On Tuesday, President Obama spoke for almost an hour on various domestic issues, including the reform of our health care system, and the introduction of universal coverage.

You can watch the part of the speech concerning health care right here, or read the transcript below. I'll publish analysis of the proposed plan tomorrow.

Excerpt of the speech concerning health care reform:



And for that same reason, we must also address the crushing cost of health care.

This is a cost that now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes. In the last eight years, premiums have grown four times faster than wages. And in each of these years, 1 million more Americans have lost their health insurance.

It is one of the major reasons why small businesses close their doors and corporations ship jobs overseas. And it is one of the largest and fastest-growing parts of our budget.

Given these facts, we can no longer afford to put health care reform on hold. We can't afford to do it.

It's time.

Already, we've done more to advance the cause of health care reform in the last 30 days than we've done in the last decade. When it was days old, this Congress passed a law to provide and protect health insurance for 11 million American children whose parents work full-time.

Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives.

It will launch a new effort to conquer a disease that has touched the life of nearly every American, including me, by seeking a cure for cancer in our time.

And -- and it makes the largest investment ever in preventive care, because that's one of the best ways to keep our people healthy and our costs under control.

This budget builds on these reforms. It includes a historic commitment to comprehensive health care reform, a down payment on the principle that we must have quality, affordable health care for every American. It's a commitment

It's a commitment that's paid for in part by efficiencies in our system that are long overdue, and it's a step we must take if we hope to bring down our deficit in the years to come.

Now, there will be many different opinions and ideas about how to achieve reform. That's why I'm bringing together businesses and workers, doctors and health care providers, Democrats and Republicans to begin work on this issue next week.

I suffer no illusions that this will be an easy process. Once again, it will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our health care has weighed down our economy and our conscience long enough.

So let there be no doubt: Health care reform cannot wait, it must not wait, and it will not wait another year.

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   All of the obvious signs point to a big day for health care reform today, as President Barack Obama addresses Congress in a joint session in Washington on Tuesday evening.

   Most administration "watchers" (and most cable tv networks, newspapers, bloggers, and your know-it-all office mate) already know what the meat of the speech is going to be: bringing health insurance coverage to the 1 in 7 Americans who currently lack it.

Great, right? Our job here is done. Right?

Unfortunately, not so fast.

With the stimulus funded, is there money left for health care???

Stated quite simply, no.

   It isn't necessarily that the money is lacking in Washington to pay for meaningful reform after close to 800 billion was spent on the economic stimulus package just last week. Rather, it is the political will, that's lacking.

   President Obama always needed 100% support from his Democratic brethren if there was going to be any hope of challenging the health care status quo. On top of this, he, and his Administration, would have needed considerable support, tacit if not actual votes, from across the aisle.

   Now, however, most Republicans in Congress are smarting from what they perceive to be a defeat over the stimulus package that (supposedly) went against everything they stand for. Because of this, they are not likely to give the President an inch in their stance on an issue, that, as I've described earlier, borders on holy doctrine for many in the Grand Old Party and their K Street supporters.

   Not only are President Obama and his health care team going up against formidable opponents in the form of Republican Congressmen and Senators, but the Administration may receive a lukewarm response from a smattering of fiscal conservatives in his own party as well. Some of these Democrats voted along party lines for the stimulus, but are privately appalled at the amount of new federal spending that the bill authorizes. These Democrats are not as likely to toe the line so readily again, especially not when it comes to any new programs that involve massive Treasury outlays.

How it might get paid for could piss off your rich uncle

   The "total cost" figure of 65 billion is one that has been floated by the administration in the press for some weeks now. It is a figure that is probably ridiculously low, realistically-speaking.

   But even if one assumes that the (initial? final? total? yearly? what?) cost of revolutionizing the way we Americans pay for health care is going to be only 65 billion dollars, where does President Obama plan on getting this money? Especially after spending 800 billion we already didn't have on the economic stimulus bill and promising to cut the budget by 50% before his first term is up...

Where will this money come from???

   Well, if you want Western European-styled government services, you're going to need Western European-styled taxation. Which is exactly the idea that is being tossed around in the West Wing these days. That's right: tax the rich.

   A repeal of the Bush tax cut on the wealthy was just a matter of time, but now the President and his allies in Congress (i.e. The Congress) have the excuse to get it done: tax the rich, in order to save our health care system, and provide insurance for all. It may sound socialist, and to many, it may sound un-American. It may also be the only option that is left.

   We can only hope that President Obama will present a logical, bipartisan plan on Tuesday, laying the groundwork for meaningful and true reform later in his term. In any case, it is going to be a long year for those of us who hope for meaningful change in the way that we all pay for health care.

Compare health plans and get instant quotes: The search for the best coverage at the lowest price starts with comparing as many plans as possible from providers in your area. To choose among the hundreds of plans available to you, use our fast and free comparison service to get quotes from major insurers in your state:

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    Whether or not President Obama ultimately decides to nominate Kansas Governor Kathleen Sebelius to head the Department of Health and Human Services, one thing is clear: the new administrations intends to pursue the reform of our health care system with the vigor and energy that the President and his supporters promised the public during the election campaign.

    Those who want to see change happen, may not have to wait much longer: according to press reports, we can expect Mr. Obama to tackle the topic of covering the uninsured in his prime-time address to Congress this coming Tuesday.

    This action couldn't be more timely. With the number of uninsured Americans expected to rise to as much as 57 million at the end of 2009, up from a high of 47 million last year, the Obama administration simply must tackle this issue head-on, lest it derail all hope of economic recovery, both for the country, and for the millions of families facing bankruptcy due to unexpected (and unpaid) medical bills.

    Of course, as with every issue of this magnitude that is discussed openly in the political arena, there is an elephant in the room that no one wants to bring up first.

    This may seem obvious, but it bears repeating: as people lose jobs, they, and very often their entire families, lose health insurance coverage. Sure, there is COBRA, but those who point to COBRA coverage as the savior of the newly-unemployed conveniently ignore one startling fact: the bridge coverage that COBRA provides often costs recipients as much as 90% of the unemployment benefits they are entitled to collect.

    When the Sisyphean choice is housing or health insurance, or even food or health insurance, the more pressing needs almost always win out. Yes, some people manage to get on Medicaid when employer-sponsored group coverage disappears, but the number of those who qualify is small as compared to the total number of Americans who are losing their jobs (tens of thousands every day, it seems).

    Lawmakers will ignore the growing number of uninsured at their peril. With every new family kicked off the traditional, employer-sponsored insurance rolls, the health care system must somehow absorb individuals who still need care, but are no longer able to pay for it. This puts additional strain especially on public hospitals, clinics, and emergency rooms, institutions that can already be described as "always reeling" from budget cuts by state and local governments.

    No one knows for sure if the already-strained-to-the-maximum health care system can absorb ten additional uninsured this year. The fact is, it probably cannot. This is more reason why Congress, even as it licks its wounds from a short but violent stimulus bill fight, must tackle head-on the issue of reforming the way we pay for health care, lest we all pay for inaction tenfold later on.



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Compare health plans and get instant quotes: The search for the best coverage at the lowest price starts with comparing as many plans as possible from providers in your area. To choose among the hundreds of plans available to you, use our fast and free comparison service to get quotes from major insurers in your state:

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As has been rumored for some time, two-time Democratic Governon Kathleen Sebelius of Kansas will be nominated by President Obama to be the next Secretary of Health and Human Services.

According to the New York Times, Governor Sebelius is expected in Washington this week to continue the vetting process, which has gotten even more stringent after the withdrawn nomination of former Senator Tom Daschle over tax issues.

Because of the deeper investigation into each new nominee's finances and business affairs, it is unclear whether the Governor will be formally nominated this week or next, however, an adviser was quoted anonymously as saying that there are no other candidates near the top at the moment.

The impact on reform

As I've mentioned before, Governor Sebelius is an excellent choice for the role of spearheading health care reform efforts, because of her years of experience in working with industry while she was the Kansas Commissioner of Insurance, and also because of her extremely effective bipartisan efforts at reform while she served as Governor.

I believe that bipartisanship will be first and foremost on the Administration's mind as it attempts to push through some form of universal coverage past a recalcitrant Congress, entrenched industry interests, and overall ideological opposition to reform that borders on the religious in some parts of the political spectrum.

Having had a relatively tough time passing the financial stimulus bill, Mr. Obama and his Administration could be facing a possibly even more formidable set of opponents as they try to overhaul the decades-old way that Americans pay for health care.

Governor Sebelius' experience in the health care arena, coupled with her bipartisan reputation, will be instrumental in moving any bill through the congressional committees that will invariably try to kill anything that resembles real change.

Would a Former Health Care Slasher Governor Make a Good Choice to Lead the Reform Effort?

After the resignation of Tom Daschle from consideration to head the Department of Health and Human Services, there has been a bit of a stampede by new candidates for the post.

Chief among these, are the candidacies of Tennessee Governor Phil Bredesen, and Kathleen Sebelius, the Governor of Kansas and a rising star in the Democratic party.

While the recent trend of choosing "executive" Governors for cabinet posts would continue regardless of which of the candidates is picked, the differences between the two can be stark.

Ms. Sebelius, a former Kansas Insurance Commissioner before becoming governor, was once named one of the "100 Most Powerful People in Health Care" by Modern Healthcare magazine; she was instrumental in preventing private take over of the state's Blue Cross/Blue Shield program by out-of-state private interests, as well as in some other initiatives, including increased prescription coverage for seniors, and an innovative program which allows Kansans to purchase less-costly prescriptions from Canada and Europe.

She has also been lauded for initiatives that crossed ideological lines in trying to lower health care costs across the whole spectrum of service.

From KSGovernor.com

In an effort to rein in skyrocketing health care costs, Governor Sebelius organized a Cost Containment Commission of business leaders, health care providers, private insurers, and patient advocates. The Commission has recommended ways to increase modern health care technology such as a transition to electronic medical records, which would reduce the cost of copying forms, as well as promote consistency in care and reduce the burdensome administrative costs that currently eat up more than thirty cents of every health care dollar.

The Slasher

Governor Bredesen, on the other hand, a former managed care executive, is reviled in many reform-minded circles for his slashing of the Tennessee Medicaid program, known as TennCare, in 2005.

At the time, the state had the highest percentage of any state's population on its Medicaid rolls. The costs, spiraling out of control, were seriously hampering the state government's ability to provide other basic services.

After some tough fights in the legislature, Gov. Bredesen cut 170,000 Tennesseans from the rolls, and reduced the benefits for countless others.

These may sound like draconian measures, more likely to be attributed to a conservative governor (and in fact, many conservatives love his candidacy for HHS), but this should not disqualify him from consideration by reform-minded progressives, seeing as he was able to bring a bloated monster of a health care system under control in his state, when inaction would have been fatal to the it.

Gov. Sebelius appeals to many for her ability to work within the system, bringing insurers, doctors, and even drug companies and hospitals together to figure out solutions. She's an excellent candidate. But I have feeling that Bredesen would not be the disaster at HHS that MoveOn and the like claim he would be. Some times, you need decisive action, even if that action is painful.

Some good news out on Thursday following the withdrawal of Tom Daschle's nomination for Secretary of HHS and administration point man on health care reform.

Two leading Democratic Senators, Ted Kennedy and Max Baucus (who has his own plan for health care reform he introduced last fall), wrote a letter to President Obama reaffirming their continued support for reform.


It's good to know that some people on the Hill intend to keep the pressure on. The SCHIP bill signing was a good first step, but we need more, much more!


Here's the full text of the letter:

Dear Sir:

We were saddened to hear about Senator Daschle's decision to withdraw from the nomination process. While we continue to believe that Senator Daschle is highly qualified to hold the position of Secretary of Health and Human Services, we respect his decision and wish him all the best in his future endeavors.

We are writing to affirm our continuing commitment to enacting comprehensive health care reform this year, and to express our confidence that you will swiftly choose an exceptionally qualified and dedicated alternate nominee for Secretary of Health and Human Services to assist in our efforts. As you have emphasized, we must act now. The ranks of the uninsured grow larger each day. The cost of health care to families, businesses and government are crippling and, although we spend more on health care than any other country, the quality of care provided by America's health care system is often uneven compared to other industrialized nations.

We have a moral duty to ensure that every American can get quality health care. We must act to contain the growth of health care costs to ensure our economic stability; to help American businesses deal with the health care challenge; and to make sure that we are getting our money's worth. Incremental efforts will no longer suffice and we cannot afford to wait any longer. With your continued leadership and commitment, we remain certain that our goal of enacting comprehensive health care reform can be accomplished this year.


Respectfully yours,


Senator Max Baucus
Chairman
Senate Finance Committee

Senator Edward M. Kennedy
Chairman
Senate HELP Committee

The measure, which passed Congress on a 290-135 vote, guarantees medical insurance through the States Children's Health Insurance Program.

The program will be expanded by the addition of up to 4 million kids, up from the current 7 million who participate.

President Obama called the signing "a down payment on my commitment to cover every single American".

Republican members of Congress, who in the past have blocked the CHIP program (a watered down version had passed in the previous Congress, but was vetoed by President Bush), expressed reservations, but didn't have the votes to beat the measure this time around.

This is a small victory for the new administration in what is likely to be a protracted battle over health care reform.

Some additional details from the the Associated Press.:


The CHIP program

_ Continues coverage through 2013 for 7 million lower income children.

_ Expands coverage for another 4.1 million uninsured children.

_ Makes 2.4 million children eligible for the program who otherwise might have access to private insurance.

_ Provides an additional $32.8 billion through Sept. 30, 2013, by increasing federal excise taxes on tobacco products. The tax on cigarettes will go up 62 cents to $1.01 a pack.

_ Provides $100 million in grants for states, local governments, schools and others to enroll more eligible children.

_ Requires states to offer a dental benefit.

_ Allows states to offer SCHIP dental coverage to children whose private medical insurance does not cover dentist visits.

_ Allows states to extend SCHIP and Medicaid to newly arrived legal immigrant children and pregnant women.

_ Allows states to use Social Security numbers to verify an applicant's citizenship, making it easier to prove eligibility and enroll in the program.

Daschle withdraws.

Damn it all to heck!

Daschle was an eminently qualified candidate. This is a major blow to our hopes for reform, AND to the Obama administration's plans for change.

The GOP is playing hardball.