Dr. Ross, I noticed that you were diagnosed and then recovering from COVID-19 in April. I must presume that you are resting as you recover from this awful plague on our nation. I have been appalled at the lack of leadership and empathy spewing from the Administration in Washington. This was preventable. The money that the US was spending on detection and warning systems around the world that Trump dismantled. The pandemic response teams put in place by Obama that Trump scrapped because of his contempt for his predecessor. The failure to act on early intelligence in January to mobilize our preparedness. The spewing of ignorance and misinformation campaigns for months as if this were some sort of public relations disaster that could be managed away rather than a pathological contagion that cannot be so easily contained. If such pathologies were so easily dealt with, we would have secured a conviction in the Senate when he was impeached for he is surely the most corrupt U.S. President of the modern age if not of all time. He represents a threat to our very Constitution and the man you could face, Sam Graves, is another sycophant of Trump that has enabled him at every turn. As co-equal branches of government, the legislative branches have failed to retain their power and have slowly surrendered their power to the executive branch. The judicial branch, with positions that an earlier Republican congress refused to fill with Obama's appointments is now stacked with young lifelong appointments loyal to the President and thus the judicial branch has also lost much of it's independence from the Executive branch. Even agencies within the Executive branch that historically operated with a degree of independence and autonomy by nature of their work such as the Justice Department, ethics bodies, inspectors generals, audits, reports to Congress, or any other mechanism that might be used to hold the Administration to some level of accountability have been censured or controlled by this President. He has assumed complete dictatorial powers in our government and all the checks and balances have been rendered neutered. They still exist in the sense that the Constitution has not been burnt to a crisp. Our three bodies of government still exist, but they do not currently function as they are supposed to.
That is why this election has become so singularly important. Our country cannot wait to see what happens in four more years. Will he surrender control after a second term if he wins? Let's not find out. We need to win this election decisively at every level. We need to take back our country. We need to undo the negative policy of the grift politics. We need to send the racists and the xenophobes back into the shadows and let them know their hate crimes will not be tolerated. We need to stop subsidizing a carbon-energy society. That industry must fend for itself and it must find carbon offset credits. It can do so by buying them from the federal government in funds that will be re-invested in green energy, or it can do so on the open market.
Trump has been pushing to re-open the economy despite the fact that cases of COVID are rising. It is known that this is disproportionately affecting people of color and the poor. I can't help but wonder how intentional this is in his plan to re-open the economy.
Get well Dr. Ross. There are still many suffering out there. They suffer from this disease. They suffer from personal loss as their loved ones pass away from this disease. They suffer from the loss of their livelihoods as their jobs have been furloughed or permanently eliminated. Even now, as the state is opening up, jobs are not returning for many of those who've lost employment. People are not going out and consuming goods or services unless they are needed. Certainly not at pre-COVID levels. We need people in Congress who will act on behalf of these out-of-work citizens and not toss more benefits to the corporatocracy and the plutocracy of America. It is time we start realizing that the cup is never going to runneth over to masses because the cup is empty. That's the ruse. We are constantly drinking from the cup so those at the bottom of the cup never see a drop. We have to start filling the cup from the bottom up for everyone to get their share. When we start with this approach, everyone will get a piece. Those at the top just have to wait for the cup to fill up before they drink from it (i.e. siphon it off to investments and holding companies in the Caymans, Panama, Switzerland, Saudi Arabia, or whatever the latest hotspot is to hide those billions of dollars away from U.S. taxes and the U.S. economy). They've been pilfering off the American middle and lower classes since the Cold War began and slowly building the Military Industrial Complex that was the model for all corporate lobbying. Our legislation now comes from K street and it is written by big business for big business in all aspects of our society: taxes, defense, healthcare, infrastructure, energy, environment, labor, food, foreign policy, domestic policy, research, and all the other spending line items that are in the federal budget. There is not one that is not influenced by these outside organizations and in the current climate it becomes heavily politicized to the point that there is not even an attempt to rise above a partisan process and pretend something is created for the greater good. It is openly hostile to specific groups and stereotypes based on political leanings.
Get well Dr. Ross. The healthcare system is broken. Our doctors can't practice medicine the way they want to. We spend 33% of our healthcare spending on the claims process itself... just getting reimbursed. We spend a fortune on medications that people can't afford, but even that is a drop in the bucket when it comes to healthcare spending because the real financial tax on the system is the man in the middle. Our healthcare system includes thousands of these plans that pay for, or pretend to pay for, certain services that people need in emergent situations only to deny the claims when it comes times to pay the bill. This creates countless hours of additional paperwork, research, follow-up, hassles & headaches, and a huge pricetag on the entire healthcare system every time a claim is denied, and for many of these supposed healthcare plans, the default state is to simply deny the initial claim regardless of the validity. That rational is that when these initial claims are denied, there are a certain percentage of them that will never be re-submitted. For a number of reasons. Sometimes it is because the healthcare facilities then bills the patient and the patient pays, not realizing the plan should pay or not willing to deal with the hassle of challenging the plan. Sometimes it is because the healthcare facility does not catch the rejected claim. Sometimes the facility just chooses not to pursue the rejected claim because they don't have the time and they will take the write-off. For the plan this is a financial win. Typically the claim is for thousands while it may only take them a few extra hours of customer service time at most to handle the customer calls when they do come through. The cost to the provider on the other hand is real. It costs them time in labor to do the follow-up and processing to get the claim re-processed, make the calls, redo paperwork, re-submit, follow-up, research, or any other aspects that go into it. This could be several hours of paid time for a single claims and would add up for multiple claims per day. Not to mention the cost of lost revenue and the time value of money. The practice is absorbing those costs while the plan is out nothing. Meanwhile, what value has the plan actually added? Did they control costs? No, not really. They may have negotiated rates, but those were really driven as a factor of the Medicare-negotiated rates. Did they facilitate payment? No, quite the opposite. Did they help facilitate care coordination? Nothing of the sort. They are trying to do more of that, but they are just adding more bureaucracy in the process as they get into the game that others (EHR Vendors, CMS, ONC, States, Private Networks like CommonWell & CareQuality) are already serving. They are trying to prove their relevancy in an industry where they currently consume 33% of the cash, but they are asking for more cash as they do it. They want doctors to take a pay cut. They want to capitate costs and hold providers accountable so they can continue to raise premiums on patients while paying less to providers on a fixed payment schedule that would guarantee them a known revenue stream for each member they sign up. Most patients could care less who is providing the plan and they certainly don't like the hassle of dealing with them when they aren't covering something. They don't like it when they receive a bill that doesn't have the price of any services or any items that were used during their care, and nothing is itemized, yet there is a notice that the total bill was $x, the plan only paid $y, and the patient still owes $z. So yes, I can see that $x is greater than $y, but I need to know where $x came from as a number. How do I know that is even accurate and that it represents the actual services I received? If I'm paying money for it, I want to know what the actual price of that good or service was before the plan payment was applied. I want to know that my prices aren't just arbitrarily 10% over whatever the plan pays so that I have to pay something out of pocket regardless when I think I shouldn't be paying anything at all. If we want to reduce the spend on healthcare, we can eliminate 1/3 or it overnight by eliminating the vast array of payer networks. The hundreds, or possibly thousands or executives with yachts and McMansions thanks to these middle-man networks and the billions of dollars in healthcare spend that pass through their shell companies every year adding no value can go find a productive avenue to direct their energies on. Might I suggest research into virology or cancer? All those other administrative personnel working for the plans will also be displaced temporarily. I feel for them, but I believe we need to redirect them as well to a venture that is of higher value. Those research organizations will still need additional administrative associates, and there will be other investments in society if we eliminate 1/3 of the healthcare spend in our economy. A single-payer system would be the most efficient way to go. The payer system is not what makes the market competitive. If so, the plans would be offering something cheaper than Medicare rates. They haven't been and they can't. They are not an efficient model. They have too much overhead. They don't have the same scale as CMS and their market is limited to that within a single state. We'd have to open the market up across state boundaries for them to approach CMS-level scale, but even then, they still could not offer better rates than CMS. Their expectation of profits outweighs the social good of a not-for-profit status and they are not innovating, so they are not making this market better. It would be to go single-market for payer and have a market for innovators that come up with new and better treatment plans for diseases and injuries of patients and new and better medical technology. Create a market for the technology and then the market must negotiate a reasonable deal with CMS. For innovators, it would be a mix of funded research from CMS and outside innovation that CMS could award prizes for, and then techniques would be taught to providers by outside market-led organizations and a physician-group would negotiate rates with CMS for certified providers that could perform the procedure.
Get well Dr. Ross. People are hungry and homeless. 14.7% of the population has filed for unemployment, a statistic that was not even tracked the last time it was this high and the numbers alive that can remember that will be few today. These are unheard of times. We must think of our neighbors, our friends, our families in these times. They are among these 14.7%. We must check on them. We must assist when we can. Sometimes they don't know where their next meal is coming from, and some of them are losing their utilities like power, water, and phone service as they are unable to pay their bills and the utilities are deciding to cut them off. Rent & mortgage payments are due or behind. For some, this means they may soon mean they have no place to live. We need to take care of people first. People have basic needs. They need food, shelter, clothing, water, sleep, air. Take a hint from Maslow. These are at the base for a reason. They are the most fundamental of needs. Once you have these, then you can start to focus on the others. The next layer is where employment is, but it is also where health, property, resources, and personal safety is. The layer itself is called Safety needs. Employment stands out a bit in this space as something that doesn't quite scream safety. These days, you look at workplace shootings (El Paso Wal-mart and Virginia Beach municipal building both in 2019) and declining workplace safety conditions (increasing workplace deaths since 2017, fewer enforcement actions, safety rule rollbacks, meat-packing plants forced to stay open even when high rates of COVID-19 in plants) and safety is not the first thing that you think of. Employment is more like the thing gives you that sense of stability. You know you will be okay because you have employment and you have an income, so it could easily be replaced by an annuity or a pension or perhaps just a good investment portfolio.. If you check that box another way, then employment doesn't belong at this level. You could easily take employment and make it part of the Esteem or Self-Actualization levels. With COVID-19 posing such a threat not only to us personally but to our at-risk loved-ones, that Safety layer takes on a special meaning and the personal security and health can challenge employment, property, and resources for dominance. People are making that decision all the time right now. Do I call in sick? Health wins. Or do I buck up and go to work? Employment wins. By itself. Employment might not win, but if property and resources are there for backup, it has a better shot of getting the upper hand. We need to help people fulfill their needs and we need to simplify their lives a bit by helping them address these problems instead of exacerbating them but forcing them out into the workplace when there are no jobs, but there is still plenty of risk to their health. All the while, they are still hungry, because they have not gotten the unemployment benefits they were promised and that were written into the CARES Act because the state opened back up and took away benefits since the economy was now open again. The logic that people will never go back to work if we get them on unemployment is a fallacy. It's true that some people take advantage of any system and exploit it's loopholes. We need look no further than 1600 Pennsylvania Avenue in Washington, DC. The biggest grifter in the land is sitting at the Resolute Desk figuring out his next scam on the American public and he doesn't care who it hurts because he doesn't have the ability to care, he is a sociopath. That does not mean we need to rip up the Constitution as a flawed document and start from scratch because the system will not work. Unemployment Insurance works and is there for a reason. In this situation, this is beyond Unemployment Insurance. This is about sustaining families during a national lockdown situation as we deal with a national healthcare crisis. Our healthcare system was ill-prepared to deal with this crisis. Our federal government only made it worse by acting too late on the information, first by ignoring the info, then by downplaying the info, never by mobilizing or taking action, and always by spreading mis-information to paint a different picture from reality. The people need financial assistance so that they can buy food and secure housing in which to lockdown until we have a clear runway to take actions towards a new future. That future looks different from the old one. It must. No longer can we rely on a trickle-down system. This is the most prosperous nation in the world. We have made huge leaps and bounds in productivity over the past 50 years and the average middle-class worker is doing worse than their equivalent from 50 years ago. Where did all those productivity gains go? Why didn't they see any of it? It is because they were working harder and paying more taxes while the plutocracy was consolidating its hold on our federal government and changing the rules. A very small number of individuals that has an out sized influence on our government has been collecting those productivity gains for the past 50 years all to themselves. They use some of it to buy these elections and they invest a small portion of it back into society, but by and large they are pulling large sums out of the economy and squirreling it away in some foreign land that will pretend like it isn't there when the IRS shows up. These plutocrats manage their out sized influence by gas-lighting and manipulating uneducated voters into voting for politicians whose very platform does not represent the best interest of the constituents, but they vote for these charlatans like Trump anyway.
Get well Dr. Ross. The people who are hungry need you. The people who are losing their homes need you. Those without healthcare need you. Those who risk their lives to work under hazardous conditions without the proper safety equipment and training need you. Those who risk their lives to save the lives of others. Those we have lost to this terrible virus need you. Those left behind, unable to properly grieve for their lost loved ones because they can't have funerals need you. Those who have learned how to work from home need you. Those who inherit this fragile planet need you. The 99% need you. MO-06 needs you. Missouri needs you. America needs you
This District deserves better than Sam Graves and I am here to support you.