Are we a developed country, or not? Mona Sobol, MD.
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Feb 22, 2017 (VISTA) the town hall meeting was filled to capacity, at 360 people seated, plus media who were standing. The overflow crowd was at about 2000, according to organizers. These are Congressman Daryl Issa’s constituents, who would like to have some face time with their representative in the United States House of Representatives. Instead, they got a where’s Waldo cut out, with a photo of the congressman. All that was missing was the congressman.
It was a good downhill meeting, concentrating on healthcare and the effects of the removal of the Affordable Care Act. There were many personal stories, but no congressman.
Before the floor was opened. Doctor Peter Brownell, the Research Director of the Center for Policy Initiatives, went over what is at stake. He quoted data from the UC Berkeley Labor Center, as well as his research on poverty in the north county.
Here are some highlights from the report:
Poverty rates in Escondido, Oceanside, San Marcos, and Vista remained higher in 2015 than they had been before the 2008 recession. Those four cities had poverty rates higher than the County overall.
· In every city, children were more likely to live in poverty – and senior citizens less likely – than the general population.
· The median household income in North County was $75,095, with a range of $47,000 between the North County cities with the highest and lowest incomes.
· The Accommodation and Food Services industry paid the least among civilian industries employing at least 20,000 North County residents: $28,035 for a year of full-time work.
As to the ACA, the labor center finds the following:
California saw large increases in health coverage under the Affordable Care Act (ACA). 3.7 million adults enrolled in the Medi-Cal expansion. 1.2 million Californians enrolled in subsidized insurance through Covered California, with average annual premium subsidies of $3,700. Statewide, the uninsurance rate fell from 17.2% in 2013 to 8.6% in 2015. Repealing the ACA threatens not only to leave millions without health insurance, but also to eliminate 209,000 jobs and cost the state economy $20.3 billion in GDP. Further negative impacts could occur if Congress decides to restructure federal payments for the entire state Medi-Cal program.
There is more:
- Health insurance at risk 259,236 low-income adults who are enrolled in the ACA Medi-Cal expansion would lose their health insurance, equivalent to 7.9% of the county population.
106,340 low- and middle-income residents would lose federal subsidies to help make private insurance purchased through Covered California more affordable
- The county’s uninsurance rate fell by 43% under the ACA, from 15.6% in 2013 to 8.7% in 2015. 215,000 residents who gained coverage since 2013 may return to being uninsured. Economic losses (projections)
- Approximately 15,000 jobs in healthcare and other industries would be lost under ACA repeal due to the reduction in federal healthcare spending and the ripple effect throughout the local economy associated with the loss of that economic stimulus.
- $1.3 billion in GDP would be eliminated from the county economy under ACA repeal.
This is the point of departure for the discussion. The state stands to lose a large number of jobs, and the social safety net and none of this data include the increase in early deaths, or of chronic infections due to lack of access to health care. This is a concern for Democrats, among them Congressman Scott Peters and Congresswoman Susan Davis who had a media event earlier in the year when they went into the details.
Then the stories started. There was a theme: Do not take my health care.
Kyle Thader was one of the many health care providers who spoke. He is a Paramedic, and he spoke of the many patients that he takes to the emergency room, that would be best-taken care off by primary care physicians. With the ACA and the expansion of Medical, that load has gone down. If the ACA goes away, that load will go up.
On the same theme, a registered Republican, in his 80s, and a victim of Agent Orange made the point that this is not fiscally sound policy. He is also retired from the medical field and told the crowd that emergency rooms cannot turn people away. They have to take care of them. So we all be paying for it, with our taxes. This is one of the economic arguments against getting rid of the ACA.
The other was given by an insurance agent. One of the remedies being proposed by Speaker Paul Ryan is the creation of high-risk pools. This reporter learned something important. We had such a policy in California at one point. These pools had long waiting lists, and in the end insurance companies pooled out. Why? It was too costly.
Mona Sobol’s story is typical She is a retired pediatrician. “I’ve taken care of thousands of healthy and sick children in my time. And I have one question for you Daryl Issa, and I know there are lots of other physicians in this community and all over the country who back me up on this. Are we a developed country, or not? And if we are, why do we not have universal health care?”
Then there was the story of Coreen Blanco who apologized for being late, but she was coming from her medical oncology appointment. “I was told that the next treatment that I have to have will cost me $30,000 dollars a dose. I need 16 doses.”
She added that she was lucky that she had private insurance, that will cover that, even though she has large deductibles. “They may cover some of this. If they don’t, I don’t know what will happen next.” From the crowd, it came, that they would set a GoFundme account. So partially we are still in the pre-ACA era when people still can lose their shirts and their savings for a medical reason.
Blanco added that she hoped that the Congressman would show up. She also remarked, to applause, that she worked for the Environmental Protection Agency for 25 years, She then added, that she worked with some “pretty lousy congressman and Issa is right up there with them.” But she was hoping he would be at the town hall, so she could ask him about the adds on TV, campaign ads, paid by the pharmaceutical industry. These adds are about a plan he has proposed to repeal and reform the ACA. He released his plan yesterday.
So we will give Blanco and the rest of our readers the answer of what that plan looks like, This is courtesy of The Atlantic:
Darrell Issa, chairman of the House Oversight and Government Affairs Committee, took to Twitter Monday to propose replacing Obamacare with an array of subsidized, state-based, market-driven comprehensive health-insurance options that are not linked to employment and don’t penalize people for having pre-existing conditions.
If Issa’s replacement ideal sounds a lot like Obamacare, it’s because so many components of the Affordable Care Act were based on ideas originally developed on the right. Rebuilding Obamacare based on conservative market principles gets you … something not that different from Obamacare. Issa’s plan would be better than the one passed into law in 2010, he insisted, because it would be based on the Federal Employee Health Benefit Plan. Yet that plan is far more generous to consumers than Obamacare and would likely cost the government more were it extended to the uninsured population as a whole.
We used the Atlantic piece since it was the most comprehensive answer.
So what other stories were there? Kazim Hassan was one of the few people not to talk about healthcare, but about the Muslim Ban. This is also a critical story. She came with her daughter. “This week we celebrate the 75th anniversary of the Japanese internment camps. With the recent executive orders and the way this administration the Muslim-American community has faced that fear.”
She invited the people at the hall, together with the Council of American-Islamic Relations, (CAIR) “to write to your legislator, and write Daryl Issa, to write legislation so this does not happen again.”
She also invited the congressman, she lives down the street, to sit down with her, day or night, and to discuss this. She even offered a fresh pot of chai and samosas. She is proud of her heritage, and her daughter is as well.
Democrats are expected to target Issa’s district, and Colonel Doug Applegate did come to the meeting, however, he did not speak. There were a few elected in the crowd, and they also did not speak.
Reverend Beth Johnson of the Unitarian Church ran the meeting, and at one point she addressed the crowd since 360 people were inside, but there were about 20000 outside, about discipline and people switching seats. They did. It took ten minutes, but others came in.
In the morning Issa did meet impromptu with both supporters and detractors at his office. There have been demonstrations every Tuesday. We also know that they expect to have a vigil at his home Thursday evening.