Resource – Page 1098

Coalition seeks statewide insurance plan

By Winthrop Quigley Albuquerque Journal Staff Writer

A coalition of more than 75 organizations are asking the state Legislature to replace conventional health insurance with a single statewide insurance plan that bases premiums on the insured’s income.

The Health Security for New Mexicans Campaign argues that health care financing is too badly broken to be repaired and should be replaced. The campaign contends that millions of dollars can be saved on administrative costs if a single health insurance plan replaces the variety of products offered by health insurance companies.

The plan faces tough sledding in the state Legislature. Similar bills have been defeated in the past, and Gov. Bill Richardson has consistently said he opposes a single-payer health system.

Richardson prefers allowing uninsured New Mexicans to voluntarily join state-supported insurance plans already in place, including the plan covering state employees. He has also proposed tax credits to help small businesses afford health insurance for employees.

However, the Health Security for New Mexicans Campaign boasts a number of marquee names among its members, including the League of Women Voters in New Mexico, Albuquerque Health Care for the Homeless, several labor unions, the New Mexico Public Health Association, and several health policy and social policy advocacy groups.

Jerry Montoya, health promotion specialist in Valencia County for the New Mexico Department of Health, said Valencia County residents are especially hurt by the high costs of health insurance because of the county’s high poverty level. Montoya said the response the coalition has received in Valencia County has been very positive.

“We are a poor community,” he said. “We’re impacted even more. … One of the things that the Health Securities Campaign has been doing here in Valencia County is going out and doing presentations to various groups. Those presentations have been very well-received, because people are actually wanting to talk about health care reform, because they know there is a problem. They are eager to hear solutions.”

In two Journal-sponsored public opinion polls, a majority of New Mexicans have said they support a single taxpayer-funded health plan.

The campaign’s proposal faces almost certain opposition from the statewide business lobby, the Association of Commerce and Industry, according to J.D. Bullington, the group’s lobbyist.

The basics of the proposal have been offered off and on over the years by former Sen. Manny Aragon, D-Albuquerque, and former Rep. Max Coll, D-Santa Fe. The 2005 legislation is expected to be introduced by Santa Fe Democratic Rep. Luciano “Lucky” Varela, according to the Health Security for New Mexicans Campaign.

“I haven’t read the latest proposal,” Bullington said. “However, our organization is adamantly opposed to a government-run, single-payer health care system.”

The Health Security for New Mexicans Campaign would pool public and private monies, including Medicaid funding and health insurance premiums paid by individuals and employers, into a single fund. The health plan would be required to provide insurance at least as good as that offered to state employees. The coverage offered each insured would be identical, regardless of the member’s age, income, employment or health status would be based on income, not health status or age.

In an interview, campaign executive director Mary Feldblum said she could not estimate how much administrative costs would be cut, but she cited studies by The Lewin Group in several states, including a 1994 study in New Mexico, that show large state-sponsored insurance pools could offer meaningful savings.

John Sheils, a Lewin Group vice president, said in a telephone interview, “What we’ve generally shown is that a carefully designed single-payer plan can result in covering more people for more services for a tad less money. There is not a lot of money saved.”

Savings in most states Lewin Group has studied would pay for providing “most of the care you’d provide to the uninsured or underinsured.” But Sheils cautioned, “It’s going to be harder to achieve that result in New Mexico because you have lots of uninsured people.”

An estimated 414,000 New Mexicans are without health insurance.

Local health insurance plans say their own administrative costs are about 10 percent or less of total spending.

A single risk pool containing most of the state’s residents “will have some market clout” when negotiating with providers and drug companies, Feldblum said. “We have too many tiny pools,” which increases the insurance company’s risks, she said.

Sheils agreed, saying, “If you put everyone in one program with one benefit package, you probably could generate some sizable administrative savings.”

But when plans include spending constraints, technology isn’t upgraded as rapidly, providers stop offering some services, and quality of care and access to care can erode.

“There are more MRI (machines) in San Francisco than in the entire nation of Canada,” which operates a single-payer health plan and restricts spending, Sheils said. “If you are 68 years old in Britain and need kidney dialysis, you’re going to die.”

“I think as a nation, we’re really strange about this,” Sheils said. “We don’t seem to make the connection that to have the miracle of modern medicine coming our way, we have to pay for it.”

Under the coalition proposal, health care providers would operate the same way they do today. Patients could choose which providers to use. Providers would negotiate payment with a 15-member commission that would run the health plan. Premiums could be changed only with approval of the state Legislature.

The plan’s commissioners, appointed by the governor, would also have authority to review providers’ budgets to “ensure that resource allocation is based on the health care needs of different communities.”

Capital spending by providers such as hospitals would have to be certified.

The campaign in its literature promises unspecified “cost containment measures” that will produce “savings that can be invested in needed health care services.”

Federal retirees and active and retired military health plan members could not join the pool because of federal legal restrictions. Indian tribes could choose to join the pool. Plan members could choose to buy additional commercial insurance.

Bullington said the experience of Tennessee, which expanded its Medicaid program to encompass adults without health insurance, and the problems New Mexico has affording its own, more limited Medicaid program demonstrate the campaign’s ideas won’t work.

The Tennessee program “is imploding,” Bullington said. “It will bankrupt and fail.”

The Tennessee program in 1994 extended Medicaid benefits to cover the working poor, uninsurable adults and traditional Medicaid-eligible populations. The program eventually consumed one of three state tax dollars. Last year, Gov. Phil Bredesen began dismantling it and reinstating traditional Medicaid.

“We still steadfastly believe that we have not exhausted market solutions,” Bullington said. “We believe the existing structure can be salvaged and improved to provide affordable health care without overhauling the entire system and increasing the role of government.”

Medical bankruptcy(Kansas City Star Website)

Upon reading about Lisa Adams’ bankruptcy (2/3, A-1, “Medical bankruptcies: Double dose of trouble”), we were reminded again of the grim prognosis of the current U.S. health-care system.

More than 45 million Americans are uninsured, yet Americans continue to spend more per capita on health care than most of our world community. Despite these exorbitant expenditures, the United States performs poorly on leading World Health Organization health indicators (37th among the developed world). We propose that a single-payer national health-care plan is a solution to this crisis.
A national health-care plan would ensure quality coverage for all, would redirect excessive administrative costs into directly serving patient needs, and would establish health care as a basic human right.

Real solutions to medical bankruptcies and rising health-care costs are within our reach. Let’s start by supporting bipartisan proposals of Gov. Kathleen Sebelius and Insurance Commissioner Sandy Praeger to provide health care to low-income, uninsured Kansans.

Blair Thedinger, Abby Snavely and Lindsay Rome: KU Medical Center Students for a National Health Program
Jonathan Jacobs, Andrea Charbonneau, Kathryn Ellerbeck, Allen Greiner, Stephen Lauer, Joshua Freeman and Dan Swagerty: Mid-America Physicians for a National Health Program ( www.pnhp.org)

General Motors CEO's position on health care reform

The Wall Street Journal
February 9, 2005
Health-Care Overhaul: GM CEO Weighs In
By Alan Murray

General Motors Chief Executive Rick Wagoner… runs not only the world’s largest auto maker (a position threatened by Toyota Motor), but also the nation’s largest private health-care purchaser (a position threatened by no one.) He’s responsible for the health of some 1.1 million people, most of them retirees and their families, and paid $5.2 billion last year for the privilege. The cost of health care now adds more than $1,500 to every vehicle sold, and is rising at double-digit rates.

So it’s no surprise that health care has become Mr. Wagoner’s obsession. He’s taken the maxim attributed to Charlie Wilson — “What’s good for General Motors is good for America” — and turned it inside out. To cure what ails General Motors, he has to cure what ails America: a very sick health-care system.

“It’s not that manufacturing cars and trucks, and quality and productivity, are not important,” Mr. Wagoner said in an interview this week. “But we have processes in place to deal with those.” The health-care system, on the other hand, reminds him of the General Motors of old, with pockets of excellence but also wastelands of inefficiency. “We can do better as a country than we are doing,” he says. “We can have higher-quality services supplied at a lower cost.”

Mr. Wagoner opposes the ultimate bailout, a government-run national health-insurance system, which would take the cost off the back of big business but put control in the hands of a government bureaucracy. Instead, he favors a consumer-driven, competitive marketplace, with better health-care information systems, better research on the clinical effectiveness of different drugs and therapies, and better information on the quality of care available to consumers. He also favors curbs on malpractice suits, and a “bipartisan national strategy to address catastrophic health-care expenses.”

http://online.wsj.com/public/article/0,,SB110790726260549399,00.html?mod=todays%5Ffree%5Ffeature

Comment: Advocates of an equitable system of universal, comprehensive health care coverage have recently become enthused over statements from executives of the auto industry that we need a national solution for our health care problems.

But is the industry ready to join advocates of national health insurance in supporting an equitable, universal, comprehensive system? If you believe that we are close to bridging that divide, you also may believe that you can cross the Grand Canyon in a single leap.

U.S. firms losing health care battle, GM Chairman says

By Ceci Connolly
Washington Post Staff Writer
Friday, February 11, 2005; Page E01

American manufacturers are losing their ability to compete in the global marketplace in large measure because of the crushing burden of health care costs, General Motors Corp. chairman and chief executive G. Richard Wagoner Jr. said yesterday as he called on corporate and government leaders to find “some serious medicine” for the nation’s ailing health system.

In a speech at the Economic Club of Chicago, the auto executive, who is responsible for providing health insurance for more people than any other private employer in the nation, graphically detailed how rising medical bills are eating into his company’s bottom line and ultimately threatening the viability of most U.S. firms”The cost of health care in the U.S. is making American businesses extremely uncompetitive versus our global counterparts,” he said. “In the U.S., health care costs have been rising at double-digit rates for many years. In 2003, they were about 15 percent of GDP, at least 30 percent higher than the next-most-expensive country.”

“Failing to address the health care crisis would be the worst kind of procrastination,” Wagoner said, “the kind that places our children and our grandchildren at risk and threatens the health and global competitiveness of our nation’s economy.”

After spending several years on the health policy sidelines, Wagoner is launching a mini media blitz, hoping the competitiveness argument will be the one that finally prompts lawmakers to take on an increasingly expensive system rife with inefficiencies and inequities. Wagoner said he intends to press his case personally in Washington and with the nation’s governors.

Though self-interest may be at the heart of Wagoner’s crusade, he and a range of corporate leaders and policy analysts warned that GM’s woes are a harbinger of what lies ahead.

“GM is the canary in the coal mine for Medicare and everyone else,” said Sean P. McAlinden, chief economist at the nonprofit Center for Automotive Research. “There are many, many more companies out there in trouble because of health care costs than just the auto, steel and airline industries.”

McAlinden, a labor expert sympathetic to union views, said many in Washington have mistakenly concluded that GM and other carmakers are simply whining about costly union contracts.

“GM and the United Auto Workers didn’t cause this double-digit inflation in health care,” he said. And if GM pushed for sharp reductions in health benefits, the powerful union would likely strike and send the company into Chapter 11 bankruptcy protection, he predicted.

Last year the automaker, known for its innovative approach to health care, spent $5.2 billion to cover 1.1 million retirees, employees and their families. Prescription drugs cost GM $1.9 billion, and the company projects overall medical spending will increase by $400 million this year. That could be offset by a provision in the Medicare drug benefit to pick up a portion of firms’ retiree drug costs.

But the figure that prompted Wagoner to raise his voice is $1,500. That is the amount of money added to the price of every single vehicle to cover health care, a cost that his foreign competitors do not bear.

Paul Hughes-Cromwick, senior analyst at the nonprofit Altarum Institute in Ann Arbor, Mich., said executives are alarmed that benefit costs are rising far more rapidly than wages. Total compensation costs for U.S. firms rose about 3.7 percent in 2004, mirroring previous years, he said, citing Bureau of Labor Statistics data. But salaries increased just 2.4 percent, while benefit costs rose 6.9 percent. The gap is the largest he has seen in two decades.

“That huge benefit hit is chewing up the salaries and wages we would be receiving,” he said. “That’s the key.”

Yesterday, Wagoner broke his silence on an idea proposed by Sen. John F. Kerry (D-Mass.) in the 2004 presidential campaign, saying he supports some type of national catastrophic reinsurance program. Senate Majority Leader Bill Frist (R-Tenn.) has also endorsed the concept of a separate government-backed insurance pool to cover the most expensive medical cases.

“If we can create a comprehensive insurance model to better share these catastrophic costs among all consumers, then we can take a big step toward providing affordable health care coverage for all our citizens,” Wagoner said.

Wagoner and fellow executives find much to be frustrated with in the health care system.

“It’s simply not acceptable for over 45 million Americans to be without health care coverage,” he said, echoing a point made recently by Jack O. Bovender Jr., chief executive of health care giant HCA Inc. “And it’s unfair for those of us who do provide health care benefits to have to pay higher bills to cover the costs of the uninsured. Talk about ‘no good deed goes unpunished.’ ”

The business leaders cannot understand why the health care industry has been slow to institute the sort of technological changes that helped them improve quality and reduce costs.

“Only in health care does bad service and bad quality get paid for in the same manner as good service and good quality,” said Humana Inc. chief executive Michael B. McCallister, chairman of the Business Roundtable’s health care task force.

The CEOs agree that the double-digit premium increases will continue as long as individuals are sheltered from the true cost of health care.

“Companies, to manage health care costs, are going to have to have employees who understand that this is something you are consuming and you have a responsibility for,” Wal-Mart Stores Inc. chief executive H. Lee Scott Jr. said in an interview.

Staff writer Michael Barbaro contributed to this report.

New tack for health insurance(SF Chronicle)

By
David Lazarus

So we learned from President Bush’s budget this week that the new-and-improved Medicare prescription drug benefit won’t cost Americans less than $400 billion over 10 years as originally proposed, but instead nearly twice that amount.

A pig in a poke? Quite possibly.
A lousy health care system? Definitely.

Boston University researchers released a study this week concluding that about half of all health care spending in the country is squandered on administrative waste, excessive pricing and fraud. Yet Californians may soon have an alternative, at least if a state lawmaker succeeds in her latest effort to introduce universal health care.

State Sen. Sheila Kuehl, D-Santa Monica, told me Thursday that she plans to unveil her California Health Insurance Reliability Act on Feb. 23. It will be Kuehl’s third stab at getting a universal-care bill through the Legislature. But this time things are a little different.

For one thing, disenchantment with the existing health care system continues to grow among both ordinary people and businesses saddled with skyrocketing insurance premiums.

Meanwhile, advocates of universal coverage have brought a new level of seriousness to their cause by hiring a prominent political operative, Andrew McGuire, to spearhead fund-raising and lobbying efforts. Less money, more coverage. And most importantly, a new report by the Lewin Group, a well-regarded health care consulting firm, finds that a system along the lines of what
Kuehl is proposing would reduce health care spending in California by $8 billion next year alone.

It also would provide coverage for the nearly 6 million uninsured people statewide and result in lower costs for virtually all California companies now providing insurance to employees. “This is an independent report proving that we can achieve universal coverage in California while reducing health spending,” Kuehl said. “It’s a very important development.”

It’s not a slam dunk, though. Kuehl acknowledged that almost as soon as she introduces her legislation this month, the insurance and drug industries will unleash all their political firepower to protect their interests.

“When they do, I plan to raise questions about the obscene profits these companies are making,” Kuehl said. “I love a good fight.” Her bill would create a so-called single-payer health system in California– the first in the nation (although similar efforts are under way in other states). Single-payer systems have existed in Canada and other nations for decades.

Under a single-payer system, any California resident could be treated by any doctor at any hospital anywhere in the state. Commissioner to oversee. The state’s medical resources would be overseen by a newly created health commissioner, who would ensure that money is spent wisely.

According to the report issued last month by Virginia’s Lewin Group, funding for a California single-payer system could come in part from an 8.2 percent payroll tax for employers. The tax would replace all current health care benefits paid for workers, dependents and retirees. Lewin estimates that this change would result in a 16 percent average saving in 2006 for all employers now offering health
benefits.

Meanwhile, salaried workers would pay a 3.8 percent payroll tax that would replace all existing insurance premiums, deductibles and co-pays. According to Lewin’s projections, this would reduce the $2,788 expected to be paid by the average California family next year for health services and insurance by about $340 per family.

Exact funding breakdowns in Kuehl’s legislation are still being tinkered with. Industry likely to oppose “If people can get past industry’s propaganda, I think they’ll see that this is really good for them,” said McGuire, who was hired several weeks ago to serve as executive director of Health Care for All — California, a
grassroots organization backing universal coverage.

McGuire’s past political efforts have included campaigns for gun control and safer cigarettes. He also serves as head of San Francisco General Hospital’s Trauma Foundation, which seeks to prevent serious injuries. “If people in the corporate world get religion and realize this is in their best interest, we could really have a chance,” McGuire said of Kuehl’s bill.

That may be true for many companies, but not for the health insurance business, which would be effectively decimated by creation of a single-payer system. Bill Wehrle, acting president of the California Association of Health Plans, which represents about three dozen HMOs statewide, said people should be wary of single payer.

“There could be some amount of administrative savings under a single-payer system,” he acknowledged. “It all depends on what trade-offs people are prepared to make to get savings.”

Long waits in Canada
In Canada, for example, Wehrle said the country’s single-payer plan has resulted in longer waits for treatment and lower pay for doctors. “We think higher quality at lower cost is achieved when you have competition in the private sector,” he said.

Perhaps, but a poll this week by Research America, a Virginia nonprofit organization focusing on medical issues, found that nearly two-thirds of respondents believe most Americans are not getting the health care they need.
And a study last month by the Kaiser Family Foundation revealed that 63
percent of adults believe that lowering the cost of health care and insurance should be a top priority for political leaders.

Kuehl said her bill stands a good chance of passage in the state Senate. The Assembly might be rougher sledding as the legislation’s tax components are scrutinized by various committees. As for what California’s unabashedly pro-business governor might do when presented with a single-payer bill to sign, that’s a whole other matter.

“We have to show him the data on who would save money here,” Kuehl said.
“Eight billion in savings is a lot.” It is. And with the stakes this high, an open mind on everyone’s part isn’t too much to ask for.

David Lazarus’ column appears Wednesdays, Fridays and Sundays. He also can be seen regularly on KTVU’s “Mornings on 2.” Send tips or feedback to
dlazarus@sfchronicle.com.

General Motors CEO’s position on health care reform

The Wall Street Journal
February 9, 2005
Health-Care Overhaul: GM CEO Weighs In
By Alan Murray

http://online.wsj.com/public/article/0,,SB110790726260549399,00.html?mod=todays%5Ffree%5Ffeature

Health costs absorb one-quarter of economic growth

Boston University School of Public Health
Health Reform Program
February 9, 2005
Health Costs Absorb One-Quarter of Economic Growth, 2000 – 2005
By Alan Sager, Ph.D. and Deborah Socolar, M.P.H.

From the Summary:
The expected $621 billion rise in U.S. health care spending from 2000 to 2005, we find, will consume nearly one-quarter of the nation’s projected economic growth (rise in GDP) of $2,579 billion ($2.6 trillion).

Had health spending in those five years grown only as fast as GDP, the U.S. would have saved $280 billion in 2005 (one-seventh of expected health cost), and $1 trillion in five years. Health spending growth averaged 8.1 percent yearly-more than two-thirds (69 percent) over GDP’s 4.8 percent.

Traditional competitive and regulatory cost controls have failed in health care. The administration urges a new strategy, cost shifting, which it touts as empowering consumers.” By promoting underinsurance, this strategy pushes
patients to deny themselves care. There is no evidence that this is clinically safe or durably contains costs. Patients are the wrong target for cost controls.

The alternative is to engage physicians in marshaling inevitably finite dollars to care for all Americans. Doctors are key to cutting cost because their decisions control 87 percent of personal health spending.

One-half of health spending goes to clinical and administrative waste, excess prices, and theft. Physicians can identify clinical waste. Careful cost controls should rest on physicians’ decisions about services needed by each patient. Pathology is remorseless but resources are finite, so trade-offs are essential. There are no blank checks. Trustworthy methods of paying doctors should minimize incentives to over- or under-serve. Variations on this approach have been called “bedside rationing” or “professionalism within a budget.”

From the report:

When single payer reformers and others design and test payment methods that
doctors understand and accept-and when a political deal between doctors and
payers is successfully negotiated-doctors will urge their patients to vote for reform.

This process of designing and testing of payment methods and related arrangements-seeking trustworthy ways to channel inevitably limited resources to meet a defined population’s health care needs-is a vital stage of reforming health care. To win physicians’ and the public’s confidence, much of that testing will probably have to come before passage of national legislation, rather than after. Indeed, actually enacting single payer legislation may well be one of the later steps in the process of health care reform, not one of the first.

For the links to the press release and the full report:
http://www.bu.edu/dbin/sph/departments/health_services/health_reform.php

The full report:
http://dcc2.bumc.bu.edu/hs/Health%20Costs%20Absorb%20One-Quarter%20of%20Economic%20Growth%20%202000-05%20%20Sager-Socolar%207%20February%202005.pdf

Comment: The report is a melding of highly credible data with “out loud thinking” on the part of the authors. The excerpts listed cover only a few of the concepts discussed in this report. But one of the more important targets for policy discussion is the control that physicians have over health care spending. Policies that improve the physician decision process obviously would be very beneficial.

Because of my own “out loud thinking,” I pulled out from the report the recommendation to design and test newer and better concepts to improve
health care spending and utilization before embarking on the enactment of the single payer model. I would suggest instead that we move forward as fast as possible with single payer reform, but include in the program the flexibility to evaluate and adopt improvements in the physician decision process. There certainly are significant political barriers to reform, but we need to move forward with actions designed to break down those barriers. Strong grassroots advocacy of the most equitable and effective model of reform should move us closer to a just health care system, sooner rather than later.

This informative and appropriately provocative report is well worth downloading.

Democrats need new agenda – including single payer

Published on Thursday, February 10, 2005 by CommonDreams.org
Progressives and Democrats: Assert Your Brand!
by Thom Hartmann

Politics is all about branding. And brands are not about issues or details – they’re about identity.

When progressives and Democrats think of how Bush voters understand the word “Republican,” they assume these folks are thinking “pro-life”; “moral values”; privatization and deregulation; “free trade”; lower taxes; and stripping power from what Republicans call “special interests,” like labor unions and groups advocating rights for women, gays, and other minorities.

But that’s not the picture average Americans think of when they hear the words “Republican” or “conservative.”

Instead, like any good brand, the words “Republican” and “conservative” evoke feelings as much as pictures. The main feeling is one of identity: “My tribe.” The main picture is the brand’s logo – the American flag. At a deeper level, they carry pictures, stories, and feelings of NASCAR, Budweiser, the American flag, “standing tough” and “standing tall” in the world, and pulling yourself up by your bootstraps

Not only are most Republican voters largely unaware of the details of the issues facing our nation, studies show that most are badly misinformed. In some part this is the fault of the media, but the larger reason is that when a person has bonded to a brand, it becomes part of their identity. They then develop a psychologically sophisticated and largely unconscious internal system to filter out and reject contradictory information.

Progressives, liberals, and Democrats have failed to apply this simple reality, and therefore have allowed conservatives to define our brands for us. The very sophisticated effort to do this has been led by Gingrich, Luntz, and Limbaugh, three men who understand the psychology of branding, and have used it to sell the Republican party and the word “conservative” to Americans with all the zeal – and all the cash – used by other famous brands like Coke, Levi’s, and Wal-Mart.

This is not rocket science, and it’s not a secret. There’s an entire industry devoted to teaching these concepts (in which I worked for two decades). So why haven’t progressives and Democrats figured this out?

We’re still letting cons define our brand for us, and they’re still doing it aggressively. In the month of February, 2005, timed to coincide with the Academy Awards, a con group has rented prominent billboards in Hollywood that will show a smiling picture of George W. Bush with the slogan: “Thank you, Hollywood!”. In a row under the prominent and smiling Bush are less flattering photos of Michael Moore, Whoopi Goldberg, Ben Afleck, and other outspoken liberals.

There are no Democratic billboards showing the biggest supporters of the Republican Party – corporate fat-cats like Ken Lay, with private jets and limousines, living in baronial mansions.

In classic marketing theory, there are two foundational concepts. Features (“what is it?”) without benefits (“why should I care?”) lack relevance. And, benefits without features lack credibility.

Once these are mastered, you “chunk up” (to use NLP terminology) to branding: “Features and benefits without identification (“Who am I when I use this product?”) lack “stickiness” or persistence.

Progressives and Democrats are still working on features – the details of programs.

Most progressives know all the features they’re interested in: Universal single payer health care, a viable social safety net, prison and sentencing reform, a livable wage, support for unions and the repeal of Taft-Hartley and its heirs, voting (and voting machine) reforms, revoking corporate personhood and getting corporate money out of politics, moral leadership in the world, and working for a reduction of crime and poverty at home and towards stable, lasting worldwide peace (to name a few).

But there’s no “benefit statement” in lists like these. Sure, some people think they’re obvious, but the cons know – as does any good marketer – that you have to lead with the benefit, and only then do you follow with the features. Sell “lower taxes” to everybody before rolling out tax cuts for the wealthy. Sell “personal accounts” for Social Security before rolling out benefit cuts for future generations. Sell “protect your children” before rolling out homophobia and theocracy.

And, even worse, the left hasn’t yet defined its brand.

What is our logo? Bill Moyers briefly talked about wearing a flag on his lapel, trying to re-brand the flag as the logo of the liberals, but because there was no national effort behind it, it died.

What is our identity? The cons have succeeded in making much of America think that to be liberal is to either be a wealthy actor or a scruffy gadfly. While many people wouldn’t mind being either, few identify themselves in such terms.

The largest lights of the Democratic Party – it’s founder, Thomas Jefferson, and it’s two most famous recent presidents, FDR and LBJ – knew their brand and their identity, and brought the majority of Americans along with them. The largest landslide Democratic election victories of the 20th century were FDR’s after he introduced the New Deal, and LBJ’s after he introduced the Great Society. Their logo was the flag, and their identity was average working people, and those who aspire to the economic and educational middle class.

Jefferson not only defined the identity of the Democratic Party that he founded – the longest-lasting political party in world history – but defined the identity of America as well. He defined us in positive terms (what we’re for) in the Declaration of Independence, as well as in contrasting terms (what we’re against like the “ban on monopolies in commerce” he tried to write into the Bill of Rights).

For example, in a February 8, 1786 letter to James Madison, Jefferson made clear his thoughts on what he considered a great international immorality-national belligerence that leads to a war of choice.

“And it should ever be held in mind,” Jefferson wrote, “that insult and war are the consequences of a want of respectability in the national character.”

Later, Madison – also a member of Jefferson’s Democratic Republican Party (which dropped the “Republican” from its name in the 1830s, although the www.whitehouse.gov website now lists Jefferson, Madison, Monroe, and John Quincy Adams – the first four Democratic presidents – as “Republicans”) would write, “No nation could preserve its freedom in the midst of continual warfare.”

FDR brought us back to Jefferson’s ideals with his third inaugural address, sometimes called his “Four Freedoms speech,” on January 6, 1941, when he said:

“The basic things expected by our people of their political and economic systems are simple. They are :

“Equality of opportunity for youth and for others.

“Jobs for those who can work.

“Security for those who need it.

“The ending of special privilege for the few.

“The preservation of civil liberties for all.

“The enjoyment of the fruits of scientific progress in a wider and constantly rising standard of living.

“These are the simple, the basic things that must never be lost sight of in the turmoil and unbelievable complexity of our modern world. The inner and abiding strength of our economic and political systems is dependent upon the degree to which they fulfill these expectations.”

In that, FDR created a brand, a packaging concept, a place for people to anchor their identity. It’s name was the New Deal, but it was far more inclusive than just that.

Twenty-three years later, in his first State of the Union speech after the death of JFK, Lyndon B. Johnson said:

“This administration today, here and now, declares unconditional war on poverty in America. …

“These programs are obviously not for the poor or the underprivileged alone. Every American will benefit by the extension of social security to cover the hospital costs of their aged parents. Every American community will benefit from the construction or modernization of schools, libraries, hospitals, and nursing homes, from the training of more nurses and from the improvement of urban renewal in public transit.”

In declaring his Great Society program and starting the Medicare program, LBJ cut poverty in America in half. And he, too, created a brand. (Had he not gotten caught up in Vietnam, he may now be remembered as one of our greatest presidents, as the impact of his social programs on America were tremendous.)

And, like Jefferson, both FDR and LBJ were overwhelmingly re-elected by the American people after declaring sweeping social programs that benefited average working people and those who aspired to the middle class.

The brand – the identity – of progressive ideals doesn’t need to be reinvented. It’s been with us since the founding of this nation. It long predates the Republican’s Faustian deal with the Robber Barons and war profiteers. And when the Democratic Party has been strongest, it’s been because Democrats have asserted a clear brand that stood in opposition to Republicans and their fat-cat owners. We are the – truly – We the People.

If the Democratic Party is to survive, it must embrace the progressive concepts that led to its founding in the late 1700s. It must tell average Americans what’s in it for them, and once again give Americans a “brand” with which they can identify. It must stop playing defense, letting the Republicans define the agenda of public debate, and instead reinvigorate traditional progressive rhetoric, legislation, and identity.

Democrats must reassert their brand, and establish their identity. To do this, the Party must say, loudly: “We’re for the average working stiff in America, and we’ll prove it by bringing jobs back from overseas by pulling out of the WTO and NAFTA, supporting organized labor, strengthening the social safety net, and keeping government from being a honey pot for either churches or corporations.” And then they must come up with a simple name for it, like Newt’s “Contract” or Roosevelt’s “New Deal” or LBJ’s “Great Society” to provide voters with a hook for identification.

They must further back this up by working with Greens and progressives for Instant Runoff Voting (IRV), the end of Republican-affiliated corporations programming our voting machines, and advocate social, economic, and environmental reforms – and bringing them into the Party.

Only then will the Party of Jefferson, Roosevelt, and Johnson again be able to advance social justice at home and peace around the world.

Thom Hartmann (thom at thomhartmann.com) is a Project Censored Award-winning best-selling author and host of a nationally syndicated daily progressive talk show. www.thomhartmann.com His most recent books are “The Last Hours of Ancient Sunlight,” “Unequal Protection,” “We The People,” “The Edison Gene”, and “What Would Jefferson Do?.”

System's ills cost us

By Mike Sweet

Ask anyone to describe someone who files for personal bankruptcy and the description most likely fits an uncomplimentary stereotype.

It’s someone who’s maxed out their credit cards buying things they didn’t need (even though their president said it was patriotic and would rescue the economy).

It would include those who took out a second mortgage on their house to consolidate bills or redecorate, or even a third mortgage to buy a summer home that they couldn’t live without because no one can own too much stuff in an ownership society.

It also can include people with all the above over-commitments, who in addition face those numbing SUV and gasoline payments and paying heating bills that literally go up in smoke, thanks to the Enrons of this world.

Generally, the bankruptcy filer is defined and denigrated as a lowlife who knowingly lived beyond their means and then tries to get out of paying their creditors, who bear neither burden nor guilt for encouraging them to overextend. The only pity permitted is for those unfortunates whose financial crisis is due to losing their job. And then it’s slim pity.

A new Harvard University study done by its law and medical schools has identified a major cause of bankruptcy -that has not been considered previously – medical costs.

Using 2001 data involving 1,771 bankruptcy cases, researchers found that illness and medical bills were the key factor in 54 percent of those bankruptcies.

Further eviscerating the everyone’s-a-deadbeat theory, the study found that most filers were middle class. They were buying homes and had college degrees and good jobs. Three of four had health insurance when they or their family member first got sick.

But as the coverage maxed out, or the insurers dropped them, or they lost their insurance along with their jobs and the ability to pay the premiums, the medical bills piled up beyond their ability to pay.

Steffie Woolhandler, the report’s co-author, concluded “Unless you’re rich, we found you’re one serious illness away from financial ruin.”

Many millions of Americans already knew that. They can do the math for income versus outgo. But they soldier on, making their daily commutes and praying that they don’t get sick or get their job cut in one of those mergers that delight Wall Street.

After a century of progress in which government and law made life better for people, we are headed back into that pre-20th century Darwinian netherworld of dog-eat-dog where we must all walk alone and die in silence, without protestation.

Big business rules. People are just worker bees to be used up. Government is there only to help the rich.

There are skeptics who reject the Harvard conclusion as political. Woolhandler and others invite flak because they belong to the National Health Program, whose members believe that “the only solution to solving the United States’ many health care problems is a single-payer system,” an idea many doctors agree with.

Woolhandler: “Every other developed nation in the world has a single-payer health-care system. There is no reason we can’t make it work in this country.”

Actually there is. It is the view of powerful conservatives like George W.Bush that such a system is socialism, which it would not have to be to work.

The only welfare conservatives countenance is for defense contractors, and for politicians, of course. After all, those taxpayer-paid salaries, generous pensions and health care are not earned in the Darwinian corporate world they insist everyone else must compete in.

Their benefits are provided by the painful contributions of a society that not only does not get equal benefits, but also endures hypocritical lectures about how they must fend for themselves.

And who are told if they go bankrupt or die for lack of health insurance, then so be it.

Announcement from Missourians For Single Payer

Missourians For Single Payer (MoSP)
Presents

“WE WON’T BE FOOLED AGAIN”
April 1, 2, 3

April 1 – April Fools’ Day Street Theater Actions around the St. Louis Area on “The Absurdities of Rationing Health Care Amidst Great Abundance”.

April 2 – Citizen/Congressional Hearings on “Solutions to the National Health Care Crisis”, with focus on single payer as a both equitable and affordable solution.

The first of several nationwide citizen/congressional hearings on solutions to the national health care crisis will be hosted by MOSP in conjunction with the Campaign for a National Health Program NOW (cnhpNOW) and the Congressional
Universal Health Care Task Force. U.S. Representative John Conyers, (D-MI),
chairs the 46-member committee and will encourage members to attend. Citizens
will testify regarding their problems with health care access, the quality of health care, and its affordability. 9:30 AM-1 PM, THE HEIGHTS, 8001 Dale Avenue, Richmond Heights, MO 63117.

April 3 – Platform Address on Health Care Ethics by Ohio Congressman Dennis
Kucinich, former U.S. presidential candidate, our nation’s leading proponent
for universal single payer health care. Program: 11 AM-12 PM, Reception: 12PM-1 PM, Ethical Society of St. Louis, 9001 Clayton Road, St. Louis, MO 63117. Public Reception to follow.

Only one Congressman has been a longtime, outspoken and eloquent supporter
for single-payer health care: U.S. Representative Dennis Kucinich of Ohio and
presidential candidate during the last election.

We’re proud that he’s agreed to give the main speech on Sunday, April 3, the
finale of our Health Care Weekend. His talk will be about 30 minutes on health
care ethics, followed by a 15-minute Q & A period, and a public reception, all at the Ethical Society of St. Louis.

Many of you know what makes Dennis Kucinich “a progressive’s progressive.” One of seven children born to working class parents in Cleveland, he scrubbed
floors as a boy to help pay his way through Catholic schools. He paid his way
through Case Western University by working as a proofreader at two Cleveland
daily newspapers, and as a surgical technician at a city hospital. He was elected
to Cleveland’s City Council at age 23, held various city posts and his strong labor- and blue collar- support made him mayor of Cleveland at age 31, the youngest ever to become mayor of a major city.

His refusal to privatize Cleveland’s municipal power system brought the wrath
of banks and corporate leaders, who forced the city into bankruptcy by calling in a few million dollars in bank loans. That cost him reelection as mayor and no company would give him a job. He ended up as a radio talk show host, TV
reporter and then started his own media consulting firm. He returned to elected
office as a State Senator in 1994, then as U.S. Representee from Cleveland in
1996.

As a presidential candidate, he joined union picket lines, attended antiwar rallies and advocated canceling trade pacts such as NAFTA. In Congress, he voted against the war, against Bush’s $87 billion war budget and the Patriot Act. He continues as one of the chief critics of Bush’s foreign policies and goals of privatization of Medicare and Social Security.

This is the third year MoSP has sponsored a health care weekend of educational programs to highlight single payer and to generate support for our cause. We are especially proud of this year’s program. As you have seen it is a very ambitious program schedule. We are grateful for Congressman Kuchinich’s participation. I know that you are proud of your officers and board for securing this very important program. This is the time for MoSP to shine! In order to have the very best success we need your help in many ways. This is your chance to “walk the walk.” Show your support!

MOSP asks for your support in any or all of the following ways:

1. Volunteer to help with the programs. We need many willing hands to complete these projects. Contact Julia or Roger Signor.

2. Attend our free programs. Do attendance building — bring friends.

3. Promote these events to all your friends, coworkers, organizations, church, etc. …. via emails, mailings, or newsletter. We have a video and printed materials for your use.

4. Recruit members to testify at the health care hearings. More about this later.

5. Make a donation to be a cosponsor of the Health Care Weekend Program. Your
name will be listed as a cosponsor on the program literature. As you can imagine, this program will be a costly affair. We believe that we can support it.
MoSP operates on small yearly membership dues and special donations. This
is the time for special donations. Members of MoSP spend many hours and donate freely of their resources to help present our message. If you believe in what we are doing please show your support by donating towards this programming.

Make checks to: MoSP and mail to MoSP at 438 N. Skinker, St. Louis, MO 63130.

Sick and Broke

By Elizabeth Warren
Wednesday, February 9, 2005

Nobody’s safe. That’s the warning from the first large-scale study of medical bankruptcy.

Health insurance? That didn’t protect 1 million Americans who were financially ruined by illness or medical bills last year.

A comfortable middle-class lifestyle? Good education? Decent job? No safeguards there. Most of the medically bankrupt were middle-class homeowners who had been to college and had responsible jobs — until illness struck.

As part of a research study at Harvard University, our researchers interviewed 1,771 Americans in bankruptcy courts across the country. To our surprise, half said that illness or medical bills drove them to bankruptcy. So each year, 2 million Americans — those who file and their dependents — face the double disaster of illness and bankruptcy.

But the bigger surprise was that three-quarters of the medically bankrupt had health insurance.

How did illness bankrupt middle-class Americans with health insurance? For some, high co-payments, deductibles, exclusions from coverage and other loopholes left them holding the bag for thousands of dollars in out-of-pocket costs when serious illness struck. But even families with Cadillac coverage were often bankrupted by medical problems.

Too sick to work, they suddenly lost their jobs. With the jobs went most of their income and their health insurance — a quarter of all employers cancel coverage the day you leave work because of a disabling illness; another quarter do so in less than a year. Many of the medically bankrupt qualified for some disability payments (eventually), and had the right under the COBRA law to continue their health coverage — if they paid for it themselves. But how many families can afford a $1,000 monthly premium for coverage under COBRA, especially after the breadwinner has lost his or her job?

Often, the medical bills arrived just as the insurance and the paycheck disappeared.

Bankrupt families lost more than just assets. One out of five went without food. A third had their utilities shut off, and nearly two-thirds skipped needed doctor or dentist visits. These families struggled to stay out of bankruptcy. They arrived at the bankruptcy courthouse exhausted and emotionally spent, brought low by a health care system that could offer physical cures but that left them financially devastated.

Many in Congress have a response to the problem of the growing number of medical bankruptcies: make it harder for families to file bankruptcy regardless of the reason for their financial troubles. Bankruptcy legislation — widely known as the credit industry wish list — has been introduced yet again to increase costs and decrease protection for every family that turns to the bankruptcy system for help. With the dramatic rise in medical bankruptcies now documented, this tired approach would be no different than a congressional demand to close hospitals in response to a flu epidemic. Making bankruptcy harder puts the fallout from a broken health care system back on families, leaving them with no escape.

The problem is not in the bankruptcy laws. The problem is in the health care finance system and in chronic debates about reforming it. The Harvard study shows:

• Health insurance isn’t an on-off switch, giving full protection to everyone who has it. There is real coverage and there is faux coverage. Policies that can be canceled when you need them most are often useless. So is bare-bones coverage like the Utah Medicaid program pioneered by new Health and Human Services Secretary Mike Leavitt; it pays for primary care visits but not specialists or hospital care. We need to talk about quality, durable coverage, not just about how to get more names listed on nearly-useless insurance policies.

• The link between jobs and health insurance is strained beyond the breaking point. A harsh fact of life in America is that illness leads to job loss, and that can mean a double kick when people lose their insurance. Promising them high-priced coverage through COBRA is meaningless if they can’t afford to pay. Comprehensive health insurance is the only real solution, not just for the poor but for middle-class Americans as well.

Without better coverage, millions more Americans will be hit by medical bankruptcy over the next decade. It will not be limited to the poorly educated, the barely employed or the uninsured. The people financially devastated by a serious illness are at the heart of the middle class.

Every 30 seconds in the United States, someone files for bankruptcy in the aftermath of a serious health problem. Time is running out. A broken health care system is bankrupting families across this country.

The writer is a law professor at Harvard University.

System’s ills cost us