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Today, Republican House Budget Chairman Paul Ryan will present his new “bi-partisan compromise” plan to a meeting of an outfit known as the “Bipartisan Policy Center.”

Ryan’s latest proposal would allow individuals to choose between traditional Medicare or vouchers that provide “premium support” for private insurance plans.

Here’s what you need to know about the Ryan’s latest attempt to repackage his hugely unpopular proposal to eliminate Medicare and replace it with vouchers for private insurance:

1). The only thing “bipartisan” about his latest proposal is that Ryan has apparently convinced Oregon Democratic Senator Ron Wyden to support it. The content of this plan is based on pure right wing privatization dogma. In fact it has much the same structure as the Bush plan to privatize Social Security.

2). Ryan admits that his latest proposal would not save any money compared with the current system. So why do it?

The real goal of Ryan’s plan is the same goal of his original plan: to allow Wall Street and huge private insurance companies to get their hands on the Medicare Trust Fund. Both plans are about nothing more than allowing insurance companies to make more money.

Since the plan would not save the government money compared with the current system, it really has nothing to do with demonstrating “that there is an emerging consensus developing on how to preserve Medicare,” as Ryan claims. (more…)

By David Sirota
Political journalist, best-selling author and syndicated newspaper columnist

Over the past few hours, the mediasphere has been ablaze with talk that Republicans and their insurance industry backers supposedly won a huge victory with a Virginia court’s ruling that the mandate to buy private insurance is unconstitutional. On the policy merits, this seems to make no sense. At all. In fact, the Republicans pushing this court case may have inadvertently helped America take a progressive step on health care, if progressives can actually take advantage of the situation. Hear me out.

The mandate to buy insurance was always a huge giveaway to the private insurers. It guarantees them a pool of customers that will pad their profits for eternity, thus solidifying private insurance as the profit-taking middleman in the American health care system. The Virginia court, however, struck down the mandate but did not strike down the other mandates forcing the insurers to sell you insurance. For instance, the court ruling did not eliminate the mandate for insurers to sell you insurance despite your preexisting condition; did not eliminate the mandate for insurers to use a certain percentage of their revenues to provide health care services (rather than padding profits); and did not eliminate the mandate that ends lifetime caps on health care benefits.

So, assuming this ruling stands (which, granted, is a big assumption), we have a situation whereby the insurance companies no longer have the state forcing you to buy a private product with no public alternative (ie. a public option), but the insurance companies do have the state forcing them to offer their product to you in a way that doesn’t discriminate against you on the basis of pre-existing condition, and in a way that allows you to buy their product when you want to buy it.

Someone please tell me how this is a bad thing for the progressive cause of cracking down on the insurance industry and empowering health care consumers.

This is exactly why you have the insurance companies freaking out, threatening ever-higher premiums unless they get the mandate they originally rammed through Congress. And like loyal corporate lapdogs, this is why you have the Obama administration – which crafted the original health care bill with the insurers – telling the New York Times that “if (the mandate) eventually falls, related insurance reforms would necessarily collapse with it, most notably the ban on insurer exclusions of applicants with pre-existing health conditions.” It’s a scare campaign aimed at making sure the insurers get their ransom – aka the guaranteed profits and power that come with a customer mandate. (more…)

Some years ago I was a staff attorney for the USW. At that time, in the 70s, there was no private option for the legally-required purchase of workers compensation insurance. It was all, and may still be, public workers compensation insurance only, in West Virginia, and some other  states.  This may be worthy of mention as a talking point, at least, in our current fight for a public option for health care insurance.  

Alfred Lawson
Central City, PA

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By Robert Reich
Former U.S. Secretary of Labor, Professor at Berkeley

“Don’t make the perfect the enemy of the better,” says the President and congressional insiders when confronted with the sorry spectacle of a health-care bill whose scope and ambition continue to shrink, and whose long-term costs to typical Americans continue to grow. They’re right, of course. But by the same logic, neither the White House nor congressional Democrats will be able to celebrate the emerging legislation as a “major overhaul” or “fundamental reform.” At best, it’s likely to be a small overhaul containing incremental reforms.

Real reform has moved from a Medicare-like public option open to all, to a public option open to 6 million without employer coverage (still in the House bill), to a public option open only to those same people in states that opt for it, or about 4 million (the original Harry Reid version of the Senate bill), to no public option but expanded Medicare (the Senate compromise) to no expanded Medicare at all (the deal with Joe “I love all the attention” Lieberman).

In other words, the private insurers are winning and the public is losing.

Pharmaceutical companies are winning as well. Yesterday, proposals to allow US pharmacies and wholesalers to import prescription drugs from Europe and Canada were defeated in the Senate. No matter that American consumers pay up to 55% more for their prescription drugs than Canadians, or that the measure would have saved the government at least $19.4 billion over ten years (according to the Congressional Budget Office). Big Pharma’s argument that the safety of such drugs couldn’t be assured was belied by the defeat of another proposed amendment that would have allowed drug imports only if their safety and economic benefits were certified by the Secretary of Health and Human Service.

Doctors and hospitals are also winning. More and more of the putative “savings” from health care reform (“savings” should really be understood as projected costs that are under the wildly-escalating costs projected without such savings) rely on constraints on future Medicare spending. But the details of such constraints keep vanishing, while ever more of the messy work of coming up with them is assigned to a so-called Medical Advisory Board that will supposedly recommend them later on. What no one wants to admit is that Congress never actually implements promised Medicare savings. When crunch time comes, it caves in to the AMA and the AARP. In a few years time, when boomers swell the ranks of seniors, and the political power of the AMA and AARP together rival that of Wall Street, the cave-ins will be boggling.

Meanwhile, opponents of abortion are winning, too. Ben Nelson (a Nebraska Democrat who enjoys being the spoiler even as much as Joe Lieberman) is holding out for even more restrictions.

The political reality right now is that Harry Reid will do anything to get sixty votes — which means Lieberman, Nelson, and even Olympia Snowe are able to use extortion on behalf of Big Insurance, Big Pharma, the AMA, and abortion foes. The President, meanwhile, remains eerily above the fray. Having closed deals months ago with Big Insurance, Big Pharma, and the AMA — in order to get their support in exchange for guaranteeing them big profits — his only apparent interest is keeping the deals going while helping Reid corral sixty votes for just about anything. (The deals have caused some awkwardness for the White House. Drug importation would have cost Big Pharma far more than the $80 billion price tag it agreed to, forcing the White House to oppose importation even though the President had publicly supported it during his presidential campaign last year, and even though John McCain supported yesterday’s amendment.)

Is the effort worth still worth it? Yes, but just. Private insurers will have to take anyone, regardless of preconditions. And some 30 million people who don’t now have health insurance will get it. But because Big Insurance, Big Pharma, and the AMA will come out way ahead, the legislation will cost taxpayers and premium-payers far more than it would otherwise. Cost controls are inadequate; in fact, they barely exist. If Wall Street’s top brass are “fat cats,” as the President described them last weekend, the top brass of Big Insurance, Big Pharma, and the AMA are even fatter. While they don’t earn as much, they’re squeezing the public for even more.

We are slouching toward health-care reform that’s better than nothing but far worse than we had imagined it would be. Even those of us who have seen legislative sausage-making up close, even those of us who never make the perfect the enemy of the better, are concerned. That two or three senators are able to extort as much as they have is appalling. Why hasn’t Reid forced much of the bill into reconciliation, requiring only 51 votes? Why has the President been so cowed? In all likelihood, the White House and the Dems eventually will get a bill they can call “reform,” but they will not be able to say with straight faces that the reform is a significant improvement over the terrible system we already have.

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Cross-posted from Robert Reich’s Blog

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Robert Reich served as the nation’s 22nd Secretary of Labor and now is a professor of public policy at the University of California at Berkeley. His latest book, “Supercapitalism,” is out in paperback. For copies of his articles, books, and public radio commentaries, go to www.robertreich.org. 

 

 

 

 

 

 

 

By Robert Reich
Former U.S. Secretary of Labor, Professor at Berkeley

First there was Medicare for all 300 million of us. But that was a non-starter because private insurers and Big Pharma wouldn’t hear of it, and Republicans and “centrists” thought it was too much like what they have up in Canada — which, by the way, cost Canadians only 10 percent of their GDP and covers every Canadian. (Our current system of private for-profit insurers costs 16 percent of GDP and leaves out 45 million people.)

So the compromise was to give all Americans the option of buying into a “Medicare-like plan” that competed with private insurers. Who could be against freedom of choice? Fully 70 percent of Americans polled supported the idea. Open to all Americans, such a plan would have the scale and authority to negotiate low prices with drug companies and other providers, and force private insurers to provide better service at lower costs. But private insurers and Big Pharma wouldn’t hear of it, and Republicans and “centrists” thought it would end up too much like what they have up in Canada.

So the compromise was to give the public option only to Americans who wouldn’t be covered either by their employers or by Medicaid. And give them coverage pegged to Medicare rates. But private insurers and … you know the rest.

So the compromise that ended up in the House bill is to have a mere public option, open only to the 6 million Americans not otherwise covered. The Congressional Budget Office warns this shrunken public option will have no real bargaining leverage and would attract mainly people who need lots of medical care to begin with. So it will actually cost more than it saves.

But even the House’s shrunken and costly little public option is too much private insurers, Big Pharma, Republicans, and “centrists” in the Senate. So Harry Reid has proposed an even tinier public option, which states can decide not to offer their citizens. According to the CBO, it would attract no more than 4 million Americans.

It’s a token public option, an ersatz public option, a fleeting gesture toward the idea of a public option, so small and desiccated as to be barely worth mentioning except for the fact that it still (gasp) contains the word “public.”

And yet Joe Lieberman and Ben Nelson mumble darkly that they may not even vote to allow debate on the floor of the Senate about the bill if it contains this paltry public option. And Republicans predict a “holy war.”

But what more can possibly be compromised? Take away the word “public?” Make it available to only twelve people?

Our private, for-profit health insurance system, designed to fatten the profits of private health insurers and Big Pharma, is about to be turned over to … our private, for-profit health care system. Except that now private health insurers and Big Pharma will be getting some 30 million additional customers, paid for by the rest of us.

Upbeat policy wonks and political spinners who tend to see only portions of cups that are full will point out some good things: no pre-existing conditions, insurance exchanges, 30 million more Americans covered. But in reality, the cup is 90 percent empty. Most of us will remain stuck with little or no choice — dependent on private insurers who care only about the bottom line, who deny our claims, who charge us more and more for co-payments and deductibles, who bury us in forms, who don’t take our calls.

I’m still not giving up. I want every Senator who’s not in the pocket of the private insurers or Big Pharma to introduce and vote for a “Ted Kennedy Medicare for All” amendment to whatever bill Reid takes to the floor. And if this fails, a “Ted Kennedy Real Public Option for All” amendment. Let every Senate Democratic who doesn’t have the guts to vote for either of them be known and counted.

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Cross-posted from Robert Reich’s Blog

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Robert Reich served as the nation’s 22nd Secretary of Labor and now is a professor of public policy at the University of California at Berkeley. His latest book, “Supercapitalism,” is out in paperback. For copies of his articles, books, and public radio commentaries, go to www.robertreich.org.

By Leo W. Gerard
USW International President

The meeting got testy. Voices rose last Thursday among Democrats over differences in the Senate Finance and Health committee versions of insurance reform.

Max Baucus defended his committee’s bill, voted out last week with one Republican, but lacking a public option and burdening the middle class. He said, according to reports by Sen. Evan Bayh:

“We are doing the best we can.”

Maybe Baucus is doing the best he can, considering the fact that his committee, in search of Republican support, has been kissing elephant trunk so long it doesn’t know which end is up.     

Democrats must stop appeasing elephants whose intent, frankly, is to squash health care reform. Dems have a supermajority in the Senate. They have the support of the American people for health insurance reform – with the latest polls showing more than 60 percent back the public option. And the power of opponents is waning, as last week’s failed attempt by the insurance lobbying organization America’s Health Insurance Plans (AHIP) to scuttle the Senate Finance Committee bill showed.

On Tuesday, as the Senate Finance Committee moved toward a vote, Baucus admonished:

“Colleagues, this is our opportunity to make history. Our actions here will determine whether we extend coverage to more Americans . . . Now is the time to get this done.”            

That’s all true. Except there’s one more thing: it must be done right. There’s no “best we can” when Democrats have a supermajority in the Senate and massive popular support for reform.

Right includes a public option. This is crucial to lower costs. Don’t take my word for it. Take that of Nobel Prize winning economist Paul Krugman. He noted in his Oct. 16 column in the New York Times that AHIP objected to the public option because public plan officials would negotiate for better prices. “Isn’t that an argument for, not against, such a plan?” Krugman asked. The public option, which is offered in the Senate Health Committee bill and House versions of reform, would create competition where there is none. Competition would drive down costs, which have risen exponentially, inexorably and annually – prompting too many companies to drop coverage for workers or increase fees and co-pays to the point where coverage is unaffordable.

The right way means passing reform without burdening the middle class. The Baucus bill smacks a 40 percent tax beginning in 2013 on plans valued at $8,000 for individuals or $21,000 for families, with some adjustments. The Congressional Joint Committee on Taxation estimated that this would quickly affect 40 percent of all plans. Officially, this tax would be levied on insurers, but there’s no question that they would pass that cost forward to the insured– further hiking up the price of insurance. The House legislation offers a much better approach – a surcharge on millionaires. They’ve gotten eight years of huge tax breaks under the Bush administration. It’s time for them to give a little back. 

The right way also means that all employers must pay their share of costs. More than 160 million Americans receive health insurance as a benefit at work, but more than $1,000 of the cost of those family plan premiums goes to cover the cost of the uninsured. And those uninsured are mostly people whose employers fail to provide health insurance. The only way to apportion these costs fairly is to require employers to provide health insurance or, alternatively, contribute a meaningful sum toward the cost of workers’ coverage.

The right way to reform does not penalize individuals who cannot afford to obtain coverage more than employers. Health care reform must ease the burden on workers and families, not worsen it.

Baucus is correct about one thing. This is an historic moment. But the “best we can” must include the public option. It must mandate that employers pay their fair share of costs. And it must not further burden workers. Forget the elephants and serve the Americans desperate for real health insurance reform.

 

By David Sirota
Political journalist, best-selling author and syndicated newspaper columnist

I don’t get it.

I know that’s the simplistic refrain of every 10-year-old, but I’m 33 and I mean it: I just don’t get it.

Specifically, I don’t get why Maine Sen. Olympia Snowe (R) — or any Republican senator, for that matter — is attracting so much attention.

In the last few months, Democratic senators eliminated the public option and substantially weakened their health care proposals in order to buy insurance industry acquiescence and, thus, Snowe’s vote. Now, based on the deafening media noise, all of American politics is focused on this unaccomplished backbencher and whether or not she will endorse the final bill. It is as if Republicans control Congress — as if Snowe, not Barack Obama, won the biggest presidential landslide since Ronald Reagan.

This is bizarre for what should be obvious reasons.

First of all, Snowe’s much-celebrated initial vote this week for an embarrassingly flaccid health care initiative wasn’t necessary to pass the bill — Democrats had enough votes to move the legislation out of the Senate Finance Committee without her approval. That’s a mathematical fact, as is the fact that Democrats control the 60 votes to overcome a filibuster with or without Snowe; as is the fact that Democrats have the 51 votes to enact health care reform through a parliamentary procedure called reconciliation — again, with or without Snowe.

So the notion that Snowe’s vote — or any GOP vote — is inherently pivotal to health care reform is a fantasy created by the Beltway media and the Democratic congressional leadership. The former is desperately trying to manufacture headline-grabbing drama; the latter is looking for a Republican excuse to water down the bill and protect corporate interests — all while absolving Democrats of legislative responsibility.

Second, the idea that Snowe’s support will result in the final legislation being called “bipartisan” — and that such billing will politically protect Democrats — is absurd. How do we know this? Because Democrats themselves taught us that via the Iraq War.

Recall that with solid Democratic and Republican backing, the 2002 Iraq resolution was far more “bipartisan” than any health care bill will ever be. Yet, Democrats turned right around and used the Iraq War to criticize Republicans — and because the conflict was so wildly unpopular, Americans in 2006 and 2008 were willing to overlook the contradiction and vote for the only major party echoing any semblance of an antiwar message.

On health care, it will be the same in reverse: The GOP will invariably attempt to turn any bill into an electoral cudgel against Democrats — regardless of how many Republicans end up voting for it.

The lesson, then, is simple: If Democrats’ hypocritical Iraq criticism only worked because the war was such a disaster, then the GOP’s inevitable health care attacks — however hypocritical — can only be thwarted by making health care reform the opposite of Iraq (i.e., a major success). For Democrats, in other words, good health care policy is great politics, and bad policy is the worst politics.

Whether passed by one congressional vote or 50, real reform that improves the system (i.e., a bill with a public option, tough insurance regulation and universal coverage) will transform the Democratic Party into an election-winning force forever known as “the generous protector of middle-class interests,” as GOP strategist William Kristol admits. Conversely, even if passed unanimously, bad legislation that makes the system worse (i.e., a bill empowering insurance companies, preventing a public option and leaving millions uncovered) will make GOP criticism of Democrats extremely effective.

That’s a truism, no matter if Snowe or any other Republicans add their support to a health care bill that doesn’t actually need it in the first place.

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David Sirota is the author of the best-selling books “Hostile Takeover” and “The Uprising.” He hosts the morning show on AM760 in Colorado and blogs at OpenLeft.com. E-mail him at ds@davidsirota.com.

 By David Cay Johnston
Pulitzer Prize winning investigative journalist

Atop the front page of the  Sept. 23 New York Times  is a color photo of Georgia homes flooded up to their rafters, an image that illustrates how when it comes to insurance our Congress applies two standards, separate and unequal, one for property and a lesser one for people.

Unlike people without health insurance, homeowners have access to public option flood insurance. 

Even those who fail to take personal responsibility to buy insurance to protect their property can get benefits, thanks in good part to politicians who are leading opponents of public option healthcare.

Consider the example of  Trent Lott of Mississippi, who was that state’s senior senator when Hurricane Katrina hit in 2005, flooding his home looking out on the Gulf. Lott had not exercised personal responsibility by taking out flood insurance even though it was available from the federal government at low cost. He did have private insurance, but his insurer refused to pay much of the claim, saying it was not wind damage (which was covered by the policy), but water damage (which was excluded).
    
Weeks later Lott introduced Senate Bill 1936, which would have authorized retroactive flood insurance. The idea came from Representative Gene Taylor, a Democrat who represented the Mississippi Gulf Coast, which should remind us that when there is voter demand for reform, and campaign contributions are not the driving force, the parties have worked together.    

Lott’s bill would have let flood victims pay 10 years of flood insurance premiums after-the-fact plus a 5 percent late payment penalty. Since this storm was rated a once in 500 years occurrence, even 10 years of premiums would not come close to covering the real costs, meaning a taxpayer subsidy was built into the Lott bill.

Instead of being laughed at by his fellow Republicans for promoting socialism, the concept of retroactive relief was warmly embraced, although not the idea for retroactive insurance. Instead the government went with handouts.

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By Robert Borasage
Co-Director of the Campaign for America’s Future

The editors of the Wall Street Journal say that the public option in health care reform has been “sent to the death panel.” Obama “concedes” the public option, reports the Financial Times. Even liberals seem to agree. The public option is “all but gone,” writes Bob Herbert of the New York Times. The American Prospect’s Mark Schmitt mourns its “likely death.”

Nonsense. There is no reason to exaggerate the strength of the small tong of conservative Democrats and claque of obstructionist Republicans standing in the way of reform. Here’s the reality:

Offering a public plan as a choice to compete with the private insurance companies has continued strong support in polling. President Obama favors it. The Democratic leadership in both the House and the Senate support it. More importantly, a majority of legislators in the House and a broad majority of Democrats in the Senate will vote for it. Needless to say, the activist base of the party thinks it vital.

The only question is whether a small minority of Democrats in the Senate will dig themselves into such a rabid fever that they would sabotage health care reform itself to stop the public option. Whether their animus derives from ideology or insurance company contributions, it is inconceivable that a handful of Blue Dogs in the House or conservative Dems in the Senate would block the president’s key reform to make their point. It would also be suicidal, for if 1994 is any indication, Democrats particularly those from more conservative districts will pay a harsh price at the polls in 2010 if they fail to pass reform.

Citizens can help concentrate their minds. Legislators have heard from the screamers in the town meetings. They’ve been besieged by legions of insurance company lobbyists. They’ve comforted seniors terrified by the lies being peddled. Now it is time for them to hear from the majority of citizens, and the vast majority of Democratic voters who want health care reform that works, one that includes both a public plan as an option to compete with the insurance companies, and the lower drug prices that will result from enabling Medicare to use its buying power to gain discounts for patients.

There are a lot of talking heads out arguing that the “left” shouldn’t be so extreme as to risk health care reform by insisting on the public option or the lifting of the absurd ban on negotiating lower drug prices. The reality is exactly the reverse. It is the handful of Blue Dogs and conservative Democrats in the House and Senate that are standing in the way of the majority in favor of a comprehensive plan. The question isn’t whether the progressive majority is unreasonably resisting reform to save the public option. The question is whether a small minority of conservative Democrats will sabotage reform simply to stop the public option.

Substantively, passing health care reform without a public plan to compete with the insurance companies makes no sense. As Jonathan Walker details, it would be an insurance company bonanza, as the government requires the uninsured to get health insurance – supplying the companies with millions of young and healthy customers – while eliminating the option of a competing government run plan that, in Obama’s words, can “keep the insurance companies honest.” For a country that must get health care costs under control, reform without the government plan as an option is irresponsible.

Similarly, President Obama and virtually every Democrat in Congress were right to campaign against the obscene provision in the prescription drug plan, the iconic symbol of the corrupt Republican Congress, that actually prohibits Medicare from negotiating lower prices for drugs. Democrats cannot pass reform without erasing that folly, and gaining lower drug prices for seniors on Medicare and for taxpayers paying much of the tab.

Politically, comprehensive reform can pass only if Democrats unite. The effort to gain bipartisan support was torpedoed by the leading Republican negotiator, Senator Charles Grassley, when he revealed his is true colors by embracing the vicious inanity about “death panels.” He aligned himself with the wingnuts, and there is simply no reason or way to negotiate with lunacy. The only thing Senator Max Baucus has achieved with his supposed negotiations is endless delay. The only thing he promises is more delay. Conservative Dems now are trotting out an ill-defined national co-op as an alternative to the public option. Most experts dismiss this as unworkable. More to the point, the Republican National Committee scorns it as a “government take over of health care.” Negotiations and concessions have produced zero Republican commitments to join reform.

Instead it is time for Democrats to unite and move. Pass a bill out of the House and put it before the Senate with the president behind it. Push the minority of Democrats standing in the way to join the majority. Then let Republicans try to filibuster it. Even if against parts of the bill, no Democrat with a working frontal lobe will vote for the filibuster and join Republicans to deny the president a majority vote on this critical reform. If Kennedy and Byrd are unable to vote, then we’ll need two Republicans. The few that haven’t gone over to pure obstruction will have to decide if they are prepared to stop a vote on reform. If the filibuster is defeated, then we just need 50 votes to pass the bill – and there is no reason why a bill with a robust public option and lower prescription drug prices can’t gain 50 votes from Democrats in the Senate.

Admittedly this is still a heavy lift. But the reality is that a plan without a public option cannot and should not get through the Congress. Over 60 House Progressives have made it clear that they won’t vote for a plan without a robust public option. That isn’t not a minority standing against reform; it is a minority expressing the majority opinion in the House, the party, and the country. (To support the progressive legislators that are leading this go here.)

Why would a handful of Blue Dogs get in the way of a unified position? A government plan as an option isn’t a difficult political vote. The hard choice is voting for any comprehensive reform and they will pay a much higher political price for failing to produce than for voting for a public option. The only reason to block a plan is either ideological rigidity, or the corrupting influence of insurance company contributions. In this circumstance, citizen mobilization can help educate the recalcitrant on the need to join the president and the majority of the party.

Less than a Full Loaf

Some reporters suggest that Obama is signaling that he’s ready to abandon the public plan. In fact, Obama has been consistent. He has argued for the public option, while stating that he’s prepared to negotiate any part of the deal to get majority support for something that works. He’s for a public option, but it isn’t a deal breaker for him.

Former President Bill Clinton came to the Netroots Nation convention last week. He was in his full glory – smart, funny, wounded, a repository of policy and politics. His core message was that it is “imperative for the Democrats to pass a health care bill now,” telling bloggers that “the president needs your help and the cause needs your help.” Since we need reform to pass, he argued, we can’t let the perfect be enemy of the good. So Clinton urged the liberal activists to keep fighting for what they want, but be ready to accept “less than a full loaf.” This is a message better delivered by the former president to his old Blue Dog and New Dem gang – to the handful of conservative Dems standing in the way, not to folks supporting the broad majority in agreement with the president.

And Clinton inadvertently sent the bloggers a very different message. Lane Hudson interrupted his speech to challenge him on the unconscionable “don’t ask, don’t tell” policy on gays in the military. Clinton’s famed temper flared as he defended himself:

“You wanna talk about “Don’t Ask, Don’t Tell.” I’ll tell you exactly what happened. You couldn’t deliver me any support in the Congress and they voted by a veto-proof majority in both houses against my attempt to let gays serve in the military, and the media supported them. They raised all kinds of devilment. And all most of you did was to attack me instead of getting some support in the congress. Now, that’s the truth.”

Well, not quite, since many of the bloggers in the audience were teenagers or younger when this debate took place. But the former president provided clear strategic insight for the current moment. We don’t want a former President Obama to say, a decade from now, that the reason we didn’t get a public option was that we “couldn’t deliver” any support for him in the Congress. It’s time to deliver that support.

So no surrender; no retreat. Don’t start embracing “half a loaf,” or thumb-sucking about the reasons for the demise of the public option. Real reform has the support in the country, the Democratic Party, the House of Representatives and the White House. It has support of a majority of Democrats in the Senate. Now it is time to deliver the president the votes he needs for the public option he favors. Full court press on the handful of Democrats that are standing in the way, and then real pressure on the two or three Republicans who have yet to surrender to the obstructionist extremes of their party.

Pull out the stops. Do whatever you can think about doing to weigh in at this time – and then enlist your friends to join you. We are very close. We don’t have to overcome a presidential veto, or the opposition of the congressional leadership. All we need to do is to get Democrats and a couple Republicans to commit to giving the president a majority vote on this critical reform, and then get 50 members of the Senate to join the majority of the House in supporting it. Forget the naysayers. This is in reach. Let’s make it happen.< >< >< >< ><–>

By Leo W. Gerard
International President

Just days ago, America celebrated her birthday with fireworks, spontaneous renditions of the Star Spangled Banner and chants of, “We’re Number One!”

In a crucial area, health care, the chant is untrue. Many of us love the individual doctors who may have saved our lives or the lives of loved ones. But the health care system in this country is not top-ranked.  It’s not even close to number two. Its poor quality and excessive expense are sucking the life out of America. For the health of the nation, both physically and economically, we need a system with a public option – that means a government-sponsored and managed alternative. And we need it now.

First, the issue of ranking. In the year 2000, the last time the World Health Organization stacked up countries’ health systems, the United States came in 37^th, behind the likes of Chile, Morocco, Cyprus, even drug war-torn Colombia, to which the U.S. donates hundreds of millions in foreign aid. The U.S. Centers for Disease Control and Prevention pointed out late last year that the U.S. ranked 29^th in the world for infant mortality in 2004, a statistic that steadily worsened since 1960, when the U.S. ranked 12^th. Twenty-two countries’ rates were below 5 deaths per 1,000 live births. The U.S. rate was 6.78 deaths.

Similarly, the U.S. ranks 42^nd for life expectancy, down from 11^th two decades ago. Contributing to that decline is the parallel drop in Americans covered by health insurance, researchers said. While 46 million Americans lack insurance, Canadians and residents of European Union countries benefit from universal health care.

We are 37^th – Yea! We are 29^th – and falling! We are 42^nd — and dying! These are not the chants of proud Americans. These are not the chants of vibrant Americans. In fact, these are not the chants of Americans who could continue financially supporting this sick system even if they wanted to. And they don’t.

The cost of the American system, with its private health insurance industry in the business of profiting off of illness by limiting care, cutting corners and denying access to those with “pre-existing conditions,” is suffocating the U.S. economy. In this one unenviable area – spending — the U.S. is number one. Health care expenditures are a shocking 16 percent of U.S. gross domestic product (the value of all goods and services produced in a nation in a year), far ahead of the closest competitor. That would be France, where it’s only 11 percent. That’s followed by Switzerland, Germany, Belgium, Canada and Austria, where it ranges from 10.8 down to 10.1 percent. These are all countries that provide national health care.

Looking at it another way, the average expenditure per individual, America remains in the undesirable position of most profligate spender. The average for an American was $7,290 in 2007, the latest year for which comparable statistics were available. But the average for the 30 countries in the Organization of Economic Cooperation and Development was a mere $2,964, with the closest to the U.S. being Norway at $4,763.

Those costs marginalize U.S. manufacturers as they attempt to do right by their American workers while scrambling to compete in international markets. Here’s how Dr. Atul Gawande put it in his June article, “The Cost Conundrum,” in “The New Yorker:” “Spending on doctors, hospitals, drugs, and the like now consumes more than one of every six dollars we earn. The financial burden has damaged the global competitiveness of American businesses and bankrupted millions of families, even those with insurance . . . By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”

President Obama warned the American Medical Association, which opposes national health care, about exactly the same thing in June when he said this: “If we do not fix our health care system, America may go the way of G.M.” Would those wealthy physicians bail out the government then?

Clearly these costs don’t contribute to quality since U.S. rates of infant mortality and life expectancy are so relatively poor. And they factor large in personal bankruptcies and delay of care as individuals are unable to keep up with medical care’s morbidly obese costs.

A Kaiser Family Foundation poll in February found that 53 percent of Americans cut health care because of cost in the previous year. A quarter reported putting off health care they needed such as doctor’s visits and surgery, and twenty percent said they have not filled a prescription. Another part of the poll explains this: “13 percent say they have used up all or most of their savings trying to pay off high medical bills in the past 12 months, and just as many say their medical debt means they have difficulty paying other bills.  A similar proportion (12%) say they have been contacted by a collection agency, while a smaller share (7%) report being unable to pay for basic necessities like food, heat or housing.”

We are Number One? This is cruel. This is wrong. This must stop.

I know that many Americans view my native land, Canada, not as a country, but as an unofficial 51^st state. But the difference between Canada and the 50 states is that Canada has national health care, thanks to Tommy Douglas, the former premier of Saskatchewan, and a party leader. One huge difference between the American system and Canada’s national health care is the extreme cost of administering private insurance in the U.S. A study published in 2003 in the New England Journal of Medicine showed that administrative costs were $1,059 per person in the U.S. but only $307 per person in Canada. That excessive $752 in administration costs paid in the U.S. for each insured person has only grown larger in the ensuing years. The study concluded: “A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system.”

In 2004, the Canadian Broadcasting Company conducted a poll to determine the country’s greatest citizen. People everywhere could vote, for anyone they wanted, so an actor, like Tommy Douglas’ grandson, Kiefer Sutherland, could have won, or a famous singer like Celine Dion or Shania Twain. But Canadians chose a politician — Tommy Douglas, the father of national health care. That’s how we feel about the national health care system in Canada.

Don’t let the Republican Party-of-No stop this. Don’t let big vested interests like the pharmaceutical, insurance, and for-profit hospital corporations keep America down. In poll after poll, Americans have made it clear they want a public option. They want care as good as Canadians get. They’re paying more than twice the price for it. To ensure that America is Number One, Congress better deliver it before the end of August.