I have two announcements for you today. First, I’m honored to announce that I’ve been asked to serve on the Board of Directors of Consumers for Affordable Health Care. They are a ”…nonprofit, nonpartisan, research and advocacy organization committed to helping all Maine people obtain quality, affordable health care.” After spending 20 years working in health care for the private sector, I'm thrilled to be able to give back by helping with CAHC's important work.

The second announcement is that I’ve decided to split this blog in two. I’ve been thinking for a while that the content is a bit schizophrenic with me jumping from a discussion of Medicare Advantage plans to my fondness for The Big Bang Theory. So, moving forward I’ll maintain two separate blogs. The first called Mitchell on Health Care will be focused exclusively on Health Care issues. The second called Mitchell at Play will focus on fun stuff like TV, cooking, restaurant reviews, etc.

I’ve copied relevant posts to their respective new homes. Please let me know in the comments section on the new sites what you think.

A look back, a step forward

With Saturday night’s historic vote to allow Senate debate on their health care reform bill, it’s a good time to look back on how we got here, and think about the path forward.


The New York Times published a great interactive chart showing the history of health care reform:
A History of Health Care Reform - For almost a century, presidents and members of Congress have tried and failed to provide universal health benefits to Americans.

It reminds us that for almost 100 years, we’ve been trying to get this done. It also makes us think of all those people who went wanting when their lives could have been so different. But past is past, and while the bill taking shape in Washington will not accomplish everything we had hoped, it will represent a vast improvement over the status quo. (I know the final bill has not taken final shape yet, but general framework of making health care available to more people and starting to reign in the unsustainable cost increases is clear.)

There is so much that can still go wrong given the poisonous partisan atmosphere in Washington. Extremists on both sides of the aisle will claim that the bad things in the bill outweigh the good (and if you’ve watched TV in the past few days you’ve seen commercials hammering home their points). But we can’t fail again! Just because the bill doesn’t help everyone and fix everything, does not mean it’s not worth passing.

We must pass a bill this session. The time is now. It won’t be perfect, but it will be a step forward.

As if we needed more proof that the health care situation in this country is unacceptable

The Associated Press: Study: Injured uninsured more likely to die in ER

Uninsured patients with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance, according to a troubling new study.

The findings by Harvard University researchers surprised doctors and health experts who have believed emergency room care was equitable.

Health Care Reform and Abortion

No one ever said health care reform was going to be easy. But does it have to be quite so hard? Last week in the final days before the house passed the “historic” legislation, an issue we thought was settled once again reared its ugly head: How would abortion be handled by plans offered through the exchange.


The answer was going to be that the funds would be segregated, no government subsidy would pay for abortion (even though it is a legal procedure in all 50 states); coverage would be paid out of the individuals’ share of the premium. Ironically, this construct is similar to how catholic schools get money; the money only pays for the sectarian part of the education, not the religious part. (If one of these mechanisms is a gimmick, aren't both of them?)

Suddenly in the final days before the vote, that answer was no longer acceptable. Thus the Stupak amendment came to pass.

Following is an excerpt from Prescriptions: Abortion Puts Some in Congress in a Bind


By By KATHARINE Q. SEELYE

Robert J. Blendon, a professor of health policy at Harvard, said the choice between trying to stop an erosion of abortion rights and trying to improve health care for women pitted “what are described as two fundamental human rights — the right to universal coverage and the right of access to reproductive services — against each other.”

“They aren’t just policy trade-offs,” he said. “And that’s why this is so wrenching.”

This issue isn’t going away. As outlined in this Reuters’ analysis by Ed Stoddard there are no easy solutions but lots of potential damage: ANALYSIS-Abortion exposes divisions among U.S. Democrats

What do I think? As I'm writing this on Sunday afternoon (11/15/09) I’m not sure. Some Democrats are saying they won’t vote for a final bill that includes the Stupak amendment – is that the right response? I vehemently believe in a women’s right to choose, that part of me says don’t vote for the bill. I also vehemently believe that we must pass some form of health reform this year to expand coverage and start to rein in costs – to not do so will be to miss an historic opportunity and result in a continuation of unnecessary deaths. All I can say today is I’m saddened by the forces in this country that continue to work towards division instead of compromise.

The sad thing is that this is completely normal

The article talks about a lobbyist supplying the same text to Democratic and Republican congressmen for inclusion in the congressional record. This happens all the time... And we wonder (or maybe we've stopped wondering) why it is so hard to do the "people's" business in Congress.

In House, Many Spoke With One Voice: Lobbyists?
By ROBERT PEAR
Published: November 15, 2009
More than a dozen lawmakers? statements on the health care debate were ghostwritten by lobbyists working for Genentech, a biotechnology company.

Sorry I haven't posted in a while

To be honest, I was upset about last week's election (Maine Prop 1) but didn't want to write anything bitter. Now that some time has passed, I'm just left with a feeling of disappointment in the voters for being taken in by the fear mongering of the opposition.

But life goes on, and it’s time to turn our attention back to health care. In the next few days I'll have more to say about some of the ongoing issues (we can't let the quicksand that is the abortion issue in this country derail health care reform) but for today, just a link to an article about my adopted state talking about how hard this all is (and to me highlighting why we need fundamental change).


From today's NY Times:  Maine Finds a Health Care Fix Elusive

OK, enough with social justice issues for now, back to the fun stuff!

When I started this blog I said it would be a little of everything, some serious some not so serious. Time for some not so serious with various TV updates:


V premiers this Tuesday on ABC (watch the first nine minutes of the pilot here: http://www.tvguide.com/News/Watch-Minutes-ABCs-1011206.aspx). I loved the original miniseries and have great expectations for the new version!

Scrubs returns on Dec 1 with two episodes, Better off Ted returns the following week to share the hour. (Remember this is a reengineered scrubs taking place in the medical school with Turk and Dr. Cox as the only two returning full time cast members – however, all the other regulars have agreed to make some appearances.)

NBC has ordered 6 additional episodes of Chuck – meaning they plan on it returning early next year instead of next March as originally scheduled. YAY!

Finally, this week we got our first look at trailers for 2 eagerly awaited Winter shows (the two MOST eagerly awaited shows) LOST and 24 – The LOST trailer was a complete non event (watch it here: http://popwatch.ew.com/2009/10/30/lost-season-6/) no new footage at all. Of course without telling us anything it did remind us how much we miss the show and how much we’re anticipating the final season. The 24 trailer (watch it here: http://www.tvguide.com/News/24-Bauer-York-1011345.aspx) does include scenes from the new season, or as we refer to it Jack’s next day from hell – this time he’s in NY and trying to retire so he can spend time with his daughter and granddaughter – I’m sure you can figure out how well that works out.

As always, let me know what you think in the comments section.

Separate is not equal

Election day is Tuesday, while I have an opinion on all the items on the ballot (I know, you’re all shocked) the most important item is Proposition 1 – The fact that no state has yet upheld the right of all people to marry is a disgrace to our country. If you are in Maine, please vote and vote no on 1.

Health Care and Marriage Equality

Both of these issues are getting a lot of play here in Maine. Health Care maybe even more so than in the rest of the country due to the importance of our Republican Senators’ (Snow and Collins) potential support of a Democratic bill. Marriage Equality because after being the first state to pass legislation allowing gay marriage that was NOT court mandated, an election fight is underway as opponents try and pass a people’s veto to repeal the legislation. I’ve written about both issues separately, today I want to talk about what they have in common.

The answer to what they have in common comes from the following two part question: Who do you identify with and who can you identify with? You might think about your family, your church, your group of friends, your school, your town, your country. Another way of asking this is how do you define your pack? Years ago, Hillary Clinton wrote about it taking a village, but again, what is a village? How are we defining our community? Regardless of how we answer today, the two issues represent part of the struggle to get to the point where we extend the definition of our reference group to all individuals.

As we developed, we started to learn to get past thinking only about ourselves. It has been noted by many that the path of our growth as a society has been our ability to identify with larger and larger groups. First it was our family, then our tribe, then our village and so on. Now we no longer fear every stranger that comes down the road; however, there is still more progress to be made.

The civil rights movement can be viewed as extending our view of the group we identify with to people of all races. Seeing a larger group as deserving of the same legal protections and rights that some already had. The battle for gay rights (and gay marriage) is a continuation of that struggle to yet another segment of the population. As we come to recognize that ultimately the key group we belong to is mankind we realize that everyone deserves the same protections and rights.

As with recognizing that all individuals deserve the right to marry, we must recognize that all individuals deserve access to health care. Again, the definition of ourselves as being part of the group of all individuals is key. It leads to recognition of the shared responsibility to take care of each other. Keep this in mind as the debate rages on in Washington. The discussion should only be about the details, the goal of affordable access to care for everyone must be taken as a given.

As always I encourage you to share your comments below.

Fall TV 2009 – An Update

It was the best of times, it was the worst of times (OK, not original but I always wanted to start out a post that way). A month into the season we’ve seen the best of times: shows already getting full season pickups (The Middle, Modern Family and Cougar Town among others) and the worst of times: a show cancelled after two episodes (The Beautiful Live) and a show cancelled even before it aired (Southland). I can’t help but mention that the two cancelled shows were not on my recommended list while the three renewed shows were :)


In general I’ve been happy with my picks. Of the returning shows Big Bang Theory is having a break out year – if you haven’t tried it yet, please do. Also off to particularly good starts among the returning shows are How I Met Your Mother, Castle and the Mentalist (but remember to take these for what they are, pure fun escapism - don’t look for realism in any of them).

Most of the rest of the returning shows on my list are still keepers. However there are two I’m having issues with: Dollhouse is an interesting experiment but after a season plus it still has issues. The plots and characters are inconsistent. The best episode of the series is the one never aired on TV (Epilogue that was shot in case the series was cancelled last year and is available only on the DVD). Given the plunging ratings, this experiment might be over soon. Heroes has been problematic since the second season – once again we were told this is the year it comes back but I’m not sure that’s true. On the plus side is Robert Knepper (T-bag from Prison Break): both a good actor and interesting character. I’m just not sure that he is enough to balance our some of the tired plot lines of the other characters.

Among the new shows, I am in love with Glee and Flash Forward – definitely keepers! Glee is just pure fun and Flash Forward has been more intriguing (and better acted) than expected. I’m still watching most of my other picks, but two have already been dropped: Accidentally on Purpose - I watched one episode and it was just horrible, according to the ratings and reviews most people seem to agree with me so it will probably not be on much longer. The other one I never even got started on, The Forgotten. I just couldn’t seem to find time to add another crime show to my list. Unwatched but still waiting for me on the DVR is The Good Wife: Getting good reviews (and a full season pick-up) I’m still intrigued, I just haven’t gotten around to watching yet but I will soon.

Vampire Diaries has been another pleasant surprise. I was on the fence before it started but am enjoying it. Not on a level with some of the others but it is fun (I get a particular kick out of the meta comments when cast characters talk about the Twilight series). Community and Hank have been disappointing but I’m sticking with them for now. Community because it has moments of amusement and Hank because I’ll let ABC decide for me (being the only one of the four new Wednesday night ABC comedies not to be renewed is a sign it may not be long for this world).

Let me know what you think of the TV season so far by posting a comment.

Medicare Advantage – spending more was NOT the idea

A good article this morning on Medicare Advantage plans and how they are part of the health care legislation debate: Medicare Advantage tussle at heart of overhaul - Health care- msnbc.com: "Medicare Advantage tussle at heart of overhaul".

 

A key fact getting lost in the conversation is that these plans were originally created to SAVE the government money over traditional Medicare. Let’s take a look at the governments own definitions from the Medicare website (http://www.medicare.gov/choices/Overview.asp):

The Original Medicare Plan – This is a fee-for-service plan that covers many health care services and certain drugs. You can go to any doctor or hospital that accepts Medicare. When you get your health care, you use your red, white, and blue Medicare card.

The Original Medicare Plan pays for many health care services and supplies, but it doesn’t pay all of your health care costs. There are costs that you must pay, like coinsurance, copayments, and deductibles. These costs are called “gaps” in Medicare coverage. You might want to consider buying a Medigap policy to cover these gaps in Medicare coverage. You can also add prescription drug coverage by joining a Medicare Prescription Drug Plan.

For more information on the Original Medicare Plan, visit the Original Medicare Plan section of this website.

Medicare Advantage Plans – Available in many areas. If you have one of these plans, you don’t need a Medigap policy. These plans include:

• Health Maintenance Organizations (HMO),
• Preferred Provider Organizations (PPO)
• Private Fee-for-Service Plans
• Medicare Special Needs Plans
• Medicare Medical Savings Account Plans (MSA)

These plans may cover more services and have lower out-of-pocket costs than the Original Medicare Plan. Some plans cover prescription drugs. In some plans, like HMOs, you may only be able to see certain doctors or go to certain hospitals to get covered services.

Click here for more information on Medicare Advantage Plans.

 

Originally, Medicare Advantage plans were conceived to save the government and plans money. By contracting with private managed care plans, the government would pay less (95%) than for standard Medicare beneficiaries but the members would get enhanced benefits because of course (note sarcasm) private industry could be more efficient.

That intent did not last in the face of special interest lobbying as the payment threshold for Medicare Advantage plans rose compared to traditional Medicare. Some more background from the Kaiser Family Foundation Medicare Fact Sheet, May 2009 (http://www.kff.org/medicare/2052.cfm):

For many years, payments to Medicare HMOs were generally set on a county-by-county basis at 95% of Medicare FFS costs in each county because HMOs were thought to be able to provide care more efficiently than FFS… Medicare Advantage plans are currently paid more, on average, than FFS costs in their area. According to MedPAC, payments to Medicare Advantage plans per enrollee in 2009 will average 114% of FFS costs for the counties where Medicare Advantage enrollees reside.

Again the original intent was lost, so now we are faced with disparate Medicare plans with only a subset of seniors receiving enhanced benefits (due to greater government expenditures – not due to the efficiency of the private plans). To try and preserve these enhanced plans makes no sense. If we want to make the decision to spend the 114% of current traditional plan expenditures on all seniors, so be it. However, to continue to spend money desperately needed elsewhere just because certain industry lobbyists have perpetuated these plans (with ever increasing expenditures) makes no sense. Just because some seniors by the luck of the draw have ended up in these rich plans is not a reason to preserve them and is not equitable.

Mary you will be missed

From entertaining us as children to helping make us better adults, you were one of the good guys.

The CNN obituary (linked below) had a great quote of hers:
"We've learned that it will take more than one generation to bring about change," Travers once said. "The fight for civil rights has developed into a broader concern for human rights, and that encompasses a great many people and countries. Those of us who live in a democracy have a responsibility to be the voice for those whose voices are stilled."

An important reminder of the responsibility we all have to help make things better. Mary, I hope somewhere it’s now your turn to frolic in the autumn mist…

Mary Travers of folk trio Peter, Paul and Mary dead at 72 - CNN.com: "Mary Travers of folk trio Peter, Paul and Mary dead at 72"

It's my 20th anniversary tomorrow; everyone should have the right to reach this milestone! Vote No on 1

For those of you not in Maine, Proposition 1 is an attempt to repeal the Marriage Equality law (“An Act to End Discrimination in Civil Marriage and Affirm Religious Freedom”) that was passed by the legislature this spring. Voting NO on 1 preserves the law.


Twenty years ago I was able to marry the love of my life. Everyone should have that right

 Vote No on 1 | Protect Maine Equality

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Another few seconds of my alloted 15 minutes of fame

I attended a town council meeting and my comments were carried in the local paper:

Cost up to $4M for improvements planned next year on Route 88 in Cumberland | The Forecaster

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Shelter dogs learn new tricks

Those of you who know Martha and me know Sheba, our faithful companion and trusty sidekick :)

Sheba is a shelter dog we brought home seven years ago.  We've never looked back and never thought twice about adopting a shelter dog!

Watch this fun video that helps sing their praises :)

Visit msnbc.com for Breaking News, World News, and News about the Economy

Robert Reich on the public option

The public option is getting lots of discussion right now (part of the "how" of health reform).  This short video explains its necessity much better than I could, please take a look. 

Robert Reich on the public option

Health Care security for all – The why of health care reform is a moral issue

The “why” of health care reform is being overshadowed by partisan bickering over the “how” of reform. Certainly how we provide health care to everyone is important, but the discussion gets lost when we lose sight of why we as a nation are again walking down this path.

Very simply, health care is a moral issue. Every man, women and child, regardless of circumstance, deserves acceptable health care.

In 1935 we as a nation made the decision to provide economic security to our seniors through Social Security. Thirty years later, we made the decision to expand security for seniors by providing health care through the creation of Medicare (a very successful government run health care option, but more about that another time). Now in 2009 we are (again) at the brink of providing health care security to everyone. This time we must be successful.

The social contract between people and government can be simply put as people obey the rules and in return are provided security. Originally, security meant that a person had the right not be killed by invading armies. We like to think that we are making progress as a society, that we are better off than those that came before us. To that end, the definition of security has expanded over time, in addition to the examples above, we have decided not to let people go hungry and for the most part, we ensure that people have a roof over their head.

It is past time that we all agree to define being secure as having basic health care. Each of us has a moral compass, whether derived from religion or elsewhere, most of us make decisions based on that compass every day. The direction our collective compass should be pointing is clear, it must point to health care for everyone. While we certainly need to figure out how to provide it efficiently and effectively (the how) it must be done and done now.

Fall 2009 TV Recommendations

I enjoy TV. For the past few years I’ve been sharing my recommendations of what new shows to watch with my friends. One of the goals of this blog is to make those recommendations more widely available.


Below is my viewing schedule for the fall. The premiere dates are in parenthesis next to the title and new shows that I'll be sampling are in bold.  (For a better view of the schedule, click on the image.  You'll then need to use your browser's back button to return to the blog.)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
If you need even more information (or want a second opinion), TV Guide has a special site set up with lots more info: http://www.tvguide.com/special/fall-preview/


The new shows I'm most excited about are V, Flash Forward and Community. The ones that made the list that I'm most on the fence about include The Forgotten and The Good Wife.

For me, the biggest TV event of the year begins mid-season when we start to work our way to the conclusion of LOST. Until then I'll try not to think too much about the Island and what it means :)

In case you're curious, I did find things to watch during the summer:
Defying Gravity
Eureka
Kathy Griffin: My Life on the D List
Kings
Leverage
Merlin
Rescue Me
Royal Pains
Torchwood
Warehouse 13

In addition to LOST, other midseason shows to look forward to include returning favorites along with some new ones:
24
Better off Ted
Chuck
Day One
Human Target
Scrubs

And of course always on my list are:
Colbert Report
Daily Show
Good Eats

Happy viewing :)

Portland (Maine) Area Restaurants

This is not an exhaustive list, just some of my favorites.


555 (Portland) - Possibly the best restaurant in the Portland area, expensive but worth it. Don't be scared by the lobster macaroni and cheese, its incredible. Consider ordering a portion for that table as an appetizer. Reservations a must, if you are planning your trip consider making them a few weeks in advance. http://fivefifty-five.com/


Front Room (Portland) - On Munjoy Hill, fun and lively. Medium priced. They don't take reservations so there can be a wait on a summer night. Not a problem if the weather is nice as it’s a beautiful neighborhood to walk around. They are good about telling you when to be back. http://www.thefrontroomrestaurant.com/


Bar Lola (Portland) - Across the street and a block down from the Front Room, they do take reservations. Their menu is set up as five small courses. Consider the self designed tasting menu (you pick one from each category for a set price) or if you're feeling adventurous, they will pick for you (they call it the "feed me" option).  http://www.barlola.net/


Flatbread Pizza (Portland) - Moderately priced family friendly restaurant right in the heart of the Old Port (next to the ferry terminal). The menu is exactly what you would guess. The large brick oven in the middle of the dining room proves to you your pizza is made fresh and served hot. http://www.flatbreadcompany.com/2007Home.htm


O'Naturals (Falmouth) - Inexpensive sandwich and salad place. All natural and fresh ingredients. 
http://www.onaturals.com/


Pon's Thai - (Portland and South Portland) - Good Thai food. Portland location is right in the Arts district close to the Art Museum.  http://www.thaitastemaine.com/


Foreside Tavern (Falmouth) - One of our favorite local places, it has something for everyone. Bar food to sandwiches to formal entrees to kid’s meal, everyone can find something to enjoy. Try the sweat potato fries. Casual and a full range of prices, also great for a drink and a snack. Family friendly and a bar, what more can you ask for?  http://www.theforesidetavern.com/


Royal River Inn (Yarmouth) - Come for the view and enjoy the food. A little pricey but set right on the royal river (in the middle of a marina). Reservations suggested. http://royalrivergrillhouse.com/


Days Lobster Pound (Freeport) - Located on Route 1 1/2 mile north of exit 17, great place for lobster rolls, precooked and live lobster. Some picnic tables out back but for us the real joy is picking up everything you need for a lobster dinner and bringing it home. No work, great taste, great bargain. (For ocean front lobster shacks, see below.)  (no web site)


Thai Garden Restaurant (Freeport) - Looking for something different after a day of shopping in Freeport? This local Thai restaurant has great moderately priced food in a casual atmosphere.
http://maps.google.com/maps?f=q&source=s_q&view=text&hl=en&gl=us&q=Thai+Garden+Restaurant+Freeport+Maine&ie=UTF8&sll=43.840852,-70.120510&sspn=0.042725,0.045724&latlng=43823050,-70139561,6832938008149215969&ei=9W46SuTqJZ7uMuj6qfUD&cd=1


Gritty McDuff’s, Freeport’s Original Brewpub (Freeport) - Good beer and food.
http://www.freeportusa.com/freeportmember080.html


Harraseeket Inn (Freeport) - Right in downtown Freeport, formal dinning at its finest. Expensive but worth it if you're looking for a treat. http://www.freeportusa.com/freeportmember088.html


Haeraseeket Lobster Shack (Freeport) - Right on the water in South Freeport, the quintessential Maine lobster experience. Be prepared to wait to park, then wait to order. ttp://www.freeportusa.com/freeportmember081.html


Henry and Marty's (Brunswick) - Nice restaurant, good food, reservations suggested on weekends. http://www.henryandmarty.com/


Sea Dog Brewary (Topsham (right across the bridge from Brunswick) and South Portland) - Local brewpub, good beer, good food. http://www.seadogbrewing.com/


Lobster Shack at Two Lights (Cape Elizabeth) - If your visiting Cape Elizabeth's parks and beaches you must have lunch here. Spectacular views, fresh lobster and fries - what could be bad? http://lobstershacktwolights.com/

Welcome

Hi!

My plan is to use this space to share interesting information and observations.  Some initial posts will focus on the new fall TV season and information on visiting Portland Maine.  This is existing material, so there will be several posts over the next few days.  Any and all comments welcome.

Thanks,

Mitch