Spring 2009

Message from the Chair

(If you're reading this, it means that APHA staff accepted my submission after the June 8 deadline.  THANK YOU, APHA!!!)

Dear All,

Last night we returned home to Florida from our previous home in West Virginia.  This morning I'm trying to get to Los Angeles,  the home I left decades ago, for a high school reunion.  [A story for another time -  the reunion of friends-of-long-duration who have not been together in decades.  An opportunity to rekindle relationships.  An opportunity to mourn the passing of others.]

As I write this, I am stuck in Charlotte, N.C. This seemed as good a time as any, and perhaps better than most, to write the Chair's Letter. This morning, I have absolutely zero control over when we take off or how soon I arrive in L.A.  But I do have control over how I use this time, stewing about it or getting something done.  Thus, it seems appropriate that the theme for this quarterly letter is patience or, perhaps "Lord grant me the serenity to ... and recognize the difference."

This same message of patience and/or serenity and constructive action applies to health reform.  The Obama administration says it wants: a health reform plan by October, a plan that includes a private and government option and which has bipartisan support.  The way things have been going since President Obama took office, the likelihood of the last consideration is in serious doubt, particularly given the time.   

Just as the Administration hopes for a bipartisan plan from Congress, it has also tried to form a health reform coalition that includes the insurance industry, the hospitals and the doctors. These stakeholders stood behind the president as he reported their agreement to help decrease the costs of health care.  Within days and even hours, many of those on the dais were backtracking, denying they had made concessions. In a similar vein, the New York Times recently (June 3, 2009) had an article on how the major insurance carriers are unwilling to extend the same largesse to the small business market they've said they will give to the individual market. No surprise – there’s more money to be had in small businesses. So if everyone is included in a health reform plan, then why is there concern about specific markets? I know many of you understand the insurance market far better than I (that's a given), and some of you may have a less jaundiced eye when it comes to their activities, so if I've got things terribly wrong, please let me know. We'll get some kind of chat going to capture the dialogue.

Each of us must become more informed about what is being discussed and who is involved in the discussions. This is not 1993 -- this is 2009. A new chance, a new opportunity to finally achieve universal coverage, even if it is not accomplished in a way many of us would prefer. What is clear is we must not waste this opportunity. In this case, patience does not mean waiting to see what happens. We must actively engage. 

Medical Care is an activist section, even though I don't know that all of our members are activists. Now is the time. If you haven't yet met your member of Congress, do so now, whether or not that individual is from the same party or shares the same views. Each of us is a health professional, although not necessarily a clinician. Many of us are educators. Good advocacy involves educating. It is easy to preach to the choir; it is much more difficult to reach those who disregard what we have to say because of our position on the political continuum. There are, however, areas on which there may be agreement, areas that allow us all to get under the tent and receive a hearing.

People are losing their jobs and, as a result, many are losing their health insurance. Businesses small and large are going bankrupt or closing their doors in anticipation of financial failure. It is not just the employees who are losing benefits – it is also the managers, the CEOs, and all their dependents. This may be the worst of times for the economy, but it may also be the best of times for change. 

Back to the reunion… Our gathering is history. We've made a pact not to attend another. Rather we're starting a new tradition for which we're looking for a name. [Suggestions are welcome.]  This year the "other" activities were dubbed the anti-reunion.  Twenty or so of us came together at a friend's home and caught up after 30 years. Now that meeting was actually fun. I met people whose names I knew from high school but had never really known. A bittersweet event... 

Okay, enough of the context. As we chatted, health care came up -- no surprise, we're older, some of us have developed chronic illnesses, some of us have lost loved ones, all of us are conscious of the costs associated with access to and use of health care and how close each medical catastrophe places as at the brink of insolvency. My friend "of longest duration" is a strong and ardent proponent for single payer reform. She is NOT a health professional, but she is a very intelligent, very engaged, very informed "stay-at-home mom." She was outraged that single payer advocates were excluded from the Baucus discussions, even to the extent of being escorted out of meetings. She made phone calls, wrote letters. Another friend, a physician, was resigned to far lesser health reform but somewhat optimistic that we would achieve something. 

I don’t know what goes into creating an activist. From where does active passion come? How can we elicit that spark, engage that inclination to act?  In the film Network, a newsman basically lost it on prime time television and announced "I'm mad as hell and I'm not  going to take it anymore!" This is our battle cry for America.

Were it only that simple. As informed citizens, most of us read newspapers, watch the news on television, listen to radio news (progressive news, hopefully).  As a result, we're inured to death, mayhem and destruction until it hits us personally -- a loved one is stricken with pancreatic cancer, or rheumatoid arthritis, or emphysema and there is nothing we can do to save their life, relieve their pain, or give them a breath to take. Health reform won't to any of those things, but it at least it will give them a chance at receiving necessary and appropriate health care without the worries of financial devastation.

Now is a time of opportunity. We may not find a perfect solution, but we will have zero chance at achieving that unless we can move our families, friends, neighbors, and colleagues to understand that national health reform is bigger than a single individual, that health must be a “right" for all and not a privilege for some, and to recognize that whether we are a democracy or a republic, our government acts on our behalf. Finally, we must all take action and let our elected officials know that America must join the majority of the world's powers and make health available, accessible, affordable, and acceptable for all.

Paz y salud!

Gail

Gail Bellamy