On Using Mr. Bullhorn, Or, DC Health Summit Thursday: Come Say Hi...Loudly

It was a long hot August for those who would like to see health care reform, as rabid “Town Hall” protesters proffered visions of public options that would lead to death panels and socialism and government tax collectors with special alien mind control powers that would use sex education and child indoctrination and black helicopters as the means for gay people to impose their dangerous agenda on the innocent, God-fearing citizens of someplace in Mississippi that I’m not likely to ever visit.

Part of the reason that opposition was so rabid was because health care interests were spending millions upon millions of dollars doing...well, doing whatever the opposite of giving a distemper shot to the angry mob might be, anyway.

So wouldn’t it be great if all the CEOs of all those health care interests were to gather at one time and place so you could, shall we say, gently express your own thoughts regarding the issues of reform and public options?

By an amazing coincidence, that’s exactly what’s going to happen Thursday in Washington, DC, as the Patient Centered Primary Care Cooperative (PCPCC) holds its Annual Summit.

Follow along, and I’ll tell you everything you need to know.

The Who, The What

There are two important bits of setting up that are required to make this story work; and the first is to explain who the PCPCC is, exactly. To quote their website:

"The Patient Centered Primary Care Collaborative is a coalition of major employers, consumer groups, patient quality organizations, health plans, labor unions, hospitals, clinicians and many others who have joined together to develop and advance the patient centered medical home. The Collaborative has well over 500 members.

The Collaborative believes that, if implemented, the patient centered medical home will improve the health of patients and the viability of the health care delivery system. In order to accomplish our goal, employers, consumers, patients, clinicians and payers have agreed that it is essential to support a better model of compensating clinicians."

The "patient centered medical home"?

Is that anything like "precious bodily fluids"?

Actually, the original idea was to create a "home" where a patient's scattered medical records could be gathered. Forty years later, the concept has evolved to a "home doctor" who coordinates all your health and wellness care from all your providers.

This is a huge shift in how care is delivered (and how healthcare dollars would be distributed), which is why the Collaborative has so many members...including seven of the top ten health insurers in the country.

The Why

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I've been getting emails that tell me CEOs such as Stephen Helmsley of UnitedHealth and Angela Braly of WellPoint (insert booing and hissing here) will be present--and these are the exact people that you should be giving a "Town Hall-like" welcome of their own when they hit Washington.

Groups such as Democracy for America and TrueMajority will be working together to bring people who have been personally affected by the insurance crisis to the meeting--even though we're not invited inside to support something like, oh, I don't know...maybe a public option?

They want you to attend as well, to make lots of noise, and to send the message that we won't be ignored. It's a critical time in the debate, as there are Democrats yet to be convinced, and if you can be at this meeting it will capture media attention that could help move those Democrats to our positions.

The Where, The When

The event takes place in Washington DC all day Thursday (from 9-4:30) at the Walter E. Washington Convention Center, conveniently located at 801 Mount Vernon Place NW; just six blocks from the Executive Office Building and the White House complex...and, on its south side, just 50 feet from K Street, the "Glitter Gulch" of lobbying.

There's a handy Metro station, and if you walk to the south end of the Convention Center (the Mt. Vernon Square end of the building) you'll find that the American Federation of Labor occupies a building across the street from the Square on the west side--and National Public Radio occupies a building diagonally across the Square on the east side.

So if you're planning to be in Washington Thursday--or you've been looking for an excuse to visit--make a day of it: stroll by the White House, see lobbyists and unions and National Public Radio at work...and most importantly of all, make sure the CEOs of the health insurers in attendance get the same kind of rousing "Town Hall" welcome at the Convention Center that they spent millions of dollars to create in our own home towns.

In other words, bring Mr. Bullhorn--and the extra batteries.

Of course, I don't want to make this too much of a hard sell.

After all, it's not as if your life depends on you attending some--hey, wait a minute...actually, I guess it kind of does.


can't go?

make noise at home: call a member of congress thursday and remind them that the public option matters, big time, to real voters.

"...i feel that if a person can't communicate, the very least he can do is to shut up." --tom lehrer, january 1965

What about common sense?

Now, let me get this straight. There are people in our country and politicians in our country that do not see a public insurance plan as something that could and would compete with private insurance companies with the end result being good competition between the two.

I am amazed that there are people in our country that cannot see this as just common sense. If the public option competes with the health insurance companies that are realizing kazillions of dollars in profits, is it not safe to say that these private companies will, by necessity, have to lower their rates?

What am I missing here?

They'll have to lower their rates

and improve the coverage they offer. If they can't make themselves more useful to the consumer, they will go the way of the horse and buggy.

I predict they'll specialize

in upper crust insurance, discretionary stuff and "red carpet" plans. A public plan would spawn a whole new wave of insurance products for wealthy and upper middle class families ... that's my bet.

It would be cool if the public option

inadvertently spawned the "private" option.



There cannot fail to be more kinds of things, as nature grows further disclosed. - Sir Francis Bacon

consider the example of...

...medicare supplemental insurance for a peek into the future: we'll likely want coverage for dental and vision (coverage which is not proposed today in any plan); and if we adopt a system like france's (where the rate of co-pay can reach 40%, is variable by procedure, and adjusted to control overall system utilization) you could expect "medigap" insurance would emerge to provide coverage for those costs.

"...i feel that if a person can't communicate, the very least he can do is to shut up." --tom lehrer, january 1965

This may be the wrong place to put this question....

I went to one of my favorite fundraiser events the other day and was asked a question I couldn't answer. I know that there is a provision in one of the 5 (or how many?) health care proposals that makes it a requirement that everyone in America has health care, so this might answer the question, not sure.

The question I was asked is "if the health care reform legislation is passed and includes a clause that says that no pre-existing condition should be considered for people to get health care, would an insurance company be forced to 'cover' someone that had no health insurance that found out that he/she was diagnosed with cancer that would cost hundreds of thousands of dollars to treat?"

I understand the question. Could there be people that waited to get health insurance because they didn't want to pay for it but when they were diagnosed with a disease or something that would cost a huge amount of money then go to an insurance company or the "public option" and sign up for the insurance to pay a small fee and get their hundreds of thousands of coverage paid by that company or we taxpayers?

Now, personally, if there is a requirement that EVERYONE have health insurance, that shouldn't happen, but we all KNOW that everyone won't get health insurance regardless of any requirement to do so. Could this cause the distruction of our health care insurance companies?

I don't put this here feeling one way or the other, but If I'm getting this question from everyday folks, it just has to be a question from a lot of people in our country.

What is the take here on this?

i would suggest...

...the answer is found in "risk-pooling".

it is almost beyond doubt that some new entrants into the insurance system will require expensive care right up front.

there is also a high probability that the vast majority of new entrants will be healthy and paying premiums for years, or even decades...which is a pretty good tradeoff.

in theory, you could "triage" the expenses by using different co-pays for different procedures (which is what france and singapore do to control system-wide spending) and make adjustments over time.

for example, you might put a 20% co-pay on joint replacements and no co-pay on angioplasty.

over the long term you can also "incentive" wellness by doing things like waiving co-pay and deductible for annual checkups or smoking-cessation programs...but that's an answer to a different question.

"...i feel that if a person can't communicate, the very least he can do is to shut up." --tom lehrer, january 1965

i'm not so sure...

...about that "buggy whip" thing.

there are private insurance companies successfully operating in canada, the uk, france, and australia, to give just a few examples, and i suspect that no matter what reforms take place here, we'll still see "supplemental" insurance plans in the future. (quick example: canada's health plan does not cover vision or dental care.)

"...i feel that if a person can't communicate, the very least he can do is to shut up." --tom lehrer, january 1965

i can help explain why:

if you're old enough, you probably recall $600 pentagon hammers, which, true or false, creates an impression.

it may not always be accurate, but it is axiomatic that "the gubmint" can't do anything right--and of course, we are, as americans, supposed to distrust the government, which doesn't help either.

the fact that a substantial number of our reps appear to be bought out by insurance interests is not helping, either.

when government does do things well, we often don't think much about it: law enforcement, firefighting and ems, the military, streets and highways...these things we do fairly well, most of the time, but you don't hear a lot of "hooray for the department of transportation!" out there.

and if there is one thing that is frightening to people, it's the idea that the government might take something like health care, which they are already uneasy about...and make it worse.

we have to make sure to address those concerns, often, if we want people to have enough trust to make either a public option or single-payer work...so in the end, i'd suggest that we have to work harder to dispel that mistrust, that we have examples we can offer that show we can trust government (which, in the end, is us...)--and as you mentioned, we have to keep pointing out that the system we have today just simply ain't working.

"...i feel that if a person can't communicate, the very least he can do is to shut up." --tom lehrer, january 1965

Make noise

Will do ... my Congressman and two Senators will get the call tomorrow

i gotta be sure...

...to get my own calls in today--although my congressman is dave reichert, who is actually famous for doing nothing.

"...i feel that if a person can't communicate, the very least he can do is to shut up." --tom lehrer, january 1965