“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

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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.


Health care reform on the 2 yard line

February 1, 2010

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

It’s really only the last five minutes of the game that count! While my husband and son dismiss me as a nut every time I say it, it’s true!  Of course, they love everything about what leads up to the final moments in any game — and I don’t. Yet, I have fond memories of their excitement (and mine) at the end of sporting events, knowing that the last at-bat, the last free throw, the last pass, or the last kick will determine the final outcome. It is certainly true for the New Orleans Saints, who are going to the Super Bowl following a sudden death field goal — in overtime, no less!

Given that this week will be dominated by football news and ads, is there any better imagery for health care reform at this moment than that of getting the ball over the goal line?  Apparently President Obama likes the idea, because he told his advisors on Friday that we are on the 2 yard line and we’re going to finish the job!

So what does that mean for us — people of faith who REALLY care about making meaningful reform happen?  After hanging around and listening to Washington insiders for 3 days at the Families USA Health Action conference last week, I think it means three things:

We have to keep cheering! We know what the home field advantage and a cheering crowd mean to a team. At this moment, legislators are working hard to resolve their differences. They need to hear that we want them to keep working. In spite of missteps, dropped passes, and hard tackles, there is enough good in the team and their efforts to cheer them to victory.  It will take all of us — the fans in the stands — to make sure that the players stay energized for the final minutes of the game.  Here are a few suggestions for your part:

  • Call President Obama, your Senators, and your Representative
  • Add your name to “A Call for Political Courage, Vision, Leadership, and Faith”
  • Join the Interfaith Virtual Vigil of Prayer, Hope, and Action
  • Send an email to President Obama, your Senators, and your Representative
  • Join this week’s Faithful Reform conference call on Wed at 2 pm EST to preview a new PowerPoint that focuses on where we are and what needs to be done.

We have to remain hopeful for what can be! Our faith histories have taught us what it means to wander in the wilderness and to live with hope for more promising days ahead. Our hope rests in a moral vision for our health care future — and in our belief that we as a country have been blessed with the wisdom, the talent, and the abundant resources to do this. This is one of our gifts to this process. Our messages and our actions must demonstrate our judgment that comprehensive health care reform is possible because our care for one another is ultimately greater than either political ideologies or the influence of powerful lobbyists.

We have to remain positive! On one of our conference calls, our friend Nick Unger reminded us that if any single piece of legislation fully achieves our vision, then our vision isn’t big enough. While we were working for a more perfect plan, we neglected to affirm the really strong provisions that will move us forward in the current legislation. We have failed to celebrate that even the weakest versions of the reform proposals move us toward a more inclusive, affordable, accessible, and accountable system of health care in the U.S.  We must remind ourselves that:

  • Nearly 3 out of the 4 of us currently without insurance will be in the system.
  • The numbers of community health centers will be generously expanded.
  • The prescription drug doughnut hole in Medicare will shrink, perhaps disappear.
  • None of us will be denied coverage because of pre-existing conditions.
  • None of us will be dropped from insurance because we get sick.
  • Insurers will be required to use a greater percentage of premium dollars on medical care, rather than on paperwork and perks.

We’re at the 2 yard line and we can make it over the goal line, even if it requires overtime.  Together we CAN win this one, but it will take ALL OF US to make it happen.

To our health care future!


“A Call to Political Courage, Vision, Leadership, and Faith”

January 27, 2010

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

A new sign-on letter for people of faith has been launched: “A Call to Political Courage, Vision, Leadership, and Faith.” It has already been delivered to Congress with the names of nearly 60 national and state/regional organizations.  It is now open for individuals and additional organizations in preparation for another delivery very soon.  Time is short!  Read the letter below and add your name today!

“A Call to Political Courage, Vision, Leadership, and Faith”

Dear Mr. President, Senators, and Representatives:

We are communities of faith who have supported comprehensive health care reform for decades. We have also offered vocal support – and occasional constructive criticism – of the health care reform effort over the last year. We write to you at this critical juncture to urge you to complete the task at hand on behalf of the millions who are left out and left behind in our current health care system.

Opportunities to comprehensively address our broken health care system are rare. Decades of failed attempts at reform testify to the difficulty of this task, and we know that the current effort has not been easy. However, we now stand closer than ever before to historic health care reform. Turning back now could mean justice delayed for another generation and an unprecedented opportunity lost.

We know that no comprehensive health care reform bill will be perfect.  (Indeed, if any piece of legislation ever fulfills our full vision, our vision is far too small.)  However, we also know – as providers and consumers of services and care – that inaction at this critical moment is no way forward:

  • Without reform, tens of thousands will continue to die needlessly each year for lack of access to care.
  • Without reform, tens of millions will remain uninsured and without adequate access to a full range of services.
  • Without reform, health costs will continue to grow much faster than wages.
  • Without reform, many millions of hard-working people and their children will join the ranks of the uninsured and underinsured.
  • Without reform, businesses, staggered by increasing employee health costs, will either drop coverage or will be unable to make needed investments.
  • Without reform, the nation’s economy – and its ability to create jobs – will suffer.

As people of faith, we envision a society where every person is afforded health, wholeness and human dignity. Martin Luther King, Jr., whose birthday we just commemorated, famously wrote in his “Letter from Birmingham Jail” that “justice too long delayed is justice denied.” Less well known is his admonition that “of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

Let us not delay health care justice any longer. This is your moment for political courage, vision, leadership and faith. We urge you to take heart and move meaningful health care reform forward.

Add your name now

This letter is coordinated by the Washington Interreligious Staff Community Health Care Working Group and Faithful Reform in Health Care.