The Congressman Castle Kent County Listening Session
Jun 29th, 2009 by Timothy Pancoast
Today I attended Rep. Mike Castle’s health care listening session in Kent County. This is a compilation of some of my notes from that meeting. It was hosted at Del Tech Terry Campus in a mid-sized room which was overflowing. Approximately 160 people attended, and many had to stand. Representative Castle brought with him a panel of several experts on different aspects of the health care debate. A representative from the Central Delaware Chamber of Commerce (CDCC), a private practice doctor, the president of Bayhealth in Dover, a member of Delaware Hospice, someone from the nursing department at Del Tech, and others. One notable absence is that no one from the insurance industry was present. I am not sure why. First Rep. Castle and the panelist presented their ideas then the floor was opened up for public comments.
I will give Representative Castle credit for setting up these meetings. As he found out today, they have become a lot harder after his vote for Cap and Trade. Rep. Castle is currently playing it safe. He doesn’t endorse any of the current bills, and he took very few solid positions on anything. Several members of the panel were more decided in what they wanted. The CDCC representative spoke about cost and availability of health coverage being the main concerns. She advocated limiting doctor liability, and making Health Savings Accounts (HSAs) and catastrophic insurance more available for patients. Others members of the panel favored the idea of coverage for all paid for by all, aside from the poor, of course. One panelist advocated turning all insurance companies into nonprofits. The hospice representative of course recommended more use of hospice services as they cut the cost per patient by about $2,300. A couple of them mentioned shortages in actual health care professionals such as nurses and doctors. All in all it was a broad mixture of ideas.
When the floor was opened to the public, the public didn’t hold any punches. People were upset by what has happened and has been proposed in some of the bills in Washington. Here are some of the topics discussed.
- The gap in Medicare part D.
- People wanting to keep their choices
- Favoring HSAs coupled with catastrophic coverage
- Concerns of rationing and even euthanasia
- Senators and Representatives voting on bills they haven’t read
- Illegal immigrants being covered
- Tort Reform
- Funding problems
- Preventative care
- The Community Choice Act, allowing nursing home care at a patient’s home
- Medicare buy-in
- A uniform insurance form
- Streamlining the permissions process
- That we need to unify in order to change things
- Medicare, Medicaid, and Social Security going broke
- The lack of incentives for wise expenditures in health care
- The re-accreditation process for doctors
- Petitions, one against government run health care and another expressing no confidence in Rep. Castle.
Several members of the community were very passionate when they spoke, and there was often applause and agreement from the rest of those in attendance. No one in the audience really spoke in favor of the Kennedy plan or any other plan for government run health care, other than requests to have existing programs revamped. Representative Castle was a gracious host, and he put up with a lot. However, I am not going to hold my breath waiting to see what results if any will come of his listening tour.
My opinion is that whatever happens in Washington I would like to see it done in bite sized pieces. Legislation on tort reform shouldn’t also cover preventative care and health savings accounts. Each issue should be considered separately, and voted on separately. If we can get legislation passed now to create a universal insurance form for doctor’s offices and hospitals, then we should. The benefit and savings from streamlining that process should not have to wait for tort reform. Nor should a solution to the gap in Medicare part D be lost in a discussion of private versus public health care. The other benefit to considering these issues separately is that we might actually be able to keep these bills under 1,000 pages. Then the Senators and Representatives will be better able to read what they are voting on and so will the public.
Your solution may actually accomplish something. The problem is that it takes away the power to bargain and hide provisions. We wouldn’t want to take away the power of the chairmen would we?
It may happen, but not if Washington can help it. They know better than we do and don’t want us interfering like it is our government or something.
We should never elect people who vote on 1,000 page packages without reading them. Then again, the elected officials are not the ones who have to pay the bills.
Castle needs a primary.
Great post. Very informative.
I was with a coalition from DE that lobbied Carper last week. One small business woman (she had to sell her business making customized splints for people with hand injuries) to the Delaware Curative Workshop. That business then got sold fairly quickly….faster than the Medicaid / Medicare system could reimburse her for work she had done. The government refused to reimburse her because of the transfer of the businesses and even though she had submitted the paperwork in a timely manner, she is out a lot of money.
She said that the forms are already fairly uniform but the way they are filled out varies.
drat, incomplete sentence in there.
Thanks for that information. I am still getting up to speed on all of this and I only have experience with my family doctor so I really wasn’t sure what aspect of insurance forms they wanted to bring into uniformity having only experienced one. I know a lot of them also want the forms and medical records and any other documentation made electronic. There are a lot of things that can be done to make the administration and record keeping associated with health care more efficient and less costly. They should all be identified and worked on. First, by the private sector and then only if needed by the government.
In the recent past I have found Rep. Castle VERY responsive in healthcare issues he needed to vote on in regards to childrens’ Medicaid. He truly was apprised of cost analysis, and some nitty gritty he was not aware of, and came thru showing support when realizing some of the idiosyncracies involved in continuing coverage. I am not surprised at all about his outreach, and have seen his responsiveness to reasonable request. Wish I knew about this meeting..shucks.
He has another scheduled for tomorrow in Sussex County at the Georgetown CHEER Community Center. It will be from 10 till 11:30 am. Due to the response to these meetings I would not be supprised if they decide to set up more.
There are many things to like about Congressmen Castle so it is all the more disapointing when he lets us down on key issues like the Waxman/Markey bill. If he gets an opportunity to undo the damage created by that choice I hope he takes it.
The use of automation to lower the cost of health care should not be seen as a magic panacea. Nor should it be seen as something that can be implemented only through the expenditure of billions in the form of pork and boondoggles.
A complete medical record for an individual could be stored in an inexpensive ‘thumb drive’ and involve a cost of a few dollars per person. Data storage is very cheap and getting cheaper.
There have been some great advances in clinical laboratory automation and some of these date back to the 1970s. I spent a few years at a pioneering firm and the technology allowed a hospital to reduce per-patient cost and reduce the chance of mistakes. A lot of firms made automated instruments and my employer linked the equipment together in a local network for a hospital. Some of our development was supported by insurers as well as private hospitals. Our Bethesda, Maryland facility did a lot of work for NIH in automating urinalysis and hematology. We were even tasked by the PHS to write a book on the topic. An effort was proposed to improve the automated evaluation of electrocardiograms. The existing program needed a mainframe computer of the day and had some internal flaws that we would eliminate. Our approach would have used smaller and cheaper minicomputers in the era before personal computers became ubiquitous.
RE: Cap & Trade
ask Mike if he knows that he voted for a federal tax on cow farts.
ask Mike if he knows that he voted require every homeowner to pay for an Energy Audit as a condition of selling their home.
Cows are evil planet wreckers.
good thing we wiped out the buffalo
Mike Castle needs a stint in the private sector and it should start at the end of 2010.
It might be a novel experience for him.
Private sector would also be novel for: Tom Carper, Joe Biden, and, BHObama. With their own healthcare and retirement system, how can they possibly relate to the constituency? Not that they want to.
Our nation’s greatness was assured by the concept of the citizen-legislator. George Washington was in the private sector for most of his life. He did serve in the House of Burgesses and in the militia in the French and Indian War. But he was no careerist.
Had he been agreeable, he could have been a king.
There have been people who have truly served the public over many years. John Quincy Adams comes to mind. But look at Obama and Biden. They have been hacks most of their adult lives. Politics is the only game they know.
But there are a lot of bright people in the public sector who know politics rather well and also know what is wrong with the system. Steve Forbes comes to mind.