The United States system of providing healthcare and financing the care provided is quite simply, broken. In 2005, nearly one out of every six Americans had no health insurance , and by 2008 that fraction had risen slightly to just over 1/6(http://www.census.gov,www.google.com/publicdata). This would entail that nearly one out of every six Americans are not going to see physicians when needed, are not afforded the chance for the early discovery and subsequent treatment of potentially fatal but otherwise easily treatable diseases, are not being administered vaccinations against easily communicable diseases, are not being educated about various health risks, and so on. What is important to draw from this is that one out of every six Americans, which is just over 50 million people (US Census Bureau), are not getting the healthcare they need. Private insurers, operating as a for-profit industry, inevitably couple healthcare with free-market capitalism, the end result of which is 50 million Americans not being afforded basic medical coverage.

Even with this significant lack of coverage, healthcare spending is accelerating at a startling pace (Fuchs, Emanuel), due to a variety of reasons, including high administrative costs  caused by the need for assessment of whether or not to cover individuals and to what extent they are to be covered. Physicians, too, serve as causal agents for the skyrocketing health costs, as is evidenced by the McAllen, Texas region. This area, on the US-Mexico border near the Gulf coast, is the most expensive region in the country when it comes to healthcare spending. Surprisingly, this was not caused by McAllen’s hospitals providing any better service, nor was it caused by the population in the McAllen region deviating any more than the rest of the United States from the general standard of good health. In fact, what was causing the region to be so expensive was the “across the board overuse of medicine”. Many physicians, acting as businessmen, had a habit of ordering tests that may not have been entirely necessary, but generated a respectable sum to be paid out to them. McAllen, although perhaps the most obvious example, was not alone in its overuse of medicine. Across the nation, patients in more expensive areas were less likely to receive low cost preventative procedures, and the more money spent per person on healthcare in a given state, the lower that particular state’s quality of healthcare ranking tended to be. It seems that the former president George W. Bush’s assertion that “the best healthcare decisions are not made by government and insurance companies, but by patients and their doctors” may not have been wholly accurate. The commercially oriented care being provided is not a part of the solution, but a part of the problem. This is not to say that all physicians are acting in a profiteering manner when ordering certain tests that may be both unnecessary and costly—malpractice lawsuits are growing out of control, and consequently the insurance physicians must pay to protect themselves from these lawsuits is also growing out of control. Additionally, physicians must be sure to order certain tests for certain conditions to protect themselves, a practice known as defensive medicine. To be fair to the liability concerns of physicians, tort reform must be present in any sort of reform legislation proposed.

The situation in place now is far too complicated and extensive to be explained in the confines of this post; however it is clear that reform is needed. Considering the recent acceleration in healthcare spending, the urgency of fixing a system that constitutes such a large portion of our national economy cannot be understated. This reform will need to bend the long term cost curve the opposite of the direction it’s currently headed. As well as being economically sound, the solution must also be ethically just.

In case you've been living under a rock for the past few days, a historic election just took place in Massachusetts, where the people voiced their opinion on the health bill that was making its way through Congress. By choosing Scott Brown, they had the opportunity to tell Washington that they did not approve of the way the situation was being handled. This healthcare bill, without the 60 senate votes needed, will now likely die.

It should.

To pass a bill so flawed just for the sake of passing it doesn't solve any problems at all. Truth be told, it may create many more problems down the road. This bill needed to die for the sake of the American people. While reform is important, it would be irresponsible to try and pass a bill that affects the entitlement to health for the entire American population. The election of Scott Brown should be seen as an opportunity for health care reform- for us to develop a bill that respects both those with low income and those with pre-existing conditions, and one that isn't politicized. While the healthcare reform bill is dead, healthcare reform it's self isn't. For lack of a better example, healthcare reform is taking a little nap. It will come back, refreshed and ready to go later.

You deserve better. It's your health that's at stake here.

veritas vos liberabit

HAWLEY: GOVERNOR’S WELFARE HANDOUT CIRUMVENTING WELFARE REFORM, TAKEN FROM THE HANDS OF HARDWORKING TAXPAYERS

            According to Assemblyman Steve Hawley (R,I,C – Batavia), Governor Paterson has unveiled plans to hand out $175 million in a “back to school” bonus program for hundreds of thousands of welfare and food-stamp recipients. 

While this year’s budget included a ten percent welfare hike, and 30 percent over the next three years, recipients with children ages three to seventeen will receive $200 cash per child, for example a family with 5 eligible children would receive $1,000.  Additionally, it has been noted that the governor’s office has ordered local officials to make grants for children in families that have violated work requirements mandated by welfare reforms, and many families whose children are no longer enrolled in school will still receive the handout, which is supposedly to be used for back-to-school items.

            This year’s state budget, which increased welfare payments, conversely cut $1.5 billion in STAR rebate payments and raised taxes and fees on hardworking families by over $8 billion, noted Hawley.

“Propagating a culture of dependence is not the way to spur the economy and improve the lives of New Yorkers,” Hawley stated.  “We should be encouraging recipients instead to look for work, to take charge of their lives and do what is right for their families.  This is a huge step back in welfare reform.”

            “While millions of hardworking New Yorkers have seen their rebate checks disappear and are struggling to make ends meet, the governor plans to hand out free money to welfare recipients?” said Hawley.  “We’re not talking stipends or vouchers here either, but cash to be used with no oversight or regulation.  It’s outrageous that senior citizens and middle-class families are stuck paying higher taxes while the governor turns around and hands the money off to those already receiving welfare and food stamps.”

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Alan Bedenko notes that New York blew it in 1997 -- under terms of the state constitution, there should have been a vote to determine whether a constitutional convention should be convened.

But it's not too late. No year is too late. The Legislature can put the question on the ballot any year, like, say, this November.  That's Bedenko's suggestion.

So what reforms would you like see included in a new state constitution?

With Talk of Reform Taking Center Stage in Albany, Western New York Minority Delegation Unveil Own Package of Initiatives

            On Monday, June 8, a bipartisan coalition of state senators passed a comprehensive list of rules reforms that if enacted, would help bring long overdue transparency and accountability to the legislative process.  On the heels of that reform package, today, the Western New York Minority Delegation led by Assemblyman Steve Hawley (R,I,C-Batavia), Assemblyman Joe Giglio (R,I,C-Gowanda), Assemblyman Jack Quinn (R,C,I-Hamburg), Assemblywoman Jane Corwin (R,C,I-Clarence), and Assemblyman Jim Hayes (R-Amherst) announced their own series of initiatives, which aims to increase government efficiency, reduce costs and create a more open, bipartisan democratic process.

            The Western New York Delegation package contains nine reform proposals, including:

ü      Term limits for Speaker, Majority Leader and Minority Leader of 6 years.

ü      Term limits for Chairpersons and Ranking Members of 8 years.

ü      Publish agendas and votes (floor and committee) online.

ü      All committee meetings video recorded and webcast.

ü      Create televised programming, NY-SPAN, by January 1, 2010.

ü      Divide any member items evenly.

ü      Messages of Necessity shall only be permitted in actual emergencies “such as legislation related to address acts of God, natural and man-made disasters and civil unrest.”

ü      Institute Member prerogative to provide each member an equal allotted amount of time to advocate for issues specific to their district.

ü      New motion and/or petition for Consideration created.

o       Separate and in addition to motion to discharge.  Permits a Member to move a bill for house consideration after 10 days on 3^rd reading.  If approved by a majority of Members present, bill is placed on next day’s active list.  Petition process is same, except must be signed by a majority of elected Members.

“Citizens in the state should never be dependent on whether their representative is enrolled in a particular party,” said Assemblyman Steve Hawley.  “True representation has no party affiliation.  It doesn’t matter whether you’re an enrolled or non-enrolled voter, your needs should be met.  For too long, Albany has operated based upon party politics, not sound governing principles.  We need to open up the process and improve transparency in order to make sure the government stands accountable to the people, not the other way around.  These reforms take a step toward just that.”

“As a reformer, I have fought for changes to the way Albany does business since I came to office,” said Assemblyman Giglio.  “Last Monday, the Senate passed reforms to increase transparency in government.  Today, we should heed their example and take advantage of a unique opportunity to reform our own house.  I call on my colleagues in the Assembly to pass these reforms as a step toward the betterment of our system and accountability to the taxpayers of our state.”

            “Since I was elected to the Assembly, I have fought to change the way Albany operates,” said Assemblyman Jack Quinn.  “Repeatedly though, entrenched and powerful institutions have overridden common-sense initiatives.  However, calls for reform have amplified and if we’re going to break the status quo and usher in a new era of reform and openness, then the time is now.  The initiatives we introduced today mirror the proposed Senate reforms.  Together, they will help reduce the stranglehold that a handful of leaders have on the legislative process, ensure all bills receive a fair vote on the floor of the chamber regardless of party, and reaffirm our commitment to taxpayers.”

            “If events of the last few months have taught us anything, it’s that state government is broken,” said Assemblywoman Jane Corwin.  “Monday, a bipartisan coalition of senators passed comprehensive rules reform aimed to bring long overdue change to the legislative process, expand the power of legislative committees, and put to an end an archaic and corrupt memberitem process that doles out resources and community aid based on politics, not need.  This is our chance to instill balance and equality in the legislative process to achieve the results that New Yorkers were looking for when they went to the ballot box last November.” 

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(via Buffalo Pundit, who also covered the event with this post).