Won't Back Down

These fake grassroots organizations are threatening America. The people that run them are not average Americans. They are very rich people who have a vested interest in keeping the status quo.

Watch this segment from the Rachell Maddow Show:

Rush Limbaugh, Glenn Beck, and Sean Hannity — who each reportedly make more than $20 million per year — have downplayed the struggles of those lacking adequate health care, asserted that “there isn’t a health care crisis,” or characterized the United States as having “the best health care system in the world.” Read more at Media Matters…

From the moment I took office as President, the central challenge we have confronted as a nation has been the need to lift ourselves out of the worst recession since World War II. In recent months, we have taken a series of extraordinary steps, not just to repair the immediate damage to our economy, but to build a new foundation for lasting and sustained growth. We are creating new jobs. We are unfreezing our credit markets. And we are stemming the loss of homes and the decline of home values.

But even as we have made progress, we know that the road to prosperity remains long and difficult. We also know that one essential step on our journey is to control the spiraling cost of health care in America.

Today, we are spending over $2 trillion a year on health care – almost 50 percent more per person than the next most costly nation. And yet, for all this spending, more of our citizens are uninsured; the quality of our care is often lower; and we aren’t any healthier. In fact, citizens in some countries that spend less than we do are actually living longer than we do.

Make no mistake: the cost of our health care is a threat to our economy. It is an escalating burden on our families and businesses. It is a ticking time-bomb for the federal budget. And it is unsustainable for the United States of America.

It is unsustainable for Americans like Laura Klitzka, a young mother I met in Wisconsin last week, who has learned that the breast cancer she thought she’d beaten had spread to her bones; who is now being forced to spend time worrying about how to cover the $50,000 in medical debts she has already accumulated, when all she wants to do is spend time with her two children and focus on getting well. These are not worries a woman like Laura should have to face in a nation as wealthy as ours.

Stories like Laura’s are being told by women and men all across this country – by families who have seen out-of-pocket costs soar, and premiums double over the last decade at a rate three times faster than wages. This is forcing Americans of all ages to go without the checkups or prescriptions they need. It’s creating a situation where a single illness can wipe out a lifetime of savings.

Our costly health care system is unsustainable for doctors like Michael Kahn in New Hampshire, who, as he puts it, spends 20 percent of each day supervising a staff explaining insurance problems to patients, completing authorization forms, and writing appeal letters; a routine that he calls disruptive and distracting, giving him less time to do what he became a doctor to do and actually care for his patients.

Small business owners like Chris and Becky Link in Nashville are also struggling. They’ve always wanted to do right by the workers at their family-run marketing firm, but have recently had to do the unthinkable and lay off a number of employees – layoffs that could have been deferred, they say, if health care costs weren’t so high. Across the country, over one third of small businesses have reduced benefits in recent years and one third have dropped their workers’ coverage altogether since the early 90’s.

Our largest companies are suffering as well. A big part of what led General Motors and Chrysler into trouble in recent decades were the huge costs they racked up providing health care for their workers; costs that made them less profitable, and less competitive with automakers around the world. If we do not fix our health care system, America may go the way of GM; paying more, getting less, and going broke.

When it comes to the cost of our health care, then, the status quo is unsustainable. Reform is not a luxury, but a necessity. I know there has been much discussion about what reform would cost, and rightly so. This is a test of whether we – Democrats and Republicans alike – are serious about holding the line on new spending and restoring fiscal discipline.

But let there be no doubt – the cost of inaction is greater. If we fail to act, premiums will climb higher, benefits will erode further, and the rolls of uninsured will swell to include millions more Americans.

If we fail to act, one out of every five dollars we earn will be spent on health care within a decade. In thirty years, it will be about one out of every three – a trend that will mean lost jobs, lower take-home pay, shuttered businesses, and a lower standard of living for all Americans.

And if we fail to act, federal spending on Medicaid and Medicare will grow over the coming decades by an amount almost equal to the amount our government currently spends on our nation’s defense. In fact, it will eventually grow larger than what our government spends on anything else today. It’s a scenario that will swamp our federal and state budgets, and impose a vicious choice of either unprecedented tax hikes, overwhelming deficits, or drastic cuts in our federal and state budgets.

To say it as plainly as I can, health care reform is the single most important thing we can do for America’s long-term fiscal health. That is a fact.

And yet, as clear as it is that our system badly needs reform, reform is not inevitable. There’s a sense out there among some that, as bad as our current system may be, the devil we know is better than the devil we don’t. There is a fear of change – a worry that we may lose what works about our health care system while trying to fix what doesn’t.

I understand that fear. I understand that cynicism. They are scars left over from past efforts at reform. Presidents have called for health care reform for nearly a century. Teddy Roosevelt called for it. Harry Truman called for it. Richard Nixon called for it. Jimmy Carter called for it. Bill Clinton called for it. But while significant individual reforms have been made – such as Medicare, Medicaid, and the children’s health insurance program – efforts at comprehensive reform that covers everyone and brings down costs have largely failed.

Part of the reason is because the different groups involved – physicians, insurance companies, businesses, workers, and others – simply couldn’t agree on the need for reform or what shape it would take. And another part of the reason has been the fierce opposition fueled by some interest groups and lobbyists – opposition that has used fear tactics to paint any effort to achieve reform as an attempt to socialize medicine.

Despite this long history of failure, I am standing here today because I think we are in a different time. One sign that things are different is that just this past week, the Senate passed a bill that will protect children from the dangers of smoking – a reform the AMA has long championed – and one that went nowhere when it was proposed a decade ago. What makes this moment different is that this time – for the first time – key stakeholders are aligning not against, but in favor of reform. They are coming together out of a recognition that while reform will take everyone in our health care community doing their part, ultimately, everyone will benefit.

And I want to commend the AMA, in particular, for offering to do your part to curb costs and achieve reform. A few weeks ago, you joined together with hospitals, labor unions, insurers, medical device manufacturers and drug companies to do something that would’ve been unthinkable just a few years ago – you promised to work together to cut national health care spending by two trillion dollars over the next decade, relative to what it would otherwise have been. That will bring down costs, that will bring down premiums, and that’s exactly the kind of cooperation we need.

The question now is, how do we finish the job? How do we permanently bring down costs and make quality, affordable health care available to every American?

That’s what I’ve come to talk about today. We know the moment is right for health care reform. We know this is an historic opportunity we’ve never seen before and may not see again. But we also know that there are those who will try and scuttle this opportunity no matter what – who will use the same scare tactics and fear-mongering that’s worked in the past. They’ll give dire warnings about socialized medicine and government takeovers; long lines and rationed care; decisions made by bureaucrats and not doctors. We’ve heard it all before – and because these fear tactics have worked, things have kept getting worse.

So let me begin by saying this: I know that there are millions of Americans who are content with their health care coverage – they like their plan and they value their relationship with their doctor. And that means that no matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what. My view is that health care reform should be guided by a simple principle: fix what’s broken and build on what works.

If we do that, we can build a health care system that allows you to be physicians instead of administrators and accountants; a system that gives Americans the best care at the lowest cost; a system that eases up the pressure on businesses and unleashes the promise of our economy, creating hundreds of thousands of jobs, making take-home wages thousands of dollars higher, and growing our economy by tens of billions more every year. That’s how we will stop spending tax dollars to prop up an unsustainable system, and start investing those dollars in innovations and advances that will make our health care system and our economy stronger.

That’s what we can do with this opportunity. That’s what we must do with this moment.

Now, the good news is that in some instances, there is already widespread agreement on the steps necessary to make our health care system work better.

First, we need to upgrade our medical records by switching from a paper to an electronic system of record keeping. And we have already begun to do this with an investment we made as part of our Recovery Act.

It simply doesn’t make sense that patients in the 21st century are still filling out forms with pens on papers that have to be stored away somewhere. As Newt Gingrich has rightly pointed out, we do a better job tracking a FedEx package in this country than we do tracking a patient’s health records. You shouldn’t have to tell every new doctor you see about your medical history, or what prescriptions you’re taking. You should not have to repeat costly tests. All of that information should be stored securely in a private medical record so that your information can be tracked from one doctor to another – even if you change jobs, even if you move, and even if you have to see a number of different specialists.

That will not only mean less paper pushing and lower administrative costs, saving taxpayers billions of dollars. It will also make it easier for physicians to do their jobs. It will tell you, the doctors, what drugs a patient is taking so you can avoid prescribing a medication that could cause a harmful interaction. It will help prevent the wrong dosages from going to a patient. And it will reduce medical errors that lead to 100,000 lives lost unnecessarily in our hospitals every year.

The second step that we can all agree on is to invest more in preventive care so that we can avoid illness and disease in the first place. That starts with each of us taking more responsibility for our health and the health of our children. It means quitting smoking, going in for that mammogram or colon cancer screening. It means going for a run or hitting the gym, and raising our children to step away from the video games and spend more time playing outside.

It also means cutting down on all the junk food that is fueling an epidemic of obesity, putting far too many Americans, young and old, at greater risk of costly, chronic conditions. That’s a lesson Michelle and I have tried to instill in our daughters with the White House vegetable garden that Michelle planted. And that’s a lesson that we should work with local school districts to incorporate into their school lunch programs.

Building a health care system that promotes prevention rather than just managing diseases will require all of us to do our part. It will take doctors telling us what risk factors we should avoid and what preventive measures we should pursue. And it will take employers following the example of places like Safeway that is rewarding workers for taking better care of their health while reducing health care costs in the process. If you’re one of the three quarters of Safeway workers enrolled in their “Healthy Measures” program, you can get screened for problems like high cholesterol or high blood pressure. And if you score well, you can pay lower premiums. It’s a program that has helped Safeway cut health care spending by 13 percent and workers save over 20 percent on their premiums. And we are open to doing more to help employers adopt and expand programs like this one.

Our federal government also has to step up its efforts to advance the cause of healthy living. Five of the costliest illnesses and conditions – cancer, cardiovascular disease, diabetes, lung disease, and strokes – can be prevented. And yet only a fraction of every health care dollar goes to prevention or public health. That is starting to change with an investment we are making in prevention and wellness programs that can help us avoid diseases that harm our health and the health of our economy.

But as important as they are, investments in electronic records and preventive care are just preliminary steps. They will only make a dent in the epidemic of rising costs in this country.

Despite what some have suggested, the reason we have these costs is not simply because we have an aging population. Demographics do account for part of rising costs because older, sicker societies pay more on health care than younger, healthier ones. But what accounts for the bulk of our costs is the nature of our health care system itself – a system where we spend vast amounts of money on things that aren’t making our people any healthier; a system that automatically equates more expensive care with better care.

A recent article in the New Yorker, for example, showed how McAllen, Texas is spending twice as much as El Paso County – not because people in McAllen are sicker and not because they are getting better care. They are simply using more treatments – treatments they don’t really need; treatments that, in some cases, can actually do people harm by raising the risk of infection or medical error. And the problem is, this pattern is repeating itself across America. One Dartmouth study showed that you’re no less likely to die from a heart attack and other ailments in a higher spending area than in a lower spending one.

There are two main reasons for this. The first is a system of incentives where the more tests and services are provided, the more money we pay. And a lot of people in this room know what I’m talking about. It is a model that rewards the quantity of care rather than the quality of care; that pushes you, the doctor, to see more and more patients even if you can’t spend much time with each; and gives you every incentive to order that extra MRI or EKG, even if it’s not truly necessary. It is a model that has taken the pursuit of medicine from a profession – a calling – to a business.

That is not why you became doctors. That is not why you put in all those hours in the Anatomy Suite or the O.R. That is not what brings you back to a patient’s bedside to check in or makes you call a loved one to say it’ll be fine. You did not enter this profession to be bean-counters and paper-pushers. You entered this profession to be healers – and that’s what our health care system should let you be.

That starts with reforming the way we compensate our doctors and hospitals. We need to bundle payments so you aren’t paid for every single treatment you offer a patient with a chronic condition like diabetes, but instead are paid for how you treat the overall disease. We need to create incentives for physicians to team up – because we know that when that happens, it results in a healthier patient. We need to give doctors bonuses for good health outcomes – so that we are not promoting just more treatment, but better care.

And we need to rethink the cost of a medical education, and do more to reward medical students who choose a career as a primary care physicians and who choose to work in underserved areas instead of a more lucrative path. That’s why we are making a substantial investment in the National Health Service Corps that will make medical training more affordable for primary care doctors and nurse practitioners so they aren’t drowning in debt when they enter the workforce.

The second structural reform we need to make is to improve the quality of medical information making its way to doctors and patients. We have the best medical schools, the most sophisticated labs, and the most advanced training of any nation on the globe. Yet we are not doing a very good job harnessing our collective knowledge and experience on behalf of better medicine. Less than one percent of our health care spending goes to examining what treatments are most effective. And even when that information finds its way into journals, it can take up to 17 years to find its way to an exam room or operating table.

As a result, too many doctors and patients are making decisions without the benefit of the latest research. A recent study, for example, found that only half of all cardiac guidelines are based on scientific evidence. Half. That means doctors may be doing a bypass operation when placing a stent is equally effective, or placing a stent when adjusting a patient’s drugs and medical management is equally effective – driving up costs without improving a patient’s health.

So, one thing we need to do is figure out what works, and encourage rapid implementation of what works into your practices. That’s why we are making a major investment in research to identify the best treatments for a variety of ailments and conditions.

Let me be clear: identifying what works is not about dictating what kind of care should be provided. It’s about providing patients and doctors with the information they need to make the best medical decisions.

Still, even when we do know what works, we are often not making the most of it. That’s why we need to build on the examples of outstanding medicine at places like the Cincinnati Children’s Hospital, where the quality of care for cystic fibrosis patients shot up after the hospital began incorporating suggestions from parents. And places like Tallahassee Memorial Health Care, where deaths were dramatically reduced with rapid response teams that monitored patients’ conditions and “multidisciplinary rounds” with everyone from physicians to pharmacists. And places like the Geisinger Health system in rural Pennsylvania and the Intermountain Health in Salt Lake City, where high-quality care is being provided at a cost well below average. These are islands of excellence that we need to make the standard in our health care system.

Replicating best practices. Incentivizing excellence. Closing cost disparities. Any legislation sent to my desk that does not achieve these goals does not earn the title of reform. But my signature on a bill is not enough. I need your help, doctors. To most Americans, you are the health care system. Americans – me included – just do what you recommend. That is why I will listen to you and work with you to pursue reform that works for you. And together, if we take all these steps, we can bring spending down, bring quality up, and save hundreds of billions of dollars on health care costs while making our health care system work better for patients and doctors alike.

Now, I recognize that it will be hard to make some of these changes if doctors feel like they are constantly looking over their shoulder for fear of lawsuits. Some doctors may feel the need to order more tests and treatments to avoid being legally vulnerable. That’s a real issue. And while I’m not advocating caps on malpractice awards which I believe can be unfair to people who’ve been wrongfully harmed, I do think we need to explore a range of ideas about how to put patient safety first, let doctors focus on practicing medicine, and encourage broader use of evidence-based guidelines. That’s how we can scale back the excessive defensive medicine reinforcing our current system of more treatment rather than better care.

These changes need to go hand-in-hand with other reforms. Because our health care system is so complex and medicine is always evolving, we need a way to continually evaluate how we can eliminate waste, reduce costs, and improve quality. That is why I am open to expanding the role of a commission created by a Republican Congress called the Medicare Payment Advisory Commission – which happens to include a number of physicians. In recent years, this commission proposed roughly $200 billion in savings that never made it into law. These recommendations have now been incorporated into our broader reform agenda, but we need to fast-track their proposals in the future so that we don’t miss another opportunity to save billions of dollars, as we gain more information about what works and what doesn’t in our health care system.

As we seek to contain the cost of health care, we must also ensure that every American can get coverage they can afford. We must do so in part because it is in all of our economic interests. Each time an uninsured American steps foot into an emergency room with no way to reimburse the hospital for care, the cost is handed over to every American family as a bill of about $1,000 that is reflected in higher taxes, higher premiums, and higher health care costs; a hidden tax that will be cut as we insure all Americans. And as we insure every young and healthy American, it will spread out risk for insurance companies, further reducing costs for everyone.

But alongside these economic arguments, there is another, more powerful one. It is simply this: We are not a nation that accepts nearly 46 million uninsured men, women, and children. We are not a nation that lets hardworking families go without the coverage they deserve; or turns its back on those in need. We are a nation that cares for its citizens. We are a people who look out for one another. That is what makes this the United States of America.

So, we need to do a few things to provide affordable health insurance to every single American. The first thing we need to do is protect what’s working in our health care system. Let me repeat – if you like your health care, the only thing reform will mean is your health care will cost less. If anyone says otherwise, they are either trying to mislead you or don’t have their facts straight.

If you don’t like your health coverage or don’t have any insurance, you will have a chance to take part in what we’re calling a Health Insurance Exchange. This Exchange will allow you to one-stop shop for a health care plan, compare benefits and prices, and choose a plan that’s best for you and your family – just as federal employees can do, from a postal worker to a Member of Congress. You will have your choice of a number of plans that offer a few different packages, but every plan would offer an affordable, basic package. And one of these options needs to be a public option that will give people a broader range of choices and inject competition into the health care market so that force waste out of the system and keep the insurance companies honest.

Now, I know there’s some concern about a public option. In particular, I understand that you are concerned that today’s Medicare rates will be applied broadly in a way that means our cost savings are coming off your backs. These are legitimate concerns, but ones, I believe, that can be overcome. As I stated earlier, the reforms we propose are to reward best practices, focus on patient care, not the current piece-work reimbursement. What we seek is more stability and a health care system on a sound financial footing. And these reforms need to take place regardless of what happens with a public option. With reform, we will ensure that you are being reimbursed in a thoughtful way tied to patient outcomes instead of relying on yearly negotiations about the Sustainable Growth Rate formula that’s based on politics and the state of the federal budget in any given year. The alternative is a world where health care costs grow at an unsustainable rate, threatening your reimbursements and the stability of our health care system.

What are not legitimate concerns are those being put forward claiming a public option is somehow a Trojan horse for a single-payer system. I’ll be honest. There are countries where a single-payer system may be working. But I believe – and I’ve even taken some flak from members of my own party for this belief – that it is important for us to build on our traditions here in the United States. So, when you hear the naysayers claim that I’m trying to bring about government-run health care, know this – they are not telling the truth.

What I am trying to do – and what a public option will help do – is put affordable health care within reach for millions of Americans. And to help ensure that everyone can afford the cost of a health care option in our Exchange, we need to provide assistance to families who need it. That way, there will be no reason at all for anyone to remain uninsured.

Indeed, it is because I am confident in our ability to give people the ability to get insurance that I am open to a system where every American bears responsibility for owning health insurance, so long as we provide a hardship waiver for those who still can’t afford it. The same is true for employers. While I believe every business has a responsibility to provide health insurance for its workers, small businesses that cannot afford it should receive an exemption. And small business workers and their families will be able to seek coverage in the Exchange if their employer is not able to provide it.

Insurance companies have expressed support for the idea of covering the uninsured – and I welcome their willingness to engage constructively in the reform debate. But what I refuse to do is simply create a system where insurance companies have more customers on Uncle Sam’s dime, but still fail to meet their responsibilities. That is why we need to end the practice of denying coverage on the basis of preexisting conditions. The days of cherry-picking who to cover and who to deny – those days are over.

This is personal for me. I will never forget watching my own mother, as she fought cancer in her final days, worrying about whether her insurer would claim her illness was a preexisting condition so it could get out of providing coverage. Changing the current approach to preexisting conditions is the least we can do – for my mother and every other mother, father, son, and daughter, who has suffered under this practice. And it will put health care within reach for millions of Americans.

Now, even if we accept all of the economic and moral reasons for providing affordable coverage to all Americans, there is no denying that it will come at a cost – at least in the short run. But it is a cost that will not – I repeat, not – add to our deficits. Health care reform must be and will be deficit neutral in the next decade.

There are already voices saying the numbers don’t add up. They are wrong. Here’s why. Making health care affordable for all Americans will cost somewhere on the order of one trillion dollars over the next ten years. That sounds like a lot of money – and it is. But remember: it is less than we are projected to spend on the war in Iraq. And also remember: failing to reform our health care system in a way that genuinely reduces cost growth will cost us trillions of dollars more in lost economic growth and lower wages.

That said, let me explain how we will cover the price tag. First, as part of the budget that was passed a few months ago, we’ve put aside $635 billion over ten years in what we are calling a Health Reserve Fund. Over half of that amount – more than $300 billion – will come from raising revenue by doing things like modestly limiting the tax deductions the wealthiest Americans can take to the same level it was at the end of the Reagan years. Some are concerned this will dramatically reduce charitable giving, but statistics show that’s not true, and the best thing for our charities is the stronger economy that we will build with health care reform.

But we cannot just raise revenues. We also have to make spending cuts in part by examining inefficiencies in the Medicare program. There will be a robust debate about where these cuts should be made, and I welcome that debate. But here’s where I think these cuts should be made. First, we should end overpayments to Medicare Advantage. Today, we are paying Medicare Advantage plans much more than we pay for traditional Medicare services. That’s a good deal for insurance companies, but not the American people. That’s why we need to introduce competitive bidding into the Medicare Advantage program, a program under which private insurance companies offer Medicare coverage. That will save $177 billion over the next decade.

Second, we need to use Medicare reimbursements to reduce preventable hospital readmissions. Right now, almost 20 percent of Medicare patients discharged from hospitals are readmitted within a month, often because they are not getting the comprehensive care they need. This puts people at risk and drives up costs. By changing how Medicare reimburses hospitals, we can discourage them from acting in a way that boosts profits, but drives up costs for everyone else. That will save us $25 billion over the next decade.

Third, we need to introduce generic biologic drugs into the marketplace. These are drugs used to treat illnesses like anemia. But right now, there is no pathway at the FDA for approving generic versions of these drugs. Creating such a pathway will save us billions of dollars. And we can save another roughly $30 billion by getting a better deal for our poorer seniors while asking our well-off seniors to pay a little more for their drugs.

So, that’s the bulk of what’s in the Health Reserve Fund. I have also proposed saving another $313 billion in Medicare and Medicaid spending in several other ways. One way is by adjusting Medicare payments to reflect new advances and productivity gains in our economy. Right now, Medicare payments are rising each year by more than they should. These adjustments will create incentives for providers to deliver care more effectively, and save us roughly $109 billion in the process.

Another way we can achieve savings is by reducing payments to hospitals for treating uninsured people. I know hospitals rely on these payments now because of the large number of uninsured patients they treat. But as the number of uninsured people goes down with our reforms, the amount we pay hospitals to treat uninsured people should go down, as well. Reducing these payments gradually as more and more people have coverage will save us over $106 billion, and we’ll make sure the difference goes to the hospitals that most need it.

We can also save about $75 billion through more efficient purchasing of prescription drugs. And we can save about one billion more by rooting out waste, abuse, and fraud throughout our health care system so that no one is charging more for a service than it’s worth or charging a dime for a service they did not provide.

But let me be clear: I am committed to making these cuts in a way that protects our senior citizens. In fact, these proposals will actually extend the life of the Medicare Trust Fund by 7 years and reduce premiums for Medicare beneficiaries by roughly $43 billion over 10 years. And I’m working with AARP to uphold that commitment.

Altogether, these savings mean that we have put about $950 billion on the table – not counting some of the longer-term savings that will come about from reform – taking us almost all the way to covering the full cost of health care reform. In the weeks and months ahead, I look forward to working with Congress to make up the difference so that health care reform is fully paid for – in a real, accountable way. And let me add that this does not count some of the longer-term savings that will come about from health care reform. By insisting that reform be deficit neutral over the next decade and by making the reforms that will help slow the growth rate of health care costs over coming decades, we can look forward to faster economic growth, higher living standards, and falling, not rising, budget deficits.

I know people are cynical we can do this. I know there will be disagreements about how to proceed in the days ahead. But I also know that we cannot let this moment pass us by.

The other day, my friend, Congressman Earl Blumenauer, handed me a magazine with a special issue titled, “The Crisis in American Medicine.” One article notes “soaring charges.” Another warns about the “volume of utilization of services.” And another asks if we can find a “better way [than fee-for-service] for paying for medical care.” It speaks to many of the challenges we face today. The thing is, this special issue was published by Harper’s Magazine in October of 1960.

Members of the American Medical Association – my fellow Americans – I am here today because I do not want our children and their children to still be speaking of a crisis in American medicine fifty years from now. I do not want them to still be suffering from spiraling costs we did not stem, or sicknesses we did not cure. I do not want them to be burdened with massive deficits we did not curb or a worsening economy we did not rebuild.

I want them to benefit from a health care system that works for all of us; where families can open a doctor’s bill without dreading what’s inside; where parents are taking their kids to get regular checkups and testing themselves for preventable ailments; where parents are feeding their kids healthier food and kids are exercising more; where patients are spending more time with doctors and doctors can pull up on a computer all the medical information and latest research they’d ever want to meet that patient’s needs; where orthopedists and nephrologists and oncologists are all working together to treat a single human being; where what’s best about America’s health care system has become the hallmark of America’s health care system.

That is the health care system we can build. That is the future within our reach. And if we are willing to come together and bring about that future, then we will not only make Americans healthier and not only unleash America’s economic potential, but we will reaffirm the ideals that led you into this noble profession, and build a health care system that lets all Americans heal. Thank you.

By Howard Dean from the Daily Beast

For the first time since Harry Truman, real health-care reform is finally within reach. While health-care reform may well pass with only Democratic votes just like Medicare in 1965, this should no longer be seen as a fight between liberal and conservatives,
Democrats and Republicans. This is now a fight between the insurance companies and the American people. The reason we are finally going to get real health-care reform is that the plan President Obama put forward recognizes the importance of giving the American people a choice: If you like what you have, you can keep it. If you don’t, there will be a public-health-insurance option. The president’s steadfast support has been critical to reform because without a public option, there is no reform, just a shuffling of deck chairs and wasting $1 trillion in taxpayers’ money.

“Republicans in Congress now have the opportunity to be on the right side of history in the health-care reform debate.”

A large number of the American people—more than 72 percent, including more than 50 percent of Republicans—strongly support the public option.

As of yesterday, both the U.S. House of Representatives, led by Speaker Nancy Pelosi, and the Senate Health, Education, Labor and Pensions Committee—ably led by Sen. Chris Dodd and guided by the wisdom of Ted Kennedy—demonstrated that they are listening to the American people. Both have passed plans that represent real reform. While the bills are not perfect, they include a public-health-insurance option like the American people have asked for. It’s not yet clear what the Senate Finance Committee will do, but it’s clear that they too should take a stand for real reform and support the bill passed by the HELP committee.

A great majority of Americans face a constant struggle to stay one step ahead of mounting medical debt. Medical crises contribute to approximately half of all home-foreclosure filings. According to a study conducted by researchers at Harvard University, 50 percent of all bankruptcy filings in 2004 were partly the result of medical expenses; 68 percent of those who filed for bankruptcy actually had health insurance, but found that insurance inadequate to cover their bills.

Even as skyrocketing health-care prices are bankrupting millions of Americans, however, the earnings of private health-insurance firms are rising. In most areas of the country, the insurance market is dominated by one or two large providers. Rather than bargaining for lower rates, large insurer conglomerates are transferring the higher prices charged by hospitals to patients and padding their profits. Between 1999 and 2008, as premiums increased 117 percent for families, the profits of the top 10 insurance companies grew by approximately 1,000 percent. During the same period, insurers merged more than 400 times, but employee premiums increased nearly eight times faster than average U.S. incomes.

Large insurers have little incentive to bargain for lower prices, and smaller insurers do not compete on premiums to gain market share. Instead, they “follow the pricing of the dominant insurer” and compete on risk. As the Urban Institute has pointed out, “competition in insurance markets is often about getting the lowest risk enrollees as opposed to competing on price and the efficient delivery of care.”

For real health-care reform, we must restore competition into health markets and reorient the business model toward quality of care. A health-care reform initiative that includes a public-health-insurance option (like Medicare) would permit individuals who do not receive coverage through an employer to choose from a menu of private and public coverage options. Enrollees would pay a subsidized premium (should they qualify for a government subsidy) and receive the coverage of their choice. The new public health plan would negotiate with hospitals and doctors for the best health-care prices. Costs would be set through a process of competitive bidding in which all of the different health-care plans (public and private) would participate to provide standard benefits.

The new plan would also use its inherent advantages to do what private insurers have only promised: Control costs over the long term. Unlike private companies—which typically spend between 20 and 50 percent of health-care dollars on expenses such as administration, executive salaries, advertising, and shareholder return on equity—Medicare has low administrative overhead and the ability to bargain for volume discounts, just as the new public plan would have.

A public-health-insurance option could use its ability to negotiate for lower prices and volume-purchasing capacity to muscle private insurers into lowering their administrative spending and using more health-care dollars to provide actual health care. This kind of reform could reduce projected health-care costs by about $2 trillion over 11 years. It could lower premiums by 20 percent on average, simplify the medical billing process (thus pleasing doctors and patients alike), and allow small businesses to finally enroll their employees into a health-insurance program that provides comprehensive health benefits.

The American people have made it clear that they want change. Republicans in Congress now have the opportunity to be on the right side of history in the health-care reform debate. It’s time to abandon the false rhetoric of the right wing and the scare tactics of the insurance companies desperate to hold on to their profits and do what’s right for America.

DAVID ESPO and ERICA WERNER | July 9, 2009 09:38 PM EST | AP

WASHINGTON — The drive to remake the nation’s health care system suffered yet another setback in Congress on Thursday when a pivotal group of House Democrats demanded changes in legislation the leadership was drafting on a fast track.

The emerging bill “lacks a number of elements essential to preserving what works and fixing what is broken,” 40 members of the Blue Dog Coalition of moderate to conservative Democrats wrote party leaders. To win their support, they said, any legislation would need to be much more aggressive in reining in the growth of health care as well as in addressing a disparity in Medicare payments they said adversely affects rural providers.

A group of the moderates met into early evening with House Speaker Nancy Pelosi and Majority Leader Steny Hoyer and arranged to sit down with committee chairmen on Friday to go over proposed changes. Officials said the public release of the bill, originally set for Friday, would occur no earlier than Monday.

It was the second setback in three days for President Barack Obama’s top domestic priority, although it was unclear whether it would amount to anything more than a brief delay for a bill of enormous complexity and controversy. Read more at Huffington Post…

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Cable and network news recently devoted considerable air time to broadcasting George H.W. Bush’s excellent 85th birthday parachute jump adventure. Changing the channel to escape this video was impossible because it was played and replayed endlessly, over and over and over to the point that it almost became nauseating.

How nice that the former President can go sky diving at age 85 considering the physical demands and risks involved. Perhaps he is the beneficiary of excellent genes. Certainly he is the beneficiary of unparalleled access to excellent health care and incomparable nutrition. So how does the average senior citizen’s access to health care and nutrition stack up to what pappy Bush enjoys? Obviously, there is no comparison.

Why don’t the rest of us have the best health care money can buy let alone basic health coverage? Why do so many seniors have to make the gut wrenching choice between paying for prescriptions and buying food? Is it because we are not privileged like Bush senior? Health care should be a right, not a privilege. It is shameful that seniors routinely fall into the bottomless pit that is the donut hole in Medicare Part D and disgraceful that anyone in the richest nation on earth should go hungry.

Recently, on CNN’s State of the Union, right wing pundit Mary Matalin suggested that Medicare will run out of money in 8 years. Assuming that Matalin has her facts straight (and that’s a big assumption), her prediction would never come to pass had Bush 43 not squandered billions on two illegal wars. That wasted fortune would have potentially provided health care to millions, plugged the donut hole and funded food assistance programs to feed the hungry.

The coverage pappy Bush’s 85th birthday bash received was overblown. What was meant to be a feel good story, presumably intended to take our minds off the innumerable problems this country currently faces instead gave us a glimpse into the disparity between the world of the haves and the have nots. The gap between rich and poor may never be eliminated but there is no question that it’s time that we bridge that chasm with a guarantee of basic health care for all. The rest of us have been in free fall without a parachute for far too long.

Let’s face it. Our medical care system is broken and beyond repair. All we can hope for is to completely rebuild our health care system into something that covers all of us without any interference by insurance companies. It only makes sense to let the government administer health care through a single payer system. You can see in front of your eyes what insurance companies have done to health care in the US. How long are we as a society going to let insurance companies profit from coming between us and our doctors?

We have a second rate health care system. Rather than make themselves useful, the Republicans instead continue to scare us that a government run health care system will plunge us into Socialism. Gee whiz!! Medicare and the Veterans health care system provide services to millions and are no more socialism than socialized fire fighting or policing. Why do Republicans and some Democrats want to destroy these systems? Why oppose a government run single payer health care system for all Americans? You need to ask those who oppose a single payer health care system the reason for their opposition. Then sift through the lies and figure out for yourself how single payer health care will work for all of us.

Premiere Radio Networks Randi Rhodes recently interviewed James Steel who co-wrote an investigative book with Donald Barlett called “Critical Condition: Health Care in America” about our broken health care system, who broke it, and what we can do to fix health care. You can listen it the interview here.

Critical Condition: Health Care in America
James Steel and Donald Barlett at the Chautauqua Institution

Posted by: Joe Allen, June 18, 2009
ProudProgressiveLiberal@gmail.com

To better understand why we don’t have single payer health care, I would suggest listening to Bill Moyers Journal. He talks with doctors who are advocates for this badly needed health care system. The best chance of identifying a cost effective mechanism of providing health care requires the involvement of everyone and that includes health care providers and informed patients.

Bill Moyers speaks with Public Citizen’s Dr. Sidney Wolfe and Physicians for a National Health Program’s Dr. David Himmelstein about single payer health care and why it is not be discussed in the media and by our elected officials. This is some real straight talk from individuals who know what they are talking about.

Follow this link to play video

Posted by: Joe Allen, June 9, 2009
ProudProgressiveLiberal at gmail.com

“I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.” President Barack Obama, June 3, 2009

Yesterday, President Obama strongly reaffirmed his support for giving Americans the choice of a public health care option like Medicare. Meanwhile, key Senators are still on the fence and others are considering trying to kill a public option by requiring a “trigger” that will never be triggered.

Today, we need to make sure your Senators get the President’s message. If your Senator is on the fence, this couldn’t be a better time for them to hear from you. But, it doesn’t matter whether your Senator is a right-wing crazy or a progressive champion; every Senator needs to know that America supports the President’s call for a public option.

SIGN UP TO DELIVER THE PRESIDENT’S MESSAGE

This is a follow up to the previous post. US Senator Bernie Sanders was recently on the Ed Show on MSNBC to talk about how important single payer health care is to our nation.

“With more than 47 million Americans without health insurance coverage, it is clear that we need major changes in our country’s health care system. But, health care coverage will not be enough to assure access to care. Over 55 million Americans, insured and uninsured, have trouble finding a primary care provider.”

Posted by: Joe Allen, June 3, 2009
ProudProgressiveLiberal at gmail.com

Socialism is no longer a dirty word. Now that we have socialized the debt of the banking and auto industries the argument is over. Need more examples of socialism in the US? We have socialized national defense, fire fighting, policing, garbage collection, the public school system. The only thing that isn’t socialized is our health care system. The argument that socialism is bad is a bogus characterization of single payer health care spewed out of the pie holes of greedy members of Congress and the health care industry.

Who in your family will you deny health care to? This is a fundamental question that all Republicans and most Democrats refuse to answer. Why you ask? Because they are being paid off by the health care industry. Members of Congress pick up campaign contribution checks from health care lobbyists on their way to work every day and still expect us to believe that they are representing our best interests. Bull pucky!! Members of Congress will deny you single payer health care while they enjoy generous health care benefits for themselves and their families at taxpayer expense. If they truly cared, we would already have single payer universal health care for all U.S. citizens.

The key word here is “Single Payer”. The latest disinformation campaign about single payer health care is that the government will decide whether you get medical treatment or not? Scary prospect, isn’t it? What they don’t want you to realize is that right now health care insurers are already making those decisions for you instead of your doctor. Every day, health insurance companies deny legitimate health care claims.They do this because they are only in business to make money and paying claims is a losing proposition. How hard is that to understand? Under a single payer health care system, no one would be denied timely and needed health care services.It is just a streamlined, cost effective payment system. Bingo!!

Let’s get one thing straight. Simply put, under a single payer health care system, when you go to the doctor of your choice, the doctor submits your bill to the government and the government pays the bill just like Medicare or the Veteran’s Administration do today.While both of these health care delivery systems have their shortcomings, by and large, they work very well. In the past opponents of single payer health care have attempted to dismantle Medicare and undermine the Veteran’s Administration system by pushing for privatization. Because they know these medical delivery systems work all too well. Dismantle these systems and eliminate any competition.

Health care is not a privilege. It is a human right. According to USA Today, “18,314 people die in the USA each year because they lack preventive services, a timely diagnosis or appropriate care.” Why are the health care insurance companies so afraid of single payer health care for all Americans? They are petrified of the competition that this payment system would bring. Free market my ass. The health insurance companies do not want any competition. That is why they are paying off Congress to keep the status quo. Just remember that the health care insurance companies are in the business of making money. If they do not have to pay your health care claim they make more money. Hello!!

US Senator Bernie Sanders recently appeared on Air America Radio’s Ring of Fire program with Robert F. Kenney Jr. to discuss the pathetic state of health care in the US and what Congress is or is not going to do about it.

Listen to Bernie Sander’s eye opening comments

I think you’ll agree your future health care is already bought and paid for. The health insurance industry owns Congress. The only sure fire way to get single payer health care is for the American people to rise up and demand health care for all. Short of that, we could take away what the people in Congress cherish the most…their jobs. Then and only then will we have single payer health care for all Americans.

Posted by: Joe Allen, June 3, 2009
ProudProgressiveLiberal at gmail.com