Questions KVO is asking Candidates

Candidates Forum on Health Care Sunday, September 28, 2008 3-5 pm

Immaculate Heart of Mary Parish Hall 21 High Street, Fairfield

Questions for the Candidates

I. General Health Care Principles

Background

The Kennebec Valley Organization is made up of congregations, unions, professional associations and community groups committed to the dignity and freedom of all people. Although our member institutions represent people from different walks of life, we all share the basic value that everyone should have the opportunity to get quality, affordable health care.

KVO member institutions held “Our Health Care Story” meetings this Spring that included more than 100 of our people from Augusta to Skowhegan to discuss our values and share personal stories of health care. From these discussions, and out of the issues arising from sixty-five health care stories KVO collected, our leadership team developed twenty principles for health care reform.

On June 18th, 40 KVO delegates and allies gathered at First Congregational Church (UCC) of Waterville to report on the Our Health Care Story meetings, learn about our current health care system and proposals for reform from policy experts and advocates, and decide on guiding principles for the KVO health care campaign. The Assembly reached consensus that the following five principles should be made a top priority and serve as the foundation of our KVO Health Care Campaign:

1. Health care is a BASIC HUMAN RIGHT stemming from the sanctity of human life. A JUST SOCIETY must ensure that everyone receives compassionate, comprehensive and competent health care, independent of employment, age, health or family history.

2. Health care should emphasize PREVENTION, and preventive medical care should be covered by every patient’s health care policy.

3. AFFORDABILTY: Everyone pays based on financial ability. 4. Special efforts should be made to provide care for geographic areas and populations that have been UNDERSERVED, such as rural areas, inner cities and impoverished communities.

5. Insurance companies and other third party payers, the pharmaceutical industry and other commercial interests should not function as barriers to care, or impede the provider/patient relationship in making medical decisions.

Questions for Candidates on General Principles:

STATE CANDIDATES and FEDERAL CANDIDATES

Do you support our Declaration of Health Care Principles, particularly our top five priorities? Why or why not?

If elected, will you take action to advance these principles? Please explain.

II. Long-Term Care

Background

Maine’s system of long-term care relies on more than 22,000 direct care workers who provide critical front-line care to elderly, disabled and chronically ill consumers in their own homes and skilled care facilities. They are nursing aides, orderlies and attendants; home health aides; psychiatric aides and technicians; and personal and home care aides. They are the CNA who helps our Alzheimer’s-stricken mother to eat her supper; the home care aide who helps our wheelchair-bound son to get on and off the toilet; the homemaker who provides a comforting word and a quick housecleaning for our homebound neighbor.

As Maine ages, demand for these occupations is expected to grow faster than any other occupation in any sector. And yet, the wages and benefits for these positions, determined to the largest extent by reimbursement levels from Medicaid (MaineCare) and Medicare programs, are generally hovering around the poverty level. More than a quarter of direct care workers lack health insurance, a bitter irony for a set of workers who provide health care as a vocation. As a result, the supply of workers for these jobs does not meet the current demand, and that mismatch is only projected to get worse.

With the crisis of direct care work comes a crisis of direct care. We heard stories from our member groups of people who worry about getting quality nursing home or home health care for themselves or loved ones, now or in the future. People are worried that they will not be able to find enough help to stay in their homes as long as possible, or, if nursing home care is required, that there will not be enough beds or that overstretched staffs will not be able to adequately attend to their needs.

Responding to stories KVO heard from members confronting this crisis as workers, providers, family caregivers, consumers, and potential consumers, we initiated a campaign in the spring of 2006 to assure quality care by ensuring quality direct care jobs. As part of the Direct Care Worker Coalition, we supported L.D. 1687, “An Act to Increase Health Insurance Coverage for Front-line Direct Care Workers Providing Long-term Care.”

Unfortunately, due to the states’ shaky fiscal climate and the uncertainty around the Dirigo Choice health plan (which would have been one of the vehicles to provide coverage), the bill was defeated in the Insurance and Financial Services Committee. However, the committee did direct the state’s Superintendent of Insurance, Mila Kofman, to convene a broad, representative stakeholders group to discuss alternative options to provide health insurance to this vulnerable group of workers.

KVO was represented on this working group by several leaders who are themselves workers and consumers in long-term care. Other members of the work group included legislators and state agencies, the Maine State Chamber of Commerce, health insurance companies, and several organizations representing direct care workers, employers, and consumers. Superintendent Kofman will submit a report to the IFS Committee by October 1st. We expect the report will detail the barriers to health care access for direct care workers, provide reasons the issue is so important, and include action recommendations to address these challenges.

We do not, however, expect there to be a “magic bullet” solution. From our participation in the discussions of the working group, it is apparent that there is no pure private insurance solution that will be both affordable to long-term care employers and employees and provide a reasonable level of benefits.

Ignoring the crisis carries even bigger costs, however, as a continued shortage of workers in this sector – particularly home health and personal care – could lead to deeper costs for consumers, workers and taxpayers in the near future.

Questions for Candidates on Long-term Care:

STATE CANDIDATES and FEDERAL CANDIDATES

Do you see the lack of health care for health care workers – particularly direct care workers in longterm care – as a crisis? And, do you believe that there is a link between this problem and the quality of care available to our communities’ elderly, disabled, and chronically ill members?

STATE CANDIDATES

The Maine Superintendent of Insurance is due to release a report on this situation, with recommendations for action, on October 1st. Will you agree to meet with us within 3 months of your election to discuss this report and work together to implement some of the action recommendations?

FEDERAL CANDIDATES

Will you work to make sure that any state-level effort is supported with federal funds?

III. Health Care for America Now! Coalition

Background

KVO recognizes that there are limits to what can be achieved at the local and even statewide level for health care reform. To create a true health care system that reflects the values and principles in our Declaration, health reform needs to be addressed at the national level.

For this reason, KVO has joined the Health Care for America Now! Coalition, which shares our vision of access to quality, affordable health care for all and endorses a set of principles for health reform that are similar to and compatible with those of KVO. The broad HCAN coalition includes community groups; unions; businesses; faith-based groups; health care providers; women; communities of color; seniors; people with disabilities; people with serious and chronic illness; advocacy and policy groups; students; political organizations; and all others who share the campaign’s statement of common purpose.

The goal of HCAN is to educate decision-makers and citizens about the choices we face in health care policy, and to ensure that the next President and Congress make access to quality, affordable health care for all Americans a top priority in 2009.

KVO and HCAN recognize that private insurance companies may well continue to play a role in this vision of health care for all. However, we also recognize that a private insurance company’s primary purpose, no matter how responsible a corporate citizen it may be within the health care system, is to maximize profits for its stockholders. Therefore, government has an important watchdog role to play with all health insurance plans, assuring that risk is fairly spread among all health care payers and that insurers do not turn people away, raise rates or drop coverage based on a person’s health history or wrongly delay or deny care. Currently, this regulatory power is focused at the state level.

A recent report from the Northwest Federation of Community Organizations, titled “Insuring Health or Ensuring Profit? A Snapshot of the Health Insurance Industry in the United States,” documents a pattern of rapidly rising profits without a corresponding increase in number of members covered. The pattern is shown to hold for Maine’s major health insurer, Anthem Health Plans of Maine, a subsidiary of WellPoint. From 2004 to 2007, Anthem’s profits increased by 89.2%, while its membership increased only 2.4%. However, when KVO joined the Maine People’s Alliance and other allies in the Maine HCAN coalition asking for some answers from Anthem regarding how they were able to make such high profits without adding many people to the ranks of the insured, our questions were ignored.

Questions for Candidates about the Health Care for America Now Coalition:

STATE CANDIDATES

Despite our efforts, we have not been able to get Anthem to provide us with basic information about their claims denial practices, the reasons their profits are skyrocketing even though enrollment has stayed flat, or the amount of policy-holders’ money that is shipped out of state to parent company and shareholders.

If elected, will you work to ensure transparency and accountability from private insurers? What will you do?

FEDERAL CANDIDATES

Do you agree with the HCAN Statement of Common Purpose? Are there any HCAN principles you don’t agree with? Why?

If elected, will you or your top health care staffer meet with representatives from the HCAN coalition to discuss common health care goals in the upcoming Congressional session?