Read the bill

I just got a "Health Care Reform Alert" from my senator John Cornyn (see picture below of the Hon. Mr. Cornyn and my sweetheart at a Pat Green concert at the Nutty Brown).

In what has become one of the Republicans' primary attacks against the health insurance reform bills, the first sentence of Cornyn's email lambasts the Senate's "2,074-page health care bill."

Who cares how many pages it is? Or how long it takes to read it. What does the number of pages have to do with the purpose of the law?

Sure, some big bills are also horrible laws. President Bush's Patriot Act, which snuffed out centuries-old civil liberties after just a few hours of congressional debate, was 348 pages long. The U.S. tax code is currently 67,204 pages long and counting.

A lot of big books are classics. Ayn Rand's "Atlas Shrugged" tips the scale at almost 1,400 pages. Heaven only knows how many pages are in the Bible. And some small texts are equally poignant. The Gettysburg Address is famously only 186 words. Depending on what you think about hunting from helicopters, Sarah Palin's "Going Rouge" is a meaty 413 pages.

In the same way, small page numbers don't necessarily correlate with good laws. The Congressional resolution authorizing the Iraq War was just six pages long, including this goodie: "Whereas Iraq both poses a continuing threat to the national security of the United States and...continu[es] to possess and develop a significant chemical and biological weapons capability, actively seek[s] a nuclear weapons capability, and support[s] and harbor[s] terrorist organizations."

The much-reviled "Troubled Asset Relief Program," also known as the Wall Street bailout bill, was comparatively light reading at just 169 pages. The "Cash for Clunkers" bill handing out $4,500 of your hard-earned tax money for P.O.S.'s like 1998 Chevy Blazers: 21 pages.

And what about reading through all these pages? Reading a bill is not like reading "The Catcher in the Rye." A lot of it is made up of endless references to and quotations from previous laws—striking out, amending, and adding new language.

I wonder when the last time Sen. Cornyn curled up by the fireplace with a good copy of the Employee Retirement Income Security Act of 1974 (the goliath legislation largely responsible for our current health insurance system that he's defending). I doubt he has. I know I haven't.

Worth a lot of money

Last night the Congressional Budget Office leaked its cost numbers for the Senate health insurance reform bill: $849 billion over ten years. Move that decimal point over to the left and that's almost $85 billion a year. Sound like a lot of money? It is. Here's what else costs a lot of money:

Social Security: $612 billion a year

Iraq War: $117 billion a year

NASA annual budget: $19 billion

Interest payments on the national debt: $249 billion a year

All national defense spending: $613 billion a year

Department of Transportation: $68 billion

Microsoft annual revenue: $58 billion

UnitedHealth Group annual revenue: $81 billion

Aetna Inc. annual income: $31 billion

Humana Inc. annual revenue: $29 billion

ExxonMobil annual revenue: $477 billion

Wal-Mart annual revenue: $406 billion

American's annual spending on tobacco products: $89 billion

Americans annual alcohol expenditures: $97 billion

American's annual spending on health care: $2,200 billion ($2.2 trillion)

My point? A lot of big, important things (roads, exploration, defense, secure retirement for senior citizens) cost a lot of money. But, of all the things we choose to pool our tax money together and buy, health care may just be the most important.

We pool our money together to make sure the elderly have some kind of retirement fund (Social Security) and free health care in their golden years (Medicare). We all pitch-in to explore outer space (NASA). Of course, we gladly contribute a hefty sum to make sure we're safe at night (defense). And we all necessarily pay a little each for freeways and air traffic control systems (Dept. of Transportation).

But, so far, the insurance industry has kept us from deciding to pool our money together to buy adequate health care for almost a quarter of our population.

To come clean, I'm perfectly happy with my current health insurance arrangement. I pay a modest co-pay when I go to the doctor's office and my premiums are a little over $2,000 a year. But that's just for me—a (relatively) young and healthy 34 year-old man. But what if you're a woman who just found out she's pregnant? Or a middle-school kid with diabetes? Or you lose your job and can barely make the mortgage payment? Then finding reasonably-priced, adequate health care coverage is impossible.

Does this mean, under a national health care plan, that we're all going to get better care for less money? Maybe not. I imagine there will be less access to care like I've enjoyed in the private system. I might have to wait a few extra minutes in the waiting room. I may have to endure government bureaucratic headaches as I navigate a new national health insurance plan. But so will everyone else—because they will have access to care. And that's worth it.

Let me get this straight

A few weeks ago a great friend of mine, who also happens to be a physician, forwarded me the following email. The subject line was "Let me get this straight."

"Let me get this straight. We're going to pass a health care plan written by a committee whose head says he doesn't understand it, passed by a Congress that hasn't read it but exempts themselves from it, signed by a president that also hasn't read it, and who smokes, with funding administered by a treasury chief who didn't pay his taxes, overseen by a surgeon general who is obese, and financed by a country that's nearly broke. What possibly could go wrong?"

To this, I simply reply:

Let me get this straight. Our health care industry is run by MBA's in suits, who pay doctors who are millionaires and hospitals owned by Wall Street shareholders a fraction of their overinflated bills, but no one knows how much they pay for their medical bills because health insurance companies send 'Explanation of Benefits' letters that read like an Enron income statement, but patients can't change health insurance companies because their employers select which insurance company they get, and the same insurance company spends most of its time tying not to pay bills because it's searching for 'pre-existing conditions,' even though it earns more profit every year and charges so much that almost a quarter of the population can't afford it, and, in the end, we all end up paying twice as much just to be half as healthy as the rest of the civilized world? What is wrong?

So far, but yet so close

The U.S. House of Representatives passed the Affordable Health Care for America Act Saturday night. That’s good news. The bad news is that the gray-hairs in the Senate are moving (full glacial speed ahead) toward passing their own version of health care reform—a watered down bill that doesn’t include a government-backed insurance plan or allows states to “opt-out” of one.

Getting the more-conservative Senate Democrats to pass a bill that will dovetail with the House’s is a long-way’s off. But, going back to Theodore Roosevelt, real health insurance coverage for every American has never been so close.

Here’s what we need to do to get there:

Email or call our U.S. Senators to tell them:

We want a strong government insurance plan included in their health care legislation. No other idea will force the health insurance industry to play fair more than this one. That’s why they’re so opposed to it. Right now, the chief executives of Blue Cross Blue Shield, United Health Care, Aetna, and Cigna are scared. They will do almost anything (maybe anything) to stop a government insurance plan from forcing their rates down. They say a so-called public option will force everyone into the arms of the federal government for insurance.

Why? They know they charge too much. They know they won’t be able to raise their insurance premiums every year just to pay fewer medical bills. They know they can’t compete with a government plan that puts patients ahead of Wall Street stockholders.

States should not be able to opt-out of the government insurance plan. Not only does this possibility raise Constitutional equal protection questions, but it prevents health insurance reform from reaching the people who need it most.

It’s no fluke that the most conservative states also have the most uninsured citizens. And these same states will be the most likely to “opt-out” of any real health insurance reform. Texas leads the nation in uninsured people (1 in 4), but is arguably the most conservative state in the country. If I know Tex. Gov. Rick Perry like I think I do, his Royal Hairness will be tripping over himself to jump in front of a microphone to be the first to opt-out.

I can hear him now: “Folks, Texans don’t need the federal government in Washington (cue slow zoom, black-and-white photo of political opponent Kay Bailey Hutchison) telling them what to do. So that’s why I’m setting a match to this stack of new health insurance policies covering every uninsured man, woman, and child in this great state of Texas. GIG ‘EM!”

If the Senate Democrats get this message, they will help make history. If they don’t (and the health insurance lobbyists roaming their chambers get their way), they won't.