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<channel>
	<title>Toastiest &#187; healthcare</title>
	<atom:link href="http://toastie.st/tag/healthcare/feed/" rel="self" type="application/rss+xml" />
	<link>http://toastie.st</link>
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		<title>Valganciclovir</title>
		<link>http://toastie.st/2011/10/26/valganciclovir/</link>
		<comments>http://toastie.st/2011/10/26/valganciclovir/#comments</comments>
		<pubDate>Thu, 27 Oct 2011 01:36:58 +0000</pubDate>
		<dc:creator>Toastie</dc:creator>
				<category><![CDATA[kidney transplant]]></category>
		<category><![CDATA[kidneys]]></category>
		<category><![CDATA[cmv]]></category>
		<category><![CDATA[healthcare]]></category>
		<category><![CDATA[prescription drug costs]]></category>
		<category><![CDATA[valcyte]]></category>

		<guid isPermaLink="false">http://toastie.st/?p=6577</guid>
		<description><![CDATA[aka Valcyte, which is used to treat CMV I usually don&#8217;t read the &#8220;patient prescription information&#8221; but was curious in this case. I had been taking one tablet a day since the transplant, then stopped it a few weeks ago because of my low white blood cell count (which necessitated the switch from one anti-rejection [...]]]></description>
			<content:encoded><![CDATA[<p>aka Valcyte, which is used to treat CMV</p>
<p>I usually don&#8217;t read the &#8220;patient prescription information&#8221; but was curious in this case. I had been taking one tablet a day since the transplant, then stopped it a few weeks ago because of my low white blood cell count (which necessitated the switch from one anti-rejection med to prednisone). Now I&#8217;m taking four a day to try to get rid of the CMV.</p>
<blockquote><p>Valganciclovir is an anti-viral drug. It is changed in the body to the active form of the drug called ganciclovir. Ganciclovir can decrease bone marrow function&#8230;This effect can cause anemia, decrease your body&#8217;s ability to fight an infection, and cause bleeding problems&#8230;Seek immediate medical attention if you develop [a bunch of nasty stuff]&#8230;May decrease the ability of men to father a baby&#8230;has caused tumors in laboratory animals&#8230;should be considered carcinogenic&#8230;</p>
<p>It is used to prevent disease caused by CMV in people who have received organ transplants. CMV can lead to serious infections in the body&#8230;including CMV retinitis, which can cause blindness&#8230;This medication helps control CMV retinitis and decrease the risk of blindness. [It] is not a cure for CMV disase. Some people may have worsening CMV retinitis even with treatment.</p></blockquote>
<p>Now get this. If you don&#8217;t have health insurance, <a href="http://www.drugstore.com/valcyte/additional-3-5-days-required-to-special-order-medication-tablets/qxn00004003822" title="Cost of Valcyte on drugstore.com">120 tablets of Valcyte (one month&#8217;s worth for me) will cost<br />
<h1>$5600</h1>
<p></a> </p>
<p>My cost today: </p>
<h1>$30</h1>
<p>And those kids are worried about their students loans. Where the &#038;*#^ were they when healthcare reform was under assault? How many of them bothered to vote last year? Ok, breathe&#8230; Maybe I should&#8217;ve posted this ahead of my last post.</p>
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		<item>
		<title>CIGNAture Service</title>
		<link>http://toastie.st/2011/03/03/cignature-service/</link>
		<comments>http://toastie.st/2011/03/03/cignature-service/#comments</comments>
		<pubDate>Fri, 04 Mar 2011 04:00:50 +0000</pubDate>
		<dc:creator>Toastie</dc:creator>
				<category><![CDATA[health]]></category>
		<category><![CDATA[kidneys]]></category>
		<category><![CDATA[pkd]]></category>
		<category><![CDATA[health insurance]]></category>
		<category><![CDATA[healthcare]]></category>
		<category><![CDATA[transplant]]></category>

		<guid isPermaLink="false">http://toastie.st/?p=5691</guid>
		<description><![CDATA[Oh, CIGNA. More crap from you. &#8220;Welcome to the CIGNA HealthCare Transplant Case Management program. Thank you for taking the time to talk to me about your health care needs. As we discussed in your call&#8230;&#8221; We didn&#8217;t discuss jack, because I didn&#8217;t return your call&#8230; &#8220;As your Transplant Case Manager, I will work with [...]]]></description>
			<content:encoded><![CDATA[<p><img class="leftpic" src="http://t3.gstatic.com/images?q=tbn:ANd9GcQhjgyc3VWtRWM_-p-rXP6zg6ETXQQIFCt1vN-dAOigx9ODEDU&#038;t=1&#038;usg=__TkjaYd7kAIp6SaUWTz7O1FpMLiI=" alt="" />Oh, CIGNA. More crap from you. &#8220;Welcome to the CIGNA HealthCare Transplant Case Management program. Thank you for taking the time to talk to me about your health care needs. As we discussed in your call&#8230;&#8221;</p>
<p>We didn&#8217;t discuss jack, because I didn&#8217;t return your call&#8230;</p>
<p>&#8220;As your Transplant Case Manager, I will work with you, your doctor, and other health care providers to offer support assistance. I can also help you access information about treatment options, provide resources on your condition/treatment&#8230;&#8221; Like what? Not getting a transplant? &#8220;I&#8217;m also planning to mail you educational materials about treatment options that may be available to you&#8230;&#8221; I&#8217;ve got a *&#&#038;$* file cabinet full of &#8220;educational materials&#8221;. Please don&#8217;t kill any trees by sending me anymore kidney disease or dialysis or transplant pamphlets.</p>
<p>He actually needs me to sign a release (&#8220;the Case Management Consent form we talked about&#8221; that we didn&#8217;t talk about). Not signing it. </p>
<p>After a year-and-a-half, I&#8217;m still trying to become active on the transplant list at Carolinas Medical Center in Charlotte. Most recently, the delay has been that CIGNA has asked for further tests before they&#8217;ll agree to cover a transplant.</p>
<p>CIGNA is getting in the way of me getting a transplant. </p>
<p>&#8220;I can&#8230;support your individual choices for health care&#8221;. </p>
<p>I choose to get a transplant. Now leave me the *&#$ alone.  </p>
<p>(<a href="http://toastie.st/2010/08/10/bcbsnc/">I basically bitched about the same thing just a few months ago, when I had BCBS of NC</a>).</p>
<p>To be clear, I am really fortunate to have an awesome health care plan, but that&#8217;s due to the generosity of my employer and has nothing to do with the company that administers the plan. I trust CIGNA about as much as I trust car salesmen. </p>
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		<title>Hidden perils of dialysis! Big surprise&#8230;</title>
		<link>http://toastie.st/2010/12/31/hidden-perils-of-dialysis-big-surprise/</link>
		<comments>http://toastie.st/2010/12/31/hidden-perils-of-dialysis-big-surprise/#comments</comments>
		<pubDate>Fri, 31 Dec 2010 05:20:14 +0000</pubDate>
		<dc:creator>Toastie</dc:creator>
				<category><![CDATA[dialysis]]></category>
		<category><![CDATA[health]]></category>
		<category><![CDATA[kidneys]]></category>
		<category><![CDATA[pkd]]></category>
		<category><![CDATA[healthcare]]></category>

		<guid isPermaLink="false">http://toastie.st/?p=5375</guid>
		<description><![CDATA[I&#8217;m not even going to watch this. So how bad is it? My chances of leaving treatment in a body-bag tomorrow are better than my winning MegaMillions, aren&#8217;t they? This is why I need a kidney, like asap. I&#8217;ll be sending out a desperate plea sometime soon. There are all sorts of annoying holiday-time news [...]]]></description>
			<content:encoded><![CDATA[<p>I&#8217;m not even going to watch this. So how bad is it? My chances of leaving treatment in a body-bag tomorrow are better than my winning MegaMillions, aren&#8217;t they?</p>
<p>This is why I need a kidney, like asap. I&#8217;ll be sending out a desperate plea sometime soon. There are all sorts of annoying holiday-time news stories about kidney donations. Like the MegaMillions, I&#8217;ve got to be in it to win it, so if I don&#8217;t beg for a kidney, I&#8217;m not going to get one. Ugh&#8230;I really don&#8217;t look forward to doing that&#8230;</p>
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<p style="font-size:11px; font-family:Arial, Helvetica, sans-serif; color: #999; margin-top: 5px; background: transparent; text-align: center; width: 420px;">Visit msnbc.com for <a style="text-decoration:none !important; border-bottom: 1px dotted #999 !important; font-weight:normal !important; height: 13px; color:#5799DB !important;" href="http://www.msnbc.msn.com">breaking news</a>, <a href="http://www.msnbc.msn.com/id/3032507" style="text-decoration:none !important; border-bottom: 1px dotted #999 !important; font-weight:normal !important; height: 13px; color:#5799DB !important;">world news</a>, and <a href="http://www.msnbc.msn.com/id/3032072" style="text-decoration:none !important; border-bottom: 1px dotted #999 !important; font-weight:normal !important; height: 13px; color:#5799DB !important;">news about the economy</a></p>
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		<item>
		<title>Absymal HR</title>
		<link>http://toastie.st/2010/12/29/absymal-hr/</link>
		<comments>http://toastie.st/2010/12/29/absymal-hr/#comments</comments>
		<pubDate>Wed, 29 Dec 2010 23:40:49 +0000</pubDate>
		<dc:creator>Toastie</dc:creator>
				<category><![CDATA[health]]></category>
		<category><![CDATA[healthcare]]></category>
		<category><![CDATA[job]]></category>
		<category><![CDATA[rant]]></category>

		<guid isPermaLink="false">http://toastie.st/?p=5363</guid>
		<description><![CDATA[Not only did they f-up the entire hiring process and fail to provide me with useful starting information, but now they&#8217;re f-ing with my health insurance. They run their HR operation out of New Jersey, and it&#8217;s readily apparent because every conversation is lacking in empathy, friendliness, and respect. I elected my 2011 health insurance [...]]]></description>
			<content:encoded><![CDATA[<p>Not only did they f-up the entire hiring process and fail to provide me with useful starting information, but now they&#8217;re f-ing with my health insurance. </p>
<p>They run their HR operation out of New Jersey, and it&#8217;s readily apparent because every conversation is lacking in empathy, friendliness, and respect. </p>
<p>I elected my 2011 health insurance provider on December 3. 26-days-later, the provider has no record of me whatsoever. My HR throws the blame back to the provider; &#8220;they should have your data&#8221;. </p>
<p>A case has been opened, and it should take &#8220;3-5 business days&#8221; to conduct an investigation. </p>
<p>Hey, f-ers&#8230;there technically aren&#8217;t any business days until January 3, so you&#8217;re telling me I may not have this resolved into January 10? What am I supposed to do until then?</p>
<p>Oh, you can fax me a letter certifying that I&#8217;m covered, which I can&#8217;t even get until January 3. </p>
<p>Here, dialysis center, this says I&#8217;m covered!  I don&#8217;t have a number or anything. I&#8217;ll accrue $1000 in charges over the next week, but, trust me, I&#8217;m covered!</p>
<p>And then I&#8217;ve got the surgery on January 19, for which the pre-authorization department already called me to get my new insurance information. </p>
<p>&#8220;It&#8217;ll be resolved by then,&#8221; I was assured. &#8220;F*U. This should&#8217;ve been resolved two weeks ago. Why would I trust a (*#*$&#038;( word you&#8217;re saying&#8221;. </p>
<p>I didn&#8217;t really say that. I told her that I had plenty of other medical expenses that would come up before then, and it was not acceptable that I had to simply lay out the money for them in the meantime.</p>
<p>But it&#8217;s acceptable to my HR department, so that&#8217;s the bottomline.</p>
<p>Seriously, I do not need this shit. This week off is great, except it&#8217;s a blip compared to what I really need right now, which is about a year off.</p>
<p>I imagined while I was on hold for 25 minutes that HR was going to come back and say, &#8220;The reason you&#8217;re not in their system is because you&#8217;ve been terminated.&#8221; And I completely believe that my company would fire someone without bothering to them. Completely. </p>
<p>Is that MegaMillions jackpot still growing?</p>
<p>&lt;/rant&gt;</p>
<p><img width="525" src="http://www.ginside.com/content/2007/03/dilbert-google-heatlh-plan.jpg"/></p>
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		<title>The Obama Presidency in Three Frames</title>
		<link>http://toastie.st/2010/11/18/the-obama-presidency-in-three-frames/</link>
		<comments>http://toastie.st/2010/11/18/the-obama-presidency-in-three-frames/#comments</comments>
		<pubDate>Thu, 18 Nov 2010 04:02:05 +0000</pubDate>
		<dc:creator>Toastie</dc:creator>
				<category><![CDATA[politics]]></category>
		<category><![CDATA[barack obama]]></category>
		<category><![CDATA[healthcare]]></category>

		<guid isPermaLink="false">http://toastie.st/?p=5189</guid>
		<description><![CDATA[It&#8217;s depicting health care negotiations, but it seems an apt summary of Obama&#8217;s entire presidency. (h/t Ezra Klein)]]></description>
			<content:encoded><![CDATA[<p><img src="http://www.kaiserhealthnews.org/Cartoons/2010/February/~/media/Images/KHN%20Features/2010/February/14%2020/cartoons/Negotiation512.jpg?w=512&#038;h=409&#038;as=1"/></p>
<p><a href="http://www.kaiserhealthnews.org/Cartoons/2010/February/Negotiation.aspx">It&#8217;s depicting health care negotiations</a>, but it seems an apt summary of Obama&#8217;s entire presidency.<br />
(h/t <a href="http://voices.washingtonpost.com/ezra-klein/2010/11/the_health-care_reform_negotia.html">Ezra Klein</a>)</p>
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		<title>Toastie navigates the healthcare system #983</title>
		<link>http://toastie.st/2010/09/14/toastie-navigates-the-healthcare-system-983/</link>
		<comments>http://toastie.st/2010/09/14/toastie-navigates-the-healthcare-system-983/#comments</comments>
		<pubDate>Tue, 14 Sep 2010 16:26:11 +0000</pubDate>
		<dc:creator>Toastie</dc:creator>
				<category><![CDATA[health]]></category>
		<category><![CDATA[healthcare]]></category>
		<category><![CDATA[rant]]></category>

		<guid isPermaLink="false">http://toastie.st/?p=4884</guid>
		<description><![CDATA[Dear Dr. Monday Night Football: I canceled my appointment for that test because it could have very likely done irreversible damage to my already shitty health. I can only imagine that you wanted to go ahead with this test because it would have given you an opportunity to get a complicated, lucrative procedure under your [...]]]></description>
			<content:encoded><![CDATA[<p><img class="leftpic" alt="stock image of an evil doctor" src="http://www.istockphoto.com/file_thumbview_approve/14116763/2/istockphoto_14116763-smiling-doctor.jpg"/ width="250px"/>Dear Dr. Monday Night Football:</p>
<p>I canceled my appointment for that test because it could have very likely done irreversible damage to my already shitty health. I can only imagine that you wanted to go ahead with this test because it would have given you an opportunity to get a complicated, lucrative procedure under your shiny money clip.</p>
<p>If you really gave a shit about your patient&#8217;s well-being, maybe you&#8217;d pick up a phone yourself to ask why I had canceled instead of having your secretary inquire into the failed transaction.</p>
<p>Toastie<br />
<br clear="left"/></p>
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		<title>bcBSnc</title>
		<link>http://toastie.st/2010/08/10/bcbsnc/</link>
		<comments>http://toastie.st/2010/08/10/bcbsnc/#comments</comments>
		<pubDate>Wed, 11 Aug 2010 02:08:24 +0000</pubDate>
		<dc:creator>Toastie</dc:creator>
				<category><![CDATA[health]]></category>
		<category><![CDATA[bcbsnc]]></category>
		<category><![CDATA[healthcare]]></category>

		<guid isPermaLink="false">http://toastie.st/?p=4755</guid>
		<description><![CDATA[Dear Toastie: We want to let you know about a very important program offered through your Blue Cross and Blue Shield of North Carolina (BCBSNC) health plan. A representative will contact you shortly to let you know about our personalized nursing support services that are available to you at no additional cost. Wow! Sounds amazing! [...]]]></description>
			<content:encoded><![CDATA[<blockquote><p>
<img class="leftpic" src="http://t3.gstatic.com/images?q=tbn:ANd9GcQhjgyc3VWtRWM_-p-rXP6zg6ETXQQIFCt1vN-dAOigx9ODEDU&#038;t=1&#038;usg=__TkjaYd7kAIp6SaUWTz7O1FpMLiI=" alt="" />Dear Toastie:</p>
<p>We want to let you know about a very important program offered through your Blue Cross and Blue Shield of North Carolina (BCBSNC) health plan. A representative will contact you shortly to let you know about our personalized nursing support services that are available to you at no additional cost.</p></blockquote>
<p>Wow! Sounds amazing! Tell me more!</p>
<blockquote><p>The health care staff at BCBSNC includes nurse case managers, social workers, and a registered, licensed dietitian.</p></blockquote>
<p>OMG, that&#8217;s awesome! That sounds just like my dialysis provider! I&#8217;m so lucky to have them looking out for me, because my health is their #1 concern. I&#8217;m sure it&#8217;s yours, too, BCBSNC, and that&#8217;s why you do this!</p>
<blockquote><p>Blah blah blah&#8230;help you better manage and improve your health&#8230;.blah blah blah</p></blockquote>
<p>Dear BCBSNC:</p>
<p>My employer and I pay you a monthly premium. You cut checks. Repeat until we tell you otherwise. That&#8217;s all you need to do. Now leave me alone. </p>
<p>Toastie</p>
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		<title>Elections matter</title>
		<link>http://toastie.st/2010/03/21/elections-matter/</link>
		<comments>http://toastie.st/2010/03/21/elections-matter/#comments</comments>
		<pubDate>Mon, 22 Mar 2010 04:40:23 +0000</pubDate>
		<dc:creator>Toastie</dc:creator>
				<category><![CDATA[politics]]></category>
		<category><![CDATA[barack obama]]></category>
		<category><![CDATA[healthcare]]></category>

		<guid isPermaLink="false">http://toastie.st/?p=4067</guid>
		<description><![CDATA[I&#8217;ll ignore the ugly stuff out there for a minute and savor the fact that the most important legislation in my lifetime has passed. It should be crystal-clear to everyone that the two political parties aren&#8217;t quite the same. Elections do matter. If you voted for Obama, and you believe that healthcare should be more [...]]]></description>
			<content:encoded><![CDATA[<p><img class="leftpic" alt="" src="http://toastie.st/wp-content/uploads08/2010/03/hcr.jpg" title="HCR vote" class="alignnone" width="323" height="157" />I&#8217;ll ignore <a href="http://www.deusexmalcontent.com/2010/03/killer-instinct.html">the ugly stuff out there</a> for a minute and savor the fact that the most important legislation in my lifetime has passed. It should be crystal-clear to everyone that the two political parties aren&#8217;t quite the same. Elections do matter. If you voted for Obama, and you believe that healthcare should be more of a right than a privilege, you can feel like your vote mattered. And if you&#8217;re a Republican, and you believe that government shouldn&#8217;t play a role in ensuring access to healthcare, you can be quite confident that your vote counted, too, since every Republican in the House of Representatives voted against the reform bill. Fortunately for Democrats, they have a sizable majority, because they did well in two straight elections. Elections do matter. And Barack Obama, for all of the blame he deserves for ceding the debate for the better part of year, deserves enormous credit for rallying his diverse party to pass a flawed, but monumental piece of legislation.</p>
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		<title>Health Care Reform: Final Arguments</title>
		<link>http://toastie.st/2010/03/20/health-care-reform-final-arguments/</link>
		<comments>http://toastie.st/2010/03/20/health-care-reform-final-arguments/#comments</comments>
		<pubDate>Sun, 21 Mar 2010 00:02:39 +0000</pubDate>
		<dc:creator>Toastie</dc:creator>
				<category><![CDATA[politics]]></category>
		<category><![CDATA[barack obama]]></category>
		<category><![CDATA[healthcare]]></category>
		<category><![CDATA[right-wingers]]></category>

		<guid isPermaLink="false">http://toastie.st/?p=4056</guid>
		<description><![CDATA[I could write a lot more about this. I&#8217;m so sick of it. Looks like Congress will pass the damn bill tomorrow. Good. Against: (Tea Partiers Protest Outside Capitol, 2010.03.20) Oh, and Civil-rights leader Rep. John Lewis is a n****r. And Rep. Barney Frank is a f****t. For: (President Barack Obama Addresses Democratic Members of [...]]]></description>
			<content:encoded><![CDATA[<p>I could write a lot more about this. I&#8217;m so sick of it. Looks like Congress will pass the damn bill tomorrow. Good. </p>
<p><strong>Against:<br />
(<a href="http://thinkprogress.org/2010/03/20/code-red-gun/">Tea Partiers Protest Outside Capitol</a>, 2010.03.20)<br />
</strong></p>
<p><a href="http://thinkprogress.org/2010/03/20/code-red-gun/"><img width="320" src="http://thinkprogress.org/wp-content/uploads/2010/03/gunshot.jpg"/></p>
<p><img width="320" src="http://thinkprogress.org/wp-content/uploads/2010/03/obamahistory.jpg"/></a></p>
<p>Oh, and <a href="http://www.washingtonmonthly.com/archives/individual/2010_03/022963.php">Civil-rights leader Rep. John Lewis is a n****r.</a></p>
<p>And <a href="http://www.washingtonmonthly.com/archives/individual/2010_03/022963.php">Rep. Barney Frank is a f****t.</a></p>
<p><strong>For:<br />
(President Barack Obama Addresses Democratic Members of Congress, 2010.03.20)</strong></p>
<blockquote><p>
I have the great pleasure of having a really nice library at the White House. And I was tooling through some of the writings of some previous Presidents and I came upon this quote by Abraham Lincoln: “I am not bound to win, but I’m bound to be true. I’m not bound to succeed, but I’m bound to live up to what light I have.”</p>
<p>This debate has been a difficult debate. This process has been a difficult process. And this year has been a difficult year for the American people. When I was sworn in, we were in the midst of the worst recession since the Great Depression. Eight hundred thousand people per month were losing their jobs. Millions of people were losing their health insurance. And the financial system was on the verge of collapse.</p>
<p>And this body has taken on some of the toughest votes and some of the toughest decisions in the history of Congress. Not because you were bound to win, but because you were bound to be true. Because each and every one of you made a decision that at a moment of such urgency, it was less important to measure what the polls said than to measure what was right.</p>
<p>A year later, we’re in different circumstances. Because of the actions that you’ve taken, the financial system has stabilized. The stock market has stabilized. Businesses are starting to invest again. The economy, instead of contracting, is now growing again. There are signs that people are going to start hiring again. There’s still tremendous hardship all across the country, but there is a sense that we are making progress &#8212; because of you.</p>
<p>But even before this crisis, each and every one of us knew that there were millions of people across America who were living their own quiet crises. Maybe because they had a child who had a preexisting condition and no matter how desperate they were, no matter what insurance company they called, they couldn’t get coverage for that child. Maybe it was somebody who had been forced into early retirement, in their 50s not yet eligible for Medicare, and they couldn’t find a job and they couldn’t find health insurance, despite the fact that they had some sort of chronic condition that had to be tended to.<br />
<span id="more-4056"></span></p>
<p>Every single one of you at some point before you arrived in Congress and after you arrived in Congress have met constituents with heart-breaking stories. And you’ve looked them in the eye and you’ve said, we’re going to do something about it &#8212; that’s why I want to go to Congress. </p>
<p>And now, we’re on the threshold of doing something about it. We’re a day away. After a year of debate, after every argument has been made, by just about everybody, we’re 24 hours away.</p>
<p>As some of you know, I’m not somebody who spends a lot of time surfing the cable channels, but I’m not completely in the bubble. I have a sense of what the coverage has been, and mostly it’s an obsession with “What will this mean for the Democratic Party? What will this mean for the President’s polls? How will this play out in November? Is this good or is this bad for the Democratic majority? What does it mean for those swing districts?”</p>
<p>And I noticed that there’s been a lot of friendly advice offered all across town. Mitch McConnell, John Boehner, Karl Rove &#8212; they’re all warning you of the horrendous impact if you support this legislation. Now, it could be that they are suddenly having a change of heart and they are deeply concerned about their Democratic friends. They are giving you the best possible advice in order to assure that Nancy Pelosi remains Speaker and Harry Reid remains Leader and that all of you keep your seats. That’s a possibility. </p>
<p>But it may also be possible that they realize after health reform passes and I sign that legislation into law, that it’s going to be a little harder to mischaracterize what this effort has been all about.</p>
<p>Because this year, small businesses will start getting tax credits so that they can offer health insurance to employees who currently don’t have it. Because this year, those same parents who are worried about getting coverage for their children with preexisting conditions now are assured that insurance companies have to give them coverage &#8212; this year. </p>
<p>Because this year, insurance companies won’t suddenly be able to drop your coverage when you get sick &#8212; or impose lifetime limits or restrictive limits on the coverage that you have. Maybe they know that this year, for the first time, young people will be able to stay on their parents’ health insurance until they’re 26 years old and they’re thinking that just might be popular all across the country.</p>
<p>And what they also know is what won’t happen. They know that after this legislation passes and after I sign this bill, lo and behold nobody is pulling the plug on Granny. It turns out that in fact people who like their health insurance are going to be able to keep their health insurance; that there’s no government takeover. People will discover that if they like their doctor, they’ll be keeping their doctor. In fact, they’re more likely to keep their doctor because of a stronger system.</p>
<p>It’ll turn out that this piece of historic legislation is built on the private insurance system that we have now and runs straight down the center of American political thought. It turns out this is a bill that tracks the recommendations not just of Democrat Tom Daschle, but also Republicans Bob Dole and Howard Baker; that this is a middle-of-the-road bill that is designed to help the American people in an area of their lives where they urgently need help.</p>
<p>Now, there are some who wanted a single-payer government-run system. That’s not this bill. The Republicans wanted what I called the “foxes guard the henhouse approach” in which we further deregulate the insurance companies and let them run wild, the notion being somehow that that was going to lower costs for the American people. I don’t know a serious health care economist who buys that idea, but that was their concept. And we rejected that, because what we said was we want to create a system in which health care is working not for insurance companies but it’s working for the American people, it’s working for middle class families.</p>
<p>So what did we do? What is the essence of this legislation? Number one, this is the toughest insurance reforms in history. We are making sure that the system of private insurance works for ordinary families. A prescription &#8212; this is a patient’s bill of rights on steroids. So many of you individually have worked on these insurance reforms &#8212; they are in this package &#8212; to make sure that families are getting a fair deal; that if they’re paying a premium, that they’re getting a good service in return; making sure that employers, if they are paying premiums for their employees, that their employees are getting the coverage that they expect; that insurance companies are not going to game the system with fine print and rescissions and dropping people when they need it most, but instead are going to have to abide by some basic rules of the road that exemplify a sense of fairness and good value. That’s number one.</p>
<p>The second thing this does is it creates a pool, a marketplace, where individuals and small businesses, who right now are having a terrible time out there getting health insurance, are going to be able to purchase health insurance as part of a big group &#8212; just like federal employees, just like members of Congress. They are now going to be part of a pool that can negotiate for better rates, better quality, more competition.</p>
<p>And that’s why the Congressional Budget Office says this will lower people’s rates for comparable plans by 14 to 20 percent. That’s not my numbers &#8212; that’s the Congressional Budget Office’s numbers. So that people will have choice and competition just like members of Congress have choice and competition.</p>
<p>Number three, if people still can’t afford it we’re going to provide them some tax credits &#8212; the biggest tax cut for small businesses and working families when it comes to health care in history.</p>
<p>And number four, this is the biggest reduction in our deficit since the Budget Balance Act &#8212; one of the biggest deficit reduction measures in history &#8212; over $1.3 trillion that will help put us on the path of fiscal responsibility. </p>
<p>And that’s before we count all the game-changing measures that are going to assure, for example, that instead of having five tests when you go to the doctor you just get one; that the delivery system is working for patients, not just working for billings. And everybody who’s looked at it says that every single good idea to bend the cost curve and start actually reducing health care costs are in this bill.</p>
<p>So that’s what this effort is all about. Toughest insurance reforms in history. A marketplace so people have choice and competition who right now don’t have it and are seeing their premiums go up 20, 30, 40, 50 percent. Reductions in the cost of health care for millions of American families, including those who have health insurance. The Business Roundtable did their own study and said that this would potentially save employers $3,000 per employee on their health care because of the measures in this legislation.</p>
<p>And by the way, not only does it reduce the deficit &#8212; we pay for it responsibly in ways that the other side of the aisle that talks a lot about fiscal responsibility but doesn’t seem to be able to walk the walk can’t claim when it comes to their prescription drug bill. We are actually doing it. (Applause.) This is paid for and will not add a dime to the deficit &#8212; it will reduce the deficit. </p>
<p>Now, is this bill perfect? Of course not. Will this solve every single problem in our health care system right away? No. There are all kinds of ideas that many of you have that aren’t included in this legislation. I know that there has been discussion, for example, of how we’re going to deal with regional disparities and I know that there was a meeting with Secretary Sebelius to assure that we can continue to try to make sure that we’ve got a system that gives people the best bang for their buck. </p>
<p>So this is not &#8212; there are all kinds of things that many of you would like to see that isn’t in this legislation. There are some things I’d like to see that’s not in this legislation. But is this the single most important step that we have taken on health care since Medicare? Absolutely. Is this the most important piece of domestic legislation in terms of giving a break to hardworking middle class families out there since Medicare? Absolutely. Is this a vast improvement over the status quo? Absolutely.</p>
<p>Now, I still know this is a tough vote, though. I know this is a tough vote. I’ve talked to many of you individually. And I have to say that if you honestly believe in your heart of hearts, in your conscience, that this is not an improvement over the status quo; if despite all the information that’s out there that says that without serious reform efforts like this one people’s premiums are going to double over the next five or 10 years, that folks are going to keep on getting letters from their insurance companies saying that their premium just went up 40 or 50 percent; if you think that somehow it’s okay that we have millions of hardworking Americans who can’t get health care and that it’s all right, it’s acceptable, in the wealthiest nation on Earth that there are children with chronic illnesses that can’t get the care that they need &#8212; if you think that the system is working for ordinary Americans rather than the insurance companies, then you should vote no on this bill. If you can honestly say that, then you shouldn’t support it. You’re here to represent your constituencies and if you think your constituencies honestly wouldn’t be helped, you shouldn’t vote for this.</p>
<p>But if you agree that the system is not working for ordinary families, if you’ve heard the same stories that I’ve heard everywhere, all across the country, then help us fix this system. Don&#8217;t do it for me. Don’t do it for Nancy Pelosi or Harry Reid. Do it for all those people out there who are struggling.</p>
<p>Some of you know I get 10 letters a day that I read out of the 40,000 that we receive. Started reading some of the ones that I got this morning. “Dear President Obama, my daughter, a wonderful person, lost her job. She has no health insurance. She had a blood clot in her brain. She’s now disabled, can’t get care.” “Dear President Obama, I don’t yet qualify for Medicare. COBRA is about to run out. I am desperate, don&#8217;t know what to do.”</p>
<p>Do it for them. Do it for people who are really scared right now through no fault of their own, who’ve played by the rules, who’ve done all the right things, and have suddenly found out that because of an accident, because of an ailment, they’re about to lose their house; or they can’t provide the help to their kids that they need; or they’re a small business who up until now has always taken pride in providing care for their workers and it turns out that they just can’t afford to do it anymore and they’ve having to make a decision about do I keep providing health insurance for my workers or do I just drop their coverage or do I not hire some people because I simply can’t afford it &#8212; it’s all being gobbled up by the insurance companies.</p>
<p>Don’t do it for me. Don’t do it for the Democratic Party. Do it for the American people. They’re the ones who are looking for action right now. </p>
<p>I know this is a tough vote. And I am actually confident &#8212; I’ve talked to some of you individually &#8212; that it will end up being the smart thing to do politically because I believe that good policy is good politics. I am convinced that when you go out there and you are standing tall and you are saying I believe that this is the right thing to do for my constituents and the right thing to do for America, that ultimately the truth will out.</p>
<p>I had a wonderful conversation with Betsy Markey. I don&#8217;t know if Betsy is around here. There she is right there. Betsy is in a tough district. The biggest newspaper is somewhat conservative, as Betsy described. They weren’t real happy with health care reform. They were opposed to it. Betsy, despite the pressure, announced that she was in favor of this bill. And lo and behold, the next day that same newspaper runs an editorial saying, you know what, we’ve considered this, we’ve looked at the legislation, and we actually are pleased that Congresswoman Markey is supporting the legislation. </p>
<p>When I see John Boccieri stand up proud with a whole bunch of his constituencies &#8212;  in as tough a district as there is and stand up with a bunch of folks from his district with preexisting conditions and saying, you know, I don’t know what is going on Washington but I know what’s going on with these families &#8212; I look at him with pride.</p>
<p>Now, I can’t guarantee that this is good politics. Every one of you know your districts better than I do. You talk to folks. You’re under enormous pressure. You’re getting robocalls. You’re getting e-mails that are tying up the communications system. I know the pressure you’re under. I get a few comments made about me. I don’t know if you’ve noticed. I’ve been in your shoes. I know what it’s like to take a tough vote.</p>
<p>But what did Lincoln say? “I am not bound to win, but I am bound to be true.” Two generations ago, folks who were sitting in your position, they made a decision &#8212; we are going to make sure that seniors and the poor have health care coverage that they can count on. And they did the right thing.</p>
<p>And I’m sure at the time they were making that vote, they weren’t sure how the politics were either, any more than the people who made the decision to make sure that Social Security was in place knew how the politics would play out, or folks who passed the civil rights acts knew how the politics were going to play out. They were not bound to win, but they were bound to be true.</p>
<p>And now we’ve got middle class Americans, don’t have Medicare, don’t have Medicaid, watching the employer-based system fray along the edges or being caught in terrible situations. And the question is, are we going to be true to them?</p>
<p>Sometimes I think about how I got involved in politics. I didn’t think of myself as a potential politician when I get out of college. I went to work in neighborhoods, working with Catholic churches in poor neighborhoods in Chicago, trying to figure out how people could get a little bit of help. And I was skeptical about politics and politicians, just like a lot of Americans are skeptical about politics and politicians are right now. Because my working assumption was when push comes to shove, all too often folks in elected office, they’re looking for themselves and not looking out for the folks who put them there; that there are too many compromises; that the special interests have too much power; they just got too much clout; there’s too much big money washing around.</p>
<p>And I decided finally to get involved because I realized if I wasn’t willing to step up and be true to the things I believe in, then the system wouldn’t change. Every single one of you had that same kind of moment at the beginning of your careers. Maybe it was just listening to stories in your neighborhood about what was happening to people who’d been laid off of work. Maybe it was your own family experience, somebody got sick and didn’t have health care and you said something should change.</p>
<p>Something inspired you to get involved, and something inspired you to be a Democrat instead of running as a Republican. Because somewhere deep in your heart you said to yourself, I believe in an America in which we don’t just look out for ourselves, that we don’t just tell people you’re on your own, that we are proud of our individualism, we are proud of our liberty, but we also have a sense of neighborliness and a sense of community &#8212; and we are willing to look out for one another and help people who are vulnerable and help people who are down on their luck and give them a pathway to success and give them a ladder into the middle class. That’s why you decided to run.</p>
<p>And now a lot of us have been here a while and everybody here has taken their lumps and their bruises. And it turns out people have had to make compromises, and you’ve been away from families for a long time and you’ve missed special events for your kids sometimes. And maybe there have been times where you asked yourself, why did I ever get involved in politics in the first place? And maybe things can’t change after all. And when you do something courageous, it turns out sometimes you may be attacked. And sometimes the very people you thought you were trying to help may be angry at you and shout at you. And you say to yourself, maybe that thing that I started with has been lost.</p>
<p>But you know what? Every once in a while, every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises that you made in all those town meetings and all those constituency breakfasts and all that traveling through the district, all those people who you looked in the eye and you said, you know what, you’re right, the system is not working for you and I’m going to make it a little bit better.</p>
<p>And this is one of those moments. This is one of those times where you can honestly say to yourself, doggone it, this is exactly why I came here. This is why I got into politics. This is why I got into public service. This is why I’ve made those sacrifices. Because I believe so deeply in this country and I believe so deeply in this democracy and I’m willing to stand up even when it’s hard, even when it’s tough.</p>
<p>Every single one of you have made that promise not just to your constituents but to yourself. And this is the time to make true on that promise. We are not bound to win, but we are bound to be true. We are not bound to succeed, but we are bound to let whatever light we have shine. We have been debating health care for decades. It has now been debated for a year. It is in your hands. It is time to pass health care reform for America, and I am confident that you are going to do it tomorrow.</p>
<p>Thank you very much, House of Representatives. Let’s get this done.
</p></blockquote>
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		<title>More thumbs up</title>
		<link>http://toastie.st/2010/02/25/more-thumbs-up/</link>
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		<pubDate>Thu, 25 Feb 2010 05:22:39 +0000</pubDate>
		<dc:creator>Toastie</dc:creator>
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		<description><![CDATA[Roger Ebert takes on that 911-fee I mentioned a few days ago and goes much further, reflecting on the state of the United States that we find ourselves in today. I feel compelled to label Ebert&#8217;s journal as a must-read once again. Roger Ebert: The gathering storm / 2.24.10]]></description>
			<content:encoded><![CDATA[<p>Roger Ebert takes on that 911-fee I mentioned a few days ago and goes much further, reflecting on the state of the United States that we find ourselves in today. I feel compelled to label Ebert&#8217;s journal as a must-read once again.</p>
<p><a href="http://blogs.suntimes.com/ebert/2010/02/the_gathering_storm.html">Roger Ebert: The gathering storm / 2.24.10</a></p>
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