Please Don’t Tell NorthBay

We learned late last week that one of my twin 15 month old grandsons will require surgery this week to correct a semi-urgent problem. It would be considered “minor” surgery for an older child but a bit risky for a child his age. The surgery is scheduled for early this week.

“Minor” surgery is what happens to someone else’s grandchild. It is my grandson and therefore it is major surgery. When you add the modifier “semi-urgent”, that is enough to make grandpa and grandma concerned. We have been preoccupied the past weekend as a result. I was not intending to write a blog entry given all the angst.

In the midst of all this, I was researching whether the name “Passama” might have a meaning in the Catalan language which is spoken along the Spanish/French border. That is a long story in itself. This is what happens when you are on the beach.

Doing this Google search on my name somehow led me to a link that allowed me to access the 600 plus blog entries I wrote for NorthBay Healthcare from 2010-2017. Eureka! I have been trying to find a backdoor to that treasure trove.

I made many predictions in those blog entries, some of which I would just as soon forget. I did find one entry where I talked about the 2016 candidates and their stances on healthcare in general and the Affordable Care Act in particular.

I found that entry interesting. I have not asked NorthBay for permission to reprint it here so don’t tell them I have done so. They may close that backdoor! Most of my career was based on seeking forgiveness when I forgot to get permission. My retirement is going the same way except now I am seeking forgiveness from my wife instead of the board.

I hope you find my thoughts in April 2016 of interest and relevant to today.

Memo to Presidential Candidates

April 07, 2016

 

The 2016 presidential sweepstakes is remarkable for the continuing absence of any real discussion of health care issues. That’s too bad because there are some serious health policy matters that cannot be ignored during a year of national debate.

When it comes to the Affordable Care Act (aka “Obamacare”), the positions of the two parties are remarkably simplistic.  That says a lot about the character of the candidates.

The Democrats love Obamacare and defend it at every turn. Memo to Democrats:  the Affordable Care Act is a deeply flawed piece of legislation which front loaded the goodies and left the payment for the goodies to occur after the 2016 elections.  

With deep Medicare cuts (a way to fund the Affordable Care Act) beginning in 2017, we will see elders have less access to a physician or care. You can also expect to see steeply rising premiums for Affordable Care Act health plans offered to people who have no insurance. Already that is happening outside of California and it will happen here with Covered California – just a little later.

Republicans hate Obamacare and want to destroy it.  Memo to the Republicans:  You are right that the Affordable Care Act is a mess but simply torpedoing it without a realistic alternative is not a responsible way to act. The reality is that too many people who did not have health insurance now have it and destroying Obamacare results in more uninsured patients not getting the care they need except in already overburdened hospital emergency services. The “hidden tax” of cost shifting will again rear its head, which benefits no one.

There needs to be discussion about changing the Affordable Care Act in meaningful ways. It needs a more secure financial base. We must recognize that “mandating” health plan coverage is viewed by many as overstepping the role of government.  Let’s at least begin the debate.

There is one other issue which has been disgracefully ignored for years at every level of government. It is what we used to call mental health and now goes by the less-threatening term “behavioral health.”

You see the result in the streets. Poorly clothed and fed people talk to themselves or make public nuisances of themselves. Many of the homeless are people with behavioral health issues.

There was a time in the 1960s and 1970s when the federal government had a much more robust role. It formed community mental health centers and funded training for psychiatric and psychological professionals. Those times are long gone.

We see the consequences every day in our two emergency services. It is not unusual for NorthBay’s two hospitals to have four to six patients with behavioral health problems taking up space in our emergency services and taking up acute-care beds while we scramble to find a more appropriate place for them to receive treatment.

They have no medical reason to be in our hospitals. They need care and treatment, but not the kind we provide.

This issue is growing across the nation, a silent epidemic stemming from public policy neglect. Yet not a word about it is being uttered by any candidate of either party.

Memo to all Presidential candidates:  Get real about health care issues.

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