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."
3) To study the NC DHHS program's Healthy Opportunities and educate the public regarding the social determinants of health.
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."
On April, 8th Wendell Potter spoke at the Lane's residence on the need for Medicare for All from the perspective of a former health insurance company executive in charge of spinning their increasingly onerous contracts so that the public would not protest too much.
On March 26, 2019 at 7:30 PM in Greensboro, Jonathan Oberlander, PhD. professor at the University of North Carolina presented "Unfinished Journey: The Future of Health Care Reform" at Union Square Campus.
The March 19, 2019 Lunch with the League related to universal health care coverage.
October 21, 2018 we had a booth at the Greensboro PRIDE festival and handed out over 200 of the League's voter's guides along with our bookmarks related to improving access to healthcare.
Piedmont Triad League of Women Voters Health Round Table met Monday, Nov. 4th, noon to approx. 1:30 at Deep Roots Conference Room
Submitted by Wayne Hale with edits by Laurey Solomon
Present: Laurey Solomon, Anna Fesmire, Jessica Goodman, Rob Luisana, Tim Lane, Wayne Hale, Marilyn Evans, Sierra Saykeo, Eleanor Stoller, Andy Stern, Teresa Bratton and Mary Carlan Eubanks
Laurey reported on a meeting that she attended on the state of women's health in GSO and Guilford Co-sponsored by the Commission on the Status of Women. Cone Health obstetrics has to deliver all of the babies covered by Medicaid (about half of all deliveries) since none of the private practices will accept Medicaid rates as of 2016. When the Women's Hospital beds are moved to the Cone Hospital campus there will be significant improvements in services.
Laurey presented the story of her American friend who is married to a Dutch citizen. They had lived in the U.S. for 5 years, but moved to Holland for his health care because they could not obtain/pay for care for him in the US. After being there 3 years, she has several complaints about the Dutch health care system. (PCP is assigned by where they live, need referral to see specialist, expensive versions of medications are not available, only 1 dental check-up per year, etc.) The story was used to illustrate the fact that prosperous Americans will have to accept compromises in service to the greater good under a Health Care for All system.
Rob had interacted with Robin Britt who was recently honored at his retirement party for his career long advocacy for children's health. Rob suggested that we ask those with expertise related to health to present at our roundtable. It was the consensus of the group that Mr. Britt be invited to present to us.
Robin Lane sent the information that the Medicaid expansion bill is dead. Some members surmised that a judicial ruling in another state declaring the work requirement unconstitutional may have contributed to Republicans not continuing to promote their bill.
Tim Lane is gathering information on what Cone Health is doing in the area of Healthy Choices. An example of what they are doing is subsidizing healthy foods for diabetic patients. He continues to try to contact Cathy Colville, a Cone Health administrator involved in promoting the program.
We spent the majority of the meeting discussing plans for the LWVPT February meeting, for which our roundtable is responsible. Laurey suggested that we use the analysis done by the Commonwealth Fund which defines 8 plans, beginning with what remains of the ACA then sequentially building on each prior plan, with the final 4 plans covering all citizens and the final 2 using a single-payer. Rob suggested making the session interactive with a panel and questions from the audience. Teresa suggested including discussion of returning to pre-ACA coverage. Tim reminded us of the psychological tendency of people to avoid risking what they already have for the chance of getting better medical insurance. Rob said that if we continue on the same course, we'll all pay more and get less He recommended we have a panel, present their backgrounds, then take questions from the audience. Robin Lane was suggested as a provider who know the Medicaid issues. Rob could represent the business medical insurance viewpoint and it was suggested that Tim Rice, former Cone Health CEO, who now supports Medicare for All, might be willing to participate. Rob will ask him. Theresa Bratton volunteered to begin by stating the LWV national position on health care then give a brief review of the Commonwealth Fund analysis of the range of proposed options. Wayne recommended that a copy of their summary tables be made available to all attendees.
Laurey is still communicating with her contact at A&T University seeking to collaborate with the faculty and students to involve them in discussion of health care proposals.
We then discussed the signs being developed, each with a brief comment pertinent to the problems with our current health insurance system. Laurey and Jessica had struggled with fitting all of the logos on the signs and the group supported limiting them to the LWV logo and the Vote411.org logo. Since the board was not comfortable with using the statement regarding the near equality of billing clerks with inpatients at Duke Hospital, Laurey will look for national data to reflect that ratio. Laurey will begin to develop further pertinent statements for signs. Anna Fesmire offered to help with printing them.
Per Robin Lane's emailed recommendation, we were all encouraged to spend further time reviewing the information on the Wendell Potter's "businessformedicareforall.org" web site that promotes the likelihood that businesses will pay less. We just need to convince them of that.
League of Women Voters of the Piedmont Triad Health Roundtable Meeting October 7, 2019 In attendance: Laurey Solomon, Chair. Members present: Marilyn Evans, Rob Luisana, Anna Fesmire, Andy Stern, Teresa Bratton, Eleanor Stoller, Tim Lane Meeting was called to order at 12:04PM Greensboro Pride Festival had good LWVPT representation in September. The League once again had its most youthful, if not most stylishly dressed, audience. There was general agreement that this event is worth the League's time and effort. We thanked all those who volunteered and especially Jessica Goodman who suggested the quiz game to engage young people. Thanks also to Tim and Eleanor, who helped generate questions. Rob Luisana reported on his Rotary talks re healthcare reform. Several upcoming talks are scheduled. Thanks to Rob taking on this responsibility with generally conservative groups, all potential voters. Medicaid Expansion Briefly discussed the continued legislative limbo of Medicaid Expansion. House bill 655 (HB665) has been introduced but because of its controversial requirements for an individual monthly premium and work requirement provisions, its progress is stalled. If passed it is likely to be vetoed by the Governor and face legal challenges to the above provisions. The League has not endorsed this legislation. The debate goes on. It was suggested that it would be of interest to hear from Rep Hardister on this topic at the upcoming LWL, where he will be a panelist. Andy Stern will have a question ready for him during Q&A. . Sign messaging for the Health Roundtable for public and internal education were discussed. The signs are almost ready to use, they need to pass review with the Exec Board and be formatted. Laurey Solomon and Jessica Goodman hope to have them ready next month. Discussion of our RT's LWL program began. We are responsible for the February program. Laurey offered to present on Violence Against Women, relating it to Womens' Suffrage and Social Determinants of Health if it is the desire of the RT. We will be thinking about this and choose our subject next month. Robin Lane will forward to the members a report on health care financing and Medicaid expansion. Tim Lane volunteered to contact Cathy Colville at Cone Health who is is focusing on social determinants (aka Health Opportunities) for the organization. Next meeting Monday, Nov 4 at noon at Deep Roots. Submitted by Tim Lane with minor edits by Laurey Solomon.
LWVPT Health Round Table Monday, Sept. 2, noon to approximately 1:00 PM Deep Roots Conference Room Submitted by Wayne Hale with edits by Laurey Solomon
Present: Laurey Solomon, Anna Fesmire, Barbara Carter, Wayne Hale, Andy Stern, Teresa Sue Bratton, Marylyn Evans and Eleanor Stoller.
Laurey announced that the FAQ's that she developed were approved by the LWVPT executive board after some minor edits, and the revised version was added to our web page.
Staffing positions are filled for our booth at the Greensboro Pride Festival on Saturday September 15th from 10:30 AM to 6:30 PM and Jessica Goodman will be bringing some additional volunteers for the afternoon hours. Vender information has been emailed to Anna, Teresa and Barbara who will be setting up our booth starting about 10:30 AM. Barbara will be doing voter registration. Anna has prepared question signs to hang on the shade tent to engage passers-by in discussions about health care access. Jessica, Eleanor, and Tim Lane created a Health Care Trivia game to play at our booth.
Laurey shared the pens that she ordered to pass out at the Festival, $158 for 500 pens, with "League of Woman Voters of the Piedmont Triad" and "Health Care for All" printed on the side. There was not room for other information. Anna volunteered to fund half of the cost.
We will not be attending the health fair that will be happening at the New Hope Missionary Church in the Cottage Grove community. They had wanted us to focus on the social determinants of health and we will not be adequately prepared to present on that topic by the time of the fair.
Laurey attended the board orientation and now has a more complete understanding of LWVPT procedures and knows who to ask for help.
Rob had his PP presentation recorded. He has made a 5 minute "teaser" from parts of it and posted it to youtube. Laurey will send the link to Wayne who will place it on our web site for viewing. We will check with Rob about viewing the entire presentation.
Laurey has made a faculty contact at A&T University in the Department of International Business who is interested in helping our roundtable connect to campus organizations whose goals are compatible with ours.
On our web page, Wayne will be splitting the Resources and Links sections to enable easier access to the most recent information added related to these topics.
An August 26th an article was published in the New York Times regarding North Carolina initiatives under Mandy Cohen, secretary of NC DHHS to improve state residents' health by paying for improved health outcomes rather than for health care provided. This article will be added under Links.
Our roundtable is currently schedule to present the January meeting of LWV of the Piedmont, but Laurey won't be available that month. She is working to change us to February. Based on her prior work related to preventing violence against women, she is considering development of a presentation on that topic as part of the information on the social determinants of health that we will be developing in the coming months, subject to the RT's agreement. The centennial of women's suffrage will occur in 2020, making this topic one we will want to emphasize.
Next efforts will be to put up signs with surprising facts about Health Care out in the community, pursue collaboration with A&T, and begin to work on supporting the state's emphasis on improving social determinants of health.
Next meeting will be Monday, Oct 7 at noon in Deep Roots conference room.
Piedmont Triad League of Women Voters Health Round Table Monday, July 8th, noon to approx 1:30 Deep Roots Conference Room Submitted by Jessica Goodman with minor edits by Laurey Solomon
Present: Laurey Solomon, Anna Fesmire, Barbara Carter, Jessica Goodman, Rob Louisana, Tim Lane, Robin Lane, Wayne Hale, Shirley Carr and Mary Eubanks
Talking Points LWVUS stance on healthcare: Every resident should have access to healthcare, including birth control and reproductive choices. Morally right Insured people pay for others anyway when hospital ER's are required to stabilized everyone regardless of ability to pay Democrats are split Access to the ACA is based on social equity politics Mention of racism as it relates to lack of health care in US (remember the 3/5ths compromise in 14th amendment). Define "resident" as used in the LWVUS' "Impact on Issues". Laurey will ask a RT member to research this.
Laurey shared two handouts she intends for members to use to advance discussions that promote health care for all. These also informed the one-sentence/short blurb signs she created. Regarding those handouts: Suggestions that were shared in the meeting: Add a Title, created date and edited date Keep Big Picture and purpose of document in mind as we edit First point: "long-term goal of many and a demand centuries old" Change "general income or payroll taxes" to just "taxes" Possibly clarify "socialism" through public vs. private options (i.e. Post Office vs. FedEx) Cite sources Will need to get the document approved by the board This task was taken on by Tim, Robin, and Laurey (with Rob's added talking points) Make your own edits and share with the RT before the next meeting.
Laurey's second handout was tabled for the next meeting. Robin Lane has agreed to become the point person for HRT's goal of Medicaid Expansion. "Healthcare Can't Wait" Initiative described by Robin Lane Effort to extend healthcare to everyone Robin (and initiative) are asking that we send a nonpartisan statement to the Guilford Delegation in order to overturn Governor's veto of budget SB681 or the "rural healthcare stabilization plan" Robin and Barbara will add this to the League Action Alerts
Jessica had to leave early, this is as far as her record goes.
Greensboro News and Record, May 2019, Wayne Hale Rising Deductibles Threaten U.S. Health
Last December it was reported that life expectancy in the U.S. decreased for the third year in a row. Canadian women now live 3 years longer and their men 4 years longer. Drug overdoses and suicides receive the most blame, but a growing contributor will be avoidance of preventive health care. The Los Angeles Times recently reported that medical insurance deductibles have quadrupled since 2006 so that on average insured people have to pay $1350 out of pocket before their medical costs begin to be covered. Since only half of non-elderly single households have liquid assets above $2000, it is very likely that a colonoscopy or stress test will be delayed if it is done at all. Increasingly, employment based health care is becoming catastrophic care, since the avoidable cancer or heart attack will result in expensive emergency care. The deductible will be met, but irreversible damage will have been done. That money may not be spent if the insured person dies, but the company's CEO certainly won't tout that cost-saving measure in the annual report to shareholders. Anxiety from being underinsured is a stressor that itself will contribute to the declining health of our nation.
Greensboro News and Record, March 17, 2019, Wayne Hale Healthcare Spending is Unsustainable
"The U.S. federal government is on an unsustainable fiscal path. ... The thing that drives our single unsustainability is health care spending. We spend 17% of GDP, everyone else spends 10%. ... It's not that benefits themselves are too generous. We deliver them in inefficient ways." You might guess that Senator Bernie Sanders said this, but it was actually Jerome Powell, Federal Reserve Board Chairman. Could that extra 7% of GDP be spent on providing services to patients, rather than on CEO salaries, excessive drug prices, middleman services, and shareholders? Healthcare costs were at the top of voters' concerns according to exit polls during the 2018 elections. The League of Women Voters of the Triad's Healthcare Roundtable is working to prepare voters for candidates' proposals related to delivering healthcare services so that they would be universally available to our population. 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 at124 E. Gate City Blvd. Attendance is open and free to the public. Let's figure out how to provide effective healthcare to everyone!
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.
Won't my taxes go up? Yes. But increased taxes will be offset by decreased health care expenses for most families. The League of Women Voters supports a system paid for by general taxes instead of insurance premiums, which would disappear. Deductibles and copays would be based on income, just like taxes, so that lower income people would pay less than those with higher incomes. In our present system where most of us get our health insurance through our jobs, the lowest paid employee in the company pays the same premium, deductible, and copays for insurance as the highest paid employee. Therefore, lower paid employees spend a higher percentage of their income on health care. This is especially true for families since family coverage is much more expensive than employee only coverage. With health care for all paid for by taxes, lower and mid level wage earners would save money. A Rand Corp study commissioned by the state of New York in 2018 to consider a single payer system for the state concluded that only those earning $134,000 as individuals and $276,000 for a family of 4 would pay more for health care as a result of the tax increase.
Why should I pay higher taxes so other people can get health care? You already pay for other people to get health care, in the least beneficial and least efficient way. When people can't pay for preventive and/or ongoing care, they end up going to hospital emergency rooms, where they know they can get at least some help without paying for it. Guess who does pay for it? You. Hospitals increase what they charge you and your insurance company to cover treatment of the uninsured. You also pay in many overarching, indirect ways like increased costs of goods and services due to lower worker productivity, poorer overall public health, and increased burdens on several public services.
Won't I have to wait longer to see a doctor and to have elective procedures and surgeries? If we try to answer this question by comparing current wait times in the US to current wait times in countries that provide health care for all, we can't. Not all countries measure wait times. (France, whose health care system is ranked #1 by the World Health Organization, does not even measure wait times.) Those that do measure wait times don't use the same standards and methods so we can't legitimately compare their results. We simply can't answer this question. One thing we do know is the wait time for people who currently have no health insurance will improve dramatically.
Isn't this socialized medicine? Of the 32 developed countries that have health care for all, most do NOT have socialized medicine. Socialized medicine means the government owns the health care facilities and employs all the people who work in them, like in the UK and a few others. The rest of the world's developed countries each have a system that works best for them. Some require everyone to buy health insurance through either their employer or the government. Some collect taxes and then pay private providers to deliver health care. Some have a system that combines both methods by taxing people to pay for basic services and if people want additional care they can buy insurance to cover it or pay for it out of pocket (at much lower costs than the US). Socialized medicine is only 1 way to provide health care for all, it is not the only way and most countries do it differently.
We have the best health care in the world. Why mess with success? Actually, we don't. We have excellent care in some areas but we fall behind many countries in others. Several organizations have researched and rank ordered the health care systems of developed countries based on factors like life expectancy, access, efficiency, medical errors, cost, and prevention. The US doesn't rank in the top 10 in any of the studies!
Will I lose the ability to choose what doctor I go to? Most health care for all systems allow people to choose their doctors.
Will health care be rationed? At first glance, this seems like a straightforward question but it's not. If we agree that rationing involves deciding how to use limited resources, that already happens in every health care system, including ours. There are several ways insurance companies in the US practice "covert rationing" (meaning they don't want you to realize they are doing it). One example is when they create "in network" and "out of network" providers. "In network" providers are those that the company has negotiated with to accept lower payments for their services. You can still go to an "out of network" provider but you will pay more because that provider won't accept payment at the same rate as "in network" providers. Another example is when an insurance company refuses to cover a drug or treatment because they label it "experimental". Or when an insurance company gives its clients a list of "approved" drugs for various illnesses and conditions. That is rationing and it already happens in the US. These are just a few examples among many. Under health care for all, any rationing that occurs will not be a new concept or practice. (Last revised 08/07/19) References:
http://www.lwv.org/sites/default/files/2019-04/LWV 2018-20 Impact on Issues.pdfRand Research Report: An Assessment of the New York Health Act, A Single Payer Option for New York State, Jodi L. Liu et al 2018
http://www.ncbi.nlm.nih.gov/books/NBK221654/http://www.sciencedirect.com/science/article/pii/S0168851013001759 http://www.beckershospitalreview.com/quality/among-11-countries-us-ranks-last-for-health-outcomes-equity-and-quality.html interactives.commonwealthfund.org/2017/july/mirror-mirror/ www.medscape.com/slideshow/2019-compensation-overview-6011286#3 http://www.verywellhealth.com/what-is-healthcare-rationing-2615389 www.forbes.com/sites/robertpearl/2017/02/02/why-healthcare-rationing-is-a-growing-reality-for-americans/#10822ff2dbad