Laura Hershey: Writer, Poet, Activist, Consultant Rotating Header Image

health care reform

Five personal reasons why I want our lawmakers to vote FOR the health care reform bill, imperfect though it is…

Five personal reasons why I want our lawmakers to vote FOR the health care reform bill, imperfect though it is:

1. I hope that some of my disabled sisters and brothers currently in nursing facilities will be able to leave the institutions, and receive the support they need under the bill’s plan to improve Medicaid. Among other provisions, states would be offered a 6% increase in the federal Medicaid match, to encourage them to provide community-based personal attendant services.

2. I hope that some future people with disabilities — which could include any of our aging parents, our returning veterans, or anyone else among us — will be able to get the assistance they need in their own homes, without impoverishing themselves to qualify for Medicaid, through the bill’s long term care insurance services program.

3. I hope that some of my attendants who are currently unable to afford health insurance, or unable to obtain it due to pre-existing conditions, will finally have access to health care. They work incredibly hard supporting my and other people’s health, independence, and quality of life, yet this important job does not provide them with employer-sponsored health insurance. I sincerely hope there will soon be affordable, meaningful, portable coverage available to them.

4. I believe, deeply, that health care is a human right. This bill takes an incremental step toward fulfilling that right, for some people. It’s not enough, but it may be a start.

5. I want to defeat these assholes.

Disability Rights Resolutions for the March 16 Democratic Caucuses

If you live in Colorado and you are registered as a Democrat, I hope you’ll help support disability rights becoming part of the Party platform. You can do this by introducing disability rights resolutions at your neighborhood caucus tomorrow night, March 16. I have drafted two resolutions — one about health care reform and community choice, the other about ratification of the Convention on the Rights of Persons with Disabilities.

The text of both of these resolutions is pasted below. Click on these two links to download printable, PDF copies of both —

A RESOLUTION TO INTEGRATE COMMUNITY CHOICE INTO HEALTH CARE REFORM (PDF)

A RESOLUTION TO URGE THE UNITED STATES SENATE TO RATIFY THE CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES (PDF)

——–

A RESOLUTION TO INTEGRATE COMMUNITY CHOICE INTO HEALTH CARE REFORM

WHEREAS Americans with disabilities and chronic health conditions rely heavily on public health programs, primarily Medicaid and Medicare, not only for primary health care but also for long-term care needs; and

WHEREAS Medicaid and Medicare contain a strong institutional bias, with funding policies favoring placement in nursing homes and other facilities, thus draining resources away from home and community based care; and

WHEREAS every state participating in the federal Medicaid program is required to provide nursing home services, but home and community based services are optional, and are thereby unavailable in many states; and

WHEREAS sixty-seven percent of Medicaid long-term care dollars pay for institutional services, while the remaining thirty-three percent must pay for all community based services; and

WHEREAS the vast majority of people disabled by age, injury, or illness would prefer to receive services in their own homes rather than in institutions, yet many are forced by current policies to enter facilities in order to get the assistance they need; and

WHEREAS the institutional bias not only deprives people of choice, home, and independence, but also costs taxpayers far more than would a comprehensive nationwide system of home and community based services; and

WHEREAS as the population ages and more people require long-term care, the current institutionally-biased health care system will become more expensive and unsustainable; and

WHEREAS the Community Choice Act (CCA), introduced in the U.S. House and the U.S. Senate, would allow individuals to choose home and community based services as an alternative to placement in a nursing facility; and

WHEREAS the CCA would provide states with financial assistance and incentives to reform their long-term care service systems to provide services in the most integrated setting;

THEREFORE, be it resolved that

THE COLORADO DEMOCRATIC PARTY supports the concept of community choice in long-term care programs; and that

THE COLORADO DEMOCRATIC PARTY pledges to ensure that health care reform legislation and policy proposals emphasize choice and independence rather than institutionalization.

——–

A RESOLUTION TO URGE THE UNITED STATES SENATE TO RATIFY THE CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITIES

WHEREAS at least ten percent of the world’s population, more than 650 million people, have physical or mental disabilities; and

WHEREAS throughout the world, many people with disabilities are denied their human rights and kept on the margins of society; and

WHEREAS the United Nations adopted the Convention on the Rights of Persons with Disabilities (“the Convention”) on December 13, 2006; and

WHEREAS the Convention establishes the legal obligations of governments to recognize and respect the rights of persons with disabilities; and

WHEREAS the purpose of the Convention is to promote, protect, and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity; and

WHEREAS the Convention sets forth general principles including individual autonomy, independence, nondiscrimination, full participation and inclusion in society, respect for difference and acceptance of persons with disabilities as part of human diversity, equality of opportunity, accessibility, equality between women and men, and respect for the evolving capacities of children with disabilities; and

WHEREAS the Convention is crucial for the social and economic development of societies worldwide, including in developing countries where eighty percent of people with disabilities live;

WHEREAS eighty-two nations have already ratified the Convention; and

WHEREAS at President Obama’s direction Susan Rice, U.S. Ambassador to the United Nations, signed the Convention on July 30, 2009; and

WHEREAS adoption of the Convention by the United States requires ratification by two-thirds of the U.S. Senate;

THEREFORE, be it resolved that

THE COLORADO DEMOCRATIC PARTY calls on all Democratic senators to actively support ratification of the Convention on the Rights of Persons with Disabilities; and that

THE COLORADO DEMOCRATIC PARTY urges the U.S. Senate to ratify the Convention on the Rights of Persons with Disabilities as soon as possible.

Putting My U.S. News & World Report Article in Perspective

I had an op-ed essay opposing futile care policies and health care rationing published in the August 2009 issue of U.S. News & World Report. The print magazine hit newsstands several weeks ago, and yesterday it was posted on the magazine’s website.

Shortly after I submitted my essay, I started hearing some Republicans criticizing President Obama’s health care proposals using some similar-sounding concepts. They warned that expanding coverage to more people would result in “rationing,” and specifically the denial of care to elderly and disabled people. Sarah Palin, who seems determined to move on from her unimpressive term as governor of Alaska to another disastrous quest for national office, is advancing such claims. She has suggested that her baby, who has Down syndrome, would be endangered by the President’s plan. Palin said the following:
“the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these ‘unproductive’ members of society could face the prospect of government bureaucrats determining whether they deserve health care.”

Click here to read Palin’s entire diatribe.

This is nonsense.

As the author of what I hoped was a thoughtful, fact-based argument, I want to clarify that my concerns about treatment refusal and related issues do NOT mean I am opposed to health care reform. I do not believe in the specter of “death panels” concocted by Palin and other right-wing obstructionists. Instead, I’m talking about what is already happening, largely as a result of our profit-driven insurance system: Physicians and administrators employed by corporate health plans feel the pressure to maximize company revenues by cutting costs. They inject their own fears into “compassionate” recommendations against treatment, but this occurs in the context of coverage plans where private money interests matter more than the public good.

The arguments put forward by Sarah Palin, and some others, basically amount to, “My family has good insurance, so why should I care what anyone else does or doesn’t have?” I find this outrageous. Around 16 percent of Americans do not have access to health care. A few of these are people who probably don’t really need it — yet — but many of the rest are families with kids, or adults with chronic conditions, for whom the lack of coverage is a real hardship.

I find it especially ironic that some of the politicians who claim to want to ensure that Grandma and Baby Trig receive all necessary health care are the very same politicians who have no problem denying care to 47 million uninsured Americans, including many people disabilities and chronic illnesses. They claim to fear “government-run health care,” implying that it would be inherently evil, or low-quality, or too expensive. In my view, an expansion of government-funded health care could be far more humane and cost-effective than the services currently offered by the major health conglomerates.

I have experience with government health care — not in England or Canada, but right here in Colorado. It’s called Medicaid, and while it’s far from perfect, for many years it has covered my medical and independent living support needs far better than any private insurance policy would have. And it does so at an administrative cost of about 3 percent — much lower than private insurance industry standards.

It’s true that I and other people with disabilities have encountered problems with Medicaid bureaucracy — unfair denials, bungled paperwork, inaccurate information, and so on. But oftentimes, problems can be resolved through individual advocacy or systems advocacy — something you definitely cannot say about the private insurance industry!

Still, we can expect the rumor-slinging to continue and, unfortunately, the fearmongers will continue to exploit people with disabilities in manufacturing their dire warnings. In a recent, rather hilarious example, a conservative US publication wrote that Stephen Hawking would be allowed to die, IF he were British. Of course it turns out that Hawking is both British and alive. Furthermore, he has some very good things to say about the National Health Service.

Click here to read a good article by someone who has read the entire health care reform bill, and analyzed it from the perspective of care for people with disabilities.

Now my perspective is that the current health care reform proposal is not entirely adequate, since it does not address the important issue of long-term care. ADAPT and other advocacy groups have been urging inclusion of the Community Choice Act in health reform. Without this, I think any changes will be far less successful. Click here to get more information about the Community Choice Act.