Health Care Reform: It’s Our Turn, Texas!

To read the newly released Centers for Medicare and Medicaid Services (CMS) “Dear State Medicaid Director” letter re: New Option for Coverage of Individuals, click here.
“We just passed a law that doesn’t do much for rich people, but really helps poor people.” –Leonardo Cuello, National Health Law Program

Now that the Health Care Reform bill has been signed into law, it’s time for us to get busy advocating for state reform allowing for aspects of the federal bill to be implemented in Texas before 2014.

The federal bill includes Medicaid expansion, which will create coverage for 16 million people by 2019. This expansion signifies a radical conceptual shift from the current Medicaid system. In the current system, it’s not enough to be flat broke to receive Medicaid healthcare coverage. You have to be “broke plus” (i.e. broke plus pregnant, broke plus disabled, etc). This current system is based on the idea that only the “worthy poor” deserve health insurance. But beginning in 2014, there will be a mandatory “catch-all” category for everyone* who earns up to 133% of Federal Poverty Limits.

However, states have the option to implement a State Plan Amendment (SPA) that allows states to start buying these low income people into Medicaid earlier than 2014. Texas could potentially phase this plan in using a “lower income first” model. For example, depending on our budget, we could start with coverage for people who are at 75% or 100% of Federal Poverty Limits. In doing so, Texas would receive federal match money to cover people who wouldn’t ordinarily be covered.

Similarly, while the Health Care Reform ensures that pre-existing condition exclusions will be prohibited starting in 2014 (2010 for children) states may create a temporary high-risk pool for adults that will remain in effect until 2014.

Interested in putting together a coalition to help bring about these reforms here in the Lone Star state during the 82nd Legislative Session?

The National Health Law Program (NHeLP) suggests that organizations and individuals in Texas interested in pushing these state healthcare reforms come together, organize ourselves, and then contact NHeLP for more information and support on how to proceed.

*Does not include undocumented immigrants, as well as other groups who already have coverage such as Medicare enrollees, people over age 65, and mandatory coverage groups like pregnant women.

The Lion Sleeps Tonight

Let’s take the very, very long view of America’s decision to make health care available to eight million or more vulnerable and uninsured children. The crude political compromises that led to passage of imperfect health care reform might have obscured a grand achievement: an end to the sacrifice of American children on the altar of insurance industry greed and a moral setback for the bankrupt ideology that justified it.

So, let’s talk about Isaac, son of the Biblical patriarch Abraham, and Iphigenia, daughter of the ancient Greek King Agamemnon. These children lie beneath the sharpened butcher-blades of their fathers and warn humankind of the karmic catastrophe that is the willful sacrifice of children.

The images and narratives are deeply embedded in the roots of Western Civilization: Isaac and Abraham atop the dry, windswept land of Moriah; Iphigenia and Agamemnon across the waters on the rocky shore of Aulis. The “Binding of Isaac” was first written down in the 9th or 8th Century B.C. Iphigenia’s tragedy first appears in the Kypria, probably written in the 7th Century B.C. Both oral legends date to the far distant past of the Ancient Near East. Two great epics of Western culture pivot upon the theme of child murder.

Isaac and Iphigenia speak with literature’s most profoundly innocent voices. Isaac asks, “Father! Here is the fire and the wood but where is the sheep for the offering?” And Iphigenia: “I must say goodbye to the light.” Their words undam the heart and roll like a river through the troubled conscience of humankind.

Hear their voices as you consider this. In Crowley, Texas, the very week the health care reform bill was approved, Blue Cross/Blue Shield denied coverage to a newborn baby, Houston Tracy, saying he was born with an uncovered pre-existing condition. Without emergency heart surgery, Houston would die. One shudders to think that this ritual sacrifice was commonplace, and might be again if we are not vigilant.

And sacrifice it would have been, to Mammon and Moloch. Millions of children have been denied care to serve the profits of the health insurance industry. We are told the deaths are an actuarial necessity so that we may live, not so different from the ancient rationale of human sacrifice condemned by the Greeks, by the Hebrew Bible’s Yahweh and by Jesus. The Qur’an says flatly: “Kill not your children.” This ought to cause contented insurance actuaries to do a little soul searching, however much they want to gloat over a 2010 study that ranked them as holding the very best jobs in the country.

Continue reading “The Lion Sleeps Tonight”

A Socialist Primer: Rick Perry, Health Care & the Governor’s Race

Perry-RallyI’m wondering what it’s going to take for my former colleagues in the Texas press corps to call out Rick Perry for using the term “socialism” over-and-over to describe the insurance reform Congress passed last week.

Either Perry and reporters covering him don’t know what socialism is (and I doubt that), or Perry again is pushing  Tea Bag propaganda, and the press is too lazy or too intimidated to challenge it.

I’m used to Perry embarrassing Texas. So, I’m not surprised he’s parroting Dolph Briscoe’s old obsession with “creeping socialism.”  Thankfully, we’ve moved beyond the 1970s, though you wouldn’t know it from the Cold War rhetoric in a statement Perry released last Sunday and sound bites he repeated later in the week. Continue reading “A Socialist Primer: Rick Perry, Health Care & the Governor’s Race”

The Hollow Men: GOP Now Attacks What It Once Proposed in Health Care

The Hollow Men 5Gov. Rick Perry and other GOP leaders around the country have whipped the kooky Right into such a frenzy over health care reform that they are spitting on congressmen, threatening violence and even home invasions of Democratic representatives. It’s cynical and ugly, and just when you think it can’t get worse….

…You discover that the GOP proposed the very thing it now calls (in Glenn Beck’s confused vocabulary) communist-fascist-socialist-totalitarian tyranny. Perry threatens to secede from the Union over it.  Texas Attorney General Greg Abbott commits taxpayer money to a frivolous federal lawsuit challenging it. Neither they nor their masters — Beck, Limbaugh et al — bother to remind Americans that the reforms were, largely, Republican proposals. The Miami Herald reports:

The lawsuit against the health care overhaul filed Tuesday by Florida Attorney General Bill McCollum is focused on a provision that has long been advocated by conservatives, big business and the insurance industry.

And then there’s this chart detailing the similarities between the health care reform just passed by Congress and a GOP proposal from 1993. Mandatory insurance coverage? You bet. The GOP loved it.  Require large employers to provide insurance to employees? You bet. The GOP loved it. Bans on exclusions for pre-existing conditions? You bet. The GOP loved it. Subsidies for low-income Americans? You bet. The GOP loved it.

(Thanks to KRLD radio star Scott Braddock for this, and for all his truth-seeking on health care reform).

Compassionate Sanity Comes to America’s Health Care System

norman-rockwell-before-the-shotA century-long effort to bring some compassionate sanity to America’s health care system was passed by Congress last night. Lo and behold, the hammer and sickle is not flying from capitols across the land. Instead, it’s care and security for millions of our neighbors who have been locked out of doctors’ offices by yesterday’s rogue insurance industry.

Insurance companies can no longer deny you coverage because of a pre-existing condition. You won’t pay premiums for years only to be kicked off your insurance plan when you get sick. Small business gets a tax break to provide insurance to its employees. A high-risk pool is established. And, the budge deficit is reduced by a trillion dollars over 20 years.

Despite the claims of the radical Right, there are no government death panels. Government is not running your health care. “Life, Liberty and the Pursuit of Happiness” remain the guarantees bequeathed to us by the Founders. “Remain” is the wrong word. Those promises were strengthened by passage of health care reform.

I have been saddened by the behavior of some during the course of the debate. The insurance industry spent millions and millions of dollars to mislead some Americans. They succeeded. Playing upon the fears and anxieties of some, they funded the tea parties which in the end were a lot more fertilizer than grassroots. That cynical effort also included the overt encouragement of racist rhetoric and even threats of violence. Those behind those manipulations will live in infamy.

The 2010 political landscape shifted last night. A win of this magnitude will certainly change the dynamics in Texas and around the country. The Republicans managed to put themselves on the defensive. When armed communists don’t show up in our living rooms and hospitals, they’ll have some explaining to do. I mean, they did wail that the bill meant certain doom for democracy.

It must be hell to be totally controlled by industry benefactors. Republicans had no choice but to carry water for their corporate benefactors. Well, they had a choice, but no courage to make the right choice. They are insurance shills, nothing more, nothing less.

I remember studying the Great Depression years and the New Deal in school. I was dismayed at the pure stupidity of Republicans who continued to make obscene gestures at the American people on behalf of their corporate godfathers. They paid the price. But they obviously haven’t learned that lesson.

Here in Texas, the 2010 election prognosticators will need to start over, just as they will in other states. It’ll take some time for the dust to settle. Democrats got a boost. But I wouldn’t put too much faith in anyone’s crystal ball in the next few hours and days. It will all be spin intended to influence the future, not predict it accurately. I’ll say this, though. It’ll be hard for Republicans to persuade us to go back to yesterday, to deny care because of a pre-existing condition. To them I say, health care reform is the new pre-existing condition.

I Think It’s Going to Rain Today

tungurahua-volcanoHuman kindness is overflowing,
And I think it’s going to rain today.

–Randy Newman

There is no better accompaniment to the vote on health care reform than Randy Newman’s “I Think It’s Going to Rain Today,” a song that mourns our lack of compassionate action while musically acknowledging a little hope.

The hope is slim and fragile. But so is the brief and heartening new volume, Made for Goodness, by Desmond Tutu and his daughter, Mpho Tutu. It takes just a few notes in the major key or a few words from an enlightened champion of humanity’s heart like Bishop Tutu to remind us of our Buddha-nature or our divine spark.

The book arrived just in the nick of time. I was watching the tea bags on Saturday spit racist epithets at Congressmen and scream that reform would ruin the country. Not a whisper from them about the health of Americans, of course. Full of gales of FoxNews lies aimed at extinguishing the spark, they acted as though an American child restored to health really meant the arrival of the Red Dawn in Calumet, Colorado, or maybe the appearance of the anti-Christ at the local bowling alley.

Bishop Tutu, no stranger to racist violence, silences the misguided bigots with a gentle reminder:

We are fundamentally good. When you come to think of it, that’s who we are at our core. Why else do we get so outraged by wrong?

Evil and wrong are aberrations…You can see from the people we truly admire that we are attracted to goodness…even after her death Mother Theresa is admired, respected and revered. Mahatma Gandhi and Martin Luther King Jr. are similarly revered…In our own time Nelson Mandela commands the same kind of admiration…

Acting like the anti-Tutu, David Brooks actually wrote that passage of health care reform was a blow against empathy and humankind. I’m not making that up. Calling an obscure Senate procedure called reconciliation (the word rang with more hope in Tutu’s South Africa) a threat to the collegial bonds among Senators (forget the rest of us), he whined:

The remnants of person-to-person relationships, with their sympathy and sentiment, will be snuffed out. We will live amid the relationships of group versus group, party versus party, inhumanity versus inhumanity.

Continue reading “I Think It’s Going to Rain Today”

Marcelas’ Mission: Young Man Wants to Save Others from Mom’s Fate

Marcelas with his Grandmom and Sisters
Marcelas with his Grandmom and Sisters

I called a committed right-wing activist the other day and asked, “Do you support taxpayer-funded fire departments?” Angrily, he said, “No. Why should I pay to put out a fire of someone else’s home?” Well, I asked, how about police departments. “Hey, if people want protection they ought to hire a security firm. Blackwater, for instance. I’m tired of the leeches living off my money.”

Okay, I made the conversation up. But doesn’t it sound familiar? It tracks the right-wing rhetoric on health care reform.  We agree to fund fire departments because it’s the right thing to do morally, but also because we don’t want the neighbor’s fire burning down our own home. We benefit from the health of others in a similar way. Disease is often contagious. Like a fire.

In addition, a healthy America is economically healthier, too. It’s just a fact that we all benefit from the health of others. There’s a reason the proposed health care reform measure will decrease the federal deficit. More productivity. More taxes. Fewer work hours lost to illness. Less burden on local taxpayers. Education improves as children miss fewer school days. I could go on an on.

We don’t look at health care like we do fire departments because the private health insurance industry doesn’t want us to. They deliver nothing of value, really. The insurance industry just found a niche:  making money by collecting premiums, denying benefits, and excluding higher risk folk from coverage. Imagine calling the fire department and being asked, “Do you have insurance?” Fire Departments don’t rebuild our homes, of course. We have homeowner’s insurance for that. Or a lot of our own savings. But property insurance is quite a bit different than health insurance. Insurance companies can make the bet that not everyone’s home will burn down. But everyone, sooner or later, needs a doctor.

But nothing I can say would be as articulate as the words of 11-year-old Marcelas Owens, who’s been in Washington lately fighting for health care reform. You can listen to Dallas radio host Scott Braddock’s KRLD interview with Marcelas here. Continue reading “Marcelas’ Mission: Young Man Wants to Save Others from Mom’s Fate”

Beyond the Palin: She Got Her Health Care in Canada

SarahPalinSarah Palin admitted in a Canadian interview that her family used to go to Canada to receive health care. That would be Canada’s single-payer health care system.

The vocal opponent of health-care reform in the U.S. steered largely clear of the topic except to reveal a tidbit about her life growing up not far from Whitehorse.

“We used to hustle over the border for health care we received in Canada,” she said. “And I think now, isn’t that ironic?”

Isn’t that twisted, you mean. Palin has railed against the very idea of health care reform in this country, once going so far as to say there would be federal “death panels” who would decide who could live and who would die. But what does she turn to when she needs a doctor? You got it. A public option. In Canada.

Dogs bark. Birds fly. Politicians lie. There’s no real news here. But the monstrous hypocrisy of Republicans like Palin lying to prevent millions of Americans from getting the health care they need to stay alive while guaranteeing themselves good care — even at the cost of a trip to Canada — is beyond the Palin. So to speak.

Nearly half of America — Medicare, military personnel, federal retirees — already receive their health care from a public option. As far as I know, Peoria hasn’t turned to Stalinism. Dr. Trotsky is not performing tonsillectomies. Opponents of health care reform are bought-and-paid for shills of big insurance. They are being paid to turn you away from the doctor. Not really all that complicated a business arrangement.

America can extend health care to hardworking families AND it will lower the budget deficit that’s suddenly all the rage to worry about. Republicans didn’t mind George Bush tripling the deficit, of course. In any case, like I said, improving Americans’ health will lower, not raise, the deficit.

Goldman Sachs, by the way, is telling its clients to buy stock in big insurance companies, because their profits are up and competition is down. These are the same companies that are rejecting your claims or refusing you coverage altogether because you once had the measles.

Health Means Life; Health Means Freedom

doctor-and-the-doll-norman-rockwellLife and Freedom are moral issues. It is time for Democrats to talk about health in those terms, beyond just policy terms like health insurance reform, bending the cost curve, types of exchanges, etc.

Health means life. If you get a major illness or injury and cannot get it treated adequately, you could die. And tens of thousands do.

Health means freedom. If you have a serious illness or injury and cannot get it treated, your freedom will be limited in many ways. Your physical freedom: you may no longer have the freedom to move around. Your economic freedom: you may not be able to work or your medical bills may impoverish you. Your emotional freedom: you will not be free to live a happy life.

Health is therefore a moral issue of the highest order. And it is a patriotic issue. Health security is a problem for far more Americans than military security. Your security is far more likely to be threatened by the lack of treatment for illness and injury than by any likely terrorist attack.

Real terror is seen in the thousands of letters sent to the White House and Congress by people whose lives have been shattered or threatened by the behavior of the health insurance corporations. Wellpoint, which made $2.7 billion in fourth quarter profits in 2009, tried to raise its Anthem/Blue Cross premiums 39% in California. Wellpoint made its profits by NOT giving health care. It treated 2.2million fewer people. It found a way NOT to treat people who needed treatment, either by refusing to insure them, or dropping them as clients, or denying authorizations. If you are sick or injured and that happens to you, you face terror — very real terror.

That’s when “health maintenance organizations” (HMOs) become health terror organizations.

Continue reading “Health Means Life; Health Means Freedom”

Where’s the Movement?

In forming his administration, President Obama abandoned the movement that had begun during his campaign for deal-making and a pragmatism that hasn’t worked. That movement is still possible and needed now. Here is a look at what is required, and how a version of it is forming in California.

We begin with this week’s triple whammy.

Freedom vs. The Public Option

Which would you prefer, consumer choice or freedom? Extended coverage or freedom? Bending the cost curve or freedom?

John Boehner, House Minority Leader, speaking of health care, said recently, “This bill is the greatest threat to freedom that I have seen in the 19 years I have been here in Washington….It’s going to lead to a government takeover of our health care system, with tens of thousands of new bureaucrats right down the street, making these decisions [choose your doctor, buy your own health insurance] for you.”

This is exactly what Frank Luntz advised conservatives to say. They have repeated it and repeated it. Why has it worked to rally conservative populists against their interests? The most effective framing is more than mere language, more than spin or salesmanship. It has worked because conservatives really believe that the issue is freedom. It fits the conservative moral system. It fits how conservatives see the world.

The Democrats have helped the conservatives. Their pathetic attempt to make any deal to get 60 votes convinced even Massachusetts voters that government under the Democrats was corrupt and oppressive, not just inept, but immoral.

Continue reading “Where’s the Movement?”