COMMENTARY

President Barrack Obama will address a joint session of Congress tomorrow evening attempting to jump start the lagging effort to get health reform through the Congress.  The problem is not a lack of interest in meaningful reform, but the definition of meaningful.  On the left, meaningful reform equals single payer, universal coverage – the President has already indicated that this is his personal preference (not surprising considering he was the most liberal member of the United States Senate prior to his election).  On the right, there are many who would wish the federal government to disappear altogether.

Yet, in the middle, lay the vast majority of American citizens.  They do not want a federal takeover of health care (1/6 th of our total economy) or excessive federal interference in the delivery of medical and health services.  But they do want common sense, meaningful regulatory oversight of the health insurance industry.  This is where you must go to move the ball forward Mr. President, the center of the field.

Attempts by the Democratic liberal majority to push through any bill they choose over the objections of centrists Democrats and Republicans is very risky and could divide the country even further than it already is on this issue.  It will also surely have a negative impact at the polls in the 2010 election for all who support this “nuclear option” in the Congress.

What does meaningful, common sense regulatory oversight entail?  What should legislation for Real Health Reform contain? Let us count the ways.

(1) Elimination of any use of pre-existing medical conditions, medical or surgical history to deny coverage

(2) Elimination of the ability of any health insurer to drop any subscriber for any reason other than non-payment of premiums

(3) Restructure of COBRA to allow for employees terminated or leaving an employer plan to move to individual coverage without a major increase in premiums

(4) Equal treatment of health care insurance tax subsidies: that is all may get the deduction or none may get it (businesses or individuals)

(5) Expansion of Medicaid to create more assistance for those that have limited resources so that they can qualify for premium adjusted Medicaid.  This is problematic to be sure, as Medicaid is a matching program and various states are struggling with their own budgetary issues (i.e. California).  However, it does force the states to participate in solutions to the overall problem.

(6) Meaningful tort reform to eliminate the need for defensive medicine thus reducing the use of tests as a means to defend against possible lawsuits.  This should involve caps on pain and suffering, not on real medical bills or costs.  Many states have already done this and it works.

(7)  Clear, concise language to address concerns about illegal immigrants accessing tax payer funded programs.  The need for verification is clear and it is lacking in all of the bills now proposed.  It is not enough to say it, there must be a mechanism to verify that only legitimate citizens are accessing these services.  By definition, health reform leads us to the issue of immigration reform, but we (as a nation) can only tackle on of these at a time.

(8) Recognition that payment for any of these reforms must be born by ALL, not by a few individuals because of their economic success, not by businesses (as they simply pass the costs on) nor by punitive fees or taxes on the health care industry (insurers, device manufacturers, pharmaceutical companies, hospitals, home health agencies etc.).  By definition, health reform also leads us to the issue of tax reform, but as we noted earlier we need to address these issues one at a time.

(9) We must have a mandate for health insurance coverage.  This should ideally be applied to the individual, as individuals are really the crux of the problem, since those employed with coverage by their employer are not really an issue.  We will never achieve 100% voluntary participation, to be sure, but this mandate will force private health insurers to create policies that can meet the needs of various subscriber groups. For example, basic catastrophic / major medical coverage for young, healthy individuals.  This is similar to use of Medicare Advantage programs to offer seniors more choice in their primary health coverage after age 65.

(10) Some form of restraint on the ability of health insurers to raise premiums beyond a certain threshold or at will.  This gets us to our original concept of the regulated utility model.  But other methods can work as well.

Well, we have laid this out in less than 1,081 pages.  True, there are a few ‘details’ to be worked out, but Mr. President you can actually achieve something good and positive by repositioning your forces and changing your game plan, as any good coach does after the first half has not gone so well.   Get rid of  the minefield issues of ‘abortion’ and ‘death panels” (even if they seem bogus to you and your allies).  Get rid of  the ‘health commissions’ with appointed persons and no Congressional input or redress.  Get rid of  any concept of ‘progressive’ taxation of individuals or businesses to finance any part of this plan.  If you can do these things, you will be making strides to help us get to the core issues (which we have outlined above).

Real Health Reform is attainable and will be a great step forward for many American citizens who legitimately need reform to address issues they live with on a daily basis.  From day one we have outlined a plan that offered real solutions.  Like others, not everyone agrees with our approach either in specific cases or in its entirety.  So  Mr. President, go for the sure yardage and not the Hail Mary play.  Nevertheless, change is one constant we know exists and we will continue to work for meaningful solutions to our health care problems which maintains allegiance to our basic American values and economic principles . . . obi  jo and jomaxx

The Plan – http://realhealthreform.wordpress.com/the-plan/

Obama Rallies Supporters on Health Care – http://www.nytimes.com/2009/09/08/health/policy/08webobama.html?_r=1&emc=tnt&tntemail0=y

Health Compromise Floated Before Obama Speech – http://www.nytimes.com/2009/09/08/health/policy/08health.html?emc=tnt&tntemail0=y

New Fee on Health Insurance Companies Is Proposed to Help Expand Coverage – http://www.nytimes.com/2009/09/07/health/policy/07health.html?emc=tnt&tntemail0=y

Health Care Debate Revives Immigration Battle – http://www.nytimes.com/2009/09/06/health/policy/06immighealth.html?emc=tnt&tntemail0=y

Obama Relaunches Health Bid – http://online.wsj.com/article/SB125192345031880833.html

President To Flesh Out His Vision In Speech: Address to Congress Is Effort To Seize Control of the Debate – http://www.washingtonpost.com/wp-dyn/content/article/2009/09/02/AR2009090202675.html?hpid=topnews

Obama moves to retake health care debate – http://www.usatoday.com/news/washington/2009-09-02-obama-health-care_N.htm

Obama to address Congress on health care issue – http://content.usatoday.com/communities/theoval/post/2009/09/68498310/1

Obama to address Congress on healthcare – http://www.latimes.com/news/nationworld/nation/healthcare/la-na-obama-healthcare3-2009sep03,0,2087815.story

Health overhaul may ride on tactic: Seldom-used rule could thwart GOP Democrats would need only 51 votes – http://www.boston.com/news/nation/washington/articles/2009/09/02/health_overhaul_may_ride_on_tactic/

How far will Democrats go to pass health reform? – http://features.csmonitor.com/politics/2009/09/01/how-far-will-democrats-go-to-pass-health-reform/

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