Rumney Town Hall Community Healthcare Forum

The Obama/Daschle Transition Health Care Team called for community meetings from December 15 to 31, 2008, asserting that they wanted input for "health care reform that comes from the ground up". In response, we held a Rumney Town Hall Community Health Care Forum on December 19th.

Rumney is a small NH town (pop. about 1400). Despite the hectic holiday timing and blinding snow storm, 14 people, including the moderator, attended. Three physicians, three businessmen, a nurse, two college professors, one NH legislator, a WW2 vet and his wife (man under the care of VA and woman on Medicare), two employees - all hardworking individuals. Each brought stories not only of themselves but of many people they know, representing a spectrum of socio-economic status.

The group's consensus was that the collection of compelling health care horror stories are countless and getting worse. The movement for true health care reform, to a system different from what we have now, will not be accomplished by merely relating the multitude of compelling stories alone, but also by an understanding of the indignities and humiliation suffered by millions of citizens who are not even aware they themselves are contributing to the total US healthcare expenditure, but yet cannot afford insurance, and have little access to health care. The inhumanity of the current dysfunctional system brings ineffable pain and suffering, not only to the 47 millions uninsured, but also to the insured when faced with unexpected serious medical problems, resulting in financial hardships. The most compelling stories follow:

Barbara McElroy RNC, 984 Quincy Road, Rumney NH 03266, (603) 786-2336

Ms. McElroy has had a great position with a not-for-profit home infusion company for almost 15 years. She had two absolutely perfect job evaluations, moving her into a new salary range, the company creating a new job title each time. The last offered promotion was two years ago, which she declined. She was confident her employer valued her and even treated her better than most. What deterred her acceptance of this promotion was that the Human Resource department of the company had a rule that after 12 weeks absence, the company no longer has to hold her job and she must move off short term disability to long term disability. This meant that after 12 weeks, the company no longer pays their part of employer funded health insurance. Hence, besides losing half of her salary, as her disability covers the other half, she also lost her vacation, 403 B contribution,etc. After 12 weeks off, she has to pay the full cost of insurance. She was diagnosed with breast cancer in mid-June this year, went out on medical leave in mid-July, and started being responsible for her full health care costs in mid-October.

She has a co-pay of $20 per physician visit, she is on multiple medications, two each three weeks requiring $40 co-pay per prescription, more than four other medications which have $10 co-pays per prescription per month. Hence, she pays full Cobra plus another $120 to $150 per month in co-pays.

She has had 3 surgeries, 5 cycles of chemotherapy (one more to complete treatment); daily radiation therapy for six weeks coming up next, then Herceptin IV every three weeks will continue till next September. Followed by Tamoxifin for a year, then an Aromatase inhibitor for 10 years, plus another surgery next September. She doesn't expect to be able to return to work in a benefited postion until April---9 months off work, 6 months paying cobra. She considers herself one of the lucky ones, since she has a supportive manfriend, though their plan to semi-retire and buy individual coverage will not work now as she has a pre-existing cancer diagnosis and needs the pharmaceutical benefit to cover the high priced Aromatase inhibitor. She is stuck with either this employer (if they take her back) or finding a new one before her cobra runs out-- only employer health care eliminates the pre-existing clause.

Vidvud Valdmanis MD, 896 Quincy Road, Rumney NH 03266, (603) 786-9551

A medical staff member in our local hospital had a throat cancer, requiring a series of chemotherapy with radiation treatment which offered him a chance of saving his vocal cords. Out of pocket expenses depleted him financially, such that he could not afford the exorbitant health insurance premiums to continue his coverage. His colleagues pitch in to pay for his premium. Now he can't change his job because of his pre-existing condition.

The physician who relayed above story himself had a prostate cancer and incurred a bill of $63,000 which fortunately was covered by his insurance. The question that nags him was ethical - how many men out there have had such a condition but do not have insurance and no financial resources to get medical intervention?

Dr. Valdmanis was approached by a man who was diagnosed with a treatable condition, and was prescribed a medication that would cost him $400 a month. The man said," Don't you think I'm better off dead?"

It does not matter if the story was that of a seeming minor condition, like that of a daughter who had a lingering problem, but delayed being seen by a physician because she does not have insurance. It still tears the audience's heart apart.

Dr. Valdmanis contributed the following note for this report: "Of course the fear conservatives express concerning nepotism of government role in health care can be answered thus: (1) Private insurers provide only negative input. (2) Government already has oversight for research funding NIH / pharmaceuticals FDA... and overall is well respected for its performance. (3) The broader issue of mistrusting government shows that the profit motive dominates to the point that a concept of public service as a noble cause fails to even resonate. (4) Have we learned nothing as the 'collapse' of excessive profiteering by banks, realtors, car-makers, hedge funds and CEOs unwinds while sucking away our retirement savings? Can we really trust such people and institutions to do a better job than our government? (5) What is the proper role of government? What does our vote mean if we so mistrust our elected officials? If money is all that matters , note USA's per-capita income in 2002 at $34,100 vs Canada's $21,130...but 'human dev.index' puts Canada 3rd vs USA 6th. Financial Times World Desk Reference - There is more to life than 'just the bucks', and government is 'more than just bureaucracy'. Vid."


Clearly identified as the biggest problem in the health care system is the cost of the profit motive private health insurance, with its yearly steep premium hikes, with increases in deductibles, co-pays and out of pocket expenses; the wasted health care dollars that goes to insurance advertising, CEO salaries, and profits of multiple insurance companies. "Too complex, too profit driven, the insurance companies consider health care a PRIVILEGE, but they retain the RIGHT to deny coverage."

Majority of the attendees believed that community meetings, traditional town hall meetings, a White House Health Care Summit, surveys that solicit ideas on reform, are ways to develop a plan to address the health system problems. A combination of these means will only work if the Congress and the President listen. Explanation and hard data of the real costs and taxpayer subsidies of our current system is fundamental in determining the reform that is most viable and sustainable. The attendees atrongly believed that with the data available, single payer health care reform as in HR676 is the only solution that will address most if not all problems that beset the current system.

The piling up of unrelenting great hardship stories along with exorbitant private insurance costs and increasing tax subsidies of same, merely prolongs the health care debate. The unanimous voice at the Rumney meeting was that the problems had long been identified. It is time to proceed to solve them by implementation of the single payer national health plan as embodied in HR676.

Our group wished to convey great expectations for real change. The health care debate has been going on nearly forever, and with the current deepening economic crisis, the decades of insurance and drug industry bailout at the expense of taxpayers has to stop. There is a huge boil plagueing our nation's health care, the site of pointing has never been so blatantly visible and ready for incision. HR676 is the instrument to accomplish this procedure. We part with the saying - "SOMETIMES IT TAKES A GENIUS TO NOTICE THE OBVIOUS" We hope there is sufficient genius within the Obama/Daschle team to notice.

Marcosa J Santiago MD
Moderator
Rumney NH 03266
(603) 786-2700 cosy@diacad.com