Saturday, October 31, 2009

Healthcare Mythbuster in Elmhurst, Queens

A few weeks ago, I had the privilege of representing the NPA at a Healthcare Mythbusters event recently. It took place at the New Covenant Church in Elmhurst, Queens. Elmhurst is far out on the eastern edge of the borough.

As I walked toward the church, a surprising --- and surprisingly nice --- smell wafted toward me: manure. It turns out that the New Covenant Church is directly across the street from the historic Belmont Racetrack, which is home to the Belmont Stakes, one of the three jewels in the Triple Crown of horse racing.

The event took place in one of the small church’s clean, well-lit reception rooms. There was a vat of sweet iced tea and Jamaican beef patties at the back of the room, courtesy of a local business owner. Attendance was small at first, but grew steadily during the hour and a half I stayed. I was the first panelist to arrive, and I started speaking while people were still trickling in.

I began with a story about a patient who’d had an adverse health outcome because of his lack of insurance, and then segued into how the current legislation would change that. I briefly sketched out the major components of the bills: insurance reform, individual mandate, employer mandate, the health insurance exchange and the public option.

Because there were only eight people in the room, I didn’t sit behind the table at the front of the room. I stood up front, close to people, and tried to make my talk informal and interactive. One audience member, Veronica Beckford, was a staffer for Congressman Gregory Meeks, who represents the sixth district. She was very informed about the legislation and contributed usefully to the discussion.

After going through the different aspects of the legislation, I talked a little about Medicare, and how this legislation would improve it. I immediately got the sense that Medicare was an important issue to people. I emphasized how the legislation would close the “doughnut hole” and would pay hospitals for quality of care, not quantity.

I tried to encourage people not to fall for the insurance industry scare tactics. Reducing unnecessary care that does not make you healthier is not “cutting your benefits,” like the Republicans would have you believe. If anyone can testify that more hospital days and more procedures do not equal better health, it’s a doctor currently working in a hospital.

Overall it was a great experience. I think people left with a more positive impression of the healthcare reform legislation than when they arrived.

My only regret was that I didn't get to visit the Belmont Racetrack. I tried to think up a good joke about not believing the manure that the insurance industry was shoveling. But I didn't tell it, and I'm pretty sure it wouldn't have gone over well anyway.

Dr. Cameron Page

Friday, October 23, 2009

Drs. Carol DeCosta and Manisha Sharma at the Emmanuel Baptist Church

My experience last week at Emmanuel Baptist church was a success. The audience was mainly the prime-time group (50 and over) at the Emmanuel Baptist Church. Reverend Rose Jones Wilson asked me to speak about Osteoarthritis as well as Health Care reform, dispelling the myths.

There were about 40 persons in attendance. Senator Vilmanette Montgomery stopped by and spoke about her support for the public option, however she questioned why children were not directly written in.
The audience was very engaged and wanted the opportunity to keep abreast of the activities in the congress and senate.

Overwhelmingly, the group embraced Dr. Manisha Sharma as she told her story. They also showed their empathy when I shared my story about the patient who was denied a CT scan for months and may now have to have surgery.

A special shout out to Manisha, she was feeling under the weather and insisted on coming out to be supportive of me. She is a great speaker and shared her knowledge about the public health insurance option in an objective manner. We worked well together and were able to answer the majority of the questions.

By Dr. Carol DeCosta

Speaking at the West 75th Street Block Association General Meeting

I was invited to speak at the West 75th Street Block Association General meeting on Oct 22 at 7:30 pm. It took place at the West End Collegiate Church on 77th Street between West End Avenue and Broadway. A representative from NYC for Change, Aliya Quraishi, was also present. We shared the stage. First, Aliya gave a brief overview of the heath care reform legislation. Then I gave the physician's perspective on Health Care Reform and why it is so necessary. The audience was very receptive to my stories and points. Several members of the audience felt moved to share their own stories. One member of the audience described when she was prescribed a medication by her doctor but the insurance company wouldn't cover it. Another member of the audience told the story of when she tried to by her prescriptions in the US it cost $680 so she went to visit her sister in Canada and got them all for $150. Next, we had a question and answer session. Some of the questions I fielded were: Why are drug prices so much higher in the US? Will the public option cover tests for Celiac Disease? Why don' they focus more on nutrition in the Health Care Reform Legislation? Will the Public Option cover chiropractors and alternative medicine? Can I explain the single payer nation health plan model? Who decides how much an x-ray costs? At the end, I received very good feed back from the organizers and audience members. Hopefully some more of these people will get involved.

Rafi Pristoop, MD

Panels on 10/22

I was graciously invited to join 2 panels on October 22nd.

Arlene Geiger moderated a panel for students of John Jay College in the afternoon. The students filled the room, and asked thought-provoking questions on health reform.

The Public Health Association of NYC and the Black and Hispanic Student Caucus of Mailman School of Public Health co-sponsored a panel at Columbia. Dr. Karen Wang and I busted some myths with the best of them (Tim Foley, Mark Hannay, Lamont Carolina, and others). Thanks to Jessica Silk and Lois Uttley inviting us to this lively event.

A common theme in both was concern over reproductive rights being sidelined in the health reform debate.

Wednesday, October 21, 2009

Dr. Manisha Sharma on Health Care Reform

On October 20, 2009 at Hammerstein Ballroom in NYC, Dr. Manisha Sharma preceded President Obama's speech on healthcare reform by sharing her personal battles with health insurance companies, to now fighting for healthcare reform as a doctor and activist.

Tuesday, October 20, 2009

Rally for the Public Option outside Obama's Fundraiser

Drs. Bill Jordan and Alex Blum speaking at the rally on October 20th outside Obama's fundraiser appearance.

Wednesday, October 14, 2009

MoveOn rally in Union Square

Several NPA-NY members were at today's rally in Union Square. Over 100 MoveOn rallies occurred throughout the nation today. The theme for New York was to thank Senator Schumer for his continued support of the inclusion of a public option in health care reform. Several physicians spoke, including our Manel Silva and Alex Blum from Doctors for America. Several MoveOn members spoke about the amount of money they have had to pay in order to stay insured, in some cases well over $10,000 per year.

Hearing the stories of individuals reminds us why we are fighting for a public option. It's not only for people who are uninsured, but also for those who are fighting to pay for their current coverage. It's for people who have pre-existing conditions that would preclude them from attaining affordable insurance.

The key operator in this is affordability. Without a public option, we have a mandate to buy coverage, and absolutely no mechanism to control the out-of-pocket costs for premiums. Without a public option, although the bills may contain useful protections for consumers, they fail to provide one of the most important protections: ensuring that care is not only available but also affordable. rally in Brooklyn

I had the opportunity to speak today at a rally on the steps of Borough Hall in Brooklyn, NY organized by to thank Senator Schumer for his support of the public option and health care reform. About 50 people attended the rally, which was peaceful and supportive of reform. Brooklyn Borough President Marty Markowitz and the President of the Carribean Women's Health Association were also present.

Monday, October 12, 2009

Dr. Silva on The Gary Anthony Ramsay Blog Talk Radio Show

I was interviewed for the web radio show 'Mad in the Middle' hosted by Gary Anthony Ramsay. My co-panelist was Pulitzer prize winning journalist Karen Hunter. The interview itself starts at at 15:45, but the conversation really starts at 17:00. If you want to skip to the best part of the interview, go to 31:45 when the Ms. Hunter starts suggesting that we should reinstitute shame as a public health intervention. But it's an argument I've heard in different forms from both progressives and conservatives- that people need to control their behaviors, and others shouldn't be held accountable for the consequences. Yes, we should have better prevention and wellness programs that address people's behaviors. But not all diseases are solely related to behavior- diabetes often develops from a combination of behavioral and genetic factors, as well as socioeconomic factors that underlie behaviors (i.e. why is that I can predict someone's risk of many diseases by the zip code that they live in?). And the solution is not preventing access to health care services, especially to a physician that can often change behaviors by a simple honest conversation (which has been proven to be more effective than most other interventions for a number of risk taking behaviors). I can tell you this as a physician who works with teenagers in the area of preventative sexual health- shame will not change risky behavior, in fact, their shame and fear is what forced them to seek my services, so we can collectively come to a solution that ensures that they won't get pregnant, have an STD, or be in an abusive relationship (and I always encourage them to speak to their parents about their situation). Lastly, people should not suffer from the very dangerous consequences of renal failure because they ate too much salt over their lifetime. Diseases have consequences and suffering that are not consistent with the behaviors they are related to, and we should not punish each other for that. We should support each other in taking better care of ourselves and our future.

Saturday, October 10, 2009

Talking about health care reform in White Plains

On Saturday, I spoke to a group of about forty members of the Calvary Baptist Church in White Plains as part of their annual Christian Education Retreat. The members were very interested and engaged and they asked many thoughtful questions about health care reform.

My sense was that they wanted to be informed about this issue so that could make up their minds about whether to support the push for health care reform and I do believe by the end of the session most people were very supportive of reform efforts.

On another note, I think churches or other faith-based organizations' core values are very much in line with most of those of health care reform (i.e. health care for all, etc) and can be very effective venues in terms of spreading the word about health care reform to their members and other groups.

Tuesday, October 6, 2009

My outing to East New York, Brooklyn

I attended a mythbuster panel sponsored by Organizing for America out in East New York, Brooklyn. (I saw "out in East New York" because I hopped on to 3 line at its penultimate stop here in Harlem and then took it to its penultimate stop in Brooklyn.) The last time I had been out there was as a 4th year medical student working at a community health center.

There had been a mix-up about the date and time of the panel so only five of us total showed up but what I quickly realized was that more important than the numbers of people who turn out is the spirit and energy of those who do. I met three residents from East New York who were devoted to their neighborhood and wanted to do whatever they could to spread the word about heatlh care reform.

We spoke for about hour and a half starting with health care reform but then moved on to obesity and hypertension as well as other medical conditions that disproportionately plague communities of color. In addition to learning about and supporting health care reform efforts, these inspiring residents wanted to be informed about preventive care and staying healthy. I was glad I could be a source of information for the residents and plan to remain in touch as they continue their efforts to create a healthier community.

Debate: Rep. Anthony Weiner vs Dr. Betsy McCaughey

I was hoping to hear a thoughtful conversation between two people who had very opposing views. I wanted to know the factual basis driving those who are anti-health care reform. But in end, I had a town hall-lite experience. Rep. Weiner presented statistics and well-documented sources about our current health care system, especially focusing on our Medicare system (a co-existing public and private insurance plan that is providing quality care with innovation in need of some changes, like payment reform and decreasing subsidies to private Medicare insurance plans). Before relinquishing the stage to Dr. McCaughey, he warned the audience: "Don't believe her when she cites a page in the bill, it's not there", pre-empting her trademark, "I've read the legislation on page XX" as she points to a gigantic black binder. Dr. McCaughey was more prone to vague references, illogical conclusions and well-known fear-mongering comments like "someone is going to steal granny's purse". During the Q&A session, a pro-Weiner audience member yelled "Answer the question!" to the ever-elusive McCaughey. A pro-McCaughey audience member also heckled Rep. Weiner several times, yelling, "Rude man! Rude man!" It was entertaining and only slightly educational. What I found interesting: 1. There are teabaggers in NYC. 2. Rep. Weiner pointed out that most people are not so enamored with their insurance company that they are afraid to lose it. Rather, people are afraid of losing access to their regular health care provider. For more, read the daily kos or politico.

Saturday, October 3, 2009

NW Bronx for Change / Ben Franklin Club Panel

I had a good experience on the panel today in the Bronx. I shared the stage with Rep Engel, Tim Foley (CIR / SEIU), and Columbia Presbyterian's Community Affairs person. It was a small and amicable crowd of about 50 people. Generally civil with good questions. Engel had to leave early to do battle on Fox News. I had the opportunity to directly dismiss a question about rationing in Canada from my personal experience as a medical student in Montreal.

See the letter to the editor in the Riverdale Press for more information.

My experience at a health care reform panel discussion at Harlem Hospital

I went to Harlem Hospital on October 3rd to hear a panel about health care reform with a specific focus about what reform means for safety net hospitals like Harlem. Congressperson Rangel was in attendance and spoke.

Some of the panelists were more informed about reform than others. A representative from AETNA who was on the panel actually stated that co-ops were a public option. Huh?

Another doc who is in private practice and was representing the Empire State Medical Association told the audience that the public option (which he supported) would put half of private insurers out of business. Huh?

What disturbed me most were a few comments from the people in the audience (several jeers) when the topic of coverage for undocumented immigrants was raised and it was raised frequently. Some folks appeared very much against undocumented immigrants getting coverage on their dime. People were more preoccupied with undocumented immigrant issue, than all other aspects of reform.

I felt disgusted. When it came time for Q and A - I spoke as a physician and said we need to make sure all Americans - undocumented or not - have health coverage because we all will pay in the end (besides, it's the right thing to do) as we are now. Also, I mentioned that many undocumented workers do pay taxes so in effect they are subsizing our care without access to the same care they are subsidizing (this got a chuckle out of Rangel). I expressed that this disproportionate focus on preventing undocumented people from getting health care was a distraction put forth by folks who don't want to see real reform happen. I received alot of support from the several of the panelists on this point.

People in the community went there to learn about reform (I assume) but if I knew nothing and attended that panel I would have been sorely misinformed for the most part.

Friday, October 2, 2009

Meeting with Congressman McMahon, NY District 13

Today I met with Rep McMahon from Staten Island, along with 5 other representatives from progressive organizations, as well as 6 members of the local Tea Party. We had a relatively civil discussion, enabling each side to articulate their point of view and why they disagreed with the opposite view. Although Rep McMahon was not clear about his opinion, it was heartening to hear him press the Tea Party people about their views on Medicare, specifically whether they believe if we should get rid of it. In the end, it was clear that beyond the facts, there were some striking ideological differences about rights, values and the role of government.
The next Monday, Rep McMahon held a townhall meeting where he stated his public support for HR 3200 as well as the public option. Yay!

Thank you Senator Schumer for fighting for health care reform!

A group of women, representing different grassroots organizations in NYC, went to Senator Schumer's Manhattan Office to thank him for his continued support of health care reform and fighting for public option. We met with his staffers, Teri Coaxum, Deputy State Director, and Victor Pichardo, Community Outreach Coordinator. The conversation mostly reinforced our knowledge that the key to passing reform would be mobilizing our bases nationwide to visit, write, or call their representatives.

We dicussed what we were doing to educate and mobilize our own groups, like the the National Grand Rounds for health care providers sponsored by NPA and AMSA, Lobby Day for Young Adults by Young Invincibles, Health Care Myth-busting Sessions, Teach-Ins, Phone Banks, Rallies by Raising Women's Voices, OFA, nycforchange, Democratic Clubs of NYC et al.

What was important to hear was that in spite of the recent Senate Finance Committee vote against the public option, Schumer's staffer/Schumer strongly believe that via some political process, the final bill would contain the public option. I'm hoping that's true. But if not, having seen the spirited efforts of numerous grassroots organizations in NYC this past summer, i know we're all in this for the long haul. So, let's keep up the momentum!

Response to NYTimes Article

Response to
New Twists in the Health Debate
NY Times

To the Editor:

Senator Max Baucus was right when he said there’s a lot to like about the public option. For one, it allows people’s health to be valued over profits.

As a practicing physician who has worked with both private and public insurers, I can assure you that there is a need for competition to ensure appropriate affordable coverage as well as innovation.

And I’m not alone: as a recent study from The New England Journal of Medicine noted, 63 percent of physicians support providing for our patients “the choice of enrolling in a new public health insurance plan (like Medicare) or in private plans.”

Doctors have nothing to gain from promoting the public-plan option, except that we know from firsthand experience what it can do to help secure affordable quality coverage for all Americans. And we are hoping that our elected officials will listen, including Senator Baucus.

Manel Silva
Brooklyn, Sept. 30, 2009

Thursday, October 1, 2009

What will happen to the Uninsured and Underinsured?

On October 1st at the "Assuring Equity Through Health and Health Care Reform" conference at the New York Academy of Medicine sponsored by Albert Einstein College of Medicine, Dr. Manisha Sharma, NPA-NY's Director of Media Relations, and Dr. Manel Silva, NPA-NY's Director, served as panelists for "Covering the the Uninsured and Underinsured", an engaging and lively discussion about an issue central to health care reform. Dr. Oni Blackstock, an NPA-NY member, moderated the panel.

Dr. Sharma spoke movingly about her own patient experience of being uninsured and her own difficulties in obtaining coverage because of a pre-existing condition. Dr. Silva, who works at free clinic for adolescents, spoke specifically about the issue of uninsurance among young adults especially those with chronic conditions. The current health care reform bills and proposals in Congress were also discussed.