It’s worth paying attention
The dogs need walking, the garden has been taken over by weeds, the porch has more bare spots than paint – and yet here I sit. I am attending a meeting of New Hampshire Voices for Health, a network of consumer and advocacy organizations set up to help improve health care quality and affordability. Prior to today, I knew little or nothing about the Patient Protection Affordable Healthcare Act (lovingly referred to as “Obamacare”), debt ceilings or “the exchange.” My life revolves around maintaining our farm/home/family and earning enough to sustain my fabric addiction and horse habit. I leave money managing to my husband and politics to those I strategically avoid at social gatherings.
My husband’s work as an appointed advocate for the Christian Science Church in New Hampshire sometimes requires a little support on my end. I dust the office, stuff envelopes for mailing and, as at present, attend meetings to take notes.
The network, New Hampshire Voices, advocates “that no one in New Hampshire should go without adequate, accessible health care coverage.” They do not endorse any specific path to health-care coverage but collaborate on specific practice and policy reforms to meet the needs of as many as possible.
Our church members and others who seek alternative care regularly choose to meet their health care needs outside of the mainstream medical conglomerate and therefore are unable to find insurance companies that will cover remedial services, including spiritual care. The thought of mandated insurance is concerning to the members of our church. And as I discovered, listening to the individuals around the table, all New Hampshire citizens should be taking notice of what is going on. Policies are being voted on at the State House that will affect all New Hampshire residents.
The Affordable Care Act, signed into law last year by President Obama, basically determines that by 2014, all U.S. citizens will be insured. The enormity of the process to do this is mind-boggling. As a first step, the federal government added to the deficit by shelling out money to each state to come up with a system that would give incentives to insurance companies to offer plans at rates affordable to the general public. New Hampshire received $1 million. At first, there was approval to set up an insurance “exchange” – sort of like a department store of insurance companies and plans. The exact requirements for participation in the exchange, the costs associated with setting up the exchange, etc., are all details that the feds wanted everyone to work out by the beginning of 2012.
When people outside of New Hampshire hear our state motto – “Live Free or Die” – they usually think back to the Revolutionary leaders speaking out in defiance of whatever was oppressing them at the time. I can assure everyone that the spirit of New Hampshire is alive and well. Through passage of HB 601, state legislators decided that we should not succumb to ideology that has any fragrance of pressure from beyond our borders. They chose to send the money back. Yup. That’s what they did. They want the feds to reduce the deficit with our generosity.
So, here’s the current state of affairs: The citizens of New Hampshire are looking at the possibility of mandated health care coverage, starting in 2014. Politicians and advocacy groups across the country are attempting to challenge the constitutionality of the ACA. Those-who-are-way-more-informed-than-I feel that there’s a slightly higher than 50-50 chance that a repeal will not happen. New Hampshire lawmakers (who pride themselves on their independence and granite resolve) have to come up with a plan, without the federal money, that meets the standards set up by the federal commission by 2012. If there is no plan, or exchange, the federal government will then set up a system for New Hampshire. So much for our independence from outside influences!
Political symbolism abounds at the expense of practical progression. As part of declining the grant, the Executive Council said it did not want a particular vendor from out-of-state to assist with the process. According to Lisa Kaplan Howe, executive director of New Hampshire Voices, if the feds become involved, it is assured they will be using that same vendor.
During the meeting, there was discussion about how the federal government is working to resolve issues of the “debt ceiling.” In other words, how to keep from spending too much of the money our government doesn’t have. The usual solution is to cut funding from social support systems such as Medicare, Medicaid, Social Security and others that support children in need, the elderly and the disabled. While this seems to be a separate issue, it definitely impacts the consumer on an individual basis through removal of services and higher costs spread over the population (cost-shifting). It will affect insurance coverage and costs as well.
This meeting, led by insightful and informed professor Tom Bunnell of the UNH Institute for Health, Law and Ethics and Zandra Rice Hawkins of Granite State Progress, included individuals from the state Department of Insurance, AARP, Every Child Matters, Healthy Kids, and other organizations. It was comforting to see these dedicated, thoughtful individuals gathering to support the poor, the infirm and elderly. They are also determined to give their time and incredible expertise to the average citizen, the business owner and all who reside in our little, quirky state. But they are advocates – voices who help to amplify the quiet call of the “average Joe” – and Jane and Junior. They welcome comments, complaints, questions and insights that are general or specific. Their website is at: nhvoicesforhealth.org.
I left the meeting feeling jumpy and uncertain. How could I have gone so long being totally in the dark about this issue? What to do now? Call my representative? Volunteer for a politician? Ugh.
I will walk my dogs, weed the garden and paint my porch, but I also will continue to share what I have learned with others. An informed populace seeks the best for its members and is not easily manipulated.