Tuesday, December 26, 2006


It was either the November elections with control of both Houses of Congress taken by Dems and 6 "pickups" by Dem Governors and or the realization that the states and the nation are rapidly going broke with the status quo "healthcare" (really disease care) system that makes me believe that finally, after all these decades of bickering, that 2007 will be the year that real healthcare reform will take place in the US. Do we really have a choice?

I last wrote about the key role that US Governors will play in March on this blog citing the Virginia Gov. Tim Kaine and Illinois Gov Rod Blagojevich (say his name bla-GOYA-vich). I also cited our nation's only Hispanic Governor of New Mexico,Bill Richardson, whose DGA tagline then was "Won't Wait for 08".

But most importantly I cited two former Governors whose ideas about Health Care reform are worth very serious re-consideration. Former Gov. of Oregon Dr. John Kitzhaber's program makes the most sense to me. His work can be found on www.archimedesmovement.org and former Gov of Colorado Richard (Dick) Lamm, while focusing less of Health Care issues recently wrote a book in 2003 entitled The Brave New World of Health Care by Richard D. Lamm (Paperback - Aug 2003. These two leaders are not just nibbling around the edges like most others but are going to the heart of what makes US Health Care so moribund and who also offer tangible but tough solutions.

Well in my blog post of March 3, 06 I posed the question where were the powerful mega- states like New York, Pennsylvania. Massachusetts, Texas and California to name a few on Health Care? I didn't hear much then to my surprise and dismay.

Little did I know that the following month (April ,2006) outgoing Massachusetts Gov. Mitt Romney(R) would send shock waves through his own state and the nation by signing a landmark (albeit complex-145 pages) health care bill that would provide nearly every citizen of ,what my blog partner Cervantes calls the Peoples Republic of Massachusetts, with some level of health care.

Building on what was viewed by many other Governors as a master stroke of compromise other states began to move quickly including Vermont, Maine, Minnesota ,Michigan, West Virginia and Kentucky. It seems that every state is jumping on the bandwagon in some form or another. And a year earlier the now notorious Maryland "Wal-Mart" law forcing large employers to contribute some health insurance to its workers- was overturned and now in appeal

A good summary can be found on http://www.stateline.org/live/printable/story?contentId=166268 "States Think Big on Health Care Reform" (Thank Stateline.org)

I've got my own eyes on three key states.

-One is where I and my family live and work. The Commonwealth (not common wealth) of Pennsylvania where healthcare is a huge business. Gov Re-Elect Ed Rendell is being very careful not to embrace a Massachusetts "Universal Health Care model" nor "A Single Payer model"

-I'll be listening carefully to what California Gov. Arnold (leg in a cast) Schwarzenegger will say on Tues January 9 at his upcoming State of the State address where he promises to explain how he will push the Golden State closer to Universal Health Care in the coming year.

- New York Governor Elect Eliot Spitzer has already shown his hand as an aggressive reformer of healthcare. This was not only reflected by his recent relentless pursuit of health care fraud as NY Attorney General but his recent support of the the New York Commission on Health Care Facilities in the 21st Century which called for the closure of 9 hospitals and the restructuring of 48 other institutions- still a drop in the bucket in Gov. Elect Spitzer's whopping $45 billion dollar Medicaid budget(ouch!). Be bold Gov. Spitzer- you cannot afford otherwise.

In the end with all the plans put forth by Governors and Feds alike (Rep Pete Stark D-CA, a staunch Medicare-for-all advocate is expected to be named chairman of the House Health Subcommittee) most are still emphasizing payment mechanisms and cost-shifting which still misses the mark. Pay for Performance, Gain-Sharing and IT- Information technology are getting some long overdue attention but not nearly enough.

Former Governor Kitzhaber says correctly we already have a de facto system of universal healthcare- expensive emergency room medicine. Kitzhaber goes on to say "about 40% of what affects people's health status are behavioral choices and lifestyle decisions. About 30% has to do with your genetics. About 15% are social factors like whether you have a job, a house or a healthy neighborhood. 5% are environmental factors" What all this means is that the $2 trillion dollar plus US health Care Industry has only about a 10% impact on US citizens overall health? What??? Could that possibly be true??? This is clearly unsustainable! Undeniable demographics, says Kitzhaber, is really what is driving us over the edge.

But let's face it a $2 trillion dollar plus industry doesn't roll over easily. Big money -real big money is on the line. Real battles lay ahead. But I am convinced the heyday of greed is over. 2007 is the pivotal year when America chose not to go bankrupt over healthcare anyway.

Dr. Rick Lippin
Southampton, Pa