Has the Senate Ruined Health Care Reform?

In a special commentary tonight, Keith Olbermann said of the present Senate compromise, "this is not health, this is not care, this is certainly not reform." Howard Dean, Wendell Potter, Anthony Wiener, and Bernie Sanders are warning that the present bill may do more harm than good. Glenn Greenwald was even more jaded, saying, "The administration wants not only to prevent industry money from funding an anti-health-care-reform campaign, but also wants to ensure that the Democratic Party -- rather than the GOP -- will continue to be the prime recipient of industry largesse."

On the other hand, we have progressive senators Sherrod Brown and Tom Harkin supporting the bill and John Podesta offering his top ten reasons why progressives should support the Senate bill. Andy Kurz, a frequent guest on this blog, says:

While many are disappointed at the compromises finding their way into the Senate bill, there are still many good reforms that deserve passage of the bill.

Here is Andy's complete 2-page memo.

IL Attorney General Lisa Madigan: Don't Preempt State Regulatory Power

Two amendments were re-introduced in the U.S. House Rules Committee on Monday that will seriously undermine needed finance reform. Amendment #88, sponsored by Walter Minnick (ID) and others, would completely do away with the proposed Consumer Finance Protection Agency (CFPA); Amendment #141, sponsored by Melissa Bean (IL) and others, would hamstring regulatory efforts at the state level.

Background: You will find an update on the overall financial reform package, the Wall Street Reform and Consumer Protection Act (H.R. 4173), here: In the Public Interest: Rein in the Financial System That Failed. The toxic amendments are discussed here: Rep. Minnick Proposes Scrapping CFPA, Embraces Chamber’s Consumer Protection Model. Elizabeth Warren, head of the Congressional Oversight Panel, explains why American needs a Consumer Financial Protection Agency in the video at this page: Reining In Wall Street.

Yesterday, on a conference call hosted by Americans for Financial Reform, Illinois Attorney General Lisa Madigan explained why financial reform is so important and why the amendment re-introduced by Illinois Representative Melissa Bean should be withdrawn a second time. The main part of Attorney General Madigan's remarks appear below:

Let me give you the perspective of a state Attorney General. I have been Illinois State Attorney general for nearly seven years. Since taking office on January 1, 2003, I have had to focus on protecting people, borrowers and homeowners, from unfair, deceptive and discriminatory mortgage lending practices.

Since I have been the Attorney General, we have investigated some of the largest sub-prime lenders in the country: in 2003 Household Finance, in 2006 Ameriquest, in 2007 and 2008 it was Countrywide, and in 2009 Wells Fargo. After uncovering and documenting their predatory lending practices, we have either settled with or sued all those companies just mentioned, for putting people into loans that they didn't understand and they couldn't afford. In many ways we have had to out of my office do all that we possibly can to keep people in Illinois in their homes.

To give you just a quick perspective on that, I set up a homeowners'  help line about a year and a half ago and we have had approximately 19,000 Illinois homeowners call us about problems with their loans, trying to stay in their homes and trying to get modifications. We're looking at right now, and I think these numbers are only through October, 140,000 foreclosure filings in the state; like every other state, the highest number in years.

So I don't think that anyone at this point disputes that the practices of sub-prime lenders led to the foreclosure crisis, which ultimately was at the heart of our country's financial collapse. As an Attorney General I also am able to put in perspective that over the last 15 years, as we have seen state enforcement authority preempted, we have seen a rise of these predatory lending practices. I also don't think that anybody who knows the history would dispute that the only people bringing enforcement actions to hold lenders accountable and to try to save people's homes were state Attorneys General. We repeatedly tried to warn the feds about what was going on in our home states, in our communities, but regulators were blocking our efforts. And then, in addition to that, they did nothing to prevent the economic disaster that ensued.

We responded, and by "we" I mean not just the Illinois Attorney General's office but, we as state Attorneys General, and state banking regulators, and state legislatures across the country. We've responded not just with lawsuits but also with laws to protect and prevent the situation from happening again. Because the fed's didn't recognize or didn't want to respond, ultimately, as we all are painfully aware, American taxpayers, so the same people who are losing their jobs and are losing their homes, have had to bail out the financial services industry to the tune of 700 billion dollars last year.

I give that as background because it makes it very clear that the need for a CFPA has never been more apparent. The consumers need their interests considered and protected. It cannot just be a situation where banking regulators get to determine what is best for all of us because their priority is, what is best for a bank. And far too often we have seen that what is best for a bank may not be and has not been what is best for consumers and what is best for our economy.

Ed also mentioned as we all know many of those entities whose actions perpetrated this economic meltdown are fighting the creation of the CFPA and they are fighting the critical role that state Attorneys General and state banking regulators play in protecting their residents from abusive lending practices. Some of the amendments that are being proposed would limit state Attorney General authority and ability to bring lawsuits as well as to pass tougher laws in response to clearly abusive practices.

So, two points I want to leave you with:

1. Don't preempt state Attorneys General. There needs to be state level enforcement, particularly when the feds don't act. And it's a situation that the feds shouldn't be the ones intermediating what states decide to do vis-a-vis banks and lenders.

2. States need the ability to legislate to protect their residents when they see a clear problem. That goes the point about how the federal rules and the federal laws need to be a floor and not a ceiling, so we can legislate above if necessary as has been the case during this lending crisis.

What's going on now with some of these amendments is an attempt to prevent us from doing that. As others have said, there is no question that the current system of consumer protection failed. And in the end, financial reform is about restoring responsibility and accountability to our financial system. And it is about making sure that our financial system serves the interests of hard-working families and individuals and not just those of the big banks.

Support our Attorneys General and give some muscle to state regulators. Support H.R.4173. Call for defeat or withdrawal of Minnick and Bean amendments. Call your congressperson today and tomorrow and every day until the debate is over.

Non-Partisan CBO Estimates of Health Care Reform

Latest big-picture analysis of health care history and proposed reform from insurance/finance insider Andy Kurz (bio here).

SUMMARY: Few doubt how unsustainable current medical trends are. With medical inflation consistently outpacing the CPI, health costs will continue to take a greater share of the economy. Private insurers claim they can solve the problem with reform but without a Public Option. History suggests this is a dubious claim at best. Looked at from multiple angles, private insurers are not likely to succeed. Profits gains have far exceeded key indices, medical loss ratios have gone way down, while costs have gone way up, competition is diminished by concentration of major insurers, and tort reform complaints carry little water.

Full report here.

Illinois Needs Health Insurance Reform

A new report from Health Care for America Now (HCAN) summarizes the need for reform and expected benefits from pending reform in House and Senate. Sources are provided for  the stats, so you can fact-check the report.

Health insurance reform will reduce the deficit by $138 billion over the next 10 years, and Illinois families will see reductions in premium costs of up to $3,000 a year. Currently, 1.8 million Illinoisans do not have health insurance, and if nothing is done, this will increase to 2.3 million by 2019. Health insurance reform will allow the uninsured to get coverage and help the 612,000 Illinois residents who currently purchase individual insurance to buy an affordable health plan. Health insurance reform will help Illinois families, seniors, small businesses, and the state.

Full report here.

Public Option Has No Cost

(Revised 12/3/09) Retired insurance CFO Andy Kurz (short bio) is always looking for new ways to put health care numbers and proposed reforms in perspective. The chart below is his latest creation. Click the image to view the chart; there is also a pdf with a second page explaining calculations.

Executive Summary:

Americans can be divided into three health groups. About 3 in 10 people are on government run Medicare/Medicaid. Four in 10 work in big business and 3 in 10 work in small business or are uninsured. Much health insurance for big business is run just like Medicare where insurers administer claims but incur no claims risk. The middle group, small business and individuals incur the brunt of “at risk” insurance that is higher cost. Those higher costs put this group at a cost disadvantage to big business.

The Public Option has no effect on big business. But most new jobs come from small business, where higher health costs create a disincentive to hire. That in turn, hinders economic growth. A non profit Public Option eliminates high profit margins from insurance and puts small business on a more level playing field with big business. Since Public Option must play by the same rules, it is unlikely to put private insurers out of business. Only a strong Public Option with a broad enrollment base will compel insurers to compete.

Comments by the author:

This whole public option is not the boogeyman that some make it out to be. The diagram puts people of the U.S. into three main groups:Medicare and Medicaid recipients, insured by large employer, and eligible for proposed Insurance Exchange. For the largest, big business, it's business as usual, for several years at least.

I added a small table to show how health care costs are extremely skewed. If you are among the 90% of population, no worries, and why care at all about reform. You should care because if you become the 1 in 10, or 1 in 100, the consequences could be absolutely devastating health care costs. Kind of an eye opener, thanks to Kaiser Foundation for the stats.

Links for page 2:

Kaiser Foundation: Trends in Health Care Costs and Spending, March 2009

Centers for Medicare and Medicaid Services: Total Personal Health Care Expenditures by Type of Service, Region, and State of Residence: Calendar Year 2004

U.S. Census Bureau: Population, Population change and estimated components of population change: April 1, 2000 to July 1, 2008 (NST-EST2008-alldata)

U.S. Census Bureau: Statistics about Business Size (including Small Business)

Talk about Market Concentration

Remember the series of reports that came out in July on lack of competition in the health insurance market from Health Care for America Now (HCAN)? The report on Illinois stated,

Health Care Services Corp., doing business as Blue Cross and Blue Shield of Illinois, is the state’s leading health insurer with 47 percent of the commercial market. Together with WellPoint Inc., they control 69 percent of the state market.

That's about to change. According to an article today in the Chicago Tribune

Wellpoint Inc., which operates locally under the Unicare brand, said it will exit Illinois and Texas...Wellpoint said its Illinois Unicare customers, largely in the Chicago area, will be guaranteed coverage if they transition to Chicago-based Health Care Service Corp., parent of Blue Cross and Blue Shield of Illinois...

which moves us toward a situation more like this:

Medical Malpractice and Costs of Health Care

by Miles Zaremski

Miles Zaremski writes here individually and not on behalf of anyone but himself. He was the longest serving chair (5 years) of the American Bar Association's Standing Committee on Medical Professional Liability. He was also the first non MD-JD president of the American College of Legal Medicine (an association of professionals formally organized nearly 50 years ago by those principally possessing both the medical and law degrees). Mr. Zaremski is not a member of any trial lawyers association and does not represent injured persons, even though he has been in health care law and policy now for 36 years. Read more from Miles Zaremski at his blog on the Huffington Post.

The following was written in response to an op-ed published September 7, 2009 in the Chicago Tribune.

I am appalled to read in the story, "Doclors and Lawyers", that, "Medical malpractice reform has to be part of health-care reform". I have studied the effects of malpractice litigation on the health care system for nearly 40 years, and can say without hesitation that medical malpractice has a negligible impact on the costs of health care in our country. To be more precise, as reported by the Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group (1960-2007); U.S. Department of Commerce, Bureau of Economic Analysis; U.S. Bureau of the Census; and "Property/Casualty Insurance Industry Aggregates", Medical Malpractice Direct Premiums Written (Nat'l. Assoc. of Ins. Commissioners, 1992-2007), medical malpractice costs, as measured by medical malpractice premiums in 2006 - - - the most recent year for which all the necessary data to make comparisons is available - - - accounted for only .58 percent of overall health care costs. This is contained in a letter of record sent to Rep. Henry Waxman, Chr. of the U.S. House's Committee on Energy and Commerce, on July 29 by the American Bar Association.

Second, your article also talks about the costs of so-called defensive medicine - - - ordering up more tests and procedures than are necessary. In a 1992 Congressional Budget Office Report "The Economic Implications of Rising Health Care Costs" (October 1992, p.27), the CBO stated that such procedures would have been provided anyway, for reasons other than concerns about medical malpractice litigation. And, in 2004, the CBO also stated in, "Limiting Tort Liability for Medical Malpractice" (Economic and Budget Issue Brief (Jan. 8, 2004, at p.6), that the savings from reducing defensive medicine would be "very small".

Finally, as is mentioned in the article on attorneys and physicians, there is a continuing mantra of what limiting noneconomic damages does for physician malpractice premiums on an annual basis. Bunk. Truth be told, however, the costs of health care in states with, and without, such caps remains incredibly high and continues to soar. Moreover, doctors' malpractice premiums spike once or so every decade (at least since the time I started studying this topic going back to the 1960s). The timing of these spikes coincides with a downturn in what the financial markets provide as returns to the insurance industry on their investments. Thus, don't be surprised that the lower the return on investment, the higher the premiums for professional malpractice premiums will be for doctors.

As with other elements in the current health care debate, much has been shown to be false, misleading, overstatements, and, in the end, nothing but attempts to instill fear in the general population without fact. That which is suggested in the article about the need to reform medical malpractice laws as part of the health care reform debate is just more of the same.

---

Note: The public option is essential to protecting the doctor-patient relationship. Three United States Supreme Court decisions in which I have been involved have had before them facts involving managed care companies making decisions for the attending doctor that harmed the patient. These cases are: Pegram v. Herdrich, Aetna v. Davila, and Cigna v. Calad. In the Herdrich case, Justice Souter (now retired) stated that "eligibility decisions and treatment decisions (are) inextricably mixed, as they are in countless medical administrative decisions every day". A public plan is designed not to allow what goes on every single day NOW - as shown by these three cases.

Medicare - cutting costs without cutting benefits

by Andy Kurz

Andy Kurz has over 12 years executive level experience in finance and risk management, including CFO for a Midwest Blue Cross and Blue Shield Insurer. Retired now, he had decades of involvement with financial applications and analytical software.

Many seniors have become fearful that cutting excess costs means cutting benefits. Medicare’s own data highlights differences between about 20% of states with the lowest costs and 20% of states with the highest costs. Cost of living explains some of the differences. But 71% higher physician and clinical service costs for essentially the same results suggests there are billions of dollars being spent with little or no added benefit.

Medicare Spending Discrepancies

States (all data from 2004 Center for Medicare and Medicaid Services)	Population	Medicare Spending	For Similar Results
26 states and the District of Columbia – combined Medicare population 17.9 million
Alaska, Arkansas, Idaho, Iowa, Kansas, Kentucky, Maine, Massachusetts, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Oregon, South Dakota, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming	20% of ALL Medicare Recipients in the U.S.	$12.5 billion in physician and clinical services	For every $100 spent on physician and clinical services in this group ...
California, District of Columbia, Florida, Nevada, New Jersey	21% of ALL Medicare Recipients in the U.S.	$22.6 billion in physician and clinical services	states in this group spent $171

more industry lobbying to oppose public health plan

Last week we found out about the health industry spending $1.4 million per day lobbying Congress to fight health care reform. Now this:

Five insurance producer associations are planning a joint lobbying effort ... on health care reform in the nation's capital...

... they will host a special joint health care reform Capitol Hill fly-in July 14-15.

With both the House and Senate poised to consider health care reform legislation in late July, the groups see this event as an opportunity for them to voice their opposition to the creation of a public plan that would [?] against private insurance companies in the health insurance marketplace.

Insurance Brokers Plan 'Fly-In' to Lobby on Health Care Reform,
Insurance Journal, June 9, 2009.

Where do they get the money to fight health care reform?

In this country, 87 million people went uninsured in the past two years. The rest of the industrialized nations spend far less than we do per person and they manage to cover everyone. How can they afford to do this?

We can cover everyone for less than we are paying now. (In fact, we could cover everyone in the U.S. and Canada for less than we are paying now.) We don't need to spend more for a better health care system. We need the money we are already spending to go to people who want to provide care, not make a profit.

playing us for a bunch of idiots

I've already forwarded this link around. The video pokes fun at right-wing scare talk about fixing the health care mess - you know, the corporate insurance extravaganza that is ravaging millions of families and keeping the economy down.



The video underscores the consistent refusal of the Republican Party to speak to the American people as if we are adults.

On a related note, State Senator Matt Murphy is apparently going to run for Illinois governor. Several months ago I asked Senator Murphy how he would balance the budget. His answer: tax cuts.

(I also asked about HB 311. After I explained that it was for single-payer health care, he said he was against it.)

where your treasure is, there also will your heart be

Update 9/27/09: since the original posting, an updated CBPP report shows the number of states with shortfalls has risen to 48 and the total deficit anticipated for the next fiscal year, 2010, is $168 billion.

According to the Center on Budget and Policy Priorities, of 50 states, 47 face budget shortfalls over the next few years. The total budget shortfall for all states for fiscal year 2009 is $106 billion. Because states cannot run deficits, sharp and immediate cutbacks in social services and infrastructure are often seen. But these measures can be false economies, taking down systems that make our communities good places to live.

Last week, Congress passed another war supplemental funding bill. There was maybe a week of debate over some of the issues - but the outcome was never in doubt. Nothing like the pitched battle going on over whether we will join the rest of the civilized world and institute universal health care. The amount of the appropriation - $106 billion.

This is insane.

Doctors arrested protesting exclusion of single-payer at Senate Finance Committee

[from the PNHP.org press release, May 5, 2009]

See also the report at PNHP.org, here:
http://www.pnhp.org/news/2009/may/doctors_single_paye.php

VIDEO footage:
Sen. Max Baucus (D-Mont.) reacts to protesters

Russell Mokhiber, Single Payer Action, speaks at hearing

Margaret Flowers, MD & Katie Robbins, Healthcare-NOW

Carol Paris, MD, PNHP

Mark Dudzic, Labor Campaign for Single-Payer Healthcare

Adam

Pat Salomon, MD & Kevin Zeese

WASHINGTON - Doctors and other advocates of a national single-payer health system - also known as an improved Medicare for All - directly confronted senators at a Senate Finance Committee "roundtable" on health reform today.

One-by-one, eight single-payer advocates in the audience stood up during the opening comments of the hearing and asked why single-payer experts were being excluded from the proceedings. They each spoke out in turn until they were removed from the committee hearing room and arrested, one-by-one, by U.S. Capitol police.

The doctors and others said that a publicly funded, privately delivered single-payer system is the only solution to the crisis plaguing our nation's non-system of health care, noting that single-payer national health insurance would guarantee coverage for everyone and contains costs.

Despite polling that shows a clear majority of public and physician support for a single-payer system, Sen. Max Baucus (D-Mont.), chair of the Senate Finance Committee, has stated on multiple occasions that single payer is "off the table" of health reform.

Today's round table, the second of three, consisted of 15 witnesses with no single-payer advocates among them. By contrast, several witnesses have direct ties to the for-profit, private health insurance industry.

The doctors and activists were dressed in black, which they said was in memory of the 22,000 people who die every year due to lack of health insurance. They represented a coalition of single-payer advocacy organizations including Physicians for a National Health Program (PNHP), Healthcare-NOW, Single Payer Action, Private Health Insurance Must Go, the Campaign for Fresh Air and Clean Politics, Prosperity Agenda, and Health Care for the Homeless.

"Health insurance administrators are practicing medicine without a medical license," said Dr. Margaret Flowers, co-chair of Maryland chapter of PNHP. "The result is the suffering and death of thousands of patients for the sake of private profit. The private health insurance industry has a solid grip on patients, providers and legislators. It is time to stand up and declare that health care is a human right."

Much to the frustration of Baucus, the multiple disruptions demanding single-payer be on the table set the tone for the second of three roundtables on Health Reform by the Senate Finance Committee.

Katie Robbins, assistant national coordinator of Healthcare-NOW, said: "The current discussion on health reform is political theater at its best. Our elected officials are hosting these events to go through the motions of what developing effective national health policy should look like. There is a big difference between getting health policy experts in the room and the witnesses here today who would profit the most from reform. That difference means our hard-earned dollars will go to further insurance industry profits, not to guarantee health care to the American people."

"It's a pretty spectacular display of raw political power," said Russell Mokhiber of Single Payer Action. "The health insurance industry demands that not one of the 15 people who testified today shall be a single-payer advocate. And the industry gets what it wants. It's time for the American people to storm the gates and demand - put single payer on the table."

Single payer is successfully implemented in the United States' own Medicare system providing comprehensive care to the elderly, as well as in many of the best health care systems in the world. A single-payer system, as embodied in legislation H.R. 676 and S. 703, would provide guaranteed, quality care to all Americans with no increase in U.S. health spending.

The single-payer advocates said they will continue to use direct actions and nonviolent civil disobedience to urge the inclusion of a publicly funded, privately delivered system.

Other methods of communication with elected officials have failed in delivering the demand for single-payer national health care as evidenced by the exclusion of single-payer advocates from official hearings on health reform.

###

Comment: The Capitol police got it wrong. They should have hauled away the lobbyists and seated the doctors who came to speak on behalf of the thousands in this country who die every year from lack of insurance and millions who are bankrupted or foreclosed because of medical bills.

P.S.: C-Span video of the entire hearing below. Note Senatorial banter as people call for consideration of single-payer:

Baucus: The comments are out of order. This may cause us to recess until the police can restore order.
Grassley: I would do it right now.
...
Baucus: We need more police.
Grassley: Isn't there someplace they can watch it on television?
...
Kerry: Is there anybody in the audience who didn't come to ... ?

To see who was invited to speak, check here.

Thoughts on Running for Local Office

by Hal Snyder

Five of us ran as Democrats in the April 7 election for Palatine Township board: Duncan Swenson for Supervisor, Joe Gump for Highway Commissioner, and Beth Siela Marcin, Jan Wood, and me for Trustee. We were joined by Dexter Stokes, running for Palatine Park District Commissioner - a non-partisan race, but Dexter was a kindred spirit.

None of us was elected. This time. We learned, though, about the democratic process and about ourselves. I asked my fellow candidates to write something about the experience of running for office. Here are some of their responses.

Beth Siela Marcin

I am in awe and thankful for our wonderful, dedicated volunteers. We could not have had the success we did have without them. To our generous donors - thank you.

For me personally, I was really challenged and had to get out of a comfort zone to speak to a group of people I did not know and express my thoughts, ideas, and feelings. I had a great time - working the trains (watching Joe Gump, the professional and natural campaigner, Hal Snyder with his infectious enthusiasm, and Dexter Stokes with his quiet determination); going door to door - reconnecting with my neighbors and meeting new young neighbors; listening to my husband getting excited when talking to his friends about my campaign. It really was a great experience - not one that I ever thought I would have.

PROUD TO BE A DEMOCRAT!

Dexter Stokes

This was an experience that I will never forget. All of the candidates of the Democratic party should be applauded, and be proud. We have shown we are a force to be reckoned with. Our time is soon to come if we continue to strive toward the goal.

Joe Gump

The reason that I ran for highway commissioner was to increase transparency, efficiency, and accountability.

It is important that township residents have a choice at election time and that the entrenched incumbents not feel as if they are entitled to their position. They need to earn our support and be accountable to those who pay for the services they are directed to provide. Due to the partisan nature of the election and the composition of the township, I was not particularly optimistic about our chances, nonetheless it was important to run.

I encourage any committed person to run for office. It is hard work, but you will benefit in many ways. It is truly what makes our democracy strong and the local level is where the rubber hits the road and can have the most direct impact on your quality of life.

a few of my impressions - hal

There's always more to do in a campaign than you have time or resources to accomplish.

You find out fast how helpless you are alone. Volunteers make the campaign happen.

It helps to have an experienced coach. We were lucky to have Sue Walton. The Township candidates started as five different people going in five different directions; we became a team working on a single set of goals.

If elected, we would have been the first Democrats on the Palatine Township board in over 150 years.

Say Hello to Kat

Kat in the Sixth!

Overview of the Health Care Crisis

By David Borris

(Thanks to David for sharing the notes he prepared for a talk at the March 28 Health Care Summit at Countryside Church in Palatine.)

Thanks to our hosts for having us here to discuss this critical topic at such an opportune time. And I appreciate everyone who took time out of their busy schedules on a Saturday afternoon to come out and share their thoughts, hopes and fears about where health care is headed in this country and how we can help shape the agenda. And it is up to us to shape the agenda if we want to see true reform. The health insurance industry, aligned with the for profit medical community and the mega pharmaceutical giants are ready for battle. They do not want to see any real reform that will jeopardize the rapacious profits they have enjoyed for decades, and they are prepared and organized to see that the status quo is not disturbed to any great degree. And most of the folks over there in Washington DC are only too happy to accommodate their major donors if we do not stand up and hold them accountable.

Meetings like this should be, and are happening all over the country as people like our hosts here and A Better Day work to create opportunities for all of us to discuss what is broken and what is possible. So thank you once again for coming- and thanks in advance for what you will be doing in the next few months to radically transform Health Care in America and make this country a more equitable, a more honest, and a more just place to raise our children and our grandchildren.

Before we talk about solutions, I would like to give an overview of the problem. So let me try to do this simply and clearly. While the details of specific solutions often appear quite complex, the problem can be stated clearly.

1. We pay too much.
2. We get too little.
3. Too many people are left out.

Let me articulate. According to both the Mckinsey Institute and the California HealthCare Foundation, the United States of America spends 16% of our 14.4 trillion dollar Gross Domestic Product on health care. That is almost $7900 for every man, women and child living in our country. By way of comparison – The organization for Economic Cooperation and Development – which tracks 30 high income nations – reports that Switzerland spends only 10.9% of its GDP on Healthcare, Germany 10.1 %, Canada and France approximately 9.5% each. So we outspend the next nearest country by over 50%, in the richest nation on earth. Surely we must get what we pay for...

Think again. Once again referring to the OECD data, the United States ranks:

1. 25th out of 30 High Income Nations in Mortality from Heart Disease.
2. 23rd out of 30 in overall Life expectancy.
3. 25th in Low birth weight children.
4. And most disturbing of all, 27th out of 30 in Infant Mortality. There are 26 high-income nations in the world who spend less than 60% of what we spend for health care who give their newborn infants a better chance at survival than we do.

Why is this? How can the wealthiest nation the world has ever known, the business-savvy, technological cutting edge envy of the world, be such a sucker when it comes to the health and quality of life for its people?

Because we leave too many people out. Walk down the street—every sixth person you pass has no health insurance, and thus a severely limited ability to access quality health care. Of the other five people who walk by you, another 1 is underinsured - so will not be able to take advantage of treatment options that he or she thought they had coverage for until they became ill.

Meanwhile, costs are soaring. Since 1999, employment based health insurance premiums have increased by 120% - well more than doubling, while cumulative wage growth has grown by a mere 29%.

At the same time, employers continue to shift the burden of rising premium costs onto their employees. The annual Kaiser Family Foundation survey released in September of 2008 reports that the average worker now contributes nearly $3400 to their health insurance premiums --$1600 more than they did in 1999, and 12% more than they did in 2007.

Is it any wonder that more and more employers have chosen to severely curtail or drop coverage altogether? According to the Illinois Main Street Alliance, 12% of small business polled in over a dozen states have dropped coverage altogether in the past two years while 35% report switching to coverage with less benefits. And just three weeks ago, Hewitt Associates released a survey stating nearly 1/5 of U.S. employers will stop offering health benefits in the next 3-5 years, more than 5 times the number that reported that just last year.

And with the current economic downturn resulting in job loss numbers of almost unprecedented proportions, isn’t it obvious that we can no longer afford to wait for a broken, noncompetitive “Market” to work out a solution?

It is time that we reconnect to what health care should be - a profession whose primary mission is to improve the lives of those it serves, not an industry whose purpose for being is to maximize profit at the expense of the least fortunate. We are currently engaged in a great debate of how to most meaningfully achieve this rebalancing.

We won’t develop comprehensive solutions here this afternoon – but we can all walk away from here with a more educated and more focused framework and direction. And we can bring the ideas that we will discuss in more detail later this afternoon to the attention of our friends, neighbors and elected officials as we make this the year that we finally address one of the most vexing issues hamstringing the economic recovery - how to provide quality, affordable health care for all.

Comment: we have an opportunity to influence health care legislation that is under consideration now. We can join forces to ensure that the result truly serves the public and not special interests. There is a major rally for health care reform on Saturday, April 18 at St. Augustine College in Chicago. A free bus to the rally and back will be available from Palatine and Arlington Heights - specifics online here. - Hal

Call Melissa Bean's office today for health care

Health Care for America Now (HCAN) is urging 8th District constituents to phone Representative Melissa Bean's office today and ask her to support President Obama's proposed budget, especially the funding of $634 billion for health care over the next ten years.

This is the second day of a call-in campaign. Word is that Congresswoman Bean is on the fence. We can let her know it's important to fund solutions to the health care crisis. (In fact, we can't afford not to fix health care if we want a full economic recovery, but more on that later.)

HCAN has an online app here (you'll need to sign up if you haven't already, then click "CALL") that saves the cost of a phone call and lets you record the outcome of the call - the name of the staffer you spoke to and the present stance of the politician called. Be polite! It's likely we're at the start of an extended discussion with the Congresswoman's office.

Gnawing at Their Restraints

Last Monday, March 16, 2009 - while much of the country was up in arms about AIG bonuses - some folks were hard at work setting the stage for more larceny. In a bit of theatrics Barbara O'Brien described as "faux populism", Senator John Cornyn (R-Exxon) held a Senate Republican Conference hearing to Protect Small Businesses from Lawsuit Abuse. Cornyn summoned Ted Frank from the American Enterprise Institute to help with the Protecting.

Senator Cornyn has taken substantial contributions from a donor who might want to avoid being sued for lead paint poisoning. In 2005, Ted Frank represented Merck in Vioxx litigation.

With the nation at the precipice of economic collapse after an orgy of deregulation, these gents want to undo one of the remaining restraints on corporate excess.

It's not just about toxins like lead or asbestos or Vioxx. Consider lawsuits brought under the False Claims Act, often initiated by whistleblowers. Compare the billions of dollars of taxpayer money recovered under the False Claims Act to the $165 million in AIG bonuses. And imagine what would happen without this protection.

The gnawing at the restraints doesn't stop.

P.S.: Antidotes to tort reform spin: Justinian Lane, TortDeform.