We can do this

The US Center for Medicare and Medicaid Services has just reported that U.S. health spending reached $2.5 trillion in 2009, and that health care's share of the economy grew 1.1 percentage points to 17.3 percent. This is the largest one-year increase in health care spending since the federal government began keeping track in 1960. Where I work, our insurance asked for a 35% rate increase to maintain our employee coverage for one more year. The same thing happened to my wife's family business this year. This experience has been repeated all over the country.

These findings underscore the fact that we are all experiencing an unprecedented "Tax" on the cost of our health care, except instead of coming from the government, it is being imposed by the insurance industry, who simply pass along their cost of paying for our dysfunctional system, while they also charge us for lobbying our Congressional representatives to stop needed reform. This is sick.

It is time to become outraged! The need for comprehensive health care reform to rein in unsustainable spending growth has never been more clear. The increasing burden on American families, businesses, and our state and local governments cannot be sustained.

What can we do now? Is there anything that might attract bipartisan support? Assuming that the minority party is willing to also work on this, I think that implementing a few modest steps now would help tremendously:

• Require that all be covered, with subsidy for the poor, and real penalties for those who opt out.
• Eliminate pre-existing conditions and have true community rating.
• Establish an online health plan marketplace in each state where plans can compete on benefits, service and price. Allow national plans to compete, but do not eliminate local plans.
• Monitor quality results by plan, and publish the results for all to consider when purchasing.
• Allow everyone to have an income tax deduction for their plan costs (not just employer plans) up to a certain annual cost.
• Enact reasonable tort reform legislation that actually directs most of the money to those who are injured.
• Require payment reform for care delivery, that incentivises provision of primary care, and encourages doctors and hospitals to provide the best care (not the most expensive), and are aware of and held accountable for their quality of care results.

We can do this, but only if our law makers work together and stop playing gotcha like middle school students. Actually, I apologize to the middle school students. They would do a better job.

"We have met the enemy, and he is us!", Pogo

The US House and the Senate have both passed health care reform bills, and it is now up to the Conference Committee to craft a compromise bill that must then be passed by each legislative body. If a bill is ultimately signed into law by President Obama, we are likely to hear years of arguments as to whether or not this bill is a good or bad thing for our nation.

What likely will not be debated, however, is our corrupt and sclerotic political system that has produced these bills. Instead of honest debate, and collaboration about how to solve a problem, we have been treated to our representatives cynically selling their votes for this bill in order to to "buy votes back home" from local voters who continue to fall for this kind of nonsense. Want examples? Here are just a few:

Senator Ben Nelson, D-Neb., has insisted that the federal government promise to pick up the full cost of Medicaid expansion in his state, costing about $100 million over 10 years, paid for by the residents of other states. In addition, he insisted that a private, physician-owned hospital being built in Bellevue, Neb., be able to get referrals from doctors who own it, which according to new regulations will be illegal throughout the rest of the country.

Senator Christoper Dodd, D-Conn., procured $100 million dollars for construction of a hospital at a public university in his state.

Senator Patrick Leahy, D-Vt., negotiated $600 million in additional Medicaid benefits for his state over 10 years. Massachusetts is getting $500 million in Medicaid help for similar reasons, all paid for by those of us in other states.

Senator Mary Landrieu, D-La., extracted an extra $300 million in special funds for a new "Louisiana Purchase."

Senator Joe Lieberman, I-Conn.,along with most Republicans, has just taken the insurance money and tried to stop everything those lobbyists do not want.

Longshoremen union supporters of Democrats were exempted from most of a new tax on high-value health insurance plans, as were electrical linemen, police officers, firefighters, emergency first responders and workers in construction, mining, forestry, fishing and certain agriculture jobs.

As citizens can vote these people out of office any time we want, and yet we do not. We can insist on ethical behavior, but we do not. Yes, these bills are a complicated mess in many ways, although probably the best that we can do for now.

The problem is us. When we continue to re-elect corrupt, cynical politicians, who buy our votes with our own money, we get exactly what we deserve. So far, they have not been able to underestimate us.

Two News Stories that Help to Make It Clear Why We Need Comprehensive Health Care Reform

Big insurers spend much less on medical care than previously reported

Dow Jones Newswire reports that a US Senate Commerce Committee investigation found that the six largest US health insurers spent less on medical care than what industry officials estimated. Of the total amount received in premiums by the companies in the individual insurance market, 74 cents of every dollar were spent on medical care, according to a review of publicly available of data on industry earnings. Meanwhile, America's Health Insurance Plans estimated that the industry spent an average of 87 cents of every premium dollar on medical care. Click Here for Complete Story

HMOs planning large 2010 premium increases despite strong 3Q earnings.

Forbes Magazine notes that although "most of the major managed-care companies" have announced strong 3Q results, the message "during this earnings season is that HMOs are focused on rebuilding margins, even if it makes insurance even less affordable." Goldman Sachs analyst Matthew Borsch "calls it 'the highest pricing trend in years.' The premium increases he's seeing are in the neighborhood of 13 to 15 percent for next year." Analysts say HMOs are concentrating on making up for operating profit margins, which "reached zero last year for the industry as whole." Moreover, the companies not only want recompense for the "higher costs" they incurred this year from COBRA, they must "cover rising ordinary medical costs that show no signs of slowing down." Barclays analyst Joshua Raskin predicts overall health spending in 2010 will "climb 9 percent."

Click here for the complete story

$ The cost of Health Care reform

You've probably heard it said by critics that health reform will cost taxpayers at least a trillion dollars. This sounds scary, which is the intent of the critics, but it turns out not to be true!

The quoted figure is not a trillion dollars a year, but rather a trillion dollars over 10 years. On a yearly basis, the cost equals approximately $140 billion dollars. To put this in perspective, the Part D Medicare Drug plan passed during the Bush presidency is about 600 billion dollars for drugs alone.

$140 billion dollars a year still overstates the cost, however. That is because other parts of the reform plan result in savings for Medicare, such as the reduction of subsidies to private insurers, reform of payment rates for doctors and a decrease in payments to hospitals for providing "free care" to the uninsured. When all of this is taken into account, the net increase in government spending for health care will likely be about $100 billion a year, which is a one-time increase equal to less than 1 percent of US national income, which has historically grown at an average annual rate of 2.5 percent every year.

While criticizing, right wing critics have stood against ideas to improve care and lower costs. For example, a plan to fund research which gives doctors, patients and health plans better information on what works and what doesn't, Republican critics have claimed a sinister plot to have the government decide what treatments you will get. Using this kind of perverted logic, a proposal that Medicare pay for counseling on end-of-life care is transformed into a secret plan for mass euthanasia of the elderly. There are many other examples.

Please, don't take hysterical criticism at face value. The truth is more complicated, but also reassuring.