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Highlights of Eshoo's responses on health care reform
Congresswoman outlines basic features of reform proposals currently before Congress

by Gennady Sheyner
Palo Alto Online Staff

Posted by Irwin Kasser, MD, a resident of Atherton, on Sep 14, 2009 at 4:27 pm

As a physician, I applaud Congresswoman Eshoo's hard work in crafting the Health Reform Bill. It appears to be very reasonable and fair. Every American should be able to obtain adequate health care. I fear that if we don't pass a bill during this session of Congress, we will have missed an important opportunity that won't be easily repeated.

Posted by James, a resident of the Monroe Park neighborhood, on Sep 14, 2009 at 4:38 pm

We need single payer, period. It is a moral imperative. It will cost us a LOT more in taxes. Social justice demands that we cover EVERYONE, including undocumented immigrants. It will involve the use of death panels, in order to hold down costs to society.

I just wish President Obama would just tell the truth, and lead us in that direction. Sadly, he has been lacking in the leadership area, even though he probably agrees with everyting I just stated.

Posted by Sharon, a resident of the Midtown neighborhood, on Sep 14, 2009 at 5:52 pm

The PwC study showing that 50% of health care dollars are wasted is well worth reading hereWeb Link

PwC is know for the quality and non partisan nature of its analysis

Posted by asenior, a resident of Another Palo Alto neighborhood, on Sep 15, 2009 at 9:20 am

All due respect, what amazes me is the rush to push through a 1000 page bill based on what it is "supposed" to accomplish. The details are extremely important. Eshoo and Obama tell us there is nothing to be concerned about. If so, then make sure those details are nailed down in the legislation.

It boggles the mind that you like "death panels" James. There are some problems with the very, very sick and dying receiving medical treatment that may extend life for a very short time but these patients are barely conscious and have no quality of life. The difficulty lies in where do you draw the line?

Even worse, why is it in the bill to encourage healthy elderly to meet with their doctor or appointed official to discuss end of life care -- what does that mean? Optional yes, but gov't could coerce by denying care for those who don't comply.

Sure we all want health care but when the gov't runs it, the govt will have enormous oversight, not just over physical health but also mental health. Sounds nightmarish to me.

Posted by Perspective, a resident of the Midtown neighborhood, on Sep 15, 2009 at 9:43 am

Discussion is irrelevant until the Senate puts forth something for us to read. HR 3200 is dead. The 2 amendments put forth to limit access to health care to illegal immigrants to emergency, life saving care only, were soundly voted down, and the bill has been proven to be a path to kill all private health insurance choices, therefore killing the chance that those of us who want to keep what we have, can ( 80% of us are fine with our health insurance right now). Our President has promised that neither of these two conclusions are true in "his" health plan, and no matter what words, words, words we hear coming from our President's mouth when he speaks of "his" plan, it all means nothing until we see a written plan that he will own. This last one was pulled out of a dusty, 30 year old drawer somewhere after being outsourced by our President to the Congress, where folks like Eshoo thought they would finally get what they have wanted for 30 years, not noticing that all the other countries that took that route now regret it and are trying hard to put the lid back on Pandora's box. So, they voted yes, then went out to do battle for the President, only to be thrown under the bus by the same one.

The only plan we have had put forth so far is HR3200 and it is no longer relevant.

Once we actually get a plan that Obama will own, and can speak from, citing page numbers and lines, then we can move forward with our national discussion, where, of course, any concerns raised will automatically be only from racists, but maybe in spite of that horrible failing inherent of critical thinkers of all colors, we will still be able to do real, American-style, truly new/progressive reform, not proven failures that will destroy all that is good in what we have.

Posted by Perspective, a resident of the Midtown neighborhood, on Sep 15, 2009 at 9:52 am

With all due respect, I have to say, any MD who supports HR 3200 means s/he supports the results, which include that future physicians would not be able to live in a place as nice as Atherton, or even Palo Alto.

I, as a non-physician health care provider, can afford to live better than my family in France, 2 of whom are actual physicians. They can't believe that any doctor is supporting a move toward the French system. IF not for the "greedy" aspect of being able to make so much more here, but for the "altruistic" aspect of being able to prescribe better care, in medicines, devices and timely procedures, here. They live with constant frustration at their hands being tied. The sad thing is, they didn't even know how bad it was there, since they only speak French and have only French "public TV" news, until I started telling them about the care we give at Stanford, regardless of status or ability to pay. And they live and work in Paris.

Posted by sarah, a resident of the Midtown neighborhood, on Sep 15, 2009 at 12:42 pm

Is it true that many women are currently being denied health insurance because of a pre-existing condition of domestic violence? Web Link

Posted by James, a resident of the Monroe Park neighborhood, on Sep 15, 2009 at 1:13 pm

"It boggles the mind that you like "death panels" James. There are some problems with the very, very sick and dying receiving medical treatment that may extend life for a very short time but these patients are barely conscious and have no quality of life. The difficulty lies in where do you draw the line?"

The death panels will determine where to draw the line, and that will, and should, involve how much we can afford to spend on granny. The NHS in England does this now. We should do the same. Quality adjusted years should become the determinant of treatment, and there must be a price put on those years.

Posted by Perspective, a resident of the Midtown neighborhood, on Sep 15, 2009 at 4:12 pm

Sarah, the link is a hit piece by SEIU. Please note who the website belongs to. The SEIU leadership believes that Universal Health Care will enrich their coffers by forcing more union membership amongst health care and government workers. Follow the money.

Denials are based on pre-existing conditions, yes, but this particular assertion doesn't pass the smell test. If someone ( male or female) has had multiple unexplained broken bones over a number of years, or has chosen to stay with someone who has tried to kill them for a number of time..yes, I suspect they would be denied because their risk is so high, sort of like life insurers don't insure people who choose to jump out of airplanes.

That said, yes, pre-existings are denied. Yes, it is a problem. Yes it needs to be fixed in a way that doesn't encourage people to not buy insurance until they are sick. No, we don't need Universal Coverage to fix this any more than you need a hammer to kill a fly bugging the family dog( with all the unintended detrimental consequences such an action would have on the poor dog you were trying to help, of course)

Posted by William Shea, a resident of the Old Palo Alto neighborhood, on Sep 15, 2009 at 4:27 pm

Sarah are you confused, the only thing more corrupt than ACORN is SEIU.

enough said.

Posted by Perspective, a resident of the Midtown neighborhood, on Sep 15, 2009 at 5:56 pm

Please note the link to the side of the SEIU page that Sarah used that says "Send your medical bills to Congress" under the one that says "Tell Congress to act on Health Care Reform". Follow the money. They are playing on the weak who don't want to be responsible for themselves, and believe that there really is a free lunch around the corner, if only we pass "universal health care" under the name "health care reform". The Dems have to realize that we voted for REFORM, not DESTRUCTION of our health care system.

Posted by Sharon, a resident of the Midtown neighborhood, on Sep 15, 2009 at 6:15 pm

here is another PwC reportWeb Link that goes into detail about the waste in the current lawyer driven rather than science drive health care system in the USA.

How to purge the lawyers is the question.

John Edwards made a fortune going after good doctors, he almost became President, then look what happened to him.

The hope hype is what it is hype.

Baghdad Bob is back on TV 5 times next week, and then on to the UN.

Posted by asenior, a resident of Another Palo Alto neighborhood, on Sep 15, 2009 at 6:42 pm

James you state that: "The death panels will determine where to draw the line, and that will, and should, involve how much we can afford to spend on granny. The NHS in England does this now. We should do the same. Quality adjusted years should become the determinant of treatment, and there must be a price put on those years."

What source of info are you using for the above claim?

Posted by Sharon, a resident of the Midtown neighborhood, on Sep 15, 2009 at 6:55 pm

Everyone should have the right to die or survive with dignity like this

see Web Link

Posted by maguro_01, a resident of Mountain View, on Sep 16, 2009 at 7:44 am

"The death panels will determine where to draw the line, and that will, and should, involve how much we can afford to spend on granny. The NHS in England does this now. We should do the same. Quality adjusted years should become the determinant of treatment, and there must be a price put on those years."

Yes they do that in the NHS and, IMHO, the UK does not spend enough percent GDP on medical care - I think it's the lowest among the larger EU countries. Life expectancy in the UK is higher than the US anyway, though lower than France or Germany. ref - CIA World Factbook Web Link . The US is ranked 50th. The US is 44th for infant death rate too. The differences are substantial and won't go away with quibbling adjustments.

Since all those countries have a longer life expectancy than the US it seems they are not pulling the plug on Granny or putting Gramps in the catfood as the GOP would have us believe. One reason older people are panicing is that they know that we can't increase the very high percent GDP we are spending on medical care and so they feel insuring more people means less for them. Other country's experience suggests otherwise. Any system will not be perfect and require adjustments, but Germany and France insure everyone, spend less per capita and percent GDP, yet have that higher life expectancy. With all the systems out there, we should be able to see them as trials and come up with a very good American single payer system.

The GOP is choosing to have virtual "death panels" that are C++ code running on private computers halfway around the world. They are also mixing up several ideas into the single term "death panels" to deliberately make coherent discussion impossible.

Additional defects of our present uniquely expensive system is that US businesses are less competitive internationally and over 50 Americans are rejected from the job market with the peak earning years apparently decreasing. No economic system envisioned can support people who only get to work half their adult lifetimes. No one is mentioning it but globalism is hitting US wages and job growth really hard - both are flat or even declining but the population has increased considerably. Medical care plus the cancerous financial sector will add up to 1/4 US GDP in a year or so, eating up the economy that has to pay for them. Medical care is inflating in cost all by itself at least 8%/yr. The national bar tab is close to tapped out. We had better get change, there's no slack any more.

Posted by asenior, a resident of Another Palo Alto neighborhood, on Sep 16, 2009 at 9:25 am

Marguro, you state, "Life expectancy in the UK is higher than the US anyway, though lower than France or Germany. ref - CIA World Factbook Web Link . The US is ranked 50th. The US is 44th for infant death rate too. The differences are substantial and won't go away with quibbling adjustments."

OK, just the facts: the US infant death rate ranks among the lowest (about 6 deaths per 1,000 births)--this is among the best rates! Yes, the US ranks 50th for life expectancy, but if you look at the actual age, in the US it is 78 and France is 80, and Great Britain is 79, you see we are quite close.

To make it sound like our health care system is in a major crisis just isn't true. Yes, we need reforms, and govt regulation can do that. We can work on improving our health care, but to have the govt take it over will make things worse not better.

Posted by Perspective, a resident of the Midtown neighborhood, on Sep 16, 2009 at 12:29 pm

If we compare across races, our life expectancy and infant mortality, race to race, soars.

Our country has so much more diversity of cultures and choices, and so many more new immigrants per capita, than other countries, that it is misleading to compare simply "one number". Sort of like that oft repeated saw "one can drown in a river that averages 6 inches depth". That could mean that some parts are 10 feet deep...

Posted by maguro_01, a resident of Mountain View, on Sep 17, 2009 at 6:53 pm

"OK, just the facts: the US infant death rate ranks among the lowest (about 6 deaths per 1,000 births)--this is among the best rates! Yes, the US ranks 50th for life expectancy, but if you look at the actual age, in the US it is 78 and France is 80, and Great Britain is 79, you see we are quite close."

Yes, but the difference is enough that it can't be dismissed out of hand or said to be a lie as some are doing. The UK even spends a great deal less percent GDP than we do, around half. Indeed, they scheduled my cousin there in Llandudno (sp?) 6 months out for stomach cancer surgery and of course he died.

My point is that these countries are managing a longer life expectancy. Yet the UK has an "underclass" as does France. You and I don't have a personal crisis in medical care (I use Kaiser, a possible model) but the US can't afford its present inflating system and it still leaves large numbers uninsured.

"Our country has so much more diversity of cultures and choices, and so many more new immigrants per capita, than other countries, that it is misleading to compare simply "one number"."

Of course, because we don't have a single payer system and we have millions of uninsured.

Posted by Perspective, a resident of the Midtown neighborhood, on Sep 19, 2009 at 11:20 am

"Of course, ...millions of uninsured".

Ok, again, sorry to keep beating this horse, but I will everytime. Even Obama ( and McCain) have magically reduced the "talking point number" from 47 million uninsured to 30 million uninsured..have you noticed?

That is because they took out the ones who were not citizens in that famous number.

So, let's hope that they take out the 10-15 million in that number who are already eligible, simply not signed up yet, for a government plan that already exists like MediCal/Aid.

That will 15-20 million uninsured. And then maybe they will finally accept what most of us already know, that 10-15 million of THAT number are people who were uninsured for only 4 months in the year of this survey, between jobs etc, and people between the ages of 18-30 who make $50,000/year or more..and CHOOSE not to buy insurance.

THEN we will be finally down to what the real "uninsured because they can't afford it" number, which is somewhere between 10-15 million.

So, what are we fighting about? Who wants to destroy all that drives the country with the best health care choices in the world for 3-5% of the population, when there are so many GREAT solutions out there that would help ALL of us lower costs, making it more within reach of the 3-5%?

Can anyone PLEASE find even one story anywhere in our nation about somebody who dies because they were refused medical care in this country, unless it is the one about the woman in Oregon who was refused Cancer care because she lived in a Universal Health Care State whose Death Panel decided she wasn't worth it? I keep hearing this sad little slogan, but have yet to find one story about it, except the Oregon story.

Solutions, American Individual Choice style:

1) Increase HSA ability to save for a rainy day

2) Allow us to buy health insurance that ISN'T up to the fully regulated standards of whatever State we live in..so that we who don't want to pay for such insurance don't pay for insurance for IVFs, sex-transplants, hair transplants, language translation, chiropractors, no-copay doctor visits etc. I never have wanted such insurance, and resent deeply being forced to pay for it, greatly driving up my costs.

Anyone who wants to help people get hair transplants etc, feel free to donate to such a fund, but stop forcing the rest of us to do it.

3) Tort reform, of course. Tort reform in all areas, actually, having the lawyer who takes the case and sues someone else pay the fees if they lose. They get to make a lot of money on contingency, why not pay back costs on contingency also? Stop the abuse of lawsuits...that alone would make the attorneys make wiser choices. Stop the absurd lawsuits, and the absurd payouts. Let the medical provider insurance premiums go back to what they were.

4) Equalize taxes for those who get insurance through employers and those who pay privately. This would encourage people to simply buy their own insurance, and then they would have much more portable insurance...still with them as they go from job to job, employed to self-employed..even when they get sick, thus lowering "pre-existing" worries.

5) Incentivize people to buy their insurance. If they can afford to get a car or want a driver's license, then they need to show proof of insurance. This would instantly lower the ones who choose not to buy it but can afford it.

6) Create a law making denials of same-insurance type in pre-existings illegal if said pre-existing happened when a person was insured, no matter what..this will cause all insurance companies to band together and work it out.

The above will lower costs, the uninsured, the number of pre-existings..all without lowering the incentives that drive our creation of new and improved meds, devices and techniques, nor the ability to draw the best and the brightest into health care.

Many forms of the above have been introduced many times throughout the last 6 years, but unfortunately the Repubs hadn't the politcial will to pass them, and the Dems don't like the idea of giving more control back to individuals.

If we did these, though, we could then assess how many were left who were truly uninsured from having to choose between food and shelter and insurance,..and then actually help those who need help, instead of those who have made bad choices.

The above will lower by

Posted by Perspective, a resident of the Midtown neighborhood, on Nov 2, 2009 at 7:32 am

Extract from the latest health care bill:

Excerpt from latest (1900 page) bill on "health care reform" coming out of Congress..

have fun reading it

imagine 1900 pages of this

and you are complaining about your private health insurance being too complicated for you and powerful over you? The one you CHOSE?

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

“(a) Outpatient Hospitals – (1) In General – Section 1833(t)(3)(C)(iv) of the Social Security Act (42 U.S.C. 1395(t)(3)(C)(iv)) is amended – (A) in the first sentence – (i) by inserting “(which is subject to the productivity adjustment described in subclause (II) of such section)” after “1886(b)(3)(B)(iii); and (ii) by inserting “(but not below 0)” after “reduced”; and (B) in the second sentence, by inserting “and which is subject, beginning with 2010 to the productivity adjustment described in section 1886(b)(3)(B)(iii)(II)”.

+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Posted by Perspective, a resident of the Midtown neighborhood, on Nov 5, 2009 at 6:16 am

Hmm..interesting...current bill still trying to forbid private insurances after 2013..conveniently AFTER the next POTUS election.

Same old crap we had in the summer...it will be interesting to see how many Dems are willing to throw themselves on the sword for their fearless leaders, Obama and Pelosi. Even Reid is re-thinking it, based on his State telling him "you do this, you are out"....

Americans want reform the American way, not destruction the European ( and Venezuela, and Cuba, and China, and Russia) way...

Posted by Sanity, a resident of the Barron Park neighborhood, on Nov 5, 2009 at 10:00 am

"current bill still trying to forbid private insurances after 2013"

It would be great if that were true but it's not.

Posted by The Real Sharon, a resident of the Midtown neighborhood, on Nov 5, 2009 at 10:01 am

[Post removed by Palo Alto Online staff.]

Posted by Perspective, a resident of the Midtown neighborhood, on Nov 6, 2009 at 5:12 am

Web Link

After saying she was "absolutely" committed to giving the American people 72 hours to read the current bill before a House vote, Pelosi decides not to let us read it after all...what a surprise...

America, do you really trust these people to do anything they say they are going to do?

And yes, as of last week the bill still contained the language that that no new private insurance policies will be allowed to be written up after 2013. What does this mean? The death of private insurances. Ergo, forbidding private insurances..

Amazingly enough, this is to take effect AFTER the next POTUS election, because the Dems believe the American people are too stupid to understand that this is all about power and money for the favored, not about "better, less expensive health care" for all. That is absolutely impossible using their same old ideas that have been tried and have failed for 100 years.

I hope that soon, very soon, the Dems wake up and use their power to effect real, American-way, new ideas to fix the small problems in health care insurance we have, not the tired old ideas to destroy all that is great about our system.

Simple ideas, easy to implement, huge pay back...But Dems are always fearful of giving back to individuals the ability to make their own choices, so it probably won't happen.

Posted by Sanity, a resident of the Barron Park neighborhood, on Nov 6, 2009 at 8:12 am

"The death of private insurances."

That would be the best thing for our system, but it's simply not true.

Posted by The Real Sharon, a resident of the Midtown neighborhood, on Nov 6, 2009 at 8:24 am

[Post removed by Palo Alto Online staff.]

Posted by Perspective, a resident of the Midtown neighborhood, on Nov 6, 2009 at 8:30 am

hmmmmmm...another person for "reform" who actually wants to "destroy".

Keep talking "reform" supporters! Destroying private industry and giving control to a government of all industries is what this government and its now minority of American supporters is all about.

While you are at it, we should destroy private life insurance, home insurance, and car insurance. The "government" could do such a better job of it!

Let's do it really right, let's just admit we are incapable of making our own intelligent choices, and have our oh so intelligent government tell us where to live ( a housing czar), how much space we can have to live in ( a fair space czar), what jobs we need to do ( a job czar), what kind of health care we are allowed to have ( which is the current bill)....after all, this would be the only fair way to do anything, wouldn't it? Distribute everything very fairly and evenly regardless of what someone does..after all, cars, houses, food, clothes, TVs, vacations, health care..these are all rights we owe everyone, correct?

Posted by Sanity, a resident of the Barron Park neighborhood, on Nov 6, 2009 at 8:33 am

Well, yes, it does turn out that thorough, good reforms mean destroying private health insurance.

But that is not on the table. You keep lying about the proposals because you can't argue on the merits. Put down the red herrings and step away from the keyboard.

Posted by Perspective, a resident of the Midtown neighborhood, on Nov 6, 2009 at 5:09 pm

Web Link

Do what the Dems tell you to do, pay the fee for "their" plan, or go to jail. From the mouths of the Dems themselves.

So, when will you let them tell you what kind of house to pay for or go to jail?

How about remembering a little bit about freedom, and rewarding good choices..like equalizing the tax code for buying health insurance, linking the privilege of renewing a driver's license with showing proof of insurance; letting us buy health insurance across State lines that covers what we want it to cover, not what the legislators have been wined and dined into mandating?

Let's go back to the principles of America. This heavy handed grab for power is going to backfire bigtime.

Even at the time of the Revolution about 30% of us preferred to keep the monarchy's yoke, fighting on the side of King George or going to Canada, which doesn't seem to have changed much in 235 years..but it would behoove our elected officials to remember that about 70% of us have always been on the side of taking care of ourselves, our families, and our own causes, just don't get in our way, government.