Month: December 2009

The Senate Has Spoken

Do I like the Senate Bill?   You know what, I do and let me tell you why.  The current healthcare expenditures in this country represent 16% of the total economy.  And while we have the best doctors, hospitals, equipment, and drugs in the world available to us, we still have a tremendous number of people who do not have any access to the healthcare system.  Further, we have many more who believe they are protected but find out how vulnerable they are once they get sick and realize that their insurance has limited or partial coverage, leaving many in terrible debt.  We can do much better as a nation.  The Senate bill puts us one step closer.  As you know, I have said all along this is not a perfect bill.  There is no such thing as a perfect bill, particularly when we are talking about something as complex as healthcare.

This bill will provide more Americans with access to affordable and stable healthcare – insurance plans that will not drop you when you get sick, will provide a minimum level of protection that we all understand, and will not deny you coverage merely because you have a pre existing condition.  Will everyone have coverage?  No.  There is still work to do, but this gets us moving in the right direction.  While there are many that object to the provision requiring mandatory coverage, I simply say tough.  It is without question the only way to make the insurance markets work.  Without the mandate (whatever version ultimately gets passed in the reconciled bill), the insurance markets will not work.  We want to maintain some sense of private insurance which is why the government plan was dropped.  The only way to do this is to make sure every American pays into the pool.

The healthcare reform is funded two ways.  New taxes and cost controls.  First, on new taxes.  No one likes them, I particularly don’t.  They are going to be put on families making over a certain amount of money (500k/1M in the house and 200K/250K in the senate) using different methodologies depending on how the bills get reconciled.  You know what?  We must do this for our country.  Low taxes are great, I get it!  But so is making sure we take care of everyone in this country with affordable and quality healthcare.  We can cut the quality for everyone but that makes less sense to me.  We have to take care of our fellow man and unfortunately, this is the only way it will work.  If you do not believe me, talk to some of the hard working callers who ask me for help each week on my radio show.  People who just do not have access and are broke.  They did nothing wrong other than getting sick.

Both bills recognize we have a great deal of waste in the current system and can also deliver care in a more efficient way.  Cutting waste is easy so long as you can find it.  As someone who works in the current healthcare system, trust me, it’s out there.  The harder part is going to be looking at how we treat and pay for certain diseases.  This is going to be much harder for the country to accept.  The bills have structures in place to look at this issue with the Senate bill being much stronger.  The question that remains is whether we as a nation are prepared to make the decisions that must be made.  Hopefully with better education and more understandable information, we will be able to tackle the hard choices like when is enough going to be enough?  And at what price do we say we can no longer afford it?  Difficult, I know, but 100% necessary.

Stay to tuned.  After many months, this is still only the beginning.  But I am satisfied we are moving the in the right direction.  This country will ultimately be much better off with this version of healthcare reform.   We will be fixing the mistakes made in the bills for years to come but at least there will be a significant number of newly insured Americans with access to healthcare we all deserve in the greatest country in the world.

60 Votes – It’s Done! And Now the Fun Starts

I know many think healthcare reform was rushed through the Senate (and House) and that we should have taken more time to get it done.  I actually think those people are wrong.  If I really thought delaying the process would have allowed people to work together to craft a better bill, well that would have made sense.   Except that is not what would happen.  In reality, more time would have meant more fighting, more horse trading, and less substance.  In the end, we just needed to get this done.  We needed to provide affordable insurance to more Americans, reduce costs, eliminate pre-existing conditions, and open the insurance markets to more choice.  These are the important goals and it looks like it will get done soon.  Doing nothing or delaying the process would have horrible consequences for this country.

While the Senate bill now gets reconciled with the House bill, and there is no guarantee the final reconciled bill will make it to President Obama for signature, a great day has arrived for this country.  30 million Americans will soon have access to healthcare without the fear of going bankrupt.  We will now have a process to start looking at reducing costs and waste from the system.  Certainly this bill is not perfect.  In fact, it’s far from perfect but there is a lot of good in this bill as well.  We will have many years to fix the pieces that Congress did not get right.  The fighting that occurred this past week over abortion and a national plan was really a sideshow for the larger goal of getting healthcare reform finished.  While it had the potential to kill the Senate bill, it was really just part of the process.  While Senator Lieberman is taking heat for killing a national plan, in fact, had the national plan been left in, more of the moderates would have dropped their support.  So accommodating his request actually sped the process along.  The abortion piece still confuses me.  Whether you are pro life or pro choice, healthcare reform was not the right place to have the debate.  That being said, I am ok with the language inserted to get Senator Nelson along.  We should all recognize choices and compromise were necessary.  

Now the fun starts.  It will take many years to put this whole program together and implement the various components.  You can feel comforted in knowing I will continue to explain how it will work as we start the process and you can always ask us questions on air or on this website.  It’s complicated and if you think the current system is tough to navigate, wait until we start the new programs.  Sadly, it will not happen fast enough.  On the other hand, by getting a bill finished over the next few weeks, a lot of Americans will be able to sleep a little easier.

Healthcare Reform is Not About One Individual

The conservatives have taken control of the airwaves and are scaring Americans into believing the current healthcare reform bill will bankrupt the country.  They want to start over.  Sadly, when Republicans ran Congress, nothing was done to reform the healthcare system.  Sure we got prescription drugs covered for Medicare beneficiaries, which is incredibly important, but in general, we saw an increasing number of Americans become uninsured and a continuous rise in the cost of providing healthcare, including insurance premiums.  How can we stop now?  We cannot and we should not allow this to happen.  This country can no longer afford to wait or even start over.  No matter who is in charge, nothing will ever work perfectly.

Unfortunately, this is not solely about healthcare reform.  As is always the case in Washington, politics plays an equal, if not dominant role.  Sadly, politicians, like all of us, are humans.  Frequently, they find themselves in the difficult position of compromising their beliefs or the good of the country to satisfy an individual constituency or a narrow belief that is at odds with the overall objective.  Whether it be a government option or funding of abortions using federal dollars allocated for insurance plan subsidies is really not the point here. The point of this legislative exercise is to start the process of insuring all Americans and bringing costs under control.  Quite frankly, we can still pass meaningful legislation without a national plan.  We can also pass meaningful legislation if federal dollars are segregated and not used for abortions – let’s just hope that our elected officials keep their eye on the prize.  That is fixing this mess.  It’s easy to scare people into believing this is an expensive government take over of healthcare.  It is not.  Certainly the government is getting more involved – we need their help – look at the mess we have created with the private health insurance markets.  If we start over or do nothing, it will be far more expensive in the future.  Many more will go uninsured and bankrupt.  Call your elected officials.  Tell them to pass healthcare reform and look at the big goals.  Work with your colleagues and compromise.  Strident opposition does nothing to advance a noble goal.  Meaningful dialogue to work out  conflict is always the best approach.  That is what I was always told.

New Plan for the Public Option

I have been asked for my opinion at least a dozen times since the new democrat plan for a public option was announced on Tuesday morning.  The basic framework of the new plan calls for allowing Americans 55 and older to buy into Medicare.  Medicare currently starts at 65 years of age.  It would also provide for a  national insurance plan to be negotiated and administered by the Federal Office of Personnel Management.  This is the office that administers insurance for all current and retired federal employees.

So what do I think?  I think it’s just another mechanism to pass healthcare reform, which I firmly support.  I have made no secret in my beliefs that we could accomplish meaningful healthcare reform, including the opening up of private insurance markets, through stronger regulation (without a public option), but that does not seem to pass muster with the liberal groups in Congress.  There are an unlimited number of ways to provide a national insurance plan to the public – whether it be through the plan described above, a co-op system, or a Medicare like plan for everyone younger than age 65.  In the end, it is all extending the governments role into healthcare – albeit with different degrees of involvement.  From my perspective, we could start without any national/government managed plan and see what happens through stronger oversight and regulation of the private sector.  It will certainly be less bureaucratic and less expensive.  Yet with the liberal (and majority) base strongly in favor of a national plan, I see no scenario whereby the private insurance market will be allowed to exist without competition from a government plan of some kind. 

Like most of us, I have many concerns and questions.  Can we afford this plan? Will the private sector be able to compete/survive (I believe they have a role – this is America after all)?  What will we pay the doctors and hospitals?   Remember, the private sector already supports the lower payments from Medicare.  Unfortunately, there is no answer to any of this right now.  Anyone who tells you they know is just not correct.  We have ideas but in truth, right now we just do not know – mainly because half of the reform is based on cost controls that still need to be worked out.  Time will tell how this is all going to play out – I do believe there will be reform and it may very well be by the end of the year (the Senate Bill anyway).  What I do know for certain, and what I have said all along, is we must pass reform.  No matter what happens, we are going to be fixing what we screw up over the next few months.  Remember, nothing is perfect.

Nothing in Life is Perfect

I think it is fair to say most people have good days and bad.  Some are just average.  I also find it very hard to believe there is anyone who can honestly say that life is perfect.  As most of us know, nothing is perfect. While many of us strive hard to do the best we can in whatever we do, maybe even trying to be perfect, it just does not happen often, if ever.

My question to anyone who reads my blog or cares about reforming our healthcare system, why should we expect or demand a perfect bill.  Nothing, including a bill, is perfect  In fact, our own US Constitution, the principles on which our nation was founded is not perfect.  It is for that reason we have amendments to clarify what may have not been fully understood or intended when the Constitution was first written.  However, I would argue the US Constitution was a pretty amazing starting point for America. Even in these exceptionally difficult times, with the economy in crisis and the world fighting terrorists, this is still the greatest nation in the world – at least I believe it to be true.


One of America’s less than perfect sectors is healthcare.  Clearly, we all know it is severely broken.  We have a President who is willing to challenge the status quo and try to tackle the healthcare system problems that have plagued this country for generations.  But guess what:  the bill is not perfect.  It includes new taxes, vague cost controls, lacks many important details, and takes a long time to solve many current problems Americans face today.  The fighting in Washington is only beginning.  Since healthcare represents 16% of our economy and is far more complicated than even the most sophisticated people can truly comprehend, why should we expect the bill to be perfect in order for it to pass?  The Republican party is using this “flawed bill” argument as one of their heavy weapons to derail reform.  Listen to me clearly, my political party affiliation is irrelevant.  My choice for president is irrelevant.  I believe we need to reform the current healthcare system and we need to focus on striving to get the best bill we can in Washington passed. It will be less than perfect but far better than what we have today.

Too many people are falling into the healthcare hole –trapped in financial ruin and lacking access to the highest quality healthcare in the world.  We can and must do better.  Do not let perfect be the enemy of the good.  We will have many years to keep fixing the healthcare system.  As I have written many times before, we have a long road ahead of us.  Healthcare reform is too important to fail now more than ever.  I work in this industry and see the struggles every single day.  I talk to people on the radio who are trapped.  Remain vocal in your support and  do not be fooled by the fighting in Washington. Nothing is ever perfect.

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