http://www.funnyordie.com/videos/041b5acaf5/protect-insurance-companies-psa
Some very talented comedians got together to make this statement about health insurance executives. This has been a long couple of months, and I know you all deserve a chuckle. Better still, the chuckle packs a wallop of meaning. Regardless of how the Senate health bill goes down, we the people, have faced the demons, and sent a clear message to our politicians that we live, breath and are aware of their every movement on the Hill, a Hill that heretofore has seemed impenetrable.
Like bacteria responding to a good dose of antiseptic, the lobbyist must now lick their wounds, regroup and reposition. The high ground belongs to us. We have sussed the money behind the machine, and we have put the power brokers in Washington on notice. The lobbyist are looking elsewhere for profits. Insurance companies are already rewriting bi-laws in preparation for a new era of business, an era that frowns on wanton profits for the sake of the almighty shareholder. Watch the investment portfolios and see how the asset share in health insurance change.
Tuesday, September 22, 2009
Friday, September 18, 2009
Step by Step Health Care Reform
If a single payer system is to be based in whole or in part on Medicare, would it not be prudent to make certain that Medicare has been brought fully up to speed before placing a load on its infrastructure. I don't know if you have seen this letter from then Chairman of committee on Energy and Commerce dated Feb 28, 2008. It concisely paints a clear picture of the Medicare and Medicaids future under the Bush administration.
http://energycommerce.house.gov/index.php?option=com_content&view=article&id=63&catid=18:platforms&Itemid=58.
What the Bush Admin did to both Medicare and Medicaid is inexcusable, and has left both programs crippled by poor management and chronic underfunding. The AMA estimates that the for profit health insurers added an extra $200 billion in cost to medical care in America due to inefficient administrative practices. http://www.ama-assn.org/ama/pub/news/news/health-insurer-report-card.shtml. In my home state of Alaska, our Medicaid program for elderly and uninsured children spent only $1 billion. How many years will it take for $200 billion to escalate into the $1 trillion that is CBOs estimate of the cost to implement health care reform as outlined in H.R. 3200.
I favor a single payer system, but first, I believe it is absolutely critical that we make much needed repairs and improvements to the following three elements of health care.
1. Revamp the current regulations governing the multi-payer, for profit health insurance system (if we in act a public option without doing so, we risk duplicating an already broken system). H.R. 3200 is a terribly long bill, but much of it is dedicated to amending already existing codes and acts (social security, public service health act, federal tax code, among others). This is critical to health care reform. We passed TARP into law in September, and we have watched as the money poured out of the holes in the regulatory system governing financial entities. I see the same potential for disaster with health care reform. Already, one can see evidence that special interest are jockeying for position at the health care trough.
2. After plugging the holes in the laws regulating health insurance, we must push for a public option. If one reads the Cautionary Statements in any of the most recent 2nd Quarter Financial reports (http://www.aetna.com/news/newsReleases/2009/pr_2ndquarter2009_earnings.html), one will gain insight into the deepest fears of the insurers, and near the top of that lists is COMPETITION. For years the baby boomers have paid into health insurance, and many still believe they have built up some sort of pool of reserves. According to AETNA's last report, no evidence of these reserves can be found. The boomers were a healthy bunch for years, and the revenue just rolled into the coffers. When Gramm Leach Bliley broke down the barriers separating the various financial entities and allowed for the creation of umbrella companies, the profits generated by our premiums was just too good for Wall Street to pass up. Our policy premiums got divvied up at the end of the year and paid out to shareholders. The medical and health insurance industry comprise as much as 16% of assets in some portfolios. Proper regulation of existing health insurers will break the hold that Wall Street has on them. The will make a profit, but they won't be able to rake in the handsome sums of previous year, and forced to maintain reserves, our premiums will not fluctuate in wild abandon (11-21% this year alone). Indeed we might see the membership to benefit ratios increase to levels seen in the eighties (84% today. 94% in the eighties and 90's). Only with proper regulation can a public option be effective. What good will it serve to create a government option that plays by the rules, when the private sector can find safe harbor in the nooks and crannies of deregulation. The public option will lose money, and the deconstructionist will giggle and say, "See we told you the government can't do anything right." They should know, they worked feverishly for decade to roll back the regulations governing health insurers. Whatever revisions may be imposed on H.R. 3200, they must not undermine the language that would provide for a stable and well funded public option. I don't mind diverting the $200 billion wasted by health insurers to a well funded, well organized public option. I do mind having money from my premiums "redistributed" to shareholders as dividends, or to executives in the form of pensions, and bonuses, and that is precisely what has been done.
3. While we rebuild the regulatory structure governing private health insurers, and implement a public option to challenge their monopoly, we must rev up the engines powering medicare and medicaid. Once this is done, and only after this is done, we can begin to restructure the system to accommodate a single payer system. Failure to provide the two programs with the muscle and backbone to carry the load will result in collapse, and once again, the deconstructionist of government will laugh and say I told you so. They should know, they did their best to rip these health care system apart. As Mr. Dingell pointed out in his letter, both programs are still heavily underfunded. H.R. 3200 provides for the return of the $576 billion into Medicare over the next ten years. This was the amount cut in the last year of the Bush administration. Our President is performing a key function of his executive duties by supervising the restructuring key elements of Medicare and Medicaid. His Secretary of Health and Human Services, Kathleen Sibelius, is getting the information highway back up and running, and finally, can we fully assess the damage done during the past administration. I invite everyone to peruse the news releases from the Department of Health and Human services: http://www.hhs.gov/news/. By scrolling backwards in time, one is able to see the building blocks of change being constructed.
I realize that the dialog of health care is maddeningly complicated, but if we look at our individual situations with health care, we can discern what truly ails the system. I recommend that those who have health insurance call their insurance companies and have their claims person walk them through a test claim. They will do this, but it takes time. Grab a cup of coffee and take notes. You will not fail to be surprised. Look at your insurance from the perspective of do I have enough to pay for any unaccounted for expenses, then find out what those expenses might be. This is purely business, and they need to cough up the information. You pay them green backs, and you expect a certain type of product in return.
Part of the battle facing health care reformers is this: people are happy with their insurance, but only about 13% or so have actually had the opportunity to use that insurance. They need to understand how ineffective the system has become. They need to challenge that system.
Another component of change lies with our attitudes towards medical care for all Americans. We must see health care as a key component to a healthier, wealthier nation. After WWII, Europe and Brittan were faced with millions of walking wounded. They had no option, but to build systems capable of accommodating the sick, the wounded and mentally ill displaced and wandering the highways and bi-ways of the countryside. Why? Simple. Europe and England had been devastated by the bombings of the war. Dresden lost 45,000 people in round of incendiary bombing, and I imagine scores of badly burned victims required advanced treatment for many years after the surrender of Germany to the Allies. America is facing its own health care crisis today. We need to face the fact that we will have to accommodate the needs of our elderly, and I will remind my and the younger generations, that the boomers put a lot of bread into the system. Irregardless of earning potential, all Americans have a right to essential health care. We will be a better nation for it. Think of all the energy and money that could be diverted away from years spent paying off medical debts and into small businesses, or even just the purchase of goods and services.
http://energycommerce.house.gov/index.php?option=com_content&view=article&id=63&catid=18:platforms&Itemid=58.
What the Bush Admin did to both Medicare and Medicaid is inexcusable, and has left both programs crippled by poor management and chronic underfunding. The AMA estimates that the for profit health insurers added an extra $200 billion in cost to medical care in America due to inefficient administrative practices. http://www.ama-assn.org/ama/pub/news/news/health-insurer-report-card.shtml. In my home state of Alaska, our Medicaid program for elderly and uninsured children spent only $1 billion. How many years will it take for $200 billion to escalate into the $1 trillion that is CBOs estimate of the cost to implement health care reform as outlined in H.R. 3200.
I favor a single payer system, but first, I believe it is absolutely critical that we make much needed repairs and improvements to the following three elements of health care.
1. Revamp the current regulations governing the multi-payer, for profit health insurance system (if we in act a public option without doing so, we risk duplicating an already broken system). H.R. 3200 is a terribly long bill, but much of it is dedicated to amending already existing codes and acts (social security, public service health act, federal tax code, among others). This is critical to health care reform. We passed TARP into law in September, and we have watched as the money poured out of the holes in the regulatory system governing financial entities. I see the same potential for disaster with health care reform. Already, one can see evidence that special interest are jockeying for position at the health care trough.
2. After plugging the holes in the laws regulating health insurance, we must push for a public option. If one reads the Cautionary Statements in any of the most recent 2nd Quarter Financial reports (http://www.aetna.com/news/newsReleases/2009/pr_2ndquarter2009_earnings.html), one will gain insight into the deepest fears of the insurers, and near the top of that lists is COMPETITION. For years the baby boomers have paid into health insurance, and many still believe they have built up some sort of pool of reserves. According to AETNA's last report, no evidence of these reserves can be found. The boomers were a healthy bunch for years, and the revenue just rolled into the coffers. When Gramm Leach Bliley broke down the barriers separating the various financial entities and allowed for the creation of umbrella companies, the profits generated by our premiums was just too good for Wall Street to pass up. Our policy premiums got divvied up at the end of the year and paid out to shareholders. The medical and health insurance industry comprise as much as 16% of assets in some portfolios. Proper regulation of existing health insurers will break the hold that Wall Street has on them. The will make a profit, but they won't be able to rake in the handsome sums of previous year, and forced to maintain reserves, our premiums will not fluctuate in wild abandon (11-21% this year alone). Indeed we might see the membership to benefit ratios increase to levels seen in the eighties (84% today. 94% in the eighties and 90's). Only with proper regulation can a public option be effective. What good will it serve to create a government option that plays by the rules, when the private sector can find safe harbor in the nooks and crannies of deregulation. The public option will lose money, and the deconstructionist will giggle and say, "See we told you the government can't do anything right." They should know, they worked feverishly for decade to roll back the regulations governing health insurers. Whatever revisions may be imposed on H.R. 3200, they must not undermine the language that would provide for a stable and well funded public option. I don't mind diverting the $200 billion wasted by health insurers to a well funded, well organized public option. I do mind having money from my premiums "redistributed" to shareholders as dividends, or to executives in the form of pensions, and bonuses, and that is precisely what has been done.
3. While we rebuild the regulatory structure governing private health insurers, and implement a public option to challenge their monopoly, we must rev up the engines powering medicare and medicaid. Once this is done, and only after this is done, we can begin to restructure the system to accommodate a single payer system. Failure to provide the two programs with the muscle and backbone to carry the load will result in collapse, and once again, the deconstructionist of government will laugh and say I told you so. They should know, they did their best to rip these health care system apart. As Mr. Dingell pointed out in his letter, both programs are still heavily underfunded. H.R. 3200 provides for the return of the $576 billion into Medicare over the next ten years. This was the amount cut in the last year of the Bush administration. Our President is performing a key function of his executive duties by supervising the restructuring key elements of Medicare and Medicaid. His Secretary of Health and Human Services, Kathleen Sibelius, is getting the information highway back up and running, and finally, can we fully assess the damage done during the past administration. I invite everyone to peruse the news releases from the Department of Health and Human services: http://www.hhs.gov/news/. By scrolling backwards in time, one is able to see the building blocks of change being constructed.
I realize that the dialog of health care is maddeningly complicated, but if we look at our individual situations with health care, we can discern what truly ails the system. I recommend that those who have health insurance call their insurance companies and have their claims person walk them through a test claim. They will do this, but it takes time. Grab a cup of coffee and take notes. You will not fail to be surprised. Look at your insurance from the perspective of do I have enough to pay for any unaccounted for expenses, then find out what those expenses might be. This is purely business, and they need to cough up the information. You pay them green backs, and you expect a certain type of product in return.
Part of the battle facing health care reformers is this: people are happy with their insurance, but only about 13% or so have actually had the opportunity to use that insurance. They need to understand how ineffective the system has become. They need to challenge that system.
Another component of change lies with our attitudes towards medical care for all Americans. We must see health care as a key component to a healthier, wealthier nation. After WWII, Europe and Brittan were faced with millions of walking wounded. They had no option, but to build systems capable of accommodating the sick, the wounded and mentally ill displaced and wandering the highways and bi-ways of the countryside. Why? Simple. Europe and England had been devastated by the bombings of the war. Dresden lost 45,000 people in round of incendiary bombing, and I imagine scores of badly burned victims required advanced treatment for many years after the surrender of Germany to the Allies. America is facing its own health care crisis today. We need to face the fact that we will have to accommodate the needs of our elderly, and I will remind my and the younger generations, that the boomers put a lot of bread into the system. Irregardless of earning potential, all Americans have a right to essential health care. We will be a better nation for it. Think of all the energy and money that could be diverted away from years spent paying off medical debts and into small businesses, or even just the purchase of goods and services.
Thursday, September 17, 2009
Stand Aside US Senate and Let the House Reform Health Care with HR 3200
hhttp://documents.nytimes.com/baucus-proposal-to-overhaul-health-care#p=4
The good Senator Baucus has shown America his hand at the table of Health Care reform, and progressive constituents are not impressed. This bill offers no public option (a catch phrase whose complete meaning has yet to be fully evaluated), and it does nothing to regulate the for profit, private, multi-payer, health insurance industry.
Here is a copy of the current text of the bill titled Chairman's Mark America's Healthy Future Act of 2009. I was not able to pull a copy from the thomas.loc.gov.
http://www.docstoc.com/docs/11382446/Baucus-Health-Care-Bill---Full-Text
Here is what the Insurance Journal thinks of this bill.
http://www.insurancejournal.com/news/national/2009/09/16/103810.htm
I am very disturbed that the Insurance Journal describes the bill in these terms
Point of fact: this bill does not "bar insurance companies from discriminating against people based on health status, denying coverage because of preexisting conditions, or imposing annual caps or lifetime limits on coverage." As with most Senate bills introduced in advance of actual House legislation, it outlines in flowery terms the proposed wishes of the Senate.
The House, and only the House will get to the guts of the language and address reform in line by line legislative reform. I admire the late Senator Ted Kennedy, but even his legislation amounts to little more than a directive to the House as regards relevant legislation.
At a mere two hundred and twenty-three pages, this bill does nothing to close the loop holes in current health insurance regulation - loop holes used by health insurers to hack and slash distribution of benefits to policy holders in such a way as to benefit top executives and the all mighty shareholder.
H.R. 3200, long and verbose, was crafted to address, line by painful line, the loopholes in the federal tax codes, the social security act, and the Public Health Service Act. We may crave the simpler version, but it our salvation lies in the mind numbing details of the more compplex House resolution.
Senator Baucus' bill references HIPAA (Health Insurance Portability and Accountability Act of 1996), a bill, which in content and in spirit appears to protect the ability of health insurers to convolute the process of health care more than it protects the rights of the patient or claimant.
http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf
If asked, most health care professionals associate HIPAA with patient privacy as opposed to any meaningful regulation of health insurers. In short HIPAA is what we study in the heath care industry when we need to know what information is shared between what agencies in what capacity.
HIPAA and the Gramm Leach Bliley Act of 19
are very similar both in spirit and in content.
http://banking.senate.gov/conf/
Both spend inordinate amounts of time and legal language to explain the rights of the average person to have their personal information guarded, yet do little to explain why that personal information need be guarded in the first place. HIPAA, to my mind, was the precursor to Gramm Leach Bliley of 1999. HIPAA was necessary to allow insurance agencies to access your credit information as a means to gauge how much they could charge you for your insurance premiums, even as Gramm Leach Bliley 1999 was needed to allow investors to blur the lines of banking so that they could issue loans to individuals based not on ability to pay, but ability to sell or flip properties. The two bills were orchestrated in the same cultural mindset, and the damage inflicted on the public by both has yet to be fully realized.
As Americans, pondering the ramifications of health care reform, we must continue to focus on the dollar. Health insurers want to continue to funnel profits from insurance premiums to either their direct shareholders or to the larger umbrella organizations of which they are a smaller part. We, as payers of premiums, must insist that our rights be held sacrosanct above those of the share holder and CEO.
H.R. 3200 holds the greatest hope for meaningful health insurance reform. Without this reform, no public options can be truly effective, and certainly any hope of a single payer system can prevail. Every tactic thus employed by the conservative right has been to deflect our attention from this House bill. Contact your state Senator and House of Representative and tell them to tell the US Senator and House of Representative that the citizens of Alaska want HEALTH INSURANCE REFORM. Tell them why in no uncertain terms and let them know that their interest and action on your behalf amounts to a vote to keep them in office. Contact Mr. Don Young and tell him that you do not support his alternative bills (which he no longer officially claims to cosponsor), and want him to vote for HR 3200, and any other legislation that opts for significant health insurance regulation, public options or a single payer system.
The good Senator Baucus has shown America his hand at the table of Health Care reform, and progressive constituents are not impressed. This bill offers no public option (a catch phrase whose complete meaning has yet to be fully evaluated), and it does nothing to regulate the for profit, private, multi-payer, health insurance industry.
Here is a copy of the current text of the bill titled Chairman's Mark America's Healthy Future Act of 2009. I was not able to pull a copy from the thomas.loc.gov.
http://www.docstoc.com/docs/11382446/Baucus-Health-Care-Bill---Full-Text
Here is what the Insurance Journal thinks of this bill.
http://www.insurancejournal.com/news/national/2009/09/16/103810.htm
I am very disturbed that the Insurance Journal describes the bill in these terms
Senate Finance Committee Chairman Max Baucus (D,Mont.)
today introduced the America's Healthy Future Act, landmark health care reform legislation to lower costs and provide quality, affordable health care coverage. The Chairman's Mark will make it easier for families and small businesses to buy health care coverage, ensure Americans can choose to keep the health care coverage they have if they like it and slow the growth of health care costs over time. It will bar insurance companies from discriminating against people based on health status, denying coverage because of preexisting conditions, or imposing annual caps or lifetime limits on coverage. The bill
would improve the way the health care system delivers care by improving efficiency, quality, and coordination. The $856 billion dollar package will not add to the federal deficit. The Finance Committee will meet to begin voting on the Chairman's Mark next week.
Point of fact: this bill does not "bar insurance companies from discriminating against people based on health status, denying coverage because of preexisting conditions, or imposing annual caps or lifetime limits on coverage." As with most Senate bills introduced in advance of actual House legislation, it outlines in flowery terms the proposed wishes of the Senate.
The House, and only the House will get to the guts of the language and address reform in line by line legislative reform. I admire the late Senator Ted Kennedy, but even his legislation amounts to little more than a directive to the House as regards relevant legislation.
At a mere two hundred and twenty-three pages, this bill does nothing to close the loop holes in current health insurance regulation - loop holes used by health insurers to hack and slash distribution of benefits to policy holders in such a way as to benefit top executives and the all mighty shareholder.
H.R. 3200, long and verbose, was crafted to address, line by painful line, the loopholes in the federal tax codes, the social security act, and the Public Health Service Act. We may crave the simpler version, but it our salvation lies in the mind numbing details of the more compplex House resolution.
Senator Baucus' bill references HIPAA (Health Insurance Portability and Accountability Act of 1996), a bill, which in content and in spirit appears to protect the ability of health insurers to convolute the process of health care more than it protects the rights of the patient or claimant.
http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf
If asked, most health care professionals associate HIPAA with patient privacy as opposed to any meaningful regulation of health insurers. In short HIPAA is what we study in the heath care industry when we need to know what information is shared between what agencies in what capacity.
HIPAA and the Gramm Leach Bliley Act of 19
are very similar both in spirit and in content.
http://banking.senate.gov/conf/
Both spend inordinate amounts of time and legal language to explain the rights of the average person to have their personal information guarded, yet do little to explain why that personal information need be guarded in the first place. HIPAA, to my mind, was the precursor to Gramm Leach Bliley of 1999. HIPAA was necessary to allow insurance agencies to access your credit information as a means to gauge how much they could charge you for your insurance premiums, even as Gramm Leach Bliley 1999 was needed to allow investors to blur the lines of banking so that they could issue loans to individuals based not on ability to pay, but ability to sell or flip properties. The two bills were orchestrated in the same cultural mindset, and the damage inflicted on the public by both has yet to be fully realized.
As Americans, pondering the ramifications of health care reform, we must continue to focus on the dollar. Health insurers want to continue to funnel profits from insurance premiums to either their direct shareholders or to the larger umbrella organizations of which they are a smaller part. We, as payers of premiums, must insist that our rights be held sacrosanct above those of the share holder and CEO.
H.R. 3200 holds the greatest hope for meaningful health insurance reform. Without this reform, no public options can be truly effective, and certainly any hope of a single payer system can prevail. Every tactic thus employed by the conservative right has been to deflect our attention from this House bill. Contact your state Senator and House of Representative and tell them to tell the US Senator and House of Representative that the citizens of Alaska want HEALTH INSURANCE REFORM. Tell them why in no uncertain terms and let them know that their interest and action on your behalf amounts to a vote to keep them in office. Contact Mr. Don Young and tell him that you do not support his alternative bills (which he no longer officially claims to cosponsor), and want him to vote for HR 3200, and any other legislation that opts for significant health insurance regulation, public options or a single payer system.
Friday, September 4, 2009
How Will the Lesbian, Gay, Transgendered and Bisexual Community Respond to the Veto of Anchorage Ordinance 64?
Mayor Sullivan vetoed Anchorage Ordinance 2009-64, S-2, and it appears that perhaps the Assembly will not overturn that vote by Monday's deadline. It is no secret that many LGBT people and people with gender identity issues recognized that Assembly Woman Debbie Ossiander was the hoped for swing vote to overturn the veto. It appears Ms. Ossiander chose not to change her position, and her vote will stand at "no." While I respect Ms. Ossiander's right to choose, I disagree with her ideologies for maintaining her position in opposition to AO 64, S-2, partly because of my wish to see it passed, but mostly because of her own words.
Ms. Ossiander’s interpretation of the law, like some folk’s fundamentalist interpretation of the bible, is very literal. She wants everything clearly defined and neatly laid out. No law can be bulletproof, and weaknesses in the law will be found and tested in court. Hence the three branches of our government: legislative, judicial, executive. The legislative branch writes the laws, the executive branch implements policy in accordance with those laws, and the judicial branch sets punishments for failing to uphold those laws or abide by the policies stemming from them. Perhaps Ms. Ossiander is less afraid of the interpretation of our court system, and more inclined to fret over the literal interpretation the religious right. Well, the Municipal bylaws state that the fundamentalist do not have the right to interpret our city laws, and Ms. Ossiander is beholden to the dictates of Municipal mandates and not fundamentalist judgement. If her convictions lead her to admit that LGBT people and people with gender identity issues are being treated badly, then she should pass the ordinance and let municipal lawyers decide what does or does not apply to this legislation. As all legislation must be tested and proved worthy, so should this ordinance.
The right wing has battered and bruised the public civic psyche with their insipid and constant attacks on all three branches of government (local, state and federal) to such an extent that citizens no longer trust each to do what must be done to maintain the system of checks and balances necessary to protect our rights under the Constitution, state and federal. The right wing attacks not only our government, but our belief in government.
So the mayor vetoed the ordinance, what do we think the assembly wants us to do next? Have we asked the assembly members who supported the ordinance what they want us to do next? I know that Equality Works suggested we turn attention to the national level and support the federal anti-discrimination bill. I agree, but what about the grassroots aspect of this fight? Did we not all come together at the Democratic caucus to support grassroots agendas? Did we not all witness the power of grass roots activism during the years that Howard Dean pushed the Democratic party to get out the vote? What happened after Obama was elected? Have we all fragmented into our little groups once more to took up once again our specific battles? What do we expect when we choose to approach reform and pursuit of equality in this manner? Small groups can be isolated, and cut off. That is what the fundamentalist right tried to do with this issue, but we saw evidence that the larger community of progressive still supports us. We need to tap into that community, throw aside any of our own misgivings (that once again LGBT will help liberals who will fail to give us a helping hand up), and get involved on the larger scale of progressive politics. As terrible as having our rights denied, the fundamentalist are in pursuit of a much larger goal, and to deprive them of that larger goal, we must continue to act as a unified front.
My argument with the fundamentalist movement goes far beyond the issue of gay rights. I vehemently disagree with their attempt to interpret the Constitution with the same selective literalism they apply to the Bible. I served my country to defend the Constitution. I did so because the principles it espouses remains through the ages. It is an extension of every other piece of codification that has helped humanity, step by step, society by society, organize itself to do more than merely exist hand to mouth, harvest to harvest, kill to kill. People come and they go. We do are best to maintain the equilibrium of justice from generation to generation in the hopes that are children’s children won’t have to reinvent the wheel and fight and die to establish a new system or revamp the one they inherited. Extreme fundamentalist have hijacked the Bible that I grew up respecting for the allegorical and metaphorical power of its message, and now they want to twist my Constitution as well.
We are all familiar by now with the habit fundamentalist have of picking and choosing which portions of the Bible they wish to interpret word for word. They seek to apply the same tactics with our Constitution. Gun rights for all (no matter how unfit to handle a weapon they may be), but that stupid first amendment is only for our preachers and lay persons who have the authority of God backing their every move. Or, we believe in the need for a strong judicial branch, but only if they abide by the wishes or OUR religious leadership, because only they have a direct line to God.
What do we think? We wanted this ordinance passed, and I think we should keep at it. We should believe in the efforts of the assembly folk who pushed for its passage. Let’s ask them what we should do and do it. In addition, we, the LGBT community need to outreach to the larger community and let them know exist. I am not talking about parades, or t-shirts or slogans, but the real deal. We need to open up, not just be out. I love what Harvey Milk did during one of his many campaigns to run for office (this man understood the need for repetition) when he asked his associates to make certain that they had come out to their parents and to those closest to them. We need to highlight what we have to offer this community; what they stand to lose if we are pushed back into the closets, and connect more deeply with those who agree that we aren’t being treated very nicely by a relative minority of people.
We have come a long way since ‘93. We can go much further, but to do so we need to remain a part of the larger progressive agenda. Other than remote parts of Canada, and various tiny islands in the Atlantic and Pacific, the places to “get away” from intolerance and prejudice are shrinking rapidly. We can flock to and hover around the hubs of big cities, and the usual avant guard locations, or we can continue to push for the right to integrate and function as normal citizens in the towns and cities of our choosing. Personally, I like it here in Anchorage, and I like being a part of my community. It isn’t perfect, but I have come too far to fall back now.
Ms. Ossiander’s interpretation of the law, like some folk’s fundamentalist interpretation of the bible, is very literal. She wants everything clearly defined and neatly laid out. No law can be bulletproof, and weaknesses in the law will be found and tested in court. Hence the three branches of our government: legislative, judicial, executive. The legislative branch writes the laws, the executive branch implements policy in accordance with those laws, and the judicial branch sets punishments for failing to uphold those laws or abide by the policies stemming from them. Perhaps Ms. Ossiander is less afraid of the interpretation of our court system, and more inclined to fret over the literal interpretation the religious right. Well, the Municipal bylaws state that the fundamentalist do not have the right to interpret our city laws, and Ms. Ossiander is beholden to the dictates of Municipal mandates and not fundamentalist judgement. If her convictions lead her to admit that LGBT people and people with gender identity issues are being treated badly, then she should pass the ordinance and let municipal lawyers decide what does or does not apply to this legislation. As all legislation must be tested and proved worthy, so should this ordinance.
The right wing has battered and bruised the public civic psyche with their insipid and constant attacks on all three branches of government (local, state and federal) to such an extent that citizens no longer trust each to do what must be done to maintain the system of checks and balances necessary to protect our rights under the Constitution, state and federal. The right wing attacks not only our government, but our belief in government.
So the mayor vetoed the ordinance, what do we think the assembly wants us to do next? Have we asked the assembly members who supported the ordinance what they want us to do next? I know that Equality Works suggested we turn attention to the national level and support the federal anti-discrimination bill. I agree, but what about the grassroots aspect of this fight? Did we not all come together at the Democratic caucus to support grassroots agendas? Did we not all witness the power of grass roots activism during the years that Howard Dean pushed the Democratic party to get out the vote? What happened after Obama was elected? Have we all fragmented into our little groups once more to took up once again our specific battles? What do we expect when we choose to approach reform and pursuit of equality in this manner? Small groups can be isolated, and cut off. That is what the fundamentalist right tried to do with this issue, but we saw evidence that the larger community of progressive still supports us. We need to tap into that community, throw aside any of our own misgivings (that once again LGBT will help liberals who will fail to give us a helping hand up), and get involved on the larger scale of progressive politics. As terrible as having our rights denied, the fundamentalist are in pursuit of a much larger goal, and to deprive them of that larger goal, we must continue to act as a unified front.
My argument with the fundamentalist movement goes far beyond the issue of gay rights. I vehemently disagree with their attempt to interpret the Constitution with the same selective literalism they apply to the Bible. I served my country to defend the Constitution. I did so because the principles it espouses remains through the ages. It is an extension of every other piece of codification that has helped humanity, step by step, society by society, organize itself to do more than merely exist hand to mouth, harvest to harvest, kill to kill. People come and they go. We do are best to maintain the equilibrium of justice from generation to generation in the hopes that are children’s children won’t have to reinvent the wheel and fight and die to establish a new system or revamp the one they inherited. Extreme fundamentalist have hijacked the Bible that I grew up respecting for the allegorical and metaphorical power of its message, and now they want to twist my Constitution as well.
We are all familiar by now with the habit fundamentalist have of picking and choosing which portions of the Bible they wish to interpret word for word. They seek to apply the same tactics with our Constitution. Gun rights for all (no matter how unfit to handle a weapon they may be), but that stupid first amendment is only for our preachers and lay persons who have the authority of God backing their every move. Or, we believe in the need for a strong judicial branch, but only if they abide by the wishes or OUR religious leadership, because only they have a direct line to God.
What do we think? We wanted this ordinance passed, and I think we should keep at it. We should believe in the efforts of the assembly folk who pushed for its passage. Let’s ask them what we should do and do it. In addition, we, the LGBT community need to outreach to the larger community and let them know exist. I am not talking about parades, or t-shirts or slogans, but the real deal. We need to open up, not just be out. I love what Harvey Milk did during one of his many campaigns to run for office (this man understood the need for repetition) when he asked his associates to make certain that they had come out to their parents and to those closest to them. We need to highlight what we have to offer this community; what they stand to lose if we are pushed back into the closets, and connect more deeply with those who agree that we aren’t being treated very nicely by a relative minority of people.
We have come a long way since ‘93. We can go much further, but to do so we need to remain a part of the larger progressive agenda. Other than remote parts of Canada, and various tiny islands in the Atlantic and Pacific, the places to “get away” from intolerance and prejudice are shrinking rapidly. We can flock to and hover around the hubs of big cities, and the usual avant guard locations, or we can continue to push for the right to integrate and function as normal citizens in the towns and cities of our choosing. Personally, I like it here in Anchorage, and I like being a part of my community. It isn’t perfect, but I have come too far to fall back now.
Wednesday, September 2, 2009
Sarah Palin Attacks Hospice Care and Advnanced Care Planning Consultation Merely to Further Her Own Personal and Political Goals
According to this story in the Huffington Post, Sarah Palin has been invited to testify before the NY Senate on Elderly Care, Death Panels.
Unless I am mistaken, Mrs. Palin has no expertise in the field of Hospice counseling, nor has she claimed any direct connection to or experience with it? What lies behind her interest in Advanced Care Planning Consultation, and what has compelled her to refer to those who provide it to others as "death panels?" I do have personal experience with hospice and with end of life counseling. My experience was uplifting and life affirming, not life denying. I am dumbfounded that people such Mr. Huckabee, our former governor, and others have have chosen to diminish, and outright discredit the positive contributions these programs have made to society. While no expert on the subject of medicine, I have professional experience reading and interpreting government regulations: federal and state workers' compensation, fisheries management, Occupational Health and Safety (OSHA), Code of Federal Regulations (CFR), Alaska Statutes (AS), and my personal favorite, the Uniform Code of Military Justice (UCMJ). I have read the section in H.R. 3200, and cannot see the connection between what has been provided for in section 1233, HR 3200 amending section 1861 of the Social Security Act and the establishment of "death panels."
Below is the full text of section 1233, page 424, of House Resolution 3200:
H.R.3200
America's Affordable Health Choices Act of 2009 (Introduced in House)
SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
(a) Medicare-
(1) IN GENERAL- Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended--
(A) in subsection (s)(2)--
(i) by striking `and' at the end of subparagraph (DD);
(ii) by adding `and' at the end of subparagraph (EE); and
(iii) by adding at the end the following new subparagraph:
`(FF) advance care planning consultation (as defined in subsection (hhh)(1));'; and
(B) by adding at the end the following new subsection:
`Advance Care Planning Consultation
`(hhh)(1) Subject to paragraphs (3) and (4), the term `advance care planning consultation' means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:
`(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.
`(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
`(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
`(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).
`(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.
`(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include--
`(I) the reasons why the development of such an order is beneficial to the individual and the individual's family and the reasons why such an order should be updated periodically as the health of the individual changes;
`(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and
`(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decision maker (also known as a health care proxy).
`(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State--
`(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and
`(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).
`(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that--
`(I) ensures such orders are standardized and uniquely identifiable throughout the State;
`(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional's authority under State law) may sign orders for life sustaining treatment;
`(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and
`(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.
`(2) A practitioner described in this paragraph is--
`(A) a physician (as defined in subsection (r)(1)); and
`(B) a nurse practitioner or physician's assistant who has the authority under State law to sign orders for life sustaining treatments.
`(3)(A) An initial preventive physical examination under subsection (WW), including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1).
`(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.
`(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.
`(5)(A) For purposes of this section, the term `order regarding life sustaining treatment' means, with respect to an individual, an actionable medical order relating to the treatment of that individual that--
`(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional's authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;
`(ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;
`(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); and
`(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.
`(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items--
`(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;
`(ii) the individual's desire regarding transfer to a hospital or remaining at the current care setting;
`(iii) the use of antibiotics; and
`(iv) the use of artificially administered nutrition and hydration.'.
(2) PAYMENT- Section 1848(j)(3) of such Act (42 U.S.C. 1395w-4(j)(3)) is amended by inserting `(2)(FF),' after `(2)(EE),'.
(3) FREQUENCY LIMITATION- Section 1862(a) of such Act (42 U.S.C. 1395y(a)) is amended--
(A) in paragraph (1)--
(i) in subparagraph (N), by striking `and' at the end;
(ii) in subparagraph (O) by striking the semicolon at the end and inserting `, and'; and
(iii) by adding at the end the following new subparagraph:
`(P) in the case of advance care planning consultations (as defined in section 1861(hhh)(1)), which are performed more frequently than is covered under such section;'; and
(B) in paragraph (7), by striking `or (K)' and inserting `(K), or (P)'.
(4) EFFECTIVE DATE- The amendments made by this subsection shall apply to consultations furnished on or after January 1, 2011.
(b) Expansion of Physician Quality Reporting Initiative for End of Life Care-
(1) Physician'S QUALITY REPORTING INITIATIVE- Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w-4(k)(2)) is amended by adding at the end the following new paragraphs:
`(3) Physician'S QUALITY REPORTING INITIATIVE-
`(A) IN GENERAL- For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment.
`(B) PROPOSED SET OF MEASURES- The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary. The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.'.
(c) Inclusion of Information in Medicare & You Handbook-
(1) MEDICARE & YOU HANDBOOK-
(A) IN GENERAL- Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall update the online version of the Medicare & You Handbook to include the following:
(i) An explanation of advance care planning and advance directives, including--
(I) living wills;
(II) durable power of attorney;
(III) orders of life-sustaining treatment; and
(IV) health care proxies.
(ii) A description of Federal and State resources available to assist individuals and their families with advance care planning and advance directives, including--
(I) available State legal service organizations to assist individuals with advance care planning, including those organizations that receive funding pursuant to the Older Americans Act of 1965 (42 U.S.C. 93001 et seq.);
(II) website links or addresses for State-specific advance directive forms; and
(III) any additional information, as determined by the Secretary.
(B) UPDATE OF PAPER AND SUBSEQUENT VERSIONS- The Secretary shall include the information described in subparagraph (A) in all paper and electronic versions of the Medicare & You Handbook that are published on or after the date that is 1 year after the date of the enactment of this Act.
The links that have been inserted into the language of the section of HR 3200 above are mine, and are not included in the original text of the legislation. I have done so to allow people to explore the definitions of certain terms, to provide links to examples of some of the organizations referred to in the section, or to other acts impacted by this section of proposed legislation. Because Mrs. Palin will be speaking in New York, the link for "health care proxy" is provided by New York's Department of Health. Similar definitions applicable to Alaskans can be found under the Department of Health.
Those in opposition to section 1233 of HR 3200 must not fully understand, or simply fail to acknowledge what is obvious in subsection (B).
`(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items--
I have read the tweets, the letters to editors, watched the videos, heard the speeches of those in opposition to HR 3200. I have heard them make the outrageous accusation that section 1233 of HR 3200 is an attempt by Obama and the progressive Democrats to cut medicare spending by directing our elderly to end their lives prematurely. I denounce these people, and refute their claims based not only on my personal experience, but on the language of this bill and the Social Security Act it seeks to amend.
The sole purpose of these accusations is to derail any attempt by governemnt to impose long overdue regulations the practics of the for profit, health insurance industry. If Mrs. Palin has another reason for taking her position on this issue, she needs to quickly clarify those reasons. If she cannot, then I suggest she find another way to capitalize on her notoriety. If her intent is to use this issue for her personal gain, then progressive Alaskans must actively denounce her efforts. The issue of Advanced Care Consultation affects thousands of Americans every year in every city in every walk of life. Hospice has done so much good for so very many, and we owe it to those who provide such services, and even to those who choose to fight for life to the bitter end, to keep the cult of personality off the table, and politics for personal gain out of the discussion.
I encourage those with a personal stake or interest in this matter, to contact your state and federal Congressmen and women, local newspapers, local assembly persons and share your stories and your opinions. And, because our former governor has chosen to speak in New York, I would recomned contacting the NY Senate. I normally do advocate interfering in the legislative affairs of another state, but as goes Sarah so go her former constituents. Think of ourselves as character references not in favor of her character. We cannot let the voices of the one or the few outweigh the concerns and the needs of the many. "Start spreading the news."
`(5)(A) For purposes of this section, the term `order regarding life sustaining treatment' means, with respect to an individual, an actionable medical order relating to the treatment of that individual that--
`(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional's authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;
`(ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;
`(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); and
`(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.
`(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items--
`(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;
`(ii) the individual's desire regarding transfer to a hospital or remaining at the current care setting;
`(iii) the use of antibiotics; and
`(iv) the use of artificially administered nutrition and hydration.'.
(2) PAYMENT- Section 1848(j)(3) of such Act (42 U.S.C. 1395w-4(j)(3)) is amended by inserting `(2)(FF),' after `(2)(EE),'.
(3) FREQUENCY LIMITATION- Section 1862(a) of such Act (42 U.S.C. 1395y(a)) is amended--
(A) in paragraph (1)--
(i) in subparagraph (N), by striking `and' at the end;
(ii) in subparagraph (O) by striking the semicolon at the end and inserting `, and'; and
(iii) by adding at the end the following new subparagraph:
`(P) in the case of advance care planning consultations (as defined in section 1861(hhh)(1)), which are performed more frequently than is covered under such section;'; and
(B) in paragraph (7), by striking `or (K)' and inserting `(K), or (P)'.
(4) EFFECTIVE DATE- The amendments made by this subsection shall apply to consultations furnished on or after January 1, 2011.
(b) Expansion of Physician Quality Reporting Initiative for End of Life Care-
(1) Physician'S QUALITY REPORTING INITIATIVE- Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w-4(k)(2)) is amended by adding at the end the following new paragraphs:
`(3) Physician'S QUALITY REPORTING INITIATIVE-
`(A) IN GENERAL- For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment.
`(B) PROPOSED SET OF MEASURES- The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary. The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.'.
(c) Inclusion of Information in Medicare & You Handbook-
(1) MEDICARE & YOU HANDBOOK-
(A) IN GENERAL- Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall update the online version of the Medicare & You Handbook to include the following:
(i) An explanation of advance care planning and advance directives, including--
(I) living wills;
(II) durable power of attorney;
(III) orders of life-sustaining treatment; and
(IV) health care proxies.
(ii) A description of Federal and State resources available to assist individuals and their families with advance care planning and advance directives, including--
(I) available State legal service organizations to assist individuals with advance care planning, including those organizations that receive funding pursuant to the Older Americans Act of 1965 (42 U.S.C. 93001 et seq.);
(II) website links or addresses for State-specific advance directive forms; and
(III) any additional information, as determined by the Secretary.
(B) UPDATE OF PAPER AND SUBSEQUENT VERSIONS- The Secretary shall include the information described in subparagraph (A) in all paper and electronic versions of the Medicare & You Handbook that are published on or after the date that is 1 year after the date of the enactment of this Act.
The links that have been inserted into the language of the section of HR 3200 above are mine, and are not included in the original text of the legislation. I have done so to allow people to explore the definitions of certain terms, to provide links to examples of some of the organizations referred to in the section, or to other acts impacted by this section of proposed legislation. Because Mrs. Palin will be speaking in New York, the link for "health care proxy" is provided by New York's Department of Health. Similar definitions applicable to Alaskans can be found under the Department of Health.
Those in opposition to section 1233 of HR 3200 must not fully understand, or simply fail to acknowledge what is obvious in subsection (B).
`(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items--
Clearly, this statement allows patients to choose to extend their lives, as well as, to chose to not extend their lives through artificial means. No where in section 1233 is it suggested that patients chose to end their lives prematurely. In addition, the following sub section would indicate that the patient has the option of increasing the frequency of counseling as the condition of their health changes.
`(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.
Section 1233 of HR 3200 does not create provisions for the creation of death panels. It does not force doctors recommend to their elderly patients that they opt for euthansia. It does not force hospitals to pull plugs, shut off IVs or refuse other life sustaining treatments so long as it does not conflict with the wishes of the patient. Moreover, end of life counseling enables the patient to clearly set forth those wishes to his medical provider and family members in the form of a legally recognized living will which can be updated at any time as the health of the patient changes. I have read the tweets, the letters to editors, watched the videos, heard the speeches of those in opposition to HR 3200. I have heard them make the outrageous accusation that section 1233 of HR 3200 is an attempt by Obama and the progressive Democrats to cut medicare spending by directing our elderly to end their lives prematurely. I denounce these people, and refute their claims based not only on my personal experience, but on the language of this bill and the Social Security Act it seeks to amend.
The sole purpose of these accusations is to derail any attempt by governemnt to impose long overdue regulations the practics of the for profit, health insurance industry. If Mrs. Palin has another reason for taking her position on this issue, she needs to quickly clarify those reasons. If she cannot, then I suggest she find another way to capitalize on her notoriety. If her intent is to use this issue for her personal gain, then progressive Alaskans must actively denounce her efforts. The issue of Advanced Care Consultation affects thousands of Americans every year in every city in every walk of life. Hospice has done so much good for so very many, and we owe it to those who provide such services, and even to those who choose to fight for life to the bitter end, to keep the cult of personality off the table, and politics for personal gain out of the discussion.
I encourage those with a personal stake or interest in this matter, to contact your state and federal Congressmen and women, local newspapers, local assembly persons and share your stories and your opinions. And, because our former governor has chosen to speak in New York, I would recomned contacting the NY Senate. I normally do advocate interfering in the legislative affairs of another state, but as goes Sarah so go her former constituents. Think of ourselves as character references not in favor of her character. We cannot let the voices of the one or the few outweigh the concerns and the needs of the many. "Start spreading the news."
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