Bozeman News

I come from an Island with one "critical access" hospital. Some of your rural "island" communities are in the same boat, and they,too, can see the visible workings of the health care system and private health care insurance work. In MA we have universal coverage based only on the private insurance industry. There is no "public option" for working families who get kicked around, unless they lose their jobs and then qualify for public welfare.

Even though our Island is only 7 miles off the coast, people are frightened to challenge the hospital or insurers. Our dream in an emergency is to be helicoptered out to Boston or Providence.

I have worked so many decades with both feet in the unnecessary human suffering from health care in every region of our country that I have no fear. Only determination to persevere.

I wrote this today for an East Coast Newspaper's Health Care Blog:

There are so many layers to exploitation and outright fraud and waste of tax dollars that raise the costs of care and deprive people of the networks of providers they want when they get private insurance.
For instance, in my home on an Island in Massachusetts, under the Romney Plan, on the Island where the Obamas will go on vacation in a few weeks a lot of these needs for reform are visible.

A couple of years ago, "Partners" in Boston "bought" two Islands' hospitals (Nantucket and Martha's Vineyard Hospitals) through Massachusetts General Hospital, which "Partners" owns along with some other hospitals). If you can figure out what this corporate monster health care holding-company really is- other than a giant high-cost Middle-Man with lipstick, let me know.

Our two Island hospitals were two of four "critical access hospitals" in MA. Apparently Partners found that if they could motivate one of these two tiny hospitals voluntarily de-certify themselves it would re-set some of the region's Medicare caps for their highest-cost teaching hospitals and bring in $170 million per year: reportedly $60-70 million per year for Mass General and some for Brigham and Womens’, and unintentionally some for UMass Memorial in Worcester (which they don't own). These are 100% federal tax dollars for doing nothing. I would guess that the final number for all of that region's high-cost teaching hospitals above $170 million.

In return Mass General/Partners said that they would guarantee the bottom line of these two little hospitals which had been somewhat stabilized by their "critical access" designations, but had bottom lines that went up and down like yo-yos (sometimes deficits as high as $2-4 million in the worst years, surpluses in others). Both Island hospitals received a lot of community donations whenever they asked.
Martha's Vineyard has 15,000 year-round residents and a bunch of wealthy summer visitors and property owners. They were in the process of raising $40 million in private donations to replace the old hospital facility.

In April 2009 the hospital announced in the paper that roughly 1,200 of the Island's low-income working families who had a partially-subsidized Romney Health Plan with a Boston-referral system "outside of" the "Partner's Network", would have to "voluntarily switch" to a Partner's-friendly Boston network. These 1,200 were 8% of the Island's year-round population. Later they ignored our protest, said it was less than 1,200 and did it anyway. No one had a choice. The Romney Plan does not include a "public option". Every private plan "slices and dices" MA's health care delivery system based on "incentives".

A few years earlier the hospital bought up and hired all the Primary Care physicians on the Island (except for one tiny rural health clinic which they fought initially).
So all those working families would lose their pediatrician and internists as well as have to fight with the only Island hospital if they did not use the state's "Health-Connector" to change by May 31st 2009.

Last week I saw headlines in the paper that the hospital is charging fees that are 4-8 times the usual and customary charges in MA where average health care costs are 30% higher than any places I have lived and worked before moving here in 1995.

So, let's see: the community raised $40 million from its users and supporters, Partners "purchased" the two tiny "critical access" hospitals to generate $170 million more for some high-cost teaching hospitals, Island hospital fees are 4-8 times the state average, which are 30% above most of the US, and 8% of the Islanders had to change plans or lose their doctors.

I am so grateful that I now have the "public option" -- Medicare, an affordable entitlement. I, like President Obama, am tired of having our citizens being "held hostage", by private insurers, incompetent or greedy healthcare providers and their "middle-men", and having our tax dollars plundered irresponsibly.

I am sure that someone will drive the Obama's by the impressive new hospital building. The only thing missing is a new hospital board, new hospital administrator, a full-time non-interventional cardiologist, more professional handling of granting medical staff privileges, a few independent primary-care docs on the Island not salaried by the hospital, some "public-option" safety from the reach of private insurers, and reasonable management of health care charges and costs.
This sounds a bit like the need for health care reform, doesn't it?

Our current "Health Care System" is utterly unacceptable, unjust, ineffective and wasteful. The status quo is not an option. We cannot let industry dupes obscure the facts.

How are the working public supposed to get tickets to this meeting? I stopped in at the Belgrade City Hall this afternoon and was told that although the City offices open at 8am, tickets won't be available until 9. They have a 'maze' cordoned off in front of the building in anticipation of a huge number of people waiting in line to get their tickets to the meeting. Since I will be at work by 9, I have no chance of getting a ticket (I was planning on taking time out of my day on Friday to attend, but I can't take hours off tomorrow morning too). So i guess the meeting will be attended mostly by students, the unemployed, the retired, and the 'independently wealthy'. Most of us out there working to pay taxes for the government to spend are being excluded. Democracy in action?!

Andy, you just discribed the crowd responsible for Obama's raving success! Evryone out there is going to be hoping for the figurative money thrown out of the hovering helicopter. Meanwhile, those of us w/o law degrees will just have to keep the real world operating by working.

Our current healthcare system is the best in the world. It is also free-market based and people have choices. Sure, there are problems that need to be addressed, but why is every solution Obama has for anything to nationalize everything and vote on it before anybody can read it ? Why is the cost always $1 trillion for every program ? Obama clearly wants a single payer government controlled program, while most Americans do not. Obama seems hell-bent on bankrupting our nation.

Why can't they just address the few problems with the system. Maybe give those without health coverage vouchers for VA hospitals. Medical savings accounts are a good idea. But the real purpose of Obamacare isn't to fix healthcare, it's to nationalize healthcare and move us towards a socialist/communist society. Stand and oppose it, or don't whine when you're fitted for the shackles of bondage. These people think that we are here to serve them.

It's interesting that for Obama's visit, the Belgrade City Hall did not get any tickets, and no lottery was imposed as promised. Instead, Baucus and Tester operatives called all their local supporters to show up at 6:am, at which time they quickly handed out the tickets and left, not giving the general public a chance. And these are the people that we elected. If they can't fairly and adequately hand out tickets to a Town Hall meeting, they certainly should not be entrusted to devise a new health care plan for our nation. Throw the bums out.

mike,
perhaps our country provides the best healthcare treatment in the world but the system as a whole certainly seems to have some major flaws. if the unemployment rate is 15% we know we're in the middle of a crisis. but with an uninsurance rate of 15% you say, "Our current healthcare system is the best in the world." that's over 40 million americans who have zero insurance. there are millions more with absurdly high premiums and prohibitive deductibles. maybe we should say our current health insurance system is not the best in the world and needs some serious adjustments.

bozeman bound,
i agree with you that americans need to exercise more. i don't agree with your xenophobic attitude toward immigrants. hitler also used scapegoats to focus popular emotion and draw attention away from real economic solutions. please don't follow his example. our comfortable lifestyle is subsidized by illegal immigrants working for substandard wages to wash dishes in restaurants, pick produce, labor on construction sites...all the jobs you and i don't want. have some respect and don't pretend all our healthcare problems will be solved by denying coverage to illegal immigrants.

100 million of us already have government health care: Medicare, Medicaid, VA, and SCHIP for kids. I love my Medicare. No middle men. My entitlement, the Public Option, works fine for me.

All the Congressional Bills exclude coverage for illegal aliens. Not an issue.

About the other comment: that "everything seems to add up to $1 Trillion now". You're right. That's true. That's Just the Media and spin-masters trying for good headlines for Health Reform. This is how it goes:

They say that Bail-outs cost a Trillion in one year, as a single event, not to be repeated. Do you believe that?

They say that war costs $180 billion a year instead of $1.8 Trillion over 10 years.

They say that Corporate welfare paid to commercial Insurers to "compete" with traditional Medicare is already costing somewhere around $100 billion a year instead of $1 trillion over 10 years.

They say that not getting the lowest available price for drugs for Medicare costs at least another $100 billion per year, but not $1 trillion over 10 years.

BUT WHEN THE MEDIA OR OPPONENTS TO HEALTH REFORM TALK ABOUT THE ADDED COST FOR UNIVERSAL COVERAGE THEY SAY $1 TRILLION (but don't tell you that is OVER 10 YEARS and not $100 billion in one year).

So, as they say, "on a level playing field", the war in Iraq costs $18 trillion over ten years.

The drug companies and insurance companies (just counting corporate welfare for Medicare) are wasting $2 Trillion over 10 years.

For Heaven's sake, compared to all that, the health and lives of 45 million uninsured Americans are worth more than the lives of 45 million gerbils or guinea pigs. We are living human beings, citizens not just "consumers". We are OUR TRUE NATIONAL TREASURE.

We waste hundred of billions on Bailouts and corporate welfare for corporations with broken business models, and investors who demanded 13% return on risky deals, but want their stupidity to be paid back to them in tax dollars.

We "little people" paid 20% on our credit cards, got 4% on Bank interest on Savings Accounts, and Adjustable Rate Mortgages. Since when I we now "a bad investment"? Since when are we now "a drag on the economy"?

Now we "little ones" pay 25% for credit cards, get 1.5 % interest on savings, and bailed-out Banks are refusing to negotiate down our mortgage loan balances on our primary residences, as they do every with people who own more than one house.

There's a good 4-5 years of detailed Health Reform work reducing the waste in the private and public health care sectors. There are hundreds of billions of low-hanging fruit that have nothing to do with patient care- just bad or fraudulent business practices and the costs of high-priced "middle-men" whose job it is to pull in more corporate welfare for private ventures.

There's no easy solution. Actually, there is. We could fix it in one day by offering Medicare to all citizens who don't have it.

phat man

your delusional, paranoid rants about anti-everything are neither coherent nor do they have a point. Not everyone who works for a living in MT agrees with you or your wing nut rants and raves.

Another Obama Dog and Pony show....WoW!

Viral emails from Axelrod, plus NBC,CBS and the MSNBC cheerleaders are still unable to convince the public that they need a government take over of the healthcare system. The more people learn about the program the more they don't want it, we also can't afford to have this administration bankrupt the country.

Regarding the "Death Panels" and NO rationing, when Obama has his advisor on healthcare, Dr. Ezekiel Emanuel, who is the health-policy advisor at the White House Office of Management and Budget (OMB) plus a member of the Federal Council on Comparative Effectiveness Research (FCCCER), don't forget to mention the brother of the President's Chief of Staff Rahm Emanuel, it seems not to be off base.

January, 2009, Dr. Emanuel published a paper in the Lancet [Persad, Govind, Alan Wertheimer, and Ezekiel J. Emanuel,"Principles for allocation of scarce medical interventions." The Lancet 373 (Jan 31,2009): 423-31]. In the paper he argues for the use of a "Complete Lives Systems" method of allocating care. Quotes from the abstract:

"We recommend an alternative system--the complete lives system--which prioritizes younger people who have not yet lived a complete life and also incorporates prognosis, save the most lives, lottery, and instrumental value principles."

"Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different states rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years."

No matter how you spin it, facts are facts! We are going broke as a nation, plus with a finite number of doctors and medical facilities care will have to be rationed. The bottomline is, Obama pushed to rush this through like the Stimulus(pork)Bill and never expected the American public to be able to really debate the issues in the Bill. They have been caught with their pants down and are scrambling around trying to defend an indefensible monstrosity that the CBO even states will not accomplish what the Administration says it was set up to accomplish.

You have to watch this group of liars like a hawk...Buyer Beware!

Mike Comstock. What is in that koolaid you are drinking. VA for the uninsured. That is for our military people. Medical savings accounts? These people don't have any money. Do you not get it? They don't have money. You cannot save what you do not have. My husband stood in line for 5 hours to get our two tickets to see Obama. We were not called. The other hundreds he stood with were from both sides of the debate. Belgrade handed out 150 tickets. Have you read HB 676? Read it. Are you going to be opposed to your government run Medicare when you turn 65? Single payer is not socialist health care. It is run like Medicare. Do your homework. Don't spill this garbage all over the internet as well as our local paper until you are informed of the facts!!

uhh Jack

are you forgetting that bush jr. already bankrupted america.
You wing nuts dont speak up when bush takes away our rights (patriot act) and trashes the constitution, launches pre-emptive strikes in the middle east, rapes the rockies for oil and gas etc etc.

but if you try to help the american public by giving them health insurance then oooh boy thats too much.

Dont forget who got us into this mess

THE REPUBLICANS and you think just like em

thanks wing nuts

Maybe Obama should take a page out of Bush's play book and have meetings and speeches on military bases for the next 3 years. It amazes me that people fight and rally to stop programs to help themselves, but have no problem with Halliburton selling cases of Pepsi for $45 each to our soldiers while they hire workers from third world countries for $30 a week.
So if you think the war in Iraq was just. Then put your tax money where your mouth is and pay for it, because Bush and Repub's borrowed the cash from CHINA and gave big tax breaks to the top 2%. That was fine right? But spend money domestically on Americans, can't have that can we? While you twisted Republicans are crying about helping illegal aliens working in the country, Bush has spent trillions building hospitals, roads, schools and yes paying for surguries and health care for millions of Iraqies.We are flying them here for healthcare Their unemployment is more than 50%. We are and have been paying for them the last 8 years.Thats when you should of been running yor d**b mouths.

Jack is right on the money!

Just curious. The Republicans in their trenches are firing volleys at Obama under the red banner of " No government intrusion into private health care ". ( Never mind MediCare and MedicAid and the V.A. clinics ). The conservative right wingers are railing and wailing against government intruding into private lives as usual, but Obama is the target.

Excuse me but aren't these the same rabbelers who just a few short years ago literally passed an act of Congress to keep just one person ---- brain dead unresponsive Terry Schiavo --- on her respirator at all costs. An Act of Congress that President Bush had to suspend his vacation to fly home to Washington from Texas to sign into law ?

Not to wholly excuse Max Baucus and his fellow Blue Dogs here, it's still painfully obvious that the GOP has purposely turned health care reform debate toxic. Purposely ; using the lowest form of political change: the mindless Angry Mob focused on the messenger not the message. The strategy conceived like Frankenstein's monster in the laboratories of the insurance lobbying firms to terrify the villagers into taking up pitchforks and torches. When the cabal echoing the outrageous claims of Sarah Palin and her ilk that Obamacare would establish Death Panels to ration care with extreme prejudice among the elderly and no longer productive , you really have to ask a fundamental question: how many deaths have already occurred in our For Profit medical system due to non-care, inadequate care or crisis-only care among the 40 million who cannot afford insurance int he first place? The GOP is protecting the profits of Big Medicine and Bigger Pharma at all costs. Americans who could've been saved by a single payer universal care system as practiced in Canada have already died because of Republicans heartless callousness.

To which I would say if there was ever a crash program that succeeded in developing a vaccine against both Greed and Hypocrisy , then the GOP would likely go the way of the Whigs and the Bull Moose Parties.... to the cemetary of political irrelevance.

I have been sending the message below out today to try to show how using private insurers and meeting their financial demands to: level the playing field has worked out so far with Bush's privatization experiment in Medicare. Doesn't make any difference to insurance companies whether your Republicans or Democrats, they just run over politicians and consumers with a bulldozer if you challenge them.

I don't think that the public option is dead. The fat lady didn't sing yet.

"Now Americans who have not been angry are getting angry with the announcement of an abandonment of the public option by the White House, to be replaced by Health Cooperatives that no one knows how to run and scheduled for 2013!

We could flip the switch in Medicare and do it in one day with no start-up subsidies. There were successful Medicaid buy-in experiments in 2002 for disabled people with incomes above the Medicaid limits . Evaluations found no additional costs or complexity for state administrators.

The insurance industry is repeating what they learned before the pre-mid-term elections during the Bush Administration when they extorted an extra $1,600 per person/year for those people who chose the Medicare Advantage programs. They announced that they would be disenrolling a hundred-thousand since they could not compete with traditional Medicare.

Only 25% now choose Medicare Advantage, 75% still choose traditional Medicare. That Medicaid Advantage costs tax payers $17.7 billion annually in the Medicare budget ($177 billion over 10 years) WITH NO ADDED VALUE.

Hey, it worked then, so why shouldn't they try again?

If private insurers now gobble up just 40 million of the uninsured at $1,600 each/ year, that adds $700 billion for someone to pay over 10 years FOR ABSOLUTELY NOTHING, NO ADDED VALUE! The two groups together waste $900 billion!

Our auto, banking, and insurance industries with broken business models require billions of corporate welfare. I recommend that we could try Grameen or Tata to run them."