Health Care Reform – The view from Washington

Yesterday my colleague Elaine Mejia and I went to our nation’s capital and met with the offices of as many members of our Congressional delegation as we possibly could. This meant seven meetings (actually one was more of a brush-off than a meeting, but more on that in a later post) over the course of the day, mostly with key legislative staff although we did talk in person with Senator Kay Hagan and Representative Mike McIntyre.

Overall, we found broad support for the idea of health reform, which was little surprise. Of course, as we are seeing right now, the devil is in the details and that’s where it got interesting. Health care bills in both the House and Senate would provide substantial tax credits to small businesses to help them buy insurance, give sliding-scale help to families with income up to around $70,000 to reduce premium costs, create a public health plan option to compete with private insurance plans, and make some efforts at controlling costs.

Despite these great bills, there were two main messages we heard in Congressional offices on health care. First, many members of Congress are not hearing from their constituents who support health care reform right now. Of course, these members have been hearing from many people over the last two years that want health reform, but opponents are out in force at the moment. Hearing from more people who support reform is critical.

Second, we heard from NC Congressional members and staff that they are worried about the efforts to control general health care costs in the bill. This doesn’t apply to the federal budget cost of the bill. Let me explain this apparent contradiction. The full cost of the House reform bill is covered by a tax on high income earners and sharply reducing payments to Medic are private plans and other costs. But what has members concerned is that some feel the bill doesn’t do enough to reduce overall health spending – which is growing a 9 to 10% a year. The Congressional Budget Office has agreed and said that the extensive prevention measures in both the House and Senate bills will do little to reduce overall health costs.

The problem is, of course, that when you seriously talk about reducing health costs, then someone is going to be making less money. And that someone likely has some very, very highly paid lobbyists in DC right now. That’s why proposals on doing comparative effectiveness research to figure out what drugs and treatments actually work and are worth paying for don’t include provisions to actually require this research be put into practice. By the same token, payment reforms where we pay doctors based on the overall health of the patient, rather than the number of procedures they do (and are paid for) are simply pilot programs.

While we need to get a little stronger on controlling health costs, but we also need to get serious about passing reform. Doing nothing is not an option. We can tweak these cost provisions in what are now very good bills to save more money. Other compromises will likely have to be made about the level at which tax credits kick in and just what a public plan option might look like. However, in the end, North Carolinians will be vastly better off with health reform than without it. In a state with an over 11% unemployment rate, over 1400 people in NC are losing health coverage every week. Let’s hope the President makes that point in his press conference on health care tonight.



  1. jacksmith

    July 22, 2009 at 5:55 pm


    We have the 37th worst quality of healthcare in the developed world.

    I know that many of you are angry and frustrated that REPUBLICANS! In congress are dragging their feet and trying to block TRUE healthcare reform. What republicans want is just a taxpayer bailout of the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT health insurance industry, and the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT healthcare industry. An insurance bailout is all you really get without a robust government-run public option available on day one.

    These industries have been slaughtering you and your loved ones like cattle for decades for profit. Including members of congress and their families. These REPUBLICANS are FOOLS!

    Republicans and their traitorous allies have been trying to make it look like it’s President Obama’s fault for the delays, and foot dragging. But I think you all know better than that. President Obama inherited one of the worst government catastrophes in American history from these REPUBLICANS! And President Obama has done a brilliant job of turning things around, and working his heart out for all of us.

    But Republicans think you are just a bunch of stupid, idiot, cash cows with short memories. Just like they did under the Bush administration when they helped Bush and Cheney rape America and the rest of the World.

    But you don’t have to put up with that. And this is what you can do. The Republicans below will be up for reelection on November 2, 2010. Just a little over 13 months from now. And many of you will be able to vote early. So pick some names and tell their voters that their representatives (by name) are obstructing TRUE healthcare reform. And are sellouts to the insurance and medical lobbyist.

    Ask them to contact their representatives and tell them that they are going to work to throw them out of office on November 2, 2010, if not before by impeachment, or recall elections. Doing this will give you something more to do to make things better in America. And it will help you feel better too.

    There are many resources on the internet that can help you find people to call and contact. For example, many social networking sites can be searched by state, city, or University. Be inventive and creative. I can think of many ways to do this. But be nice. These are your neighbors. And most will want to help.

    I know there are a few democrats that have been trying to obstruct TRUE healthcare reform too. But the main problem is the Bush Republicans. Removing them is the best thing tactically to do. On the other hand. If you can easily replace a democrat obstructionist with a supportive democrat, DO IT!

    You have been AMAZING!!! my people. Don’t loose heart. You knew it wasn’t going to be easy saving the World. :-)

    God Bless You

    jacksmith — Working Class

    Republican Senators up for re-election in 2010.

    * Richard Shelby of Alabama
    * Lisa Murkowski of Alaska
    * John McCain of Arizona
    * Mel Martinez of Florida
    * Johnny Isakson of Georgia
    * Mike Crapo of Idaho
    * Chuck Grassley of Iowa
    * Sam Brownback of Kansas
    * Jim Bunning of Kentucky
    * David Vitter of Louisiana
    * Kit Bond of Missouri
    * Judd Gregg of New Hampshire
    * Richard Burr of North Carolina
    * George Voinovich of Ohio
    * Tom Coburn of Oklahoma
    * Jim DeMint of South Carolina
    * John Thune of South Dakota
    * Kay Bailey Hutchison of Texas
    * Bob Bennett of Utah

  2. Single Payer Action

    July 22, 2009 at 7:10 pm

    interesting analysis “Bait and Switch, How The ‘Public Option’ Was Sold” from Kip Sullivan at PHNP’s web site. Click on link

  3. Single Payer Action

    July 22, 2009 at 7:12 pm

  4. Mary Jo Bankard

    July 22, 2009 at 7:17 pm

    I would just like to ask Jack Smith if he is in the habit of voting for something when he does not have all the facts?

    Would you buy a house or car and not know how much you’ll actually have to pay or if it comes with some kind of warrenty?

    I think not! It is pretty scary that President Obama wants to push this health reform bill through and neither he nor members of the Senate or the House have even read the whole bill.

    That certainly calms my fears about what is in this bill.

    I agree that health care needs reform, but spell out what the reform entails and who’s paying for it since America is pretty much bankrupt right now.

  5. Single Payer Action

    July 22, 2009 at 7:22 pm

    Quote from the Kip Sulivan piece. He hits the nail on the head:

    “The people who brought us the “public option” began their campaign promising one thing but now promote something entirely different. To make matters worse, they have not told the public they have backpedalled. The campaign for the “public option” resembles the classic bait-and-switch scam: tell your customers you’ve got one thing for sale when in fact you’re selling something very different”

  6. Brittancus

    July 22, 2009 at 8:39 pm

    It tends to make a lot of good people despondent and at the least susceptible, when they read, watch and listen to the maverick storm of media ads, thumping down President Obama’s health care initiative? Much of the rambling artifacts are the Simon and Lois ads of the Clinton administration, heavily armed against any revisions in this issue that wealthy insurance companies and subsidiaries won’t tolerate.

    They insulted the senior citizens with their propaganda and bald faced lies about the European government run health care system. Being originally an Englishman myself, I guarantee in the 1960’s, we had a unique form of medical services, inclusive of eye and teeth. Even government run medical care in Australia was exceptional. It did plummet down somewhat, when business starting recruiting foreign labor from the commonwealth and Northern Europe. Many were out for a free financial ride and got it, along with their large families that British citizens have to support with their limited pounds sterling.

    Just as the anti-governmental health care extremists have been pounding the airwaves, the open border, globalist is now subjecting the American people to a torrent of inflaming immigration polls. But like all polls they can be intentional manipulated, in exactly how the questions are worded? Sure they can keep their co-pays, deductibles and pre-existing small-print clauses, squeezing every penny from a hurting economy, but tell the–BLOODY TRUTH!

    It’s a sad fact that you cannot trust the Liberal slant regarding this searing problem, although not all Liberals are favorable to another AMNESTY? The Democratic leadership, hiding liberal views behind closed drapes tried to annihilate any good, workable illegal immigration enforcement laws. In an earlier session of the Senate an error was made with E-Verify, so it’s was fortunate to survive Sen. Reid and Pelosi’s notion? Anything that has an impact on removing illegal immigrants is intercepted by business oriented free traders.

    GOOGLE—illegal immigration–to find out their sinister intention, to just throw open the gates, ports and airline entrances to cheap labor, that also become the downfall of the European Union. the polling I have seen has been calculatedly –ENGINEERED–to get results, that they can brandish around, declaring the majority of Americans believe in a path to citizenship and open borders? Already the Democrats are ready to flag the Save Act, 287(g) local police enforcement to weaken these laws.

    Currently both issues have heavy fallout, and you the voter should let your Senator or Representative know your opinion on either matter at 202-224-3121—BEFORE IT’S TOO LATE. Both have massive consequences in costs and quality of life in your future and generations to come.WE MUST SAY NO AMNESTY! SEAL OUR BORDERS AND NO MORE FREEBIES TO ILLEGAL ALIENS. THEY ARE THE CRIMINALS, NOT AMERICANS WHO SACRIFICE TAXES? GOOGLE–NUMBERSUSA for details our government and the media have a nefarious talent, for keeping facts under wraps?

  7. Kimberly

    July 23, 2009 at 11:52 am

    I have emailed Etheridge, Burr, and Hagan several times to ask that they support Health Care Reform that includes: a National Public Health Plan with a Hardship Waiver option, making it illegal for insurance companies to charge anything over the normal rate for pre-existing conditions, making it illegal for insurance companies to deny coverage and treatments, making it illegal for insurance companies to continue the practice of “purging”, to put medical decisions back into the hands of the medical professionals and their patients, to lower the costs of prescriptions and DME, and to guarantee that every citizen has access to health care and health insurance regardless of income, gender, disability, or any other discriminatory reason. I have shared my families story with my elected leaders and I have spoken out in every forum that I can find, attend, and participate in. I believe in Health Care Reform as I stated above because every day, families like mine, are suffering and people are needlessly dying. Families like mine have sacrificed too much to obtain health care for our children with special needs. We are one more statistic on families with children with special health care needs, one more statistic on uninsured adults, and I do not want to add one more number to the 18 thousand people who die a year due to lack of health insurance, that is one statistic that I fear I may be counted soon without affordable access to health care.

  8. Adam Searing

    July 23, 2009 at 1:45 pm

    Kimberly – It’s great that you emailed them, but I’d also give their offices a direct phone call – it’s much more effective and can add to your email you’ve already sent:

    Our friends at FamiliesUSA even have a toll free number that you can use – just call and ask for whichever member of Congress you want:


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