One of the major differences of the Controversies in Childbirth Conference is that we claim to be a neutral venue for inclusive discussion. I have been asked and have heard people asking others, "Can a conference really be neutral?"
One of the things that makes "Controversies" different is that is not produced by a membership organization. It is a totally independent conference. All membership or association conferences are self-serving! They are designed to make you feel good about the job you're doing and to feel good about the association that you belong to and pay your dues to. Therefore, you will probably not see a seminar on the schedule of an association conference that is critical of the association or the profession.
Next, associations are extraordinarily political!!! There are official and unofficial hierarchies. There is generally paid staff who want to keep their jobs and not rock the boat. Often you will hear someone say that they don't submit speaker abstracts, because some officer, director or muckety-muck doesn't like them and has blocked them from appearing on panels in the past.
Rarely will you find debate in a session between the presenters. One reason for this is that the association does not want members leaving the room yelling at other members. Remember, association conferences usually contain business meetings, and someone needs someone else’s support to get elected or to get a project passed through the board or membership.
The Controversies in Childbirth Conference is different. There are no business meetings, there is no hierarchy, and there is no politics. There is a small group of people that help with the conference and also help decide on seminars and speakers. As the conference coordinator, I try very hard to keep these people's identity secret. This avoids the unpleasantness of receiving phone calls from friends, trying to get other friends on the program or get seminar topics approved.
Being neutral also means that there is no agenda hidden or otherwise. It's not about showing homebirth is good, epidural so good, obstetricians are bad, midwives are bad, etc. Many panels are done in debate or panel format with presenters who may not agree with each other. Please know that although there may be disagreement, everyone involved with the conference is committed to professional, civilized discourse and discussion.
If you want to hear how great homebirth is, go to MANA. Want to feel good about doulas? Go to DONA. Want to feel good about the contributions of OB/GYN's ? Goto ACOG. Need a pat on the back for being a nurse midwife? Go to ACNM. I could go on and on.
Do you want to hear the issues that other professionals involved in birth face, in an unbiased professional manner? Come to the Controversies in Childbirth Conference! !
Alan
Alan@birthconference.org
Starting Wednesday, we will talk about the newly announced seminars for the conference.
Tuesday, November 10, 2009
Monday, November 9, 2009
Whose Job Is It to Prevent Premature Birth?
By now, everyone knows that the US ranks 30th in infant mortality. I could point to the fact that different countries report infant mortality statistics differently, to say that it's not as bad as it sounds. For today's post, let's accept that. #30 is very, very bad.
On Friday, November 6th, I said "Let's stop calling it, "Healthcare Reform" and let's call it "Health Payment Reform." I now propose we change the name From "Health Insurance" to "Sick Insurance!"
Why sick insurance instead of health insurance? Because our system pays the medical expenses for people who are sick or injured. There may be token payments for annual physicals, etc., but the bulk of the payment is for sickness or injury.
So the United States has this high prematurity rate? The media is in a tizzy! The birth advocates are in a tizzy! The health reform advocates are in a tizzy! My question is, "Has anyone proposed anything that will lower the prematurity rate?"
For years I tried convincing HMOs and health insurance companies, as I was negotiating contracts, that our birth center should receive a "Healthy Baby Dividend” because our prematurity rate was 1/2 of 1% (0.05%). Every premature birth that we prevented saved an insurance company at least $100,000.
Needless to say, no insurance company was willing to pay a “Healthy Baby Dividend.” If the baby was born premature, they would happily pay the $100,000 NICU bill, but they would not pay a dime as a reward for preventing prematurity.
If we really want to bring the prematurity rate down, we should pay cash incentives to physicians and midwives who can show a much lower prematurity rate than the national average, with of course a formula to compensate for high-risk patients.
Only when we are willing to put our money where our mouth is, and pay incentive bonuses for healthy babies as opposed to sick babies, will we start taking steps toward reducing prematurity and making America healthier.
Alan.
Alan@ birthconference.org
Tomorrow-amazing seminars being announced at Controversies in Childbirth Conference
On Friday, November 6th, I said "Let's stop calling it, "Healthcare Reform" and let's call it "Health Payment Reform." I now propose we change the name From "Health Insurance" to "Sick Insurance!"
Why sick insurance instead of health insurance? Because our system pays the medical expenses for people who are sick or injured. There may be token payments for annual physicals, etc., but the bulk of the payment is for sickness or injury.
So the United States has this high prematurity rate? The media is in a tizzy! The birth advocates are in a tizzy! The health reform advocates are in a tizzy! My question is, "Has anyone proposed anything that will lower the prematurity rate?"
For years I tried convincing HMOs and health insurance companies, as I was negotiating contracts, that our birth center should receive a "Healthy Baby Dividend” because our prematurity rate was 1/2 of 1% (0.05%). Every premature birth that we prevented saved an insurance company at least $100,000.
Needless to say, no insurance company was willing to pay a “Healthy Baby Dividend.” If the baby was born premature, they would happily pay the $100,000 NICU bill, but they would not pay a dime as a reward for preventing prematurity.
If we really want to bring the prematurity rate down, we should pay cash incentives to physicians and midwives who can show a much lower prematurity rate than the national average, with of course a formula to compensate for high-risk patients.
Only when we are willing to put our money where our mouth is, and pay incentive bonuses for healthy babies as opposed to sick babies, will we start taking steps toward reducing prematurity and making America healthier.
Alan.
Alan@ birthconference.org
Tomorrow-amazing seminars being announced at Controversies in Childbirth Conference
Friday, November 6, 2009
Some People Just Won't Buy Healthcare
The Congressional Budget Office (CBO) estimates that the fines on individuals and employers for not having health insurance will bring in $167 billion over 10 years, which they are counting on to offset the $1 trillion plus dollar cost of health reform.
(Click here to read this report)
It seems a little perverse that the CBO believes that the IRS can collect fines from people who illegally decide not to carry health insurance. Why do they think the IRS will send out a lot of tax bills to poor people that can’t afford to pay for health insurance and this money will be collected?
This is interesting, but, not the point of today's blog. I'm getting tired of using the term healthcare, when we mean health insurance. Keep in mind that with all the proposals there will still be deductibles and co-pays, because, there is no proposal for true first dollar universal healthcare.
The following quote appears in the above article: "There's just going to be some people who choose rather to pay (the fine) than to pay for health care," said Stephanie Lundberg, spokeswoman for House Majority Leader Steny Hoyer, D-Md. "There's going to be some people that just philosophically don't want to buy health care."
What about all the alternative medical/healthcare providers? If you go chiropractor and pay cash, aren't you buying healthcare? If you pay cash at the dentist, aren’t you buying healthcare? If you go to Wal-Mart for glasses, aren't you buying healthcare? If you go to a reike healer, aren't you buying healthcare? If you go to an acupuncturist, aren't you buying healthcare? If you pay cash to a mental health therapist, aren't you buying healthcare?
I hope you get my point! I vehemently object to the politicians and pundits calling this healthcare reform. We are not reforming healthcare, we are changing the system that pays for some types of healthcare. Why can't we just call it, "Health Payment Reform!"
As things stand now, there is a lot of doubt that a health reform bill will be signed by the President before the Controversies in Childbirth Conference, February 19-21, 2010 in Tampa, Florida. The sad thing is, I really don't know if that's good or bad. The system is broke and needs fixing, I just don’t know for sure whether or not, the proposed cure is better than the perceived disease?
Have a great weekend.
Alan.
Alan@birthconference.org
(Click here to read this report)
It seems a little perverse that the CBO believes that the IRS can collect fines from people who illegally decide not to carry health insurance. Why do they think the IRS will send out a lot of tax bills to poor people that can’t afford to pay for health insurance and this money will be collected?
This is interesting, but, not the point of today's blog. I'm getting tired of using the term healthcare, when we mean health insurance. Keep in mind that with all the proposals there will still be deductibles and co-pays, because, there is no proposal for true first dollar universal healthcare.
The following quote appears in the above article: "There's just going to be some people who choose rather to pay (the fine) than to pay for health care," said Stephanie Lundberg, spokeswoman for House Majority Leader Steny Hoyer, D-Md. "There's going to be some people that just philosophically don't want to buy health care."
What about all the alternative medical/healthcare providers? If you go chiropractor and pay cash, aren't you buying healthcare? If you pay cash at the dentist, aren’t you buying healthcare? If you go to Wal-Mart for glasses, aren't you buying healthcare? If you go to a reike healer, aren't you buying healthcare? If you go to an acupuncturist, aren't you buying healthcare? If you pay cash to a mental health therapist, aren't you buying healthcare?
I hope you get my point! I vehemently object to the politicians and pundits calling this healthcare reform. We are not reforming healthcare, we are changing the system that pays for some types of healthcare. Why can't we just call it, "Health Payment Reform!"
As things stand now, there is a lot of doubt that a health reform bill will be signed by the President before the Controversies in Childbirth Conference, February 19-21, 2010 in Tampa, Florida. The sad thing is, I really don't know if that's good or bad. The system is broke and needs fixing, I just don’t know for sure whether or not, the proposed cure is better than the perceived disease?
Have a great weekend.
Alan.
Alan@birthconference.org
Thursday, November 5, 2009
Same Set of Facts,... Totally Opposite Conclusion
About 15 years ago, the cesarean-section rate was climbing to alarming levels. At that time, insurers and Medicaid paid substantially more for cesarean sections, then for vaginal birth. The payers decreed that henceforth: vaginal birth and cesarean section will pay the same.
The obstetricians said: "Do you expect us to perform surgery for the same amount of money as a vaginal birth?" Thus, for the same amount of money, the obstetricians started doing more vaginal birth and cesarean rates declined.
A generation of obstetricians later, the cesarean section rate is at an all time high and climbs with no end in sight. When asked, “Why the change?”, the response that can be read between the lines is: "For the same amount of money, do you really expect us to go into the hospital at all hours of the night and wait hours to deliver a baby, when we can do a cesarean during normal business hours in 15 minutes?”
The same set of circumstances: “paying equal for cesarean as for vaginal delivery,” yielded totally opposite results. The reason depends on where you started. If you were being paid more for cesareans and the change came paying the same, then you felt that you feel your work is being devalued and you would lean toward non-surgery. However, if you were ALREADY being paid the same, then the amount of extra and unpredictable time that it takes to do a vaginal delivery would be hard to justify.
That is why it is important to understand someone's current mindset and to propose changes based on how things are operating today, and not how they operated years ago. You cannot understand a person, unless you've walked a mile in their shoes (or moccasins, or sneakers, or Birkenstocks).
Alan.
Alan@birthconference.org
The obstetricians said: "Do you expect us to perform surgery for the same amount of money as a vaginal birth?" Thus, for the same amount of money, the obstetricians started doing more vaginal birth and cesarean rates declined.
A generation of obstetricians later, the cesarean section rate is at an all time high and climbs with no end in sight. When asked, “Why the change?”, the response that can be read between the lines is: "For the same amount of money, do you really expect us to go into the hospital at all hours of the night and wait hours to deliver a baby, when we can do a cesarean during normal business hours in 15 minutes?”
The same set of circumstances: “paying equal for cesarean as for vaginal delivery,” yielded totally opposite results. The reason depends on where you started. If you were being paid more for cesareans and the change came paying the same, then you felt that you feel your work is being devalued and you would lean toward non-surgery. However, if you were ALREADY being paid the same, then the amount of extra and unpredictable time that it takes to do a vaginal delivery would be hard to justify.
That is why it is important to understand someone's current mindset and to propose changes based on how things are operating today, and not how they operated years ago. You cannot understand a person, unless you've walked a mile in their shoes (or moccasins, or sneakers, or Birkenstocks).
Alan.
Alan@birthconference.org
Wednesday, November 4, 2009
Missouri Natural Birth Center Announces Closing
The Columbia Community Birth Center has announced that it will close its doors at the end of the year. According to media reports, medical director, Elizabeth Allemann, M.D., is leaving the practice and the center is unable to find a replacement physician. Without a physician, the birth center is unable to accept insurance reimbursement.
Click here to read newspaper story.
Other media reports claim that the community and legal acceptance of homebirth , midwives also made it difficult for the birth center to continue.
Columbia Community Birth Center was opened three years and delivered 175 babies.
I do not have first hand information into the closing of the center other than what I have eread in the press, although I have had conversations with Dr. Allemann in the past.
A commentary on the closing of this Missouri birth center is actually quite difficult , because of the mutual distrust in Missouri, between midwives and physicians. Allow me to give a brief history from memory, and my apologies if I get it wrong.
In Missouri it was a felony to act as a midwife without a nursing license. Missouri did not recognize the CPM. A committee chairman in the Missouri legislature put wording into a bill that decriminalized midwifery. The wording was in such archaic language, that the word midwife was not used, (I believe even the terms labor and birth were not used) and no one objected until after the bill was passed. The governor refused to veto the bill after the midwifery clause became publicly known, not because the governor wanted to legalize midwifery, but rather he needed the rest of the bill and would not veto the entire bill. The physicians brought a court case to overturn the new law and were eventually rebuffed at the Missouri Supreme Court, due to "lack of standing."
If one were to look at this as an outsider, you would see everyone did what they needed to do. The homebirth advocates got very creative and found a legislative supporter to push the bill through. The physicians attempted to protect their turf by fighting against it (although they claimed that they were fighting on behalf of moms and babies, which is not their mandate and which the court called them on, when throwing out their case)
My question is: are you surprised that based on the above stated scenario that it would be difficult for the birth center to find physicians who want to work with it?
Yesterday, when discussing agendas,. I talked about battle plans. The problem in political and legal battles, is when the battle is over (although the war may continue) you may actually have to work with your enemy or your friend who is on the other side. It's why in sports it's bad form to run up the score.
When you win your battle, keep an open door to your opponent. You never know when you need them.
Alan
alan@birthconference.org
Click here to read newspaper story.
Other media reports claim that the community and legal acceptance of homebirth , midwives also made it difficult for the birth center to continue.
Columbia Community Birth Center was opened three years and delivered 175 babies.
I do not have first hand information into the closing of the center other than what I have eread in the press, although I have had conversations with Dr. Allemann in the past.
A commentary on the closing of this Missouri birth center is actually quite difficult , because of the mutual distrust in Missouri, between midwives and physicians. Allow me to give a brief history from memory, and my apologies if I get it wrong.
In Missouri it was a felony to act as a midwife without a nursing license. Missouri did not recognize the CPM. A committee chairman in the Missouri legislature put wording into a bill that decriminalized midwifery. The wording was in such archaic language, that the word midwife was not used, (I believe even the terms labor and birth were not used) and no one objected until after the bill was passed. The governor refused to veto the bill after the midwifery clause became publicly known, not because the governor wanted to legalize midwifery, but rather he needed the rest of the bill and would not veto the entire bill. The physicians brought a court case to overturn the new law and were eventually rebuffed at the Missouri Supreme Court, due to "lack of standing."
If one were to look at this as an outsider, you would see everyone did what they needed to do. The homebirth advocates got very creative and found a legislative supporter to push the bill through. The physicians attempted to protect their turf by fighting against it (although they claimed that they were fighting on behalf of moms and babies, which is not their mandate and which the court called them on, when throwing out their case)
My question is: are you surprised that based on the above stated scenario that it would be difficult for the birth center to find physicians who want to work with it?
Yesterday, when discussing agendas,. I talked about battle plans. The problem in political and legal battles, is when the battle is over (although the war may continue) you may actually have to work with your enemy or your friend who is on the other side. It's why in sports it's bad form to run up the score.
When you win your battle, keep an open door to your opponent. You never know when you need them.
Alan
alan@birthconference.org
Tuesday, November 3, 2009
What's My Hidden Agenda?
In the months before the March 2009 Controversies in Childbirth Conference, I would get some interesting phone calls such as:
A midwife asking if this conference was a propaganda piece for ACOG, and if we will only hear about the poor underpaid obstetrician!
An obstetrician asking if this was one of those natural birth conferences telling us how great midwives are!
A hospital administrator asking if this conference is about preaching homebirth!
A homebirth advocate asking if this conference is to show that homebirth is dangerous!
Even after the conference, when every attendee went home to their communities and raved about learning different viewpoints, and having a fair and frank exchange of ideas, people still could not believe it was nuetral. There must have been an agenda!!
Do I pretend not to have any biases? OF COURSE NOT!! However, if you want a conference where everyone in front of the room will agree with you, you can probably find one every weekend somewhere in the US or North America. However, if you want to learn the issues that the other side faces, so you can become more effective at communicating with your patient/client or advocating for your cause, then the Controversies in Childbirth Conference will give you that..
A number of years ago, I had a conversation with midwifery icon: Ina May Gaskin, who I consider a friend. I said: " Ina May, you have been fighting this battle for 30 years, and by every indicator, be it cesarean section rate, infant mortality, or midwifery access, you are losing." To which she responded, "You're right, we are losing, but we don't know what else to do."
So here is my agenda: To get people that are involved in the birth care process to communicate with other people involved in the birth care process, even if, they vehemently disagree with each other's means and methods. It is my belief that only with, "abortion" (which we do not discuss) can middle ground NOT be found., because the subject is so deeply rooted in people's religious and moral convictions In the arena of birth. I believe it is proven over and over that middle ground is findable and is the preferred way of getting things accomplished.
There's a simple rule of battle that President Bush learned, and Pres. Obama is experiencing. When you are losing: retreat, surrender, or change your battle plan. You do not keep doing the same thing over and over and continue to lose.
How many of you have been fighting this battle for 30 years? Please tell me how many WINS, you can claim credit for. Have you reduced the cesarean section rate? Have you decreased the infant mortality rate? Have you decreased the maternal mortality rate? Have you decreased the number of babies admitted to NICU? Have you decreased the number of women choosing epidurals?
If you have answered “NO” to the questions above, then it's time for you to change your battle plan.
Last Friday, I proposed a different type of physician owned facility. This is now causing discussions in the physician world. This proposal is a game changer to physician’s because it is asking them to change their battle plan, since they also believe that they are losing. They're not happy with the hours they work, the conditions in the hospital, the lack of time they have for each patient and the lack of money they receive for their time as well as a training and expertise.
Changing your battle plan, sounds crazy doesn't it? On the other hand, what do you call repeating the same action over and over and expecting a different result?
Alan
alan@birthconference.org
Tomorrow- Another birth center announces it’s closing!
A midwife asking if this conference was a propaganda piece for ACOG, and if we will only hear about the poor underpaid obstetrician!
An obstetrician asking if this was one of those natural birth conferences telling us how great midwives are!
A hospital administrator asking if this conference is about preaching homebirth!
A homebirth advocate asking if this conference is to show that homebirth is dangerous!
Even after the conference, when every attendee went home to their communities and raved about learning different viewpoints, and having a fair and frank exchange of ideas, people still could not believe it was nuetral. There must have been an agenda!!
Do I pretend not to have any biases? OF COURSE NOT!! However, if you want a conference where everyone in front of the room will agree with you, you can probably find one every weekend somewhere in the US or North America. However, if you want to learn the issues that the other side faces, so you can become more effective at communicating with your patient/client or advocating for your cause, then the Controversies in Childbirth Conference will give you that..
A number of years ago, I had a conversation with midwifery icon: Ina May Gaskin, who I consider a friend. I said: " Ina May, you have been fighting this battle for 30 years, and by every indicator, be it cesarean section rate, infant mortality, or midwifery access, you are losing." To which she responded, "You're right, we are losing, but we don't know what else to do."
So here is my agenda: To get people that are involved in the birth care process to communicate with other people involved in the birth care process, even if, they vehemently disagree with each other's means and methods. It is my belief that only with, "abortion" (which we do not discuss) can middle ground NOT be found., because the subject is so deeply rooted in people's religious and moral convictions In the arena of birth. I believe it is proven over and over that middle ground is findable and is the preferred way of getting things accomplished.
There's a simple rule of battle that President Bush learned, and Pres. Obama is experiencing. When you are losing: retreat, surrender, or change your battle plan. You do not keep doing the same thing over and over and continue to lose.
How many of you have been fighting this battle for 30 years? Please tell me how many WINS, you can claim credit for. Have you reduced the cesarean section rate? Have you decreased the infant mortality rate? Have you decreased the maternal mortality rate? Have you decreased the number of babies admitted to NICU? Have you decreased the number of women choosing epidurals?
If you have answered “NO” to the questions above, then it's time for you to change your battle plan.
Last Friday, I proposed a different type of physician owned facility. This is now causing discussions in the physician world. This proposal is a game changer to physician’s because it is asking them to change their battle plan, since they also believe that they are losing. They're not happy with the hours they work, the conditions in the hospital, the lack of time they have for each patient and the lack of money they receive for their time as well as a training and expertise.
Changing your battle plan, sounds crazy doesn't it? On the other hand, what do you call repeating the same action over and over and expecting a different result?
Alan
alan@birthconference.org
Tomorrow- Another birth center announces it’s closing!
Monday, November 2, 2009
1990 And Not a Clue How Much I Will Have To Pay
1990 is not a year, it is the number of pages in the House Health Reform Bill, proposed by Speaker Nancy Pelosi last week.
If you are so inclined, you may download your very own copy by clicking here.
I've written about this before, and I will say it again and again: "How much do I have to pay to buy a policy. under this bill?” I understand that the insurance companies can set their own rates, but since the current bill proposes a "Public Option" the government must surely be able to estimate how much it will cost the average American to buy into this government program and what it will cover.
I believe that the previous House committee bills were about 1100 pages, so in the new 900 pages, could someone take a minute to guesstimate costing coverage? At the end of the day isn't this the most important question. How much will I have to pay for it?
I know the media makes a big deal of the Congressional Budget Office guesstimating $one trillion and a few odd billion dollars, and that is scary to America as a whole. However $1,000,000,000,000 PLUS dollars notwithstanding, please tell me if insurance will cost me $200 month, $500, a month or $1,000 per month for ME!!! Is this asking too much??
I've read the initial reports of what is and is not in this bill. I will await the analysts to go through all 1990 pages and report back their opinions. I've already seen some troubling areas. One of the most troubling is the analysis that the public option may actually cost more than private insurance. I do not know if this is true, but if it is, you can look for the insurance companies to raise their rates..
A little political commentary, if I may: I wish the Republicans would stop telling us that the current system works. It does not! It is unaffordable for individuals and businesses and no one is happy with it. As the economy gets worse, look for employers to reduce coverage, increase deductibles and coinsurance, and increase the portion that the employee must pay.
Likewise, the Democrats must stop turning the insurance companies into the villains. The insurance companies combined profits are reported as 2.2% of revenue, which is not very high. Furthermore, if this was ONLY about insuring the uninsured and uninsurable, it would not need 2,000 pages. This si about fundementally changing who control's America's health care system.
I am also disappointed in President Obama, because as a candidate he promised transparency in these major issues, even promised the C-SPAN cameras would open the secret congressional negotiations to the public. The Pelosi and Reid, Health Reform Bills were negotiated behind closed doors, and the President encouraged this. It appears and the polls confirm that he has squandered his unprecedented support when he took office, and that Washington is back to business as usual, and it is not pretty.
The media is still not asking the question: How much will I have to pay? Why can the media tell you how much the average American will spend on Thanksgiving dinner? How much the average American will spend on Christmas presents? How much the average American will spend on vacation? But they can't tell us how much the average American will pay for health insurance under this 1990 page bill.
Alan
alan@birthconference.org
If you are so inclined, you may download your very own copy by clicking here.
I've written about this before, and I will say it again and again: "How much do I have to pay to buy a policy. under this bill?” I understand that the insurance companies can set their own rates, but since the current bill proposes a "Public Option" the government must surely be able to estimate how much it will cost the average American to buy into this government program and what it will cover.
I believe that the previous House committee bills were about 1100 pages, so in the new 900 pages, could someone take a minute to guesstimate costing coverage? At the end of the day isn't this the most important question. How much will I have to pay for it?
I know the media makes a big deal of the Congressional Budget Office guesstimating $one trillion and a few odd billion dollars, and that is scary to America as a whole. However $1,000,000,000,000 PLUS dollars notwithstanding, please tell me if insurance will cost me $200 month, $500, a month or $1,000 per month for ME!!! Is this asking too much??
I've read the initial reports of what is and is not in this bill. I will await the analysts to go through all 1990 pages and report back their opinions. I've already seen some troubling areas. One of the most troubling is the analysis that the public option may actually cost more than private insurance. I do not know if this is true, but if it is, you can look for the insurance companies to raise their rates..
A little political commentary, if I may: I wish the Republicans would stop telling us that the current system works. It does not! It is unaffordable for individuals and businesses and no one is happy with it. As the economy gets worse, look for employers to reduce coverage, increase deductibles and coinsurance, and increase the portion that the employee must pay.
Likewise, the Democrats must stop turning the insurance companies into the villains. The insurance companies combined profits are reported as 2.2% of revenue, which is not very high. Furthermore, if this was ONLY about insuring the uninsured and uninsurable, it would not need 2,000 pages. This si about fundementally changing who control's America's health care system.
I am also disappointed in President Obama, because as a candidate he promised transparency in these major issues, even promised the C-SPAN cameras would open the secret congressional negotiations to the public. The Pelosi and Reid, Health Reform Bills were negotiated behind closed doors, and the President encouraged this. It appears and the polls confirm that he has squandered his unprecedented support when he took office, and that Washington is back to business as usual, and it is not pretty.
The media is still not asking the question: How much will I have to pay? Why can the media tell you how much the average American will spend on Thanksgiving dinner? How much the average American will spend on Christmas presents? How much the average American will spend on vacation? But they can't tell us how much the average American will pay for health insurance under this 1990 page bill.
Alan
alan@birthconference.org
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