Gerry Connolly Defends Health Care Reform

There's a reason that Gerry Connolly was voted president of the freshman class in Congress. He faced the lions in the den at Fox New and ably disputed both their anchorwoman and Kansas Representative Lynn Jenkins, who was spinning misconceptions and outright falsehoods. Connolly stood his ground and defended healthcare reform and the public option despite the attempt of the Faux News "journalist" to cut him off in the middle of his rebuttal.

Watch.

Pull the Trigger for a Public Option

My friend, Ben Tribbett, sent out an email asking for those of us who support a public option to help by "pulling the trigger" for a public option. In order to help the campaign to keep that in any health care reform, go here to contribute to Firedoglake's campaign to keep the public option alive and in any health care bill that gets through Congress.

I am going to keep the link up in my sidebar as well because I can't think of a more worthy effort.

Mark Warner's Perilous Fork in the Road

One of my favorite poems has always been Robert Frost’s “The Road Not Traveled.” In that poem, the narrator describes coming to a fork in the road. Although both paths appear equally pleasant and leafy, the narrator must choose which path to take. Knowing he may never pass that way again, the direction he takes will have consequences for the rest of his life. And that's the thing about difficult choices. They have consequences.

When it comes to the difficult choices about health care reform, our junior senator, Mark Warner, faces just such a fork in the road. Whichever choice he makes will have consequences, not just for his personal ambition but also for the fortunes of his party, his nation and his state. That’s a lot resting on his shoulders and those of his colleagues in Congress.

Senator Warner has aligned himself with the Senate’s conservative Democrats, who are allied with the House’s Blue Dog caucus, especially on health care reform.

Before going further, let's acknowledge that Mark Warner always was a pro-business centrist. Virginians not only understood this but embraced it. As governor, he led from the center and was largely successful because he applied good business practices to Virginia and put its fiscal house back in order, restoring its AAA bond rating and balancing its budgets. But as governor, he also found ways to balance the best practices of business with meeting the needs of Virginia’s ordinary citizens. He was successful because he did not sacrifice the well-being of the neediest on an altar of fiscal conservatism. Instead, he found a way to balance the two sets of priorities so that all Virginians benefited from the commonwealth’s prosperity.

Now, however, the nation is in an economic crisis that is the most severe since the Great Depression of the 1930s.

At the same time, we are facing a crisis of our health care system and it urgently needs reform. To reform it in a way that provides near universal coverage is going to require a lot of spending. That goes against the grain of cautious, centrist, business oriented politicians, such as Warner. But the alternative is a health care delivery system whose costs put such a strain on the economy that it will threaten our recovery. Our health care costs are far higher and our medical outcomes are far worse than those of the rest of the industrialized first world. It would seem to be a no-brainer. We are paying more money for less quality of care than countries like Canada, France, Germany, and even Taiwan.

And the problems have been exacerbated by the climbing unemployment rate because so many people’s health insurance is tied to their employers. With the loss of jobs comes a loss of health care coverage.

To my mind, the best solution would be a single payer system not tied to one’s employer. But I understand that that solution is unpalatable to the vast majority of Americans despite the fact that it actually works very well in other countries, regardless of how much the far right in this country tries to discredit it.

It’s important to note, though, that the single payer option is the solution of choice on the left end of the spectrum, supported by liberals like Dennis Kucinich and Bernie Sanders in the Senate and John Conyers, Tammy Baldwin, and Elliott Engel in the House.

On the right, especially among Republicans, the solution would not have any public option and would depend solely on market-based solutions with little government interference. It would depend on encouraging consumers to purchase private insurance plans and give them a tax cut to do so (every right wing solution to any problem depends on the so-called free market and a tax cut and little else).

The reason I am pointing that out is because it’s important to note that the plans currently under discussion in the Senate and the House are varieties of centrist compromise that would still be based largely on private insurance companies and employer based options. They are neither single payer options nor socialized medicine. What is under discussion is various ways to fund the plans, including a government subsidy only to those who couldn’t afford to purchase insurance, penalties for large businesses who don't cover employees, insurance pools and tax breaks to small businesses to encourage them to purchase insurance for their workers, and a public option for those who truly can’t afford a private plan even with a subsidy.

Supporters also hope a public option would provide more competition to the private insurers to get them to keep premiums low and provide better coverage. There would also be stricter regulations to ensure that insurers don't deny coverage to those with pre-existing conditions or cancel coverage for those who get sick. That is the plan of the true centrists. It’s the one progressives don’t necessarily favor, but are willing to support to get to the goal of near universal coverage.

Mark Warner does not support that plan. He has aligned himself with the conservative Democrats in the Senate, led by Max Baucus, and the Blue Dogs in the House, led by Jim Matheson and Mike Ross. They are neither moderate nor centrist – they are conservative. That’s the first thing you need to remember.

Now, let’s examine what those congressional Democratic conservatives stand for.

Both groups oppose the public option. Neither group has an appetite to fund health care reform by taxing the wealthiest one percent of the nation. Yet the Senate conservative Democrats, and their Republican allies, have no similar reluctance to tax the health benefits of those who currently have “generous insurance plans.” In fact, most of those on whom that tax burden will fall are fire fighters, police officers, government workers, and those who are professionals and middle managers. In other words, the middle and working classes will bear the burden with additional taxes, with the upward distribution of wealth once again preserved for the most fortunate – those with friends in high places.

In addition, without the public option, Americans would be mandated to buy health insurance from private providers, unless their employers provide it. Not only would this not actually help ordinary citizens, it would simply be an unfunded mandate on them. And it would create a windfall profit for insurance companies, who would reap even greater benefit under this so-called reform, as even this article in Business Week points out.

Although the Senate supports regional co-ops instead of the public option, we have even less evidence that these would work on a national level than we do that a single payer system would be effective. There are a few such co-ops operating in some states with various degrees of success but it is hard to say whether that model would translate well elsewhere. Certainly, if you object to risky and costly experiments, the regional co-ops would qualify for that description even more than the public option would.

There are many good reasons for supporting the more progressive health care reform plans out there. But for the Blue Dogs in Congress and the conservative Democrats in the Senate one very good reason is that their financial ties to the insurance industry are, by now, also very well documented, as this Washington Post article, for example, demonstrates regarding Mike Ross:

Ross has received nearly $1 million in contributions from the health-care sector and insurance industry during his five terms in Congress, according to an analysis by the Center for Responsive Politics, which tracks campaign contributions. The lawmaker founded Ross Pharmacy of Prescott, Ark., which he and his wife sold in 2007. The couple received $100,000 to $1 million in dividends last year from the sale, according to House financial disclosure forms.

Records of political fundraisers since 2008 compiled by the Sunlight Foundation, a Washington-based watchdog group, show a steady schedule of events for Ross sponsored by the health industry or lobbying firms that represent health-care companies. They include two "health-care lunches" at Capitol Hill restaurants in May 2008 and March 2009, as well as receptions sponsored by Patton Boggs and other major lobbying firms.

Further, the above mentioned Business Week also points out Mark Warner’s connections to UnitedHealth. Here’s the telling quote:

UnitedHealth's relationship with Democratic Senator Mark R. Warner of Virginia illustrates the industry's subtle role. Elected last fall, Warner, a former governor of his state and a wealthy ex-businessman, received a choice assignment as the Senate Democrats' liaison to business. The rookie senator landed in the center of a high-visibility political drama—and in a position to earn the gratitude of a health insurance industry that has donated more than $19 million to federal candidates since 2007, 56% of which has gone to Democrats.

UnitedHealth has periodically served as a valuable extension of Warner's office, providing research and analysis to support his initiatives. Corporations and trade groups play this role in all kinds of contexts, but few do it with the effectiveness of the insurers. In June, Warner introduced legislation expanding government-backed Medicare and Medicaid coverage for hospice stays for the terminally ill and other treatment in life's final stages. The issue isn't a top UnitedHealth priority. But the corporation wanted to help Warner with his argument that in the long run, better hospice coverage would save money. UnitedHealth prepared a report for lawmakers finding that 27% of Medicare's budget is now spent during the last year of older patients' lives, often on questionable hospital tests and procedures. Expanded hospice coverage and other services could save $18 billion over 10 years, UnitedHealth asserted.

When Warner went to the Senate floor on June 15 to offer his bill, he cited those exact figures. He thanked the company for its support and put a letter from UnitedHealth applauding him in the Congressional Record.

If voters are angry with Democrats and disillusioned by politics, it’s because after two election cycles of successfully running against lobbyists, special interests, and the culture of corruption, powerful Democrats are beginning to look exactly like those they replaced

The only way for those Democrats to stanch that anger and disillusionment and keep their own seats at the midterms is to take the road less traveled, less profitable, and ultimately more moral. It’s to stand with the ordinary working people and the middle class rather than with the powerful and wealthy special interests who usually managed to turn legislation to their advantage, regardless of which party is in power.

If they don’t, they could face dire consequences at the election polls sooner rather than later. Indeed, Ben Tribbett makes that prediction in a tweet, where he predicts that those who don’t support a public option, including Warner, Webb, Boucher, Connolly, Perriello, and Glenn Nye will all lose their seats in the midterms. But I believe electoral disaster could come even sooner than that in Virginia.

That’s because the very first election where fallout from anger at the Democrats for failing to get health care reform right will be right here in Virginia. The gubernatorial race is the canary in the mining shaft. It's the forerunner to the midterms in two years. And here is where there is a double irony for Mark Warner especially.

Currently, Creigh Deeds and Jody Wagner are running hard as Virginia Democrats in the mold of Mark Warner. How ironic, then, it would be if Warner’s own actions helped to kill the health care reform and take down with it Deeds and Wagner at home and then the Virginia Democrats in Congress a year later. Even if Warner were to survive it based on his personal popularity, that would spell the end of any ambitions he has on the national stage.

But that’s the choice he has to make as he stands at this fork in the road. Choose wisely, Mark. Your future and ours depend on it!

When Unions, EFCA, and Health Insurance Get Personal

I know you are not supposed to reprint a newspaper column in its entirety on a blog - all that stuff about fair use versus copyright infringement. But I am going to pull a point of privilege, with apologies to the newspaper that was kind of enough to run this column in its original form, last Friday.

You see, it's a small newspaper, with editions out of Manassas and Culpepper. Probably more people read it than read my blog. But I want to share my husband's column with my friends because I'm so danged proud of Dan. So, please indulge a wife's pride. And, yeah, it's about EFCA :)

Employee Free Choice Act Will Grow the Economy, Help Middle Class

I come from a working-class family. I grew up in Cleveland, Ohio, where my father was a rank-and-file tool-and-die machinist. He followed the space industry, and when he had the chance to buy back his old home in Tennessee in 1968, he did.

I got to see first hand the difference between working in an area with a lot of unions and an area without. As a kid, you don’t know what that means; as an adult, you learn what that means.

Dad had a job with a pension and health care while he was working in Cleveland. When he moved home to Tennessee, he couldn’t even put on his job application in some cases that he worked for a union company.

So my father, who never graduated from high school, made sure that his kids went to school. Both Mom and Dad fought and struggled and told us to “make sure you get a job with a pension because it sure beats eating snowballs in the winter.” My father had some illnesses and it cost us some things at home. As a kid, you don’t understand; as an adult you realize what your parents went through.

I’m a member of the Seafarers International Union. I’ve been employed by them for 22 years. With the Seafarers, I was able to do what my father suggested: find a job that has a pension and find a job that has health care. Little did I know how important that would be until 1994 when I was diagnosed with non-Hodgkins lymphoma. To this day, I have no idea what the medical costs were.

I do know, however, one thing that happened, and I know I wouldn’t be here if it wasn’t for the union. Eighteen hours before I was supposed to have a bone marrow transplant, the national insurance company called my house and said, “You’ve done everything we’ve asked you to do the previous six months: going through chemotherapy, going through all the tests, having everything that you needed to do. We’re not covering you anymore.”

I called my union. The next day, I’m being wheeled into the hospital, put under and when I came out, everything was taken care of. The union called the insurance company and threatened to pull the whole national account. An average person doesn’t have that advantage. An average person doesn’t have someone to stand behind them and work for them like that. That’s one reason why unions are important.

The middle class is struggling. As unions become smaller and smaller, the chances that you get a job with health care, with a pension and with benefits get fewer and fewer. As unions shrink, benefits for the middle class shrink.

Common sense guides the three principles of the Employee Free Choice Act.

* First, workers should be the ones who decide how they form a union, and it ought to be free from employer intimidation.
* Two, there should be real penalties when corporations break the law by threatening, coercing or firing workers. These penalties already are on the books when a union attempts such acts.
* Last, when workers decide they want a union, it should mean something. A company shouldn’t be allowed to delay the bargaining process indefinitely like they do now; in fact, almost half of the time, workers who decide they want a union never get their first contract.

The point is, workers have hit a breaking point. A major way to get out of this economic crisis is to let workers band together to bargain for the wages and benefits they deserve. We saw this work in the midst of the Great Depression when the National Labor Relations Act originally passed.

What workers wanted then is the same thing we want now. The Employee Free Choice Act will grow the economy, close the wage gap between the wealthy and the rest of us and strengthen the middle class.

By the way, the story Dan told about his insurance company refusing to cover his bone marrow transplant and informing us at the 11th hour is absolutely true. What Dan didn't say, and what is seared into my memory, is that we were not told until Dan was already in the hospital and preparing for that grueling medical procedure.

He was nervous enough to be facing that. And then he had to hear that it was to be delayed, while I argued with an insurance company. The reason the insurance company gave for turning down the claim was that they considered the bone marrow transplant "experimental." Actually, at that point, it was not. It had a proven record of success and would soon become standard treatment. In fact, within several years, it was replaced by an even more cutting edge treatment, stem cell transplants.

I begged the doctors and the hospital to go ahead with the procedure and vowed that I would pay them the full amount no matter how I had to raise the money. Of course, as Dan mentioned, his union threatened to pull their entire and very lucrative contract if the insurance company didn't honor their original obligation. Meanwhile, my own insurance company had agreed to pay for the bone marrow transplant. For all that people used to advise me that, for young people, we were "over-covered" with insurance, I learned the hard way never to trust or depend on only one company for health insurance coverage. We remain gratefully "over-covered."

Basically, his greedy company almost denied Dan his life. So, please, don't ever tell me we don't need significant health care reform or stronger unions. It gets personal!

Getting Priorities Straight on Health Care Spending?

Warning: This is a joke. It was sent to me by a friend with a slightly twisted sense of humor. It's why I cultivate and value her friendship:

Pfizer Announcement
Pfizer Corp. announced today that Viagra will soon be available in liquid form, and will be marketed by Pepsi Cola as a power beverage suitable for use as a mixer. It will now be possible for a man to literally pour himself a stiff one Obviously we can no longer call this a soft drink, and it gives new meaning to the names of 'cocktails', 'highballs' and just a good old-fashioned 'stiff drink'

Pepsi will market the new concoction by the name of: MOUNT & DO.

Thought for the day: There is more money being spent on breast implants and Viagra today than on Alzheimer's research. This means that by 2040, there should be a large elderly population with perky boobs and huge erections and absolutely no recollection of what to do with them.

On a more serious note, there are insurance companies that will pay for Viagra but not for prescription birth control pills or devices. Even more telling, dental care is not covered as a medical expense by many insurance companies. Nor are glasses, hearing aids, orthotics and other auxilliary medical devices. I can't imagine that those items are not considered medically necessary while coverage of Viagra is earnestly defended as "medically necessary to preserve and enhance lifestyle choices," as one executive years ago claimed on one of the Sunday morning talk shows.

Why The GOP Can't Support Obama's Health Care Reform

Most progressives expect the GOP, especially its conservative wing, to give stiff opposition to any Democratic health care plan. Indeed, Republicans have been promising (threatening) more of the same obstructionism that has so turned off the nation in two election cycles. They are clinging to the hope that if Congress and the new president fail to accomplish the goals they set out to, and thus fail to keep their campaign promises to the public, voters will get so disgusted at them that they will turn back to the Republicans. They've more or less bragged that this is their strategy for regaining control.

Now, Huffington Post writer, Nicholas Graham, reports on just how scared some in the Republican Party are about Democratic reforms, especially about successful health care reform. To make his case, he uses this extensive quote from James Pethokoukis, at U.S. News:

1) Passage would be a political gamechanger. Recently, I stumbled across this analysis of how nationalized healthcare in Great Britain affected the political environment there. As Norman Markowitz in Political Affairs, a journal of "Marxist thought," puts it: "After the Labor Party established the National Health Service after World War II, supposedly conservative workers and low-income people under religious and other influences who tended to support the Conservatives were much more likely to vote for the Labor Party when health care, social welfare, education and pro-working class policies were enacted by labor-supported governments."

Passing Obamacare would be like performing exactly the opposite function of turning people into investors. Whereas the Investor Class is more conservative than the rest of America, creating the Obamacare Class would pull America to the left. Michael Cannon of the Cato Institute, who first found that wonderful Markowitz quote, puts it succinctly in a recent blog post: "Blocking Obama's health plan is key to the GOP's survival."

Basically, Paul Krugman, New York Times columnist and Nobel winning economist, made the same point in his recent book, The Conscience of a Liberal. According to Krugman, conservatives will fight tooth and nail to prevent a national health care system because if the government is successful at implementing a program that delivers universal health care, it will give lie to the conservative argument that "government is the problem not the solution."

We actually know, for a number of reasons, the market is not the solution to every social problem, though it does a very good job at delivering consumer goods, which is what it was designed for. But if the government takes over a service that is basically bankrupting large corporations (one of the reasons that manufacturing and other businesses are no longer competitive in the global market is that we are one of the few first world nations that doesn't have government aid in health care delivery) and does it successfully, it discredits the philosophy of the Ronald Reagans, Grover Norquists, Alan Greenspans, Milton Friedmans, Martin Feldsteins, and the whole host of supply siders who insisted that governments were stupid and markets were omniscient.

So, look for tooth and claw resistance to any health care plan put forth by the Democrats. The Republicans in Congress will once again be putting dogmatic ideology and loyalty to party over pragmatism and the good of the country. Unfortunately, doing so is their only key to survival right now.

Obama v. McCain: A Tale of Two Health Care Plans

The difference between Barack Obama’s and John McCain’s health care reform proposals couldn’t be starker. Obama’s plan is based on the reforms enacted under Mitt Romney in Massachusetts. McCain’s plan has some roots in existing plans in about 34 states, which have met with some degree of success. But a good deal of his proposal is untried and is based more on free market ideology and wishful thinking than proven remedies. Let’s start with Obama’s plan.

Under his proposal, most people would stay in their current employer-based health care plan. Large companies that didn’t offer a health benefit would have to pay penalties. That would encourage those businesses that can afford it to provide health coverage for their workers. But people who work for small businesses that can’t afford to pay for health benefits would be encouraged to buy their own insurance from the individual markets. In Massachusetts it’s mandatory to have health insurance – just as most states make car insurance mandatory. If you refuse to get coverage, you too could pay a penalty. But if you can’t afford coverage, the state would subsidize it for you.

In fact, that’s the one sharp difference between the existing plan and Obama’s idea. He wouldn’t make it mandatory. He caught flack for that from Hillary Clinton and even Paul Krugman, both of whom feel that making it required by all would be a better way to make sure it's truly universal. I think they’re right, but Obama is correct that politically it would be much harder to get such a bill passed. Even with a Democratic majority in Congress, you would still have the conservative Blue Dogs uniting with the remnant of GOPers to block its passage. So, if politics is the art of the possible, you go with what you can get. But back to the Massachusetts plan.

In addition, in Massachusetts the private insurance companies can’t deny coverage to those with pre-existing condition or charge them more for coverage.

So far, this plan is working well. It’s popular with citizens and has increased the number of insured. But it hasn’t been without drawbacks, as reported by this Washington Post article.

In the 31 months since the experiment here began, the share of working-age people without health insurance has plunged -- from 13 percent to 7 percent by one estimate -- more sharply and quickly than anyone expected, leaving Massachusetts with the lowest uninsured rate in the country. But the unexpected number of people also has translated into higher-than-expected costs. Massachusetts has been forced twice to scrounge for extra money, totaling more than $250 million this year and last, from state funds and other places.

But even its biggest supporters agree that it’s less than perfect.

"It isn't like you come up with a perfect plan and turn it on and see how it works," said Brian Rosman, research director at Health Care for All, the nonprofit that runs the state's largest private health help line. "Washington needs to understand that as well."

John McCain’s plan, however, could be so much worse. For starters, some believe that it would be more expensive than the Massachusetts plan. And the major part of it is completely untested. Here’s the run down of how McCain’s plan works.

Under his proposal, everybody would get a tax credit to buy their own insurance on the open market. To pay for that tax credit, McCain would tax the existing employer-based health insurance benefit. This is the first time this was ever done and even some of McCain’s own advisers admit it could discourage businesses from continuing to offer health coverage to their employees. In addition, McCain would allow people to buy their coverage in companies out of their own states ostensibly to increase competition.

But this would encourage many insurance companies to set up headquarters in states that have the least restrictions and leave customers with less protection from predatory and unfair industry practices. Some likely outcomes include insurance companies charging deceptively low premiums up front but with large deductibles, limits on coverage, refusal to pay out for many different types of conditions, and denial of coverage to large numbers of consumers. In fact, large private insurance companies would cherry pick the healthiest customers, dropping those who prove to be too expensive. Those are already common industry practices and allowing people to buy their insurance across state lines, practices like that would only exacerbate the problem.

Worse, even with a tax credit or subsidy, many people would be unable to afford insurance. The proposed tax credit is only $5,000 per person and decent insurance costs about $12,000. That would leave middle class families scrambling to pay an extra $7,000, much more than what they’d have to pay for an employer-based plan. Douglas Holtz-Eakin admits that many people who currently enjoy employer-based health care would be left out in the cold with no insurance.

And those who have health risks, such as being overweight or just being too old, would be thrown into high risk pools. It’s the high risk pools that the Washington Post examined in this article. And they found real problems with them.

First you deserve to know what is right with them. Thirty-four states already have these plans and some of them do their job fairly well for those covered. The oldest and best high risk pool is probably in Minnesota. And the treatment they provide is excellent.

Here in Minneapolis, Lynn R. Gruber, MCHA's president, said: "We treat them like gold. It's all we do, focus on these chronically ill members, what their needs are." Members get discounts on specialty drugs. Those who are particularly sick get letters or phone calls coaching them on how best to manage their ailments.

Despite that the drawbacks to high risk pools are significant. Most importantly, they cost more than Obama’s plan. They cost the state more and they cost the consumer more too. Here are some quotes.

The Maryland Health Insurance Plan, the only high-risk pool in the Washington area, has been growing so fast that it needed to raise the fees on hospitals that help pay for the program and require new members to wait longer for coverage of existing illnesses -- or pay extra for it.

And referring to Minnesota:

Its finances are strained and getting worse, but less so than in other states. California's high-risk pool is so strapped that it put a limit on enrollment this year and lowered the maximum it would spend on anyone's treatment. Tennessee's pool has had to eliminate low-income subsidies for new members. Florida's pool has not let in anyone since 1991.

And the burden of high costs are also borne by those enrolled in the pool.

No one in Minnesota can say for certain how many people who need MCHA stay away because of the price or the waiting period. But the American Cancer Society says that only a tiny fraction of the more than 100 Minnesotans it has referred to the program because they were rejected by insurance companies ever signed up, according to Stephen Finan, the society's associate director of policy.
As another sign of the financial burden, an increasing number of MCHA's members lately have been choosing to pay more out of their pockets -- deductibles as high as $10,000 -- in order to have less expensive monthly premiums.

So, higher costs for the state and the consumer and also higher deductibles and less coverage. It is, of course, better than nothing. But as even one of its own top administrators admits, this is a stopgap measure, not a solution to the health care crisis.

Still, even MCHA's most ardent supporters believe a risk pool is not the best solution for those who are hard to insure. "It is not a panacea. . . . We need to be moving in the direction of universal coverage," said Gruber, who has run MCHA for 18 years. "No one should be rejected because of their health conditions. Our federal government has failed us . . . if we are still here in five or 10 years."

As I said at the beginning, the contrasts in these two different approaches couldn’t’ be more different. Nor could the response of those most intimately involved with them. On the one hand, there’s the Massachusetts approach that Obama favors. Both citizens of that state and those who work with the program are enthusiastic about it. Its main drawback is higher than anticipated cost.

McCain’s proposal, the high risk pool, also higher costs but less service and its own administrators admit it’s a stopgap not a solution. And then there’s the rest of the McCain program, which is untried and based on faulty free market, anti-regulatory ideology that is rapidly becoming discredited in every other enterprise where it has been tried.

Here I have to add that the free market proponents keep claiming that one of the advantages of their approach is that if people have to purchase their own health care on an open market, they will make better, more cost conscious decisions.

The truth is choosing medical care is not like shopping for a new Chevy van or a new dress. It is not elitist to state that most patients are not in a position to make a clear headed decision about the best course of treatment for a catastrophic illness when they are in the throes of it. Even most doctors admit that once they are patients with conditions outside their specialties, they are as daunted and confused as any other patient. The amount of knowledge, technology and treatment options are dizzying. The cheapest option may not in the long run be the best option and asking people to make a decision based upon their pocket book at such a time is ridiculous.

A patient may well be able to shop around for the cheapest place to get treatment for a strep throat and the best price on the antibiotics with which to cure it. But give that person a Stage IV throat cancer and he shouldn’t be wasting his time consulting his banker before choosing between treatment plans.

So, there you have the choice. Two very different approaches to health care. Next Tuesday, vote as if your life depends on it – because it very well may.