Freedom, Patriotism — and, of course, Health Care

July 4, 2011

~by Rev. Linda Hanna Walling, Faithful Reform in Health Care

“… with a firm reliance on the protection of Divine Providence we mutually pledge to each other our lives, our fortunes, and our sacred honor.”
~The Declaration of Independence”

Oh how we love our red, white and blue bunting, balloons, T-shirts and lapel pins to show our patriotism.  And there’s nothing like a good fireworks display synchronized to a rousing rendition of Sousa’s “Stars and Stripes Forever” to give rise to a few goose bumps!

But perhaps a more authentic expression of our love for democracy would be that of exercising our freedoms to reclaim the values upon which our nation was founded. Dare we forget our forebears’ declaration that in the sacred act of creation we are granted with certain unalienable rights, including life, liberty and the pursuit of happiness? And dare we forget that they constituted a government to promote the common good and secure the blessings of liberty?  Indeed, the ideals, the freedoms — and the responsibilities — crafted by those leaders are not to be taken lightly.

In the midst of the pomp and picnics of this holiday, just maybe one of our greatest acts of patriotism should be that of actively participating in the democratic process, and of calling upon our elected leaders to truly work for the common good.

The two cherished freedoms of religion and speech conveniently intersect in our health care work. We celebrate our religious freedoms, including the right to give voice to sacred values that guide how we live as individuals and in community: compassion, concern for those who are vulnerable, health and wholeness, and sanctity of life, to name a few.  Just as important, we celebrate our right to speak out in support of a health system that reflects those values — and to publicly oppose legislative proposals that undermine our collective vision.

Unfortunately, passing the Affordable Care Act did not end our work on health care reform.  The assaults on it continue daily as opponents work to repeal, de-fund, or dismantle it.  In addition, Medicaid and Medicare are under attack to address our federal budget and debt concerns. We know, of course, how important both programs will be in our health care future and that cutting benefits or restructuring either program will compromise the successful implementation of health care reform itself.

The assault on Medicaid and Medicare will reach fever pitch as both houses of Congress convene this week. Faith voices must help build the groundswell of opposition to using either program as the solution to solving our nation’s financial problems.

Send an email to the President, your U.S. Senators, and your U.S. Representative to show your support for Medicaid and Medicare.  Just a few quick clicks will send your message to each of these elected leaders.

Empowered by our commitments to social justice, let’s exercise our freedoms, our rights, and our responsibilities to make our democracy work for the common good.  Let’s raise our voices, inspired by the passion of our earliest leaders when they penned the final words of their declaration:  “… with a firm reliance on the protection of Divine Providence, we mutually pledge to each other our lives, our fortunes, and our sacred honor.”

May this be your most patriotic July 4th ever!  Take action today!

SEND your email to the President, your U.S. Senators, and your U.S. Representative.


MLK’s “Radical Revolution of Values”

January 17, 2011

by Rev. Linda Hanna Walling
Faithful Reform in Health Care

“…we as a nation must undergo a radical revolution of values. We must rapidly begin the shift from a ‘thing-oriented’ society to a ‘person-oriented’ society.”  [Rev. Dr. Martin Luther King, Jr., April 4, 1967, Riverside Church, New York City]

In a recent gathering with Arkansas faith leaders, I listened as Rev. Wendell Griffen, the pastor of New Millennium Baptist Church in Little Rock, passionately proclaimed that what we need is the “radical revolution of values” of which the Rev. Dr. Martin Luther King, Jr. spoke a year before his death.  Absolutely!  Of all of Dr. King’s eloquent words, these are among the ones most needed now.

It was a very different time in our nation’s history, and Dr. King was speaking in opposition to the war in Viet Nam. But his words – a radical revolution of values – call us to the timeless need to turn to our moral values when deliberating over those things that define how we share life as an American family.  The revolution of values to which Dr. King called us still awaits the transformation of our hearts and minds – and our commitment to working for the common good… to building a sense of community that offers blessings for all… and to acting upon our concern for those who are most vulnerable.

The events of recent days demonstrate how little progress has been made in our ability to live together.  Senseless killings by a man presumed to be mentally ill have caused endless speculations about what led to these horrific acts. Was the killer incited by inflammatory political verbage?  Is security sufficient around public officials? Are our gun laws too lax?  Was this an anti-Semitic act? Is this a statement about inadequate mental health services?  Or was this simply a random act of evil which we don’t quite understand?

All of these potential explanations are woefully inadequate, perhaps because we are asking the wrong questions.  As people of faith, a revolution of values means that we have to challenge priorities that elevate politics over people… or protect the rights of gun owners over needs of victims and perpetrators of gun violence… or demonize rather than celebrate our diversity… or exclude those with mental illness from our system of health care.  If we were to engage in this deeper conversation about values, wouldn’t the teachings of our communities of faith lead to different conclusions about the Arizona shootings and our ability to live together as a national community?

The health care debate, which symbolizes our nation’s discussion on numerous social justice issues, was laden with what many called values-based messaging.  Economic values. Political values. Personal self-interest values. But people of faith labored on with messages about moral values which focused on the common good, compassion, concern for those who are most vulnerable, shared responsibility, and an equitable distribution of our abundant health care resources.  And we were right to do so.

In the midst of this tragedy, above the babble of blame, we are beginning to hear others join the call for a return to the values that bind us to one another.  And in that conversation we are called to commit ourselves to Dr. King’s “radical revolution of values” that will always put the needs of people – our brothers and sisters – above all else.  We do this believing that we can be instruments of healing as our country continues to dialogue about how to make Dr. King’s vision of a beloved community – and our vision of health, wholeness, and human dignity – a reality for all.

Health and peace,

Rev. Linda Hanna Walling

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Take action today in support of health care reform!

In honor of the Rev. Dr. Martin Luther King, Jr., take action today to promote our faith-inspired vision for our health care future.  Send an email to your member of Congress — and then invite family, friends, and colleagues to join you!

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“A Daily Dose of Truth” (#6): The “R” Word (rationing) in Health Care Reform

November 19, 2010

~by Rev. Linda Hanna Walling, Faithful Reform in Health Care

Daily DoseTruth is witness to the whole.  One short sound-bite taken out of context — even if it’s a fact — does not necessarily represent the whole truth. We denounce the use of such sound-bites (from any party!) when they are intended to pervert truth for electoral gain. In the end, we acknowledge that a manipulation of facts to frighten and confuse vulnerable populations is just plain immoral.

Efforts to help us make informed decisions about our health care are supported by the comparative effectiveness research (CER) that is conducted by the National Institutes of Health and the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ), among others.

The AHRQ’s website states that “comparative effectiveness research is designed to inform health-care decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options. The evidence is generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver health care.”

While CER has been a long-established but under-funded practice in the U.S., such research was propelled into national discourse when it received $1.1 billion in stimulus funds and the Federal Coordinating Council for CER was established. Now associated with the subsequent effort to reform health care, CER has become one of the targets of those who oppose reform – even though the results of the research will not be used to impose mandates on the delivery of health care.

For opponents to reform, this attempt to practice better stewardship in the distribution and use of our abundant health care resources has become synonymous with rationing.  But, truth be told, which is what this series is all about, is that rationing already happens in U.S. health care. 

We already ration health care when:

  • We exclude the nearly 50 million people who are uninsured from the system, leaving them without access to needed care in a timely manner.
  • Insurers can deny coverage to people with pre-existing conditions, or deny payment for services, or cap annual or lifetime payments for claims.
  • Some communities have access to an abundance of resources that are under-utilized (such as MRI machines) and other communities have none at all.
  • Some employers offer health care benefits, and some do not.

Very simply, CER represents a commitment to REDUCE rationing because research will inform better stewardship in the use and distribution of our abundant health care resources. The commitment for greater funding for comparative effective research is intended to move us closer to a health system that includes and works better for all of us. 

When coupled with other provisions of reform, CER will help us achieve our vision of a society in which all of us are afforded health, wholeness, and human dignity — and will lead to successfully designing a system in which our health care resources are shared equitably.

Note: The latest flurry of emails about this issue seems to have emerged as a result of a speech by an orthopedist who supports a particular candidate in a Michigan electoral battle.  He specializes in sports medicine, not health policy.

For more information:

U.S. Department of Health and Human Services, Agency of Healthcare Research and Quality – What Is Comparative Effectiveness Research?

Kaiser Family Foundation – What is Comparative Effectiveness Research?

PolitiFact – Analysis of claims made about comparative effectiveness research


“A Daily Dose of Truth” (#5): Making end-of-life decisions

November 19, 2010

~Rev. Linda Hanna Walling, Faithful Reform in Health Care

Daily DoseTruth is witness to the whole. One short sound-bite taken out of context — even if it’s a fact — does not necessarily represent the whole truth. We denounce the use of such sound-bites (from any party!) when they are intended to pervert truth for electoral gain. In the end, we acknowledge that a manipulation of facts to frighten and confuse vulnerable populations is just plain immoral.

Since the beginning of doctor-patient relationships, doctors have consulted with families about treatment and care for patients who are faced with end-of-life decisions.  Clergy are often involved in these conversations, as well as attorneys, because families struggle with heart-wrenching medical and moral decisions when medical treatment can no longer contribute to quality of life and human dignity. Further, the recommendation that all patients have living wills or advanced health care directives have left patients and families with questions that are best addressed by their doctors and other professionals.

Medicare benefits do not include payment for the time physicians spend in such consultations. With the limits imposed on many doctors for how much time they can actually spend with us, a provision to provide an “advance care planning consultation” was included in health care reform to compensate physicians for these conversations with Medicare enrollees. 

However, after the August 2009 furor over “death panels,” as these doctor-patient conversations were labeled by the opposition, the provision was dropped.

Health care reform was passed without this change to Medicare benefits. But most of us, not just Medicare beneficiaries, will continue to seek the counsel of our physicians as we make our own choices about the final days of our lives – while we still have the capacity to make such decisions for ourselves. And physicians will continue to consult with us because of their commitment to health, wholeness, and human dignity for their patients. 

For more information:

FactCheck – False Euthanasia Claims

PolitiFact – PolitiFact’s Lie of the Year: Death PanelsSimply send an emailwith your suggestions.

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Make suggestions for future topics based on the mis-information you are receiving in ads, emails, and conversations.


A Daily Dose of Truth” (#4): A Lot to Like in Health Care Reform

November 19, 2010

~by Rev. Linda Hanna Walling, Faithful Reform in Health Care

Daily DoseTruth is witness to the whole.  One short sound-bite taken out of context — even if it’s a fact — does not necessarily represent the whole truth. We denounce the use of such sound-bites (from any party!) when they are intended to pervert truth for electoral gain. In the end, we acknowledge that a manipulation of facts to frighten and confuse vulnerable populations is just plain immoral.

Many people of faith have been guided by A Faith-Inspired Vision of Health Care as they have advocated for comprehensive and compassionate health care reform in the U.S. The statement envisions a society where all persons are afforded health, wholeness, and human dignity and a health care system that is inclusive, affordable, accessible, and accountable. Since health care reform became law on March 23, 2010, we already have made progress in working toward that vision.
 
VISION: An inclusive system of health care

  • Children under age 19 can no longer be denied coverage because of pre-existing conditions.
  • Young adults up to age 26 can stay on parents’ policies that go into effect after 9/23/10, unless they are offered coverage at work.

VISION: An affordable system of health care

Senior adults are receiving rebate checks when they reach the gap (doughnut hole) in their prescription drug coverage.

  • Key preventive care, such as mammograms, colonoscopies, immunizations, pre-natal and new baby care will be covered without co-pays or deductibles in new plans after 9/23/10.
  • Prior authorization cannot be required for emergency care; higher costs cannot be imposed for out-of-network emergency care in new plans after 9/23/10.
  • Small businesses are receiving tax credits for providing health care benefits for their workers.
  • 46 states are using resources under the new reform law to pass or strengthen premium rate review laws.

VISION:  An accessible system of health care

  • Women now have direct access to OB/GYNs without a referral.
  • Enrollees in new plans after 9/23/10 must have a choice of primary care physicians.
  • Lifetime limits on insurance payouts will be eliminated, and annual limits will be greatly restricted.
  • Expanded funding for community health centers will increase access to medical care in under-served areas.
  • Persons who have been uninsured for 6 months because of pre-existing conditions now have access to Pre-Existing Condition Insurance Plans

VISION: An accountable system of health care

  • Insurance companies can no longer drop people from coverage because of illness.
  • Members of Congress and their staff members will receive their health insurance from the same exchanges.
  • Persons will have the right to external appeals of decisions made by insurers.

About the polling data:

Attack ads, debates, and press conferences feature the opposition saying that the American people do not want reform.  If just one aspect of polling is considered, it is true that many folks do not like the “caricature” of reform that is based on mis-representation and misunderstandings.  However, polling results on some of the benefits outlined above reflect a very different TRUTH about what the public thinks about reform.

There’s no question that the public is confused, in part because health care reform is confusing. But there are many benefits in reform that are crystal clear, and when those facts are known, who would want to give them up — either for themselves or their neighbors?

For more information:

Read What I Like about Health Care Reform from Faithful Reform in Health Care.

View the Kaiser Family Foundation YouToons video, Health Reform Hits Main Street, which highlights the benefits of health care reform.

Visit HealthCare.Gov, the website that was mandated by health care reform, which includes videos and fact sheets about health care reform.  Be sure to note the new section with information about finding affordable insurance and/or health care services by zip code.

Read an editorial in the Philadelphia Daily News, The Down-Side of Health Care Repeal: Which of These Features Would Opponents Be Willing to Lose?

Review Kaiser Family Foundation’s Data Note, How Popular is Repealing Reform, a compilation of polling data.

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Make suggestions for future topics based on the mis-information you are receiving in ads, emails, and conversations.  Simply send an email with your suggestions.


“A Daily Dose of Truth” (#3): The Requirement to Buy Insurance

November 19, 2010

~by Rev. Linda Hanna Walling, Faithful Reform in Health Care

Daily DoseTruth is witness to the whole.  One short sound-bite taken out of context — even if it’s a fact — does not necessarily represent the whole truth. We denounce the use of such sound-bites (from any party!) when they are intended to pervert truth for electoral gain. In the end, we acknowledge that a manipulation of facts to frighten and confuse vulnerable populations is just plain immoral.

Health care justice and the common good are best served when everyone is actually IN a nation’s system of health care.  And that’s the whole point of the health care reform requirement for everyone to have insurance.

With everyone IN, we’ll all have timely access to the benefits of health care coverage rather than waiting until too late, or worse, getting no care at all.  With everyone insured, society-at-large partners with the health care system, fairly distributing the responsibilities, costs, risks, and benefits.

The requirement for everyone to have insurance:

  • Protects all of us from the costs of medical care for patients who can pay for insurance but refuse to do so. The subsidies will be designed so as not to impose a burden greater than any one person or family can bear.
  • Affirms the government’s rightful role in regulation and oversight on behalf of the public good.  It is an effort to get everyone playing by the same rules, resulting in fair treatment for everyone fairly in return.

Exemptions to the requirement for insurance:  Persons exempt from the requirement to have insurance will include:  those whose faith communities object to insurance; those without coverage for less than 3 months; American Indians; undocumented immigrants; those with hardship exemptions (for whom the lowest cost plan available exceeds 8% of individual income); and those who earn too much to qualify for Medicaid but earn too little to file income tax.

Penalties for not purchasing insurance:  The Congressional Budget Office and the Joint Commission on Taxation estimate that by 2016 only about 4 million persons (1% of the population) will choose to pay the assessed penalty rather than purchase insurance.  Two-thirds of those would qualify for subsidies in the exchanges; the remaining third would be among the top 10% of income-earners in the U.S.

Those who choose not to purchase insurance will pay a penalty that will help cover the cost of maintaining the health system, including the cost of uncompensated care.  The penalties will begin in 2014 and increase each year:  2014 – the greater of $95 or 1% of taxable income; 2015 – the greater of $325 or 2% of taxable income; 2016 – the greater of $695 or 2.5% of taxable income; beyond 2016 – indexed to the cost of living.

What happens if the requirement to purchase insurance is repealed? 

Insurance costs would likely rise for everyone. In the negotiations leading to reform, this requirement was coupled with the ban on the insurers’ practice of banning persons from coverage because of pre-existing conditions. The costs for adding persons with pre-existing conditions will escalate if the enrolling the sick is not off-set with healthy enrollees.  (One interesting note:  Polls continue to show the usual split between supporters and opponents of reform.  However, once those who support repeal are told it would mean ending the ban on insurance exclusions for pre-exisitng conditions, only a quarter of repeal supporters hold their original position!)

The costs of uncompensated care will continue to increase costs system-wide. Very few people travel through life without accessing the health system at some point. The penalty for not purchasing insurance simply helps offset the medical costs for those who choose not to purchase insurance, but do not have the ability to pay for expensive care.

For more information:

Read the full statement from Faithful Reform in Health Care: Faith Values & Responsibility in Health Care Reform

View the Kaiser Family Foundation YouToons video, Health Reform Hits Main Street, which includes a section that clearly articulates the relationship between the requirement to buy insurance and the ban on insurers’ exclusions for pre-existing conditions.

Read the New England Journal of Medicine article, A Broader Regulatory Scheme – The Constitutionality of Health Care Reform, which discusses the constitutionality of the requirement to buy insurance.

Make a suggestion for future topics based on the mis-information you are receiving in ads, emails, and conversations.  Simply send an email with your suggestions.


A Daily Dose of Truth (#2): Health Care Reform & Home Sales

November 19, 2010

~by Rev. Linda Hanna Walling, Faithful Reform in Health Care  

Daily DoseTruth is witness to the whole. One short sound-bite taken out of context — even if it’s a fact — does not necessarily represent the whole truth. We denounce the use of such sound-bites (from any party!) when they are intended to pervert truth for electoral gain. In the end, we acknowledge that a manipulation of facts to frighten and confuse vulnerable populations is just plain immoral.

Is there a new tax on home sales to help pay for health care reform?

Short answer: Beginning in 2013, there will be a 3.8% Medicare tax on the PROFIT in home sales for families making more than $250,000/year ($200,000/individuals).  If the home is a primary residence, per existing law, the first $500,000/families ($250,000/individuals) in profit will be exempt from the tax. Most home sales will not be affected by this provision in the health care reform law.

Longer answer:  The Patient Protection and Affordable Care Act, amended by the reconciliation act H.R. 4872, provides for a 3.8% Medicare tax on unearned/investment income starting in 2013 (section 1402, revised to 1411, on page 33) for families making more than $250,000 per year ($200,000 for individuals). Investment income includes profit on property sales. 

A family that makes $250,000 ($200,000/individual) and sells a home for a profit will be required to pay a 3.8% tax on that profit (not on the sale price, only on the profit) as part of their capital gains taxes. However, if the home is a primary residence, per existing law, the first $500,000/families ($250,000/individuals) in profit will be exempt from the tax. It is estimated that only the highest earning 2% of families will be impacted by this provision.

Why the confusion?  Another example of a fact taken out of context, this myth about the impact on all home sales seems to have started with a March 28, 2010, Op-Ed written by Paul Guppy for a Spokane, WA newspaper.  The author is the Vice President for Research at the Washington (state) Policy Center, “an independent, non-partisan think tank promoting sound public policy based on free-market solutions.” The author’s claim was immediately refuted by the government affairs director of the local realtors’ association

For more information:

FactCheck.org provides a detailed analysis of this issue and numerous links to other sources of information.