By Gary Erickson, Owner and Founder, Clif Bar, Inc.
This paper was originally published as a part of the CodeBlueNow! Papers series in November 2005 in the Seattle Post Intelligencer.
About 15 years ago, from a garage I shared with my dog, assorted outdoor gear and a couple of trumpets, I founded the business that would become Clif Bar, Inc. Back then, it seemed natural to combine my passion for endurance sports with a lifelong love of food and pleasure at the table.
Today, Clif Bar is the leading maker of organic and natural energy foods and beverages. You may wonder what I have to add to the discussion about health care. Truth is, I think a lot about the health and well being of my Clif Bar colleagues and our consumers. At its very core, this company is about health.
Clif Bar makes energy products for active people to enjoy while they’re out pursuing their passion. We make healthful products, based on sound nutritional science. Unlike most of the chemically-laden products in the sports nutrition field, Clif and Luna bars, gels and beverages are made without artificial ingredients and harmful trans fats. We’ve converted many of our products and ingredients to organic because we feel that this form of agriculture is better for our planet. We are proud to sponsor athletes of all ages and abilities because we model healthfulness in all aspects of our business.
A focus on health also translates to the way we treat our employees. I’ll give you some examples. In our Berkeley, Calif., headquarters, home to about 100 employees, there’s a full gym offering about 25 fitness classes, all during business hours. We have four personal trainers working full time to help our employees stay strong. We keep a couple of loaner bikes tuned up and ready to go, so that employees can pedal, rather than drive, to complete local errands. Employees can take part in company sponsored bike rides, ski trips and other outings – strictly optional activities, but you may be surprised at how popular they’ve become.
By Steve Case, Co-founder of AOL and CEO of Revolution, LLC
This paper was originally published as a part of the CodeBlueNow! Papers series in November 2005 in the Seattle Post Intelligencer.
I’m often asked why I chose to enter the health care industry, and become an advocate for sweeping change, even though I have no real background in the field. The answer comes from personal experience. Even a family as fortunate as mine isn’t immune from the problems that everyone else faces in dealing with the health care system. In its most extreme form, I saw caring doctors and nurses trapped in an inhumane bureaucracy when my brother, Dan, died from a brain tumor in 2002. And, on the more run-of-the-mill side of things, as a parent, I’ve been frustrated when a child has developed a fever or a twisted ankle on a weekend – and the only choices were waiting until Monday to see a doctor, or going to a hospital emergency room.
In these experiences, and others, I’ve seen a system that fails to put the patient first. I’ve seen waste we wouldn’t tolerate in other industries. And I’ve seen doctors and nurses unable to spend time doing what they do best: taking care of patients, not filling out forms or dealing with paperwork. It doesn’t have to be this way. At Revolution Health, I’m putting my money where my mouth is, so to speak, by investing in ideas fall into three categories: content, coverage, and care.
By “content,” I mean that every person should have access to the information and tools needed to help make the best health care decisions for your family. Right now, you can pick a restaurant online – why shouldn’t it be just as easy to find the right doctor on the Internet? Right now, your kids can research their homework online – shouldn't you have equally easy access to the latest fact-checked information about an ailment that you or a loved one has contracted? Right now, you can manage your financial records or bill paying online – shouldn’t you be able to do the same for your personal health records and health care finances? Right now, you can easily connect online with folks who share your interest in needlepoint, or motorcycle riding, or baseball teams – shouldn’t there also be a place to connect with those who share your health concerns, when you need support, information, or comfort? At Revolution Health, we’re building an online portal that will meet these needs, and many others.
By Elizabeth A. McGlynn, PhD, RAND Health
I work at the RAND Corporation, a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world.
At RAND Health, where I am the associate director, we study problems related to the costs of health care, access to the health system and the quality of medical care.
For nearly 20 years, I've been investigating how well the U.S. health care system delivers services that are consistent with professional standards and good science. I've found that most people assume they are already getting top-quality medical care – but unfortunately, this is often not the case. People are dying needlessly as a result.
A major RAND study I led found that American adults on average get only about half of the health care services they need to prevent, diagnose and treat common medical problems that are the main causes of death and disability. The study found that the average adult needed about 16 health services – specific types of tests or treatments – over two years, but usually received only eight of those services.
Over a period of 10 weeks in the fall 2005, the Seattle Post-Intelligencer ran a series of guest editorials, “The CodeBlueNow! Papers.” In preparation for our Health Care Town Hall on September 18th, we would like to publish some of these papers again. Although written three years ago, this was the beginning of our discussion which has now led to our upcoming Voters’ Health Care Platform we will be announcing on September 18th.
Please read and share:
Re-creating the Health Care System
by Arne Carlson, R, Minnesota and Booth Gardner, D, Washington (September 2005)
By way of introduction, both of us served as Governors for eight years: Minnesota and Washington. As Governors, we created MinnesotaCare and the Basic Health Plan in our states—programs to provide health care for hard working, decent people whose employers did not or could not pay for it. But that was ten years ago. Now these plans are being significantly altered, our economy has changed, and our political climate has eroded.
It is not just Minnesota and Washington. State after state is dismantling similar programs. In
Tennessee alone this year--to balance the state budget—over 191,000 adults will be cut from the
TennCare program. It will also cut benefits for hundreds of thousands of others because it cannot afford the $8.7 billion program. Missouri intends to completely dismantle its Medicaid program by 2008. Now, instead of working together to build programs, hundreds of thousands of people are without health insurance with precious few places to turn. This is not inconsequential—one of every five Americans under 65 has no health insurance.
Couple this with changes in the economy and it spells trouble. Jobs are being outsourced to other countries largely due to costs such as health care. This leaves even more people without health insurance, because under the current system when you lose your job, you lose your health care.
Special thanks to the Editorial Page of the Seattle Post-Intelligencer for their leadership and vision in publishing this unprecedented series originally.
Much of the health care reform debate now will be negative campaigning. All the other various reform groups will be focused on their ads and negative press, but CodeBlueNow! and a few other groups are bringing new possibility to the table.
Or country has had enough negativity – it’s time we rally around a fresh vision and take health care out of a partisan political fight. We are working on a health care platform for the people, a template we can then present to Congress. Another group is doing things in a positive way, also.
Faithful Reform in Health Care is trying to raise 100,000 voices to bring compassion, value and vision to health care. Click here to support their campaign.
Faithful Reform, like CodeBlueNow! is a national, nonpartisan, 501(c)3.
This coming Tuesday, July 22, the American Health Insurance Association (the folks who brought us Harry and Louise), are starting their Campaign for American Solution, a “listening tour” combined with an advertisement and recruitment campaign.
The first event is a conversation with the uninsured in Columbus, Ohio. They are not saying how much money they are putting into this, but we are sure it is as much, if not more than the Health Care for America Now campaign which launched Tuesday, July 8th and makes no bones about the fact that they have a campaign chest of $40 million.
The steering committee consists of groups that gave half a million dollars to the campaign, something that most organizations could never afford no matter how good their work is. This Tuesday, July 15th, the National Coalition on Health Care launched its campaign to put aside partisan politics and act on reform. Their principles are outlined in their letter to Congress, and are very similar to our own. Consumers Union has a bus tour on health care reform, Cover America Tour.
Clearly health care reform is a hot issue and lots of new groups are trying to tackle it in their own way. Well, we’re doing things differently. We aren’t collecting stories, we aren’t launching ads, and we do not have $40 million.
We have a quiet campaign, which has been spending its time doing very important work in the background. What we bring to this myriad of health care groups, is the Declaration for the Health of America and solid market research, two ways we are spreading our message that Americans do largely agree on what reform should look like. CodeBlueNow! knows the public is not as conflicted as all these different groups and politicians make it seem. Our good work is publicity such as our July 2nd op-ed in the Seattle Post-Intelligencer and our upcoming Town Hall, and ongoing research to prove that reform does not have to be a divided process.
Don’t let both politics and the grass roots be dominated by big money. Support the campaign that knows the American public is vastly smarter than they are given credit for when it comes to health care. Support CodeBlueNow! today.
Cheers and more later. Kathleen
We don’t usually focus on the negative aspects of health care because nearly everyone else does. But, this particular episode from a friend caught our attention on some of the idiocy that happens. This from Mary Koch in Omak, Washington.
Lady Liberty Reigns: A Widow Bit
My mother slipped her halo just in time to avoid the rockets’ red glare.
Three months ago Mom, 91, fell and broke her neck. She ended up in a device called a “halo,” which is literally screwed into the patient’s skull – like Lady Liberty’s crown – to anchor four vertical titanium rods that point into the air several inches above the patient’s head. The halo keeps the neck absolutely stable while the broken bones heal – for three months.
Mother’s beloved granddaughter calculated the timeline and said cheerfully, “Well, Grandma, if you’re still wearing it on the Fourth of July, we can use it to launch bottle rockets!”
It was that kind of humor, plus her own faith and determination, that would get Mother through the three-month ordeal. She posted a sign by her bed, pronouncing: “Blessed is she who breaks her neck, for she shall wear a halo.”
Late in the afternoon on the Friday before the Fourth, we visited the neurosurgeon. He would remove the vertical rods, send Mother across the street to the hospital for X-rays, and if the bones looked good, the halo itself would go. Problem was, he couldn’t find the proper-size wrench to remove the rods.
The tool he had in his office “fidn’t dit,” as my late husband would have said. The doctor excused himself, ran across the street and returned with an automobile tool kit – the kind you get with expensive, luxury cars. Nothing fit. Finally, his nurse called the medical device company that had supplied the halo. Apparently there is only one halo wrench in all of the greater Tacoma metropolitan region, and the technician was loathe to let go of it late on a Friday afternoon. Someone else might need screwing or unscrewing over the weekend. After intense negotiations, this unique and highly valuable piece of medical equipment was delivered in a brown paper bag and the rods quickly removed.
The surgeon put a temporary brace on Mother’s neck to stabilize her for the trip across the street in her wheelchair. Despite the doctor’s specific orders to remove the brace for the X-rays, the technicians said they weren’t “allowed” to. I don’t know if I was “allowed,” but time was a-wasting, so I took it off. Mother remained in good humor as the technicians posed her in one odd position after another. When they had her raise one arm straight up and cross the other over her chest, she intoned, “I pledge allegiance . . .”
After many communication failures too exasperating to describe, the doctor eventually appeared. By that time, his office was closed, so we couldn’t return to remove the halo. (What!? They don’t trust the surgeon with a key to his own office?!)
BUT, he had the precious wrench, in its brown paper bag, and there, in the radiology waiting room of Tacoma General Hospital, he removed Mother’s halo.
No bottle rockets for Mom, but the brilliant fireworks displays on the Fourth paled in comparison with our pride and joy in her determination and resiliency.
Mary Koch, Freelance Writer & Editor
www.marykoch.com
This Op-Ed written by CodeBlueNow! CEO Kathleen O'Connor, appeared in the Seattle Post-Intelligencer on July 3rd, 2008.
The coming months will be laden with laments on the sorry state of our health care system. Meetings will be held with story after horror story. We don't need more horror stories. They won't fix the system. We need action -- but not rote mindless action on "solutions" that have failed consistently.
Health care reform has been dominated for 80 years by two equal and opposing forces: single payer vs. marketplace. We know the public will support neither of those two polarized alternatives. Data from our CodeBlueNow! Pulse surveys prove that, as does data from Commonwealth Fund and Kaiser Family Foundation, among other national studies. Neither solution is acceptable to the majority of the American public.
A solid majority of Americans think we must cover all our citizens, but until recently there has been no consensus on how. Until recently, precious few groups have tried to build consensus. Reform has been dominated by single-solution advocacy groups and has traditionally been very partisan. But we know from history that partisan solutions to health care will not work. Former Sen. Thomas Daschle, D-S.D., and Sen. Charles Grassley, R-Iowa, agree that partisan political solutions cannot succeed.
In CodeBlueNow!'s research to identify areas of common ground and consensus in health care reform, we found considerable consensus exists on key issues. Our surveys in Washington and Iowa mirror other national surveys that indicate what Americans want in their health system: affordability, accountability, choice, information, prevention over high-tech cures, efficiency, researched treatment outcomes and a shared responsibility in financing and management with employers, the government and the individual.
The challenge in moving forward with that approach is significant. Neither the parties nor the advocacy organizations on both ends of the spectrum want that message told. Consensus must not be considered newsworthy. But in our surveys in Iowa (red state) and Washington (blue state), there was only one statement that had a statistically significant difference: More people in Washington (75 percent) than Iowa (69 percent) thought a basic benefit package should include any licensed health care professional.
Other than that one issue, there was less than a five-point difference on any statement. When we asked the market research firm what that data means -- to have the two states be mirror images of each other -- the staff replied: "In the absence of action from our leaders, the American public has come to some pretty solid conclusions."
But that consensus has not been reported because many voices want it silenced. So, we have taken our Declaration for the Health of America, a collection of principles and core elements for America's health care system that reflect the views of the American public, and have now documented it with data from our research and the research of others.
We urge you now to read our declaration, send it to your elected representatives and the presidential candidates, and ask that any health care solution address those points. We have some solid, nonpartisan first steps toward a voters' health care platform.
Kathleen O'Connor is founder and CEO of CodeBlueNow!, a nonpartisan, nonprofit based in Seattle that is building consensus on health care reform; codebluenow.org.
Today’s Boston Globe announced Senator Kennedy’s leadership in pressing for bipartisan health care reform.
But a review of the article shows the folks working on this “bipartisan” effort are all the usual suspects looking to flawed ideas. Congress and key advocacy groups have made up their mind on what we need to do, without consulting the public.
Congress is incapable of finding a bipartisan solution. It is a bitterly partisan institution that doesn’t listen to the other side. I think the Democrats are hoping they will get a large enough majority in the House and Senate to pass a health care bill in 2009. But, to pass this bill, they will need some Republican support, especially in the Senate. The Massachusetts bill is badly flawed. There are no cost containment measures.
The public is deeply concerned about the Wyden-Bennett Bill.
What Congress and/or the Candidates should be doing is building consensus on some core elements of a plan that would have support across party lines. It clearly exists, as CodeBlueNow!’s research shows.
This should be a wakeup call to the parties and the candidates. What is the definition of insanity? “Doing the same thing over and over again expecting a different result.”
We can no longer leave health care reform to the candidates and advocacy organizations, they have failed us since 1929.
Cheers and more later. Kathleen
Here’s a headline you would not see in Germany, France, Canada, Japan, England, Italy, Australia, New Zealand, Spain, Portugal, Ireland, not to mention Norway, Sweden, and Finland:
A day in bankruptcy court would make you sick
In reflecting on what other countries do for health care, it is fascinating the misinformation that is out there. Germany had private, but nonprofit, insurance companies. They organize health care around employers, just as we do. There is one basic benefit package everyone gets; both employers and individuals can buy more. There are over 400 different insurance packages. Doctors have private practices. Rates there, like here, are set by the government.
If someone cannot afford their insurance premiums, the government pays the premium and the individual continues to see their doctor. There is no major separate public program.
We win the prize as having the best ‘paper care’ system in the world. Rules for what Medicare will and will not cover are thicker than the IRS tax code. We have the best well-kept paper system in the world. No one knows what they are buying or what it will cover.
It doesn’t have to be that way. Think how easy it would be to have one set of benefits and one claim form. Say goodbye to fleets of rules and regulation that offer no value. You can do that and still have insurance companies and choices of health plans.
Save the date: September 18th -- when we launch our Bipartisan Voters’ Health Care Platform. More consensus exists than we are told by the parties and the press. We need to act now to tell the candidates what we want and what would work.
Once again, politicians are rushing to judgment on a plan that the public will not support. Senators Ron Wyden, D, Oregon and Senator Bob Bennett, R, Utah, have co-sponsored a bill to move the responsibility of health insurance away from employers and over to individuals. Does the public want that? No. Data from the Kaiser Family Foundation clearly show there is significant resistance to this idea (See Drew Altman’s essay on their research). CodeBlueNow!’s data clearly show this, as well.
It would not take rocket science to build a health care system – it does take political will. What we have found is that more public consensus on health care reform exists than either the parties or the candidates will admit.
That’s why we have to get elected officials out of the center of attention to create a proposal. They can’t do it. We the people have to create our own Voters’ Health Care Platform. I think our Declaration is as good a place to start as any.
Stay tuned! Cheers and more later.
Kathleen
Seattle, WA. June 18, 2008. CodeBlueNow!, a nonpartisan, nonprofit based in Seattle, issues a Health Care Challenge to the McCain and Obama campaigns. CodeBlueNow!'s grassroots polling reveals broad agreement on important issues of health care reform. CodeBlueNow! challenges both candidates to create a bi-partisan platform for reform based upon what a majority of Americans want, by adopting CodeBlueNow!’s Declaration for the Health of America. http://www.codebluenow.org/Declaration%20with%20statistics%20FINAL.pdf
Kathleen O'Connor, Founder and CEO of CodeBlueNow! states: "The public is tired of negative campaigns and attacks. They seek a vision for a positive future. With more consensus among the public than we realized, we have asked the candidates not to fight each other on health care but rather to work to find elements they can both support. After the election they will need each other’s support to move toward successful reform.”
Between now and the November election, CodeBlueNow! will survey the candidates on their proposals, report their responses to the press and the public, and launch a Voters' Health Care Campaign to hold the Administration and Congress accountable to the public on health care issues.
About CodeBlueNow!
CodeBlueNow! is a nonpartisan, national grassroots nonprofit organization dedicated to giving the public a voice in shaping a new health care system. The Seattle based organization conducts research, forges partnerships, builds consensus and creates a positive vision. CodeBlueNow! formed in October 2003 from ideas that emerged in a national contest to Build an American Health System and is actively working to build consensus on key principles and core elements for a new system. www.codebluenow.org
The Senate Finance Committee met yesterday for a daylong bipartisan symposium to lay the groundwork for next year’s health care legislation. Senator Charles E. Grassley of Iowa, the senior Republican on the Finance Committee, was cited in the New York Times as impatient with the process:
"Health care is 'the No. 1 economic issue in our country,' Mr. Grassley said, but 'Congress does not seem to have the political guts to do anything about it.'”
When a senator of Grassley’s stature thinks that Congress does not have the political guts to do anything about health care, it is time to take health care out of the clutches of Congress and demand change ourselves. That is why this week we are issuing a challenge to the candidates to adopt the elements of our Declaration for the Health of America in both their health care platforms. This Declaration not only identifies key values and core elements, but it also take statistically valid research data to validate those points.
The Senate Finance Committee discussed reform, agreed that everyone should be covered and that we should keep a private insurance market and keep the employer involved.
We could not agree more with Senator Grassley. Please sign and send our Declaration today to your elected officials.
Cheers and more later.
Kathleen
We will jump continents now to Japan and look at their health care system. Having lived in Japan, I have actually seen how the Japanese deal with health care. The Japanese did not get universal coverage until the 60s when small businesses revolted and demanded the government do something so their employees could have coverage as well as the large employers. They argued that they contributed as much to the economy as the large employers who could afford to offer coverage, and that led to universal coverage.
Everyone is covered and everyone is required to pay into a national health insurance fund. Fees are set by the national government. All providers are paid the same fee for each service. Employers pay 50 to 80% of the health insurance premiums. Individuals and dependents pay for premiums out of their salary—at about 8.5%. In addition they have co-payments. Co-payments account for about 20 to 30% of individual health care costs.
Health insurance companies are required by law to offer a basic benefit package that includes medical consultation, medications, as well as home health care and nursing care.
Individuals are assigned to a private insurer, according to their employment situation. The government funds the National Health Insurance which insures the unemployed, the elderly and the self-employed, such as lawyers and doctors.
Health care providers largely have their own private practices and it is quite common for a doctor to own a hospital. In fact, nearly 80% of all hospitals in Japan are owned by doctors. By law all hospitals are required to be nonprofit. The other 20% are large, public, state owned and managed teaching hospitals.
The Japanese are truly conscientious about their health. Many large companies start the day with employee tai chi type of exercise. In the winter and the flu/cold season nearly everyone wears a white surgical style mask over their nose and mouth. During the same season, when we lived on a Japanese Air Self-Defense Force base, we had to wash our hands in something like ammonia before we could enter the base.
As for malpractice in Japan, it tilts in the favor of the doctor, but with a real kicker. All the member of the Japanese Medical Association, or a little over 40% of all Japanese doctors , have a collective insurance pool they pay into. Private doctors and hospital employees can buy insurance in the private market, but it is not required by law. The professional liability program reviews out of court claims, but the system is biased toward the doctor rather than the patient. The review board’s decision is binding, but patients who disagree may go to court. In Japan, injury or death from a medical error is a criminal offense.
Read more about Japan’s health care system: Japan Factsheet.
There is no cookie cutter approach to health care. All systems reflect the values of their country of origin.
Cheers and more later. Kathleen
Thinking productive workers meant healthy workers, Bizmarck introduced the first national health insurance system in Germany in 1883. The US was close to adopting this model, but with advent of World War I, the US backed off.
Like France, everyone participates--the employer, employee and the government. Like the US, it is a public/private system. Everyone pays for health care which is organized around the employer who contracts with private insurance companies to manage the care. The employer must pay at least half the premium and the other half is deducted monthly from the employee’s salary. The government covers the health care contribution costs of the unemployed and the low income.
Now this is an interesting thought. Everyone in Germany—wealthy or poor—has the same benefits. If the individual cannot pay, the government pays his or her premium contribution. Think what this would save if we did that here? So, instead of having 50 different Medicaid programs with 50 different benefits and premiums, the government simply paid the premium and the individual could use the same services as everyone else.
This is not a government-run, centralized system. Each of Germany’s 16 states share responsibility with the federal government for the upkeep and maintenance of hospitals and clinics. State regulated insurance companies oversee cost controls. The insurance companies are both public and private.
There are over 200 private insurance companies that over 400 different plan options. Doctors have private practices. Some doctors are hospital employees and of the 2,030 hospitals in Germany, 790 are public; 820 are private non-profit and 420 are private, for profit.
As for malpractice, initial claims are sent to mediation with expert panels set up by the physicians’ guild. Patients are free to reject the mediation results and take their cases to court, very much like the US system.
So much for “socialized medicine.”
For more on the German health care system, see our factsheet.
Cheers and more later. Kathleen