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Healthcare Reform Is Too Important to Fail

Posted: 04/13/09 03:58 PM ET

By now many of us are all too familiar with the troubling facts informing our need to take action on healthcare reform: forty-six million Americans lack health insurance and tens of millions more are underinsured and at risk of financial ruin; family budgets are squeezed and businesses are less able to compete globally because of skyrocketing healthcare costs; and despite our world class hospitals, our healthcare system still fails to prevent millions of avoidable, deadly heart attacks and strokes.

The time to act is now. But still, the "who" and "how" of health reform is up in the air. That is why we heartily support President Obama's plan to address healthcare reform immediately and to evaluate any reform proposal against eight commonsense, nonpartisan principles: protecting families' financial health, making health care coverage affordable, aiming for universal coverage, providing portability of coverage, guaranteeing choice, investing in prevention and wellness, improving patient safety and quality of care, and maintaining long-term fiscal sustainability. These are principles that everyone -- Democrats, Republicans, Independents, mayors, business and labor -- can and should rally around.

We need everyone's participation and everyone's good ideas if we are to reform the fragmented system we have today. In our respective roles as Mayor and leader of the nation's largest union of nurses, doctors and healthcare workers, we have worked tirelessly to improve the health care of our city residents and fellow New Yorkers. New York City has supported our award-winning public hospital system which serves more than 450,000 uninsured patients; invested in the nation's largest primary care electronic health record network linking more than 1,100 doctors with real-time, prevention-focused electronic health records; connected thousands of residents with public health insurance and small businesses with affordable coverage for workers; and engaged in innovative public health campaigns to reduce smoking and promote wellness. In New York City as well as in major cities around the country, SEIU healthcare workers have dedicated themselves to expanding healthcare coverage and improving the quality of care in hospitals, clinics and community health centers.

We know these efforts are making a real difference in the lives of New Yorkers and working families everywhere. But in this time of economic emergency, our country needs and deserves more than partial solutions that are fraying under the weight of state and local budget crises. Our families, our communities, and our businesses need Washington's committed leadership to fix our broken healthcare system.

We see the momentum growing. With each passing week, the Obama administration and key members of Congress have begun to build the foundation for major healthcare reform legislation. In a little over sixty days, they have expanded SCHIP coverage to more children, dedicated new funding to improve healthcare technology and invest in our healthcare workforce to aid America's economic recovery, and approved a budget that establishes a critical down payment on real healthcare reform.

And yet, some of the hardest work is still to come, and our challenge is to keep Congress focused on achieving a real and comprehensive solution -- and not to walk away when the going gets tough. In this time of crisis, we have to be willing to try new things and keep focused on our goals to make health care more affordable, effective and accessible.

In the past few months, we've heard a lot about how government has to step in when a company is 'too big to fail.' Well, this push for healthcare reform is too important to fail. It's too important to our cities. It's too important to our nation. It's a challenge we can't turn from -- and it's an opportunity we must seize.

 
By now many of us are all too familiar with the troubling facts informing our need to take action on healthcare reform: forty-six million Americans lack health insurance and tens of millions more are ...
By now many of us are all too familiar with the troubling facts informing our need to take action on healthcare reform: forty-six million Americans lack health insurance and tens of millions more are ...
 
 
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01:47 PM on 04/15/2009
Lovely how everyone has casually ignored my question about what will happen when Universal Health Care is acheived, and people begin to realize that MORE people are dying, not less, because no one cared enough to go after the real issue, beyond cost, that the health CARE system, the drugs and procedures and treatments we are given are often times just as dangerous to our health than any ailment we might develop. Not to mention how simple "preventative care" is going to help those babies who are BORN with cancer, lukemia, or any one of a number of congenital birth defects, many of which have no known cause, and therefore no known prevention or cure. Not to mention those adults already living for 20-30-40-50 years with disabilities that will not kill us, but will cost us tens or hundreds of thousands of dollars AFTER insurance, out of pocket to manage
02:00 PM on 04/14/2009
Well written article. I admit that was was taken aback to hear that Mayor Bloomberg is running as a Republican for his re-election campaign -- so it's refreshing to come across this article. Clearly, he's one of few that aren't afraid to agree with President Obama on some issues.

I wish others would follow.
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HUFFPOST SUPER USER
mountainweb
Conservative Commonsense
01:36 PM on 04/14/2009
Yeah, check this out http://www.foxnews.com/story/0,2933,515578,00.html "Nurse Called Out of Surgery, Laid Off", as long as the welfare of patients comes in 3rd or 4th in the hospitals we dont need "reform", we need a massive change in the way that all the crooked HMO's, hospitals and doctors do business.
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HUFFPOST SUPER USER
SelenicMagick
Old, grouchy, toothless, sub-human bridge-dweller
02:44 PM on 04/14/2009
A local nurse was terminated from the local hospital because her supervisor told her to keep her mouth shut and she reported a suspected case of child sexual abuse to the police... AS REQUIRED BY LAW.
01:28 PM on 04/14/2009
very thoughtful uncomplicated ideas and solutions. when does the gov't choose that path.

these will not work because the fed. is not thoroughly in control. TOP to BOTTOM
01:24 PM on 04/14/2009
The whole business should have been helped a long time ago. I have been on all edges of it since I am an aged person. I can remember when no one had insurance and could pay for most treatments on a cost that most could afford or with help could afford. Then there came a time when some could afford insurance for extra things like private rooms and better hospitals, etc. Some people couldn't afford anything they just went home and hoped they would live with home care. (Many died) Then some companies supplied insurance or took it out of your pay. Then they came up with medicare (doctors first where very much against it, but they changed) The insurances now can just cancel or reject you. They can wait till you have an illness and call it preexisting or whatever they wish. The whole system needs fixing.
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TheBurdicks
Whatever happened to my yellow bus?
12:55 PM on 04/14/2009
We have a shortage of primary care. We may not need more doctors to address this. Most primary care can be provided by nurse practitioners, physician assistants, and other “physician extenders”. The introduction of walk-in clinics at Wal Mart, Walgreen’s, CVS, etc. already portends vastly improved access to primary care. Primary care should be funded by national health insurance supplemented with a small copay.

The “Emergency Room” has already been nationalized. No one can be turned away. The care of emergencies should be federally funded with no copay. The non emergency should be sent down the street to the primary care clinic, like the one at your neighborhood Wal Mart. Emergency Department staff should be salaried under a program of federal subsidy to hospitals.

Medical care other than primary care and emergencies should be through referral from primary care or an emergency physician. This should be funded by a program of national health insurance supplemented with a small copay.

Prices of pharmaceuticals and supplies should be negotiated by government.

We should include tort reform, with caps on punitive judgements and “pain and suffering”, and with claims paid by the government.

A parallel system of private insurance could provide enhanced coverage for those who desire it.

We can have enhanced universal access to primary care, emergency care, and advanced treatment, without rationing by ability to pay, spending less than we do now.

Our statistics will come into line with other developed countries.

Dwight Burdick, MD, FACEP
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TheBurdicks
Whatever happened to my yellow bus?
12:54 PM on 04/14/2009
We already have universal health care.

Some (with money) pay out of pocket. Some have private insurance. Some have public funded medical care. Some have blended modes of payment. The rest have the “Emergency Room”. Everybody gets basic care, at least in the time of crisis.

What we don't have is a system of health care.

The result is more spent per capita than any other developed country, and statistics ranking us near the bottom.

We desperately need a system, designed with quality as the driving force. It is less expensive to design a system to prevent failure, than to treat failures in a poorly designed system. Illness and injury represent system failures. Treatment accounts for a disproportionate share of the health care dollar.

A properly designed system would emphasize prevention through education in the home, school, workplace, and primary care office. This is where the bulk of our money should go.

Prevention can be enhanced by spending public money on recreational facilities, sidewalks, pedestrian malls, bicycle lanes, and public transportation. Prevention can be enhanced by taxation. Tax tobacco, alcohol, drugs, and fast foods at least adequately to offset the cost of treating their damage to our health. Prevention can be enhanced by mandating evidence based medicine, especially in the primary care office. This will decrease the inappropriate use of pharmaceuticals and interventions, and increase the appropriate use of counseling. Prevention can be enhanced by carefully designed electronic medical records focusing on prevention.
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HUFFPOST SUPER USER
TheBurdicks
Whatever happened to my yellow bus?
01:04 PM on 04/14/2009
We have a shortage of primary care. We may not need more doctors to address this. Most primary care can be provided by nurse practitioners, physician assistants, and other “physician extenders”. The introduction of walk-in clinics at Wal Mart, Walgreen’s, CVS, etc. already portends vastly improved access to primary care. Primary care should be funded by national health insurance supplemented with a small copay.

The “Emergency Room” has already been nationalized. No one can be turned away. The care of emergencies should be federally funded with no copay. The non emergency should be sent down the street to the primary care clinic, like the one at your neighborhood Wal Mart. Emergency Department staff should be salaried under a program of federal subsidy to hospitals.

Medical care other than primary care and emergencies should be through referral from primary care or an emergency physician. This should be funded by a program of national health insurance supplemented with a small copay.

Prices of pharmaceuticals and supplies should be negotiated by government.

We should include tort reform, with caps on punitive judgements and “pain and suffering”, and with claims paid by the government.

A parallel system of private insurance could provide enhanced coverage for those who desire it.

We can have enhanced universal access to primary care, emergency care, and advanced treatment, without rationing by ability to pay, spending less than we do now.

Our statistics will come into line with other developed countries.

Dwight Burdick, MD, FACEP
01:41 PM on 04/14/2009
We need to reform our medical culture. Our doctors should be doing more, not less. We shouldn't need every doctor to have 10 nurses at their beck and call, and still demand astronomical salaries for the 30 seconds of face time they spend with patients.

Canadian doctors are expected to do more, and earn less.

Instead of arguing that we need more nurses because doctors are too expensive, why not ask why doctors are so expensive?
This user has chosen to opt out of the Badges program
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12:18 PM on 04/14/2009
Sponsored by Congressman John Conyers, HR 676, The United States Healthcare Act, is before the House now. It is a bill that will expand and improve Medicare to cover 100% of all necessary medical care, including dental and psychiatric care and long-term care, for everyone in the United States, with no deductibles, no co-pays, and no exceptions. The companion bill in the Senate is S 703.

By eliminating the for-profit private health insurance industry, HR 676 will save enough money to cover everyone. Private insurance bureaucracy and paperwork consume nearly one-third (31%) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for ALL Americans. You know, like the coverage our elected officials and their families enjoy.

Single-payer healthcare for all ... it will free-up our pocketbooks, those of the cities and states that are having a difficult time covering their large expenditures in providing for their current employees and those in retirement ... and we come together in this nation for each other.
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HUFFPOST COMMUNITY MODERATOR
OlderBudWeiser
Retired RN in Ca.
12:36 PM on 04/14/2009
Sure hope they will do away with the Bush Part D. I'm lucky to be a healthy senior and take no drugs. But the D costs more than my car insurance. $500. dollars for the first pill covered. (premium and deductable) And co pay on top of that. Insurance cut is to high. Excise insurance with the chain saw.
04:35 PM on 04/15/2009
agree completely!!!!!!!!!
11:18 AM on 04/14/2009
Someone please answer me this. Hypothetical situation.

What if we manage to completely extinguish the insurance industry so they are no longer an issue, and the government provides us with direct health care. What do we then do to address the concerns that many of us have regarding the absolutely abysmal quality of what care we receive, when there is no reform of the FDA and the approval process in distributing drugs to doctors, hospitals, etc, that are doing serious harm to our bodies, or downright killing us?
10:51 AM on 04/14/2009
Hey!
This is news!
Finally some news!
American Healthcare was reformed?
Holy cr*p, when did this happen?
10:43 AM on 04/14/2009
I'm 100% in favor of universal health insurance, with ONE key stipulation.

Not ONE more dollar.

Our government already spends $850 billion per year, which translates into $2750 per citizen per year. That's MORE than enough to deliver universal health insurance. It's more than Britain spends per capita to do it.

Essentially the ONLY argument for a single payer, centralized system has to do with cost efficiency, so show us that you are capable of delivering that cost savings by using the money you already spend.

Stop squandering hundreds of billions to buy off seniors. Stop squandering billions catering to the doctors' unions. Stop the media campaign against insurance companies, who have nothing to do with how the government runs their own insurance. Stop all the stuff that is driving up the cost of delivering government health care in the first place and take responsibility for the HUGE amount of money we already entrust to you every year.
10:54 AM on 04/14/2009
Define "universal health care". To me that sounds like everyone will be covered if they have a broken arm, jock itch or erectile dysfunction. But Godforbid if you have a long term chronic congenital birth defect, cause it's just going to be too damned expensive to cover 20% of the population, when the other 80% like you are saying "Not one more dollar". So we might as well throw the babies out with the placenta if they are born with MD, MS, CP, or Spina Bifida, because their 20-30-40+ years of constant critical care needs are just too expensive to cover
12:22 PM on 04/14/2009
Does Britain throw MD, MS, CP, or Spina Bifida kids into the dumpster?

Doesn't Britain have seniors, veterans, and poor kids too?

How about Canada? They seem to manage to cover all these populations for roughly the same amount we spend just to cover seniors veterans, the disabled, and poor children.
Bladernr1001
Vote Libertarian
11:50 AM on 04/14/2009
The problem with any universal system is that is appears to be "free" to the recipient on the services (or course it is not). What happens when a scarce resource is made free or perceived to be free? You get what would amount to an almost infinite demand for the service (hence the propensity to see a doctor for a paper cut). Of course the availability of the service is NOT infinite. So removing the cost/benefit aspect of health service decisionmaking upsets the supply/demand equation. That is why governments who administer single payer systems resort to higher taxes or rationing in an attempt to put supply and demand into equilibrium. In the end the systems are probably unsustainable because what one person or even small group of persons thinks they can keep the supply/demand equation in equiliblrium? Especially when there are always so many political pressures trying to bend things to their own narrow interests?
12:06 PM on 04/14/2009
Amen. Finally someone has seen the light on single payer and its inevitable tendency to ration or simply cut the most effective high tech treatments, because only a small number of people use it, therefore it is not cost effective, and the patient ends up suffering or dying, even if they have the health care or money out of pocket to pay for it, because the treatment is simply no longer available
09:46 AM on 04/14/2009
We will not have decent healthcare in this country as long as for-profit insurance companies, run by billionaires, are the gatekeepers between doctor and patient. As long as you have people getting rich by letting Americans stay sick, the system will not work.
09:42 AM on 04/14/2009
We MUST not let those who are against healthcare reform win.

And despite the millions they'll spend trying to convince people the SOCIALISM medicine is a "cure" worse than the disease, ask anyone with Medicare if they're willing to give it up? How about social security? I read that John McCai (despite the mulit-millions of household income) still accepts his social security check.

Let's start a conversation about eliminating those two programs and watch the PROTESTS then. Want to see the "rabble roused" that'll do it!

As for healthcare companies continually raising premiums, I would like to see an investigative report document increase in premiums to increase in CEO salaries and bonuses. There will be a correlation.
10:46 AM on 04/14/2009
Of course they won't give up Medicare. They're getting treated like kings. We overspend so egregiously to keep seniors, veterans, and poor parents happy that the other 70% of the country is left empty handed.

Your ignorance at somehow thinking that's a GOOD thing is exemplary of the thinking that's holding back universal, affordable health insurance.
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HUFFPOST COMMUNITY MODERATOR
OlderBudWeiser
Retired RN in Ca.
12:47 PM on 04/14/2009
You seem to believe Medicare is free! It isn't. Us old farts pay for it.
09:33 AM on 04/14/2009
I read a telling statistic recently. On average, Americans are shorter than in any of the industrialized nations. More of us also are shorter (on average) than we were in the U.S., 100 years ago and 200 years ago. They were shorter overall but a greater percentage were taller than that percentage is now. The reason? Too many of our children do not have access to decent healthcare when they are young and in the growth stages.
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drricklippin
physician-activist-poet
09:23 AM on 04/14/2009
Thanks Mayor Bloomberg and Mr Rivera

My two key "mantras" in this debate are-

-fairness is a moral imperative

YET

- more is not always better in medicine (which more US health consumers are recognizing)

If we attend to these core principles we will be ok

Dr. Rick Lippin
Southampton,Pa
12:01 PM on 04/14/2009
In fact, more can be worse. The pharmaceutical companies, in concert with the FDA has set up a system where we are often given one drug to treat one ailment or illness, and the drug has not been rigorously tested, so it ends up causing other ailments and side effects which are worse than the original issue, and we are then prescribed more drugs to manage the side effects of the original drug to treat an ailment which, on closer inspection might not have been necessary to begin with
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drricklippin
physician-activist-poet
04:04 PM on 04/14/2009
You are absolutely correct on this point PlaceboStudman

Thanks

Dr. Rick Lippin
Southampton,Pa