Obama’s Health Care Forum in Greensboro Today

We went, we saw, then we had lunch. Two of us from the Health Access Coalition – outreach coordinator Hope Marasco and myself – attended the Obama/Perdue forum on health care today at NC A + T University. (Great new dining hall there by the way – $5, all you can eat from salads to subs.)

The discussion before lunch at the forum was also all about value, interestingly enough. Obama has made the decision that health care costs are the primary focus of his health effort. Sure, we need to get folks covered but we also have to get costs under control. I agree – we do need to get costs under control, as HAC’s Adam Linker just detailed in a new report yesterday, but we can’t lose sight of the imperative to guarantee affordable coverage to everyone.

Access wasn’t one of the three major sections of the forum, but, since it was a public forum, it came up anyway, and I hope that’s one of the big things that Obama health care point person, Nancy-Ann Deparle brings back to the White House. Who brought it up best? Dr. Bill Roper, chief of the UNC health care system. Here’s what he said:

I urge you to work towards a system quickly that covers everyone. I know you are concerned about cost but if we spend smartly we can cover everyone and deliver quality care.

His main message – let’s get serious about paying for effective health care and improve quality while we save money, but it is critical that we make access the top priority. I know the polling shows (as well as our health conversations with people all around NC in our HAC forums) that cost is a primary concern for people. However, with NC’s unemployment rate now nearing 11% and NC leading the nation in percentage increase in uninsured, access is now more important than ever. Thanks to Bill Roper and several other speakers, that was a theme that came though loud and clear.

In addition to access, several other themes came up. A state employee, April Graham, brought up the State Health Plan crisis. She said she felt betrayed by many politicians she had worked so hard for last year now that the state health plan might be “reformed” to cost even more – when she thought she was electing people to really fix health care. Right now she can’t cover two of her kids because she can’t afford the dependent health care premiums – and the General Assembly wants to increase those premiums even more.

April asked Governor Perdue to work on this issue and, given the mess the NC Senate has made of things, this sounds like a great idea.

A couple of other interesting themes. NC Blue Cross didn’t speak at the forum, but their name came up multiple times. Usually Blue was mentioned when someone who tried to get a policy but was quoted prices like $3,200 a month (as one speaker related). Not great advertising. Then there was the man who couldn’t afford Blue Cross, so he tried the new NC High Risk Pool. Couldn’t afford that either – “I realized it was only for wealthy people.” Ah yes, how well I remember how our effort to subsidize premiums in the pool fell flat from insurance company opposition.

We’ll see how the federal health debate plays out, but I’ll leave with this. Nancy-Ann Deparle made clear that starting gate to fixing our health system is passage of Obama’s budget request for an over $200 billion downpayment to get reform rolling. Yes, that’s the same budget that NC Senator Kay Hagan was in the press this past weekend opposing. We’ve clearly got some work to do here in NC. Let’s get to it.


  1. Robert Stevens

    March 31, 2009 at 9:38 pm

    Can you tell me if Single Payer was discussed? If so, what was the general reaction?

  2. Molly Beacham

    March 31, 2009 at 10:24 pm

    Adam, was anyone talking about skipping the insurance coverage part and just providing health care? The insurance companies could still make money insuring houses, cars, etc. Health care doesn’t need to be a profit center.

  3. Louis

    April 1, 2009 at 7:13 am

    interesting post at the Black Agenda Report on Obama’s attitude towards single payer which he used to support. Click on my website link.

  4. Louis

    April 1, 2009 at 7:14 am

    The article is “Barack Obama: Hypocrite on Health Care, Hater on Single Payer”

    by Bruce A. Dixon

  5. Adam Searing

    April 1, 2009 at 9:42 am

    There was clear anger at the insurance industry in the meeting – multiple times. In addition, on person brought up that it was critical that a public option health plan be part of any reform effort.

    The feeling I got from the meeting was that people who were there were pretty pragmatic – they wanted action quickly that would guarantee affordable coverage and they didn’t much care how it happened, just that it was done sooner rather than later.

  6. Adam Searing

    April 1, 2009 at 9:45 am

    Oh, and Louis – during the election campaign, President Obama was pretty clear about the type of health reform he was proposing – and it wasn’t a single payer system. Agree with him or not on that issue, I don’t think you can call him a hypocrite.

  7. Kimberly

    April 1, 2009 at 11:55 am

    I wish I could have been there, I always have much to say about this topic. It was nice to hear that I’m not the only one that has been quoted a totally unaffordable rate for insurance – my family was quoted $8k per month due to 4 children with special needs. It was also nice to hear someone else state that the High Risk Insurance Pool is for the richer folks. The idea behind it is sound but the cost is too high for most people. I have shared my story on bluenc.com and I have sent my story to our Governor and our President. I know that the majority of people are now suffering and want some kind of national health care plan and at least those in power are listening.

  8. Niki

    April 1, 2009 at 12:50 pm

    There was not much opportunity yesterday for people to speak other than some who had been pre-selected. Yes, we indeed need national reform but heaven help us in NC to promote state reform … NOW!

    BCBSNC who “rules over” the State Health Plan also rules North Carolina Health Choice (NCHC – the program for children from low income families who do not meet criteria for Medicaid) and applies the same criteria for benefits and services across the board. This is so ridiculous because you cannot compare the NCHC population of with BCBSNC’s insureds or state employees – neither in demographics or needs. Recently, BCBSNC, and therefore the State Health Plan and NCHC, have started denying outpatient ancillary services such as respiratory therapy. There are several companies in NC that provide clinical and educational services to children with asthma, under their physician’s order, through programs in schools and home. Asthma is the most common chronic childhood illness. Last year there were more than 83,000 children with asthma in NC schools – 3-4 per classroom. It is a leading cause of missed schools days and hospitalizations. Missed school days for children = missed work days for parents. The respiratory programs have demonstrated many positive outcomes including decreasing missed school days and reducing ER visits/hospitalizations resulting from unmanaged asthma. A typical ER visit in NC for asthma is more that $2,000 and a hospital stay is more than $10,000 … Do the math here – just one hospitalization prevented would pay for a WHOLE lot of outpatient respiratory services to a WHOLE lot of children!!!!

    Again, as we heard yesterday … the system is only focused on sick care – not well or preventive care.

  9. Niki

    April 1, 2009 at 12:54 pm

    PS … And I was told very clearly by a BCBSNC administrator, BCBS’s business is to make money not health care. Hmm, guess that explains that higher premium lower benefit thing …

  10. Adam Searing

    April 1, 2009 at 4:01 pm

    And I though NC Blue Cross was a nonprofit organization!

  11. AdamL

    April 1, 2009 at 4:04 pm

    At least NC Health Choice will move to Medicaid once the administrator is up and running.

  12. Niki

    April 1, 2009 at 4:34 pm

    That may be true but the companies who have been providing the services to children will be out-of-business with no reimbursement until then. And, we are have no guarantee what NCHC will look like when it moves over. Providers and recipients are told now that if a child rolls back and forth from NCHC to Medicaid, as some do related to changes in income, that the two programs are seamless. When you have a benefit for your child on the 31st of the month and don’t the next day, I am not sure what they mean by seamless other than the electronic transfer of the patient from one program to the other. It is hard to help parents understand that. It is even harder to make them understand if they make a few more dollars then their child receives less benefits. It is all so messed up … the harder you work, the more premiums you pay and the less you get. I totally understand parents who say sometimes they are better off to not find a job …

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