Sanders' Healthcare Revolution

[babylonsister]

http://www.thenation.com/blogs/edcut/544502/sanders_healthcare_revolution

Sanders' Healthcare Revolution
posted by Katrina vanden Heuvel on 03/23/2010 @ 4:22pm


Senator Bernie Sanders had it just right when he said of the healthcare legislation signed Tuesday morning, "This legislation revolutionizes primary healthcare in America."

And it does so in large measure because of the Senator's long-term and tenacious fight to ensure that all Americans have access to primary care (see here and here).

The historic bill signed today by President Obama includes provisions Senator Sanders long advocated for, including $10 billion over five years to expand, construct and operate community health centers. It also increases the investment in the National Health Service Corps to train more primary care doctors and other health care professionals. Another $2.5 billion for health centers operations is in the reconciliation package.

All told, the legislation will double the number of health center sites nationally over the next five years from 7,500 to 15,000. The number of patients served by these facilities will rise from 20 million today to about 40 million by 2015. That means most Americans will have access to primary care, dental care, mental health counseling, and low-cost prescription drugs on a sliding-fee scale so that no one is turned away. Since 18,000 Americans die annually due to their inability to afford insurance or care, these facilities are literally life-saving changes in our health care system.

snip//

About 6 months before his death Senator Edward Kennedy--who created the federal community health center program in 1966 and cosponsored legislation with Senator Sanders last year to strengthen it--said, "Community health centers and the National Health Service Corps are more important than ever. From inner city clinics to low-income communities across the country, they make a large difference in the health of millions of our people. I look forward to working with my colleagues to strengthen these two vital programs as part of our commitment to achieve quality, affordable health care for all Americans."

Today those programs have indeed been strengthened, and we are a stronger nation for it.

[DrToast]

1. Yet another major overlooked benefit of the legislation. (nt)

[nightrain]

2. doubtful that it's a revolution. Probably more likely a sop. Having participated in

the NHSC, I have experienced the difference between first class and "sorta adequate" health CARE. Would be better if these clinics were staffed more permanently as continuity of care is usually vital for the populations served by these clinics.

And yes, they're better than nothing. Can we not aspire to provide better than that though? Isn't it unethical to provide different levels of care, particularly to populations desperately needing consistency?

[babylonsister]

3. It's a great first start despite your negativeness. You're grasping at

anything to shit on any idea involved with HCR. That is obvious, and consistent.

[nightrain]

4. are you a healthcare practitioner? do you have first hand experience

providing health care?

[nightrain]

8. **crickets** **crickets**

Guess that's a "no". Perhaps my experience and training in multiple fields adds a particular perspective that you aren't familiar with.

Interesting how easily some people can talk about policies/programs with which they don't have firsthand experience. But it ends up being shallow and uninformed. Facile "solutions".

[babylonsister]

12. I went to bed; is that okay with you? And no I don't, but I know what

I read, trust Sanders and Katrina, and doubt she'd write something that wasn't true. So, like I said, sounds great to me and also sounds like it'd benefit a whole lot of people in spite of your high and mighty attitude which has been consistently negative.

[nightrain]

16. what you hear is stridentness based on training and experience with these issues. Try to hear the

ardent concern with patients' welfare embedded in the stridentness. Practitioners have a valuable perspective. Try hearing Dr Angell or some of the practitioners in PNHP.

Obama hasn't been concerned with policy as much as he "should" have been. Transferring peoples' wealth to private usurious corporations is a terrible policy precedent. He's made "political" decisions where he needed to make bold policy changes instead. Now we have the polishing of the turd political part.

Disillusionment is painful. That's what I hear when you call me "negative". We need "care" but we get the "opportunity" to purchase overpriced restrictive premiums, or to participate in a second-rate program. Try to hear the criticisms though because this country is heading towards a cliff and Obama's bill just delayed the drop for a bit. Of course people don't want to hear the flaws, but if we don't hear the flaws???

Another option is to remain in denial about how bad it actually is, stay in the giddy intoxication of "how wonderful this inadequate part-measure is". Doing that carries more risk.

[cali]

20. what on earth is "stridentness"?

do tell.

[nightrain]

26. in case you don't have a dictionary handy--

"strongly, loudly, urgently expressed"

Does that help?

And could you address what I commented then? or do you just want to be disruptive?

[cali]

31. I'm afraid you're the one who needs the dictionary.

there is no such word as "stridentness". There is strident, and stridently, but certainly no "stridentness".

[nightrain]

33. LOL!! how to divert from the issues.... back to my points???

[cali]

34. what points? CHCs can and do provide quality healthcare including

primary care, diagnostics, mental health services, dental care and a wide range of treatments for ailments that kill thousands every year if left untreated, like diabetes, heart conditions, high blood pressure, etc.

You are just wrong- and not only with your ludicrous made up words.

You are, quite simply, full of it.

[nightrain]

36. LOL. no point continuing with you if you don't address the issues I've

raised in these many sub-threads. Continuity of care, fragmentation, loss of staff, NHSC obligations, funding problems...

For example, see this article today about Arizona's CHCs--

http://www.azcentral.com/arizonarepublic/news/articles/2010/03/24/20100324arizona-non-profit-clinics-cuts.html

I'm still FOS?

[cali]

39. You refuse to address the points I make

yes, there are problems, and a massive injection of money will go a long way to fixing them. Providing primary care and treatment to millions is a good thing, but then you know sooo much more than Bernie and Dennis, I'm sure.

:rofl:

yes, you are still completely full of shit/

[nightrain]

40. the sure sign of a failed argument is a personal attack. I have

plenty of training and experience around CHCs, which apparently you do not. End of story. Your attack is noted.

[Beetwasher]

14. I Have First Hand Experience

So now what? These health centers are a fantastic part of this legislation that will bring healthcare directly to populations that desperately need it. Just becuase some of them may potentially be managed poorly doesn't mean it's not a good idea or a step in the right direction. Once this infrastructure is in place, it can be improved and built upon. In order to do better than "better than nothing" you still have take the first step, and frankly, these CHC's are WAAAY better than nothing. They are in fact quite a terrific idea. Rome wasn't built in a day.

[nightrain]

18. think about the millions going to insurance execs in their obscene

compensation that could have gone toward home health RN visits, psychotherapy sessions, well-baby exams, completing chemo that gets cut off because of a yearly maximum, diabetic teaching, PT and OT visits.

CHC's have been in existence since the 60s. They are a terrific option if the fragmentation of care issues are addressed adequately.

Let's see who benefits from this "reform"--insurance and drug corporations or people? We'll know pretty soon. Pay attention to premium increases and out of pocket costs as the insurers continue to shift costs to people and rake in the profits.

[cali]

21. CHCs can and do provide all those services.

[Beetwasher]

22. Don't Change The Subject Now That You've Shown To Be Full Of Shit

The CHC's are terrific and provide direct access to health care. Period.

[nightrain]

23. I've been shown to be FOS? How's that?

[Beetwasher]

25. Basing Your Criticism On Hypotheticals

About how the CHC's may, possibly not provide the type of care that you deem to be adequate, and so therefore they are only merely better than nothing, is, IMO, a bullshit criticism and makes you full of shit. IMO.

[nightrain]

27. You're not reading carefully. What I have said in these many threads is that there are

demonstrable problems over the years with CHCs in terms of their funding and how care is provided. I gave examples which are based on experience and research, not stuff I pull out of my butt. If you have information to the contrary, please cite it.

Again, disillusionment is painful.

[Beetwasher]

28. No, You Have Hypotheticals Since These CHC's Are Not Even Built Or Funded Yet

Since the legislation was just signed yesterday. IOW, you've got bullshit and your own personal anecdotes.

[nightrain]

29. CHCs have been in existence since the 60s. If you don't believe me, check it out.

[Beetwasher]

30. Duh. So What?

Talk about reading comprehension. I said "these" CHC's, you know, the NEW one's that are going to be built that haven't even had a chance to do anything yet? You know, the one's that THIS thread is about? And they are a terrific idea and always have been. Again, because you think SOME may have been managed poorly in the past, you conclude that the creation of thousands more that will directly provide care for tens of millions of people are only merely "better than nothing".

It's bullshit based on an extrapolation of your supposed personal experience with them.

[nightrain]

32. that's your refutation? terrible. hard to have a decent conversation with you when

you don't read carefully and fully, and don't provide more.

Here's something of interest about Arizona's CHCs--

http://www.azcentral.com/arizonarepublic/news/articles/2010/03/24/20100324arizona-non-profit-clinics-cuts.html



These kinds of funding problems are what I'm talking about. The funding over the years has been very inconsistent leading to huge gaps in primary care for patients. For instance, not being able to get referrals to specialists, care interrupted because of lack of funds, labwork not done, frequent changes in staff, ending of NHSC obligation time and no replacements, etc.

I stated--"CHCs are terrific when the fragmentation issues are adequately addressed". Somehow you keep ignoring that.

[Beetwasher]

35. LOL! Umm, That's Why This NEW Funding Is So Terrific. You Call THAT Refutation???

Umm, there are problems with EVERY system. It doesn't make it merely "better than nothing".

All you have are your hypotheticals about some "fragmentation issues". It's bullshit criticism.

Every system has problems of one sort or another, especially when there's inadequate funding. We can file your criticisms under "No shit Sherlock".

[nightrain]

37. you're good at name-calling, but not so good at substance. I depart now.

[Beetwasher]

38. Buh Bye

As opposed to all your err, substance (read: Hypothetical bullshit).

[4lbs]

6. Maybe the quality wasn't as good because the funding wasn't there.

Now, with an additional $12.5 billion (that's $12,500,000,000) from the federal government, I think the quality and access will greatly improve.

[nightrain]

10. this add-on was to procure Sanders's vote. Yes, I know how many zeros there

are in a billion.

Sure, funding is a problem. Depends on how the money is spent. There have been a slew of issues with CHCs since their inception in the 60s. I've studied snd written about them in detail. The idea is great. The difficulties seem to lie in various aspects of how care gets delivered--staffing issues, continuity of care, cost, comprehensiveness, referral ability, follow-up, outreach, etc. NHSC staff sometimes have short stays and then continuity of care is lacking and patient care suffers. It's not simply money, but that might help.

[Jennicut]

11. I would say the continuity and quality of care is a problem with regular Dr. offices in general.

I dumped my endocrinologist today. Told by the staff that my doctor was out until July after they bumped my appt. to a different day and time...when I had to drop my kids off at school. I was told I couldn't see another doctor there because patients are not allowed to switch doctors. Wonderful for me, as a type 1 diabetic. My blood sugars are all over the place and I wanted to talk to them about getting a pump. No Dr. for 4 months. I have been through so many doctors it is not funny. Apathetic seems to describe some of the doctors and all of the staff. Maybe they are just overwhelmed. The system has been broken down for a long time. I actually am going to go to a diabetic clinic at they said they will see me right away.

[nightrain]

13. yes. probably a problem with many offices. sad, but maybe you'll

get better and more consistent care at the clinic. Consider working with a nurse diabetic educator or specialist. Nurses are often better than physicians when it comes to ongoing care.

http://www.diabeteseducator.org/ --to find one near you.

Yes indeed, the "system" has been broken for a long time, and it's not going to be fixed with "insurance reform". It actually only adds more layers to the fragmentation.

Wishing you well...

[Jennicut]

41. Thanks. The diabetic nurse at the place I was at before was better then the Doctor!

[nightrain]

42. I'm not surprised that the nurse was better. Nurses know the trenches.

Keep us posted as to how the clinic works out for you.

[Teaser]

7. you want teleportation

I just want a goddamn train.

[nightrain]

9. then enjoy your trainride if you can afford the ticket, I want more.

[cali]

19. I get my excellent healthcare through a CHC

In fact, nearly a quarter of my fellow Vermonters do too, and all of the CHCs here provide first class care. And I mean really first rate. You have no frickin' idea what you are talking about. Obviously.

[nightrain]

24. glad you are pleased with your healthcare.

And I have "no frickin' idea about what I'm talking about"? Where's that come from?

[Cha]

5. It's a wonderful start and

Thanks to Senator Sanders for his invaluble contribution~

[Raine1967]

15. It's one of the best things about this legislation and

thankfully it went under the radar during the HCR process. Otherwise it would have been way too watered down.

Millions of people will have access to primary care -- AND DENTAL CARE!

[dkf]

17. It's the only part of this legislation that is worth a damn.

And it isn't Obama's idea. While Obama thinks health care happens through insurance Sen Sanders realizes that the only true health care is health care.

Thank God for Bernie Sanders. He is one of the few who have a clue.

[harun]

43. How does one find these Community Health Centers?