Saturday, June 02, 2007

Liveblogging the Health Care Forum Q&A

I got to today's Health Care Forum for the fifth district congressional candidates a little late. The Pike was shut down for about a half hour, just before the 495 exit, after a deadly SUV rollover. I missed the opening statements, but I was able to transcribe some of the responses to the short question-and-answer period. Other bloggers were there liveblogging, and you can read Charley on the MTA's post at BMG and you can read Ryan's Take at his blog.

My notes from the Q&A session are in the full post. They're a little raw, so forgive any mispellings or bad grammar.

1st question about the prescription drug problem: Fast tracking of new drugs by FDA worth it?

Niki Tsongas: Until the FDA gets its house in order, fast-tracking won't work.

Barry Finegold: Need to streamline FDA, but not at the risk of putting untested drugs on the market.

Eileen Donoghue: If we look at Vioxx, the safety concerns and the harm done by fast-tracking gives me pause. Didn't work, I don't support it.

Jim Micelli: People should still have the availability of experimental drugs, if there's nothing left.

Jamie Eldridge: Concerned about Vioxx and a couple other drugs. We need a Federal Govt that is supporting prescription drugs. FDA is biased toward Pharma.

Is the Federal Govt doing enough to plan for avian flu?

BF: No. Not enough on the state govt level, either. Could kill up to 2 million people. We need to educate people, as well, we're not doing enough.

ED: No. Fed Govt hasn't done enough to stockpile. Not enough room in hospitals, etc. There are other natural disasters that we need to stockpile for.

JM: Look at Katrina, no transparancy of responsibility. Same problem when it comes to preparing for disaster.

JE: Need to stockpile more antiviral. USDA should hire more people to inspect poultry facilities. We need to be proactive to prevent deaths before flu comes to US. MA used to have best public health infrastructure in the US, not so much any more.

NT: It's unfortunate. Past commissioner of public health says they know it's going to come. They need to coordinate with public safety and public health.

Q: Tort reform?

ED: Doesn't attribute rising costs to med. malpractice. There are 100,000 deaths due to avoidable medical error. Doesn't want to shut out families harmed by medical error.

JM: Doctors are practicing defensive medicine. People should be entitled to any justifiable reimbursement, but there are times when people aren't getting the best from their doctor for obvious reasons. We might have a schedule that holds the doctor harmless.

JE: Tort reform is stripping the citizen's legal rights to redress injuries. To reduce medical malpractice premiums, we need universal single payer health care.

NT: In favor in the context of a "team approach" to medical care, that doesn't single out the doctor. Until then, it's not appropriate.

BF: We need to stop frivolous lawsuits. Trying to keep OB/GYN in MA is tough. Why are these rates going up? Related to the stock market.

Why are costs high?

JM: A good part of the cost is due to the way physicians are practicing "defensive medicine". The doctors are inhibited by "what lies around the corner." A good part of the cost is due to the practice of the physician.

JE: Single payer will solve all cost problems.

NT: Look to best-practices institute. Our instinct is to have every test taken, and the doctor's instinct is to offer it. We should analyze what's appropriate.

BF: We had our second child in a blizzard, and doctors and nurses risked their lives for us. We need to fund health care better.

ED: Don't blame the doctors. We need to reform the system. if a patient is in the hospital, the hospital has to eat the days that aren't covered by medicare.

What restrictions on abortion?

JE: Fully support Roe v. Wade. Concerned about anti-choice Supreme Court. We need a Democratic president.

NT: Same. We need to be ever vigilant. Has been endorsed by EMILY's List.

BF: Appalled by Supreme Court's decision. Not the government's place.

ED: "Ditto"

JM: I'm a pro-life candidate. I voted for stem cell research, supports exceptions for the life of the mother.

Do you support medical marijuana?

NT: Yes, and decriminalization for minor amounts.

BF: Yes, depending on distribution system, compared to sudafed and oxycontin.

ED: No. Still issues concerning quality control. There are other drugs.

JM: No. Don't know how you could control it.

JE: Yes. Govt should not be involved in restrictions on how doctors can treat patients.

Do you support needle exchange programs?

ED: Coming from Lowell, I am concerned. I'd explore it.

JM: No.

JE: Yes, I was proud to support over-the-counter hypodermic needles. The science says it reduces diseases like HIV and TB.

NT: There's been one in four different communities for the past ten years and it's been effective. Police think it's good, let's expand the pilot programs.

BF: Yes, it's also a safety issue with first responders and those who deal with drug addicts.

Do you support the importation of drugs from Canada?

JM: Yes.

JE: Yes. Constituents tell him about how they take buses up to Canada.

NT: Yes, as long as they meet safety requirements.

BF: No. We need to make sure our drugs are the same prices as they are in Canada in the first place. No more drug advertising.

ED: Yes. Supports the specific bill before Congress.

Do you support health spending accounts?

JE: This is a GOP tactic that says "you're on your own". We need to support national health care.

NT: No, supports the Edwards-type plan that provides access to affordable health care.

BF: Don't think it can be used as a substitute for health care coverage.

ED: No, you're treating sickness not wellness. How do you know when you're going to get sick and how much it's going to cost?

JM: Absolutely not. It would be an absolute disaster.

Govt administered health care like the VA has been very efficient. Why is the debate around the country focused on the market?

NT: We have to contend with the political realities of the health care issue. We finally have a national consensus based on the Massachusetts "success". We need to address the cost of care, which is tied to the cost of insurance. Can we really move forward? We have an opportunity if we elect a Democratic President.

BF: Through health markets, we'll have a choice between a Medicare system and a market system. The most efficient one will win out. The admin costs in his own business he feels should come down.

ED: No doubt that medicare and VA are efficient, and models toward single payer. If the will were there, she would support single payer. In the meantime, let's solve issues with Medicare.

JM: everything has to be on the table. You can't look at them and say the efficiencies mean that this is the way to go.

JE: We're not going down there to accept political reality. We're going there to show political leadership. Medicare is single payer. Massachusetts health care law does little to reduce costs. Already, people are being exempted because costs are too high. Premiums and copays are also too high.

Medicare says same-sex couples are strangers. Can we change that?

BF: Strong supporter of gay rights.

ED: Strong supporter of marriage equality. Goes beyond marriage to death benefits, medical benefits, etc.

JM: No.

JE: Yes, I have been a leader on gay rights. There are still couples in MA who are not allowed to receive benefits because they are Federal employees, thanks to DOMA.

NT: Once someone embraces marriage equality, you have to embrace all the rights and privledges that go with it.

Do you believe mental health should be treated equally to physical health? What about homeless mentally ill and returning soldiers?

ED: We have a crisis in mental health coverage -- need more beds, etc. it's contributing to homelessness. First act would be to file a GI bill of rights. It's a disgrace that returning soldiers are treated poorly when they return home.

BF: Mental illness affects 26.6% of the American adults. We need to de-stigmatize this. We need to make sure that insurance covers all mental illnesses.

NT: Endorse the need to take care of people with mental illnesses. It creates pressures on people. It's more apparent to us. Bush admin has no plan in taking care of returning veterans. It may be a lifetime commitment.

JE: MA has the mental health parity law, requiring mental health care. On the federal level, but the way to get there is universal single-payer health care. High populations of mentally ill in prisons, costs us a lot.

JM: What faces the veterans as they are returning, particularly Walter Reed, is a disgrace. Been an advocate for the Tewskbury hospital in his district. Not happy with what's been done on a national level.

Here are my notes on the candidates' closing statements:

JM: 16th term in the legislature. Served in many committees, and now a chairman and the highest-ranking legislator running. He's worked very hard for his district. He has town meetings and office hours and been an effective legislator. He can "hit the ground running". He also built a business -- everyone had great health care and profit sharing. Feels that he can do an outstanding job.

JE: Forums allow us to focus on specific issues. At the end of the day, the only proposal that would guarantee health coverage is to move to universal single-payer. It's going to be for the benefit for all of society. Who is going to fight the hardest to make that happen? He is. One candidate wants a market-based system -- that's the problem to begin with. One candidate is concerned about HMO profits -- he doesn't care about profits.

NT: She believes its a time for a change in tone and a change in policy. Health care is about everybody. We have an opportunity to provide coverage for people right now -- not sometime in the future. She believes in shared responsibility. We need to protect community hospitals and health centers. We can't get there until we provide broad-based coverage. Believes in stem-cell research and that we should address the growing nursing shortage.

BF: Starting to see familiar faces at all these debates. Would also have a district office in Hudson -- important that every single city and town is represented. He's voted to make health care a right. Health markets can insure that access to everyone. We need legislation that prohibits discrimination. Benefited from great health care. Major problem with drug advertising, we should ban it and make sure that money goes to R&D. Govt and HMOs should not make decisions between doctors and patients.

ED: Single-payer health care in the real world is the way to go. I would fight for it. Leadership is more than standing for principle, it's about results. Since 1993, we've added 10 million to the rolls of the uninsured and doubled costs to families. We can't wait 15 years. In the meantime, let's get access to universal coverage to as many people as we can while we strive for the single-payer system. Expand Medicare and make coverage mandatory on employers and employees -- can't let employers off the hook. We're spending 75% of health care dollars to treat diabetes, heart disease and obesity -- all treatable, all preventable. We don't have another 15 years to waste while we wait for a "perfect solution".