I attended your Lakewood town hall tonight, and appreciated your intelligent answers and support for a public option in health care reform.  Many questions were asked about how to pay for reform.  I want to share some ideas with you. 

* INCREASED ACCESS TO MIDWIVES AND OUT OF HOSPITAL BIRTH.  Medicaid pays for a lot of births, and requiring federal Medicaid to reimburse a Certified Professional Midwife in an out of hospital setting reduces costly intervention, including Cesarean section.  The WHO recommends an optimal 15% c-section rate and the US rate is now 31%.  These surgeries are costly, many are unnecessary, and could be prevented with midwifery care for healthy women.  Please watch this video:  www.reducinginfantmortality.com.

*  INCREASED ACCESS TO ALTERNATIVE/COMPLEMENTARY PREVENTIVE CARE.  I listened to a round-table on preventive care held by the administration, and many medically-trained providers lamented the fact that they did not get adequate training in disease prevention.  Naturopaths, massage-therapists, acupuncturists, midwives, etc. all provide low-tech preventive and wellness-promoting care.  This also solves the problem of lack of adequate providers while expanding patient choice.

* INCREASED ACCESS TO FAMILY PLANNING.  Preventing unintended pregnancy reduces costs to insurers.  If everyone had access to services provided by state family planning waiver programs (like the Take Charge program in Washington), people would be able to control their reproductive lives and save the state money.

* REPEAL THE BUSH TAX CUTS AND INCREASE TAXES FOR THE WEALTHIEST AMERICANS.  We all benefit from the great things the US has to offer, and the ones who benefit the most need to give back the most. 

Thank you so much for the work you do for us.  Keep it up.

Sincerely,

Alison Duren-Sutherland
Medical Insurance Biller
Homebirth Mom
Apprentice Midwife

Emailed to Senator Maria Cantwell, 16 June 2009:

Dear Senator Cantwell,

Thank you for all that you do for Washington State.  I am writing today to let you know how important health care reform is to me, and give you a few points that I believe are essential to real reform of the health care system: 

* A PUBLICLY-FINANCED HEALTH CARE OPTION IS VITAL.  I work in insurance billing for a small medical practice, and it is ridiculous that private insurance companies make so much money off of trying to avoid paying for their member's health care.  The system is too complicated to be understood by professionals like me, let alone health care consumers.  I can only hope that a public option would provide clear, streamlined billing practices, as exists for Washington State Mediciad. 

* WOMEN MUST BE ABLE TO ACCESS A FULL RANGE OF REPRODUCTIVE HEALTH CARE OPTIONS THROUGH PUBLIC HEALTH COVERAGE.  This includes contraception, abortion, midwifery care and out-of-hospital birth.  Providing coverage for all of these options will lead to significant cost-savings.
I encourage you to learn more about how Certified Professional Midwives and out-of-hospital birth reduce health care costs while optimizing outcomes.  Please review the Milbank Report, found here:  http://www.childbirthconnection.org/article.asp?ck=10575

*PROVIDING COVERAGE FOR WELLNESS-PROMOTING "ALTERNATIVE" AND "COMPLEMENTARY" CARE PROVIDERS WILL SAVE MONEY.  Like midwives, practitioners like naturopaths, acupuncturists, massage-therapists, cranio-sacral therapists, etc provide alternatives to expensive drugs, surgeries, and hospital procedures. 

Thank you for you service, and for reading this. 

***

Emailed to the WA State Chapter of the American Medical Association in response to this bit of news:

I urge WA State Delegates to vote against the resolution which proposes to develop CPT (billing) codes to identify and label “non-compliant... Read More” patients at the American Medical Association’s (AMA) Annual Meeting next week. As a health care consumer, childbirth educator, and paramedical worker, I hope that Washington doctors understand that their patients are ultimately responsible for their own health-care decisions. Doctors need to be their patient's allies, not adversaries. This is especially important to me on issues of choosing a location and method of childbirth -- for pregnant women seeking quality care and good outcomes, “non-compliance” is often our only alternative to accepting care which is not evidence-based, such as mandatory repeat cesarean and continuous electronic fetal monitoring.

Thank you for your time.

Heard from a pregnant friend yesterday that she's decided to homebirth at 33wks -- in the third trimester.  It was wonderful to hear her talk about what a good choice it felt like for her family.  I truly think she will get more the kind of birth she wants.  She expressed something to me that I often feel when receiving healthcare:  the insurance company has it set up such that it's very easy to follow the medical model of care, and the care we get is fine.  But there is a type of care that we desire that is beyond what this model can provide, and if we are willing and able to take a little time, do a little research, and often spend more of our own money, we can access better, more holistic and respectful care. 

I have an appointment with my craniosacral therapist (no longer covered by my insurance) for when we return home after our mother's day visit to Portland.  I can feel stuff going on in my body that needs work and release.  Jamie has said that pregnancy was easy for me, but motherhood is taking its toll on my body, and it's true.  My joints hurt, hands, knees, ankles.  I imagine that craniosacral will help, as it did with my sciatica during pregnancy. 

As a consumer and an aspiring provider of alternative healthcare, I want to be respectful of the people in my life who don't quite get the choices I make, and who would make different choices for themselves.  Jamie has said that he's trying hard not to feel that the energy work components of accupuncture & craniosacral therapy is just woo-woo silliness.  Those modalities are not for him, and I respect that.  But I need care providers who look at my whole body, my energy, my emotions; and I know that they are out there.  I don't want to be an evangelist about midwifery, because evangelism is often disrespectful of the choices that other make.  But I do want the people I care about to know that they have choices.  I'm so glad my friend decided she wanted her birth care to be better than fine, & she figured out what that meant to her, and made a choice she feels good about.