When Will Obama Deliver His State of the Union Address?

There was a short article in this morning's paper describing the process by which the Senate and House Health Care Reform Bills will be reconciled. What I found interesting is that the time line for the process suggested a completion date sometime in February. Previous reports had suggested a Reform Bill had to be on President Obama's desk before January 19th so he could sign it in time for his State of the Union Address. I had the date circled on my calendar!

Apparently there is no requirement that the SOTUA must occur in January; in fact, in the first year of a new President's term, it usually doesn't happen until February. Nevertheless, previous reports had indicated a January 19th target date for Health Reform legislation to be done. This followed earlier reports that it would be done by Christmas. Or Thanksgiving. Or, Labor Day.

It's actually pretty sad. About 75% of what is in both the House and Senate Bills is acceptable to liberals and conservatives alike. A Bill could have been passed months ago.

Et tu, WSJ ?!

The airwaves are full of ads from doctors, dentists and other health care providers encouraging you to spend "unused" dollars before the end of the year. Even my own dentist, in advance of a routine appointment last month, sent me a personalized letter informing me I had used only a fraction of my Dental Plan's annual limit, so wouldn't I like more dental care before year end? (Oh please, let's go for a crown!)

I don't blame providers for trying to drum up business and perhaps there is some logic to spending unused flex dollars that can not be rolled over from year to year. Just because you've satisfied your health plan deductible or other out of pocket limits, let's not kid ourselves - as the ads would have us believe - that there is no cost to additional spending.

The WSJ Editorial Board has been a great champion of restoring "consumerism" to health care markets. They have long advocated that individuals should have some "skin in the game" so as to make more prudent spending decisions. Thus it was particularly galling to read an advice column authored by Anna Wilde Mathews in a recent Wall Street Journal 'Sunday' feature, in which she suggested to readers that at this time of year they need to "check that you aren't missing out on free stuff"!!!

Let me make this crystal clear: whether paid for by your insurance plan or the government, health expenses are NOT "free"! Premiums (or taxes) paid - whether all or in part by an employer - proportionately reduce employee spendable income. And claims paid - even those at year end after our deductibles have been satisfied - add to overall utilization which causes even higher premiums (or taxes).

This lesson reminds me of the P. J. O'Rourke quip: "If you think health care is expensive now, wait until you see what it costs when it's free."

End of Life Care: A Beautifully Written Essay We All Should Read

The raging health care reform debate seems to evoke the most angst when discussing end of life issues. Nothing I might write would be as thought provoking and personal as an essay contributed by local cardiologist Dr. Bruce Wilson that appeared in yesterday's edition of the Milwaukee Journal Sentinel.

I urge you to read his piece at this link.

Is The Public Option Dead?

In a marathon session ending at 2:15 a.m. today, the Senate finished its markup of their health reform bill. Two amendments earlier in the week proposing a Public Option were defeated and while I couldn't possibly have reviewed the Senate Bill as of this posting, it would appear - at least in the Senate - there is not enough support for that to resurface.

Why is that? Well, I think these two clips from YouTube might shed some light on the subject. In the first, a Harvard Professor by the name of Jacob Hacker - who many consider the 'architect' of the Public Option - makes clear his 'strategy'; i.e. that the Public Option is just a stepping stone to a Single Payer System.

In the second clip, those who have bought in to Hacker's strategy, 'confess' their intentions.

So the real question becomes, do you support health care reform that incrementally leads us to a total government takeover - Single Payer - or not. Last night on Larry King live, Michael Moore proclaimed that the majority of Americans did indeed support Single Payer. Fact checks of such proclamations can often be found at a Pulitzer Prize winning site called PolitiFact . Apparently a growing majority of Americans actually fear further expansion of the government's role in their health care. And growing deficits.

It will be fascinating to see how the CBO 'scores' the new Senate Bill. Things are about to get interesting!

Conspicuous By Their Absence

The most recent U.S. News & World Report on America's Best Hospitals ranks the top 25 hospitals in sixteen different categories. Not one hospital in southeastern Wisconsin - not one - makes the grade!

So, if I need anything other than the most routine care, should I be looking to go out of state? And if I do, are the most highly rated facilities considered "In Network" by my health insurer? With so many people considering year end 'Open Enrollment' health plan options, this might be a very oportune time to do a little home work.