Portsmouth Herald: Obama visits Portsmouth for health care forum
By Rick Fabrizio
The capacity crowd awaited the arrival of Sen. Barack Obama at the health care forum hosted by Seacoast Media Group. The standing-room only crowd gathered around a roundtable-style discussion in the press room of the newspaper's new location at Pease International Tradeport.
Among those in attendance included Dr. Arthur Hilson, a community leader and founder of the New Hope Baptist Church in Portsmouth and Seacoast physicians Dr. Thomas Clairmont and Dr. Terry Bennett. Also in attendance was Valerie Cunningham, a local historian who has traced three centuries of African-American history in the city of Portsmouth and the Seacoast and members of the media including national, state and local print and electronic outlets.
Tickets to the event were limited due to space constraints of the meeting area and tickets offered to the event by Seacoast Media Group were dispersed in a period of hours after the event was announced.
Sen Obama, D-Ill., is one of three early frontrunners for the Democratic nomination for president who include Sen. Hillary Clinton, D-N.Y., and former Sen. John Edwards. Edwards, who ran as vice president on John Kerry's failed presidential bid in 2004, has been left somewhat in the position of having to catch up terms of early popularity to the two sitting senators.
One interesting historical footnote is the fact that only two sitting U.S. senators have ever won the presidency, with the last being John F. Kennedy in 1960. The other was Warren Harding, who won the presidency in 1920 and served one term from 1921-23. Harding, a Republican, was born near Marion, Ohio, in 1865, became the publisher of a newspaper,according to the Web site, www.whitehouse.gov. Harding married a divorcee, Mrs. Florence Kling De Wolfe.
The history against sitting senators hasn't seemed to faze the early field for the 2008 presidency, as Sen. John McCain, R-Ariz., is among the senatorial field that includes Democrats Obama, Clinton and Sen. Chris Dodd, D-Conn.
The Democrats, led by Clinton and Obama, have grabbed the lion's share of the headlines across New Hampshire as part of early politicking for the "first in the nation" primary, which could come as early as the end of January. The Republican field has been led so far by McCain and former New York Mayor Rudy Giuliani and former Massachusetts Gov. Mitt Romney. The GOP field grew yesterday as former Wisconsin Gov. Tommy Thompson threw his proverbial hat into the presidential ring.
The clock just passed 3 p.m. and Sen. Obama was due to arrive at 3 p.m. It is not unusual for candidates to run behind schedule as most days are packed with appearance that often follow one another. We're certain to know the minute the senator arrives from the crowd's reaction. About 100 people received passes for a seating area set up in a circle around where Barack will speak. A few in attendance are wearing the purple "I'maHealthCareVoter.org" T-shirts that are beginning to populate many of the candidates' speaking engagements.
Health is, and is expected to continue to be one of the very top issues in the 2008 presidential election. The growing cost of health care for all persons and in particular for small business owners have some fearing that cost could negatively impact an economy, which according to some economic experts faces uncertainties in coming years.
Just how to improve the nation's health-care offerings is sure to be one of the more difficult policies for whoever will become the nation's 43rd president.
Every American should have health care coverage within six years, according to Sen. Barack Obama. Just how to make that possible is likely to be one of the questions for Illinois' junior senator. That particular issue is sure to draw significant attention on the the Democratic side of the ticket as Sen. Clinton worked diligently, though with little success, to bring universal health care to the United States during her husband's first term as president.
Howard Altschiller, executive editor of Seacoast Media Group, has just taken the microphone to introduce the anticipated arrival of Sen. Obama, who is expected to speak on health care issues for 90 minutes. Altschiller is sharing his wife's story who is battling cancer.
"You see the bills coming in and we know that if we didn't have insurance and pretty good insurance, we would be destroyed financially," Altschiller said in his opening remarks.
Altschiller is also detailing for the crowd how all the presidential candidates have been invited to similar forums hosted by the paper.
Sen. Obama has entered the room to a prolonged standing ovation.
"Thank you everyone, thank you very much," Obama said. "Let me start by thanking everyone for making this happen. I'm very grateful to all of you."
Sen. Obama welcomed Rep. Carol Shea-Porter, R-N.H., who received an ovation.
"Here is the idea, I have always found I've learned the most and my favorite aspect of an elected officials is the community meetings," Obama said, in discussing his past work as a community organizer, in particulary his work in helping those impacted by the closing of manufacturing businesses.
"It was the best education I've ever had, because I learned to listen." In state legislature helped to pass health care measures including those to help children.
"My job is not to just come in with a predisposed agenda, but to listen" he said.
Change is difficult because American citizens are divided from their governemnt, Obama said. They are not setting the agenda at the federal level and even the state level in some instances, the senator said.
Last year, Obama worked with Sen. Feingold on lobbying reform in Washington, D.C., to reduce the power held by lobbying groups and in particular the pressure that comes from lobbyists for health care companies. Half of all bankruptcies today arise from health crises among Americans.
"We are spending only about 5 cents for every dollar on preventative measures," Obama said. The U.S. is among the last industrialized nations to still use paper records instead of digital record keeping. My hope today is that we can not just hear stories of how health care is affecting you, but about building a movement for change," he said. Helping those who are underinsured to buy into larger pools to save money, especially for small businesses that don't have access to larger employee pools of American corporations, is one way that can help, Obama said.
Americans have yet to effectively develop a constiuency to hold elected officials accountable, Obama said before adding by the end of his first term in office America will have universal health care, which drew applause.
Sixty-five percent of adults are obese or overweight. Changes in the approach to health care that includes preventative measures and medicine is part of the solution. "I can't do this by myself," he said. "I'm a Democrat, I'm considered a progressive Democrat...but I also want to bring openminded ideas from all sources."
Obama included Republicans and Libertarians in that group. "Nobody has the monopoly on good ideas," he said.
We are about to open the discussion to those in the audience to related stories and ask questions.
"If you have a good story, I may want to follow up with you," Obama said. Andrea with a 9-year-old daughter. "I'm a mother of three, my last child I just had is 3 years old. We paid out of pocket to have him because we couldn't afford the health care for it," she said.
Costs included $700 for a blood test. Her husband is self-employed and she is not working right now. "I don't have the money to pay for that kind of thing. The system is just broken. I am hopeful that you will come in and change the system. You have my vote and my family's vote." Obama is asking her follow up questions about what she is doing now. She has castrophic insurance. "Presumably you have a very high deductable," Obama asked. Andrea estimated her deductable was $10,000 and the insurance policy basically was set up to protect the family from losing its house or facing other financial disaster.
Obama said two-thirds of people who don't have health insurance do work, often in a self-employment nature. Consequently, many people put deductables on credit cards or take out second mortages, leading to the high rate of bankruptcies related to a health-care crisis, Obama said.
"New Hampshire is not that insurance friendly," Andrea said. "I remember trying to switch over when I was pregnant with my second child and I remember them saying, 'Honey, pregnancy is a pre-existing condition." Obama said his mother has experience working with small businesses around the world and shared Andrea's family's challenges in having regular health care insurance. She battled ovarian cancer and faced and who fought insurance company over it being a pre-existing condition. She died in six months after its diagnosis. Had she lasted longer, she would have been devastated financially, Obama said.
A second woman spoke, who said she is a registered nurse. The woman said she fought one insurance company over $13,000 it said she owed and she said her family didn't. Family is now paying over $2,000 a month for a plan that came through a pool group.
"I don't want to see more competition," she said to an applause. "I don't have time to be comparing apples to oranges; it's confusing. I'm looking for one plan. I'm looking for no deductables. I'm looking for no co-pays. I want a national standard that would be similar to Medicare. That way the companies that are not willing to take people are out of business. And the other thing I'm looking for is to keep it separate from employment."
"I'm looking for a plan to keep health care affordable, fair and held to a national standard," she said. Obama said the notion that an insurance company won't pay if you're sick "sort of defeats the notion." Most of the time, all of us these days are going to be susceptible to claims of pre-existing conditions, especially in light of the human genome project, Obama said. The issue of portability is key, Obama said. 47 million uninsured and many of them work, or are between jobs, or working part-time jobs, Obama said. It was somewhat by accident that we ended up with health care tied to employment providers, Obama said. Blue Cross was set up to help groups bring down some of the costs. During WWII, FDR put in wage controls.
But companies were able to provide more benefits, and companies used that as a way to attract more employees.
Nancy, from Portsmouth, a divorced mother with two boys. One at UNH, who is covered through N.H. Healthy kids. Her second son, is a 22 year old with Down syndrome. "I tried my best not to get sick," she said. "People use the term accessibility. I think the rhetoric needs to change. We need to be provided health care. With need single universal health care that will follow you wherever you go."
Where is that money going to come from, she asked. How about the billions of dollars being spent in Afghanistan and Iraq, Nancy suggested.
"You make a powerful statement," Obama said. "How we funded the war in Iraq was terrible. We put it in on a credit card."
One of the small employers is that because it is such a small pool they are susceptible to huge gyrations in costs, Obama said. Leslie Parker, a representative of a small company is speaking. Rates paid by company will go up 22 percent next year. "That has happened every year since 1994," she said. "We want to be a moral, good company and we have wonderful employees. We personally want the best health coverage we can have. From our standpoint, I don't really know what we are going to do. The plan we offer is actually a worse plan than we offered last year, and last year's plan is a worse plan than the one before that."
A lot of small businesses are operating on small margins, Obama said. The company pays $16,000 per family health care plan for 10 employees, she said. The company is looking at health savings accounts. Interesting exchange as Obama had the woman fill him in on some of the restrictions of HSAs and then asked her what she would advise the president in the area of HSAs.
Small businesses are nurseries for larger businesses down the road, she said. Spending significant dollars on health care prevents growth, she said. Richard, a physician in the state is speaking now. "Where do you see the most waste in the system," Obama asked. Overuse of testing and therapy that is of no benefit, is one of the areas, the physician pointed to, as was an overreliance on prescription drugs in America.
Decision was made to not allow Medicare to negotiate drug prices with pharmaceuticals was harmful and made before Obama was in the Congress. He also pointed out the decision was made before Rep. Shea-Porter was in Congress. "So we can't take credit for that," Obama joked, which drew a round of laughs. Obama asked who was employed and was happy with her health care. "I want to find out if folks are ready to move off an employer-based system," Obama said.
One 20-something woman talked about her benefits and paying $300 to $400 a month, which "was burdensome but affordable." She was in a group plan for a while with a previous employee. She is an athlete and she said her company tried to talk her out of playing soccer because of the risk of injury requiring medical attention. "Three years ago, I was working for mutual firm in Boston and doing very well," she said. "I think I've seen 18 different doctors. I've had tests. And I'm on 9 different medications. I lost my job because I was sick. I graduated from an Ivy League school. I'm ambitious. I want to work. I lost my house. I was bankrupt."
"Would you rather have a safety net and trade off some of the things of an employer-based plan," Obama asked. "The specifics of the system that are valuable is having a choice," she said. "Four or five that are reasonable, rational and well spelled out." But she said the the larger public companies, the health insurance companies are stockholders in other companies within the health care industry. "Most analysts that I have been watching say health care is the sector to buy," she said.
Rev. Arthur Hilson is speaking. He works two jobs and is retired from the military. He has three college age children. Last year, he came down with prostate cancer. He needed treatment, radiation, chemotherapy, every day for a prolonged period. He was able to get the care he needed. "But I wondered about those who don't have coverage," he said. "What about those? Do they die. I feel the government does have a responsibility. When you can find $80 billion like that, to kill people, you ought to be able to find $80 billion to help people live." His remarks drew applause.
Preventative care is so critical, Obama said. Pointing out that cancer like prostate cancer can be cured. "And I have to say, you look pretty good," Obama said to Hilson. America needs to figure out how to shift more money into preventative care. Hilson is in 70s, making it more difficult, or more expensive to add insurance.
"We feel very cynical about the goverment," one woman said. "We really need a single payer system, not an HMO." Remarks drew applause. Obama asked if anyone in attendance worked for an insurance company or a drug company. One person said they worked for IMG. "I had a stroke," he said. "And they let me go the next day. He was insured by that company. "They fired you the next day," Obama asked. "Yes," the man said. "What did they say; tough luck?" Obama said. "Let's say I proposed a plan that moved to a single-payer system," Obama said. "It would cost a huge amount of money from the government."
Private businesses would no longer have to pay for it. The insurance companies and the drug companies are going to argue that will result in rationing and waiting for services, Obama said. Drug companies will argue if they have to negotiate for lower prices, they won't have money available for research, he said. "We probably have to raise people's taxes a significant amount," Obama said
"It seems to be more of a value system," one woman said. "How many years have we been talking about this? There are many intelligent passionate people discussing this. I think it comes down to does our country have value about having equity in people's lives." Whenever she goes to the doctors or has a medical examine, "I always think of those people who can't go. She said she is skeptical that this will change even if Obama is elected president.
Obama said lobbyists have a disproportionate access. They will fight tooth and nail for even one thing, even while the public realizes what the right thing to do. "When people talk about money corrupting politics," Obama said. "They money from lobbyist because they think it will help them get elected or help them keep their seat. I think my point is...I don't want people to lose confidence in the capacity for people to change politics."
"I don't want you to lose hope, I guess is what I'm saying," Obama said. The woman said we should continue to have this discussion, even if it is frustrating. "You talk about values, what is it about the status quo that they want to prevent or stop this movement from moving forward," Obama said. Leaders need to find out what works in current system to sell that in creating a new system, he said. "What these stories add up to is that the kind of system we have is actually rationing. Rationing who gets health care. Rationing who lives and dies." That is a product of for-profit system, the woman said, to applause. "Even the U.S. Supreme Court; they ruled in 2004 that we can't sue an HMO if a doctor rules we need something and the HMO determines they are not going to pay for it. That is ration
"That is rationing. And a single-payer system is not going to have that," which drew more applause.