2. Identify three biggest problems with health care system today.
Miceli: Portability — keep same coverage between agencies and jobs. Standardization of coverage. Businesses should be able to buy into pools like GIC. On national level we have nothing like that. Maybe single-payer option should be something to look at.
Eldridge: Solution to portability is universal health coverage. I was Legal Aid lawyer — many clients went into medical bankruptcy. Cost: Ch. 58 doesn’t control costs. In US, we spend far more on health care than anyplace else. Profits: have no place in health care (applause). Tsongas worries about profits for private health care companies. Imagine taking Fallon’s profits and preventing infant mortality.
Tsongas: We have problem with covering uninsured. Cost of insurance will go down when we have everyone in the system and provide preventative care. Need to get everyone covered now — as under Edwards plan. Nursing shortage.
Finegold: 18,000 die each year b/c they can’t get care. Cost of prescription drugs — drug companies spent 4.5 billion on drug advertising. We need to do better — that $ should be in R&D. Stop using ER as primary care. More preventative care.
Donoghue: Preventative care — get people coverage as quickly as possible. Focus has gone from patient care and safety to making money. Why do we have to buy drugs from Canada? Non-profits are making money too — MGH makes money.
Mitchell — impressed that candidates have done their homework.
3. Drugs: Fast-tracking of new drugs by FDA sounded like a good idea — was it?
Tsongas: Not under this current FDA. Maybe under different leadership … not now.
Finegold: Need to streamline, but no.
Donoghue: Vioxx was terrible example — given us pause.
Miceli: No for me too — but people do need access to experimental drugs.
Eldridge: No. Support bulk purchasing of prescription drugs.
4. Avian flu?
Finegold:I would vote for more $, prevention, education. Pushed for it at state level.
Donoghue:Need to stockpile beds and necessities. We can’t sustain a surge.
Miceli: Look at Katrina — no transparency of responsibility. Need to know who’s in charge.
Eldridge:Need to have FDA go to places where poultry is produced. Stockpile drugs. Be proactive, expand public health infrastructure. Provide for revenue.
Tsongas:Avian flu is coming — we don’t know when. Shared responsibility. Middlesex CC has aggressively considered what to do — that’s how we need to act.
#5: Tort reform?
Donoghue: Not too concerned. We have many deaths due to avoidable medical error. Depends on details, but it’s not the cause of our crisis.
Miceli: Doctors practice defensive medicine. I don’t want to shut anyone out. But sometimes folks aren’t getting the best care. Maybe we could have a schedule for holding docs harmless.
Eldridge: Under single-payer, docs will provide less defensive care. Fully re-imburse docs.
Tsongas: Create culture of safety — doesn’t single out doc but be guided on safety and appropriate care. But docs need to be held accountable.
Finegold: Need to stop frivolous lawsuits; need to control malpractice insurance rates. Need to keep OB/GYN’s here.
#6: What part of cost problem lies with doctors?
Miceli: A good part — defensive medicine. Docs inhibited from giving correct care.
Eldridge: Dont’ think it’s docs problem. Too many admin costs in system, reduce defensive medicine.
Tsongas: Docs instinct is to offer every service — but some aren’t effective. We need a best-practices institute.
Finegold: We need to fund health care better — docs are running around too much.
Donoghue: System needs re-alignment of incentives to provide good care.
#7: Abortion
Eldridge:I support Roe v. Wade — we need a Democratic president.
Tsongas: I support Roe v. Wade. EMILY’s list has recognized me as pro-choice woman.
Finegold: Appalled by SC decision.
Donoghue: Ditto.
Miceli: I am a pro-life candidate.
#8: Medical marijuana?
NT: Yes. Decriminalize small amounts, not legalize.
BF: Yes, with good distribution.
ED: No. Look to other drugs like Marinol.
JM: No. How do you control it?
JE: Yes. Gov’t should not limit how docs treat patients, just trying to ease pain. Fully support.
#9: Support Bush policy on stem cells?
BF: No. Fully fund.
ED: No.
JM: No. Need to explore with even more depth.
JE: No. Our president values stem cells more than a human being. I have a friend with cystic fibrosis — we could help cure this disease.
NT: No — signed letter to Pres to sign Stem Cell Research Act.
#10: Needle exchange programs?
ED: Not sure — look to MA plan for info on success or failure.
JM: No.
JE: Yes — science shows it reduces HIV, TB. Use science, not ignore like Bush admin.
NT: There’s been needle exchange in four communities — police support. Expand pilot programs to other places.
BF: Yes. Police and firefighters support.
#11: Drug reimportation from Canada?
JM: Yes.
JE: Yes.
NT: Yes, with standards.
BF: No — do it ourselves — cut prices in US.
ED: Yes — support Kennedy and Emanuel’s bill.
#12: HSA’s?
JE: No. GOP talking point.
NT: No.
BF: Not a substitute for health care coverage.
ED: No. You’re treating sickness, not wellness.
JM: Absolutely not. Came close to that in Bush I with Golden Rule. That would be an absolute disaster.
#13: Medicare and VA is effective and efficient. Private is not. Why is debate focused on the market?
NT: We have to contend with political realities — Truman filed legislation in 1945. We have emerging consensus based on MA plan. Cost is inextricably linked. Get everyone in the system, for prevention. We need Dem president to do just that.
BF: With Health Markets, you’ll have choice between public and private plans. I’m a business owner — trying to figure out plans takes a lot of time.
ED: VA and Medicare are good models, but political will isn’t there. There are cuts proposed for Medicare which would affect small hospitals. Need to get everyone covered quickly.
JM: Everything has to be available, on the table.
JE: We’re not going down there to accept political reality — we’re going down to provide leadership. Medicare is more efficient. MA plan is good, but doesn’t reduce costs, many are exempted, and premiums and co-pays are too high for working people.
Mitchell: We’re doing the best we can [laughing].
#14: Anybody *not* think gov’t should negotiate with drug co’s under Medicare Part D?
All: No.
#15: Medicare doesn’t recognize same-sex couples. What would you do to protect them?
BF: I would support any legislation to get them benefits.
ED: Strong supporter of marriage equality. Provide legislation as necessary.
JM: No.
JE: Yes, I support marriage equality in MA House. Still couples in MA who are married but don’t get benefits b/c of DOMA. Meehan has gone against that — I’ll take up the lead.
NT: Supporter of marriage equality, on federal level, also Don’t Ask Don’t Tell, all rights that straight couples receive.
#16: Mental health, esp. for vets?
ED: Promise that 1st act will be updated GI Bill of Ri
ghts. It’s a disgrace the way they’re being treated — jobs, benefits.
BF: Mental illness affects 26% of people — we need to destigmatize. Applaud Sen. Antonioni. Make sure insurance covers mental illness. Have to make sure vets get proper help.
NT: Need to take care of those w/ mental illness. Puts tremendous pressures on people. Vets: Great travesty of Bush administration — no planning for taking care of returning vets. PTSD, physical care — has to be there, lifetime commitment.
JE: Proud to be MA resident and legislator: We have mental health parity mandate. Federal level: Single-payer. Provide mental health services. Highest increases in prison population are mentally ill. Suicides. We need mental rehab for them.
JM: We need new GI Bill with full benefits. Walter Reed was disgrace. I’d go farther: Fought for Tewksbury hospital. Not happy with what’s done on nat’l level. Definitely pro-parity.
Closing statements:
JM: Longest serving – 16 terms. I’m good at constituent services — office hours, town meetings, people call me up. I’ve got the experience, I know what it’s all about. I’ve built a business with great health care benefits. I would do an outstanding job for you.
JE: There have been a lot of great proposals, but the only proposal that guarantees right to health care is National Health Insurance bill. For benefit of all of society. This isn’t about political reality, it’s about political leadership. It’s important to point out the differences: shouldn’t expand through marketplace. I don’t care if HMO’s have profits — that’s what’s damaged people. I’m only Clean Elections candidate ever elected to House — voted against Finneran.
NT: It’s time for a change in tone and direction: Health care is about people. We have an opportunity to put in system, first since Truman in 1945. Health care for every American. I believe in Massachusetts’ extraordinary health care system, from which I’ve benefited. Bring costs under control, but must first provide coverage to all. Stem cell research. Address nursing shortage.
BF: Would have district office in Hudson, as well as Lowell, Lawrence and Haverhill. Believe HC is a right, health markets will help us get there. Prevent cos from refusing coverage for pre-existing conditions. Ban drug advertising. I don’t want gov’t to make decisions between docs and patients — nor an HMO.
ED: Single-payer in ideal world would be way to go. I would fight for that in Washington. But leadership is getting results. Since 1993, what has happened? 10 million more uninsured. Doubled cost per family. Can’t wait another 15 years. In the meantime we get access to coverage as quickly as possible. Cover all kids under SCHIP; cover working poor under Medicare. Make employer coverage mandatory. 75% of health care $ are for diabetes, heart and obesity. Have to provide universal access. Needs massive reform to prevent massive gaming. Not defeatist, not shirking leadership — shows leadership. I have struggled with budgets — frustrating to see health care eating budgets. Have to work on all fronts.
sco says
SUV flipped over on the Pike and I was stuck for nearly an hour. 🙁
sco says
Here’s my liveblog.
annem says
Great public service by convenors of the forum, by BMG for the pre-posts and calls for questions, and gratis to Charley for posting from the forum for those who couldn’t be there. (sco, hope no one was hurt badly in the pike accident)
<
p>
Jamie Eldridge, you are my hero!!!! Right up there with Eleanor Roosevelt and a few select others.
<
p>
Please check out Jamie’s campaign site for more details on his helathcare and other policy positions, and please consider giving him a donation. I did and I’m not even in his district.
<
p>
We need leaders like Jamie Eldridge in every level of public office, including the U.S. Congress.
will-w says
Charlie:
<
p>
Here’s a Tsongas supporter that agrees with an Eldridge supporter (well to a point, Jamie is not quite Eleanor Roosevelt), but your service at BMG on this debate is exemplary. I think the moderator mentioned that the blogs are the newspapers of days past. Presenting running summaries of the statements from the event on an informational basis is a great service on an important issue.
<
p>
I have two older children who are out of the house and out of state. They are without coverage due to the fact that their employers have found a way around providing health care. I worry about them daily.
<
p>
At the debate, I was struck by the two most substantive candidates, Tsongas and Eldridge, both clearly committed to public service, but having taken different paths on healthcare. Also, both with great range on a complex issue. Sometimes I wonder if Jamie should be running as a Democrat or as a Bernie Sanders type Independent, but you have to respect his backbone and fervor.
<
p>
Presenting issues as businesses are bad and government is good is a little simplistic. Yes, government has a responsibility. So do businesses, communities and private citizens. I remain concerned about the horrific examples of the government’s failures in situations like Hurricane Katrina. The serving on boards seems a bit of a red herring. Why doesn’t Jamie criticize Eileen Donoghue for serving on the board of Saint’s Medical Center. I’d say the hospital’s positions are hardly consistent with progressive Democrats on choice and family planning.
<
p>
Note to campaign observers. Its about values, trust and the ability to work effectively with others.
<
p>
Anyway, kudos to BMG. Keep up the good work.
<
p>
Will W
michael-forbes-wilcox says
You say,
without really explaining what you mean.
<
p>
From what I can tell, Jamie is the only true Democrat in the field. Please refer to the platform of the Massachusetts Democratic Party, in which there is an unequivocal call for universal single payer healthcare.
<
p>
Here’s the start of the section on Health Care:
<
p>
david-eisenthal says
my two cents worth. I would only add that I was very happy as a part of the “BlogLeft” group to be involved in sponsoring this event.
tgmhealth says
Why are people defending Chapter 58?
<
p>
The politicians decided to provide insurance companies with more customers under the guise of helping the sick.
<
p>
The law forces people to buy plans that cost $1,200 to $14,000 (see earlier article about couple with illness). Now, if they stay healthy, they do not have to pay more dollars. If they get sick, they pay the first $2,000. And, if they get really sick, they only get $50,000 of health coverage. In today?s market, $50,000 will go awfully fast.
<
p>
The next time the politicians want to get together on health care, maybe they will propose a law that will actually help the sick.
<
p>
James Eldridge is the only one who makes sense about the issue.
margot says
it’s a hospital bail-out program. What sick person is going to benefit if they have a $5,000 deductible? And it greatly increses the power of the insurance companies. I agree with Eldridge, also. But another factor no one seems to be talking about is the need to control costs generated by big institutional providers sucking at the trough of whatever procedures are generously paid for at any given moment.
ryepower12 says
I was there too and broke it up into three parts. I’m going to write a general summary, with my thoughts to follow. I’m just about ready to make an endorsement, which will probably come on this Tuesday’s LeftAhead Podcast with Mike and Lynne.
<
p>
Anyway, here’s part one, part two, and the closing statements. Spelling and typos mistakes abound as it was live, but I am going through it to eliminate those right now.
<
p>
Also, I took some pictures and will add them in later, as well as a general review that’s much more accessible than the live blogging. We learned a lot about the candidates today and it’s important that everyone know about them.
centralmaguy says
I was also at the health care forum this morning in Hudson and was impressed by Rep. Jamie Eldridge’s performance during the event. He clearly dominates on the health care issue.
<
p>
Eldridge stayed on his message that the US needs a universal single payer system in order to cover all Americans, provide quality service, and drive down administrative costs.
<
p>
Donoghue seemed to try to be all things to all people by saying she supported single payer but wanted to do something now to provide universal access to health care. Light on details.
<
p>
Tsongas and Feingold were basically undistinguishable in their positions on health care. Both are center-right on the issue of universal coverage, preferring to require coverage but leaving service provision and cost control to market forces. DLC types. Tsongas was heavy on rhetoric and light on substance.
<
p>
Jamie Eldridge won this forum. The applause was loudest and strongest for him overall. He was substantive. Most importantly, Jamie criticized Tsongas for her positions on health care (considering she serves on the Fallon HMO Board of Directors) for being too market-driven and not focused enough on people. He did so in a way that made comparisons but was not negative.
<
p>
It’s clear now that Jamie Eldridge is the only real alternative to Tsongas in this race. The other candidates are too similar in their positions to Tsongas.
will-w says
Hey CentralMAguy,
<
p>
Here’s your quote:
<
p>
“Tsongas and Feingold (sic) were basically undistinguishable in their positions on health care. Both are center-right on the issue of universal coverage…”
<
p>
OK, Tsongas supports Edwards. Finegold supports eliminating pharma ads.
<
p>
Not quite center-right but then I guess you’ve never been to Kansas.
<
p>
All this makes Eldridge what, a moderate? Take that running dogs of capitalism.
<
p>
Will
<
p>
centralmaguy says
Tsongas sits on the board of the center-right Concord Coalition, which, as you probably know, advocates fiscal responsibility through market means and smaller government. Feingold is a founding member of the Massachusetts branch of the DLC, another organization which believes that government policy should be implemented through the private sector when at all possible. Both of these candidates seem to be allergic to the thought of government-provided and administered services, such as health care, despite the failures of the market to provide public services adequately and cost-effectively, and despite evidence that the federal government is efficient and effective in providing public services (e.g. Social Security benefits, Medicare coverage, VA benefits and medical coverage).
<
p>
Eldridge is a progressive. He has made the point that US policy on issues like health care have been dominated by market-oriented “solutions” for decades and without real results. As a result, he’s pushing for government-funded universal single payer health care.
<
p>
I really don’t know what your comment about Kansas has to do with anything, and I’ve been all over.
paintitblue says
If progressive means being in tune with Democratic primary voters, Niki and Barry don’t qualify. Clinton pollster Stanley Greenberg did a poll last month that showed 70% of likely Democratic primary voters support single-payer.
fairdeal says
why only about 15% of democratic politicians (or aspiring politicians) openly support single payer.
<
p>
is there any other issue that so separates the office holders/seekers with the will of the voters?