In Health Bill, Obama Attacks Wealth Inequality

For all the political and economic uncertainties about health reform, at least one thing seems clear: The bill that President Obama signed on Tuesday is the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.

Over most of that period, government policy and market forces have been moving in the same direction, both increasing inequality. The pretax incomes of the wealthy have soared since the late 1970s, while their tax rates have fallen more than rates for the middle class and poor.

http://www.nytimes.com/2010/03…

From Chad Livengood on Twitter:

“House Republicans have a “plan” to reform gov’t top-to-bottom but won’t disclose it until Gov. Nixon stands with them to announce it.”

Considering that the Republicans think that removing campaign donation limits increases openness in elections, who knows what they could do with reforming the Missouri State Government.

This would be courtesy if the plan can be checked out by both sides before agreeing to an announcement. But keeping a Government reform plan under wraps seems suspicious.

A report released Thursday entitled, “Lives on the Line: The Deadly Cost of Delaying Health Reform,” sheds light on the real moral issue at the heart of America’s national debate on health care: people needlessly dying because they don’t have access to preventive or primary medical care.

At a current rate of 68 deaths each and every day, the Families USA report cautions that without immediate action on health care reform, the body count will grow to a shocking 84 people a day in 2019: this is over 30,000 dead each year; a far more conservative estimate than the well-known Harvard study claiming 45,000 unnecessary deaths are happening each year.

Bottom line: not only are we facing an economic emergency in regard to our need for health care reform, but with this level of inhumanity and carnage associated with the status quo, for political actors to not face this head-on shows a certain moral depravity and unwillingness to break out of a political death spiral. As Republicans dissembled at the summit, they continued on their way down.    

What every other Western democracy has succeeded at delivering to their citizens, Big Insurance, Big Pharma and Big Money have prevented here at home. Who cares if people die, as long as the bottom line and our contractual performance clauses are sated? Unfortunatly, only in America.

But I’ll make the argument that this is simply un-American. The blessings of modernity and medical science are not solely reserved for the wealthy, nor would the 18th century enlightenment principles that birthed our nation sanctify the presence of a mighty multi-national conglomerate divvying out life or death dictates strictly based on profits and compensation.

What depths have we let our peculiar fascination with market populism drive us to?  

Even the vaunted Adam Smith, heralded as the ideological champion of “free markets” by Republicans, historians, and economists, had doubts about the moral capacity of corporate behavior; especially when incentives for “hurtfulness” were designed into the system.

Nick Robins’ book on the world’s first transnational, “The Corporation That Changed The World”, exposes a side of Adam Smith conveniently left out of most free-market ‘invisible hand’ evangel.

“In Smith’s opinion, the joint stock corporation was a deeply flawed piece of public policy. A particular danger was the impetus for hazardous speculation created by separation of ownership and management in the joint stock arrangement… As a result, ‘negligence and profusion must always prevail, more or less, in the management of the affairs of such a company’, simply becoming a vehicle for even more ..’malversion’.”

I think ‘malversion’ aptly describes the perverted and distorted form of the healing profession’s ethical mandate ‘to do no harm’, bent out of shape by moral zigzagging through corporate-profit minefield with a body count in the health insurance industry’s wake.

Another landmine exploded when we lost activist Melanie Shouse to the callous nature of an elitist for-profit health care system.

There is a thing called psychological numbing, which is a mental defense mechanism used to prevent psychological trauma. Denial.

People against health care choose to ignore these casualties on their face. Republicans offering deals that add a paltry 2 million to the health care rolls when 50 million are missing, are choosing to look the other way.

They are the priest and the Levite that pass by the beaten and robbed traveler.

As wiki says,

“A well-recognized situation of psychological numbing is that associated with killing another person. By being numb, the person refuses to recognize the implications of having killed the person, allowing their psyche, as it existed before, to continue as it was.”

We need to pass health care reform to save lives.

In the coming weeks, Congress will be transformed into a giant ER with tens of thousands of future victims lives hanging in the balance. It’s time to stop the talking points about ‘socialism’ and ‘government takeovers’ and face the fact that the unregulated private sector and free market profiteers, wallowing in monopolies and anti-trust, have enormously failed the American people.

What do we want? Health care.

When do we want it? Now.    

Weekly Address: Learning from History to Reform Wall Street

Posted by Jesse Lee on December 12, 2009 at 12:00 AM EST

The President explains that while he continues to focus on jobs, it is also profoundly important to address the problems that created this economic mess in the first place. He commends the House of Representatives for passing reforms to our financial system, including a new Consumer Financial Protection Agency, and blasts Republican Leaders and financial industry lobbyists for their joint “pep rally” to defeat it.

Let’s take a look at how members of the House from Missouri voted on the bill:

FINAL VOTE RESULTS FOR ROLL CALL 968

(Democrats in roman; Republicans in italic; Independents underlined)

     H R 4173      RECORDED VOTE      11-Dec-2009      2:28 PM

     QUESTION:  On Passage

     BILL TITLE: The Wall Street Reform and Consumer Protection Act of 2009

—- AYES    223 —

Carnahan

Clay

Cleaver

—- NOES    202 —

Akin

Blunt

Emerson

Graves

Luetkemeyer

Skelton

[emphasis added]

Okay, what’s with that?

The bill summary (as introduced}:

H.R.4173

Title: To provide for financial regulatory reform, to protect consumers and investors, to enhance Federal understanding of insurance issues, to regulate the over-the-counter derivatives markets, and for other purposes.

Sponsor: Rep Frank, Barney [MA-4] (introduced 12/2/2009)      Cosponsors (None)

Related Bills: H.RES.956, H.RES.964, H.R.3126, H.R.3818

Latest Major Action: 12/11/2009 Passed/agreed to in House. Status: On passage Passed by recorded vote: 223 – 202 (Roll no. 968).SUMMARY AS OF:

12/2/2009–Introduced.

The Wall Street Reform and Consumer Protection Act of 2009 – Financial Stability Improvement Act of 2009 – Directs the Comptroller General to audit and report to Congress on all actions taken by the Board of Governors of the Federal Reserve System (Federal Reserve Board) and the Federal Reserve Banks during the current economic crisis pursuant to specified authority granted under the Federal Reserve Act.

Establishes a Financial Services Oversight Council, consisting of the heads of specified federal financial regulatory bodies and chaired by the Secretary of the Treasury, to: (1) resolve a dispute among two or more federal financial regulatory agencies in specified circumstances; (2) subject a financial company to stricter prudential standards; and (3) require a financial holding company to undertake one or more mitigatory actions to address any grave threat its activities pose to the financial stability or economy of the United States.

Directs the Federal Reserve Board to impose stricter prudential standards on a financial holding company in certain circumstances.

Authorizes the Council to subject a financial activity or practice to stricter prudential standards for financial stability purposes.

Amends the Home Owners’ Loan Act to establish a Division of Thrift Supervision within the Office of the Comptroller of the Currency. Abolishes the Office of Thrift Supervision, and transfers its functions and personnel to the Division.

Amends the Revised Statutes of the United States to direct the Secretary to appoint up to five Deputy Comptrollers of the Currency, including a Senior Deputy Comptroller for National Banks and a Senior Deputy Comptroller for Thrift Supervision.

Amends the Federal Deposit Insurance Act (FDIA) to place the Chairman of the Federal Reserve Board on the Board of Directors of the Federal Deposit Insurance Corporation (FDIC) in lieu of the Director of the Office of Thrift Supervision.

Amends the Bank Holding Company Act of 1956 to prescribe requirements for the treatment of industrial loan companies, savings associations, special purpose holding companies, and certain other companies.

Prohibits certain conversions of troubled banks and thrifts.

Amends the FDIA to revise requirements for calculating a depository institution’s assessment.

Credit Risk Retention Act of 2009 – Amends the Securities Act of 1933 to direct the appropriate federal financial regulatory agencies to prescribe regulations to require any creditor to retain an economic interest in a material portion of the credit risk of any loan the creditor transfers, sells, or conveys to a third party, including for the purpose of including such loan in a pool of loans backing an issuance of asset-backed securities.

Dissolution Authority for Large, Interconnected Financial Companies Act of 2009 – Prescribes a procedure under which the Secretary shall appoint the FDIC as receiver for one year to resolve, liquidate, or take other specified emergency stabilization actions with respect to a financial company whose imminent or actual default would have serious adverse effects on financial stability or economic conditions in the United States.

Requires the FDIC Inspector General, if the Secretary appoints the FDIC as receiver for a financial company, to establish an Office of Resolution to audit and investigate the activities of the FDIC in its capacity as receiver for that company.

Amends the Federal Reserve Act to prescribe requirements for financial crisis management actions by the Federal Reserve Board in the event of a liquidity event that could destabilize the U.S. financial system.

Establishes a Council of Inspectors General on Financial Oversight.

Amends the International Banking Act of 1978 to authorize the Federal Reserve Board to terminate the activities of the U.S. branch, agency, or subsidiary of a foreign bank that presents a systemic risk to the United States.

Corporate and Financial Institution Compensation Fairness Act of 2009 – Amends the Securities Exchange Act of 1934 to require a separate, non-binding shareholder vote to approve the compensation, including golden parachute compensation, of corporate and financial institution executives. Requires each member of the compensation committee of the board of directors of an issuer of securities to be independent.

Over-the-Counter Derivatives Markets Act of 2009 – Amends the Commodity Exchange Act to require joint regulation of swap markets by the Commodity Futures Trading Commission (CFTC) and the Securities and Exchange Commission (SEC).

Requires swap repositories, swap dealers, major swap participants, and swap execution facilities to register with the CFTC.

Repeals the exemption from CFTC regulation of derivatives transaction execution facilities and boards of trade.

Revises requirements for foreign boards of trade.

Authorizes the CFTC and the SEC to ban: (1) abusive swaps; and (2) access to the U.S. financial system of any entity domiciled in a foreign country whose regulation of swaps or security-based swaps markets in that country undermines the stability of the U.S. financial system.

Amends the Securities Exchange Act of 1934 to repeal the prohibition on regulation of security-based swaps and applies specified requirements to such swaps.

Consumer Financial Protection Agency Act of 2009 – Establishes the Co
nsumer Financial Protection Agency (CFPA) as an independent agency to regulate the provision of consumer financial products or services.

Prescribes related requirements for examination and enforcement for small insured depository institutions (with total assets of $10 billion or less) by the FDIC and credit unions (with total assets of $1.5 billion or less) by the National Credit Union Administration (NCUA).

Directs the CFPA to develop risk-based programs to supervise nondepository covered persons.

Authorizes the CFPA to take actions to prohibit unfair, deceptive, or abusive acts or practices in connection with any transaction with a consumer for, or any offering of, a consumer financial product or service.

Specifies prohibited acts.

Requires the CFPA Director to lead a Negotiated Rulemaking Committee to promulgate appraisal independence requirements for residential loan purposes.

Specifies the preservation of the civil enforcement powers of state attorneys general.

Prescribes standards for federal preemption of state law regarding national banks and subsidiaries and federal savings associations.

Specifies CFPA enforcement powers.

Transfers to the CFPA the consumer financial protection functions of the Federal Reserve Board, the Comptroller of the Currency, the Office of Thrift Supervision, the FDIC, the Federal Trade Commission, the NCUA, and the Secretary of Housing and Urban Development (HUD).

Prescribes requirements for the collection and use by the CFPA of deposit account and small business data.

Requires the CFPA Director to conduct an annual financial autopsy regarding bankruptcies and foreclosures, including any specific financial products or services that have caused substantial numbers of them.

Private Fund Investment Advisers Registration Act of 2009 – Amends the Investment Advisers Act of 1940 to require private fund investment advisers to register with the SEC and maintain records and make reports on systemic risk data. Exempts venture capital fund advisers from the registration requirements. Directs the SEC to exempt from registration requirements any investment adviser of a private fund with assets under management in the United States of less than $150 million.

Accountability and Transparency in Rating Agencies Act of 2009 – Amends the Securities Exchange Act of 1934 to revise requirements for regulation of nationally recognized statistical rating organizations (NRSROs). Requires the SEC to examine NRSRO credit ratings to review whether an NRSRO has established a system of internal controls and adhered to it.

Directs the SEC to: (1) establish an office to administer SEC rules with respect to NRSRO practices; and (2) eliminate the exemption of NRSROs from the Fair Disclosure Rule.

Directs the SEC to establish a Credit Ratings Agency Advisory Board.

Investor Protection Act of 2009 – Amends the Securities Exchange Act of 1934 to establish an Investor Advisory Committee to the SEC. Authorizes the SEC to engage in consumer testing.

Amends the Securities Exchange Act of 1934 and the Investment Advisers Act of 1940 to direct the SEC to promulgate rules to prescribe a fiduciary standard of conduct for a broker or dealer when providing personalized investment advice about securities to a retail customer.

Authorizes the SEC to prohibit or limit agreements that require customers or clients of any broker, dealer, or municipal securities dealer to engage in pre-dispute arbitration.

Establishes within the SEC a Capital Markets Safety Board.

Directs the SEC to report to specified congressional committees on the implementation of SEC reforms in the wake of the discovery of fraud by Bernie Madoff.

Authorizes the SEC and the CFTC to form and operate a joint advisory committee.

Prescribes or revises prohibitions and requirements relating to: (1) securities lending; (2) lost and stolen securities; and (3) fingerprinting of personnel of registered securities information processors, national securities exchanges, and national securities associations.

Declares that any condition, stipulation, or provision binding any person to waive compliance with any rule of a self-regulatory organization shall be void.

Directs the Comptroller General to study and report to Congress on the SEC revolving door.

Establishes a Financial Reporting Forum to discuss immediate and long-term issues critical to financial reporting.

Directs the SEC Chairman to appoint an SEC Ombudsman.

Amends the Securities Investor Protection Act of 1970 with respect to, among other specified items, an increased: (1) assessment paid by Securities Investor Protection Corporation (SIPC) members; (2) borrowing limit on Treasury loans; and (3) cash limit of protection.

Amends the Sarbanes-Oxley Act of 2002 with respect to: (1) the Public Company Accounting Oversight (PCAO) Board oversight of auditors of brokers and dealers; and (2) foreign regulatory information sharing, and related matters.

Directs the PCAO Board to appoint an ombudsman.

Directs the SEC to establish a program of grants to states for enhanced protection of seniors from misleading and fraudulent marketing of financial products.

Amends the Securities Exchange Act of 1934 to require municipal financial advisers to register with the SEC.

Federal Insurance Office Act of 2009 – Establishes in the Treasury the Federal Insurance Office (FIO) to: (1) monitor the insurance industry; (2) recommend to the Financial Services Oversight Council that it designate an insurer as one subject to stricter standards; (3) assist in administering the Terrorism Insurance Program; and (4) perform other related duties.

Preempts a state insurance measure only to the extent it: (1) directly results in less favorable treatment of a non-U.S. insurer domiciled in a foreign jurisdiction that is subject to a covered agreement than a U.S. insurer domiciled, licensed, admitted, or otherwise authorized in that state; and (2) is inconsistent with such a covered agreement.

Requires the FIO Director to study and report to specified congressional committees on: (1) the global reinsurance market; and (2) how to modernize and improve the system of insurance regulation in the United States.

There’s lots of stuff in there, some of which has to do with, you know, regulating people and entities which have shown a powerful need for regulation.

The text of President Obama’s weekly radio address (as delivered):

…Over the past two years more than seven million Americans have lost their jobs. Factories and businesses across our country have been shuttered. In one way or another, we’ve all been touched by the worst economic downturn since the Great Depression.

The difficult steps we’ve taken since January have helped to break our fall and begin to get us back on our feet. The economy’s growing again. The flood of job losses we saw at the beginning of this year slowed to a relative trickle last month. These are good signs for the future, but they’re little comfort to all our neighbors who remain out of a job. And my solemn commitment is to work every day, in every way that I can, to push this recovery forward and build a new foundation for our lasting growth and prosperity.

That’s why I announced some additional steps this week to spur private sector hiring. We’ll give an added boost to small businesses across our nation through additional tax cuts and access to lending they desperately need to grow. We’ll rebuild more of our vital infrastructure and promote advanced manufacturing in clean energy to put Americans to work doing the work we need done. And I called for the extension of unemployment insurance and health benefits to help those who have lost their jobs weather these storms until we reach that brighter day.

But even as we dig our way out of this deep hole, it’s important that we address the irresponsibility and recklessness that got us into this mess in the first place.

Some of it was the result of an era of easy credit, when millions of Americans borrowed beyond their means, bought homes they couldn’t afford, and as
sumed that housing prices would always rise and the day of reckoning would never come.

But much of it was due to the irresponsibility of large financial institutions on Wall Street that gambled on risky loans and complex financial products, seeking short-term profits and big bonuses with little regard for long-term consequences. It was, as some put it, risk management without the management. And their actions, in the absence of strong oversight, intensified the cycle of bubble and bust and led to a financial crisis that threatened to bring down the entire economy. It was a disaster that could have been avoided if we’d had clearer rules of the road for Wall Street and actually enforced them.

We can’t change that history. But we have an absolute responsibility to learn from it, and take steps to prevent a repeat of the crisis from which we’re still recovering. And that’s why I’ve proposed a series of financial reforms that would target the abuses we’ve seen and leave us less exposed to the kind of breakdown we just experienced. They would bring new transparency and accountability to the financial markets, so that the kind of risky dealings that sparked the crisis would be fully disclosed and properly regulated. They would give us the tools to ensure that the failure of one large bank or financial institution won’t spread like a virus throughout the entire financial system. Because we should never again find ourselves in the position in which our only choices are bailing out banks or letting our economy collapse. And they would consolidate the consumer protection functions currently spread across half a dozen agencies and vest them in a new Consumer Financial Protection Agency. This agency would have the authority to put an end to misleading and dishonest practices by banks and institutions that market financial products like credit cards and debit cards, mortgage and auto and payday loans. These are all common sense reforms that respond to the obvious problems exposed by the financial crisis.

But, as we’ve learned so many times before common sense doesn’t always prevail in Washington. Just this week Republican leaders in the House summoned more than a hundred key lobbyists for the financial industry to a pep rally and urged them to redouble their efforts to block meaningful financial reform, not that they needed the encouragement. The industry has already spent more than three hundred million dollars on lobbying to influence the debate this year.

The special interests and their agents in Congress claim that reforms like the Consumer Financial Protection Agency will stifle consumer choice and that updated rules and oversight will frustrate innovation in the financial markets.  But Americans don’t choose to be victimized by mysterious fees, changing terms, and pages and pages of fine print. And while innovation should be encouraged, risky schemes that threaten our entire economy should not. We can’t afford to let the same phony arguments and bad habits of Washington kill financial reform and leave American consumers and our economy vulnerable to another melt down.

Yesterday the House passed comprehensive reform legislation that incorporates many of the essential changes we need and the Senate Banking Committee is working on its own package of reforms. I urge both houses to act as quickly as possible to pass real reform that restores free and fair markets in which recklessness and greed are thwarted, and hard work, responsibility, and competition are rewarded – reforms that works for businesses, investors, and consumers alike. That’s how we’ll keep our economy and our institutions strong.  hat’s how we’ll restore a sense of responsibility and accountability to both Wall Street and Washington. And that’s how we’ll safeguard everything the American people are working so hard to build – a broad-based recovery, lasting prosperity, and renewed American Dream. Thanks.

Congressman Ike Skelton’s office issued the following press release:

FOR IMMEDIATE RELEASE

Friday, December 11, 2009

[….]

Skelton Defends Home Town Banks and Their Customers

WASHINGTON, D.C. – Today, Congressman Ike Skelton (D-Mo.) submitted the following statement in the U.S. House of Representatives during debate of H.R. 4173, The Wall Street Reform and Consumer Protection Act.  Discussing his vote against the measure, Congressman Skelton stated:

“While the House bill is well-intentioned and I support much of it, the measure falls short in my goal to target Wall Street without disrupting Main Street banks and bank customers.”

On December 11, 2009, the House approved the measure by a vote of 223 to 202.  Congressman Skelton’s full remarks are set forth below:

______________________________

December 11, 2009

This week, the House has debated legislation that would put in place the most sweeping financial regulations since the Great Depression.  I feel strongly that Congress should enact tough new regulations on Wall Street.  Many big banks and financial institutions, in addition to irresponsible mortgage agents and borrowers, in this country helped cause the financial crisis last year. They did not play by the rules and operated with a “get rich quick” mentality that served their own interests but that had little regard for the interests of the American people.  Federal regulators must be given greater authority to monitor complex financial products and to ensure American taxpayers are never again on the hook for corporate misdeeds that threaten the nation’s entire economy.

But, as important as these new regulations are to our country, Congress must be careful in writing them.  We must focus tough regulations like a laser beam on Wall Street and other bad actors while not wrapping our home town banks into costly and complex sets of new rules. Community banks and credit unions have been playing by the rules for years. They are conservative with their money and did not cause last year’s economic mess. They and their customers ought not pay the price for Wall Street’s misdeeds any more than they, like all Americans, have already been asked to do.

While the House bill is well-intentioned and I support much of it, the measure falls short in my goal to target Wall Street without disrupting Main Street banks and bank customers. In particular, the Consumer Financial Protection Agency, which is created under the legislation, would create a cumbersome set of new requirements for home town banks. These new rules are not fair to community banks and their small town customers, and the legislation could have been written to exclude them.

As the House and Senate continue debating financial regulatory reform, the interests of community banks and credit unions must be given utmost attention. These financial institutions are the heart of family, small business, and farm lending in rural America and will be key to our nation’s economic recovery. Congress ought not punish them for the misdeeds of Wall Street tycoons and irresponsible mortgage lenders. I look forward to working with my Democratic and Republican colleagues to find common ground on this important legislation for America.

– 30 –

You think he’ll vote for the bill that comes out of conference? Maybe so, but I don’t think any of the Congressman’s republican colleagues will join him.

“…Just this week Republican leaders in the House summoned more than a hundred key lobbyists for the financial industry to a pep rally and urged them to redouble their efforts to block meaningful financial reform…”

Secretary of Health and Human Services Kathleen Sebelius held a conference call on health care reform for regional media early this afternoon. Part of the purpose of the conference call was to promote reports released by HHS on the status quo of health care in each of the fifty states. After her opening remarks Secretary Sebelius took questions from media in on the conference call.

Secretary of Health and Human Services Kathleen Sebelius:  Good afternoon everybody. And, um, I appreciate you joining us today. Um, as you know, here in Washington people are working hard to push forward health reform and we know that there’s some urgency about this from citizens across this country.

Um, since two thousand health insurance premiums have doubled and health care premiums are growing three times faster than wages. But unfortunately quality of care is going down as those costs continue to rise. So, even with, for people who have, uh, access to health care, uh, all it takes is a stroke of bad luck to become one of the nearly forty-six million uninsured or the millions who have health care and are having trouble affording it.

Today, uh, at the Department of Health and Human Services we’ve released fifty new reports on the health care status quo in every state around the country. The new reports are available on our web site, http://www.healthreform.gov. And they pretty clearly outline the challenges that we have. Um, the reports include statistics on the percentage of residents in each state without insurance, the increase in the costs of premiums, and the overall quality for health care in each state. And they use some of the most current data available.

Uh, unfortunately the reports are a clear demonstration that there are problems with health care in every state. Whether they’re rural, urban, East coast, West coast, it really doesn’t matter. The health crisis impacts all of America. The additional reports out today are from our Agency for Health Research and Quality. And frankly states get a pretty mixed review for the quality of care they provide.

Uh, these are more than just numbers and facts, more than statistics on a page. They represent real people and families in states across the country who are struggling. Uh, what we know is every day in America families are being crushed by the high cost of health care that threatens their financial stability, leaves them exposed to higher premiums and deductibles, and puts them at risk for possible loss of health insurance as employers struggle to provide adequate health coverage.

So now Americans are demanding reform that protects what works and fixes what’s broken. And in Congress, um, a number of members of the House and Senators from both sides of the aisle are working hard to make reform a reality. We were encouraged that just yesterday a bipartisan group of leading Senators, including  the top Democrat and the top Republican on the Finance Committee, Max Baucus and Chuck Grassley, recommitted to working together on health reform this year.

So I’m confident that we are gonna get a bill passed and to the President’s desk. And the statistics that we’re releasing today should help to inform people about the serious challenges that we face and why we can’t wait for reform to happen.

Um, again the reports are on our web site healthreform.gov.  And they are a state by state look at what’s going on in quality and cost. So with that I’d, I’d be willing to, um, answer some questions. I think we have about…

Media questions:

…Question: Hi  Secretary, uh, thank you very much for taking the call. Um, I am wondering what the chance are of getting a, um, public option through this year?

Secretary Sebelius: Well Jenna, as you know the President has made it pretty clear that, um, he actually believes in market strategies and feels very strongly that having a public option compete with private insurers is the best way to have cost containment. Um, I’m pleased that the House bill which has been drafted, and I testified to earlier this week, um, the outlines of the Senate bill from the Health Committee, both have public options. Uh, we haven’t seen the specific language from the Finance bill yet, but I, I think it’s clear that, um, with the bill coming forward the public option is definitely part of the strategy.

…Question: [garbled] Secretary, um, we’re, in Virginia particularly small businesses make up seventy-one per cent. And I’m wondering how the health care plan that’s being developed is going to help smaller businesses and people who work with them in developing a health care option for their employees?

Secretary Sebelius: [garbled] That’s a great question. Um, as you know, not only in Virginia, but in every state across the country small business owners are the majority of employers. And it’s the, um, kind of backbone of our economy. And frankly, in the current system they are the ones offering, I mean, often bearing the brunt of, um, the cost curve. Uh, they get squeezed out of the marketplace more quickly if one or two employees have some kind of pre-existing condition. They pay higher costs because they don’t have the volume to leverage, uh, big discounts. And, um, often they, they don’t get to keep or attract the best employees because employees follow health care. And while over close to sixty per cent of small business owners as recently as five years ago provided coverage, we’re now down to thirty-eight per cent. Um, so it’s, uh, they’re at a competitive disadvantage. So health reform I think offers a lot to small business owners. First of all it kind of pool, in the new health exchange, will give some, uh, affordable options, uh, for small business owners that they don’t have now, gives them choice. The elimination of pre-existing condition will mean that they can actually come into the marketplace without their costs, uh, skyrocketing. All of the proposals, and the President has made it very clear his proposal, um, includes some tax incentives for small business owners who offer insurance coverage. And I think that even if, um,  the kind of pay or play employer mandate ends up in either the House or Senate bill, it’s part of the House bill, but there is an exemption, uh, for small businesses. So I think there’s a, there’s a good deal of focus, um, of beneficial outcomes for small business owners. And at the end of the day costs have to go down for everybody, but I think it’s a, it’s a workforce issue that will make them more competitive with their, in this global marketplace.

…Question: In your report [garbled] you document, uh, the number of businesses that are dropping health insurance benefits. Uh, if there’s a public option won’t that cause more businesses to, to drop, uh, offer, offering health insurance benefits and just tell their employees to go the public option?

Secretary Sebelius: Well, Eric, the way that the public option is, is being crafted it really is available for, um, those who do not have coverage right now. And, um, I think there, there is concern about the so called dumping, but, uh, frankly the President has made it pretty clear that he really wants to encourage a system that builds on what we have. That if people have coverage that they like, that’s affordable, a relationship with a doctor that, um, is good for you and your family [garbled] want to keep it. So the, the exchange, the new marketplace is really for, uh, those Americans who have no insurance coverage at all or who are, um, un, underinsured at this point, uh, because of the cost prohibitive nature of the coverage.

…Question: Yes Secretary, is there any form of ranking here? How do we know how our states are comparing to other states, for example, in the number of uninsured, um, the costs of premiums etcetera?

Secretary Sebelius:  Um, at this point Mary Joe, there isn’t a, a, you know, comparison. These are
really state by state reports. So, there wasn’t an attempt to, um, either on the quality reports or the, uh, cost in coverage side to rank these, uh, in order of one to fifty. Uh, but really give a snapshot for citizens, business owners, policy makers in that state an idea of, of really what’s happening within the borders. Be a good math project for somebody to go through and, you know, calculate this, but, um, that wasn’t part of the, what we do here at the department.

…Question: Madame Secretary, there’s a lot of talk about bipartisanship. I’m just wondering, if the Democrats have the votes to pass what they want, why don’t you just do it? The Republicans have said that they want to kill this project, a lot of them have. Why don’t the Democrats pass what they think is the best proposal and to hell with bipartisan…, bipartisanship?

Secretary Sebelius: Well, I, I, I think, um, while the, the votes may be there because the majority is, is pretty hefty in the House, um, of Democratic support. The reality in the Senate is basically you need sixty votes, uh, in order to move procedurally to a vote of anything, so there’s more of a, a kind of procedural requirement for bipartisanship. But I think at the end of the day health care is probably the most personal issue to every American. It, it really, uh, affects businesses and governments and families. Um, and I would hope, and I think the President is very hopeful and keeps pushing for this, that this, uh, doesn’t break down along partisan lines, but it, it’s an American issue. It’s the one that we really have to figure out a strategy that’s uniquely American. We have a, uh, an insurance system right now that doesn’t look like any other country in the world. We want to build on what we have and fix what’s broken. But, um, I’m still hopeful that, uh, Republicans will be engaged and involved, as they are right now in the Senate Finance Committee. I mean, I think that sets a great example. I’m hopeful we’ll have some House Republicans who end up, uh, becoming part of this solution in moving forward on health reform. This isn’t really a Democratic issue and it shouldn’t be a Democratic bill. It should be a bill that really finds a solution to this challenge for all Americans.

…Question: Yes, Madame Secretary, you spoke about a number of, uh, countries, how we’re different than those, uh, countries. Yet many of these, uh, industrialized countries around the world do better with their health care plans than the United States. Which countries, uh, systems are you specifically looking at in developing a better system for the United States?

Secretary Sebelius: Um, I did not suggest that we were looking to other nations to develop a better system. I said I thought we needed kind of an American solution because our, our health system is different than most countries around the world. I do think we have a lot to learn from other countries about health outcomes and cost effective, uh, strategies that produce better outcomes. So, um, one of the efforts in health reform is really to help promote, incentivize higher quality care for each and every American. It exists in some pockets of the country. Uh, some systems work enormously well, with doctors and hospitals in a collaborative strategy. Others don’t work very well at all. And though we spend twice as much as any nation on Earth, and yet our health outcomes don’t, um, show it, don’t show those results. So I think we, we will continue to learn from what is cost effective and, more importantly, what’s effective for patients in terms of medical strategies and try to use Medicare and the payment system and the incentives we have here in the Department of Health and Human Services to, uh, improve the quality of care for everyone.

…Question: Yes, thank you Madame Secretary. One alternative to the public option that’s been proposed is regional cooperatives. Uh, isn’t that a little bit like putting all the sheep in separate pens to keep them from ganging up on the wolves?

Secretary Sebelius: [laughter] Um, well, I think the, uh, there was a discussion, I think early on in the Senate about, um, actually multiple cooperatives being one alternative, uh, to look at for competition. Uh, my understanding is that recently the, the CBO, the Congressional Budget Office has suggested that they don’t think that’s, um, either a feasible idea or an effective strategy, so I, I think that the conversation going on right now is, is a national, um, option. As you know the President and the administration very strongly support, um, not a cooperative strategy, but a, a true public option that would be a, um, a benefit program run by the government that can compete side by side with private insurers and help hold down costs and offer some choice to consumers.

…Question: Is making it mandatory for all Americans to purchase health insurance being seriously considered? If so, will there be a waiver for those whose religious beliefs preclude them from going to doctors or hospitals, or for individuals who believe in natural or holistic to health and are taking preventative measures such as healthy diet or regular exercise, making them less likely to need medical assistance than someone with risky behaviors?

Secretary Sebelius: Um, the, I, I think there is discussion in both the House and Senate, um, of some kind of an individual mandate. Um, it was part of the Massachusetts strategy when they passed their proposal. I know that there, um, in the House version of the bill is a specific exemption for, um, economic hardship for, uh, the ability of someone to opt out based on, um, the fact that they, whatever the price, they still can’t afford it. I have not seen the specific language, particularly about the religious issue I assume [garbled] Christian Science, Scientists and others who don’t access the traditional health care system. Um, but that’s a very good point. I, I don’t know if that language is in the bill. I, I can take a look at it, but I think that’s one we can share with the committee members….[end]