Well-informed patient advocacy and member participation are the keys. Health Systems Management helps members and their families take maximum advantage of the data they’ve collected on hospitals, doctors, and outcomes throughout our region; they make sure no one slips through the cracks.
In brief, Local 49 has solved one of the trickiest challenges of the U.S. health care crisis: they’re getting outstanding medical outcomes with effective cost control, and getting ahead of the costs that continue to spiral out-of-control for almost every other group.
Unlike dictatorships, we participate actively in our government in the United States, and so it becomes our collective legacy – our goal is to ensure the best parts of our experience here persist while we seek to polish up and refurbish the areas that need improvement. It will always be a work in progress, thriving on the attention of the citizenry. I want my son to have the chance to follow his dreams, to prosper in a community that he contributes to, to enjoy what we continue to build in this amazing, messy democracy.
To stay the course we need leaders who step up and do more than take responsibility for their own actions, we need leaders who expect and demand that government become an increasingly effective tool for preserving our standard of living and our values: life, liberty — including speaking our minds and assembling to hold discussions — and the pursuit of happiness. The President has resisted the “attention-getting” approach that has dominated our information media in favor of a call for thoughtful, respectful unity.
“I believe that for all our imperfections we are full of decency and goodness, and that the forces that divide us are not as strong as those that unite us.”
President Barack H. Obama
12 Jan 2011 Tuscon, Arizona
The actions of a disturbed young man have precipitated national reflection, and for many a near-desperate search for proof that he is not “like us,” whoever “us” is in this context – because until we’re confident he was (and is) not “one of us” then our self-confidence in our identity is shaken. People “like me” would never shoot a Congresswoman to resolve our differences, right? People “like me” would never pull out a gun at a grocery store, killing and wounding bystanders, right?
We crave proof the killer is a part of some “other” group – that nothing we identify with is part of what drove this insanity. Yet President Obama did nothing to distance himself from Jared Loughner.
That’s the sort of leadership we expect from our President. He’s working to restore our confidence, to preserve our great country for future generations, and he’s doing it selflessly. President Obama didn’t travel to Tuscon looking for somebody to blame, let alone to stoke a witch-hunt; his speech showed that he continues to lead by example.
President Obama is optimistic about the future of this democratic republic despite such incidents. With a Federal Judge, an innocent child, and others snatched from their families by a senseless gunman’s bullets, with many critically wounded and fighting to recover – including the gunman’s ostensible target, U.S. Representative Gabrielle Giffords (AZ-8), the President called on us to honor the fallen, and be true to their memory.
Obama’s optimistic about our ability to become stronger and better, to heal — and so am I.
Here’s the list as it stood in October.
If Republicans in Congress think government controlled health-care is a problem, why do they continue to trust it for themselves and their families?
It seems no more than plain old political posturing, aimed at controlling the message going into the 2010 elections – messaging dictated by elite GOP strategists who aren’t even subject to election themselves.
We’re accustomed to politicians talking out of both sides of their mouths, at times, and putting the special interests that pledge donations ahead of the interests of the people who actually vote for them — but how a party that claims to be fiscally conservative can get behind a message that keeps us on a path to economic collapse is frankly mind-boggling.
Facing such a daunting prospect, having brought talking-points instead of substantive proposals of their own to the televised bi-partisan summit, the GOP — already saddled with the “Party of NO!” tag — gambled people won’t think they’re mostly Republi-cants.
Let’s be clear: President Obama never included the gold standard of a single-payer on his list of things he said were attainable goals. He said prior to election that if starting with a blank canvas then a single-payer system was the ideal. But we aren’t starting at a blank slate, there are huge systems in place. Many people took his hypothetical “start from scratch” comment to mean he’d work around the clock for both that and a public option. The fact that many still think it’s the best way to go, and the reality that Joseph Stiglitz has no more confidence in big insurance than he does in the U.S. banks and sees single-payer as the only viable solution, doesn’t mean people will suddenly get rational about what they want from legislators in Washington.
The President’s familiarity with Congress, as many have commented, dictated a pragmatic agenda. His support for reform is abundantly clear, and today’s televised summit is part of that process. He’s on record as favoring a public option, and single payer, but every signal he’s given suggests he can’t see a path from here to there in any timely manner; the genuine political risk associated with accomplishing no reform can’t be denied.
Most of us can only guess at what transpires behind the scenes. Given what happened on camera at the retreat in Baltimore it stands to reason the GOP doesn’t want to have this process televised, but they were busily complaining for the record about the “lack of transparency” and the administration has called their bluff. Managing appearances means the GOPers will stick to talking points, as will most of the Democrats. Few are able to carry their side in a real debate the way we’ve seen the President do.
The GOP will be talking for their base. Period. This is about politics, not progress, from their perspective.
The President has backed reform opponents into a public relations corner (admittedly with their help) and they are mostly focused on not losing face. I wish I could offer a kinder assessment, but the evidence isn’t there to suggest that Republicans in Congress are after a deal: they’re posturing, not negotiating in good faith.
“…what we’ve seen is that the private healthcare insurers do not know how to deliver an efficient way.”
World Bank Chief Economist, Joseph Stiglitz
So today’s televised forum offers the potential, merely the potential, that the public appearance will provide the pressure necessary to get most of the Senate Democrats to sign on, coupled to the extreme likelihood that we’ll hear bluster from the other side about the consequences of the “nuclear option” of reconciliation — and whatever comes of this process will fall short of most of our ideals – yet it will be the first substantive progress in decades addressing a system that is, frankly, already government subsidized even if you ignore Medicare (I don’t know any other way to classify the tax-exemptions for insurance premiums: insurance is, frankly, part of a person’s compensation/benefit package through their employer.)
So before the day’s event is even done I’m encouraging you to look at the eventual outcome as a “glass half full” when it’s been empty. I’m assuming the Democrats will get something passed and on Obama’s desk before the fall elections if they want to avoid “throw the bums out” being aimed solely at their party.
The health insurance system is flawed. It’s arguably the most wasteful part of medical expenses: by the very nature of business and capitalism, the incentives for “improvements” by insurers are confined to their own profit margins, while premiums pay over $1 million/day to high-dollar lobbyists to steer legislative outcomes instead of medical and/or cost-control improvements.
Politics is, and has always been, the art of the possible. It’s messy, but it’s better for our avid participation even when we don’t all agree.
A handful of facts:
Government for the people
A year into President Obama’s first term it’s obvious Congress is in no hurry to pass reforms, so citizens live with growing risks and financial burdens. “We the People” are supposed to be in control of our government, but our needs are being trampled by a combination of one party largely posturing for political points and digging in their heels, while lobbyists use special interest money to shave off just enough votes from the other party to keep progress at an effective standstill.
Leadership isn’t leaving the system as it’s always been. That kind of “leadership” would mean we were still colonies of European countries, if not living in caves. Inaction is rarely a viable approach to confronting a crisis, and the flagrant profiteering of health care insurance in America is a crisis. We have some of the best doctors, nurses, and medical training facilities in the world, but a few greedy corporations are exploiting the system at the expense of our standard of living today.
Is Congress hoping to leave this vast, profitable industry to self-regulate, the way they did with Wall Street? Are they really expecting advice from people hoping to make a profit will build a system that protects you and me?
The sooner we fix how we pay for our health care the better off we’ll all be. The founding fathers had the courage to face unpleasant truths and act despite the very real risk to their lives by opposing the King of England and his military legions. Are the people in Congress today opposing health care insurance changes scared to face down one money-making industry, or simply greedy?
President Obama gave a dynamic, thoughtful State of the Union address [transcript] with a good balance between summarizing the progress his administration has made, with some admitted stumbles along the way, and outlining what he wants to focus on in both the near-term and over the longer sweep of time which responsible planning and budgeting necessarily encompasses.
Any sense that the President might have devoted too much of the speech to reminders of the state of the economy, in particular, when he was sworn into office dissipated as Virginia Governor McDonnell set about spinning the familiar talking points to gloss over what had happened during Bush & Cheney’s era of aggressive military policies abroad and laissez-faire approach to the economy. Perhaps McDonnell wasn’t paying attention in late summer of 2008 when Senator McCain abruptly suspended his campaign to rush back to Washington and (at least ostensibly) deal with the economic crisis that Wall Street became – or perhaps McDonnell’s speechwriters saw no benefit in reminding voters of reality.
Obama’s speech quite nearly removed the apparent basis of McDonnell’s performance, actually. Most of the Governor’s well-rehearsed litany as he described preserving choice for U.S. citizens in front of a hand-picked audience seemed destined to echo with GOP partisans, but unlikely to win the hearts, minds, or votes of any coveted “swing” voters who were more likely to hear it as echoing the points the President had just made. Perhaps the opposition piece would’ve been more effective if they’d waited to draft (and stage) their reaction to such a major speech until their speechwriters and strategists have had the time to digest and reflect upon what the State of the Union addressed and crafted an actual – well – response. The tax gibes, for example, on the heels of Obama’s citing dozens of tax cuts and proposing a spending freeze despite not having raised income taxes seemed ill-conceived despite being predictable.
While McDonnell’s effort was clearly more polished than the maladroit “Republican response” by Bobby Jindal when he was handed a similar opportunity last year, his performance evoked a sermon to the faithful rather than being an articulation of substantive differences.
The President resisted the chance to hammer lopsidedly on the opposition party, which highlights his awareness that there’s a restiveness among the electorate not confined to those who for the moment flock to the Teabaggers banner. He’s right that Americans, unified by the terrorist attacks in 2001, have been systematically re-dispersed by the calculations of politicians intent on retaining their personal power and influence — and that neither party in Congress has accomplished much on behalf of the people.
That unity was squandered by career politicos.
We expect politicians to posture and pander, to capitulate to public pressure only when they can spin it to their advantage. We’re accustomed, sadly, to them approaching challenges with all the flexibility of self-centered children more interested in hoarding their toys and getting attention than anything else. Yet, in the already complex world over 200 years ago the founding fathers established a system that explicitly relied on adults, acting for the greater good at home and overseas.
Hopefully Obama’s candor and diplomacy will break the persistent patterns of patronage that have overcome the good sense, and good intentions, of our nation’s elected officials so that they can, in fact, lead on the issues he’s rightly suggested cannot be postponed or denied: the health and education of the American people, the health and reliability of the American economy, and the sense that all people – not just Americans, but all people – are deserving of the respect articulated in the U.S. Constitution.
Voters, inspired by Obama’s vision of how great American can be, are watching both parties with barely contained skepticism. Obama doubled-down last night, daring supporters and opponents alike to deny the importance of restoring the U.S. economy as a cornerstone in the foundation of greatness.
If those privileged to serve in Congress seek a leadership role for themselves domestically and for America in the world they have to accept and adopt that leading can only be done by example. They don’t have to deny differences of opinion any more than the President did. They have to approach the challenges creatively, however, and confront them head-on rather than stamping their feet like petulant, privileged brats.