Healthcare Meeting with Jenelle Krishamoorthy

Where do I begin? Judy Zobel started the healthcare discussion with some facts and figures, but most interestingly, told her story of having lost her employer-provided healthcare coverage and needing to pay $500/mo premiums with a $2500 deductible. She considers herself lucky that she has the means to pay for the coverage. People of lesser means do not and are part of the 27 million American uninsured.

Then I was up. I told how I had found the application for IowaCare in the Welfare office and had to be not only assertive but aggressive with the IowaCare gatekeeper to get a mammogram scheduled. My mom's breast cancer was found through a mammogram, so it's important for me to have them every year. Jenelle was engaged. Then I told of the time I came down with a cold and had a cough still after three weeks and so called IowaCare. They told me it would be two months before I could be seen in a clinic. I gave up on them and three weeks later still had the cough so went to the Community Health Free Clinic where they found I had irreparable lung damage. I explained that now that I'm on disability, I'm also on Medicare and I get to see my own doctor who knows my history, and that this kind of coverage should be available to everyone -- paid for by the government with medical decisions made by the physician and patient. There are 18,000 deaths every year among people 18-64 because of uninsurance. That is simply not acceptable.

I felt validated to have someone in Janelle's senior position not only listening to me, but hearing my story and agreeing that these things aren't right. BTW, when the meeting was over, Janelle hugged me and told me to keep in touch. I'm going to work with her to see if when she's in Cedar Rapids we can meet with her. The Des Moines group is going to set up a meeting by videoconference with Janelle after the election. My hope is that we can meet with her in person. You'll like her. I know it.

Our request of Janelle was that Senator Harkin champion single-payer healthcare coverage next year. She was polite, but blunt. The public, the insurance companies, businesses, healthcare providers, all want healthcare reform, but the political atmosphere is such that single-payer just won't fly. She thought of one Senator who is always working outside the envelope who could introduce such a bill, but that so much depended on who is elected to the White House. McCain doesn't want healthcare reform. Obama's plan hasn't been fleshed out yet. That would be up to Congress.

Right now Senator Harkin is holding hearings with everyone involved in the debate, bringing them all to the table, to gather information and build trust in the concept of a paradigm shift in American healthcare, or what Senator Harkin calls, "sick care." One point Jenelle made was that under the current system physicians and other providers get paid for the number of procedures they do, when they should be getting paid based on outcomes. She said she doesn't get paid based on the amount of work she does, but on the quality of her work. I thought that was quite interesting.

Let's discuss this more while we butter bread in September. Also, we will be having a training conversation with Leland in September. I'll be interested to see what he's picked up from working through the Basics materials.