Medicare for Environmental Health Hazards?

UPDATE: Hat tip goes out to Jeremy Koulish, of Carrots and Sticks, for running down the CBO numbers and giving us a rough estimate of how many people would likely be covered by this provision of the bill. That number is in the thousands, a few thousand or so. As Jeremy said, "Yeah, not particularly earth-shattering, but obviously great for those 3,000 people." We will be doing some more analysis of this, and should it pass, we will check back to see how this provision is being implemented.

There is something interesting in the new health care amendment, Section 1881A.

MEDICARE COVERAGE FOR INDIVIDUALS EXPOSED TO ENVIRONMENTAL HEALTH HAZARDS.

We have still got a lot of reading left to do on this section of the amendment, but it has raised some very interesting questions.

I will start with what, as my reading leads me to believe, this section of the amendment does. This section allows for certain individuals, deemed affected by environmental health hazards, to be eligible for Medicare in the event that the individual is not eligible for necessary care under other public or private programs. It also allows for the creation of a pilot program to determine eligibility and to provide necessary benefits.

First and foremost, this is not restrictive by age. Meaning, regardless of how old you are, if you are deemed affected by environmental health hazards, you may be eligible for Medicare.

The first question this raises, who is considered an "environmental exposure affected individual"

(e) ENVIRONMENTAL EXPOSURE AFFECTED INDIVIDUAL DEFINED.—

(1) IN GENERAL.—For purposes of this section, the term ‘environmental exposure affected individual’ means—

(A) an individual described in paragraph (2); and
(B) an individual described in paragraph (3).

(2) INDIVIDUAL DESCRIBED.—
(A) IN GENERAL.—An individual described in this paragraph is any individual who—

(i) is diagnosed with 1 or more conditions described in subparagraph (B);
(ii) as demonstrated in such manner as the Secretary determines appropriate, has been present for an aggregate total of 6 months in the geographic area subject to an emergency declaration specified in sub- section (b)(2)(A), during a period ending—

(I) not less than 10 years prior to such diagnosis; and
(II) prior to the implementation of all the remedial and removal actions specified in the Record of Decision for Operating Unit 4 and the Record of Decision for Operating Unit 7;

(iii) files an application for benefits under this title (or has an application filed on behalf of the individual), including pursuant to this section; and
(iv) is determined under this section to meet the criteria in this subparagraph.

(B) CONDITIONS DESCRIBED.— For purposes of subparagraph (A), the following condi- 13 tions are described in this subparagraph:
(i) Asbestosis, pleural thickening, or pleural plaques as established by—

(I) interpretation by a ‘B Read-er’ qualified physician of a plain chest x-ray or interpretation of a computed tomographic radiograph of the chest by a qualified physician, as determined by the Secretary; or
(II) such other diagnostic standards as the Secretary specifies, except that this clause shall not apply to pleural thickening or pleural plaques unless there are symptoms or conditions requiring medical treatment as a result of these diagnoses.

(ii) Mesothelioma, or malignancies of the lung, colon, rectum, larynx, stomach, esophagus, pharynx, or ovary, as established by—

(I) pathologic examination of bi- opsy tissue;
(II) cytology from bronchioalveolar lavage; or
(III) such other diagnostic standards as the Secretary specifies.

(iii) Any other diagnosis which the Secretary, in consultation with the Com- missioner of Social Security, determines is an asbestos-related medical condition, as established by such diagnostic standards as the Secretary specifies.

(3) OTHER INDIVIDUAL DESCRIBED.—An individual described in this paragraph is any individual who—

(A) is not an individual described in paragraph (2);
(B) is diagnosed with a medical condition caused by the exposure of the individual to a public health hazard to which an emergency declaration applies, based on such medical conditions, diagnostic standards, and other criteria as the Secretary specifies;
(C) as demonstrated in such manner as the Secretary determines appropriate, has been present for an aggregate total of 6 months in the geographic area subject to the emergency declaration involved, during a period deter- mined appropriate by the Secretary;
(D) files an application for benefits under this title (or has an application filed on behalf of the individual), including pursuant to this section; and
(E) is determined under this section to meet the criteria in this paragraph.

That is a lot of language to say that, essentially, an "environmental exposure affected individual" is someone affected by asbestos or someone in the geographic area where an "emergency declaration aplies."

I am going to ignore the part about asbestos, for now (it comes back up at the end). How do we define whether or not an "emergency declaration applies?"

(2) EMERGENCY DECLARATION.—The term emergency declaration’ means a declaration of a public health emergency under section 104(a) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980.

In other words, a Superfund site that has been deemed an emergency. So this amendment would make it so anyone affected by a health hazard, who lives in an area designated a Superfund site under an emergency declaration, would be eligible for Medicare if they are not already eligible for the needed care through other public or private entities.

Not a huge deal. Especially considering how rarely a Superfund site is deemed an emergency.

But there was one part that caught my eye, when I came across the section on pilot programs:

(b) PILOT PROGRAM FOR CARE OF CERTAIN INDIVIDUALS RESIDING IN EMERGENCY DECLARATION AREAS.—
(1) PROGRAM; PURPOSE.—

(A) PRIMARY PILOT PROGRAM.—The Secretary shall establish a pilot program in accordance with this subsection to provide innovative approaches to furnishing comprehensive, coordinated, and cost-effective care under this title to individuals described in paragraph (2)(A).
(B) OPTIONAL PILOT PROGRAMS.—The Secretary may establish a separate pilot program, in accordance with this subsection, with respect to each geographic area subject to an emergency declaration (other than the declaration of June 17, 2009), in order to furnish such comprehensive, coordinated and cost-effective care to individuals described in subparagraph 15 (2)(B) who reside in each such area.

"Other than the declaration of June 17, 2009." What declaration was that? None other than the first, and only, emergency declaration by the EPA under the Environmental Response, Compensation, and Liability Act of 1980.

And now is when I will bring back the asbestos stuff that I chose to ignore at the beginning. This emergency declaration happens to revolved around problems with, you guessed it, asbestos. So, now I am confused.

Does this bit about excluding the declaration of June 17th exclude all these people from being eligible for Medicare, or are they included by the bits about asbestos?

We are working on getting in touch with Senator Baucus's office (given that it is the weekend, and a crazy one at that, we may have to wait for Monday) to help us tackle some of these questions. I hope you will join us in trying to figure out this peculiar section of the amendment. Check back for updates.

Deanna Zandt on New Media, Race Relations, and the Power of Storytelling

There was a moment in Deanna Zandt's speech at the Organizing 2.0 conference that I wanted to highlight:



The power of storytelling must not be underestimated. I will use the Obama campaign as an example, since storytelling played a larger role than anything else, I would argue, in their message strategy.

The campaign had introduced a rather different candidate to the world, an improbable campaign. They clearly recognized that he would not be able to win on issue statements alone, he had to reach out to people who agreed with him on policy but were questioning, "Who is this different looking guy with a funny name?" Through telling his story, he was able to bridge whatever divides existed between himself and millions of Americans.

Although the campaign officially began years later, we can really trace the 2008 Presidential campaign all the way back to the 2004 Democratic National Convention when, then a candidate for U.S. Senate, Barack Obama was introduced to the country when he gave the keynote address. What he did in that speech, more than talk about issues, was that he told his story. He told where he came from, and through that we learned why it was that he was supporting Senator Kerry for President. Without question, it was the most memorable moment in the 2004 Presidential campaign. And that is exactly what President Obama trained his volunteers to do. As an organizer for the campaign, I told my story 8 trillion times. I repeatedly told volunteers, "You may not be an expert on every issue, or on any, but you are an expert on who you are and why you support Barack Obama, and that is what you need share with your neighbors."

What anyone working the campaign will tell you, we would not have won without storytelling. The polls showed that President Obama was right on the issues, but everyone knows that is not enough when it comes to politics. People need to be able to trust their President. And trust, as Deanna Zandt mentions in her speech, is developed through sharing stories with one another. What the campaign realized is that it was not enough to have President Obama's story out there, he needed to expand the reach exponentially by turning every volunteer into a little storytelling machine themselves. President Obama's story is "uniquely American," and it was not enough. What the campaign demonstrated, and what sounds obvious, is that your neighbor's story is more likely to impact you than a candidate's.

They had members of the community talking with their neighbors, sharing struggles of a failing economy and failing health care system, together. And this made all the difference. During President Obama's speech on race, back in PA during the primary, he ended his speech on the power of storytelling:

There is a young, twenty-three year old white woman named Ashley Baia who organized for our campaign in Florence, South Carolina. She had been working to organize a mostly African-American community since the beginning of this campaign, and one day she was at a roundtable discussion where everyone went around telling their story and why they were there.

And Ashley said that when she was nine years old, her mother got cancer. And because she had to miss days of work, she was let go and lost her health care. They had to file for bankruptcy, and that's when Ashley decided that she had to do something to help her mom.

She knew that food was one of their most expensive costs, and so Ashley convinced her mother that what she really liked and really wanted to eat more than anything else was mustard and relish sandwiches. Because that was the cheapest way to eat.

She did this for a year until her mom got better, and she told everyone at the roundtable that the reason she joined our campaign was so that she could help the millions of other children in the country who want and need to help their parents too.

Now Ashley might have made a different choice. Perhaps somebody told her along the way that the source of her mother's problems were blacks who were on welfare and too lazy to work, or Hispanics who were coming into the country illegally. But she didn't. She sought out allies in her fight against injustice.

Anyway, Ashley finishes her story and then goes around the room and asks everyone else why they're supporting the campaign. They all have different stories and reasons. Many bring up a specific issue. And finally they come to this elderly black man who's been sitting there quietly the entire time. And Ashley asks him why he's there. And he does not bring up a specific issue. He does not say health care or the economy. He does not say education or the war. He does not say that he was there because of Barack Obama. He simply says to everyone in the room, "I am here because of Ashley."

"I'm here because of Ashley." By itself, that single moment of recognition between that young white girl and that old black man is not enough. It is not enough to give health care to the sick, or jobs to the jobless, or education to our children.

But it is where we start. It is where our union grows stronger. And as so many generations have come to realize over the course of the two-hundred and twenty one years since a band of patriots signed that document in Philadelphia, that is where the perfection begins.

Really Operation Rescue?

Do you get the same reaction when you read this paragraph from an email Operation Rescue sent out? It was an email announcing that Operation Rescue is honoring the life of James Pouillon as OR's 2009 person of the year. (emphasis mine)

Mr. Pouillon was a long-time pro-life street activist from Owosso, Michigan, who was gunned down on September 11, 2009, as he protested abortion outside Owosso High School. A local man, Harlan Drake, has admitted to targeting Mr. Pouillon for death because he did not agree with his views on abortion.

Wait, what? "Admitted to targeting Mr. Pouillon for death because he did not agree with his views on abortion"? Seriously? For those of you that are not completely familiar with this story. Harlan Drake was the man who recently gunned down two people, and planned to go after a third. They were based on grudges, all having a different motive.

Harlan Drake has admitted that he was "offended" by James Pouillon's anti-choice demonstrations, but the admission had little to do with Mr. Pouillon's views. Harlan Drake said he was offended by "the fact that [Mr. Pouillon] was outside the high school with his signs in front of children going to school," according to the county's chief assistant prosecutor, Sara Edwards. Let me repeat that, the chief assistant prosecutor, you know, the person arguing against Mr. Drake, not some pro-choice activist, said that he was offended that Mr. Pouillon was outside a school with his signs.

And what were these signs? "Graphic fetus images".

Keep this in mind. Harlan Drake has said nothing about being offended by anti-choice beliefs, he has admitted to being offended by someone holding up huge "graphic fetus images" outside a school. Definitely not an excuse for murder. But murder is no excuse for OR to go around lying in order to drum up political support.

Now, before some anti-choice nuts yell at me, I am not saying that James Pouillon should not be OR's person of the year (I am in no position to make any judgement on who they choose as their person of the year). However, I will not keep silent when they send a blatant lie to my inbox.

Training Tuesday with #org20: Getting Through the Bureaucracy

This week, we have something new for our Training Tuesday series. We still have plenty of videos left to come from Democracy for America's Campaign Academy, but a couple weekends back, we attended the Organizing 2.0 conference in New York. This conference was a unique opportunity for activists to learn about new media and online organizing from some of the greatest online organizers around.

Today, we present the first session we attended on navigating the bureaucracy of organizations and figuring out how to fit new media into existing organizational structures. Our panelists today are Charlie Albanetti of Citizen Action of New York, Elana Levin of the Writers Guild of America, East (WGAE), and Michael Whitney of Fire Dog Lake. A lot of their advice today boils down to one thing: you need to have a policy for this. That is, you cannot just plop your organization online and expect everything to run efficiently. You will need to sit down with the leadership and anyone else involved online and build a policy for online engagement. This is a process over time, not a Friday meeting over lunch.

Today's training is all bout opening the door. How do you maneuver through the bureaucracy of well entrenched community organizations to provide the conditions necessary to succeed with new media? Not everyone gets to be the Obama campaign with a boss that gets and appreciates online activism (and even they had to fight through a lot of bureaucracy to build their online organization).

Our panelists will provide us with some helpful tips on how to manage your organization's transition into the new media world. There are all these fun and powerful tools available online, but they are useless to you if your organization is not prepared to accept or understand them.

One of the more significant changes you will encounter as you transition your organization from 1.0 to 2.0 is that what was once primarily one-way communication is now heavily two-way (or three, four, five, six thousand.... etc)



Now that you have made it clear that what happens online is very different from traditional forms of organizing, you need to figure out how to include something so overarching and so necessarily flexible into the rigid structure of an organization:



An interesting conversation was sparked by a question about what to do with a boss that not only accepts online activism, but wants to play a large role, maybe too large a role...



And our last video for today, certainly not our least, is about when to train other staff to use online tools and when not to:


That's all for today. Check back next Tuesday at 6:00pm EST for another session of Training Tuesday!

Music Monday: Ezra Furman & the Harpoons

Sum of Change made the long trek to Baltimore last Tuesday for some brew, billiards and of course, music.

We were attracted to Ottobar, a hip and happening venue in the Charles Village area, by Ezra Furman & the Harpoons, a young band on the road full-time for the first time.

The four lads met during their undergrad years at Tufts University and made the decision to tour after graduating in 2008. They're a dedicated bunch, putting on a spirited show for the somewhat sparsely attended gig. But despite the fact that Tuesday nights in a city far from Boston don't make for the liveliest of crowds, those in attendance were quick to get into the groove.

Transitioning from university students to rough and ready musicians can't be easy, but Ezra Furman & the Harpoons seem to enjoy it. These boys may just make it big some day.

Ottobar
2549 North Howard Street
Baltimore, MD 21218-4506
(410) 662-0069

Boozing it up at the State of the Alcohol Industry Briefing

This post is featured on Plight of the Pumpernickel.

___________________

Last Thursday, I finagled an invite to the first annual State of the Alcohol Industry Briefing at the National Press Club in Washington, DC.

Actually, 'finagled' is a bit of a misnomer. Went to their website, registered myself and then printed out a free ticket is a more apt description. It was pretty easy to get in.

Once inside, the scene was a bit like a room in Willy Wonka's factory. Except everything was alcoholic. As the man says, candy is dandy, but liquor is quicker.

Set up along the walls were a myriad of alcohol stations. Custom martinis with Kahlua liqueur and pumpkin spices, flights of variously aged Hennessy, drinks mixed with top shelf vodka and gin, and more types of wine and beer than I could count. It was glorious.

A prime rib carving station, a chef making custom risotto dishes and countless hors d'oeuvres were also available for our enjoyment.

Incredibly, the entire event was free. Not to say the evening came without a price; my gaggle of friends and I found ourselves in the obvious minority as the youngest patrons in attendance. And perhaps the only liberals. Big surprise, the alcohol industry is comprised of lots of old conservatives. Who knew.

This didn't seem like such a bad thing until a particularly sleazy one began chatting up a friend. Let's just say the old guy's comments were less than PC. Here is a truncated version of the conversation that ensued:

Old guy: I like that snazzy shirt you're wearing. (Points to my male friend's red shirt) I bet you're popular with the ladies.

Friend: Um, well. I dunno. I'm here with my girlfriend.

Old guy: Because there are a lot of tasty young things here. (Points to me and my two female friends).

Friend: Um...

Old guy: That one of the right is cute. (Nodding at my friend) But she's a redhead. You never know what you're getting with those.

Friend: Yeah, uh. Well...

Old guy: The one in the middle is nice looking. (Pointing to me) She kind of has the cute Washington thing going on. Only good for one night, though.

Friend: I don't think I could feel more uncomfortable...

Old guy: Now, that girl on the left. (Points to African American friend) I've never had one of those. I'd really like to sink my teeth into that.

Friend: ...and there we are!

Ah, yes. My first taste of truly creepy, old, conservative Washington.

Interestingly enough, none of the six people in my early to mid 20s aged crowd were carded. I don't think I need to tell you that I could easily pass for 20 years old. Just saying.

All things aside, it was an extraordinarily fun evening. So much fun, in fact, that I would happily endure again a stream of come-ons spouted by a man old enough to be my father. A small price to pay for such enjoyment.

Tell Us

Over the holidays, we at Sum of Change will be hard at work redesigning the web site. I should really say "recreating" the web site, as it will look and feel very different from our current design. We are coming out with a new logo based on the DC flag as well. Before we sit down to completely revolutionize how our web site looks, we want your input.

Please send an email to info at sum of change dot com, or just use our contact page and answer these 5 questions:

1) How did you find out about SumofChange.com?

2) When you visit SumofChange.com, what are you looking for? What brings you to the website?

3) When you visit, are you able to find what you are looking for easily? If not, please tell us why and how we might be able to make things easier to find.

4) What do you like least about our current site design?

5) What do you like best about our current site design?

Please do take a minute send us an email and answer those 5 questions. We have a laundry list of things we would like to change, but your input is vitally important to us since our web site is designed for you.

Szakos' a Free Man

A while back, we covered a somewhat unique story. Joe Szako, the Executive Director of the Virginia Organizing Project, had been arrested while attempting to contact Anthem Insurance during a demonstration at their headquarters. We were there when Mr. Szako appeared in court, Tuesday September 22nd 2009, in Henrico, VA. You can read more about the arrest and watch video footage of the arrest here.

At the end of November, the case ended with Mr. Szako a free man, for the most part. He will have to stay out of trouble for six months (and yes, that includes any visits to Anthem's headquarters):

Trespassing charges against Virginia Organizing Project Executive Director Joe Szakos are to be dismissed after six months with no incident and no visits to Anthem’s property.

Evidence showed that customers are permitted in the main entrance where Szakos attempted to enter Anthem’s Richmond headquarters in July. Evidence also showed that Szakos was connected by cell phone at the time of arrest-waiting for an Anthem representative-following the instructions Anthem security had given him. Judge Neil Steverson chose not to convict Szakos for trespassing on his own insurance company’s property.

After the trial, Mr. Szakos released this statement:

I am relieved that Judge Steverson recognized that I was well within my rights to visit my own insurance company and ask them a question. I look forward to the official dismissal of these charges in six months so that we can all move on. Until that six months is up, I am barred from visiting Anthem’s property. This is not a problem since they rarely listen to their customers concerns anyway. Being officially barred is perhaps a more formal exemplification of Anthem’s existing customer service policy: ‘Don’t ask questions, just pay your bill.’

Anthem has succeeded in wasting thousands of taxpayer dollars on this charade. Anthem has used the time and resources of the Henrico County Police to arrest a paying customer who visited their building during normal business hours. Today, an hour of the court’s time was spent providing no real benefit to the County. Instead, the court’s time was spent deliberating on whether or not it is legal for a paying customer to walk up to their own health insurance company and ask to speak to a live person. It is absolutely absurd that this has gone this far.

Virginians are already paying outrageous health insurance premiums through Anthem. They should not be forced to pay for the court costs involved with Anthem’s crackdown on customers who question their business practices. I think that Anthem should apologize to the people of Henrico County for making them foot the bill for this nonsense. And then Anthem should apologize to the Virginia Organizing Project for taking up our time and resources with this trial.

The private health insurance industry has given us a health care system where customers have to deal with skyrocketing premiums, denied claims, and even trespassing charges for asking to speak to a representative in person. I am glad that Senators Mark Warner and Jim Webb voted Saturday to begin debate on health care legislation that will force insurance companies like Anthem to be competitive and improve their service. We all deserve better than this.

So, in conclusion, it apparently is not illegal to visit your health insurance company and try to ask them a question. Now if only we could visit our insurance company and expect some type of health care too. Yes, I am a dreamer.

Will 2010 Look Like 2008?

As we studied the numbers after the 2009 election, one thing stood out glaringly: the Obama voters had stayed home. Nate Silver showed us that the electorate that came out that day in Virginia had voted for McCain by 51-43, a stark difference from 2008's actual VA results.

Who knows whether or not this election was a sign of things to come, or just a reinforcement of the trend that when a new President takes over, the party suffers in the next election.

But if Democrats want 2010 to look anything like 2008, they better take a cue from this recent bombshell of a poll:

A new national poll finds that fully one third of Democratic voters say that they’re “less likely” to vote in 2010 if Congress doesn’t pass a public option, underscoring the possibility that dropping the provision seriously risks dampening the Dem base’s enthusiasm.

Why am I so sure that Republicans and Blue Dogs will find a way to say that this poll shows that the President should run to the center on health care? All I can say is, polls have shown that for the last several years health care has been the most important issue amongst liberal voters, so I am not shocked in the slightest bit by the results of this poll.