healthcare – R&R – Reachout and Rebuild

Covid Notes: “We don’t trust the white coats anymore.”

David Posnett — Wed, 28 Feb 2024 16:36:25 +0000

Norbert Goldfield MD:

‘Ask Nurses & Doctors’

This Covid outbreak is on the decline but Long Covid is here with documented impact on children. We have failed our older people: “In the last week of 2023 and the first two weeks of 2024 alone, 4,810 people 65 and older lost their lives to covid. Consider that this number of persons would fill more than 10 large airliners. But the alarm that would attend 10 large plane crashes is notably absent. During the same period, the flu killed 1,201 seniors, and RSV killed 126. Note: we have trouble getting Paxlovid for Covid patients. “As Leanna Wen quotes: “Why can’t you take a covid test at the pharmacy and have the pharmacist confirm the diagnosis and dispense Paxlovid?” We need to plan now for the next pandemic and not pretend all is fine. We need to enact better global approaches to vaccine access instead of protecting big pharma.

Consider:

Florida Surgeon General Ladapo is contending with a measles outbreak. He is not encouraging vaccination.
Even the CDC head has pleaded with the AMA for assistance to fight Covid misinformation.
Other than issuing statements, health professional trade associations do not use their lobbying muscle (see below for what lobbying muscle means for tobacco company Juul). Until that happens, especially Republicans will chip away at public health measures.
For example Ft Myers/ Collier County, Florida ended fluoridation, a proven public health measure to decrease tooth decay: Commission Chairman Chris Hall said the issue is “all about health freedom” and “We don’t trust the white coats anymore.”
Washington Post: Two health professional organizations pushing Covid misinformation, Front Line Covid-19 Critical Care Alliance and America’s Frontline Doctors, went from receiving $1 million in donations when they were formed in 2020 to $21 million in 2022. Organized medicine spends almost nothing to fight against this tragedy.
With the IVF Alabama decision, abortion continues to be the health electoral issue. Republican states are trying to pre-empt ballot initiatives in favor of abortion rights.
On drug abuse programs this drug abuse treatment program is a real positive, Despite this great program, the fundamental problem is that mental health and substance professional reimbursement is lacking.
Lobbying to push smoking continues. STAT’s Nicholas Florko “dove deep into a new trove of internal emails and other documents to see how Juul, the tobacco company, advances its cause, from orchestrating untraceable political donations to paying think tanks for favorable research… in an effort to prevent both Congress and the FDA from taking action”.
Washington Post: “What if we had medications that cost 5,000 times less than Ozempic (used for weight loss) and are better at preventing heart attacks and strokes? And what if only 1 in 5 people who need these medications get them? That’s the situation with drugs to treat high blood pressure”. We need a national push including health professional organizations.
We need many more graduates from overseas to cover our depleted health professional ranks. But that only robs health professionals from desperately poor countries as recently reported: “Entry level nurses in the U.K.’s National Health Service (NHS) start with a £28,407 ($35,660) annual salary. A well-paying nursing job in Nigeria may offer 150,000 naira ($100) monthly but even that is typically a scarce job.” Typical nursing wages: $20/ month.
According to Rachel Kleinfeld: “A widely-circulated analysis documented that the ideological gap between men and women is growing. Over the past fifteen years, men across the globe have voted for radical right-wing parties at much higher rates. More than one in ten men in their prime aren’t working at all. Nearly three in every four deaths of despair—largely from opioids and suicide—are male. These deaths became so common that they were causing a decline in life expectancy for American men even prior to COVID-19.”

According to The Hill, At least 8 in 10 voters said it was “very important” for the 2024 presidential candidates to talk about inflation and the affordability of health care. Adults also said they care more about affording unexpected medical bills than routine expenses such as gas, utilities, food and housing costs. Christian nationalism, abortion, drug price control, and preservation of Medicaid that increasingly includes help with food are all at stake this November.

In response, AND (Ask Nurses and Doctors) is continuing to expand its network in swing states. We are focused on 3 equally important initiatives. Our next monthly call of “seasoned” and young activists in dialogue will be March 4, 8-9pm – with Bill Fletcher and Nadi Kaonga. . Please sign up below. Register in advance for this meeting:

https://us02web.zoom.us/meeting/register/tZMpf-GrrzwuHNKIsKWBv8unXgWIdXM0gE9D

After registering, you will receive a confirmation email containing information about joining the meeting. April 5 will feature Don Berwick and medical student activist Austin Vaughn. On May 6, Dave Fleischer and Andrew Goldstein will focus on Deep Canvassing. All from 8-9 pm.

For health professionals, 5 minutes is all it will take to record a message of support for Biden on the issue of abortion (see 1st attachment for details on how/where to send). Please copy me when you send in the recording to the Biden campaign.

We will soon start posting on the Ask Nurses and Doctors website brief policy documents with actionable steps for any activist anywhere in the country. See 2nd attachment describing the effort. Your involvement is welcome!

Norbert Goldfield, M.D.

Founder, Executive Director Healing Across the Divides

Author of Peace Building Through Women’s Health: Psychoanalytic, Sociopsychological, and Community Perspectives on the Israeli-Palestinian Conflict (Routledge, Taylor Francis; 2021);

Founder, Executive Director Ask Nurses and Doctors

Author of Public Health, Public Trust and American Fragility in a Pandemic Era: The Critical Role of Health Care Professionals (Routledge, Taylor Francis; 2024).

Sowed Discord

David Posnett — Fri, 28 Aug 2020 15:01:42 +0000

Trump ‘s lackey boy, Lee Zeldin

Springs
August 24, 2020

Dear David:

The past three and a half years have been a master class in the havoc that can be wrought when a president is constrained by neither truth nor decency. Starting with the size of his inauguration crowd, it’s been brazen lie after brazen lie (20,000 and counting), and a never-ending assault on the rule of law.

He has sought to end health-care coverage for millions of Americans (and continues to do so during a pandemic), encouraged violence against journalists and political opponents, attempted to extort the president of Ukraine, re-tweeted preposterous and vile QAnon conspiracy theories, actively sown discord whenever he thinks it’s to his political advantage, and most recently he installed an unqualified lackey to sabotage the U.S. Postal Service. The list goes on and on.

But Trump couldn’t have inflicted so much damage on his own; he needed help from those willing to excuse his corruption and incompetence, and in that respect, our congressional representative, Lee Zeldin, has been a standout. Parroting any number of the president’s ridiculous talking points — from how confessed felon General Flynn has been treated unfairly to decrying that Lt. Col. Vindman “is no martyr” (No, he’s a Purple Heart recipient who served his country for 20 years and came forward when he witnessed wrongdoing), to lauding the president’s “phenomenal” handling of the coronavirus. Zeldin is an embarrassment.

Nancy Goroff, a distinguished scientist with years of experience tackling difficult problems and finding solutions, is running against Zeldin in November. The choice is ours. Do we want a sycophant who has spent the better part of his last two terms supporting the worst instincts of a dangerous president, or a woman who will represent and fight for the interests of her constituents with dignity and intelligence?

Sincerely,

CAROL DEISTLER

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

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.

The Issues that Matter in NY CD-1

David Posnett — Mon, 21 May 2018 01:45:42 +0000

From: Steven Lupo as posted on FaceBook:

I was knocking on doors for Kate Maguire Browning today. At one of the first homes I went to, a young woman answered the door. She looked exhausted. I apologized for disturbing her and explained why I was there. She asked me for Kate’s position on healthcare and I gave her the best answer I could. I then asked why it was important to her.

She responded her daughter was terminally ill. She been up most of the night and that’s why she looked exhausted. My heart broke. She said life has been a struggle, not only because of her daughters illness but also the constant battle with insurance and pharmaceutical companies, who try to deny her daughter coverage.

I brought up the fact that my daughter was born premature and spent 14 days in NICU. But I was lucky. I could concentrate on my daughter’s recovery. I didn’t have to worry about going broke or fighting insurance companies. I stated no American should have to go through what she is going through.

At this point I reminded her of Zeldin‘s position on healthcare. I reminded her how he voted to take healthcare away from millions of Americans. He has voted on the side of the insurance and pharmaceutical companies, to charge us more money, while offering inferior coverage.

Later in the day I met a widow on a pension. She is living on her deceased husband‘s federal pension. She is very worried that the Trump administration will reduce her benefits. She’s worried if Social Security and Medicare will be there for her children. She’s worried the inflation we are starting to see will eat away at her fixed income.

Many live in the echo chamber of #RussiaGate, but most Americans are looking much closer to home. They are concerned about their jobs, affordable healthcare, affordable homes, lower taxes, educating their children, environmental issues, the opioid epidemic, etc.

That’s what I focus on as I speak to folks. That is the message we need to focus on to unseat Zeldin.

And we must never, NEVER, bash the other Democratic candidates. NEVER!

We must unite and rally around the primary winner. We have a tough battle ahead. Please stay positive!

US Healthcare: no Bang for the Buck

David Posnett — Sat, 19 May 2018 22:36:07 +0000

Health care in the US is more expensive, by far, than anywhere else on this planet. It represents greater than 17.9% of the US GDP. Health spending is projected to grow 1.0 percentage point faster than Gross Domestic Product (GDP) per year over the 2017-26 period; as a result, the health share of GDP is expected to rise from 17.9 percent in 2016 to 19.7 percent by 2026. Other comparable developed countries pay much less:

The question is why are we so wasteful and what do we get for all this money. If you look at longevity as the overall measure of success for healthcare, we are not doing very well, as described in a recent article in the NY Times:

The above graph shows life expectancy over time compared to similar developed nations.

This shows life expectancy as a function of health spending per person.

So what are the proposed causes for this dramatic inefficiency? The authors propose many factors to explain the sudden up tick in health care spending around 1980. For example:

“suppliers marketed very costly technological innovations with gusto,”and they “found ready customers in hospitals, medical practices and other entities eager to keep up with rivals in the medical arms race.” The last third of the 20th century or so, was a fertile time for expensive health care innovation: Coronary artery bypass grafting, innovative drug treatments for H.I.V. for cancer and expensive NICU care for premature babies.

But innovation does not necessarily translate in to better outcomes. Almost no matter how it’s measured, longevity in the United States has not kept pace with that of other nations.

Another study, published in JAMA, found that even accounting for motor vehicle traffic crashes, firearm-related injuries and drug poisonings, the United States has higher mortality rates than comparably wealthy countries.

So here is the presumed bottom line.

“The lack of universal health coverage and less safety net support for low-income populations could have something to do with it. The most efficient way to improve population health is to focus on those at the bottom,” says Ms Glied from Columbia Univ. “But we don’t do as much for them as other countries.”

The effectiveness of focusing on low-income populations is evident from large expansions of public health insurance for pregnant women and children in the 1980s. There were large reductions in child mortality associated with these expansions. “Those reductions were much larger for poor children than for richer children,” Ms. Currie said.

In 1980 the United States spent 11 percent of its G.D.P. on social programs, excluding health care, while members of the European Union spent an average of about 15 percent. In 2011 the gap had widened to 16 percent versus 22 percent.

Slow income growth could play a role because poorer health is associated with lower incomes. “It’s notable that, apart from the richest Americans, income growth stagnated starting in the late 1970s,” Cutler said. “Social underfunding probably has more long-term implications than underinvestment in medical care.”

Read more here about how social programs can lead to increased longevity: Are better health outcomes related to social expenditure?

It has been known for some time that low income/wealth is associated with much decreased longevity:

as the income gap increases in the US, so does the disparity in life spans between rich and poor as reported in the NY Times
in the U.S., the richest 1 percent of men lives 14.6 years longer on average than the poorest 1 percent of men, while among women in those wealth percentiles, the difference is 10.1 years on average.
This eye-opening gap is also growing rapidly: Over roughly the last 15 years, life expectancy increased by 2.34 years for men and 2.91 years for women who are among the top 5 percent of income earners in America, but by just 0.32 and 0.04 years for men and women in the bottom 5 percent of the income tables.
U.S. tax and spending policy does relatively little, compared with its peers in the developed world, to reduce inequality and with the new tax policies enacted by our current government this will worsen.

In the NY Times (2014) Leonhardt and Quealy note that “The American Middle Class Is No Longer the World’s Richest”. The following interactive graph shows who many developped countries like Norway, Canada, Germany, Sweden, Netherlands are making gains for the lower 20th percentile of wage earners surpassing American incomes for this bracket. American incomes are losing their edge, except at the top:

It is this same bracket (the lower 20th percentile) that have such poor life expectancy dragging down the overall life expectancy for the entire country.

Finally, this study shows an interesting shift: since about 2004 the lowest quintile income group in the US is spending much less on healthcare on a per capita basis, than the highest income quintile. One of the authors remarks that “co-payments and deductibles have bent the cost curve. But it’s come at the expense of poor people and middle-income people.”

My conclusions:

efforts by the GOP to slash medicare will make things worse
the new tax law will make things worse by aggravating income disparity
advances in medicine benefit the health care industry and affluent Americans who have access to the newest treatments, but on average the population does not benefit as measured by life expectancy, for example.
How you vote may be a matter of life or death.

Out-of-pocket healthcare spending could rise thanks to Lee Zeldin

David Posnett — Wed, 24 Jan 2018 18:02:17 +0000

Implementation of the Affordable Care Act (ACA, Obamacare) was associated with reduced out-of-pocket spending for US medical care, particularly among those with lower incomes, but not with reduced premiums.

That is the conclusion of a new study published in the medical journal JAMA Internal Medicine.

As summed up by Les Masterson on the HealthCare Dive

the ACA led to reduced out-of-pocket spending, especially for low-income Americans. That said, many people still feel the burden of high out-of-pocket costs and premium spending.
medical expenses continue to “consume a large share of many families’ incomes and compound income inequities.”
repealing or reversing gains made by the ACA will “especially harm poor and low-income Americans.” Premiums will likely increase for people in the exchanges if healthier people leave the exchanges.

This affects residents in our Congressional district: NY-01. Rep. Lee Zeldin has consistently voted to undermine the ACA and has supported very unpopular Trumpcare. Republicans also putting Medicare and Medicaid in jeopardy via the recently passed tax bill. Thanks for stealing our money!

Read more about the LZ track record on healthcare:

https://resistancesuffolk.blog/2017/03/18/zeldins-deception-on-health-care/

https://resistancesuffolk.blog/2017/06/30/zeldins-approval-of-senate-healthcare-bill-reveals-his-lack-of-concern-for-veterans/

http://www.1clickdaily.com/1429473

https://resistancesuffolk.blog/2017/09/25/zeldin-must-stand-up-and-protect-long-islands-health-care/

https://resistancesuffolk.blog/2017/05/21/is-zeldin-untruthful-about-healthcare/

and Zeldin complicit in CHIP used as bargaining chip:

Zeldin Must Stand Up And Protect Long Island’s Health Care

David Posnett — Mon, 25 Sep 2017 17:27:26 +0000

Letter To Editor: Zeldin Must Stand Up And Protect Long Island’s Health Care

Published in “Smithtown Matters”, Friday, September 22, 2017 at 6:08PM

Dear Editor,

Next week, Senate Republicans will debate a cruel plan to take away health care from millions of Americans and tens of thousands of Long Islanders. Under the Graham-Cassidy bill, there would be a massive shift of federal support from “blue” states to “red” – especially from New York to Texas. In fact, New York could lose more than $45 billion dollars in federal funding. This would create enormous market uncertainty and devastate thousands of Long Islanders, particularly working families, the elderly, and the disabled.

Where is Rep. Lee Zeldin on the bill? Does he realize how much funding would be stripped from New York? Does he care? Even some New York Republicans, like Rep. Tom Reed and Rep. Peter King, have come out against Graham-Cassidy. I urge Rep. Zeldin – who voted to strip health care from millions of Americans earlier this summer – to stop playing politics with the lives of Long Islanders and oppose this bill for the good of his constituents.

Perry Gershon

Democratic candidate for New York’s 1^st congressional district

Also, check this out:

http://www.businessinsider.com/graham-cassidy-healthcare-bill-obamacare-insurance-2017-9

David Posnett MD

Americans Don’t Want Senate’s Health Care Plan, But It’s Unclear What They Do Want

David Posnett — Thu, 13 Jul 2017 08:27:32 +0000