www.roanoke.com

Carilion Clinic appears to have taken criticism about its bad debt policies to heart. After a Roanoke Times article last year detailed Carilion's extensive efforts to collect unpaid medical bills even from patients who should have qualified for charity care, the nonprofit hospital appears to have re-examined its policies and looked for better ways to provide for those who can't afford care while collecting from those who can.

In an editorial for later in the week, we'll praise those changes.

The Tea Party planned a huge "flash mob" today to protest the rollout of the new health care reform bill by House Democrats.

It didn't turn out quite as planned. About 10 protesters showed up, according to Talking Points Memo. As one participant said, "If this is organized, we suck."

I don't know whether to be grateful or not for an item posted on the Richmond Times-Dispatch offering assurance that the flu doesn't have to scare off trick-or-treaters this Halloween. It hadn't occurred to me to regard the little ghosties and ghoulies as a real threat this year, but it should have, given the early flu season and the reported ease with which the H1N1 virus is transmitted between humans. So, to open the door to the kids, and maybe a case of the flu, or not? I'm going to risk it, but follow safety tip No. 1: drop the candy in the bag; avoid direct contract with the visiting humans. Assuming they are humans.

We can't afford to fail on health care reform

Tom Joyce

Joyce, of Hardy, is a retired information technology office director for the federal government.

We must reform health care and health insurance in America to increase the length of life and improve the quality of life in America and to prevent the collapse of our economy that will surely happen if we fail to act. The clock is ticking.

The current health care system in the United States for the uninsured is unworthy of this great nation. In the U.S., the world's richest country, many sick people who can't pay stay sick or die.

Read more.

When told that health care reform looks like a "train leaving the station with President Obama at the wheel," recently on Fox News, GOP Chairman Michael Steele responded, "I'm the cow on the tracks. You're gonna have to stop that train to get this cow off the track to move forward."

Apparently, Steele isn't too familiar with what happens to cows that go head-to-head with trains.

Follow this link for an example. The video itself isn't graphic, but there is some bad language from the engineer.

Wednesday, we'll laud Virginia Tech for its management of an international resource management project that won a Nobel for one of its researchers, and applaud the university's success in winning a multimillion-dollar federal grant for the university's bioinformatics institute. Both are pointed reminders of the important role research has to play in the lives of ordinary people, and the wisdom of investing in it.

Want to take dry policy discussion and make it listenable? Give it a beat, and subject it to an iPhone app that lets anyone sound like T-Pain.

Watch:

A few days ago, I put up a post about a recent David Brooks' column lamenting that the far-right wing of the Republican Party wields more influence than it deserves. The Limbaugh-Hannity-Beck wing of the party is loud, but small.

Here's some more validation of that theory: Despite all the braying about death panels and a government takeover, health care reform remains very popular. In fact, a public option, among the most contested portion of reform by the far right, enjoys a nearly 2-1 advantage according to a recent poll. Sixty-one percent of those polled favor a government-run insurance option while only 34 percent oppose it.

The rabid outcry from some in the Republican Party is winning few converts. As Washington Monthly's Steve Benen summed up the poll results: "Only 25% approve of the job congressional Republicans are doing; 25% have a favorable opinion of the GOP; 29% believe Republicans are acting in good faith; and 31% trust the GOP to handle health care (16 points lower than the president)."

Benen used those numbers to ridicule Virginia Rep. Eric Cantor, House Minority Whip, for his unsupportable statement that a public option "has been resoundingly rejected by the American people." No, it's been resoundingly rejected by an incredibly small portion of the American people, who by their obstinate behavior and unwillingness to engage in rational discussion, are increasingly becoming irrelevant.

There was an interesting piece on NPR's Morning Edition today about steps the grocery chain Safeway has taken with its health insurance.  CEO Steve Burd explained that it charges obese employees -- with a BMI greater than 30 -- higher premiums to offset the greater medical expenses they will accumulate on average.  It's the same approach many companies take with smokers who on average also incur higher medical expenses.

The Safeway program does not just apply a stick, though.  The company also offers incentives to obese employees who lose weight.

Burd said the program has kept its health care costs flat over five years thanks to the program. He also argues that if national health care reform incorporated something similar, it could go a long way to reining in medical expenses in America. The Centers for Disease Control calculated that in 2008 obesity-related problems cost the nation about $147 billion, and an obese person every year incurs $1,4000 more in medical bills compared to someone with a healthy weight.

Any serious conversation about health care reform cannot ignore these sorts of expenses.

Some governments are not waiting for the federal government. North Carolina will start charging its state obese and smoker employees higher premiums. Maybe that's something the Virginia General Assembly should look into when it convenes next year.

Make landlords install CO detectors

Carbon monoxide poisoning strikes in Christiansburg this time.

Last week, four men in Christiansburg wound up in the hospital after exposure to high levels of carbon monoxide. They were lucky. The gas only made them sick. They could have died, as at least one Southwest Virginian has in recent years after carbon monoxide exposure. Dozens more have been sickened by the odorless gas, including two dozen near Virginia Tech two years ago.

Prudent homeowners, especially those with natural gas heating, install carbon monoxide detectors. Renters, like the four sickened men, don't decide on that, and the Republican-controlled House of Delegates refuses to help.

Read more.