Abandoning Children
    Regulations and rules are now a top priority. Insurance companies are already disputing that they are required to provide coverage for all children. The law was written to prohibit insurers from discriminating against any child on account of a pre-existing condition. But insurers are already contending that they do not have to offer coverage at all until 2014 when the law requires them to cover everyone. i will push the Administration to issue regulations serially instead of attempting to complete a package to cover the entire law. The first set of regulations must address coverage for children. Insurers are saying they will challenge the regulations in court. I have been litigating coverage issues against big insurance for over a decade. I will accept that challenge at the same time I will be working stronger language in the law to make sure they cannot turn it into a loophole.

    The political opposition to the HCRA is about VOTES. For decades, America's retirees associated their monthly social security checks with FDR's administration. It was an enviable legacy that sustained Democratic Party control for two decades. The over 30 million who are today uninsured will remember the Obama administration when they have to go to the hospital or they are diagnosed with a chronic or catastrophic disease. When you hear a politician railing against health care reform, think "VOTES."

    On November 19, 1945, President Truman sent a special message to Congress outlining a comprehensive, prepaid medical insurance plan for all people through the Social Security system, with medical insurance benefits for needy people financed from Federal revenues. The proposal was called "National Health Insurance." Truman's proposal was stymied for two decades by opponents who called it "socialism." Truman was the first American to enroll in Medicare after Lyndon Johnson signed it into law on July 30, 1965.

    IMAGINE LIFE WITHOUT MEDICARE: History does not support the arguments of politicians, such as Charles Djou, that free competition among health insurance companies will reduce the number or uninsured. When President Johnson signed Medicare into law, 44 percent of those 65 years of age or older had no health insurance because unbridled competition between commercial insurers had done away with the community rating system that kept premiums down for higher risk patients such as the elderly. That means that if Medicare opponents Ronald Reagan, George H. W. Bush, Barry Goldwater, and Robert Dole had had their way, chances are you would be paying for your parents' medical care out of pocket.

    As of 2008, Medicare Advantage plans cost, on average, 13 percent more per person insured than direct payment plans. No one reasonably disputes that private insurance companies made a killing with Medicare Advantage plans. So why would the Senate refuse to cut payments to private Medicare Advantage insurers, designating those federal funds for increased coverage of children's health? Heavy lobbying from the insurance industry. President Bush subsequently vetoed the expanded coverage for children.

    Don't ever believe that the insurance industry is an intelligent entity. It is more like a chaotic nursery full of hungry infants who will gorge themselves without supervision. Health insurers are gratified by one thing and one thing only: higher profits. They must be put on a diet and their incentives restricted to force them to excel at solving the big problems facing our health care system: better prevention, driving down the cost of expensive procedures such as transplants and MRIs by making them more widely and readily available, educating more doctors and nurses, and improving morale among health care workers. . . .to name a few.

    I have fought insurance companies repeatedly for approval of advanced medical technologies. The insurance industry’s resistance to these advances substantially drives up the cost of care. For example, according to Bartley P. Griffith, M.D., head of cardiac surgery at the University of Maryland Medical Center and professor of surgery at the University of Maryland School of Medicine, the minimally invasive totally endoscopic coronary artery bypass, which uses a surgical robot requires, about $8,000 more in equipment and supplies than the old "open heart" procedure. BUT Griffith’s study showed that patients who undergo the open heart surgery alternative stay an average of 12 days in the hospital (at $1,000 to $2,000/day), compared with an average of 5 days for patients who had the robotic procedure. The study also showed that 88 percent of patients who had the robotic bypass had no complications, while 34 percent of those who had open heart surgery had to be readmitted to the hospital for complications. The study also showed that cost savings are even higher when high risk patients who have lung or kidney disease or other health problems have the robotic procedure. The insurance industry's resistance to new technologies is irrational.

    Did you know that in 2008, Medicare paid $5.7 billion in salaries and benefits for medical residents in training?
It also paid $2.7 billion in subsidies to hospitals to train medical residents. Still, we have a serious doctor shortage. There are approx 17,000 medical school graduates per year in this country, and 25,000 first-year residency positions. The 8,000 left-over positions have been going primarily to foreign-born, foreign-trained doctors, but that trend is disappearing because foreign doctors are getting better working conditions at home than they would in this country, thanks to insurance companies.

    The insurance industry is intent on exporting wealth to insurance executives and investors. In 2007 through 2008, seven biggest health insurance companies paid their chief executives over $190 million, the start up cost for two new medical schools. That is money they took out of the health care system that we will never get back. Our Congress let them do that. Why? Who do you think pays for their re-election campaigns?

    BTW, $190 million could have paid the salaries of 1,000 primary care doctors, or the cost of a medical education for 2,000 medical students, or the salaries and benefits of over 500 medical residents for two years. The health care reform act includes funding to support new or expanded primary care residency programs at teaching health centers, and to establish newly accredited or expanded eligible primary care residency programs,but the seven CEOs made as much each year as the government is investing in both of these program expansions.