Congress Is Behaving as if the Health Care System Isn't in Tatters

[This article also appears on Huffingtonpost.com. You can access it from my author page here.]

When it comes to health care reform, I feel like the house is on fire, but nobody in Washington (except maybe President Obama) seems to see it. Or worse, they see it, and they don't care.

Here are some statistics, via the nonpartisan/bipartisan National Coalition on Health Care (NCHC), to demonstrate just how dire the current health care situation is:

- 46 million Americans under the age of 65 (which represents 18 percent of the population) had no health insurance in 2007. And given the spike in the unemployment rate and downturn in the economy since then, that figure has to be even higher now.

- $2.4 trillion was spent on health care in 2008, representing 17 percent of the U.S.'s gross domestic product. That's more than four times what we spend on defense.

- Costs are trending in the wrong direction. Projections have costs reaching $3.1 trillion in 2012 and $4.3 trillion by 2016, if the same health care system remains in place.

- The NCHC has compiled projections on the negative impact of spiralling health care costs on the economy, state and federal budgets and employers, large and small, and the effects are stifling. Health care costs are a major threat to our future.

- We are also very inefficient. We spend more money per person on health care than nations that provide universal coverage to their citizens. The NCHC, citing the Organization for Economic Cooperation and Development, points out that health care spending was only 10.9 percent of the gross domestic product in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France, all countries that provide single-payer health care.

- And what about the small businesses Republicans are always pretending to defend? They are getting killed by health insurance payments. Employer-based premiums rose 5 percent in 2008. In 2007, rates for small employers went up 5.5 percent, and companies with less than 24 employees saw an even bigger increase, 6.8 percent. The Republicans call any health care reform measure from the Democrats a job-killer, but nothing is killing the ability of small businesses to hire Americans more than the rising cost of health insurance.

- Not that Republicans care about American workers, but I thought Democrats were supposed to be looking out for them? They are getting hammered, too, according to the NCHC. In 2008, employees had to pay a whopping 12 percent more in health insurance premiums than they did in 2007, so that the average worker is now paying $1,600 more a year for premiums than he/she did in 1999. In fact, since 1999, premiums for employment-based health insurance have increased 120 percent. (NCHC notes that during that same period, wages grew only 29 percent.) That means that health insurance costs are increasing four times faster for American workers than their wages are, on average.

- Republicans love to talk about how bad health care will be if the government gets involved, and President Obama has taken great pains to assure Americans that, under his plan, if they like the coverage they have, they can keep it. But the evidence points to the fact that care in the United States isn't as good as it could or should be, and is not the best in the world. The NCHC notes that we are not in the top three in infant death mortality rate; ours is 7 percent, while the leaders are at 2.7 percent. The U.S. rate of mortality from treatable conditions is a third lower than the world's leader. A drop more than half of adult Americans get the care recommended for them, and less than half of those suffering from diabetes and less than a third with coronary heart disease receive proper care. There are also growing problems with medical errors and infections in hospitals.

There really isn't a question of if there needs to be a complete overhaul of the health care system. Rather, the only question should be, How much can we change it? But if you listen to the debate in Congress right now, it sounds like a race to see who can do the least. And you would certainly never get the idea that the status quo is as broken and dangerous as it actually is.

The last time I wrote about health care, last month, my central concern was that Republicans were intentionally stoking fears of "socialized medicine" to kill a public option, all in defense of the insurance companies at the expense of the American people. A month later, my concern seems almost quaint by comparison.

A Washington Post-ABC News poll released over the weekend showed that support for President Obama's handling of health care dipped below 50 percent for the first time. (It should be noted that more respondents still supported him than not, 49 percent to 44 percent, and Republicans continue not to be thought well of on health care, with only 34 percent trusting the GOP on the issue.)

While I wish President Obama's rating was higher, I can't say I am surprised. Yes, part of the blame goes to Congressional Republicans who are on an all-out blitz to kill health care reform, and their motives for doing so -- the protection of the big corporations who control the industry, including the health insurers and drug companies -- are in no way involved with helping the American people.

But if the Republicans were the only problem, I wouldn't be too concerned. Reforming the country's broken health care system is such an obvious need, I am sure that the Democratic majorities in the House and Senate would be able to shepherd through meaningful legislation, if that's what they wanted to do.

The problem, as I see it, is that none of the bills working their way through the House and Senate committees now really address making fundamental changes to the broken-down health care system I described above. Instead, the proposed pieces of legislation would seek to find ways to pay for more Americans to be covered under the old, broken, insurer-dominated status quo.

I thought Health and Human Services Secretary Kathleen Sebelius did a pretty good job battling David Gregory on Meet the Press yesterday. She made a good case that no consensus bill has emerged yet, so it's unfair to claim that any eventual legislation would include the failings that any of the proposals currently contained. And she did an excellent job pointing out that we have a long way to go, from the current broken system to one that eventually achieves the president's three goals of improving quality, lowering costs and expanding coverage.

But the one fact that Sebelius could not get around, and one that Gregory pressed her on repeatedly, is that the current pieces of health care legislation in Congress, according to the Congressional Budget Office, will not significantly lower costs.

I wasn't surprised by this problem, since as the debate has unfolded, it seems as though the policies that might actually reduce costs by addressing the domination of profit-motivated health insurers are the ones that have been the most contentious, especially the introduction of a government-run public health insurance option to compete with the private insurers. As I pointed out last month, there is an inherent contradiction to right-wing criticisms of the public option. They say that such a policy would create poor care for Americans while wiping out private insurers. The problem, of course, is that if the care would be so bad, why would people choose it at the expense of their current private insurers? And, if the private insurers would be ruined because the public option would create less-expensive, superior care, why wouldn't we want to adopt a system that raises quality and lowers costs? The Republican argument is completely disingenuous.

And yet, there are plenty of Democratic senators who have come out against a public option or failed to openly support it.

The Republicans are seizing on the obstacles President Obama is facing with health care reform, sensing an opportunity to dent his popularity. A banner headline on the Huffington Post today trumpets that Republicans from Michael Steele to William Kristol are predicting, as Sen. Jim DeMint of South Carolina did over the weekend, that health care will be "Obama's Waterloo." Hell, things are looking so good to the Republicans that Kenneth the Page impersonator/governor of Louisiana, Bobby Jindal, has reappeared to chime in that he has "seen enough."

But blaming the Republicans for risking the health and economy of the American people to kneel in supplication at the altar of their big-business patrons is like blaming the scorpion of the famous proverb for stinging the frog. It's in their nature. Few of the GOP's policy positions actually benefit the majority of Americans, and even fewer are adopted for that purpose.

No, the blame gets spread across the entirety of Capitol Hill for the current state of health care reform, since not even all of the Democrats seem to realize the enormity of the problem. Rather than pushing for systematic change, they are dancing around the edges, trying to find ways to cover uninsured individuals without changing the way in which Americans receive (and pay for) health care.

I sincerely believe that President Obama sees the need for a massive overhaul of the health care system to lower costs, cover most Americans, and provide quality care. It's time for the Democrats in Congress to become as committed to these principals as the president seems to be. In light of the attacks by Republicans, which paint the president is some kind of take-over-crazed socialist trying to turn the U.S. into some amalgam of the Soviet Union, Sweden and hell, it seems like Democrats from pink and red states are running scared, afraid of being painted as too liberal in their next elections. And I'm sure that these same moderate Democrats are also feeding from the same insurance-company-supplied troughs as their Republican brothers and sisters.

Frankly, I'm less concerned about the "why" than the "how," as in, How do we move forward from here? So far, the concerns in Congress have led to tepid legislation that, if you believe the CBO, may cover more people, but won't address the underlying problems in the system. A government option should, if done correctly, help lower costs by forcing the private insurers to be more competitive in pricing and service. But even if a public option can find its way into a final bill, will it be strong enough to accomplish what it is designed to do?

In the end, we need a massive overhaul of the health care system that increases costs, increases quality, and covers most Americans. And it seems that right now, President Obama is one of the few players in Washington who seems to realize this fact. I was glad to read today that he is going to take a more aggressive approach to the health care debate, because I don't think it's an exaggeration to say that health care is shaping up to be the biggest leadership challenge of his presidency thus far.

The way things are going now, we are either going to get no health care reform (if the Republicans win) or watered-down health care legislation that acts as a bandage, helping some people but ignoring the larger problem creating the pain. Neither of those options are acceptable if we want to prevent a looming health care disaster that will not only risk our well-being, but also our economy, both individually and nationally.

We need fundamental change to the health care system, and President Obama has to find a way to convince his fellow Democrats on the hill that it's in their best interest politically to get on board. Because if the Democrats can come up with a solution that truly provides quality health care to more Americans for less money, their constituents will reward them in the voting booths. And if no health care legislation emerges, or if the bill that is produced is easily assaulted for threatening to balloon the deficit without addressing rising costs, voters will hold the Democratic lawmakers accountable.

The fire is burning, and it's time for real action to extinguish the flames. President Obama needs some help to do it. Let's hope he can convince enough of his colleagues in Congress to join him.

"Drop Dead Diva" and "Battle of the Bods": Is This Any Way to Treat a Lady?

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"10 Things I Hate About You" Is One of the Few New Comedy Options This Summer

[NOTE: The following article will also appear as my regular television column for WILDsound.]

Summer has become synonymous with reality television. An alien landing on earth last week who watched television to learn more about American culture would probably come away thinking we were obsessed with rich teens, people getting hit with padded objects and overweight people dancing. At this point, I am desperate to watch a new scripted show, and especially a comedy. So I ventured to teen-friendly ABC Family to catch the series premiere of "10 Things I Hate About You" (Tuesdays, 8 p.m. Eastern ).

Adapted from the 1999 feature film of the same name that launched the career of Heath Ledger, the single-camera sitcom follows two sisters as they start a new year of school. Cat (Lindsey Shaw, the much-missed "Aliens in America") is an NPR-listening, universal-health-care supporting rebel who couldn't care less what the kids at school think of her. Her younger sister, Bianca (Meaghan Jette Martin, "Camp Rock"), on the other hand, just wants to be popular, telling Cat to "speak English" when she makes references to Kim Jong Il and burkas.

In fact, before stepping foot in high school for the first time, Bianca has done extensive Facebook research to learn everything she can about queen bee Chastity (Dana Davis, "Heroes"), plotting their first encounter so she can ass-kiss her way into the popular clique. Bianca is seemingly oblivious to the fact that sophomore dork Cameron (Nicholas Braun) has a major crush on her, so smitten he takes the idea of his fellow nerd buddy Mikey (Kyle Kaplan) -- although he wants to be called Michael now, part of his plans to escape the lower rung of the social ladder -- to throw a party at his house.

While Bianca is on a mission to be popular, Cat keeps running across bad boy Patrick (Ethan Peck, in the part Ledger tackled in the film). Everyone is terrified of the motorcycle-riding Patrick, except Cat, that is, who, in a cute scene, outstares him, fixing her glare until he finally turns and leaves. Cat also has a run-in with Chastity, purposely taking off the bumper of her Mini Cooper after she tries to commandeer Cat's parking spot (when Cat sneers at Chastity that she didn't know the spaces were assigned, Chastity replies, "They were assigned. By Charles Darwin."). Cat and Chastity's running battle threatens Bianca's plan to hitch her wagon to Chastity.

Cat and Bianca live with their slightly overprotective doctor dad Walter (comic Larry Miller, reprising his role from the film), a single-father who has raised his two girls since their mother passed away.

With a soundtrack filled with female-fronted pop-punk anthems (Letters to Cleo's cover of Cheap Trick's "I Want You to Want Me," which appeared on the movie's soundtrack, plays over the last scene of the first episode of the program), a peppy and zinger-filled pace, and a swoon-inducing alleged bad boy to obsess over, "10 Things" is clearly targeted at ABC Family's main demographic: teenage girls. Which has to be why no effort is made to deviate from the plots and themes of seemingly every other Hollywood high school movie and television show ever offered to the American public. Everything we've come to expect is present and accounted for: geeks and jocks, cheerleaders and quarterbacks, outcasts and artists, and struggles of the heart. Chastity is dating a quarterback, but she threatens to leave him if he isn't named the starter. Mikey is carried off to be stuffed in a locker, Cameron pines for the girl out of his league who doesn't know he's interested, and there are cheerleader tryouts and a big party.

So if adults come to "10 Things" expecting anything out of the ordinary, they will be disappointed.

That's not to say that there aren't good things about the show. The writing is way sharper than a teen-targeted comedy has a right to be. When the two sisters are about to start their first day of school, Bianca asks Cat, "How do I look?" When Cat replies, "Shallow," Bianca, without missing a beat, shoots back, "Thank you!" When Cat is hauled into the principal's office after purposely hitting Chastity's car, Chastity claims her neck is sore, leading Cat to snap back, "That's probably from flipping your hair too much." Cameron and Mikey get their moments, too. When Bianca talks to Chastity before Cameron gets a chance to approach her, he tells Mikey, "Too late. Voldemort's got her." And when Mikey suggests Cameron throw a party to get Bianca's attention, Cameron argues, "The last party we went to was a bar mitzvah. Yours."

I also liked the acting of the main family. Martin is steady as the vain Bianca, resisting the urge to take her too close to cliche-land and giving her some heart below the ambition. Miller is restrained (that's a compliment) as the gruff-but-lovable father who keeps the peace between his two very different daughters. And Shaw does a good job carrying the bulk of the action, adeptly handling the witty banter written for her character. If you were an "Aliens in America" fan, you will be impressed by how different Shaw is in "10 Things."

Unfortunately, the rest of the cast members sometimes feel like they're appearing in a different program, playing their characters to the extremes. Braun is especially broad as the geeky Cameron, acting as if he was in a stage musical, rather than a single-camera sitcom. (I thought it was funny that Chastity chooses Justin Timberlake over Zach Ephron in response to a query from Bianca, but Braun and Davis's performances feel like something out of "High School Musical.")

And while I'm happy to go with the simple, tried-and-true plotting, I can't buy Peck's Patrick as a dangerous guy, as he looks far more "Zoolander" than "Rebel Without a Cause." When outcast aspiring artist Mandella (Jolene Purdy of the short-lived "Do Not Disturb") tells Cat that Patrick is so dangerous that he is rumored to have "tasted human flesh," I laughed, thinking that it looks far more likely that he's modeled in Armani runway shows. Cat asks Patrick why everyone is afraid of him, but I can't imagine Patrick striking fear in anyone (excpet maybe a girl afraid he was going to steal her eye liner). I'm sure that teenage girls will find Peck to be crush-worthy, but as the Cat-Patrick potential relationship is supposed to be the center of the show, it's problematic that the character falls flat (and is badly miscast). It's a lot to ask Peck to live up to Ledger's legacy, but that doesn't mean that the performance (and, to be fair to Peck, the way the character is written and directed) gets the job done.

When I reviewed "The Secret Life of the American Teenager" last summer (another ABC Family program), I noted that I couldn't begin to say I knew if teenagers would like the show, but I could assess if adults would be entertained. The same can be said for "10 Things I Hate About You." Maybe teens will like the snappy dialogue, or maybe even they're sick of the done-to-death themes of high school comedies (with nothing new to add). I can't tell you. But for adults, I would say that the plot may not keep your attention, and some of the acting is hard to watch, but some fun can be had from the witty dialogue and strong performances of three of the stars. Which may be enough to draw attention in a summer filled with lousy reality programs. After all, the bar hasn't been set all that high when the schedule is filled with entires like "Wipeout," "NYC Prep" and "Dance Your Ass Off."