President Obama's Address To Congress on Health Care

Remarks of President Barack Obama – As Prepared for Delivery
Address to a Joint Session of Congress on Health Care
Wednesday, September 9th, 2009
Washington, DC

Madame Speaker, Vice President Biden, Members of Congress, and the American people:

When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression. We were losing an average of 700,000 jobs per month. Credit was frozen. And our financial system was on the verge of collapse.

As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods. A full and vibrant recovery is many months away. And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes. That is our ultimate goal. But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.

I want to thank the members of this body for your efforts and your support in these last several months, and especially those who have taken the difficult votes that have put us on a path to recovery. I also want to thank the American people for their patience and resolve during this trying time for our nation.

But we did not come here just to clean up crises. We came to build a future. So tonight, I return to speak to all of you about an issue that is central to that future – and that is the issue of health care.

I am not the first President to take up this cause, but I am determined to be the last. It has now been nearly a century since Theodore Roosevelt first called for health care reform. And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way. A bill for comprehensive health reform was first introduced by John Dingell Sr. in 1943. Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.

Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point. Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy. These are not primarily people on welfare. These are middle-class Americans. Some can’t get insurance on the job. Others are self-employed, and can’t afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer. Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.

We are the only advanced democracy on Earth – the only wealthy nation – that allows such hardships for millions of its people. There are now more than thirty million American citizens who cannot get coverage. In just a two year period, one in every three Americans goes without health care coverage at some point. And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone.

But the problem that plagues the health care system is not just a problem of the uninsured. Those who do have insurance have never had less security and stability than they do today. More and more Americans worry that if you move, lose your job, or change your job, you’ll lose your health insurance too. More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won’t pay the full cost of care. It happens every day.

One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn’t reported gallstones that he didn’t even know about. They delayed his treatment, and he died because of it. Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne. By the time she had her insurance reinstated, her breast cancer more than doubled in size. That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America.

Then there’s the problem of rising costs. We spend one-and-a-half times more per person on health care than any other country, but we aren’t any healthier for it. This is one of the reasons that insurance premiums have gone up three times faster than wages. It’s why so many employers – especially small businesses – are forcing their employees to pay more for insurance, or are dropping their coverage entirely. It’s why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage. And it’s why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else’s emergency room and charitable care.

Finally, our health care system is placing an unsustainable burden on taxpayers. When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid. If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined. Put simply, our health care problem is our deficit problem. Nothing else even comes close.

These are the facts. Nobody disputes them. We know we must reform this system. The question is how.

There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada’s, where we would severely restrict the private insurance market and have the government provide coverage for everyone. On the right, there are those who argue that we should end the employer-based system and leave individuals to buy health insurance on their own.

I have to say that there are arguments to be made for both approaches. But either one would represent a radical shift that would disrupt the health care most people currently have. Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn’t, rather than try to build an entirely new system from scratch. And that is precisely what those of you in Congress have tried to do over the past several months.

During that time, we have seen Washington at its best and its worst.

We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform. Of the five committees asked to develop bills, four have completed their work, and the Senate Finance Committee announced today that it will move forward next week. That has never happened before. Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors’ groups and even drug companies – many of whom opposed reform in the past. And there is agreement in this chamber on about eighty percent of what needs to be done, putting us closer to the goal of reform than we have ever been.

But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government. Instead of honest debate, we have seen scare tactics. Some have dug into unyielding ideological camps that offer no hope of compromise. Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge. And out of this blizzard of charges and counter-charges, confusion has reigned.

Well the time for bickering is over. The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care.

The plan I’m announcing tonight would meet three basic goals:

It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. And it will slow the growth of health care costs for our families, our businesses, and our government. It’s a plan that asks everyone to take responsibility for meeting this challenge – not just government and insurance companies, but employers and individuals. And it’s a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election.

Here are the details that every American needs to know about this plan:

First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.

What this plan will do is to make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there’s no reason we shouldn’t be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.

That’s what Americans who have health insurance can expect from this plan – more security and stability.

Now, if you’re one of the tens of millions of Americans who don’t currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. It’s how everyone in this Congress gets affordable insurance. And it’s time to give every American the same opportunity that we’ve given ourselves.

For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need. And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned. This exchange will take effect in four years, which will give us time to do it right. In the meantime, for those Americans who can’t get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. This was a good idea when Senator John McCain proposed it in the campaign, it’s a good idea now, and we should embrace it.

Now, even if we provide these affordable options, there may be those – particularly the young and healthy – who still want to take the risk and go without coverage. There may still be companies that refuse to do right by their workers. The problem is, such irresponsible behavior costs all the rest of us money. If there are affordable options and people still don’t sign up for health insurance, it means we pay for those people’s expensive emergency room visits. If some businesses don’t provide workers health care, it forces the rest of us to pick up the tab when their workers get sick, and gives those businesses an unfair advantage over their competitors. And unless everybody does their part, many of the insurance reforms we seek – especially requiring insurance companies to cover pre-existing conditions – just can’t be achieved.

That’s why under my plan, individuals will be required to carry basic health insurance – just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements. But we cannot have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees. Improving our health care system only works if everybody does their part.

While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses to purchase affordable coverage, and a requirement that people who can afford insurance get insurance.

And I have no doubt that these reforms would greatly benefit Americans from all walks of life, as well as the economy as a whole. Still, given all the misinformation that’s been spread over the past few months, I realize that many Americans have grown nervous about reform. So tonight I’d like to address some of the key controversies that are still out there.

Some of people’s concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Such a charge would be laughable if it weren’t so cynical and irresponsible. It is a lie, plain and simple.

There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false – the reforms I’m proposing would not apply to those who are here illegally. And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.

My health care proposal has also been attacked by some who oppose reform as a “government takeover” of the entire health care system. As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government just like Medicaid or Medicare.

So let me set the record straight. My guiding principle is, and always has been, that consumers do better when there is choice and competition. Unfortunately, in 34 states, 75% of the insurance market is controlled by five or fewer companies. In Alabama, almost 90% is controlled by just one company. Without competition, the price of insurance goes up and the quality goes down. And it makes it easier for insurance companies to treat their customers badly – by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.

Insurance executives don’t do this because they are bad people. They do it because it’s profitable. As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill; they are rewarded for it. All of this is in service of meeting what this former executive called “Wall Street’s relentless profit expectations.”

Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. The insurance reforms that I’ve already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don’t have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.

Despite all this, the insurance companies and their allies don’t like this idea. They argue that these private companies can’t fairly compete with the government. And they’d be right if taxpayers were subsidizing this public insurance option. But they won’t be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers. It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities.

It’s worth noting that a strong majority of Americans still favor a public insurance option of the sort I’ve proposed tonight. But its impact shouldn’t be exaggerated – by the left, the right, or the media. It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it. The public option is only a means to that end – and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have.

For example, some have suggested that that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others propose a co-op or another non-profit entity to administer the plan. These are all constructive ideas worth exploring. But I will not back down on the basic principle that if Americans can’t find affordable coverage, we will provide you with a choice. And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need.

Finally, let me discuss an issue that is a great concern to me, to members of this chamber, and to the public – and that is how we pay for this plan.

Here’s what you need to know. First, I will not sign a plan that adds one dime to our deficits – either now or in the future. Period. And to prove that I’m serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don’t materialize. Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for – from the Iraq War to tax breaks for the wealthy. I will not make that same mistake with health care.

Second, we’ve estimated that most of this plan can be paid for by finding savings within the existing health care system – a system that is currently full of waste and abuse. Right now, too much of the hard-earned savings and tax dollars we spend on health care doesn’t make us healthier. That’s not my judgment – it’s the judgment of medical professionals across this country. And this is also true when it comes to Medicare and Medicaid.

In fact, I want to speak directly to America’s seniors for a moment, because Medicare is another issue that’s been subjected to demagoguery and distortion during the course of this debate.

More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years. That is how Medicare was born. And it remains a sacred trust that must be passed down from one generation to the next. That is why not a dollar of the Medicare trust fund will be used to pay for this plan.

The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies – subsidies that do everything to pad their profits and nothing to improve your care. And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.

These steps will ensure that you – America’s seniors – get the benefits you’ve been promised. They will ensure that Medicare is there for future generations. And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pocket for prescription drugs. That’s what this plan will do for you. So don’t pay attention to those scary stories about how your benefits will be cut – especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past, and just this year supported a budget that would have essentially turned Medicare into a privatized voucher program. That will never happen on my watch. I will protect Medicare.

Now, because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody. We have long known that some places, like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania, offer high-quality care at costs below average. The commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system – everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.

Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan. Much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers. This reform will charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money – an idea which has the support of Democratic and Republican experts. And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long-run.

Finally, many in this chamber – particularly on the Republican side of the aisle – have long insisted that reforming our medical malpractice laws can help bring down the cost of health care. I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine. I know that the Bush Administration considered authorizing demonstration projects in individual states to test these issues. It’s a good idea, and I am directing my Secretary of Health and Human Services to move forward on this initiative today.

Add it all up, and the plan I’m proposing will cost around $900 billion over ten years – less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the beginning of the previous administration. Most of these costs will be paid for with money already being spent – but spent badly – in the existing health care system. The plan will not add to our deficit. The middle-class will realize greater security, not higher taxes. And if we are able to slow the growth of health care costs by just one-tenth of one percent each year, it will actually reduce the deficit by $4 trillion over the long term.

This is the plan I’m proposing. It’s a plan that incorporates ideas from many of the people in this room tonight – Democrats and Republicans. And I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open.

But know this: I will not waste time with those who have made the calculation that it’s better politics to kill this plan than improve it. I will not stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what’s in the plan, we will call you out. And I will not accept the status quo as a solution. Not this time. Not now.

Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it most. And more will die as a result. We know these things to be true.

That is why we cannot fail. Because there are too many Americans counting on us to succeed – the ones who suffer silently, and the ones who shared their stories with us at town hall meetings, in emails, and in letters.

I received one of those letters a few days ago. It was from our beloved friend and colleague, Ted Kennedy. He had written it back in May, shortly after he was told that his illness was terminal. He asked that it be delivered upon his death.

In it, he spoke about what a happy time his last months were, thanks to the love and support of family and friends, his wife, Vicki, and his children, who are here tonight . And he expressed confidence that this would be the year that health care reform – “that great unfinished business of our society,” he called it – would finally pass. He repeated the truth that health care is decisive for our future prosperity, but he also reminded me that “it concerns more than material things.” “What we face,” he wrote, “is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.”

I’ve thought about that phrase quite a bit in recent days – the character of our country. One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government. And figuring out the appropriate size and role of government has always been a source of rigorous and sometimes angry debate.

For some of Ted Kennedy’s critics, his brand of liberalism represented an affront to American liberty. In their mind, his passion for universal health care was nothing more than a passion for big government.

But those of us who knew Teddy and worked with him here – people of both parties – know that what drove him was something more. His friend, Orrin Hatch, knows that. They worked together to provide children with health insurance. His friend John McCain knows that. They worked together on a Patient’s Bill of Rights. His friend Chuck Grassley knows that. They worked together to provide health care to children with disabilities.

On issues like these, Ted Kennedy’s passion was born not of some rigid ideology, but of his own experience. It was the experience of having two children stricken with cancer. He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick; and he was able to imagine what it must be like for those without insurance; what it would be like to have to say to a wife or a child or an aging parent – there is something that could make you better, but I just can’t afford it.

That large-heartedness – that concern and regard for the plight of others – is not a partisan feeling. It is not a Republican or a Democratic feeling. It, too, is part of the American character. Our ability to stand in other people’s shoes. A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand. A belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgement that sometimes government has to step in to help deliver on that promise.

This has always been the history of our progress. In 1933, when over half of our seniors could not support themselves and millions had seen their savings wiped away, there were those who argued that Social Security would lead to socialism. But the men and women of Congress stood fast, and we are all the better for it. In 1965, when some argued that Medicare represented a government takeover of health care, members of Congress, Democrats and Republicans, did not back down. They joined together so that all of us could enter our golden years with some basic peace of mind.

You see, our predecessors understood that government could not, and should not, solve every problem. They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom. But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited. And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes for wisdom, and we can no longer even engage in a civil conversation with each other over the things that truly matter – that at that point we don’t merely lose our capacity to solve big challenges. We lose something essential about ourselves.

What was true then remains true today. I understand how difficult this health care debate has been. I know that many in this country are deeply skeptical that government is looking out for them. I understand that the politically safe move would be to kick the can further down the road – to defer reform one more year, or one more election, or one more term.

But that’s not what the moment calls for. That’s not what we came here to do. We did not come to fear the future. We came here to shape it. I still believe we can act even when it’s hard. I still believe we can replace acrimony with civility, and gridlock with progress. I still believe we can do great things, and that here and now we will meet history’s test.

Because that is who we are. That is our calling. That is our character. Thank you, God Bless You, and may God Bless the United States of America.

Sen. Max Baucus Calls For 50+ Health Insurance Co-Ops

Senate Finance Committee Chairman Max Baucus (D-Mont.) on Tuesday unveiled his "compromise" blueprint for healthcare reform, proposing new taxes on high-end insurance plans and offering fifty or more separate non-profit state level insurance cooperatives as an alternative to a national health insurance option. (A health coop is in reality an insurance company owned by the policy holders.) [LATimes - Raw Story]

The Baucus version of health insurance reform would provide federal funds to help set up nonprofit, state-level cooperatives in which consumers would would have the option to purchase health insurance.

Just as auto coverage is now mandatory in nearly all states, Baucus would mandate that all Americans get health insurance either through a private insurer or their local state cooperative. Penalties for failing to buy health insurance would start at $750 a year for individuals and $1,500 for families. Households making more than three times the federal poverty level — about $66,000 for a family of four — would face the maximum fines. For families, it would be $3,800, and for individuals, $950.

The Baucus plan would require insurers to take all applicants, regardless of age or health. But smokers could be charged higher premiums. And 60-year-old people could be charged five times as much for a policy as 20-year-olds. Baucus' co-op plan would not drive down health insurance costs and would do little to insure the 48 million people now without health coverage, but the mandate penalties would drive many into the waiting arms of private health insurers. (see: Insurance Industry Pushing For "Private, For Profit" Insurance Mandate In Reform)

Many doubt that replacing a national public health insurance option with fifty smaller and unassociated state health insurance co-ops is a good idea.

Robert Reich: Co-ops are a "bamboozle" that "won't have any real bargaining leverage."

Former Clinton Labor Secretary Robert Reich described Sen. Kent Conrad's (D-ND) reported cooperative health insurance proposal as a "bamboozle" and said that "nonprofit health-care cooperatives won't have any real bargaining leverage to get lower prices because they'll be too small and too numerous. Pharma and Insurance know they can roll them. That's why the Conrad compromise is getting a good reception from across the aisle." [The American Prospect, 6/11/09]

Krugman: The "supposed alternative, nonprofit co-ops, is a sham."

In his August 20 New York Times column, Nobel Prize-winning economist Paul Krugman wrote: "And let's be clear: the supposed alternative, nonprofit co-ops, is a sham. That's not just my opinion; it's what the market says: stocks of health insurance companies soared on news that the Gang of Six senators trying to negotiate a bipartisan approach to health reform were dropping the public plan. Clearly, investors believe that co-ops would offer little real competition to private insurers." [New York Times, 8/20/09]

Jacob Hacker: Co-ops are "not going to have the ability to be a cost-control backstop."

In a June 14 post to The New Republic's blog The Treatment, University of California-Berkeley professor Jacob Hacker argued that Conrad "has offered no reason to think that the cooperatives he envisions could do any of the crucial things that a competing public plan must do." Hacker continued:

An easy way to think of the public plan's functions is the three "B"s: We need a national public plan that is available on similar terms in all parts of the nation as a backup. This plan has to have the ability to improve the quality and efficiency of care to act as a benchmark for private insurance. And it has to be able to challenge provider consolidation that has driven up prices to serve as a cost-control backstop.

Cooperatives might be able to provide some backup in some parts of the nation, but they are not going to have the ability to be a cost-control backstop, much less a benchmark for private plans, because they are not going to have the reach or authority to implement innovative delivery and payment reforms. And so Conrad's idea appears to be yet another compromised compromise that cuts the heart out the idea of public plan choice on the alter of political expediency. [...]
A national cooperative would still fall so dramatically short of a public plan that it would only be attractive in addition to a national public plan, not as a substitute for it. Indeed, this point holds more generally. Given the need for countervailing power in the health care market, the federal government should encourage a range of consumer-oriented health plans and state-based public plan options, so long as there is also a national public plan capable of being a backup, benchmark, and backstop. [The New Republic, 8/14/09]

Baucus and his staff forgot to delete the name of the author of the Finance Committee's health plan from the Acrobat version of the document.

In the Properties dialogue box of the PDF, in the "author" slot, the name Liz Fowler appears. Fowler is a Baucus staffer who was with the senator in the early part of this decade but left to take a breather in the private sector and only returned to Capitol Hill last year. During her time in the private sector, can you guess where Fowler worked?

She was the VP for Public Policy and External Affairs at WellPoint, the health insurance parent company of Blue Cross.

Plano Balloon Festival

Plano Balloon Festival
Balloons Gracefully Floating Across The Texas Sky
Fri. Sept. 18 to Sun. Sept. 20, 2009

The Plano Balloon Festival is coming Friday, September 18th through Sunday, September 20th. At its usual Saturday night peak attendance level over 50,000 people will be in attendance.

The Democratic Party of Collin County has had a booth at the event for years. The organization is again asking for volunteers to help cover shifts in their booth over the three day festival.
Contact Micky Mayer at 972.818.9595 if you are able to help.

School Daze

By John Cole at The Times Tribune

Prepared Remarks of President Barack Obama for the September 8th 'Back to School Event'

Rolling Stone: How Washington Is Screwing Up Health Ins. Reform

Matt Taibbi writes a hard hitting article in the Rolling Stone on the health insurance reform debate. It's long, but it's worth reading the entire thing - it details the health insurance debate describing the actual plans proposed in the House and Senate committees. Through it all Taibbi weaves observations about how the insurance reform idea has gotten so screwed up:

Let's start with the obvious: America has not only the worst but the dumbest health care system in the developed world. It's become a black leprosy eating away at the American experiment — a bureaucracy so insipid and mean and illogical that even our darkest criminal minds wouldn't be equal to dreaming it up on purpose.

The system doesn't work for anyone. It cheats patients and leaves them to die, denies insurance to 47 million Americans, forces hospitals to spend billions haggling over claims, and systematically bleeds and harasses doctors with the specter of catastrophic litigation.

The cost of all of this to society, in illness and death and lost productivity and a soaring federal deficit and plain old anxiety and anger, is incalculable — and that's the good news.

Click to read the full story...

Letter From Lewisville ISD Parent On The ISD's Decision To Block President Obama's Speech

From whosplayin.com - A letter from a Lewisville ISD (LISD) parent to the LISD school board in response to the ISD's decision to block President Obama's speech to school students.

snippets...

. . .Before moving here, my husband and I were both Active Duty servicemembers with the United States Navy, we served proudly for a number of years. During the course of our duty we were faced with the tragedy of September 11th. For me that time was painful and frightening.

. . .My reason for sharing my anecdote with you, was that during this time I never forgot that I had my country behind me. I knew that my government was doing everything in its power to protect its citizen and maintain the greatest country in the world. I knew that the Office of the President of the United States and my Commander in Chief had worked tirelessly to win the position of the most powerful man in the world and that when he spoke, we listened. Not because we always agreed with him but because it was part of the social contract of being a citizen of the United States of America.

. . .After hearing the news that Lewisville Independent School District chose not to televise President Obama's speech to America's school children on the importance of an education and staying in school, I became outraged. As a veteran of the Armed Forces, I am offended that the elected officials who supervise my son's education are disrespecting the Office of the President of the United States. ...I am truly offended by what appears to be a partisan decision that you have made out of fear.

. . .You are robbing my son of these moments that make him American and I will not allow to do so. We will be keeping him home on Tuesday, September 8th so he can witness first hand, the President of the United States address him directly.

Click here to read this concerned parent's letter in full...

The GOP Wants To Save School Children From Obama!

What’s In the House Health Insurance Reform Bill For Seniors?

Rising health costs are hitting seniors’ wallets—with the average Medicare Part D plus Part B premium consuming an estimated 12% of the average Social Security benefit in 2010—and 16% by 2025. Medicare, the government program that provides health care for Americans age 65 and older, will be strengthened under America’s Affordable Health Choices Act. In fact, for Medicare enrollees, the House bill lowers prescription drug costs, makes preventive care free, ensures that you can keep your doctor, and improves the quality of your care.
In a press conference to discuss what health insurance reform means for America’s seniors Rep. Xavier Becerra, Vice Chair of the House Democratic Caucus and senior member of the Ways and Means Committee, dispelled myths about the legislation. Rep. Becerra was joined by Richard Fiesta from the Alliance for Retired Americans and representatives from the Center for Medicare Advocacy and National Womens Health Network.


What’s in the health reform bill for seniors?

LOWER DRUG COSTS

Ending the ‘doughnut hole’ for prescription drug coverage. The reform bill will result in lower overall prescription drug costs for seniors, according to the non-partisan Congressional Budget Office. Right now, evidence suggests the “doughnut hole” coverage gap reduces seniors’ use of drugs prescribed by their doctor by an average of 14%, posing a real health threat to seniors who simply cannot afford the drugs.

FREE PREVENTIVE CARE

So you pay nothing on recommended preventive services that will keep you healthier longer. Right now, one in five women age 50 or over did not have a mammogram in the last two years, and 38% of adults age 50 or over have never had a colonoscopy – with costs often a factor.

BETTER PRIMARY CARE

Ensuring you have access to and can spend more time with your primary care doctor, and making sure your care is better coordinated to ensure you get recommended treatments, particularly for chronic diseases. Right now, about 12 million seniors lack access to a primary care doctor in their community.

GUARANTEED ACCESS TO YOUR DOCTOR

Eliminating the 21% pay cut your doctor was facing for Medicare reimbursements, ensuring that these doctors will still be able to care for seniors—especially in rural areas. Right now, without reform, 40% of doctors say they will reduce the number of Medicare patients they treat.

IMPROVED SAFETY

Developing national standards on quality measurement and reporting, investing in patient safety and rewarding doctors and nurses for high quality care. Right now, nearly one in five Medicare patients who are discharged from the hospital are readmitted within 30 days—many for preventable reasons.

PROTECTION OF MEDICARE

Extending the solvency of the Medicare Trust Fund by five years, to help ensure Medicare can cover every American as they get older. Right now, the Medicare Trust Fund is projected to be exhausted in just eight years, in 2017, which could cause cuts to services and care.

TIGHTER OVERSIGHT

Focusing health care dollars on your care and benefits and cracking down on waste, fraud, abuse, and overpayments to enrich private companies. In the last year alone, improper Medicare payments that were discovered and stopped totaled more than $450 million.

Rep. Becerra also released a guide on health insurance reform for seniors — including frequently asked questions and the facts on repeated myths. Download a copy(.pdf) here>>

A Teachable Moment

Teachable Moment By Nick Anderson, Houston Chronicle

Pres Reagan Gave A National Address To Students in 1988 — Broadcast on C-Span — where the president used the opportunity to sell his ideas about cutting taxes.

On the eve of the 1992 presidential campaign Pres. G. H. W. Bush gave a speech broadcast live to school classrooms nationwide where he promoted his own education plan. (video at DailyKos)

On September 11, 2001 Pres. G.W. Bush was visiting an elementary school to deliver his message to students.

President Obama's speech is reportedly focused on encouraging students to stay in school, work hard to get good grades and take responsibility to get a good education. Republicans object to Pres. Obama's message to their children! Florida Republican Chairman Jim Greer says:

"As the father of four children, I am absolutely appalled that taxpayer dollars are being used to spread President Obama’s socialist ideology. The idea that schoolchildren across our nation will be forced to watch the president justify his plans for government-run health care, banks, and automobile companies; increasing taxes on those who create jobs; and racking up more debt than any other president, is not only infuriating, but goes against beliefs of the majority of Americans, while bypassing American parents through an invasive abuse of power.”

If Pres. Obama's message really goes against beliefs of the majority of Americans, he wouldn't have been elected president in a near landslide of Obama 365 to McCain 173 electoral votes!

Politifact investigated the claim made by Florida Republican Chairman Jim Greer that President Obama's upcoming address to schoolchildren will "indoctrinate" the kids with "socialist ideology." Their conclusion: it's a "pants on fire" lie.

Al Franken Talks Down Angry Mob

DUSTYTRICE.COM: About a dozen tea party activists had staked out Sen. Al Franken’s booth at the Minnesota State Fair and confronted him loudly when he arrived.

But within minutes, he’d turned an unruly crowd into a productive conversation on health care.

The discussion went from insurance reform, to the public option, to veterans benefits, to cap and trade. He made a few laugh and even told a touching story that moved a few to tears. A whole lot of common ground was found.

Texans Tell Democrats "Git ‘er Done" Regarding Health Insurance Reform

ProgressPolitics.com: 2000 Texans tell Democrats "Git ‘er Done" regarding Health Insurance Reform and a Public Option. 2000 reform supporters from across Central Texas attended a rally with Congressperson Lloyd Doggett in Austin this past weekend to show unwavering commitment for health insurance reform and a STRONG and ROBUST Public option!

DailyKos: There were plenty of speakers at the Doggett event, which was really more of an educational forum than a rally. Pastor Jim Rigby spoke about our ethical obligation to provide health care. Chris F., a veteran, spoke about how one third of vets in Texas lack health insurance, and many can't access the VA because they live in remote, rural areas. Brittany M., a college student, told her heartbreaking story of losing her mother to heart disease, and the medical debt of her parents she assumed after their passing. Every story made it clear time and again that our health insurance system is broken, and we need real reform.

picture of Ms. Van Auken used with her kind permission

On Monday Texas G.O.P. Reps. Sam Johnson of Plano, Joe Barton of Arlington, and Jeb Hensarling and Pete Sessions of Dallas hosted a town hall at the Eisemann Center in Richardson.

During the meeting Barton said. "We do believe the president's proposal is a radicalization and some would say socialization." He said the best option would be to defeat the current plans.

Kelley van Auken (pictured above) attended the Eisemann Center town hall to voice her support for Health Insurance reform.

"Most people [who oppose health insurance reform] were actually quite nice, but there's an abundance of misinformation," said Ms. van Auken. She said that one opponent of health insurance reform told her that she doesn't need health insurance, rather, she just needs to go to church for help with health care costs. Ms. van Auken, who is confined to a wheelchair, commented that opponents of health insurance reform believe, "there are churches that will cover my $72k/year drug costs and other medical expenses." In a CBS 11 news interview Ms. van Auken said, "I've been disabled my whole life and I've been fortunate to have access to healthcare, unfortunately there are a lot of people like me or with less ailments who don't have it and really do need it."

Many opponents of health insurance reform believe private insurance companies provide all the health insurance coverage America needs. Many of those who have health insurance and are "satisfied" with their coverage, in fact aren’t “insured” from the financial burdens of rising health care costs or an unexpected costly illness.

“Under-insurance is the great hidden risk of the American health care system,” says Elizabeth Warren, a Harvard law professor who has analyzed medical bankruptcies. “People do not realize they are one diagnosis away from financial collapse.”

A national study released this year found that while medical debt contributed to 62 percent of the bankruptcies in 2007, 78 percent of those bankruptcy filers had health insurance but “still were overwhelmed by their medical debt.” No government agency keeps an official count of the under insured.

A 2007 survey by the Commonwealth Fund, a New York-based nonprofit that studies health care issues, estimates 25 million under insured Americans can't afford to cover the gap between what their insurance covers and their medical bills demand, up from 16 million in 2003.

Tens of millions more Americans may not realized they are under insured by their current private health insurance because they and their family members fortunately have not needed to call on their private insurance company to pay for a serious and costly illness.

From the MiamiHerald.com:

Cathy Kerns has multiple sclerosis. The drugs she takes are lifesaving, she says, but they cost more than $5,000 a month -- and she must make a 20 percent co-payment. Her specialized physical therapy costs $600 per half-hour -- and she pays 20 percent of that.

``If I call and plead with the insurance company that I need more therapy so I can walk, they say, `Sorry, it isn't in the policy,' '' she says. ``I'm paying more than $30,000 a year out of pocket. I'm running through my savings.''

Kerns, 60, who is retired and lives in Orlando, represents hidden millions in America's healthcare crisis. She has insurance -- but she is underinsured.

In that category she joins a California woman who was bitten by a rattlesnake, ran up a $73,000 hospital bill for medicine and an overnight stay, and learned her insurance would pay only $3,000 of it. And a Miami woman whose policy won't cover her diabetes because it was a preexisting condition.

The underinsured include the working poor whose employers don't provide full coverage, people who lose their jobs and their employer-subsidized insurance, and those who fail to understand the fine print in policy contracts and end up with less coverage than they expected.

``People often become underinsured because they lose their jobs,'' says Lori Parham, Florida state director for AARP. ``They can't afford to continue the good insurance they had through their employer, so they shop around for cheaper coverage -- policies with low cost, but so many limitations.''

Under the federal law known as COBRA, people who leave their jobs can continue their employer-provided policy for up to 18 months. But they must pick up the entire bill -- so if, as an employee, they paid 20 percent and their employer paid 80 percent, under COBRA they must pay 100 percent.

Kerns, who was a hotel-restaurant marketer in Orlando, left her company in 2000 and went into a COBRA plan that let her keep the insurance by paying 100 percent of its cost. She now pays $14,500 in premiums a year with a $5,000 deductible, and more than $12,000 a year in co-payments for her expensive drugs. ``Premiums keep going up,'' she says. She has been trying to get cheaper coverage, but can't because of her multiple sclerosis.

Although she is sick, she must do what she can for her husband Gary, 69, who survived esophageal cancer but now has congestive heart failure and just entered a hospice.

``It's horrifying,'' she says. ``I'm a human being. I'd like to enjoy what little time I have left.''

Even when people do find less expensive policies, they often come with limits -- higher deductibles, lower maximum healthcare payments, more exclusions for preexisting conditions and other restrictions.

Vote Centers Coming To Collin Co. For Election Day This November!

Sharon Rowe, the Collin County Elections Administrator, this afternoon notified Vote Center Site Selection Committee members by email that Ann McGeehan, Director of Elections in the Texas Secretary of State office, selected Collin County to participate in the County Wide Vote Center Program for the November 3, 2009 election. Ms. Rowe indicated that, "A formal letter from the State will arrive [at the Collin County Elections office] later today."

The U.S. Dept. of Justice (DOJ) must give final clearance for Collin County to implement the "County Wide Vote Center" plan under Section 5 of the Voting Rights Act of 1964. The DOJ may not make their final ruling on the vote center plan for until late September or some time in October.

Related Posts:

• Last Public Hearing On Implementing Voting Centers
• Next Public Hearing On Implementing Voting Centers
• Vote Centers Coming To Collin Co. For Election Day This November?
• Consolidated Polling Centers Coming To Collin Co. Next Election Day?

Health Care Reform Is A Powerful Motivator Of The Base

Health Care Reform Is A Powerful Motivator Of The Progressive Base. The Progressive Change Campaign Committee and Democracy for America teamed up to target a key opponent of health insurance reform. The two progressive groups have raised over $65,000 in 24 hours on the fundraising clearinghouse Act Blue to air the new video ad about Sen. Chuck Grassley's (R-IA) opposition to reform.

Progressive News Network Sept 1st Report

Progressive News Network [10 min 35 sec]

Ben Armbruster of the The Center For American Progress and Think Progress discusses the week’s political stories; This week - Health care reform.

Tom Daley Answers The Republican Party's Augments Against Fixing The American Health Care System

Today Sam Johnson (R-TX 3rd Congressional Dist.) together with other North Texas Congressmen Joe Barton (R-TX 6th Dist.), Jeb Hensarling (R-TX 5th Dist.) and Pete Sessions (R-TX 32nd Dist.) held a health care town hall discussion at the Eisemann Center in Richardson. Congressman Johnson, who represents most of Collin Co. in the U.S. House, and the other honorable congressmen explained and defended the Republican Party's many augments against passing legislation to fix what is broken in the American health care system.

The following is a letter to the editor of this blog from Tom Daley, the Democratic Candidate who opposed incumbent Sam Johnson for the 3rd Congressional District U.S. House seat in the 2008 election. In his letter Mr. Daley answers the Republican Party's many augments against passing legislation to fix what is broken in the American health care system.

By Tom Daley 2008 Democratic candidate U.S. House of Representatives, TX 3th Congressional District The current debate about “healthcare reform” centers around one and only one issue: whether there will be a “public interest” option (currently called the “public option” in the media). There are a host of distractions offered by the Republicans in Congress and their acolytes in the paid media. Let me first deal with some of these distractions, myths, and lies, and then discuss the public interest option. DISTRACTIONS, MYTHS, and LIES MYTH: People are going to lose their power to choose. Truth: Today, very few have the absolute power to make their own healthcare decisions. Only people healthy and wealthy enough to pay for medical care without using insurance have 100% freedom to make their own health care choices. That’s a small minority. Your choices are greatly reduced once you depend on any insurance company to pay your bills. No matter which insurance company you purchase a plan from, that insurance company decides which doctors they will pay for, which treatments they will pay for, which pharmaceuticals they will pay for, and whether they will keep you as a customer from year to year. Beware: insurance companies organize customers (they call them “risks”) into “risk pools.” They work like this: You and others who apply when you do get put into a risk pool and are charged a premium based on the risk that pool represents. Over time, people in that pool get sick, make claims, and increase the overall risk represented by that pool. In response, the insurance company raises the rates for everyone in that pool. Once the rates get high enough, all the healthy folks in that pool leave and buy a different policy with another insurance company and start all over again. Those that are too ill to qualify for a new plan with another insurance company are left behind in that risk pool, and their rates rise uncontrollably until the sick can no longer afford insurance or can no longer qualify for a new policy, and join the ranks of the uninsured. No matter how healthy or young you are, this story only ends one of two ways: you either pay enormous premiums or lose your insurance. Well, there is a third option. You can be bankrupted by healthcare expenses and then qualify for a public option such as Medicaid. In this situation, a public option is viewed by the insurance industry as a good thing because it only insures those too poor to buy private insurance. Keep that in mind: a public option is good as long as it serves non-customers. Most people obtain private health insurance coverage through their employer under a group plan. If you obtain your coverage this way, you have no choice in who the insurance company is, what they cover, or how much you pay. In fact, if you are in a higher level position with a company that provides group coverage, you might not have a choice to opt out of health insurance, unless you can prove you are otherwise covered. You MUST have health insurance. So much for choice. The great thing about a group plan is that you can’t lose this kind of insurance. That is, as long as you’re healthy enough to work and your job hasn’t been exported overseas by a company trying to reduce its costs by laying you off. Now if the company survives after you lose your job, you can continue on that group plan for several months as long as you pay the full premium (COBRA). That’s right, as soon as your income goes to zero, you can keep your insurance as long as you can afford to pay three to four times what you had been paying when you had a job. But even that is not your worst-case scenario. If the company files for bankruptcy or goes out of business, the insurance company calls “King’s X” and cancels the group policy (even though all the people who were in the group would happily continue to pay their premiums) and you don’t even get the choice of continuing with that coverage. So as long as you’re healthy enough to work and you’re employer is healthy enough to keep you, you can have health insurance. Once either of those conditions fails, you’re on your own. And that takes you back to where we started: Try to purchase a private policy (if you are “insurable”), purchase from your state’s high-risk pool coverage (bad coverage, high premiums), or go broke paying healthcare expenses and wind up on one of the public options such as Medicaid. Again, the insurance industry has no problem with you being able to “choose ” a public option, as long as you’re poor or present such a high risk that they no longer want you for a customer. A Public option is good as long as it serves non-customers. (A mantra so simple, even a caveman can remember it.) So this argument that health insurance reform will eliminate choice is fraudulent, at best. The vast, vast majority of Americans have little or no choice at all under our current system. There’s nothing left to lose. DISTRACTION: Under the President’s proposal, 119 million people will lose the coverage they have now through their work. This teeters on being a lie, but let’s give Sam Johnson the benefit of our serious doubts about him and treat it as a distraction. Under the President’s proposal, no one is required to change insurance companies. Period. What Sam and his ilk, who by the way has received 20% of his 2010 reelection funds from the healthcare industry, really mean is this: 1. If there is a public interest option, a non-profit entity covering people’s health insurance needs. 2. If the entity is non-profit, it will charge less than the PAC-filling, for-profit insurance companies. 3. If companies can buy equal insurance at a lower price, they might well choose (right, choice is for companies and politicians, not for people) to drop their for-profit carrier in favor of the lower cost non-profit. But that’s a fraudulent argument as well. Every year employers re-bid their health insurance agreements and every year they either chose to stay with the current provider or move to a lower-cost provider. You, as the employee lucky enough to have one of the ever-diminishing number of full-benefit jobs, have no choice whatsoever. If your employer uses Blue Cross this year and you like your doctor who happens to accept Blue Cross, next year you may find yourself insured by United Healthcare and your doctor might not accept United Healthcare insurance. Still think you have a choice? LIE: Healthcare reform will provide government benefits to illegal immigrants. This is an insidious lie. Sam Johnson and his fellow fear-mongering liars are so desperate to please their PAC overlords that they will jab their filthy hands into their constituents’ deepest fears and prejudices to fight this off. They know they can’t win by telling the truth, so they lie. Which in turn causes their supporters to lie because they’re too ignorant to do anything more than regurgitate whatever swill the Republican misleadership feeds them. But here’s the truth: The President’s proposal does not cause any new dollars to be spent on healthcare for anyone, whether here legally or not. DISTRACTION: Healthcare reform will mean that abortions are publicly funded through the public option. Again, the President has made clear that no new federal dollars are to be spent on reforming the health insurance industry. If that’s true, no matter how restrictive your views of women’s rights to self-determination, this little nugget, thrown out by Sam Johnson as an afterthought (thought?) is a distraction. Maybe it’s a lie. Yes, it’s a lie. MYTH: If the President’s initiative fails, all will be great in the land of the “haves” and no worse for the “have nots.” That’s half true. If you don’t have health insurance now, whether public or private, defeating the President’s proposal will not make your life any worse. But if you do have employer-sponsored private health insurance now, your life is going to get a lot worse, particularly if you’re over age 60 or have a chronic illness. Do you remember defined-benefit retirement plans? That’s where your employer (maybe you, too) make a contribution to a retirement plan that will pay you a fixed benefit upon your retirement. Those were the standard form of retirement 20 years ago and now they are being eliminated as fast as a bankruptcy judge can say “You’re OUT!!” Now retirement has been privatized through 401(K) and similar plans. How much will you collect on retirement? It’s anybody’s guess. Privatized retirement plans implode every eight years due to fluctuations in the stock market. No one retires anymore. They just work until they can’t and then try to subsist off of Social Security until they either die or go into a nursing home, when that public option health insurance kicks in again. Here’s another nostalgic nugget: Do you remember having a secure job? People used to talk about those. My dad even had one. But they don’t exist anymore. As soon as your job can be done by someone for less pay, it’s no longer your job. That’s true whether that less-costly worker is in the US or elsewhere. You are expendable. Do you think corporate employers take a different view toward health insurance? Do you really think they’ve eliminated retirement plans, sick leave, and job security but intend to hold on to group health insurance? Of course not! Companies are dropping group coverage as quick as they can using our current economic plight as cover for harsh decisions. When they drop their group coverage, there’s no COBRA—you are on your own. But what if you can’t qualify for health insurance on your own after your employer drops their group coverage (which they are going to do)? Who knows—but you better not let untreated health problems get in the way of your job or you’ll lose that too. So, if the President’s initiative fails, the “haves” will soon enough join the ranks of the “have nots.” LIE: Health insurance reform is all about taking my tax dollars to provide health care for the lazy and the uneducated—in other words, the poor. We’ve all heard our obnoxious brother-in-law say “Why should I have to pay for somebody else’s health care?” First, equating financial disadvantage to moral decrepitude is an idea as old as beating one’s wife and selling people into slavery. And it’s just as ignorant. People have written entire books on this topic (see “Rich Christians in an age of Hunger”) so I’ll leave that argument to them—I simply felt the need to point out the ugliness hidden such rhetorical parries. Second, you already are. When a young person with no money gets a cough, where do they go? To school or work—they sure don’t go to a doctor. When a fever joins that cough where do they go? Back to school or back to work. And when that fever and cough develop into H1N1 where do they go? You guessed it, back to work or back to school. And when they collapse on the floor, where do they go? To the emergency room where what could have been treated for $100 at a private physician’s office will be treated with $2,000 worth of emergency care. What could have been isolated to a single case of the flu turns into an above-the-fold health scare. We currently provide health care insurance for a high percentage of the poor. Children are on CHIPS, others are on Medicaid, the elderly are on Medicare, military retirees are on Champus, Congressmen are on—wait, let’s leave that for later. The poor are covered and, yes, you’re paying for it. And you’re buying the most expensive, least effective medical care available. Health insurance reform is all about rescuing that vast majority of us whose financial profile classifies us somewhere in that long spectrum between poor and rich. As you’ve seen, the poor are covered by public options (because the insurance companies don’t want them), the elderly are covered by a public option (because, again, the insurance companies don’t want them), retired military are covered by a public option (because, right, the insurance companies don’t want them), prisoners are covered by a public option (do you see a pattern?), retired politicians are covered by a public option, federal drug-sniffing dogs are covered by a public option, even ferrets in the National Zoo in Washington D.C. are covered by a public option. Who does that leave out? YOU!! LIE: Health insurance reform will cost taxpayers over a trillion dollars. There are two problems with that statement. First, in the world of federal budgets, costs are projected over multiyear periods, say 5 years or 10 years. So even if the estimate were correct, that would be a trillion dollars over 10 years, not a trillion dollars every year. A trillion dollars over 10 years is $100 billion per year, which is less than 1% of our national economy, which can be counted on to grow at least 2.5% a year. But whether the number is a trillion a year or a 100 billion a year—they’re both wrong. All of the plans in Congress would pay for any outlays through offsetting savings in other areas. So the real cost is ZERO. LIE: Health insurance reform amounts to a government takeover of health care. This takes us back to where I started when I mentioned the importance of a public interest option. The big fear is that if corporate America had to compete with a government run insurance program, corporate America would lose because they just aren’t up to the task. (This argument is from the same folks who tell us government can’t run anything properly which is why we have to privatize our public highway system.) Corporate America, in the eyes of FOX “News” and Sam Johnson, not only can’t compete with foreign companies, they can’t even compete against the same federal government they vilify as being wasteful, incompetent, and corrupt. But, let’s assume that’s all true. Go to www.fec.gov and look at who is donating to congressional reelection campaigns for 2010. Or, just take my word for it. Over 20% of the money being thrown into the 2010 election cycle is from companies and individuals in the healthcare industry, and 90% of that is coming from health insurance companies. Knowing how money can make the worst ideas seem positively brilliant, what do you think are the real odds of a bill that contains a real public option landing on the President’s desk? It’s not going to happen. We need it to happen, desperately, but it will not happen in this go-round. Without a public option in a health care reform bill (the result of a genuine triumph of Republican noise and mayhem over thoughtful debate and the public good), corporate America will have nothing to fear, not even fear itself. THE PUBLIC INTEREST OPTION We cannot yield control in this debate to those whose lifestyles are supported, in part, by the injustice of our current system of paying for healthcare. We must bring greater intensity, greater passion, and greater imagination to bear on this problem than do Sam, most Republican legislators, and a few wolves in blue-sheep’s clothing. The stakes are too high, the result is too important, and the goal is too near for us to pull up short now and cede this debate. A lot of pundits, prognosticators, pollsters, and politicians are writing the obituaries for a public interest option. I, too, just a few short paragraphs ago, explained why I think Congress will face this great opportunity and blink. But that doesn’t have to be the end of it. As I said throughout 2008, we should not expect to solve all the problems with the way we fund health care in the US in a single bill. Right now, the demographics of our country favor making some significant changes. As our population ages and as corporate America continues to drop health insurance benefits, thereby stranding more and more people, our public will strengthen and we will be ready to take our next steps. For the reasons I offer below, I believe that the most important next step is a public interest option. Private Health Insurance Companies Are Profit-Seeking Corporations A foundational notion of our economic system is that when one provides a service, one must receive fair compensation for that service. By extension, to the extent that private insurance companies provide a valuable service, they must be able to collect fair compensation for that service. Sellers price their goods and services in order to make the most money. Sometimes that means that certain people are priced out of the market for various goods and services. For example, Rolls Royce has priced their cars such that I can’t afford one. There’s no great injustice being thrust upon me: I can buy a less expensive car or do without a car. Either way, I’ll live. There are two types of services without which people cannot be fully vested in their constitutionally guaranteed rights to life and liberty: health care and legal services. A full discussion of legal services is outside the scope of what we are considering here. But keep in mind that the law of the land is that when a person’s freedom is in jeopardy, when a person is facing jail time, our government guarantees that person an attorney, free of charge. One’s right to liberty is considered sacred in our legal system. How much more sacred is a person’s life? Even incarcerated people are constitutionally guaranteed basic health care. The amount that people have to pay for healthcare vary so widely that we have come to rely on a vast arm of the financial services industry to help us hedge against the risk of unaffordable healthcare expenses. This arm of the financial services industry is the health insurance industry. Private Health Insurance Leaves the Middle Class Behind The problem with a system that is made up only of private insurers is that these private, for-profit companies price their services in order to make the most money, not create the greatest public benefit. Because of that, they have priced their services beyond the reach of many individuals. There are four large groups of people who, as a rule, cannot afford private health insurance: The very poor, the middle class, the unemployed, and the elderly. Many of the very poor are eligible for Medicaid coverage and the elderly are covered by Medicare. The unemployed can be covered through COBRA benefits, if they can afford the premiums. That leaves the middle class. As a rule, a person in the middle class cannot afford private health insurance unless he or she is young and healthy and can qualify for an individual, major medical policy. We must have a public option. There is only one issue standing between the legislative pileup we have now and there being a bicameral bill passed and placed on President Obama’s desk: The Public Option. All the other issues are feints designed to draw our attention from the real debate. Hospitals, doctors, pharmaceutical companies, employers, friends, and neighbors all want everyone to be covered by health insurance. That’s why all of the above support most of the President’s initiatives. A country in which everyone has health insurance makes everyone’s life easier. Everyone’s. A mandate from Congress that everyone must buy health insurance or pay a fine is great news for the insurance industry. (I can’t imagine working in an industry where everyone in the country is forced to buy my product or pay a fine. Only the insurance industry gets this kind of break.) Insurance companies certainly like the idea. Who wouldn’t? An old insurance company maxim is that “there is no such thing as a bad risk, just a bad rate.” Insurance companies will insure anything, anywhere, anytime, as long as they get to set the rate. Congress will mandate that everyone purchase health insurance or pay a fine. That works for the insurance companies because they will pick up the millions of young people who are currently uninsured, but whose healthcare costs are near zero. Congress will also require health insurance companies to insure all comers and, in so doing, take on some additional financial risk. No problem there, either. They’ll just charge more for the additional actuarial risk. So institutionally, there’s no debate over whether we want universal healthcare: We want it and the powerful lobbies want it. How powerful are the lobbies? For the upcoming Congressional election in 2010, one of every five dollars contributed to Sam Johnson comes from people and PACs associated with healthcare. Source: Publicly filed campaign finance report data available at www.fec.gov. If Congress enacts the health care equivalent of mandatory auto insurance laws, everyone who is exposed to the financial risk of the uninsured or who will begin to collect premiums from the now uninsured comes out a big winner. If all the institutional players are in favor of universal health insurance, what is all the fuss? That danged Public Option. You see, the President has hired some folks who understand that if demand goes up and supply remains the same, prices will go up. They also understand that when buyers are forced to purchase something or pay a fine if they don’t, then sellers can charge a “stay out of jail” premium, which generates enormous profits. This works beautifully for the sellers because every other profit-motivated seller has a bottom line price below which they will not go or their profits will vanish, their stock options will become worthless, and their CEO’s will writhe in the penury of the otherwise unemployable. With mandatory coverage, there will be little control over the cost of insurance. What about free market competition, I hear you cry. For the free market to work, the market must be free. An essential element of a free market is buyers being able to choose not to buy and sellers being able to choose not to sell. Here, buyers have to buy, or face jail time. And sellers have to sell, but at prices they set. That is not a free market—it’s open season! Consider this: What if there were only one seller of bananas and buyers had the choice of buying bananas from this one monopolistic seller or not buying any bananas at all? Sure the price of bananas would be higher than if we had, say, twenty sellers, but the price would not be infinitely high. The banana seller would have to keep prices within range of buyers’ abilities to pay so that the seller himself would not be forced to eat nothing but his own bananas. But what if we change the market dynamics a little? What if we have one seller of bananas and everyone in the country were required to either buy bananas or go to jail? We’d expect the price of bananas to become outrageously high. Why is that? Because in the first scenario, people could chose between buying a banana and buying something else that would bring them equal satisfaction. The banana seller would have to compete with all other uses of the buyers’ money. But in the second example, the banana seller only has to compete with the buyer’s desire to stay out of jail. Most of us would pay all the money we have for a banana if that would keep us out of jail. Having 1,000 banana sellers would hardly change this outcome at all. The U.S. Senate is prepared to force us into such an untenable market, not a free market, where we will either have to buy health insurance, or, ultimately, face going to jail . (Make no mistake—if the government can impose a fine, they can impose jail time, even if the only prescribed penalty is a fine. That may not seem just, but it’s true all the same.) Enter Team Obama. They understand that if people have the option of not being covered, a lot of folks will take that option and end up on the public dole for health care or bankrupt, as is the case today. So the option to remain financially incapable of paying for one’s own healthcare must be eliminated. But rather than throw us into the lion’s den, so to speak, they want to offer a public option whereby people can purchase health insurance from a non-profit entity that will not be able to take oligopolistic, nay feudal, advantage of the American people. What’s wrong with that? Easy: In the perverted minds of insurance executives, PUBLIC OPTION = (future) SINGLE PAYER. Their logic goes like this: A non-profit entity, whether run by the government or not, will be able to take on the same risks for a lower rate. In other words, such an entity would be able to offer coverage at lower prices and would have every incentive to do so. Eventually, this non-profit insurance company would capture 100% of the market, the insurance companies would die, and we’d have a single payer system. They’re not that far off, but, they’re off nonetheless. If only we had an example of single-payer health insurance, we could look into that space and see whether private insurance companies died off. If they had, we know the insurance executives (the same geniuses who invented credit-default swaps) are right. If we could find a single-payer market where private companies still thrive, we’d know the insurance executives are wrong. We don’t have to look far. Medicare covers every person in the United States over the age of 65, with the exception of military retirees who have a separate program for themselves. Medicare is a single-payer system, with a limited customer base: mainly people over 65. And have private insurance companies died out? No! Every major insurance company sells “med-i-gap” policies (that cover the difference between what medical providers charge and what Medicare pays) and long-term care insurance (that covers home health and nursing home care for folks that don’t want to depend on Medicaid). So it’s clear that we must have a public option and a public option will not only protect us from predatory pricing, it will provide rich profits to the insurance companies who sell premium coverage above and beyond what the public option provides. A lot of us view the current healthcare debate with a mixed sense of excitement that we are finally going to make some progress and a sense of foreboding knowing that we’re not going to fully reform our unjust, inefficient system. But having a roadmap for future progress will help us prepare for the next debate. We’ll take what we can get this year. That will narrow the issues for the next iteration of this debate. And in that iteration, we must all focus our efforts on achieving what the vast majority of Americans want: universal coverage at affordable prices.

House Leadership Memo Urges Dems: Remember That Public Option Has Tons Of Support

ThePlumline: In a sign that House Dem leaders remain committed to making a public option a part of health care reform, the leadership is urging members in a new polling memo to keep in mind that the public plan remains overwhelmingly popular despite weeks of attacks on it.

The memo — which will be distributed to members of Congress and others later this morning and was sent over by a leadership aide — is designed to arm Congressional Dems with ammo to beat back claims that the public option’s popularity has tanked.

“Coordinated attacks by Republicans and other opponents of health insurance reform have had little effect on the strong support for a public health insurance option,” the memo reads.

The memo, which comes as intra-Dem fighting over the public option is set to intensify, also sends a simple message to centrist Dems: The public wants this done. The memo, which you can read right here, reproduces much recent polling in a handy chart:

Three recent polls show overwhelming support for the public option, and the fourth poll, by Rasmussen, finds a large majority opposes a plan without one. The memo also stresses that the pulic plan gets much greater support when you offer respondents a “choice.”

The memo’s goal: To put some spine into individual members spooked by the relentless assault on reform and the chorus of punditry claiming that the public option will have to be nixed in order to get reform done.

Congressmen Sam Johnson (R-TX) Health Care Town Hall Aug 31

On Mon. Aug. 31, @ 7PM (Doors open at 5PM) U.S. Congressmen Sam Johnson (R-TX 3rd Dist.), Joe Barton (R-TX 6th Dist.), Jeb Hensarling (R-TX 5th Dist.) and Pete Sessions (R-TX 32nd Dist.) will host a health care town hall discussion at the Eisemann Center in Richardson. This "congressional field hearing" with panelists is "open to the media and the public."

Congressional hearing panelists include:

1. Eddie McBride, President, Lubbock Chamber of Commerce;
2. Christopher Crow, MD, Village Health Partners, Plano, TX;
3. Joel Allison, President and CEO, Baylor Health Care System;
4. Tarrant County Judge Glen Whitley, First Vice President of the National Association of Counties, to discuss local prescription drug card plans.

John Goodman, President and CEO of the National Center for Policy Analysis, of Dallas, will serve as the moderator of the event.

For the safety of all attendees, the Center prohibits large signs, posters or banners and any placard affixed to sticks or other sharp objects from being brought into the Center. In the event the Hill Performance Hall reaches capacity, attendees will be directed and seated in over-flow rooms where they may watch the event via a live video feed.

Monday, August 31st
7:00 p.m.
Eisemann Center in Richardson
Doors open at 5:00 p.m.

Who's Running For Governor Now

Updated August 30,2008 @8:00PM
Kinky Friedman (right) will officially announce his candidacy for the Texas Governor's Office Tuesday, according to his campaign manager, Rania Batrice. Friedman reportedly will file to have his name listed on the March 2010 Democratic Party Primary Ballot. Friedman, who received 12 percent of the vote in 2006 when he ran as an Independent in the four way race for Governor against incumbent Republican Governor Rick Perry, Democrat Chris Bell and Independent Carole Keeton Strayhorn, formed an exploratory committee last spring. Rick Perry won the 2006 election with about 38 percent of the vote.

Friedman will join a Democratic field that already includes Fort Worth schoolteacher Felix Alvarado, Whitehouse rancher Hank Gilbert, Fort Worth lawyer and former Ambassador Tom Schieffer and Garland therapist Mark Thompson.

Hank Gilbert addresses the 2006 Texas Democratic Convention as Candidate for Agriculture Commissioner

According to the Capitol Annex, Hank Gilbert, age 49, (D-Whitehouse), the Democratic Party’s 2006 nominee for Agriculture Commissioner, has thrown his hat in the ring to run for the governor's office in 2010.

After losing his 2006 bid to become Agriculture Commissioner, Gilbert, a Tyler-area rancher, has used the last four years to work at the grass roots of Texas to fight against toll roads and other bad GOP policies such as the Trans-Texas Corridor, land use and energy issues.

Gilbert, who was the second highest vote-getting Democrat in the 2006 elections with his 42 percent of the vote against Republican Todd Staples for agriculture commissioner, has been effectively laying the groundwork for a gubernatorial campaign for the last 4 years organizing with independent, moderate, and even Republican voters at the rural community level.

Houston Chronicle [14 min. 55 sec.]

Listen to Houston Chronicle reporter R.G. Ratcliffe interview Hank Gilbert about his announcement.

A little-known Fort Worth resident Felix Alvarado announced on August 13, 2009 that he plans to run in the 2010 Democratic primary race for governor. Alvarado's name was removed from the 2006 Democratic primary field when his $3,750 check for the candidate filing fee was returned for insufficient funds.

Early in May Mark Thompson, 2008 Democratic candidate for Railroad Commissioner, announced he will run for Governor in 2010. (Picture right)

Thompson received 44.6 percent of the vote in 2008 when he ran against Republican incumbent Michael Williams for the Railroad Commission seat.

Thompson joined Tom Schieffer (left) and humorist Kinky Friedman as the line up for the Democratic primary ballot next March.

Long time Texas Democrat Tom Schieffer chose Texas Independence Day (March 2nd) to announce he was forming an "exploratory committee" for a possible bid for the governor's office. (website)

Tom Schieffer is a former State Representative, former partner in the Texas Rangers, brother to Face the Nation moderator Bob Schieffer, and Bush-era Ambassador to Australia and Japan.

Schieffer, a lifelong Democrat, did endorse G.W. Bush for the offices of both Governor and President, but he supported Barack Obama for the 2008 primary and general election, and he supported Democrat Chris Bell in the 2006 Governor's race. Schieffer argues that he can attract not only Democrats, but Independents and even moderate Republicans. Even so, many Democrats are not comfortable with Schieffer's support of G.W. Bush or his service in the Bush administration.

• Todd Hill of the Burnt Orange Report sat down for an extended interview with Tom Schieffer in March. (D)

The Republican primary ballot position for governor is also getting a bit crowded. Texas Gov. Rick Perry's (R) and Texas Sen. Kay Bailey Hutchison, pictured left, top the ballot position.

Next down the Republican primary ballot position for governor is Debra Medina. Medina is currently the Wharton County Republican Party Chair and stands to Perry's right on the political spectrum beside Rep. Bermen.

Medina describes herself as a tireless advocate of private property rights, gun ownership, individual responsibility and adherence to the Constitution. She has actively opposed big government, taxes, bailouts, mandatory vaccinations, the Trans Texas Corridor and abortion.

A likely side-effect of Bermen and Medina running in the Republican primary is that they will eat away votes from Perry's right-wing conservative base giving Hutchison the primary win.

The next gubernatorial candidate to the right of Perry is Larry Kilgore who says, “The US government must abolish the Federal Reserve and allow Congress to reassert its constitutional authority over monetary policy. However, few of us believe this will occur. Therefore, we should research alternative scenarios and their implications for Texas.”