Townhall Meeting on Women’s Health Care
August 30, 2009
Great Hall, Bryn Mawr
Lynn Yeakel, moderator
LY: Introduction and welcome. Met Joe Sestak in early 2006. He has amazing credentials. He was second in his class at the Naval Academy, earned a Ph.D., and served in the Navy for 31 years. In the Clinton administration he worked in the National Security Agency as the Director of Defense Policy.
To get things started she asked Sestak, to give three examples of how current pending health care legislation impacts women’s health issues.
JS: 1) mandate that maternity services be covered. There are more women in individual health care plans than employer-based health care plans; individual plans can currently deny coverage for maternity services.
2) spread risk in the individual health care market; creates health care exchange
3) covers preventive screenings at $0 co-pay, annual mammograms at 40, biannual at 30.
Later he added two more:
4) no discrimination based on gender, currently individual plans may do this.
5) can no longer charge women more for health insurance than men are charged
LY: What may fall by the wayside in a consensus plan?
JS: 1) The public health care option. Approximately 42% of the state’s population live in the Philadelphia area, and in that area 70% of the people are insured by one company. Through the state two companies insure 70% of the population.
2) How the pay for half of it; the president’s plan he reduces the mortgage deduction for the very wealthy to pay for part of the proposed health care reform.
Questions from the audience:
Q: What options would suggest for a cancer survivor who is self-employed?
JS: 1) Under the new plan companies would not be allowed to deny insurance for pre-existing conditions
2) Small businesses can go onto the health care exchange, the charge depends on what the company makes, can get 50% subsidy
3) If your income is less than 400% of the poverty level you would get a subsidy
The benefits level is based on the plan congressman have. You would never pay more than $5,000 a year per individual or $10K a year per family.
Q: What is the likelihood of the bill passing?
JS: If the senate majority leader, Sen. Reid, leads, there is a good change of the bill passing in November, but I am fearful of the public plan. It would start in 2013.
Q: What should we doing?
JS: Call, write, push. If necessary the bill can pass through reconciliation with 51 votes. Politicians should not worry about their jobs but what is good for Pennsylvania
Q: What is the bracelet you are wearing?
JS: My daughter made it.
Q: Why aren’t there numbers to show that preventive care is cost effective?
JS: Studies disagree. How do you measure the cost of a longer life with end of life care for someone who had treatment for breast care at a younger age with the cost of that treatment? One study showed that the uninsured cost us $100 billion in lost productivity. A Rand study says $260 billion in lost productivity due to the uninsured.
Q: c-section rate higher for insured women with access to prenatal care than among those who might medically need it more because of limited access to prenatal care; infant mortality rate
JS: 2 out of 5 African Americans [blogger’s note – this might be just women] are without health insurance for 6 months of the year. Our current health care system is good but accessibility is an issue.
Q: Will we maintain the same level of coverage for abortion?
JS: This legislation only reinforces legislation in place; no federal money can be sued for abortion.
Q: student health insurance, cancer survivor almost out of college and will soon be ineligible on parent’s insurance, won’t be able to get insurance on own
JS: Under the proposed legislation you wouldn’t be denied coverage for a pre-existing condition. Under our current system my daughter will be in your situation when she graduates from college.
Q: Are you in favor of allowing states to have their own single payer system?
JS: I voted against it. Dennis Kucinich presented it in committee, there was a line in it that would prevent people from using private insurance for something not covered under the single payer plan. Could not support that so voted against it.
Q: In favor of single payer?
JS: 1) We subsidize other countries single payer plan; they buy American drugs at 30% the cost we pay and we can’t buy it back from them at the lower cost.
2) Medicare is not a single payer system; our bill keeps it alive until 2022 (currently bankrupt in 2017)
3) In the long term if you are able to get rid of the worst aspects of market, like monopolies, but keep innovative aspects, develop new drugs, etc., our system will be even better.
Q: please clarify death panels
JS: The provision in the bill will reimburse doctors who voluntarily sit down with clients who sit down voluntarily and talk about who will make decisions if the patient is incapacitated, especially if the patient does not have any family. The VA has had a similar pamphlet since the mid-1990’s; it was there in the Bush administration.
Q: There is a huge difference in the information presented on Fox and MSNBC.
JS: I’m on Fox 4 or 5 times a week. Likes going on Fox because both sides should be heard. There are philosophical differences of opinion. I blame the Democrats for not coming out of the gate to the recess to present the bill better.
Q: terrible practices like recision
JS: This is where insurance companies will deny you coverage for things like making a clerical error on an application ten years ago. Under the new plan recision would be outlawed.
Q: have primary care providers been reading the bill and giving feedback and advice?
JS: There are a number of doctors in congress and the AMA and other organizations have been invited to go over it. The bill also enhances tuition reimbursement for primary care physicians. It changes reimbursement to doctors from the quantity of service provided to the quality of service provided, to emphasize preventive care; that will best benefit primary care.
Q: Does the $5K cap on out of pocket outlay include premiums?
JS: I don’t think so but will have someone get back to you on this for certain.
Q: What is the affect of this legislation on community health care centers?
JS: Theoretically the need for them will go away, like SCHIP. Also, we can make them part of the network.
Q: Will this affect pharmacists who refuse to fill contraceptive prescriptions because of their religious beliefs?
JS: The bill will not change that.
LY: Joe Sestak was picked as the most productive member of congress and has demonstrated his support for women and families.
Personal observations: Lynn Yeakel, who ran for the Senate against Arlen Specter in 1992, is very impressive, low key but powerful. She did a great job handling questions that were often more statements than actual questions.
There were about 65 or 70 people in attendance, which was pretty good for something not well advertised and difficult to find. The address given did not match the street address in my and other people’s gps, and there were no signs to indicate where it was. Bryn Mawr’s building signs did not make note of it and there were no Sestak signs around. As I was walking around trying to find it three people drove by and asked if I knew were the Great Hall was. Eventually a small group formed and we asked some students unpacking their cars. They gave us directions. There were no indications anywhere that the event was happening. I would imagine a number of people tried to find it and gave up. The people at the door were more interesting in getting contact info for those attending than in handing out campaign material. I had to watch to see where the handouts were and go back for one.
Sestak came into the room without a lot of farfare. He was on time and took a few minutes at the start to talk with Yeakel whom he said he called frequently for advice. He alluded to Arlen Specter twice but never mention his by name. After the formal even was over Sestak stayed and talked with people until all their questions were answered and then talked further with Yeakel.
There were three cameras taping the event, two in the back of the room and one young man with a hand-held videorecorder who stood near the front, off to the side. At one point Sestak asked him to go to the back of the room because he might interfere with the other cameras. It turned out that young man was actually working for Sestak and so was invited back to the front.
Overall it was an interesting event.
Sunday, August 30, 2009