Employer-sponsored health plans insure not only the largest sector of our society, but also the healthiest: the healthy workforce and their young healthy families. Because of the greater purchasing leverage of employers, economies of group plans, better regulatory oversight, and the lower average health care needs of the beneficiaries, premiums being paid for employer-sponsored plans represent the greatest value that we can expect in health care financing. Today a working family pays $13,375 for its coverage (which includes the employer contribution paid indirectly by the employee in forgone wage or salary increases).

The subtitle of this article is “Why Obama Needed Single Payer on the Table.” The full article is well worth reading.

In health care, we spend more and receive less, and everyone agrees that has to change. The decision has been made that we will do that by regulating our dysfunctional health insurance market, and then mandate that everyone who is not covered by other qualifying programs be required to purchase private health plans. To be certain that everyone has access to a plan, an insurance exchange will be established.

The heated debate over health care reform was certainly not unexpected. What has been a surprise to many of us is the intensity of the nastiness of the opponents of reform.

President Obama, in his speech before the joint session of Congress last evening, did not break new ground on the current proposal for reform being developed by Congress and the administration. So, based on the framework that has been advanced, what impact will the current proposal have on the numbers of uninsured?

Average-income Americans – the majority of us – are finding the impact of health spending growth to be onerous, and it will get worse.

In his Labor Day speech yesterday, President Obama, in using his “I continue to believe…” phrasing when mentioning a public option, made it quite clear that he will not tell the joint session of Congress tomorrow that the lack of a public option in the reform bill will result in a veto.

This may be the most important week in this window of opportunity for health care reform. Matt Taibbi’s well researched article tells us where we are and how we got here. It’s a must read for those who care. Hopefully it will motivate us to put down our Hallmark cards and join in the fight for real health care justice for all.

Under the House bill for reform (HR 3200), a family of four with an income of $88,200 that had health care needs could be responsible for $19,708 of their health care costs, which is 22% of their income (23% under the Energy and Commerce amendments). That would leave them with an income of $68,492 for all of their other needs and wants (and some of that could be burnt up in out-of-network costs and non-covered services that do not apply to the cap).

Although there are many reports on the deficiencies of the Massachusetts reforms, this report stresses two serious design flaws that impair affordability and access for low and middle income patients: 1) both public and private plans often fail to provide adequate financial protection even for those with only modest health care needs, and 2) the complex maze of programs and plans are very difficult to navigate with ever changing eligibility for the various programs, leading to frequent unavoidable lapses in coverage or no coverage at all.