And now, the President of the United States: 

The White House, Washington

Good afternoon,

You are receiving this email because you signed up at WhiteHouse.gov. My staff and I plan to use these messages as a way to directly communicate about important issues and opportunities, and today I have some encouraging updates about health care reform. The Vice President and I just met with leaders from the House of Representatives and received their commitment to pass a comprehensive health care reform bill by July 31.

We also have an unprecedented commitment from health care industry leaders, many of whom opposed health reform in the past. Monday, I met with some of these health care stakeholders, and they pledged to do their part to reduce the health care spending growth rate, saving more than two trillion dollars over the next ten years — around $2,500 for each American family. Then on Tuesday, leaders from some of America’s top companies came to the White House to showcase innovative ways to reduce health care costs by improving the health of their workers.

Now the House and Senate are beginning a critical debate that will determine the health of our nation’s economy and its families. This process should be transparent and inclusive and its product must drive down costs, assure quality and affordable health care for everyone, and guarantee all of us a choice of doctors and plans.

Reforming health care should also involve you. Think of other people who may want to stay up to date on health care reform and other national issues and tell them to join us here:

http://www.whitehouse.gov/EmailUpdates

Health care reform can’t come soon enough. We spend more on health care than any country, but families continue to struggle with skyrocketing premiums and nearly 46 million are without insurance entirely. It is a priority for the American people and a pillar of the new foundation we are seeking to build for our economy.

We’ll continue to keep you posted about this and other important issues.

Thank you,

Barack Obama

P.S. If you’d like to get more in-depth information about health reform and how you can participate, be sure to visit http://www.HealthReform.gov 

County Clinics and Emergency Rooms have been carrying the burden of healthcare expenses for illegal immigrants in the state for many years. William Walker, director of Contra Costa Health Services, said the national ambivalence on immigration policy means that illegal immigrants are living here but without federal or state funding to provide essential medical services to them.

While Counties can take action to eliminate healthcare services to illegals, Emergency Rooms and hospitals cannot. They are required by law to provide care to all regardless of immigration or insured status. There is a fear amongst State health officials that this action will result in more Emergency Room visits by illegal immigrants and further inflate healthcare costs to legal citizens of the State and the insured. Others are concerned that lack of treatment will result in communicable diseases going untreated and put everyone at risk.

In light of the recent swine flu outbreak, how do you feel about treating non-citizens for communicable diseases? Should we treat them or not?

Birth control pills require a doctor’s prescription and although more powerful, the Plan B pill will not. In a country where most states will not allow teens to buy spray paint, get a tattoo or a body piercing without a parent’s permission, it is okay for them to have a powerful drug that could end a pregnancy?

What type of message are we sending to our youth? Feel free to insert whatever moral argument you want here, there are many.

From a healthcare expense perspective, have you ever pondered the financial implications for all Americans when a reckless judge applies policy changes, such as this? I suspect there will be cases of drug reactions, sexually transmitted diseases from unprotected sex and teen pregnancies. All of these outcomes bear some expense. Is the drug manufacturer going to share profits to cover these costs? Is the judge going to be responsible or the FDA?

No, the expense will play out on the backs of private insurance companies and State and Federal healthcare budgets as it has every other time the courts legislate a healthcare policy change. What that means is taxpayers and consumers of private insurance lose. Thank you Judge Korman, this is just what we need, more medical inflation.

I am referring to hospitals billing habits. Have you ever received an Emergency Room bill or surgery bill from a hospital? You know, one of those over inflated bills they send every 30 days. They ignore the fact that you are insured and immediately send duplicate copies to you and your insurance company. Better yet, there are professional services bills, facilities bills and bills just for the sake of sending them bills.

If the multiple bill thing did not confuse you, then perhaps the 1,000 percent mark up for services will. I once saw a hospital bill with a charge of $22 for a single Tylenol. Why do hospitals do that? Is it supposed to scare you into paying the bill or make you appreciate the care you received? Just tell us the real price of the supplies and services provided. Enough of the shell game already!

Ironically, once your insurance company receives the bill they have to “re-price” it down to their contracted amount for the supplies or services with that specific hospital. Seems like a lot of extra work. I will never understand why hospitals don’t just start with this step and send the bill with the contracted amount.

With re-pricing comes a whole new wave of paperwork. The insurance company sends you an EOB (Explanation of Benefits) that shows the adjusted price and their payment to the hospital. Odds are, the hospital has sent out another inflated bill as part of their 30 day billing cycle. Once the hospital actually receives the payment and records it, they have to send you an amended bill to reflect the “re-priced” items and the credit. Keep your fingers crossed that it all works out to a $0 balance; otherwise you could be receiving “balance bills” for months to come.

Doesn’t seem like a very efficient or “green” process to me. Who knows, one day we may see a line of recycled paper that was made from hospital bills. Then again maybe not, the cost would be 1,000 percent more than standard paper.

In the wake of this Heparin tainting, a congressional subcommittee questioned the commissioner of the FDA and uncovered some scary facts.

• The tainted Heparin came from China. (Not the first time the U.S. has received poor quality products from China – remember all those lead tainted toys last year?).
• 714 drug making plants in China provide prescription drugs to the U.S.

Scared yet?

• $20 Million is the estimated annual cost to inspect 15% (500) of the 3,249 foreign plants that ship drugs into the U.S.
• Roughly 10% (350) of foreign facilities will be inspected with the FDA’s $13 Million budget in 2008.

Are you scared now?

As I ponder these statistics, I am reminded of all those drug company excuses for the soaring prescription drug prices during the last ten years. You know the line, “Drugs are more expensive in the U.S. because of the FDA trials and the approval process.” My response, “What good is the FDA approval process if we don’t inspect the foreign facilities supplying us drugs?”

Perhaps drug companies should divert some of those huge profits from their advertising campaigns or their “drug pushing cheerleader” workforce or their massive political contributions to funding the FDA inspections of the foreign facilities they are using to supply us with drugs. Besides, they are the ones that moved to these foreign locations to add to their profits. 

With situations like this occurring, you may want to reconsider that next prescription.

I am seeking the opinions of you, my friends in the employee benefits arena. How does it make you feel to know that:

• McCain proposes the elimination of tax favored employer insurance?
• Clinton would like to mandate that all Americans have healthcare?
• Obama wants employers to provide coverage or contribute to a new public plan?

Any thoughts or ideas on these subjects?

• CDHPs and “High Deductible” health plans are not the same thing.
• Large or “jumbo” self insured employers have the most to gain (financially) by introducing a CDHP, but only if they entice or force a sizeable enrollment in the plan.
• A CDHP shifts costs from employer to employee by increasing deductible/out of pocket costs and making participants responsible for managing their healthcare purchases.
• When voluntarily offered, CDHPs typically attract the young and healthy.
• A CDHP all by itself does not improve the health of its participants.
• Plan design, wellness incentives, access to cost and outcome information and communication tools are “key” elements to a robust CDHP offering. 

 For small to mid-size employers:

• A CDHP with all the bells and whistles does not exist in a fully insured environment, although a few insurers have “modified” CDHP offerings with some tools.
• If your rates are “pooled” or “book rated”, there is no improved financial impact with insurance carriers for having a healthier or wiser population.

While this is not a comprehensive write up on CDHPs, I believe it answers some of the recurring questions I receive.

Do you have a spare $455,000 to pay your portion of this obligation? According to former Comptroller General of the United States, David Walker, this is the amount of money per household it will take to meet our obligations.

Why aren’t politicians talking about this or changing our course of direction to head off this impending tragedy? Why is this not the preeminent topic of political debate rather than super delegates or fanatical preachers? Is America listening? Does anyone care or are we all so consumed with the political bloodshed that we are enjoying our cruise on this “unsinkable” super structure?

Let me add some alarming perspective for you. Quoting U.S. Treasury Secretary Henry Paulson, he said, "Without change, rising costs will drive government spending to unprecedented levels, consume nearly all projected federal revenues, and threaten America’s future prosperity." Did he say what I think he just said? ALL FEDERAL REVENUES WILL BE CONSUMED BY THESE TWO PROGRAMS.

The iceberg is coming into sight. We are only 11 years away from 2019, when the Medicaid trust fund will become insolvent. With the speed at which our government operates, it may already be too late to avoid significant damage to our vessel.

What caused this iceberg to break away from the larger ice mass? Perhaps Al Gore was correct with his Global Warming theory (forget for a minute that this has been our coldest winter in 40 years).  On the other hand, “burden passing” or inaction by one President/Congress to the next has caused the collapse of the ice structure and resulted in this massive $53 trillion dollar iceberg.  Forget for a minute all your other political beefs and ask your President, your Congress, yourself – “what are you doing to melt this iceberg?”  

Sicko attempts to highlight selected individuals and their healthcare troubles as the “status quo” for the American for-profit insurance industry. Its main message is that government-run health care is a better model than the present US health-care system. It exclusively portrays the present system as being corrupt and putting the almighty dollar ahead of care delivered to patients.

The movie starts by retelling the stories of people who submitted their “Health Care Horror Stories” to Moore as solicited via his blog. You can only imagine the type of stories that were shared. Some were simple in nature while others were tragic, all intended to scare you into believing that your insurance carrier would rather you die than pay your claim.

Ironically, the details of the stories come exclusively from the patients or family members that are claiming impropriety. There was not one Doctor, nurse, employer or insurance company representative interviewed pertaining to these cases. Nor were there any details pertaining to the type of insurance coverage provided.

Having been involved in the insurance business for many years, I recognize that mistakes can and sometimes are made. That does not make them any less tragic or horrific for those making the mistake. The insinuation that bonuses are paid and promotions given every time a service or claim is denied is completely ridiculous.

Similar to auto or homeowners insurance, there may be exclusions to your health insurance policy. If you incur a charge that qualifies, it is paid. All four of my children were born while I was insured through an HMO. I never paid more than a small co-payment for my wife’s pre-natal care or the delivery of our children. With our fourth child, my wife was hospitalized for 7 weeks due to complications. Again, we paid our co-payment without further obligation. Legitimate examples such as this were noticeably absent from the film.

Why wouldn’t they be absent? Mr.. Moore with his deceptive film making practices want you to believe that doom and gloom persist in our healthcare system. He wants you to believe that the system is corrupt and that maintaining socialized Fire, Police and Postal services qualifies the government for taking on healthcare. He wants you to believe that patients in Canada, France and the UK receive “free” healthcare through their socialized medical systems. (Nothing is free -I’ll save that for my next blog entry). He wants you to join him in becoming a Socialist.

The Los Angeles Times reported on May 31, 2007 that Mexican consulates have been advising illegals of how to obtain medical care without the fear of deportation. The program called Ventanillas de Salud or Health Windows, screens illegals for high cholesterol, blood pressure and offers other preventative tests. Based on the outcome of the tests, referrals are given to clinics or other government run medical facilities where care can be obtained for free and without the fear of being reported to U.S. authorities.

This program is currently operating in 11 major U.S. cities with a goal of having this type of program available in all 47 consulates around the country.

What is the cost and who pays for this type of service? According to the California Department of Health Services, over $1.1 billion was spent on illegals through the Medi-Cal program in 2006. This does not take into consideration all of the hospital or emergency room charges that discounted or forgiven every year. It is obvious that law abiding, tax paying citizens are footing the bill for these programs.

One example outlined in the Times article was the case of Maria Cortez. As an undocumented housecleaner she had no insurance coverage but sought care in an ER from a stomach ailment. She was diagnosed with an ulcer and received a $1200 bill which she could not pay. Explaining her plight, the hospital forgave all but $80 of the charges.

Ira Mehlman, spokesman for the Federation for American Immigration Reform stated, “The (Los Angeles) county is broke, they are cutting back on services, they are closing emergency rooms, yet they are dreaming up new ways to provide benefits to illegal aliens.” “It’s lunacy.”

I wonder if Michael Moore will address these types of situations in his upcoming documentary, “SiCKO”. This film is intended to explore the American healthcare system in an unconventional way.

For all politicians reading this blog – Please present a real solution to our healthcare and immigration troubles. If other states are facing similar expenses at the hands of the illegal population, it appears that building a wall and enforcing the border would be a cheaper alternative than providing healthcare to the 16 – 20 million illegals already here.