ACA – R&R – Reachout and Rebuild

Covid Notes

David Posnett — Mon, 28 Feb 2022 23:22:05 +0000

From Norbert Goldfield, M.D., Ask Nurses and Doctors (AND)

We are continuing to build up health professional networks in preparation for the 2022 elections. As part of this effort, Jeff Lerner (AND lead in Pennsylvania) and I appeared on the Robert Hubbell podcast last week. Hope to see you all next week on March 9 at 730 pm when AND will host a webinar on Engaging Social Media and Policymakers as we build and prepare for the elections. Appearing will be

Jeff Lerner PhD, President Emeritus, ECRI and adjunct senior fellow, Leonard Davis Institute of Health Economics of the University of Pennsylvania; AND consultant; director of AND PA

Dan Stone MD: Medical Director Cedars Sinai Hospital Los Angeles, CA AND Consultant

Gail Wilensky PhD Project Hope and CMS Administrator under President GHW Bush, AND Board of Advisors

It never happened to me before during this pandemic – out of the 23 patients, I saw last Tuesday I had four who I convinced to get the vaccine. I failed at two others including one patient of mine. But I felt an incredible high; what a strange idea – again unique during my lifetime that I feel a sense of exhilaration at the end of the day having convinced four previously unvaccinated individuals to change their minds.

A remarkable COVID statistic: in the six months between April and October 2021, the number of children experiencing the death of a parent or primary caregiver as a result of COVID-19 nearly doubled to more than 5·2 million globally – surpassing the total number of reported COVID deaths worldwide. The mental health and substance abuse impact is staggering. Just as I am writing this, I am working with a young mother using ten bags of heroin a day laced with fentanyl (she has Narcan) who is now in withdrawal and we are trying to convince her to switch to suboxone.

Many of you have heard of the new CDC Covid guidelines. Bottom line, I will continue to wear masks when I go to the grocery store. As the Post reported, instead of focusing on eliminating transmission of the virus, the framework is aimed at preventing hospitals and healthcare systems from being overwhelmed and protecting people at high risk for severe illness, officials said.

Public health in the U.S. is deteriorating with public health officers continuing to leave their positions. Not surprisingly, private companies have stepped into this increasing void. After bankruptcy, the Detroit Public Health Department was privatized with disastrous consequences. Trust is the key. National public health systems simply will not occur at this point in the US. But they could happen, I am convinced, at a state level. I continue to have meetings in Massachusetts. Poor public health services exacerbate the social disparities impact of COVID. Here are some specifics: In Virginia, 41% of Medicaid enrollees 5 and older are vaccinated, compared with 76% of state residents in that age group. Sadly the new surgeon general in Florida is not clear that vaccines work and that ivermectin doesn’t.

Vaccines for all, throughout the globe, should be a basic public health tenet. We are still falling short on this goal – both in terms of the financial commitment of all countries including the US and the willingness of countries such as the U.S. and Germany to waive intellectual property rights on the vaccines and allow countries to produce this life-saving treatment at a lower cost.

Bob Herman from Axios gave a very nice summary of the overall challenges the U.S. health care system faces. An overarching issue is the price. Take the example of hip replacement: Empire Blue Cross Blue Shield paid $98,000; Cigna paid almost $71,000; UnitedHealthcare paid $66,000. Medicare paid around $20,000. Most agree that Medicare payment is “reasonable.” But while Obamacare was a significant step forward, there is no agreement on next steps. Health professionals and voters will have a significant role. As we look to the 2022 election midterm elections AND continues to work on vaccines, public health and healthcare reform.

Reminder: join us if you can on March 9 at 7:30 pm eastern. We are beginning to build our health professional networks now, in preparation for the 2022 elections. Hopefully, you can either play a part for just 1 hour/month. Perhaps you know health professionals who are interested. Effective use of social media is key.

Just click here to join on March 9 7:30 pm: https://us02web.zoom.us/j/2548017298.

Also, you will like the short 30 minute podcast that aired last week on the work of AND.

Norbert Goldfield, M.D.

How We Got Here

David Posnett — Fri, 24 Apr 2020 20:36:44 +0000

In the Southampton Press:

How We Got Here

The media has accurately reported how President Trump’s mismanagement of COVID-19 has exacerbated this global health crisis. But Trump’s damage to our public health goes back to the beginning of his administration — and for Congressman Lee Zeldin and the rest of the Republican Party, their culpability starts much earlier.

It begins with the universal Republican vow to eliminate the Affordable Care Act and is compounded by their ideological orthodoxy to starve every federal agency of funding, including those agencies that are charged with public health. Like every Republican, this was the platform Zeldin ran on in 2014, and this is how he has voted as a member of Congress.

But these dual GOP missions — repeal the ACA and reduce the size of government — have directly contributed to the disastrous federal response to this crisis.

The ACA, while primarily concerned with health insurance access and patient protections, also focused on public health issues through the Centers for Disease Control and Prevention. In 2010, the ACA established the Prevention and Public Health Fund (PPHF) at the CDC. It supported a public health mission that included the “early detection of and response to health threats.”

The GOP could not repeal the ACA while Obama was president, but once they took over the House after the 2010 election, largely on the strength of campaigning against the ACA, they worked hard to consistently weaken it, including weakening the PPHF. Then, in 2017, with the inauguration of Trump and complete control of the federal government, they went full-steam ahead to repeal the ACA and reduce the size of all federal agencies. The CDC and the PPHF were no exception.

In early 2018, Trump signed the budget bill that cut the PPHF by $1 billion over 10 years. Later, in 2018, Trump eliminated the global health security office within the National Security Council and made further cuts to public health programs by diverting money from the CDC and the National Institutes of Health for his policy to detain migrant children. Public health experts at the time warned that such drastic moves would harm the country’s ability to respond to and contain outbreaks of disease.

Trump and Zeldin are now working overtime to bury this history. To deflect blame, Trump insists that his name be stamped on the stimulus checks being mailed to desperate Americans. In a similar vein, Zeldin recently announced how he alone got much-needed medical equipment rushed to Suffolk County.

They would like you to forget how we got here.

Barbara Weber-Floyd

Westhampton Beach

No Surprise

David Posnett — Sat, 18 Apr 2020 17:49:31 +0000

From Southampton Press: No Surprise

For those of us inclined to pay close attention to the Trump administration, this aspect in particular stands out: the undoing of all varieties of federal regulation. Environmental, banking, consumer and health regulations have been targeted for extinction or reduction. In the words of former Trump advisor Steve Bannon, “Our job is the deconstruction of the administrative state.”

Deconstructing important parts of the “administrative state” increases the threats to our health and safety, with loss of life an all-too-common outcome.

Shortly after President Trump was inaugurated, he issued an executive order directing federal agencies to use their administrative powers to begin dismantling the Affordable Care Act “to the maximum extent permitted by law.”

Last July, the federal Centers for Medicare and Medicaid Services, or CMS, proposed a reversal of Obama-era rules that aimed to protect nursing home patients by requiring all nursing home facilities to hire at least one full-time specialist in infection control. Seema Verma, the CMS administrator and a presence at President Trump’s daily coronavirus briefings, expressed concern about not “micromanaging the process.”

It should come as no surprise to learn that a nursing home lobbying group has contributed to the Trump campaign (New York Times, “Regulator Intends to Relax Oversight In Nursing Homes,” March 16, 2020).

The first novel coronavirus hotspot in the United States occurred at the Kirkland Life Care Center for the elderly in Washington State. In neighboring New Jersey, COVID-19 is running through St. Joseph’s Senior Home in Woodbridge Township. And, closer to home, Peconic Landing, an elderly community on the North Fork, is experiencing a heartbreaking toll of infected COVID-19 patients.

Is there a direct cause-effect relationship between regulatory rollback and any one positive COVID-19 case? No, but having a full-time infection control specialist knowledgeable about the science of infectious disease and vector control would have established policy and protocol ready to take the most efficacious approach to life-saving measures.

Mike Anthony

Westhampton

Mr. Anthony is a former Southampton Town Democratic Committee chairman — Ed.

Trump’s Sabotage of Healthcare

David Posnett — Wed, 19 Feb 2020 16:44:17 +0000

In spite of Trump’s SOTU lies, healthcare disinformation (with Lee Zeldin’s complicity), here is where we are on health care:

A recent poll shows Americans disapprove of President Trump’s handling of the Affordable Care Act by 56 to 35 percent and prescription drug prices by 54 to 30 percent.

Dismantling Pre-Existing Condition Protections – While President Trump lies to the American people that he supports protections for people with pre-existing conditions, he is in federal courts waging a campaign to eliminate these lifesaving protections and destroy every other protection and benefit of the Affordable Care Act. At every opportunity, President Trump has tried to undermine protections for people with pre-existing conditions. An excellent recent review demonstrates how Trump’s efforts to sabotage Obamacare are going:

1. Individual mandate eliminated 2. States allowed to add “work requirements” to Medicaid 3. Cost-sharing reduction subsidies to insurers have ended 4. Access to short-term “skinny” plans has been expanded 5. Funds to facilitate HealthCare.gov sign-ups slashed

Caving to Big Pharma on Drug Price Negotiation – After promising to negotiate drug prices “like crazy” before he was elected, President Trump caved to Big Pharma and has abandoned his pledge to support the drug price negotiation that House Democrats delivered in the Lower Drug Costs Now Act. Again and again, President Trump has pulled his punch on Big Pharma, making vague and unworkable announcements that have left seniors and hard-working Americans on the hook for sky-rocketing drug prices.

President Trump’s latest assault on health care: his new illegal Medicaid block-grant scheme.

The Administration’s plan for states to cap and slash Medicaid would push Medicaid recipients off lifesaving medicines, impose unaffordable premiums to maintain coverage and leave more vulnerable families exposed to catastrophic medical bills – with ruinous consequences for rural hospitals, for families seeking opioid addiction treatment for their loved ones and for middle-class seniors with long-term care need.

House Proudly Passed Lower Drug Costs Now

During this difficult time, the House will continue our strong legislative agenda For The People: lower health care costs by lowering prescription drug prices, bigger paychecks by building the physical and human infrastructure of America, and promoting cleaner government.

American seniors and families should not have to pay more for their medicines than what the drug companies charge people in other countries for the same drugs. That’s why Democrats proudly passed H.R. 3, the Lower Drug Costs Now Act, in December! This legislation finally levels the playing field for American patients and taxpayers:

Gives Medicare the power to negotiate directly with the drug companies, and creates powerful new tools to force drug companies to the table to agree to real price reductions, while ensuring seniors never lose access to the prescriptions they need.
Makes the lower drug prices negotiated by Medicare available to Americans with private insurance, not just Medicare beneficiaries.
Stops drug companies ripping off Americans while charging other countries less for the same drugs, limiting the maximum price for any negotiated drug to be in line with the average price in countries like ours, where drug companies charge less for the same drugs – and admit they still make a profit.
Creates a new, $2,000 out-of-pocket limit on prescription drug costs for Medicare beneficiaries, and reverses years of unfair price hikes above inflation across thousands of drugs in Medicare.
Reinvests in most transformational improvement to Medicare since its creation – delivering vision, dental and hearing benefits – and turbocharging the search for new cures.

The Democratic House has sent Senator McConnell more than 275 bipartisan bills – yet, calling himself the “Grim Reaper,” he still refuses to take them up! The American people deserve and demand action. In this New Year, we will continue to turn up the heat!

Another good article on the topic:

‘Trump is trying to kill Obamacare again and Democrats couldn’t be happier”

Published Sat, Mar 30 2019, 9:55 AM EDT. Updated Sun, Mar 31 201911:11 AM EDT

Medicare-for-all-who-want-it

David Posnett — Mon, 11 Nov 2019 17:12:19 +0000

Adapted from John Hooker in response to Wendell Potter’s statement:

“There’s now a chorus of voices, led by Senators Sanders and Warren, that are saying, ‘enough’. An entire generation has grown up hearing the stale health insurance industry talking points (that I helped craft decades ago). And they aren’t fooled! Politicians who keep defending the insurance industry will go down with them when the health care system finally collapses.”

I will repeat myself until I’m unable to write any more. THIS IS NOT THE RIGHT STRATEGY FOR SUCCESS. Wendell Potter is right factually but is playing the role of an activist (and selling books).

If you want to change something, choose Medicare for all who want it (MFAWWI) – also known as the public option. This will do the work without being bombarded with slogans like “socialism” etc. Remember, not so long ago, even some Democrats did not support Obamacare in 2010. They were too afraid of the public reaction when Republicans began bombarding the country with their fraudulent slogans.

We have reached, a “McCarthyism” situation in this country where the number of people becoming irrational is increasing. This is very dangerous. If we do not reform, we will screw up this country for good.

Introducing the government option or MFAWWI will do the dirty work of putting the insurance companies gradually out of work. It will bring the price of pharmaceuticals down because the increasing size of MFAWWI will put pressure on pharmaceutical pricing. It will force re-structuring through market forces and do this at a more manageable pace for society so that it can adapt to this huge change.

There is too much now to disentangle in one fell swoop — particularly while half of the opposing stakeholders will be bombarding a well-meaning single-payer system.

Time to be realistic. The only way to get the whole country to move in a direction of this magnitude (re-structuring one-sixth of the economy) is to have a huge majority convinced that that is what we have to do — like a war effort! We aren’t there yet.

Same for climate change!! Which is even bigger an issue.

Candice Hildebrant

David Posnett — Tue, 02 Apr 2019 02:19:51 +0000

In early March, just a few weeks before she died, Candice Hildebrant posted her story. I will let her tell it in her own powerful words.

Candice was in her thirtys, a tireless advocate for a single payer healthcare system, and an activist in Suffolk county.

Please consider a donation towards a Go-Fund-Me collection to fund future college tuition for a young daughter she leaves behind: gf.me/u/rviu6w

Candice Hildebrant

March 4, 2019 (published in themighty.com)

How the Broken U.S. Healthcare System Is Breaking My Family

I am one of of the many people in America who is suffering from the broken healthcare system we have in our country right now. Every single day of my life I have to fight against my multiple chronic illnesses. It is a daily struggle that sometimes I win, and many times I lose. I fight these battles every single day, and I fight them with no support from the people in government who are supposed to be there for me.

In my experience the government has looked the other way and ignored the many New Yorkers and even more Americans like me who are in dire straits due to mounting health care costs and coverage gaps. My family and I are in trouble, and our government officials, who have been elected to speak for us and guide our state and country to a better way, are failing us. We need help and we need it now. We don’t have the luxury to wait and see what plans might come down the road. We need serious health care reform now, otherwise people will lose their homes, their families and their lives.

In January of 2014 I went to my family doctor after having been sick for days. I wasn’t able to breathe, my chest ached and I felt so sick – I thought I had the flu. I was given different medications and told to rest. A week later I was back in my doctor’s office, having gotten worse. Again I was given more medication and told to rest. I couldn’t breathe, I couldn’t get out of bed, I was so sick my husband wanted to take me to the hospital then and there. But we didn’t go – it would cost just too much money, and after all it was just the flu being compounded by my asthma. So instead I went back to my doctor’s office, where I was told by the doctor there was no other choice – I had to go to the hospital. My lungs weren’t working and I wasn’t getting enough oxygen, so I was taken immediately by ambulance from the doctor’s office to the hospital.

I didn’t leave that hospital for weeks. I was put on a breathing machine while they ran test after test to find out why I wasn’t able to breathe, stand or even sit up. It clearly wasn’t just my asthma aggravated by a virus. My husband was at a loss, and my young daughter – only 5 at the time – was so confused as to where Mommy had gone and why she couldn’t see me. Eventually I was well enough to leave and go home, still not knowing what had caused this. I was able to be back with my husband and my daughter. But I still wasn’t well enough to walk on my own, shower on my own, feed myself or even get out of bed by myself.

As a small family in a small apartment with already mounting medical costs, my husband couldn’t stay home from work to care for me. We had no money for a home health aide and our insurance wouldn’t cover one. This meant my husband would make a lunch for me in the morning, put it in a lunch bag and leave it on the bed for me to eat while he was at work. I was left at home alone, not able to even walk on my own, with a cooler bag containing some food and drink and a commode next to the bed. This was the best my family could do, all we could do. It took months of living like this before I was well enough to leave my house and go back to work.

Ever since then, I have been sick; I have never fully recovered. I saw doctor after doctor since 2014, trying to determine what was wrong with me – why am I still ill? I visited asthma specialists, pulmonologists, orthopedists, rheumatologists, neurologists, hematologists etc., a neverending parade of specialists. Eventually, over the last three years of waiting and searching and being ill, it was determined I have a variety of chronic illnesses – all of which stem from a double whammy of progressive autoimmune diseases. l was in a desperate search to find the right specialist – if there even was one – that could help me.

Finally I received the answers I had spent five years of pain and frustration struggling to find. I have psoriatic arthritis, fibromyalgia, chronic pain disorder, PTSD, bipolar disorder, anxiety and asthma – all of which have no cure. I face a lifetime of fighting these illnesses, two of which are progressive. Since they are progressive I have to receive consistent, regular treatment so I can slow the progression, otherwise it will get worse than it already is. I am a fighter, but I need comprehensive medical coverage so I can effectively fight these diseases! For every one of those doctors, hospitals and medications I needed, there was and still is a cost — a big fat bill associated with each and every one of them.

You see, I have health insurance – “good” health insurance (if any of the health insurance companies we have can be called that) – United Healthcare Oxford. My daughter and I have this health insurance through my husband’s job. Our insurance has a $2500 deductible per person, per year. Our insurance costs us $368 per month. In addition, I have to pay over $250 per month in co-pays to see my doctors. I take 16 different medications. Each one has a prescription co-pay, and in all, it costs more than $600 per month just to pay for these medications. This means over $1200 per month immediately goes to life-saving healthcare costs, assuming I don’t need any special treatments that month (which I often do), and excluding the $2500 deductible.

Obviously, the crushing costs of all this is not something we have been able to maintain; we are drowning. I have thousands of dollars in debt from medical bills. They go all the way back to the hospital bills from 2014. But this debt isn’t just mine – it hangs over my entire family’s heads. There are times I have to go without the medical treatment I need just to keep the lights and heat on. There are times I have to choose between getting my daughter the basic things she needs, or paying the rent, over the medical care that I need.

My family lives in an apartment above a store on Long Island. My husband has a good job. I used to work too until June 2017, and the one and only reason I had been able to keep my job for so long while being so sick is FMLA. I worked for as long as I was able to, because now that I am enrolling in disability, which my doctors tell me I should have done a long time ago and have hurt myself by not doing until now, we will not be able to afford our apartment or pay our bills. My disability payment would cover less than one paycheck per month I was receiving while working. That is not enough to cover even the medical costs we have every month.

Every minute I am home I am lying in my bed sleeping or resting. I am not able to cook, clean, take care of my family, play with my child – none of the things most people take for granted. I cannot even take a shower without becoming tired and in pain. By the time I am done washing my hair my arms feel like they are going to fall off from the exhaustion. This is my life now.

All of this because I am unlucky enough to become a sick person in the lower middle class in New York, in America. People like me are stuck. We used to make too much money to qualify for Medicare or financial assistance, and yet not enough to pay the medical bills and all our other bills without going bankrupt, or going without medical treatments and care we need just to provide for our family.

Now that I am unable to work at all I have filed for disability. I was denied in my initial application. I then had to file an appeal. I have now been waiting over 18 months just to get a hearing date – not even the hearing itself. We are down half of what our family was making. My husband alone is trying to keep this family afloat by working three different jobs. How in the world does the government expect a person who has become disabled to live while their disability application is processed? How are we supposed to pay the rent, the bills, buy food, afford medical treatments? We can’t. This slowly sinking ship has become the Titanic.

I am 35 years old with no savings. We own nothing and have nothing to show for all the hard work my 39-year-old husband and I have put in over the years. Both of us have worked since we were teenagers, and we have nothing to show for it. With the way things are now in our state and country, I don’t see how we ever will.

In this great progressive state and nation, why is this a reality for my family and so many others? How is this allowed to be ignored by so many? How is this the America we have when we know this is not the America we want and have believed in? My family and so many others need your help right now. You can help us by supporting the NY Health Act (A5248/S3577) – a bill here in NY, and supporting a national single-payer, universal health bill federally, such as H.R. 676, the Expanded and Improved Medicare for All Act.

I believe these types of bills will save people’s lives. These bills can alleviate the pain and shame associated with being chronically ill by stopping the accumulation of crushing debt that comes with being sick. These bills can help people get the medical care they need without having to choose between providing for their family or going to the doctor. These bills will help people who are afraid to go to the hospital when they are ill because the cost is just too high – and that is when terrible things happen, as I know all too well. You all have the power to do something about this. So I beg of you, stand up for me. Stand up for all of us that cannot stand on our own. Stand up and stop this. Support universal health care – and please, I beg of you, do it now, before it is too late.

Image Credits: Candice Hildebrant

Being Hospitalized Is The Worst

Published on Medium.com

Candice & Robert Hildebrant

Mar 10

As I sit here in my here in my hospital bed I am trying so hard to not feel that sense of hopelessness that invades at the back of your head. That voice that says “your always going to be sick, just give up”. Well — I refuse to give up, but some days are a lot harder than others. Today is one of those days. I have been in the hospital for 8 days now and they still haven’t said when they are going to discharge me. I have been seen by a neurologist, infectious disease doctor, pulmonologist and am still waiting on a rheumatologist. I cannot tell you how much this situation sucks. All I want to do is be out of this hospital and home with my family.

Right this minute my IV antibiotics are leaking out and I have called the nurse twice to let her know that my IV is leaking all over me. No one seems to care. I am low maintenance, I really am, but come on people — basic care is needed! How is it that I am the only person who finds an issue with the fact that my antibiotics are leaking out of my arm? I have had the same IV in since I came to the hospital. IV’s should be changed every 3 days — I am going on 5 days at this point. It hurts and it bleeds and it’s leaking the precious antibiotics everywhere. I even pushed the call button for the nurse before I started writing this and she still hasn’t appeared. It is so frustrating and infuriating.to be helpless like this and dependent on others, who are frankly failing big time.

I finally got a nurses aid to come in and I told her my IV is leaking and bleeding and her response was “I’ll tell your nurse”. I have heard those exact words before — about 20 minutes ago when I first called for the nurse to tell them my IV is leaking. It isn’t just leaking, it hurts — a LOT. Finally the nurse appeared and said “well that failed at the right time, your antibiotics are done”. Leave it to me to have a fortuitous IV failure.

Being in the hospital all alone day after day is the most depressing thing I can think of. You sit there endlessly with no motivation or anything to do except be in pain. I’m currently in here for pneumonia and the flu — a double whammy. And on top of that, my Psoriatic Arthritis has flared up so badly that I am swollen like a sausage. My hands and feet are three times the size that they should be. I’ve never had a flare up this bad before, but it does make sense that the swelling would come into play because I have been off all my medications for PsA for about a month. You see, I cannot take my PsA medications if I am sick, as they lower and damage my immune system. Therefore, when I am so sick I feel like I’m gonna die, I then get the added bonus of a PsA flare.

The hospital is such a trying place. There are so many people, plus there are so many sounds — the beeping of a million machines. Not to mention the atmosphere — the pain and suffering coming from every room and every look from a person. In the hospital there is no happy, cheery people, just sad and tired patients who want to go home. I am definitely one of those people.

Tonight is my daughter’s concert — she plays the violin. And I’m not going to be there! I have never missed an event of hers — come hell or high water I am always there. Unfortunately this time I am going to miss it, and it is killing me. The fact that I am missing one of her performances hurts more than all the pain I am in now combined. She is my reason, my everything, and I feel like I am letting her down. Logically I know that there is no way I can be there, and she knows that too. My husband promised to record the show so that I can see it.

I saw the show — she was amazing! I am so proud of her. I wish so much that I was there in person to tell her that.

I have a feeling that I am getting out of here soon — I just need one more test and a good result on it and I can hopefully blow this Popsicle stand. I know I just need to keep reminding myself that this is temporary. I will be out of here before I know it and my family will be waiting for me. That thought is what gets me through the day — the knowledge that I am missed by my family and that they want me to come home. Well, I am coming home as soon as I can!

Medium member since Jan 2018

Candice is an avid reader and writer. She is currently disabled and loves to spend her time reading or with her loving husband Robert and their daughter.

Our Healthcare System will Change (Like it or Not)

David Posnett — Mon, 05 Nov 2018 01:44:40 +0000

Submitted by John Hooker

In reply to a recent laudable post “Drug Prices: How Pharma Games the System,” I have this to add.

To gather momentum to change our system we should be relentless in emphasizing the cost that affects patients directly.

There is one major fallacy of our healthcare system. We chose to link healthcare insurance to employment in the years following World War II. In contrast, at that same time, Europeans chose to provide health care as a right for all (Universal Healthcare). Their countries chose different systems (some public and some private), but the underlying intent was always to insure everyone in the country, because that is how a successful insurance system works.

Healthcare obtained through your employer was our original sin. It never insured more than 70% of the population, and it actually took over our rights to choose and in stead put our employers in charge.

As per “Drug Prices: How Pharma Games the System,” Medicare is not allowed to negotiate prices. Pharmaceutical prices are still unregulated. Worse, Medicare is hamstrung by administrative rules that tend to increase fraud or waste. As we all know, that led to claims that anything government puts “its hands on” cannot work.

But the reality is that Medicare was engineered to be inefficient and to maximize profits for our private health care industry.

However, recent talk about healthcare is raising factual awareness and creating a platform for campaigns. Excessive patenting to extend branded product life, as described in “Drug Prices: How Pharma Games the System,” is only one aspect of the problem.

Most important is to remind ourselves that American pharmaceutical companies are free to charge whatever they want, whether the product is on or off-patent! Even if the drug is 30+ years old! That is outrageous.

Another point related to messaging: We should stop reminding the younger generations that health care costs are rising and implying they are being made to pay the bill for the costly care of older Americans via higher healthcare premiums. What no one seems to get, is that this is how insurance works! If you are a very careful car driver and never have an accident you are still paying insurance and this “covers” the expenses of the insurance company when others submit claims. In contrast to auto-insurance where higher premiums due to accident prone driving make some sense, health issues are often unrelated to negligent behavior. Even if you think that those who smoke, drink, or have unprotected sex with multiple partners, should be made to pay higher healthcare premiums, consider this. In our immediate future, say in 10-20 years, everyone will get a full sequence of their genetic profile. This means that you, your doctors and perhaps even your health insurance, will know the details of which diseases you are prone to get in the future.

Will you get a heart attack with 10% chance or with a 90% chance? Will you get hypertension? Will you have a stroke? Will you have diabetes? Will you get any number of different cancers? Thanks to Angelina Jolie and other celebrities, everyone already knows about BRCA gene mutations and the high risk for breast cancer and ovarian cancer that they impart. Within a few decades there will be thousands of such cancer genes. You can bet that private for-profit health insurance companies would love to get your genetic profile and charge you insurance rates accordingly.

The ONLY way to “overcome the inequity of nature” is to adopt the widest healthcare insurance pool possible, distribute the risk, and lower premiums for everyone.

It is time to debunk healthcare insurance through employment. It increases the lack of transparency. It decreases control for the individual. It is unmanageable in its current form and it is getting worse.

Experts predict that the expanded use of genomics will eventually afford predictability of disease for the entire population. This is the “holy grail” for healthcare providers. It is also the right time to dramatically change our healthcare insurance system.

If not politics, science may compel us to accept Medicare for all.

Let’s simplify and make good.

John Hooker is an International Medical Communications Consultant with 36 years of experience working with Big Pharma.

10 REASONS WOMEN MUST #FlipThe1st!

David Posnett — Fri, 26 Oct 2018 14:25:08 +0000

Issue #2: August, 2018 by Jacquelyn Gavron and Amy Turner

Lee Zeldin repeatedly votes for laws that jeopardize the health and financial wellbeing of 55% of his constituents: the 310,000 females in New York’s 1st Congressional District. Women in NY01 deserve a representative who understands that when women succeed, families and communities do too. Here’s Zeldin’s voting record, which speaks for itself.

#1 “FEMALE” IS NOT A PRE-EXISTING CONDITION

Zeldin and the GOP-controlled house voted to repeal the Affordable Care Act (ACA) and replace it with the American Health Care Act (AHCA). Had it passed, 61,951 people in NY01 would have lost their health care (ACASignups.net). And insurance companies would be allowed to charge women more than men and refuse to cover:

Essential services—pregnancy, maternity and newborn care
Pre-existing conditions —pregnancy, C-sections, celiac disease, hysterectomies, eating disorders, and treatment for domestic violence and sexual assault
Preventive services—mammograms, screenings for cervical cancer, osteoporosis, anemia, gestational diabetes and preeclampsia; and breastfeeding support and supplies.

Did you know. . . Zeldin has received a whopping $267,975 in contributions from insurance companies since 2014. (OpenSecrets.org).

#2 WOMEN DESERVE EQUAL PAY

In Suffolk County, women earn $51,014 for a job that pays men $65,326—$14,312 less. (labor.ny.gov). Don’t expect Zeldin to help. He’s repeatedly undermined equal pay protection by:

Voting to block Congress from considering the Paycheck Fairness Act, a bill to end the pay gap and protect workers from retaliation for sharing info on their wages. (H.R. 1619, 2015)
Voting to make it extremely difficult for women seeking equal pay to bring a class action lawsuit against their employers. (HR 1927, 2016).

#3 LET WOMEN CONTROL THEIR OWN BODIES

Zeldin voted for a bill to ban abortion at 20 weeks (directly challenging Roe v. Wade), which was opposed by the American Congress of Obstetricians and Gynecologists as a serious threat to women’s health and not based on sound science. Zeldin has supported:

Amending the constitution to ban abortion except to save life of mother
A nationwide ban on private insurance coverage of abortion
Federal legislation allowing parents to prevent their daughters from receiving abortions
Requiring rape victims to wait 48 hours before obtaining an abortion
Barring the government from distributing emergency contraceptives

#4 GUN VIOLENCE IS A WOMAN’S ISSUE

Zeldin co-sponsored the federally mandated concealed carry bill, which would override New York’s strict gun laws and let gun owners with a history of violence against women roam our neighborhoods with a hidden, loaded gun. Most people don’t know the hidden toll guns take on women:

50 women a month are shot to death by a current or former partner
4.5 million American women have been threatened with guns, often by intimate partners, so they live in fear for themselves and their children for days, months and even years.
U.S. women are 16x more likely to be killed with a gun than in other high-income countries.

#5 WE NEED PAID FAMILY LEAVE

Most workers are covered by the Family Medical Leave Act, which lets you take up to 12 weeks of leave a year to care for family members. But for most people, that leave is unpaid. The GOP solution? Take a “loan” from Social Security and delay receipt of your retirement income.

#6 SOCIAL SECURITY: ON THE CUTTING BLOCK

The GOP tax scam gives huge tax cuts to the wealthy and large corporations that add $2 trillion to the national debt. They’re using this as an excuse to slash Social Security—it’s especially important to women as they earn less, take more time out of the workforce, live longer, save less and get smaller pensions.

In NY01, 150,262 people receive Social Security. Zeldin said he’d “continue to support legislation that protects and supports Social Security and Medicare” (letter, 6/2017) but he:

Voted YES to a constitutional amendment that would allow Social Security to pay beneficiaries only if a federal budget surplus could offset them. (HJ Res.2, 4/12/18)
Voted to block the transfer of tax revenue to keep the Disability Insurance afloat—unless it was part of a larger plan to cut benefits or tax increases. (HRes 5, 1/6/15; Politico).

#7 GOP GUNNING FOR MEDICARE & MEDICAID

In New York, nearly 2 million women rely on Medicare for their health insurance. Zeldin voted for a budget resolution (H.Con.Res 71, 10-15-17) that would pay for Trump’s huge tax cuts by:

Slashing Medicare by $487 billion
Increasing the age at which you can apply for Medicare from 65 to 67 nscpssm.org

More women than men are covered by Medicaid as they often work in lower paying jobs, and many work for small businesses that don’t offer health insurance. But Zeldin voted to take way the Medicaid option. And Trump recently gave the go-ahead for states to take away Medicaid from people who aren’t working a minimum number of hours a month. This disproportionally hurts women because they:

Often work in low-wage jobs with inconsistent hours that may not meet the requirements.
Typically care for children or other family members and aren’t in the paid workforce

#8 UN-AFFORDABLE CHILD CARE

Trump’s tax scam doubled the maximum child tax credit from $1,000 to $2,000—“but the parents of about 29 million kids won’t get the credit because their families earn too little.” (TPC.org).

#9 PLANNED PARENTHOOD

Zeldin has repeatedly voted to defund Planned Parenthood. Perhaps he doesn’t understand that Planned Parenthood provides a wide range of health care services to 2.4 million clients, including, prenatal care, breast exams, PAP smears, vasectomies, HIV and STD testing and treatment, and sex education.

#10 WOMEN DESERVE A REP WHO VALUES WOMEN

In January 2017, thousands of Zeldin’s constituents showed up at women’s marches in D.C., NYC, Port Jeff, Sag Harbor and other places to advocate for women’s rights. But rather than acknowledge their concerns, Zeldin questioned their sanity, suggesting that some of his constituents might hold views that are “off the reservation” and using his 37th birthday two weeks later as an occasion to express his “love” for “even those Hillary supporters who have lost [their] beautiful minds since the election.”

Zeldin is Lying about your Healthcare

David Posnett — Sat, 20 Oct 2018 05:33:34 +0000

In his robocalls Zeldin uses a local physician to assure patients and constituents that he and the Republicans are not about to

deny insurance for pre-existing conditions
will not touch medicare
will not abolish social security

The physician, Dr. Vacirca, identifies himself and his practice twice in the robocall. He said Zeldin supports care for patients with pre-existing conditions and supports Social Security and Medicare, while [the democratic oponent] Gershon supports “socialist-style, government control” health care that will drive up taxes and bankrupt Medicare.

Jessica Waterbury, a patient of Dr. Vacirca, said she found Vacirca’s relationship with the Zeldin campaign “troubling.”

“Now that this information has come to light, I am more than dismayed, and do not want the money that paid for my treatment going to someone who is willing to take away protections for pre-existing conditions (like my cancer), and who voted against the individual market for health insurance,” Waterbury said.

Mitch McConnell disaggrees with Zeldin:

Republicans Will Take on Obamacare and Entitlements if They Win in Midterms, Mitch McConnell Says. By Nicole Goodkind On 10/17/18 at 5:31 PM

“…after indicating that he would like to cut spending on Social Security, Medicare and Medicaid, Senate Majority Leader Mitch McConnell told Reuters that if Republicans win the Senate this November, they will once again take up their fight to repeal the Affordable Care Act, also known as Obamacare.

McConnell … clarified his desires to cut spending on Medicare, Medicaid and Social Security programs,”

Nothing surprising about these devious maneuvers. The Republican mojo has been clear for a while:

1st hand out a huge tax cut for the super rich that fund the Rep. party.

2nd complain about the deficit they created and blame it on Medicare, Medicaid, Obamacare and Social Security

3rd repeal Obamacare and cut all the social programs drastically

Don’t Make Me Laugh

David Posnett — Thu, 13 Sep 2018 14:41:01 +0000

By Perry Gershon:

Lee Zeldin wants you to think he’s an environmentalist. He’s spending big bucks blasting that absurd idea across Long Island television.

Don’t make me laugh.

In his four years in Congress, Lee has voted against the environment over and over again. He’s taken tens of thousands of dollars from the oil and gas industry to prop up his campaign.

It’s no wonder Lee opposed protecting the environment on 21 out of 22 votes.

Lee opposed seven bills on air quality protections.

He opposed protections for clean water 19 different times.

He opposed protecting wildlife eight times.

And he continues to stand by a president who insists climate change is a Chinese hoax.

Get the idea? Lee Zeldin is no friend of the environment, of clear air and water, or protecting our planet for future generations.

Long Island voters have a clear choice in November.

I promise to work tirelessly to protect the environment – whether that be our clear air, clean water, clean energy production, or protecting wildlife.

Lee’s record is clear, and that’s just another reason why he has to go.

Donate $5 right now. Let’s show Zeldin we won’t stand for his hypocrisy on the environment.

Posts on R&R (since July 2018) related to Zeldin’s environmental record:

Zeldin’s Environmental Voting Record Goes from Bad to Worse

Posted on August 28, 2018 by D. Posnett MD

Lee Zeldin wants to Drill in the Ironwood Forest National Monument By Marc Rauch: Latest update: Zeldin’s Environmental Voting Record Goes from Bad to Worse in 2018 In the first 3 years of Lee Zeldin’s congressional term (2015-2017), he earned … Continue reading →

Posted in climate change, Environment, EPA, Executive Order, GOP, National Parks & Monuments, Trump, Uncategorized, water quality, Zeldin | Tagged Environment, lee zeldin, voting record | 2 Comments | Edit

Zeldin’s War on the Environment

Posted on August 20, 2018 by D. Posnett MD

By Perry Gershon: (Source: https://www.facebook.com/pg/perry4congress/posts/?ref=page_internal) Lee Zeldin continues to support the Trump Administration’s destruction of our environmental protections. The new “plan” for coal represents one more example of the total disregard for the serious health effects of air pollution. The … Continue reading →

Posted in Air Pollution, Environment, Trump, Uncategorized, water quality, Zeldin | Tagged car emission, clean air, clean water, pollution | 2 Comments | Edit

Is Lee Zeldin Really “Good On The Environment”?

Posted on January 19, 2018 by francescarh

A slickly produced mailer from Lee Zeldin appeared in my mailbox this week. It touted our Congressman’s supposed record in “safeguarding our environment.” Mr. Zeldin has been very adept in pulling the wool over voters’ eyes about his actual environmental … Continue reading →

Posted in Uncategorized | Leave a comment | Edit

Zeldin Boasting about Environment Record?

Posted on January 2, 2018 by maidstonejewelry

Recently Congressman Lee Zeldin (R, NY-1), co-chair of the Long Island Sound Caucus and founding member of the “Congressional Estuary Caucus”, was joined by EPA Regional Administrator Pete Lopez, New York State Department of Environmental Conservation Regional Director Carrie Meek … Continue reading →

Posted in climate change, Environment, EPA, Paris Climate Accord, Uncategorized, Zeldin | 4 Comments | Edit

More Bad Zeldin Environmental Votes

Posted on October 12, 2017 by D. Posnett MD

By Marc Rauch and Chelsea Estevez Since our last update in late August, fourteen bills impacting the environment have come before the House of Representatives. Lee Zeldin took the anti-environment position on 12 out of 14 of these recent bills. … Continue reading →

Posted in climate change, Environment, EPA, Paris Climate Accord, Trump, Uncategorized, Zeldin | Tagged environmental justice, EPA, fracking, methane, ocean, public land | Leave a comment | Edit

Complete Lee Zeldin Environmental Voting Record

Posted on July 2, 2017 by D. Posnett MD

A great resource! D Posnett Marc Rauch·Friday, June 23, 2017 Complete Lee Zeldin Environmental Voting Record (Last Updated 6/29/17) Introduction Linked here https://docs.google.com/spreadsheets/d/19e5j3Z3xupufWNReLsO-P69eL316sJDLBbf8EZDFklg/edit?usp=sharing is an easy-to-use Excel spreadsheet summarizing Lee Zeldin’s complete environmental voting record in Congress. Purpose This spreadsheet … Continue reading →

Posted in Air Pollution, climate change, Environment, EPA, National Parks & Monuments, Offshore Drilling, Uncategorized, Zeldin | Tagged energy, Environment, record, wind, Zeldin | 2 Comments | Edit

Lee Zeldin’s Duplicity on Environmental Issues

Posted on March 7, 2017 by D. Posnett MD

Marc Rauch, from Bellport, New York. had the following letter in the March 2, 2017 edition of the Long Island Advance: I was taken aback by Rep. Lee Zeldin’s “official positions” on protection of the environment, as reported last week … Continue reading →

Posted in Environment, Uncategorized, Zeldin | Tagged duplicity, Environment, pollution, Zeldin | 1 Comment | Edit

Zeldin & Environment?

Posted on February 19, 2017 by D. Posnett MD

My letter to editor of LI Advance was published this week- 2/16/2017 Voting to loosen standards on oil and gas industries Where is Congressman Zeldin on the environment? Two weeks ago I visited Congressman Zeldin’s office to talk with a … Continue reading →

Posted in Environment, Uncategorized | Tagged Environment, Zeldin | 5 Comments | Edit

Flip the House — Defeat Zeldin!

Posted on August 4, 2018 by amyturner2000

By Jacquelyn Gavron & Amy Turner, July 19, 2018 New York’s First Congressional District (NY-1), historically a swing district, is represented by Lee Zeldin (R). He was initially elected with Tea Party support and is an unwavering Trump loyalist with … Continue reading →

Posted in ACA, AHCA, economy, Environment, Guns, Health Care, Politics, Tax Reform, Uncategorized, Women, Zeldin | 3 Comments | Edit

Moral Obligation to send Zeldin packing

Posted on July 19, 2018 by D. Posnett MD

Published in the East Hampton Star – the July 10, 2018 To the Editor: Offered less than 10 days into our district’s 133-day congressional race, The Star’s advice to local Democrats (“First District Dilemma”) is not only premature, but also … Continue reading →

Posted in perry gershon, Uncategorized, Zeldin | Tagged David Rattray, democratic, gershon, Star, turnout | Leave a comment | Edit