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This isn't about me. I have great health insurance, and so does every Member of Congress. This debate is about the letters I read when I sit in the Oval Office every day, and the stories I hear at town hall meetings. This is about the woman in Colorado who paid $700 a month to her insurance company only to find out that they wouldn't pay a dime for her cancer treatment – who had to use up her retirement funds to save her own life. This is about the middle-class college graduate from Maryland whose health insurance expired when he changed jobs, and woke up from emergency surgery with $10,000 in debt. This is about every family, every business, and every taxpayer who continues to shoulder the burden of a problem that Washington has failed to solve for decades.

- President Barack Obama, Press Conference, July 22, 2009

Health care reform is about the health of our country – both literally and figuratively.  It's about the health of the people, and it's about fiscal health.  It's about providing for people, not the insurance or pharmaceutical industries.  And it's about care, not just insurance.  People aren't cars, which might possibly have an accident.  People get sick.  Period.  Not "might" get sick.  Will.  People need real health care, not just an insurance plan.  The President knows this.  Most of Congress knows this.  So why are some fighting so vehemently against the truth?

Can We Teach a Blue Dog New Tricks?

One of the current obstacles to health care reform is the "Blue Dog" coalition of moderate to conservative Democrats who promote fiscal conservatism and accountability.  There are eight Blue Dogs on the Energy and Commerce Committee, the remaining House Committee with jurisdiction over health care to vote on the bill before it goes to the floor of the House for a vote.  Concerns raised by seven of the eight Blue Dogs about the health care bill have caused the Committee to delay its consideration of the pending legislation.

All this resistance comes despite the fact that President Obama has pledged that health insurance reform will not add to our deficit over the next decade.  In fact, according to the President, "two-thirds of the cost of reform can be paid for by reallocating money that is simply being wasted in federal health care programs. This includes over one hundred billion dollars in unwarranted subsidies that go to insurance companies as part of Medicare – subsidies that do nothing to improve care for our seniors."  In fact, the President's budget plans on saving $176 billion by cutting these subsidies to private Medicare plans.  What makes the Blue Dogs' resistance so difficult to understand isn't just their obtuse positions, but rather their constituents.

In the 111th Congress there are 48 Congressional districts that were won by John McCain in the election but that are represented by a Democrat in the House.  Most of these districts are rural, blue collar areas.  Blue Dog Democrats represent most of them. On July 10th 2009 Gallup released their study of every Congressional district on "Health and Well Being". One of the questions asked in this survey was whether citizens had health insurance.  The median uninsured population of all Congressional districts is 14.6%.  Of the 48 Districts won by McCain, 31 (roughly two-thirds) have numbers of uninsured well above the national median.

Take for example the districts of four Blue Dogs who are on the Energy and Commerce Committee: Charlie Melancon D-LA (21.9% Uninsured), Mike Ross D-AR (21.8% Uninsured), Bart Gordon D-TN (17.3% Uninsured) and Zachary Space D-OH (16.8% Uninsured). The House and Senate proposals are meant to assist these rural poor districts by directing the Institute of Medicine to study geographic inequities in Medicare reimbursement rates, and instructing the Health and Human Services Secretary to revise payment rates based on the findings. The bill even ensures that rural doctors are paid the same rate for their work as urban doctors. Yet, health reform's biggest obstacle might just be the Blue Dog representatives of those who need, and will benefit from, reform the most.

Public Plan a Must

Private insurers comprise a major for-profit industry.  They serve their own interests and those of their stockholders before those of beneficiaries.  First and foremost, insurers are in business to make a profit, not to take care of people.  Their job is to calculate risks.  Their goal is to maximize profits, which may conflict with providing health coverage.  And they aren't going to save the country money, either – quite the contrary, in fact.  The cost of private Medicare has proven that.

Public coverage, on the other hand, saves taxpayers' money.  A recent study by the Commonwealth Fund, a non-partisan health policy research group, indicates that including a public health insurance option similar to Medicare in any proposed reform would save almost two TRILLION dollars more than any reform that does not include a public option (See our Weekly Alert of June 25, 2009).

Now another, separate, study has concluded that a public health option will save money and provide stable access to health care.  According to Commonwealth Fund President Karen Davis, "health reform can help pay for itself… A public insurance plan can help drive new efficiencies in the system that will produce large cost reductions.  Without a public plan, much of those potential savings will be lost." [1]

With a public option and a standard set of benefits across all private and public plans, everyone will be better able to access coverage they can understand, at a price taxpayers can afford. 

We get it. We need health care reform – soon. It is about our health and our quality of life.  We need a public option with the goal of providing care, rather than producing profits.  We hope our legislators can get it, too.

Express your opinion to Congress at 1-800-828-0498, and blog about it at http://cmahealthpolicy.com/.