Wednesday, September 30, 2009

Use YouTube to Support the Public Option

The majority of Americans (including doctors!) support the public option. And yet, today the Senate Finance Committee voted against the public option & patient choice. So we've joined the on-line "I Support the Public Option" video petition to ensure that our collective voice is heard. At tonight's meeting, we each made our own video and posted it to the website.

Check out the website:
--> Make your own video!
Check out the youtube channel:

Thursday, September 24, 2009

"Why I went to medical school…."

by Nina Agrawal

I went to medical school to help people get healthier not to help CEO’s get wealthier.

I went to medical school because I believe in giving all kids a fair chance in life and not based on their immigration status.

I went to medical school to build relationships with patients not insurance clerks.

I went to medical school to prescribe treatments that are best for my patients not for insurance companies.

I went to medical school to prescribe medications because they work not because the insurance company covers them.

I went to medical school to save lives from illness not from insurance company greed.

I went to medical school because I wanted to make a difference.

*Please support the public option. More than 64% of physicians do.*

Wednesday, September 16, 2009

It's crystal clear: doctors support a public option LIKE MEDICARE

According to a study published yesterday in the New England Journal of Medicine, 63% of doctors support expanding health insurance coverage through both private and public options. NPR reported on this survey with the headline, “poll finds most doctors support public option,” and immediately elicited comment from the American Medical Association, since the organization has equivocated on support of the public option in its public statements, while the study explicitly demonstrated support for the public option among AMA members (62%). Not surprisingly Dr. James Rohack, the president of the AMA (who has previously made confusing comments about the public health insurance option implying that subsidized private plans could be considered a public option), challenged the meaning of the findings, “[the public option] means different things to different people, kind of like the Rorschach ink blot test.” However, his attempts to obfuscate only further emphasize that the official positions of the American Medical Association do not represent the viewpoint of most American doctors (or apparently in some cases even AMA members).

While it is true that there are different versions of the public health insurance option described in the bills coming out of the House, the Senate HELP committee, and the framework envisioned by Jacob Hacker, the findings of this study are not up for interpretation. A Rorschach test is purposely subjective so a clinician can interpret a patients' psychological state. Conversely, good researchers ask precise questions and describe their methods in detail so that their findings can be reproduced. The reputation and influence of peer reviewed journals, like the New England Journal of Medicine, is dependent on publishing quality research.

The consistency and reliability of the research demonstrating doctors’ support for public health insurance similar to Medicare should relieve us all of the fear mongering around “socialized medicine." Ironically, conservative politicians fear "government bureaucrats standing in between them and their doctors," while their doctors do not. The evidence is crystal clear.

In 2003, Ronald Ackerman and Aaron Carroll asked 3188 randomly sampled physicians, “In principle, do you support or oppose government legislation to establish national health insurance?” At that time 49% supported this type of legislation and 40 % opposed.

In 2008, the authors repeated the study, this time with 59% agreeing and only 32% opposing national health insurance. They also asked, “do you support achieving universal coverage through more incremental reform?” 55% supported and 25% opposed this type of proposal.

And now, with the study by Keyhani and Federman we have another question directly relevant to the current health care debate:

Respondents were asked to indicate which of three options they would most strongly support:

1. Public and Private Options: Provide people under age 65 the choice of enrolling in a new public health insurance plan (like Medicare) or in private plans.

2. Private Options Only: Provide people with tax credits or
low-income subsidies to buy private insurance coverage (without
creating a public plan option).

3. Public Option Only: Eliminate private insurance and cover everyone in a single public plan like Medicare.

63% of doctors chose option #1 - the public and private options.
It is not clear to me how Dr. Rohack could be unsure what the public option means in this context. It's right there in the study's methods.

These research findings are robust and consistent: doctors support national health insurance (i.e. Single Payer); but when asked specifically about a public health insurance option similar to Medicare and available to everyone below 65, they overwhelmingly support it. There even seems to be a trend developing where a greater percentage of doctors support public health insurance.

Doctors are not afraid of government health insurance bureaucrats – we already have private insurance companies' utilization reviewers to contend with. The study's findings may be a surprise to some, since doctors tend to be conservative as a whole, but the truth is that most doctors are sick of fighting with insurance companies. The average physician spends 43 minutes per day and $65,000 per year on interactions with health plans; there have already been multimillion dollar class action lawsuits against Aetna, Cigna, Humana, Blue Cross Blue Shield, and others for underpaying doctors (among other charges), and ultimately we have yielded too much decision making capacity to managed care companies.

So when we talk about a public health insurance option, we mean a plan modeled on Medicare. We do not mean a co-op; we do not include a trigger option; and we don't want expanded coverage limited to public subsidies for private plans. The data is there in black and white - in the shape of a bar graph, not an ink blot.

Aaron Fox, MD
NPA - NYC Local Action Network

Thursday, September 10, 2009

Raising Women's Voices health care reform teach-in

Drs. Manel Silva, Local Action Network, Director, and Oni Blackstock, NPA-NYC, spoke at Raising Women's Voices' Community Teach-In For Health Reform - Busting the Myths at Judson Memorial Church on September 10th. Dr.Silva spoke passionately about why we need health reform and Dr. Blackstock addressed and dispelled several common health reform myths in front of an eager and excited crowd of about sixty people. For more on the event, please visit Raising Women's Voices' blog.

Thursday, September 3, 2009

Doctors Support Health Care Reform

Dr. Manel Silva of the National Physicians Alliance addressing a crowd in Jersey City gathered at a candle light vigil in support of health care reform (and from the signs, the crowd is clearly in support of a public health insurance option):

Dr. Viraj Patel, also of the National Physicians Alliance, shared a patients story at a vigil in Manhattan:

59% of physicians support national health insurance and 55% support achieving universal coverage with more incremental reform. We need to get out there and let the country know that doctors want a health care system that is fair and that is focused on the needs of our patients.

Wednesday, September 2, 2009

Health Care Can't Wait

Dr. Alex Blum of DFA

Reclaiming the Healthcare Battle

Dr. Nina Agrawal on GritTV

The Tale of Two Townhalls

Last week, I had the very interesting experience of attending two town
hall meetings on healthcare with Rep Yvette Clarke and Rep Anthony
Weiner (both Democrats in NY).

Despite the fact that they were only a few stops apart on the Q train,
it was like being on two different planets. Despite the fact that the
topic and the Q&A format at both was the same, the process seemed
driven by two different objectives.

First, I arrived at Rep Clarke's town hall at a church in Flatbush. A
few cops stood outside, but otherwise it was quiet. Inside, there was
a noticeable diversity of constituents of all ages and backgrounds
among the 200 or so present. The signs people were holding up were
clearly in support of health care reform. Rep Clarke spent the
majority of her time explaining the content of HR 3200, especially how
people would be affected. There was frequent applause in support of
her efforts and of the House bill. Not a single voice expressed
dissent. The presentation is available on Clarke's website.

Then I got on the Q train and took a bus to CUNY Kingsborough
Community College to hear Rep Weiner speak. A few cops stood outside
as well as several anti-reform protesters holding signs equating Obama
with Nazis, and other equally reprehensible, illogical accusations. I
could hear people shouting before I entered the auditorium. Most of
the anti-reform people were older and white (men were more likely to
get on the mic), while the pro-reform were younger and people of
color. Rep Weiner was attempting to answer people's questions, but
many in the crowd kept shouting him down. This was not a discussion
but rather an argument. There was no opportunity to debate. People
would ask questions and then prevent him from answering. People made
statements disguised as questions - about death panels, government
take-over of care, paying for lazy people who don't want jobs, etc.
When a woman, claiming to be a former enrollment officer for SCHIP,
screamed about the children of illegal immigrants getting health care
I couldn't hold back. I stood up yelled: "But they're children!!!" She
was obviously ignorant or unconcerned with the fact that the current
proposed legislation doesn't cover undocumented immigrants.

For the most part, those in support of health care reform made their
voices heard through the Q & A process. Several health care
professional, some from other countries, shared their views. All
except one nurse and one of the docs who spoke were in support of
health care reform. One man filmed the proceedings while, at the same
time shouting at Rep. Weiner, who nonetheless would directly approach
his camera to make certain points. Rep Weiner, as many of us are
aware, knows his facts. He put a lot of energy into attempting a
discussion about those facts. For many who were there however, the
facts were not the point. As I left the room I was engaged in a
“conversation” with one of the anti-reform people, who kept insisting
that this was a government takeover and that we couldn’t afford it, at
the same time acknowledging that she didn't support private insurance
industry practices. She made no sense. At the end I suggested we
agree to disagree.

Some great quotes:
- By Rep Clarke, regarding the “individual mandate”: "We all have the
intellect, as a species that shares this planet, to understand that we
all have the opportunity to become vulnerable to things such as
communicable diseases, e.g. H1N1 flu.” The point is that we are all
affected (whether through shared vulnerability or shared cost) if
someone without health insurance needs and cannot receive medical
treatment. The unmet cost of insurance or of treatment ultimately
falls on the taxpayer. The benefits of an “Individual mandate” seem
widely misunderstood.

- By a reform supporter in response to a heckler yelling about how
reform would increase his taxes: "I don't have a problem paying my
taxes, I have a problem paying my premiums!"

- By Rep Weiner: "So let me clarify to you what socialism means:
socialism is when the government has control over the means of
production, not just the means of paying for a service. So this is
not socialism, even if you want it to be. Just in case you didn't
understand what the word meant..."

Lesson learned: People are not interested in the facts; and they're
interested in feeling right. The question is, how do we have a
conversation with that?

Manel Silva, MD,
Director, NPA NY Local Action Network

Tuesday, September 1, 2009

MD Town Hall Experience in Rochester

Dr. Javeed Sukhera, DFA regional director in Upstate New York/NPA member, who recently attended a town hall meeting for Eric Massa (D-Corning), wrote about his experience in Physician: Town Hall ignorance stifles respectful debate.

Despite the silence of summer in its halls, the high-school auditorium was packed to the brim with a raucous crowd of Americans, eager to have their voices heard. As a physician, I joined a group of colleagues, united in our pursuit of meaningful health-care reform. We work on the front lines of the nation's health care system. Our privileged roles allow us to bear witness to and alleviate the suffering of our patients. We have also struggled through the challenges of the system. Challenges including insurance companies demanding prior authorizations for medications our patients need, or denying them coverage all together. Frustrations include patients' physical suffering exacerbated by the emotional suffering of financial hardship, lack of insurance, medical debt or even bankruptcy. I arrived at the town-hall meeting for Rep. Eric Massa, D-Corning, with an eagerness for respectful debate. I left with a sense of disgust and disappointment. The atmosphere was so vicious that any attempt at meaningful dialogue was met with perverse heckling including screams that our nation should have "dropped a nuke" on Iraq instead of spending three trillion dollars on the war, and someone screaming "give Obama's wife to the Insurance Industry!" On my walk into the meeting, I stood next to a gentleman wearing a T-shirt with President Obama's face and a Hitler moustache. I heard him argue with a World War II veteran, who told him he should be ashamed of himself. During the course of the meeting, a man shouted that he received timely treatment after a cancer diagnosis, but that if he lived in Canada he would be dead. Another woman shed tears over her fear that health care reform would turn America into a communist country, screaming that the house bill would allow the government to come into citizens' homes and take their children. Another man echoed her concerns, stating that the bill would permit the government access to every Americans' bank account. Their animosity and ignorance are stifling debate instead of promoting it. They have a right to free speech, but citizens have a right to know the facts. Canada and almost every other developed country have far better demographic indicators than the US include life expectancy, especially compared to how much we spend per capita on health. The house bill says nothing of the government coming into homes or dipping into bank accounts. Most importantly, the vast majority of Americans support meaningful health care reform. As a physician it pains me to sit idly and watch the system deteriorate as premiums rise and inefficiencies mount. The cost of inaction is far greater than the cost of making positive change happen. We are a great nation and our citizens deserve a far better health system than the status quo.