Health care can suffer when job fears affect decisions on drugs, doctor visits

by Scott Monroe Staff Writer Kennebec Journal Morning Sentinel published August 8, 2009 Paul MacDonald thought he had found a way to save a good chunk of money he was spending on his prescription medication. MacDonald, 67, of China, said his medications, such as blood-pressure and cholesterol pills, are covered under a Medicare program, though it still costs him about $250 out of his own pocket each time. MacDonald said he recently found a program through a supermarket in Augusta to save about $580 each year by purchasing generic medication brands, or about $120 out of pocket. But he isn't allowed to under the program, at least not until Jan. 1. MacDonald, who says he's on a fixed annual income of $28,000, said the inability to save on his medications right now is a burden, especially in an economic downturn and with rising expenses. "It would save Medicare what it would cost me," MacDonald said. "Here you are trying to save some money and they don't want to. I'm sure there's plenty of people that really need the program and want to be in it, but surely there are a lot of people in my predicament." MacDonald's efforts to save money on health-related needs and expenses represent one example of how some people are trying to save money when it comes to health care. But are more and more people actually delaying -- or even forgoing -- necessary appointments, medications or procedures? There have been some indicators that, nationally, that could be happening. A study released by the Center for Studying Health System Change, a Washington, D.C. health policy research group, said that, in 2007, more than 28 percent of the 72 million working-age people in the U.S. with chronic illnesses such as depression lived in households that struggled to pay their medical bills. The study also said that while the uninsured are most vulnerable, medical-bill problems were growing among people with insurance, too. According to the National Employment Law Project, more than a million jobless Americans will exhaust their unemployment insurance benefits by the end of the year. More calls have been coming into Crisis & Counseling Centers, a private, nonprofit social-service agency with offices in central Maine. Lynn Duby, CEO of Crisis & Counseling, said calls to the agency increasingly deal with complex needs, in which health services are cut out or cut back. "One phenomenon is people who have been unable to get services they might have gotten in the past and they find their situation worsening, so by the time they call us they're much more likely to need services at a higher level," Duby said. "Our job is to try to help people earlier so they don't need to be hospitalized for services, so when people delay as a result or lose support, then their situation doesn't deteriorate." Hospital officials in central Maine reported no noticeable trend in people cutting back on health needs, though postponing or "spacing out" expenses has been noticed. "Our primary-care physicians have not experienced appointment cancellations associated with the poor economy; in fact, schedules are busier than ever," said Frances Renye-Smith, administrator for employed-physician practices at Inland Hospital in Waterville. "However, several specialists have reported seeing patients postpone routine or elective procedures because of their concerns regarding extended recovery times, time away from work, etc. It's a concern because postponing certain medical procedures can put a patient at risk for future complications." For example, a patient had been scheduled for a colonoscopy at Inland, but after learning of a pending layoff at his place of employment, he postponed the procedure out of fear of losing his job for time he would be away from work, Renye-Smith said. Karen Mosher, clinical director of Kennebec Behavioral Health, echoes that observation. "I know we've seen some of that -- people feeling they need to space things out, so they can afford their co-pays and so forth," Mosher said. MaineGeneral Health Associates, with hospital campuses in Augusta and Waterville, is seeing more "self-pay" for services, perhaps highlighting the pressures on employer-offered health insurance, said company president Dr. Barbara Crowley. That could suggest employees sharing more of a burden with employers to pay for health-insurance premiums and higher deductibles. In order to help people avoid facing costly services, MaineGeneral offers several programs such as preventative visits and screenings, Crowley said. One example is an outreach effort to encourage women over 40 to have mammograms to detect breast cancer, she said. Crowley also pointed to the company's CarePartners program, which is a group of doctors, hospitals and other health care providers who volunteer to provide check-ups and other preventative services to people either under-insured or uninsured and not covered by MaineCare. Although there are signs nationally of the economic downturn leveling out, the cost pressures on health needs are bound to get worse in Maine where state government faces mounting deficits, according to Duby, of Crisis & Counseling. "Hopefully legislators ... are open to creative ideas to address the problem because just cutting services is not always the best solution," Duby said. Scott Monroe - 861-9253 smonroe@centralmaine.com FIRST IN A THREE-PART SERIES Sunday: Why doctors offer fewer free prescription samples. Monday: Area hospitals offer voucher programs to help fill the health-care gap. BENEFITS 'EXHAUSTION' According to the National Employment Law Project, about a half-million people in the U.S. will exhaust their unemployment benefits by the end of September. That number will total more than 1 million by December. The organization estimated these "exhaustions": * 542,921 in the U.S. by the end of September * 1,492,830 in the U.S. by the end of December * None in Maine by the end of September * 5,573 in Maine by the end of December

High costs put preventative Health Care out of reach

America's current health-care system needs fixing now. Many working families are one illness away from losing everything they've worked for if a family member gets sick. We cannot keep the status quo. It is not working. The skyrocketing costs of care put preventive measures out of reach for many. I had my annual physical and mammogram and that alone came to a little over $400. People used to receive health insurance as a benefit through their work. Many businesses now cannot afford to provide coverage for their workers. Companies lay off workers in order to be able to maintain their benefit package, or they simply choose an insurance plan that covers less. Those fortunate enough to have health coverage through their work are finding that their co-pays, their share of the premiums, their deductibles have increased. Those who purchase individual health insurance policies are at the whim of the insurance company. Extremely high deductibles, $5,000 to $10,000 annually to allegedly make the policy "affordable," the high co-pays, then what is and isn't covered does not make for good coverage. I'm one of the uninsured. I work, but my employer does not offer insurance because she cannot afford to. My family had a catastrophic plan, until I learned that our deductible was $30,000 per year, instead of the $10,000 I thought it was. We need health-care reform now. Reform needs to contain cost, cost of insurance and cost of care. Helen Hanson South China my Letter to the Editor published in the Kennebec Journal August 2, 2009

Health Care Reform Opponents Resort to Mob Rule

by Mike Hall, August 4, 2009 The extremist fringe of the anti-health care reform movement—with a wink and a nod from more mainstream health care opponents—is using mob rule to disrupt town hall meetings and community forums set for the congressional recess. Mob rule tactics stopped the Florida vote count during the contested 2000 presidential elections, ultimately turning the presidency over to George W. Bush—a strategy now emulated by the anti-health care reform lobby. As Slinkerwink at DailyKos wrote yesterday: The crazies are coming out in full force to local town hall and community events being held by Democratic lawmakers—with only one goal—to interrupt the Democratic lawmaker on health care reform, and shout right-wing talking points at him or her to scare the rest of his or her constituents at that event by sowing confusion and fear in the crowd. The coalition of extremists groups, including FreedomWorks, Right Principles, American Liberty Alliance, even has written game plan. The anti-government group Right Principles is telling people how to take over a meeting. Be disruptive early and often. You need to rock the boat early in the rep’s presentation. Watch for an opportunity to yell out. The goal is to rattle him…stand up and shout out. Look for these opportunities before he even takes questions. At town hall meeting in Setauket, N.Y., Rep. Tim Bishop (D-N.Y.) was confronted by a loud mob that yelled criticisms of his stands on health care, energy and the economy and shouted down his answers. He even suspended some scheduled town halls. I have no problem with someone disagreeing with positions I hold….But there is no point in meeting with my constituents and [to] listen to them and have them listen to you if what is basically an unruly mob prevents you from having an intelligent conversation. On Sunday, a group of protestors showed up at a town hall in Philadelphia with Sen. Arlen Specter (D-Pa.) and Health and Human Services Secretary Kathleen Sebelius. They shouted and booed loudly enough to drown out remarks from both officials and questions from the audience. On America Blog, Joe Sudbay describes these tactics as “thuggery that undermines democratic principles.” But thuggery seems just fine with some Republicans who, like Rep. Pete Sessions (R-Texas), chairman of the National Republican Congressional Committee, told Politico the days of civil town hall meetings are “over.” When asked if the Republican Party would use similar mob and shout tactics against Democrats, he said simply, “Wait until next year.” As Think Progress reported last week, these disruptive tactics have been used at a growing number of meetings and forums. This growing phenomenon is often marked by violence and absurdity. Recently, right-wing demonstrators hung Rep. Frank Kratovil (D-Md.) in effigy outside of his office. Missing from the reporting of these stories is the fact that much of these protests are coordinated by public relations firms and lobbyists who have a stake in opposing President Obama’s reforms. The lobbyist-run groups Americans for Prosperity and FreedomWorks, which orchestrated the anti-Obama tea parties earlier this year, are now pursuing an aggressive strategy to create an image of mass public opposition to health care and clean energy reform. The union movement has always supported free speech rights and the right to demonstrate and picket. But that’s not what these disruptions are about—they are crude and anti-democratic efforts to silence speakers, elected officials, in fact, in meetings with constituents—and intimidate people’s exercise of associational rights. Thousands of supporters for health care reform rallied June 25 in Washington, D.C., and with Congress on recess in August, union members and our allies plan to pack town halls and hold rallies across the nation to convey the message that Congress needs to enact health care reform now. Later today we will have more on recess actions on health care reform. AFL-CIO NOW Blog

Enough to Sign

In the “A Better Union Bill” editorial (BDN, July 23), the paper rehashes the worn-down stereotype of a key provision of the employee free choice act — majority sign-up. When I enlisted in the U.S. Navy, and later the U.S. Army, I signed my name both times. When I bought a car, I needed to sign on the dotted line. No one questioned my choices. I was not coerced nor tricked into fighting for my country, nor buying a car. The BDN correctly recognized the stalling, abuse and harassment that workers often face when forming a union, so why not recognize my signature as proof that I want a union? Majority sign-up is based on a simple idea: If a majority of workers say that they want a union, they should get a union. The Employee Free Choice Act also allows workers to form a union through a ballot election, but the point is that workers are in control, not the boss. The editorial needlessly questioned the status of majority signup in Congress. Majority sign-up is alive and well because it restores balance and is the best way for workers to form a union freely and fairly, without intimidation or harassment. Speculating on what may be part of a bill that has yet to be introduced is both fruitless and counterproductive. Congress must vote on majority sign-up because we desperately need legislation to level the playing field for working people. Ted Rippy Brewer Ted is 771's secretary. His letter was published in the August 1, 2009 edition of the Bangor Daily News. GO TED!

Own a piece of the movement

Yesterday, August 4th, was our President's birthday. And we wanted to celebrate in style.

SEIU has partnered with Florida-based artist Derek Gores to create an original piece of art for those closest to the movement to fix health care. Using words, photographs, and symbols of our movement as inspiration, Mr. Gores has captured this unique moment in our nation's history.

Sign-up to receive a limited edition print on health care reform.

The past few weeks have proven that in order to break the gridlock in Washington, we're going to have try harder, shout louder, and be more active in our communities than ever before. But if each of us pitches in, there's no doubt we'll win this thing.

The current bill in Congress, H.R. 3200 "America's Affordable Health Choices Act," will dramatically expand access to care and finally put a leash on health insurance companies. As we prepare to fight for reform with everything we've got, take a moment to enjoy Mr. Gores' vision of what our country might look like once we win.

Reserve your original Derek Gores full color poster here.

Obama trims sails on Health Reform

White House alters pitch in bid to reinvigorate president’s signature issue by Ceci Connolly WASHINGTON - From the start of his presidency, Barack Obama made clear that his plan for enacting comprehensive health-care reform came down to three words: fast, broad and bipartisan. That was then. Now, as lawmakers begin to flee Washington for a month-long recess, the White House team is retooling its message and strategy, hoping a more modest approach will reinvigorate Obama's signature domestic policy initiative and give him a first-year victory for Democrats to carry into the 2010 mid-term elections. Legislative wrangling, a well-coordinated Republican opposition and the sheer complexity of an issue that consumes nearly one-fifth of the nation's economy have taken a toll on the president and his bold ambitions. Polls show that support for Obama's handling of health reform has declined as anxiety deepens about its effect on middle-class, insured Americans. "There was a view that because of the recession this could be sold as an economic fix," said Howard Paster, President Bill Clinton's legislative affairs director in 1993. "That's not selling. The public has spoken loudly." With the debate shifting from partisan-charged Capitol Hill to the kitchens, diners and churches of America, Democrats are under pressure to counter the GOP's "risky experiment" story line. Four congressional committees have approved bills, largely on party lines, that would require that every person carry health insurance, would offer credits to families and small businesses that have trouble affording coverage and would begin to realign financial incentives toward performance-based care. A key fifth committee in the Senate is negotiating a more centrist bill, which could pave the way for a less-ambitious compromise. "Over the next few weeks, we must build upon the historic consensus that has been forged and do the hard work necessary to seize this unprecedented opportunity," Obama said Saturday. Eyeing success By leaving the bill-writing up to Congress, Obama is better-positioned to claim success no matter which bill is adopted. Already, he has abandoned his opposition to the proposed requirement that everyone have insurance, known as an individual mandate, and signaled a willingness to consider financing schemes -- including tax increases -- that originally were not on his agenda. His patient, hands-off style -- reminiscent of his methodical primary campaign last year -- has frustrated some anxious Democrats but stands in stark contrast to Clinton's unsuccessful strategy of crafting a 1,300-page bill in secret and then pressing lawmakers to approve it. Both political parties and dozens of interest groups intend to be heavily engaged throughout August with television ads, door-to-door campaigning, traditional town hall meetings and Internet-based, grass-roots activities. Health and Human Services Secretary Kathleen Sebelius, previewing a hectic month of travel for the entire Cabinet, makes appearances in Philadelphia on Sunday and Connecticut on Monday. Obama, too, will strike out beyond the Beltway with large rallies to energize supporters. Emphasizing market reforms Guided by polls, the administration intends to emphasize insurance market reforms -- prohibiting practices that have made buying coverage impossible or excessively expensive for many who are sick, older or had a prior illness. The theme of Sebelius's event Sunday with Sen. Arlen Specter (D-Pa.) and a webcast Friday is "Health Insurance Reform: What's in It for You?" Those regulatory changes -- included in every bill in Congress -- address the most common frustrations of the 180 million people who have health insurance. "If you're an American with insurance, you're saying, 'Where am I in this debate?' " said senior White House adviser David Axelrod. "We want to make sure that people understand" the many items in the legislation targeted to such individuals. Axelrod acknowledged that two critical constituencies -- senior citizens and women -- need to be reassured that reform will translate into the "security and stability" that Obama promises. "That's work that we need to do," the adviser said in an interview. For months, the White House assiduously courted industry trade groups, attempting to neutralize historically powerful opponents of change. But the talking points for the August recess have moved to a sharper critique of business interests. House Speaker Nancy Pelosi (D-Calif.) and top lieutenants have warned that they are not bound by deals the White House struck with drugmakers and insurers. "The glory days are coming to an end for the health insurance industry," she said Friday. More than rhetoric The shift may be more than rhetorical. Speaking of the 100 members of the Senate, White House health czar Nancy-Ann DeParle said: "I could get 100 votes" on the insurance changes being touted by Obama. If Congress enacted only the insurance provisions, it would still represent a significant achievement, though far less than the broad overhaul many expect. Administration officials have also begun whispering a phrase used during the presidential campaign, speaking of putting the nation on a "glide path" to universal coverage rather than the insurance-for-all trumpeted by many Democrats. Though few remember, Obama never promised coverage to all 47 million uninsured Americans. A slower, phased-in attempt to cover everyone would help reduce the cost of legislation. "A bill that gets us on a glide path is a win," said one Democratic strategist who recently visited the White House and spoke on the condition of anonymity because he is not authorized to comment on administration strategy. Many of Obama's problems of the past six weeks mirror the natural course of a new president pursuing a broad agenda. Although some allies question the wisdom of Obama's get-it-done-now approach, Republican pollster Bill McInturff said it made sense. "The longer legislation is around, inevitably the more you focus on the pain part," he said. Weakening his brand The Obama brand -- long the envy of politicians of every stripe -- has weakened as voters examine a record that has thus far entailed huge government spending to help the economy, said McInturff, who was a key strategist in the defeat of the Clinton plan. "This is not irrevocable, and it doesn't mean the fate of health care has been settled," he said. "We're going into this incredibly intense period where the fight for the hearts and minds of these members of Congress will be substantial." Sen. Robert F. Bennett (R-Utah) said, "Voters will punish people if we don't move ahead." But he and other senators have voiced frustration at being shut out of the negotiations. Splits Democrats say they are concerned that they are losing the message wars and facing substantive disagreements within their ranks. "Americans are asking what's in it for them, and I don't think the Democrats have responded as directly as we should on that," said Sen. Sherrod Brown (D-Ohio). With so much attention focused on the legislative brawls and missed deadlines, he said, "it looks like we're drifting." Sen. Ron Wyden (D-Ore.) fretted that the debate has been "dizzying" for the average American and that "there's an awful lot of substance that needs to be fleshed out as well." Sen. John D. Rockefeller IV (D-W.Va.) said that there is sufficient time for Congress to deliberate but that Obama should be "very aggressive" this month in rebutting attacks by well-funded interest groups. "He's got to get tough," Rockefeller said, "maybe tougher than he's ever been." The tensions have prompted Senate Democratic leaders to revive threats to use a parliamentary procedure to force health-care legislation through on a simple 51-vote majority rather than a filibuster-proof 60 votes. A month away from Washington may provide a much-needed "breather," as Rockefeller put it. But there are inherent risks for Obama when lawmakers who have yet to cast a vote are exposed to four weeks of intensive lobbying at home. "He needs to make sure he doesn't have a lot of defections" by Democratic lawmakers or industry groups that could return in September with new demands, Paster said. "His first year is going to be judged by how well he handles this issue," Paster continued. "If there is a health bill by Christmas, it will be deemed to have been a good first year." from MSNBC.com

SEIU Working to Repeal Provisions that Reduce Social Security Benefits if You Start Working in Public Sector

The Government Pension Offset (GPO) and Windfall Elimination Provision (WEP) are two provisions under Social Security which either reduce or eliminate retiree Social Security benefits upon retirement. Tell your Representative and Senator to repeal these harmful provisions. There are a variety of proposals which have been offered that would either revise or eliminate the GPO and WEP. SEIU supports the Social Security Protection Act (S. 484/H.R. 235) sponsored by Senators Dianne Feinstein (D-Calif.) and Susan Collins (R-ME) and Representatives Howard Berman (D-Calif.) and Buck McKeon (R-CA) that would repeal the Government Pension Offset (GPO) and the Windfall Elimination Provision (WEP) allowing public employees to collect the benefits they have earned upon retirement. It is great to see Senator Collins' name on the list of sponsors. Click here to show your support by signing SEIU's petition.