Wednesday, December 24, 2014

Practicing Christmas

Growing up, my brothers and I would practice Christmas morning.  I’m not sure what motivated us to do this – I can’t imagine any child forgetting how to do it – but just to be sure, we would practice.  

The rules were:
1.    First one up wakes everybody up.
2.    Get Mom and Dad up.
3.    Rip ‘em apart.

We’d run through the drill several times in the days leading up to Christmas morning.  And sure enough, when the big day came, we were perfect.

It’s true – we do get better at the things we practice.  So I sometimes wonder why we don’t practice Christmas all year.  At Christmas, we take treats to our neighbors and send cards to faraway friends.  At Christmas, we give to the hungry and to the homeless.  At Christmas, we make sure that all children have warm clothing to wear and toys to play with.  At Christmas we make it a point to spend time with our families.  And at Christmas we tend to focus more on our blessings and less on our troubles. 

On this Christmas Eve, may we be mindful of the true spirit of the season.  Merry Christmas and Happy New Year.

Tuesday, December 9, 2014

Health Care Reform: Is It Working?

Last Tuesday I had the opportunity to attend the Utah Health Policy Project’s Conference, titled, “Is It Working? – Taking the Pulse on Health Reform in Utah.”  It was a great conference with way too many key messages to cover in a short blog post, so I’ll cover the ones that spoke to me.

The morning keynote speaker, Mr. Rick McKeown, began with the message is that we solve common problems when the common pain is sufficient.  He addressed the many forces that are driving health care reform in our nation.  His list of eight pressures follows:

1.  Economics – recovery from the recession, job stagnation
2.  Demographics – aging boomers, obesity and chronic illness
3.  Consumers – we’re demanding transparency in our health care costs
4.  The Affordable Care Act
                A.  Access to health care
                B.  Regulating the insurance industry
                C.  Defining benefits
                D.  Medicare and Medicaid improvements
                E.  Uncertainty and unintended consequences
                F.  Politics
5.  Judicial – the debate between state and federal exchanges causing more uncertainty
6.  Employers – transitioning from a defined benefit to a defined contribution
7.  States – looking for autonomy and the ability to craft solutions that fit their populations
8.  Reconfiguration of risk – outcomes vs. services

Is this enough common pain?  Are we there yet?

Disclaimer:  I consider myself fairly liberal and am glad of the health care reforms brought about by the Affordable Care Act.  I live in a fairly – OK, I live in a very conservative state where most of the leadership is less than impressed with the Affordable Care Act.  That said, liberals and conservatives came together at this conference, leaving their egos at the door, to discuss real solutions for real people.  A panel of those real people spoke to us, giving us hope that the solutions in place are working for some. 

Lynn Quincy, Associate Director of Health Reform Policy for Consumers Union, gave us tips for getting the value from our health insurance, confirming the idea that we need to become intelligent consumers of health care services.  She noted that this has been difficult because of the current model of health care delivery.  I've experienced this myself – when nobody could tell me the price of an x-ray.

The liberal in me was exposed to a new perspective when the “Healthy Utah” plan to address the coverage gap was presented.  People who fall below 133% of the federal poverty level currently fall into the coverage gap in the states that opted not to expand Medicaid.  Because they should have been covered by the Medicaid expansion, they are not eligible for subsidies to assist with buying private insurance on the marketplace (  Utah’s solution, as I understand it, is to use federal dollars that would have been given to the state for the Medicaid expansion to provide subsidies for Utahns that fall into the coverage gap.  The upside of this plan – one I had not considered – is that it removes the stigma of being on Medicaid as well as opening up better choices for health care.  A privately-issued insurance card opens more doors to services than a Medicaid card.  The plan was well received by the conference attendees.  Now – on to the Legislature for approval.

Is the health care reform law working?  Not perfectly, but it’s a start.  And I am hopeful that in the State of Utah, well known for its innovative approaches to quality health care, it will continue to improve.