The health roundtable was reinstituted March 13th 2018. Please come to the next meeting and add your thoughts to help us advocate for improving our healthcare. system. We are planning monthly meetings and additional working subgroup meetings.
In keeping with the League of Women Voters of the United States health care goal to 'promote a health care system for the United States that provides access to a basic level of quality care for all U.S. residents, including behavioral health, and controls health care costs' the League of Women Voters of the Piedmont Triad Health Roundtable will focus on two goals. Our goals for 2018-2019 are for specific advocacy and education.
1) To educate the public regarding the extent to which our health care system is underserving particularly the poor and financially stressing the entire society.
2) To seek to encourage legislators to move first toward "Medicaid expansion" and then eventually toward a program of "Medicare for all."
The 2016 - 17 public policy statement of the League of Women Voters of the Triad under social policy, health care was, "Promote a healthy community that recognizes the importance of social, geographic, political influences. Promote a health care system for the Piedmont Triad that provides access to affordable, quality care for all residents, including prevention of disease, primary care (including prenatal and reproductive health), acute care, long-term care, and mental health care (including substance abuse treatment). Promote control of health care costs, equitable distribution of services, efficient and economical delivery of care, advancement of medical research and technology, and a reasonable total expenditure level for health."
The March 19, 2019 Lunch with the League will relate to universal health care coverage.
On March 26, 2019 at 7:30 PM in Greensboro, Jonathan Oberlander, PhD. professor at the University of North Carolina will present "Unfinished Journey: The Future of Health Care Reform" at Union Square Campus.
Present were: Tim and Robin Lane, Ann Shaw, Laurey Solomon, Barbara Avent, Mary Eubanks, Teresa Bratton, Rob Luisana, Barbara Carter, Anna Fesmire, Wayne Hale
Ann talked about a recent article in the N and R suggesting Medicare for All might help the GOP in 2020. She suggested we need to be ready to counter arguments against it. Robin suggested we help the state League develop messages beyond the need for Medicaid Expansion. We will address these issues after our March commitments are fulfilled.
We agreed to ask for $500 for our expenses next year.
Rob gave a presentation listing and explaining several ways the ACA has impacted all Americans, not just those who receive health insurance through their states' marketplaces. The recent court decision in Texas that declared the ACA unconstitutional could have far reaching, unpopular consequences if upheld. It is expected to reach the Supreme Court, so now we wait. A few of the changes instituted by the ACA that Rob discussed are as follows:
The ACA closed the "doughnut hole" in Medicare recipients' drug costs.It propelled the movement away from a strictly fee for service payment structure toward a value based structure and bundling of services. It increased hospital accountability and helped slow down increases in cost of care. Rob discussed several more changes instituted by the ACA. This is just a sample.
Robin reported on progress made on our Oberlander event. She shared a very well organized, detailed set of charts. To summarize:
The title is "Unfinished Journey: The Future of Health Care Reform"Topics will include the 100 year journey, Medicare/Medicaid/ACA, and the ongoing movement of reform Target audiences include students at UNCG and ATT, being reached out to by Jessica Goodman and Zach Usey, as well as minority groups. We need to develop a strategy to reach out to them. Sponsors at this point include Cone Health Foundation ($500), Sally Austin Ed Fund ($1000), Health Care for All NC ($250) and we are hoping for another $1000 from individual donors and possibly other sponsors Tim is in communication with Dr O about the specific questions he will address in his presentation Robin showed us a first draft of a Save the Date card, discussion followed leading to minor adjustments
Location is Union Square Campus
Please support House Bill 662
My name is Wayne Hale and I am a family physician educator who taught for nearly 30 years at the Cone Health Family Medicine residency program. During that time we were increasingly dealing with the issue of patients with chronic pain who had a tendency to abuse or divert narcotics. We responded with pain medication contracts and lab test to determine if they were actually taking the medication. Since then the DEA and state have put further restraints on the amounts of medications physicians can prescribe. This resulted in addicted patients seeking street drugs such as heroin and fentanyl. The result is the current epidemic of opioid overdoses, some of which occur because the narcotic medication is more potent than they expect, resulting in respiratory arrests. Our police and first responders have become experts in reversing the breathing difficulty using Narcan, but the associated expenses are great. In 2013 two people in North Carolina were dying of opioid overdose every day. Three years later, in 2016, that number was 4 people dying daily. Seventy people died of overdose in Guilford County in 2016 and 80 in 2017. And that was despite over 700 opioid overdose reversals.
Our only hope to curtail this epidemic is to get those addicted into treatment programs. The $250,000 state grant for GCSTOP for our EMS and UNCG counseling services was a great start for getting overdose victims to seek rehabilitation, but that treatment is very expensive. Many of them don't have medical insurance that will cover those costs. Since the North Carolina legislature opted not to expand Medicaid, the dollars that could have been used to rehabilitate these addicts have gone to other states. We have nearly 400,000 residents who fall into the gap where they are not eligible to receive Medicaid, but don't make enough money to qualify for a subsidy from the Affordable Care Act to enable them to get medical insurance.
Representative Donny Lambeth from Forsyth County a year ago proposed House Bill 662 known as Carolina Cares as a way of expanding Medicaid to these citizens in the form of an insurance product. It has co-pays and premiums. For those who are able, there is a requirement to be working or seeking employment.
The Carolina Cares bill may not be perfect from various viewpoints, but the opioid crisis cries out for solutions. I am hoping that our commissioners will recommend to our state legislators that this bill be brought up for discussion so that a compromise bill could provide treatment options for those who suffer from opioid addiction.
Letters to the Editor: Greensboro News and Record, April 15, 2018, Laurey Solomon
Medicaid Expansion is the right thing to do.
A 30 year old single adult in Guilford Co whose income is $12,070/year can choose from among 6 policies that cost between $0 and $56.42/month because that person will be eligible for a subsidy under the Affordable Care Act. Someone who makes $12,050/year or less will have to pay between $225.21 and $598.42/month for the same coverage. (The threshold for eligibility for a subsidy is $12,060.) It makes no sense for someone who has less income to have to pay more for health insurance. Obviously, no one whose income is less than $12,060 can afford even the cheapest insurance available to them at $225.21/month. The Affordable Care Act was designed to offer Medicaid to people whose income was below the threshold for a subsidy. Since each state helps pay for Medicaid, the Supreme Court said each state can choose whether it does extend Medicaid to its low income residents. At the present 32 states and Wash DC offer Medicaid to people who can't afford a subsidy. North Carolina does not. And it needs to.
Letter to the Editor Greensboro News and Record April, 2018 Wayne Hale
"Save Our Medicare" The above statement is commonly seen at rallies on both sides of the political spectrum, but the sign bearer is likely unaware of the true threat to Medicare's perpetuation. Medical care costs continue to grow faster than the GDP. America spends about $5000 more per person on health care than other rich countries, but our outcomes don't make the twenty best on most measures. Since 1997 Medicare Advantage plans pay insurers a premium to keep subscribers healthier, though that result has not been proven. Meanwhile mergers give ever-larger health system businesses more clout for bargaining with other entities. E.g., CVS merging with the insurer, Cigna, purportedly will be more efficient, but shareholders rather than payers will likely reap the benefits. When have monopolies ever lowered costs for consumers? Health care will become more cost-effective when many of these unnecessary and costly middlemen are removed. Traditional Medicare has kept overhead costs under 3%. Providing Medicare for all as Canada does (for under 2% overhead) is the best way to streamline our system. Otherwise, we are just giving Paul Ryan reason to propose Medicare cutbacks because the expenses are too high to be supported by the new tax plan.