Silence - Not A Winning Strategy

Last week I spoke to lawyers, retired judges and others at a local bar association meeting about the "Patient Protection and Affordable Care Act" (the "ACA").  As I spoke about the availability of high risk insurance coverage, the Elder Justice Act, parents' health insurance for children up to age 26,  Long-Term Care insurance, the support for young families (including college students),  and the ultimate effect that supporting and encouraging young families to have children by removing financial and health insurance barriers through  providing health insurance and other benefits, it was clear that my audience was hearing this material for the first time.  WHY?

It wasn't their fault. Congress passed and President Obama signed a comprehensive health care reform act and the only thing the public heard were a few words from the administration about its benefits and a lot of words from the right about its high costs.  The administration spent a lot of time demonizing insurers, provider groups and our existing system but failed to support champions out in the field explaining to groups of citizens why the ACA was specifically in their interests.

In visiting with my Texas family this past week, I heard that a member who has a vital interest in maternity coverage, could not find an insurer who would provide it at a reasonable affordable cost.  Thus, her entire concept of health reform is that it has resulted in escalating costs and insurance unavailability. She was right in her observation that her interest in health insurance with maternity benefits is important for her and her family and for our country.  So it's time for the Administration to address her issue and at the same time champion provisions of the ACA which are good for American businesses and individuals.

Health care is not a game of golf- 18 holes and a visit to the clubhouse for lunch and drinks.  American lives and security  are at stake. Mr. Obama, treat health care as a continuing important subject. Commit the resources to champion the benefits that each American will - at some point in his or her life -  experience in the ACA.

Otherwise, Americans will face the bleak prospect of unaffordable health care while the lobbyists celebrate victory at their clubhouses.

The End Game

In chess, beginners can start the game with a flourish, but they lose. Average players can work into the middle-game with some wins and some losses. But the champion chess player excels in the end game where inventiveness, visualization, skill and guts make the difference between winning and losing.

Health care reform is approaching the end game. The issue is whether Reid, Pelosi and Obama have the inventiveness, ability to visualize, skill and guts to win true health care reform with a federal alternative insurance program.  Are the lobbyists for pharmaceuticals, insurers and health professionals going to determine how and whether Americans get the health care they need and the nation can afford? Are there any legislators who think in terms of what is best for America and its citizens rather than their political supporters?

Will Obama, Reid and Pelosi be check-mated?

But We're Not Greedy

Imagine that President Obama is walking along Chicago's Michigan Avenue and a guy comes up and offers to sell him 75 cents worth of health care for a $1.00. Obama is irate. Look, I'm a Harvard lawyer: what kind of fool do you take me for?

The guy explains, "it's a good deal". He goes on, "I work for an insurer that spends a lot of lobbying money and we support Democratic and Republican Representatives and Senators. We do a lot of investing, financial stuff and manage a lot of money. All we want is to do business as usual. America, it's employers and citizens pay us a dollar, we give 75 cents worth of health care. But we're not greedy - we share some of the remainder with the political parties and legislators, and every one's happy".

Is this imaginary? Is everyone really happy?

Insolvency: Medicare's Hospital Trust Fund

The Trustees of the Social Security and Medicare trust funds issued their 2008 report (see summary at www.ssa.gov/OACT/TRSUM/index.html) on March 25, 2008. The report was issued under the names of Henry M. Paulson, Jr., Secretary of the Trasury and Managing Trustee, Michael O. Leavitt, Secretary of Health and Human Services and Trustee, Elaine L. Chao, Secretary of Labor and Trustee and Michael J. Astrue, Commissioner of Social Security and Trustee. Notably, the two public trustees who should have participated could not, because they were never appointed by the President, subject to Senate confirmation.

Ten years ago, I would have been significantly more trusting in the report than I am today. In the interim, our government, and particularly the Executive branch. has proved itself to be untruthful and incompetent. Rampant political bias has infected every element of decision making, personnel placement and expectations, and public communication. In short, since we have been lied to repeatedly why should we accept the truth of this report which, for the most part, comes under the signature of political appointees of that very same Executive? The integrity of the report cannot be greater than the integrity of its source.

The report ends with the statement: "This year's Trustees Reports describe large long-term financial imbalances for Social Security and Medicare, and demonstrate the need for timely and effective action. The sooner that solutions are adopted, the more varied and gradual they can be." Unfortunately, this is a political call to arms. Instead, the call should be for sophisticated bipartisan analysis and recommendations, which are isolated from political maneuvering, political contributions, and lobbyists and which will focus on the health of Social Security and Medicare as they relate to the health of our country and its people.