Keri Renault

Spin the Bottle on Health Care Reform

Filed By Keri Renault | August 17, 2009 5:00 PM | comments

Filed in: Living, Marriage Equality
Tags: deathers, health care reform, keri renault, public option, rationing, Sarah Palin

My head is spinning with health care reform. Who and what should I believe? I'm sick and tired of it and I definitely won't take it much longer.

Ultra-conservative Sarah Palin accuses Democratic-led reform of mandating senior citizen "death panels." But Congressional health reform proposals spell out a different truth. Medicare coverage, paid for once every five years, for consultations between doctors and senior patients about hospice care and living wills.

Big business and corporate interests scream "socialism." That health care reform is a devious ploy to turn America into a socialist state. But isn't that the same failed play from the long-defunct playbook used against the Kennedy and Johnson administrations prior to the passage of a hugely popular social reform called Medicare?

Is it just me or are other LGBTQ Americans as exasperated by the war waged over Health Care Reform? Of equal or greater consequence, what are the ramifications on LGBT health care reform?

Many questions--fewer answers. Exactly the point of spin: divide and conquer a confused mass.

No sooner did the Obama administration utter the dreaded words "National Health Care Reform" than partisan debate ignited like a Molotov cocktail. When Congress unveiled HR 3200 the Affordable Health Choices Act on July 15th rational dialogue went up in smoke as did the hopes of un-insured and under-insured Americans. The media today reveals a polarized nation engaged in an uncivil war of wicked words, otherworldly myth and sinister spin.

Witness the perfectly executed, backhand spin of moral righteousness by the Family Research Council (FRC) in a recent commercial. Watch as the "Evil Empire" of the Obama administration plays the diabolical role of biblical money-changer, rationing away life-sustaining Medicare benefits from the elderly while surreptitiously lining the coffers of Planned Parenthood through a proposed public health care budget.

Truth is reproductive health benefits--including abortion-- already exist in many private plans. They'll continue to be privately funded under health care reform, unlike Medicare and Medicaid which are government funded programs. 60% of likely voters in a recent Mellman Poll would not support health care reform if it didn't include reproductive health, including abortion.

Hear us, we the people, if you can.

As for the charge that senior care would be rationed--also untrue. No proposed reform plan reduces Medicare benefits especially to the detriment of a sickly senior. Reform promises savings by cutting billions of dollars in overpayments to inefficient insurance companies. Waste, fraud and abuse will be eliminated, not Medicare benefits. The $300 billion plus in savings will be pumped back to into health care reform, defraying its cost.

Of course, FRC's main goal isn't admonishing government health care reform, its derailing community access to Planned Parenthood, an ongoing crusade of this far right fundamentalist juggernaut.

The Family Research Council is but one case study in a colossal portfolio of spin. Health Care reform has never been a game for the weak of heart. Ask Bill and Hillary Clinton who tried to play in the mid 90's. While spin most assuredly is a game, health care reform is anything but, although some insiders do consider it "the Big Game", our economy's version of the Super Bowl with huge vested interests and great financial spoils in the balance.

Nobody has a greater financial stake in the game of spin than Big Insurance. The Republican far right may be drumming up disruptive Tea Parties at Town Hall meetings across America, but the heartbeat of anti-health care reform pulses strongest in Washington, echoing impact from sea to shining sea. There, lobbyists and advocates of Big Insurance are creating the grandest spin of all: That a government-run, public insurance option would undercut price (premiums), reduce competition and drive private insurers out of business. That only reform guided by the experienced hand of private insurance can assure fiscally responsible health care reform.

If only we knew the truth.

Political effigies burn on headline news, but by the time Congress returns from August recess, only ashes may be left of well-intentioned government health care reform.

Even as these words are typed, swing-vote Blue Dog Democrats (the ones wearing Republican fiscal red hearts hidden under progressive blue pinstripe lapels) are being wined, dined, paid for and indoctrinated into the highly orchestrated, massively funded and alluring appeal of private insurance. The largest of them all, UnitedHealth, advocates policy reform, too; not on behalf of constituents back home, but for the benefit of record profiteering, private insurance industry, its grotesquely overpaid executives and money-hungry board-of-directors.

To wit, the health insurance industry has donated more than $19 million to Federal candidates since 1997. United HealthCare, the largest private insurer in terms of revenue has spent $3.4 million on lobbying in 2009 alone.

They say numbers don't lie, but statistics can be bent, just as spin can be spun in any conceivable direction.

Republican and Blue Dog Dem opposition to a public insurance option gets plenty of ammo to spin a war of words from actuarial number-cruncher John Sheils. Sheils--of the Lewin Group--estimates 56% of workers currently on employer-provided coverage would drop private insurance in favor of the government's public option. A mass exodus this large, the opposition argues would destabilize the marketplace, sounding the death knell of the private insurance industry. It's an allegation used by many ranking Republican detractors of a government-run health insurance option, led by House Republican Whip Eric Cantor (R-VA).

But how about this truth: the Lewin Group is owned by UnitedHealth. Who says Big Insurance can't spin a tune? They play the game to win.

Isn't it time we the people prepare ourselves to take a stake in the game?

If the deleterious effect of spin is inevitable in an internet driven age, a self-serving outcome in favor of special-interests is not. It's time Americans roll up their sleeves to dig in deep for real answers. Uncover the honest-to-goodness facts. Take an informed stand based on the truth. These are ways to stop the momentum of spurious spin dead in its tracks.

Here are the facts I know about American health care:

  • Health care is a $2.2 trillion dollar business; by 2017 it's expected to grow to $4 trillion, a full 20% of the entire U.S. economy.

  • The average American spends $8,000 on health care each year.

  • 47 million Americans are uninsured.

  • The average family premium is projected to rise to over $22,000 over the next decade.

  • Coverage is denied or grossly limited based on pre-existing conditions. We can take that to the bank.

  • People get sick, are denied benefits, surpass lifetime limits, go into debt, go bankrupt and even die as a result.

  • Nearly 1 million people face bankruptcy each year because of medical expenses.

  • Workers lose their insurance coverage when they lose their employer.

  • In a shrinking, recessionary economy with prices on the decrease, health insurance premiums continue to increase, up to 8% this year alone.

And I know this of Medicare:

  • The Government Accountability Office (GAO) labels Medicare "high risk" with billions of dollars in overpayments and fraud each year.
  • Medicare overpays Medicare Advantage (part of UnitedHealth) by 14%.
  • 18% of hospitalization for Medicare beneficiaries results in readmission, creating more profit for private insurance, more unnecessary pain for patients, more waste of taxpayer dollars.

It's the same old song since Clinton health care reform was thwarted in 1993-94. And the beat goes on--spin baby, spin.

I repeat, 47 million Americans are presently uninsured. They have zip, zero, nada, nothing--no line of defense. Better off, but by no means safe are the millions of Americans who think they have adequate private insurance coverage. What they really have are huge deductibles, high co-pays, a laundry list of exclusions and woefully inadequate coverage limits. I've been there myself. The system is designed to defeat you.

What's not to reform in the American health care system? Why would anyone not want a public alternative in a free market? Deny competition? Now that's Un-American if you ask me. We may not believe we need a health insurance option today, but tomorrow is only a day away. For most of us, the current system couldn't be much worse.

But it does get worse for us, doesn't it? Not surprisingly, things are far worse for LGBTQ Americans. "And this" as Paul Harvey was fond of saying "is the rest of the story"...

The Center for American Progress reports that members of the LGBT community are less likely to hold private health insurance--of any kind, employer-sponsored or individually funded. Discrimination continues to be a key culprit. Those that do have insurance often overpay for limited coverage.

How about our reform?

The report, entitled, "LGBT Issues in Health Reform" reveals substantial disparity. An equity divide exists between the care afforded mainstream America versus the access and quality of care available to Lesbian, Gay, Bisexual and Transgender citizenry.

LGBTQ individuals are more likely to have AIDS/HIV or suffer breast, cervical or anal cancers. Since these diseases are classified as pre-existing conditions, those within the community who desperately need care are often denied.

The gulf of LGBTQ disparity widens:

  • In most states and municipalities same sex partners are not offered spousal or family health insurance benefits. Children in these families are left out, too.
  • Health benefits are tax-exempt in traditional families, but not in same-sex marriages and domestic partnerships. The disparity adds an average of $1,069 per year in taxes to these same LGB employees.
  • Many small businesses cannot afford taxes on domestic partner benefits and have discontinued them.
  • Transgender individuals are routinely excluded from coverage for anything transition related, including SRS/GRS.
  • Insurance companies often deny standard procedures based on past hormone therapy and unrelated transition treatments. Take a broken arm, for example.

Cultural competency is another pressing need LGBT Health Care Reform is targeted to address. Many lesbian and bisexual women are at increased risk for breast cancer. One of the risk factors is not having given birth. They're also less likely to receive regular gynecological care, mammograms, pap smears, or conduct breast self-exams.

Transgender individuals have unique dual-needs which include medical treatment related to biological birth sex and post-transition gender. Trans-women are at risk for both prostate and breast cancer. Insurance may pay for either or neither, but not both. Likewise, trans-men can be at risk for both breast and cervical cancer. Many health care providers have little or no training in the etiquette of serving transgender without bias. Inappropriate pronoun use is but one small but important example.

Another challenge to LGBTQ equality is Health IT reform. The threat is to privacy. New and improved IT may deliver greater efficiency and cost-economies to the mainstream, but it's a double-edge sword placing many LGBT individuals at risk. Computer-based personal records are accessible and disclose private details, such as sexual behavior, gender history and other sensitive information. Not every health care provider needs access to this critical information.

There's legitimate concern about the consequences of privileged health information shared among providers, employers and insurance companies. No wonder many LGBTQ individuals shy from discussing sexual orientation or gender identity with their doctor. The information could get them fired in up to 38 states, making privacy protections crucial.

Understanding from the health care industry, cultural competence from its providers and protection of personal privacy creates a welcoming environment for LGBTQ individuals, encouraging them to ask questions and get needed care.

In June, Representative Tammy Baldwin, (D-WI) sponsored the Ending Health Disparities for LGBT Americans ACT (ELHDA) to address rampant inequity. But with the spin swirling over government health care reform is there any real chance the needs of our community will be served?

When the power brokers of health care cut the final deal, will the LBGT community be represented at the bargaining table? Or will the "bad-boy" coalition of big insurance, religious imperialism and republican ultra-conservatism spin us right out the door and out into the cold?

The time to take a stand is at hand. Visit the websites of your elected officials. Educate yourself to their positions. Write letters or email your representatives requesting answers or support of your position. If you live within travel distance, set up an advocacy meeting even if it's with a legislative aide. Above all else keep informed by subscribing to leading LGBT advocacy sites and contribute where and how you can.

Whatever you do, learn the truth yourself by reading, investigating and exploring the issues. Start today if you believe your life and the lives of your family are worth it.

American health care reform isn't a game. It's time we send a message to stop the spin.

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Rick Elliott | August 18, 2009 10:20 AM

Already health care is being rationed. One example: a woman with asthma and COPD has to ration her Singulair only to days when her breathing is worse. She hasn't been able to get basic dental work in 20 years. A tooth cracked and was lacerating the inside of her cheek. She ws able to get an emergency appointment 2 months away. A non-emergency would have been 4 months. They told her to just put cotton batting inside her mouth, but even wouldn't provide the batting.
A second example: expensive treatments are being rationed. I had a treatment that would have been life-changing for me and would help alleviate the constant pain I live with. It had to be pre-certified. The doctor making the decisions was one who couldn't sustain a practice and was listed as an endocrinologist. He didn't know of the latest treatments in diabetes. He would only talk to my primary care doctor who had to spend most of the time educating him about diabetes. He initially turned it down because he didn't find data to show this program would aid my condition. The treatment has been a standard part of the repertoire for over 10 years, the first articles being written 15 years ago. Any competent endocrinologist would have known the treatment. We persisted and got approval for use for 3 months and recertification would need to be done. We had to start from scratch with a new doctor, labeled an endocrinologist. Same story of incompetence, second verse. Eventually they stopped because they said I should have been cured of diabetes-LOL. It was to treat systems not cure. How cold it be that four endocrinologists knew so little about diabetes?

What we need to do is to organize a nonprofit LGBT oriented insurance cooperative. The rates would be more reasonable for us since there would be no need to generate profits just enough to pay employees a reasonable salary. The money paid in can be partially invested. Make it attractive to doctors to accept it by making it streamlined and easy on their end.
Give us lower life, health, auto insurance and make it available to our designated family structures.
As it starts to work for us and grow the it will start to attract non-LGBT people and get larger. It would be another option aside from public gov't run which causes turmoil and private for profit which is actually designed as a profitable business rather than a way to provide healthcare.

I realize that the following may be alittle off
topic but I feel this is a timely health care
situation that could possible affect members of
the LGBT community.

My Partner and I have Medical Power of Attorney
foe each other. We have been able to be with
each other during doctor visits and visits to
the hospital.

Today my Parter was ill and when I when to
accompany him during the visit, the nurse said
it was not allowed due to a new federal law. I
repeated that we have Medical Power of Attorney and over the last thirteen years had always been allowed to be with each other. The nurse then said "I believe with this new law, Medical Power
of Attorney only applies to end of life decisions.

Rob, I like the idea of an LBGT cooperative. Not sure how it would be organized from a legal/bureaucratic/tax standpoint, but it would serve the same purpose intended by a public health insurance option. That's a step we need to take ASAP. Of course, another benefit an insurance co-op targeted to the LGBT community would be its ability to fulfill the objective of "cultural competency". Right now, the traditional medical and insurance industries are providing woefully inadequate accommodations based on our unique needs.

Rick Sour, your story once again illustrates the dire need for health care reform which would address diversity training and cultural competency hot button issues like these. To me, estate planning, living wills, medical POA and advance health care directives are "must haves" for any LGBT couple in a committed relationship, civil union or marriage. Sadly, these legal orders are only as good as the people acting upon them. I'd contact Lambda Lega, your state Equality organization or local LGBT Community Center for clarification.

Keri Renault | August 19, 2009 10:51 AM

I agree, Rick. Many health insurance policies do nothing but ration care. Bare bones policies and fine print make it very difficult to recognize the limitations of a policy--until we need it. The situations you describe shouldn't be tolerated--and they wouldn't be in EU countries which offer public health care. You present two strong examples illustrating the imperative for health care reform and a public option.