A moment to pause….  Review then participate. It's vital.

This is not a high school musical or an attempt to overlay analogy on top of reality however it's a moment where Charles Dicken's "Christmas Carol" imagery might well be heeded. 

Dear friends, citizens, visitors, both the young and old are afraid in the United States about access and payment for health care.  While "cute debates about better healthcare in Finland" have aired.  There is a question today if this outcome is uncovered policy or part of a set of conflicting promises new leadership base has put forward?

Who ever you voted for…does the repeal of the Affordable Care Act make sense?  Maybe now we will choose.

The "new" plan to reverse ACA direction yields a panoply of horrible images as a management tool…: A projected run on the ER instead of regular coverage? Co-pays beyond any logical capacity to pay in seniors, who are already stressed by care taking and now being shamed for not working? Red states are negatively impacted.

"The message of righteous anger sent and justifiable anger" heard…but do you want a sicker, poorer population with patients left out or worse?  Find out the facts on what is being proposed that will determine your future.

Given a reversal of care options and higher premiums….going backwards seems unacceptable and explains why Governors, membership groups, citizens, doctors are saying do not go forward with what has been proposed.

Watch the news today. Read the GAO report. Find your voice on this.  People die without timely care, prevention education, ongoing programs, or make others sicker.  Saving money this way whatever the "new" priorities is deadly.  Find out what the NIH or the CDC, the EPA, and access to an ER, telemedicine, meds at the right moment actually does. This is not a health care exchange problem.  It is a crisis of conscience because at the core health care is a necessity at every age, not a luxury for the few. It is not an option for the working poor, but part of being able to work for many.  Seniors, lapsed premiums, the poor, those with disabilities or chronic illnesses or injuries beware.

This week you could be helping someone write a go fund me campaign as an alternative to going without "immunosuppression meds" because in the absence of the "Hippocratic Oath" in lobbyists and representatives …social media seems to some a call to action.  A real call to duty…is to do your research and respond today before the vote, during or afterwards.

Look up your Senator or your Congressional Representative and see if they had a townhall.  Call the White House.

Listen to the rhetoric and decode it or make up your own mind using facts. Write your story, but stop the rush to dismantle and repeal Affordable Care Act if that makes sense. Consider something that fixes, not revokes, or at least does not pit older voters against younger ones. The bill must reworked after it is investigated if it continues at all, due to bias and pitfalls.

This bill may already be a force celebre for Americans to move towards saner options like the single payer plan as a move towards high quality, health care for everyone. The GAO has weighed in.  What is offered not "the best" option promised in the presidential debate and leaves millions out.

The Republican plan as a strategy may already be mounting single payer as the best option, a reaction that they did not expect.

Single Payer has never received more press and the disappointment nationally to today's vote may have already begun driving the conversation on American healthcare towards a new look at international and fairer solutions.

Should this new program fail gain enough muster….. because of rate increases, denial of service, doughnut holes, failing to serve the most in need….another words…more insurance balderdash and …less healthcare then the proposed Obama care replacement will be in the spotlight as the opposite of "terrific" and "a viable alternative" to what exists on the exchanges now.

You can read about Marin's townhall meeting reaction below.

And what if the proposal of what seems mean spirited and anti people as a free market approach may be actually hurting the party?  Will it create or has it created a health backlash instead of a thriving presidency? Could previous partisans actually see their states will turn around against them? Does existing coverage revert to raising rates on their spouse, parents, friends, and millions of other consumers instead an affordable and available equitable, available, responsive, and affordable plan for service instead of paperwork and rejection?  Does anyone want to be left out of care when needed?

This version of health care needs consideration and review.  So far under scrutiny this version of the affordable care act repeal is not up to the needs or the values to be served as promised or may be a bait and switch because of competition in the leadership.

Other responses in the news:

"Transfer of $1B? 54M left out?"  "Jerry Brown against the repeal of Obama Care…..loudly declaiming the Trump bill as ignorant and dangerous."

Recommendation use the democratic process:

Be Active, use the library, your phone, or the internet and look up reliable sources.

Before the vote, look at your state and its responses. Read the bill. Ask your congressman or representative how they are voting.  Look at the issues.  Literacy has never been more priceless or your phone and computer, library, or civic participation more necessary. 

Find out what this means and call congress today. 

Express yourself once you decide where you stand on the issues, and these coverage issues in health care access and services for years to come.

Marin townhall response as an of getting informed and participating….a great example:

"Rep. Jared Huffman, (D) North Bay to much applause. Every aspect of the Republican plan was characterized as unfair.

"As more and more uninsured folks start returning to use the emergency room, for primary care and just showing up as hospitals when they're very, very sick, those costs have to be spread throughout the healthcare system. And, it means, even if you're on an employer plan, you're premiums are quite likely to go up," said Congressman Huffman.

States will lose billions of Federal dollars. "With those budget costs, it's gonna force the state to make some very difficult choices about cuts in eligibility and cuts in service," said Ken Jacobs, a UC Berkeley Medical Cost Analyst. "50,000 Marin residents, one out of five, is at serious risk of losing coverage. If people lose coverage, more people will become sick and more people will die earlier," said Grant Colfax, Marin County Health and Human Services Director.

Representative Huffman produced a young boy who, he says, whose life was saved from leukemia, as a toddler, by three-and-a-half years of intense treatment, thanks to Obamacare.

"My parents had to tell my sister that I might die of cancer," said 9-year-old Rhett Krawitt, who added,

"Don't repeal the Affordable Care Act. Improve it. Why?

Because my name is Rhett and I give a damn."

This kid got a standing ovation. "  This is not a Dr. Strange movie, or a time for hyperbole.  This is a day for voting adults to read, write, call and participate, given the alternative is not a good option…

Here's some resources to explore below… including the exchange maps, interactive regional maps, articles and analysis.  Read and compare several sources and enjoy your freedom to weigh in on this issue.

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Here are some sources to explore

The Plan:

http://healthaffairs.org/blog/2016/06/22/the-house-republicans-health-plan/

Summary:

http://kff.org/health-reform/press-release/the-american-health-care-act-new-house-gop-bill-summary-and-interactive-maps-of-its-effects-on-tax-credits/

GAO did respond get the text:

http://www.gao.gov/products/GAO-12-768

http://www.nationalreview.com/corner/341589/gao-report-obamacare-adds-62-trillion-long-term-deficit-andrew-stiles

Fair market is not a place to handle health care, example, transplants:

https://www.medicare.gov/coverage/transplants-kidney-adults.html

http://money.cnn.com/2016/11/15/news/economy/trump-pre-existing-conditions/index.html

Other previous responses to a national problem:

https://www.nytimes.com/2016/03/11/us/christians-flock-to-groups-that-help-members-pay-medical-bills.html?_r=0

Interactive Map of the Affordable Care Act Exchanges and Coverage:

http://kff.org/interactive/interactive-maps-estimates-of-enrollment-in-aca-marketplaces-and-medicaid-expansion/

http://kff.org/health-reform/issue-brief/how-affordable-care-act-repeal-and-replace-plans-might-shift-health-insurance-tax-credits/

Another Map:

https://www.washingtonpost.com/blogs/plum-line/wp/2017/02/03/the-gops-obamacare-repeal-plan-could-hurt-republican-areas-this-map-shows-how/?utm_term=.3e6148687a2f

Health Care is not easy to rework concedes president:

https://www.nytimes.com/2017/02/27/us/politics/trump-concedes-health-law-overhaul-is-unbelievably-complex.html

Forbes:

https://www.forbes.com/forbes/welcome/?toURL=https://www.forbes.com/sites/dandiamond/2015/07/31/donald-trump-hates-obamacare-so-i-asked-him-how-hed-replace-it/&refURL=https://duckduckgo.com/&referrer=https://duckduckgo.com/

California's State of the State Address (comments on repeal and replace bill):

http://abc7news.com/politics/brown-takes-on-trump-in-state-of-the-state-address/1718344/

http://www.sfchronicle.com/opinion/editorials/article/A-bristling-retort-to-Trump-10881086.php

Who wins and loses:

http://money.cnn.com/2017/03/06/news/economy/republicans-obamacare-repeal-replacement-bill/index.html

https://www.forbes.com/special-report/2013/what-will-obamacare-cost-you-map.html

http://www.latimes.com/nation/la-na-trump-obamacare-repeal-20161212-story.html

https://www.washingtonpost.com/news/to-your-health/wp/2016/11/17/the-ultimate-qa-about-health-care-under-president-trump/?utm_term=.23bf22f92449

http://carefacts.blogspot.com/2017/03/trump-voters-lose-most-under-gop.html

Jackson Browne, 1972, Doctor My Eyes:

https://www.youtube.com/watch?v=fqFUmo8VVg0

Michael Moore makes us laugh:

https://www.youtube.com/watch?v=6EStuK5XdxI

Women and Obama Care:

https://www.americanprogress.org/wp-content/uploads/issues/2012/05/pdf/women_obamacare.pdf

Majority favors single payer-Gop tactics moving away from full appeal:

http://thehill.com/policy/healthcare/229959-majority-still-support-single-payer-option-poll-finds

January 2016:

http://www.nbcnews.com/news/us-news/congress-send-obamacare-repeal-president-n491316

http://www.cbsnews.com/news/house-republicans-mulling-options-for-obamacare-replacement/

http://www.ontheissues.org/Celeb/Republican_Party_Health_Care.htm

AARP Response:

http://www.aarp.org/politics-society/advocacy/info-2016/why-medicare-matters-special-report.html

http://thehill.com/policy/healthcare/318370-aarp-threatens-to-sue-trump-over-obamacare-change

Other opinions:

http://thehill.com/homenews/campaign/325333-healthcare-fight-pits-trump-against-club-for-growth

http://www.ncpssm.org/EntitledtoKnow/entryid/2272/gop-obamacare-replacement-hurts-older-americans-gives-wealthy-600-billion-tax-break?utm_campaign=blog_tracking_link&utm_source=entitled_to_know&utm_medium=blog_title_link

AMA:

http://www.nbcnews.com/health/health-care/american-medical-association-opposes-gop-health-care-plan-n730741

Comparisons:

http://www.faegrebdfiles.com/etimages/website_docs/GOP%20Legislation%20Comparisonv2.pdf

https://www.americanprogress.org/issues/women/reports/2009/10/27/6780/unmarried-and-uninsured/

http://obamacarefacts.com/the-difference-between-obamacare-and-trumpcare/

Research:

http://www.nber.org/digest/apr06/w11609.html

Obamacare:

http://obamacarefacts.com/health-care-reform-timeline/

NY Times (Headlines: GOP health plan is a meaner, more regressive version of the ACA) take a look:

https://www.nytimes.com/2015/03/18/us/politics/house-republican-budget-overhauls-medicare-and-repeals-the-health-law.html?_r=0

https://www.nytimes.com/2017/03/22/us/politics/health-care-vote-republicans.html?ribbon-ad-idx=3&rref=politics&module=Ribbon&version=context®ion=Header&action=click&contentCollection=Politics&pgtype=article

Some of the issues:

Is it about tax breaks for the richest 2%?  Does all this cutting go to device companies and to pharmaceuticals giving away health care to tax the working poor and the most at risk?

Medical Care is part of our social fabric?

http://uprisingradio.org/home/2009/08/07/black-agenda-report-on-health-care-reform

Physicians ask for a fundamental change, but not this:

http://www.pnhp.org/

Doctors stating this is not for patients, but for insurance companies:

https://www.theguardian.com/us-news/2016/may/05/us-doctors-calling-universal-healthcare-system-affordable-care-act

Pulling Away from Trump:

https://www.onfaith.co/commentary/evangelical-uprising

East Coast blog overview:

http://nittanywhiteout.com/2017/03/19/trumps-budget-nih-funding-in-mass/

https://thehillnews.net/news/Many-Trump-voters-would-feel-effects-of-Trump's-proposed-budget-cuts

Hurting Health and Human Services, Housing, Research, CalFresh,….so much more:

http://graffiotech.com/2017/03/20/trump-budget-would-inflict-heavy-cost-on-marin/

http://www.villagevoice.com/news/trumps-assault-on-nycs-social-safety-net-begins-with-35-million-cut-to-nycha-9750575

SB plan for health care in California?

http://healthcareforall.org/what-california-universal-healthcare-act-sb-810

http://healthcareforall.org/

Congressman Jared Huffman has a health care panel with 2000 attending his townhall:

http://www.ktvu.com/news/241363537-story

Priceless and necessary:

https://www.democracynow.org/topics/healthcare

https://www.democracynow.org/2017/1/10/part_2_if_obamacare_is_repealed