In The Debate

(CBS)  Last weekend I was in Vermont on vacation when I heard that Senator Bernie Sanders was hosting a town meeting on health care. On Saturday, August 15, I grabbed my video camera and went to the afternoon meeting of an estimated 450 people in the small town of Arlington. Their voices were passionate and emotional but civil and respectful. Although it was a hot summer day, tempers simmered but never boiled over. That makes for good discussion but bad television. Absent fiery sound bites, the event flew under the radar of most media.

Two microphones were set up, one for people who support health care reform and the other for people who don't. At one mike , a diabetic iron worker who called himself a "proud blue collar guy" described what it felt like to be out of work and have no health insurance. A woman with breast cancer and no insurance told us about having to sell "everything we had worked for" to pay for her treatment. At the other mike, a woman asked "why we need a system for everyone." A man voiced his distrust of the government, saying it can't run Social Security, Medicare or the post office so why should he trust it with health care reform.

CBSNews.com Special Report: Health Care

Senator Sanders listened carefully, spoke thoughtfully, and welcomed opinions on both sides of the issue. But I do think there was a moment of missed opportunity. At one point a woman, referring to the health care reform bill ( H.R. 3200), introduced in the House of Representatives, asked Senator Sanders "Have you read the entire thing?" He admitted, "No, ‘cause I'm not in the House." She then went on to read from a piece of paper, saying "Page 430, lines 11 through 15, the government will decide what level of treatment you will have at the end of your life. It IS in that bill." The Senator responded, "That is not in that bill. Sarah Palin notwithstanding, that is not in that bill." The Senator was referring to Sarah Palin's contention that the current health care reform proposals would lead to "Obama's ‘death panel'" deciding who is "worthy of health care."

A more specific response from the Senator would have been more instructive to the crowd. I looked up that section and it refers to Medicare covering for the first time doctor-patient consultations about end of life planning such as drawing up a living will or planning hospice treatment. It describes "advance care planning," clearly stating (on page 424, lines 21-23) "the term ‘advance care planning' means a consultation between the individual and a practitioner." It is NOT about an interaction between the individual and the government.

The fact that so few people have actually read the bill is a formula for mischief. Imagine if everybody in your English literature class - including the teacher - had only read the Cliffs Notes of the books being discussed. Granted, the bill is 1017 pages long and is filled with cryptic language. But there are only a few sections that have led to widespread misinterpretation such as the death panel myth. Members of Congress should read the actual language of these passages rather than rely on summaries.

I left the meeting impressed by the tone of the conversation. In his closing remarks, Senator Sanders said he was proud that "we live in a state where people can have different points of view and yet we can listen to each other and we can treat each other with respect." Respectful listening by people with diametrically opposed points of view won't usually end up in the headlines but it does end up on today's episode of CBS Doc Dot Com. I look forward to your comments.


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[babooph]

"Media" also missed all the years US insurance medical claims are sent to be examined in the 3rd world,a percent of what is DENIED is the payoff !!!

[ConDale]

My problem with the town hall meetings and the medias coverage is the fact that more "specific responses" are not offered. I realize the Health Care Bill is over 1,000 pages long, but if we are to make intelligent decisions regarding this very important issue, the public needs the media and our Senators to offer the "facts" and not rhetoric.

[PodGuy2881]

I am a resident at a major NY city hospital, seeing what really goes on in the healthcare world behind the scenes is scary. I started a blog about it, and my recent entry is about illegal aliens getting free healthcare. If anyone wants to check it out, the like is: http://realworldhealthcare.blogspot.com/

[wmb1957]

No, my belief is that both illegal aliens, and nonresident aliens should be required to get coverage, but at full price.

For example, I do not believe that exempt employers or those employers that receive a subsidy should get one for nonresident workers, such as H1-B visas or illegal aliens.

I do not believe illegal aliens or nonresident aliens should get a lower premium at the expense US citizens and those that are eligible to work here legally.



------------------
by misha256 August 21, 2009 8:44 AM EDT
by wmb1957 August 20, 2009 11:16 PM EDT
So, yes, they do get covered by the bill. As complete coverage as anyone with insurance.

----

Not all insurance including that offered in the US covers medical care overseas -- visitors should be able to purchase insurance at the NORMAL price (no government assistance). Are you some kind of barbarian that would not allow a visitor to insure their potential medical needs?

[wmb1957]

Your reading comprehension skills would be better if you read my complete posting. Fact check didn't read the whole bill as a whole then. The also confused affordibility credits with insurance or services apparently.

This section cvoers only affordiblity credits.
Subtitle C?Individual Affordability Credits
SEC. 246. NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS.
Nothing in this subtitle shall allow Federal payments for
affordability credits on behalf of individuals who are not lawfully
present in the United States.

This section prohibits discrimination on "personal characteristics extraneous to the provision of high quality health care or related services."

Immigration status is not a "personal characteristics extraneous to the provision of high quality health care or related services."

Subtitle F?Relation to Other Requirements; Miscellaneous
Sec. 152. Prohibiting discrimination in health care.
(a) In General.--Except as otherwise explicitly permitted by this
Act and by subsequent regulations consistent with this Act, all health
care and related services (including insurance coverage and public
health activities) covered by this Act shall be provided without regard
to personal characteristics extraneous to the provision of high quality
health care or related services.


>>>>>>>>> by wmb1957 August 20, 2009 11:16 PM EDT
I've read it and I still have questions about it. Mainly because what I read conflicts with much of what the Democrats are telling me it says.

One example, will H.R. 3200 cover illegal aliens. Yes, the way I read the bill.

Subtitle F Section 152 prohibits discrimination in health care. Requires that health care be provided without regard to "personal characteristics extraneous to the provision of high quality
health care or related services." That is all kinds of health care, including insurance.

Subtitle C Sec. 246, the only part that refers to "undocumented aliens" applies only to Subtitle C, and prohibits the Federal payment of affordibility credits only.

So, yes, they do get covered by the bill. As complete coverage as anyone with insurance.

>>>>>>>>>>>>>by america4ever August 20, 2009 11:41 PM EDT

You are a fool.

H.R. 3200: Sec 246 ? NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS

Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.

http://factcheck.org/2009/08/seven-falsehoods-about-health-care/

[america4ever]

Does it strike anyone else the the people who whine the most about big government are the right wing welfare queens?

This is how much each state takes from the big bad federal government for each dollar they pay in. Despite Barrack Obama winning 365 to McCain's 173 electoral votes notice that McCain won almost all of the top ten welfare states.

Unproductive welfare states:
New Mexico $2.03 Obama
Mississippi $2.02 McCain
Alaska $1.84 McCain
Louisiana $1.78 McCain
West Virginia $1.76 McCain
North Dakota $1.68 McCain
Alabama $1.66 McCain
South Dakota $1.53 McCain
Kentucky $1.51 McCain
Virginia $1.51 Obama
----------------------------

Hard working taxpaying states:
Colorado $0.81 Obama
New York $0.79 Obama
California $0.78 Obama
Deleware $0.77 Obama
Illinois $0.75 Obama
Minnesota $0.72 Obama
New Hampshire $0.71 Obama
Connecticut $0.69 Obama
Nevada $0.65 Obama
New Jersey $0.61 Obama

If you don't like socialism send back the checks deadbeats!

[robham777]

We're an anomaly: we insist on 'for profit' health insurance, and not only is it KILLING us financially, but it doesn't even insure 50 million people! And 18,000 of THEM DIE EACH YEAR

Really so the death rate among the uninsured is under 4% while the average in the U.S. is something in the order of 8%. You have proven your point! The insurance companies have scammed us.

I just need to find that 1 800 number to cancel my policy.

[auntc3]

no doubt about it we need healthcare reform now before the insurance companies bury all of us.

[ubrew12]

The country is bankrupt, its broke.
We CAN make money from nothing, however, and here is how:
We spend $2.2 trillion on healthcare every year, and its widely known that we spend TWICE as much on it as any of our trading partners spend, for similar coverage and similar health outcomes. Hence, if we were to just switch over to the healthcare system practiced by most of our trading partners, like Britain, Canada, France, etc, we would immediately save ONE Trillion dollars every year.

We cannot afford NOT to do this. Once upon a time, this country could turn its back on a One trillion dollar a year savings, but not now. Its time, purely on fiscal responsibility issues, to embrace single payer nationalized health insurance.

[glenncinca-2009]

The patient-doctor consultation regarding end-of-life options sounds great on paper. However, the real problem is in how it might get implemented. With the federal government getting into the business of trying to contain health care costs, doctors could easily be incentivized by the government to sway the sick and dying toward low cost palliative measures instead of more "expensive" but effective medical treatments. This is the real crux of the issue that most people aren't seeing. And it all comes down to whether you trust some faceless government bureaucrat in a cubicle 2,000 miles away to make the right decision for you or your loved one. I certainly wouldn't.

[robham777]

"There shall be no administrative or judicial review under section 1869, 1878"

As far as I can tell this passage used six times in H.R. 3200 references sections from the Social Security Act(thank you shorty) which deal with accessibility too and compensation for benefits provided. I interpret this as "all decisions are final". These final decisions will be decided by a commissioner and the secretary(HHS). These decisions will not be based on your individual circumstances but rather your case history and statistical information(maybe you should take the pain killer). Is this not what we are currently offered by the private sector(the 85% to 90% of us currently covered). I would hope that whatever legislation ends up being passed would incorporate a system for appeals and take into account individual circumstances.

P.S. this information is for entertainment purposes only and I make no claims that my interpretation of this portion of the 1017 page document are accurate, and furthermore have had no contact with Limbaugh, Hannity, or Beck(he really gets under my skin).

[Califsue]

Thank you Doctor, we need more articles and some sensible dialogue.

Yes, I believe the media on all sides have not done this important topic justice.

[bcpats]

Apparently No one -- including Obama has read either version in its entirety. There are groups of folks assigned to various sections - - they interpret, compile and pass on their "take" on it, then those are combined and given to whomever to parrot out to the public. There is incomprehensible referencing back to obscure addendums of this that or the other. There was a gentleman on TV last night that stated that HIDDEN in the bill(s) is financing for such things as bike paths, hiking trails and the like ! ! ! Is that not more "pork"?????????? No one talks about that.

[fredwein]

Until such time as I have read the bill in its entirety I will refrain from comment.

[partagus7]

"A man voiced his distrust of the government, saying it can't run Social Security, Medicare or the post office so why should he trust it with health care reform."

That pretty much sums up my beef with all this too. Total lack of confidence in my governments ability to get anything right anymore.

And I'm still not sure why we must pay $1 trillion to get reform. If you make it law that the insurance companies cannot deny coverage for existing condidtions, cannot cap benefit payouts, cannot drop you... where is that costing the government any money? You could throw in some tort reform while you are at it for additional effect. You want more competition? Allow these insurance companies to sell nationally instead of state level policies.

I have heard folks mentioning these ideas and their representatives turn a deaf ear to them. They suggest that the bill is too complex for regular folks. If we actually understood what was written in there, we'd ALL be for it! We are just the confused masses. How elitist and above us they all must be to be senators and congressional representatives. What was I thinking to even question?

[jsd330]

partagus7

The problem is they are afraid of stepping on the states toes. State regulation kills insurance competition therefor higher costs and the states are the ones benifiting from your premium dollars.

[shortyfudpuc]

robham777. Look at the Social Security Act section 1869 & 1878. I believe this is what they are referring to. If you read enough of the bill you will find that they repeatedly refer to the Social Security Act and give section numbers like 1878....

Short

[robham777]

Thank you Short for actually answering a question. I have found the referenced material in the Social Security Act and will do the best I can to interpret the meaning.

[sgersonpt]

categorize the major aspects of the health care issue and seek to resolve them one at a time.

[FactsNotIdeology]

Health care is not the only issue the media dropped the ball on. They are unreliable, short-sighted, lacking in insight, driven by ratings, narcissistic,self-righteous and lazy. They were not even aware that many people who voted for Obama did so for health care reform, thus the media cannot understand how this issue slipped up on them. It is THE issue for people and even Obama doesn't see that. Blind leading the blind.

Hey, media, do you get this: what is the one factor in everyone's life that determines physical and financial health, the one factor that overrides all other issues as far as a family's or individual's time, budget, security, well-being? If your insurance premium, if you are given the privilege of obtaining insurance, is more than your income, what is the outcome? Shame on the media crackpots for the spin and the ignorance.

[auntc3]

well said

[robham777]

GildaRadnerNeverMind

Google Nataline Sarkisyan. Her death was about the profit margin of private insurance. That should scare people!


http://abcnews.go.com/Health/story?id=5517492&page=1

Her doctor offered hope in the new chemotherapy drug Tarceva, but the Oregon Health Plan sent her a letter telling her the cancer treatment was not approved.

Instead, the letter said, the plan would pay for comfort care, including "physician aid in dying," better known as assisted suicide.

"I told them, I said, 'Who do you guys think you are?' You know, to say that you'll pay for my dying, but you won't pay to help me possibly live longer?' " Wagner said.

google Barbara Wagner. Her life was about the state of Oregon saving money, but don't let that scare you.

[robham777]

P.S.

"There shall be no administrative or judicial review under section 1869, 1878"

This statement appears six time in hr3200 but I can't find sec 1869 or 1878 in the text of the bill. Does anyone know if this refers to another bill?

[robham777]

http://www.oregonlive.com/opinion/index.ssf/2008/11/sensationalizing_a_sad_case_ch.html

To be fair here is another story on the same case.

[GildaRadnerNeverMind]

robham777

It is sad. Sincerely. But the co-pays for private insurance for that same drug is listed online at around $1,400 per MONTH. Should Oregon issue it @ that same rate/same co-pay? Or do you expect them to pay the prescription in full? She seems like a good, decent, honest, hard working woman. Somehow I don't believe she had that kind of income for co-pays. So, if you were honest, you would reconize that her having private insurance or if Oregon offered it for $1400 per month co-pay, she still would NOT have had it available to her. Only now because it was cost prohibitative.

[clandesdun]

One of the sad but funny parts of this whole so called "debate" is the people who are getting all paranoid about the government getting access to their personal information are the same ones who sloughed off the Bushies egregious abuses of the Freedom of Information act by saying they trusted the government and you would to if you had nothing to hide.