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August 22, 2009
Dear President Obama #215: Fighting from the ropes
Posted: 06:49 AM ET
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Reporter's Note: President Obama, in a poll late this week, has found more Americans disapproving than approving of how he is handling health care reform. I’m writing a letter each day to the White House, whether anyone approves or not.

Tom Foreman | Bio
AC360° Correspondent

Dear Mr. President,

This is gut check time. Time to back yourself into a corner, rally your team around you, and prepare to defend the castle. This letter is not about whether your health care reform plan is good, bad, wise or silly. That’s for you and others to decide. Polls are running against you now on this issue; people who voted for you are raising questions about your abilities. So this letter is about tenacity.

When I was a kid, we moved from South Dakota to Illinois and I tried to settle into a new neighborhood over the summer. Champaign was much bigger than the town I’d known, and I was more than a little nervous. One day my brother and I were throwing a football in a field across from our house. An errant throw landed near a kid on a passing bicycle. He hopped off, and punted it as far as he could for me to chase.

“Now, go get it!” I ordered, with all the toughness of a third grader with something to prove. (Bear in mind, back then transferring schools was like going to a new prison; you had to establish your credentials up front.) He walked right up, stared me in the eye, and said, “Are you going to make me?”

The fight was fast and decisive. He took a swing, I pounced, and with the luck of the Irish and a weight advantage I took him down, grinding him into the dirt and pinning his arms beneath us.

“Give up,” I commanded, in the timeless tradition of back yard fights.

“No,” he responded.

“Give up!” I urged.

“No.”

“Punch him,” my brother said.

“No,” we both responded.

That’s how it went until my mother pulled us apart. I later found out, the kid was named Ken and was renowned for never, ever, under any circumstances surrendering. His insistence on fighting out to the very end any dispute was not the model of diplomacy to be sure. But it made him a force to be reckoned with. Even in defeat, he commanded a strange respect because he showed no fear, and you knew he would fight you the next day, the next, and the next.

Being President, of course, is not like being a schoolyard tough, but sometimes some of the same rules apply. This is something I can tell you about this town with certainty: Presidents can lose fights, but if they appear weak, indecisive, or beaten they effectively lose their presidencies. So I’ll give you the same advice I’d give to any President in such a situation.

One: Don’t let anyone tell you the fight is lost. That is a decision only you can make. Hillary Clinton won many admirers, even among Republicans, for her toughness in the campaign; for fighting on, and making you prove your stuff, even when the math said she could not win.

Two: Win, lose or draw, stand up and face the music with a steely eye. When I was coaching one of my daughter’s soccer teams, I always said, “We don’t have to win every game, but we have to play hard every time, no matter the score. Losing is not the end of the world. But losing your self-respect comes pretty close.”

And three: Keep your perspective. No matter what happens in this fight, it is only one battle. The victory does not go to the faint heart or the easily dissuaded. Often it goes to the person who just hangs in and keeps swinging.

Call if you need more encouragement. Like I said, this is not about health care; this is about the kind of character we expect in our leaders, no matter what policies they pursue.

Regards,

Tom

Find more of the Foreman Letters here.

72 Comments
72 Comments
Patrick   August 22nd, 2009 8:06 am ET

Let's learn from history... we did nothing and were given Pearl Harbor... did nothing after the first World Trade Center attack and eventually got to see them fall... Do nothing to fix the problems in healthcare (1/6 of GDP) and our children and their children will get a failed economy... Obama we in the black community didn't rally behind you expecting for you to be popular... We rallied for change.

RLWellman   August 22nd, 2009 8:36 am ET

This is a problem. You tell the President to back into a corner and defend himself and his health care reform plan.
1st- It's not his health care, it will be ours! Him nor his cronies will be signed up to have this plan for themselves.
2nd- It's not his job to defend his plan. He is our representative, not our boss. He is supposed to work and provide what the majority of the country wants.
3rd- You don't make laws for the whole country by listening to the minority left liberals. That's why we are a Democracy, majority rules.
This President does not care what the majority wants. He wants what he wants and if you don't go along, you're the bad person.

Innocent   August 22nd, 2009 8:46 am ET

Mr President, Tom Foreman's letter to you is poignant and the truth is that your are on the right track. It doesn't matter what the insurance companies and their cohorts are doing to derail this rerform. You inherited all these problems and now they are yours. So don't give in to agents of blackmail and continue to serve America the best you can. The stimulus has already shown that you are right and posterity will vindicate you that healthcare reform with public option is the right thing to do in order to save our companies,people and country from been insolvent.
Bess you Mr President

bakinakwa   August 22nd, 2009 10:01 am ET

Your letters to the President have become increasingly patronizing and borderline condescending. It isn't clear in what capacity you deserve to be offering advice to the President in the first place, but to then to come across as a know-it-all who feels the need to coach and encourage the President, using a tone and diction one would normally use when speaking to children, is plain embarrassing. Maybe you and CNN think these letters are funny and clever; to me, they just seem bizarre and borderline offensive. You should consider ending this little project.

Bak

Helen   August 22nd, 2009 10:23 am ET

As a Canadian, with "national" health care, I can only wonder at the reluctance of Americans to accept the beginnings of a national system of health care that addresses the deficiencies in the system Americans presently enjoy, or not.. The rhetoric has gotten so out of proportion to the actual proposal that it almost becomes its own force. Even voices of calm and assurance cannot break this cycle of aggression towards fellow Americans. Looking in from your northern border, many Canadians are bewildered by what looks like pettiness and unChristian-like bad feelings. You know, Europeans, Canadians, and many others have a national health care system that while in some instances might be flawed, it generally works, and when people are sick, help is available. It really doesn't get any simpler: all people need to be assured of some level of care, not just those who can afford it, and not second rate care for those who can't. The proposal by the Obama administration seems to address most of the issues of the "haves' by allowing people to choose their own health care providers and by seeking a middle ground. Why can't it work? The present system doesn't seem to be working for those who work and for those who don't work. It seems to work for the very rich, who just buy whatever they need. It really doesn't seem to work for those who pay huge amounts of money for care that then is proscribed by rules of HMOs who don't allow payers to choose their health care provider anyway. Somehow health care has become anti-American, anti democratic, anti-history. Last time I looked, Finland, UK, Belgium, Norway, Sweden, Canada etc were democracies. Flawed but still there. And we live longer than the averaage American, flawed health care or not.

Greg   August 22nd, 2009 10:45 am ET

I second that. You can't win every battle
They only remember if you
One the war

John   August 22nd, 2009 10:53 am ET

I agree but I say you stand on what you belive in and never back down unless someone can show youa better way to acheive the same results. We need healthcare and you know it even if people are listening to the nay sayers now stand strong and see this thing through. If our for fathers would have given up as easily we would all be speaking with a British accent.

Lee Harris   August 22nd, 2009 10:55 am ET

Has anyone ever read the story of the three little pigs, well one of the little pigs runs all the way home shouting weewee, so I would imagine when the president states that everyone is all weewee'd up he is saying some reporters and politicians are just running around in August with nothing else to do.....just weewee'ing and shouting all the way home....LMAO

mike huber   August 22nd, 2009 11:07 am ET

Tom

Good comparison, I agree. I knew Obama would make mistakes, the question now is 'will he learn from them?'

Tom, Jr   August 22nd, 2009 11:24 am ET

Dear President,

How about a few facts, please?

I do not mean facts such as Medicare is wonderful and our senior citizens are happy with their care. That is debatable, and 1. they have no other option and 2 many doctors will not accept new medicare patients because their cost is less than medicare's reimbursement. (And guess who gets to pay the difference.) By the way, in an interview an insurance company exec said that everyone of the company's health insurance subscribers was paying a little over $1,000.00 in higher health insurance premiums because of this medicare policy. No, I don't believe everything I hear, but I can tell you that every doctor's office you call these days and inquire about the practice accepting new patients will ask if you are on medicare and many flatly state they will not accept medicare insurance even before asking the question.

And we are going to save billions from medicare of the forthcoming decade by reducing unnecessary costs and eliminating waste and abuse. Ah, right. Which administration ever since medicare was introduced hasn't made that claim? And why would you want to? Medicare fraud is probably the biggest growth industry we have in the United States. Probably has more new players even than the royal court composed of special advisers, panels, and czars not to mention their individual dukedoms. When you promised to create, albeit then modified to "save or create," millions of jobs, most of use did not realize it wasn't productive jobs. Sorry, I transgress.

No, it is not a fact that a doctor will not treat your diabetes because he can get a bigger pay-out if he waits and amputates your foot. Is that not what you said in your speech? Wasn't that just before you attacked the critiques for misrepresentation or spreading lies and falsehoods? Sure, I know it was a parable. And I don't think that aspect was lost on the Bible clutching, gun toting crowd. I suspect it was aimed at those who went to the polls last November and elected the prom queen instead of a president. I seriously doubt if many of them understood it was hyperbole. You weren't really serious, right?

When you say that health care cost will double in the next ten years, it is inference that since it has doubled in the last ten, we can extrapolate that curve into the next 10, right. Or did someone actually take the time to look at what is going to happen to the gross numbers of medicare eligible in our population? Excuse me, but will you also please mandate that my property taxes that too have doubled in the last ten years be held in check... or my house insurance that has more than tripled, or my kids' college costs, or my fuel bills...? If I support you here, can you get rid of that pesky personal property tax for me ... or should I offer Dodd or Mertha a campaign contribution and see if they will take it in?

And when the crazies say that health care will be rationed under such a government program.... Of course it is fear-mongering. Just like in 2006 when the government run program in Great Britain decreed no coverage for an effective, but expensive, special drug for macular degeneration (a disease that strikes the elderly much more frequently than youngsters) until the elder was totally blind in at least one eye. That's not rationed care? How dare They extrapolate that public system with one we have never tried... Sorry, I momentarily forgot that we are not a Christian nation like them.... Have nothing in common, right? We are much more like the Canadians whose national health care system inked deals with US hospitals to send their patients to the US hospitals for tests and procedures they did not want to invest in. Oh. Have you worked that out with Mexico?

So, if you do decide to give us facts instead of rhetoric, please make it facts – not your (or an adviser's) conclusions from somebody's facts. Believe it or not, there are a few of us who like to know facts and can use them to draw our own conclusions.

Warren-Canada   August 22nd, 2009 11:35 am ET

Exactly Mr. President, you represent that which is good about America-respect and dignity for those in need as opposed to private greed. Keep your eye on the prize so to speak and in the long run your efforts will be rewarded with a second term in 2012. You will always have your detracters but stand firm on this issue and you will be judged by voters and by history as a great president.

Tyrone   August 22nd, 2009 12:05 pm ET

This healthcare situation is just amazingly stupid! President Obama is trying to do the right by Americans. And you got these stupid white so-called American. Mad about no body knows what. They are just yelling! Then you got the white stupid racist media that repeat the same talking point. " President Obama should have started off better explaining his healthcare program! If President Obama fails to get his plan past then he is a failure as a President. Which is just not true. Sane people know that JOBS and geting the country back from the stupid situation President Bush put the country in is not easy task. Shamefully republicans that voted for the Iraq War that took to date 4,339 American troop FOR NOTHING! Where quick to vote for a war that was a lie. President Bush didn't have to do much explaining. The 911 report stated that President Bush and the idiot that sent American troops to Iraq. Forgot armor that could have saved 750 troops from death. The healthcare bill will help 47 million un-insured Americans. And sick white Americans call President Obama Hitler?

Christopher   August 22nd, 2009 1:09 pm ET

I watch CNN fairly regularly and I was shocked when I watched a commercial claiming to be Canadians seeking health care treatments in the US. One lady claimed she had to seek chemotherapy treatment in the US due to a six month wait list. I found this to be absolutely absurd. I am a registered nurse who worked in oncology for many years (recently) and once diagnosed a patient was offered up to-date state of the art treatment options. If chemotherapy was an option it was offered to the patient and they could begin treatment immediately. I currently work in a dynamic and state of the art open heart surgery intensive care. Our current surgical wait list is up to-date. If your condition required surgery today you would receive it. Despite Sarah P's myth about Canadian death panels – health care in Canada advocates for ALL people – even visiting Americans who decided to travel without mediacal insurance – on the flip side – over 40 million Americans cannot access basic health care and for those who have insurance – death panels in insurance companies decide on what treatment they can afford for you if any.

The health of a nation must not be it's gross national product or the strength of their postion in the world – it should be based on how well they care for all of their citizens. Universal health care is not socialist, it is a personal responsibilty for all citizens to show compassion and advocate for those less fortunate. I recently traveled to Hawaii on a cruise and our stateroom officer (American) told us he lost his wife to cancer in Alaska. Apparently his insurance did not cover the chemotherapy treatment and she died as a result. That would NEVER happen in Canada. I used to work in a downtown ER and many uninsured Americans would visit the ER (they were 19 or 20 years old) due to being over intoxicated or injured as a result of the latter. They refused to give their address or credit card upon admission. We never refused treatment – we treated them as if they were citizens of Canada – however – we had to pay their bill as a result of their self inflicted injuries. This never happened from visitors from other countries, They were more than happy to offer contact information – provide their insurance dicuments or credit card.

Our system is not perfect. We too are lookiing at improving upon what we consider a very good system. You need to travel abroad to third world countries to really value the gift and responsibility universal health care has on a nation. All citizens have value in such a system.

America – President Obama's plan may not be perfect – the health of your nation is failing on so many levels – listen up and care for one another. If you believe a politician (Sarah) who cannot complete a term in her political career (Governor and Mayor) – you're doomed. Your country is on the verge of civil war – you're so divided – bring back what America stood for – for each other – you are the beacon to the world for so many things – however – your integrity is being challenged. Stand up and embrace health care for ALL Americans. If you deny this opportunity – it sends a message to the world that you do not care for the basic needs of your nation – this is where you will loose credibility on the world stage. We need you back!!!!!!

Listen to your brothers from the north.

Mickey McGovern   August 22nd, 2009 1:21 pm ET

Dear Mr. President, Tom's right. And you're not alone. There are
many of us out there with you. When you took office I was hoping
that the fights between the Democrats and the Republicans was
over. That they would join forces to solve the many problems this
country has. But it's clear to me. Crystal clear. That they don't
want to help. They just want to bring you down. Stand up to these
people! Let's rumple!

kathryn harwood   August 22nd, 2009 1:21 pm ET

Why, oh, why doesn't anyone look at Canada's health care. I wish I was at one of these town hall meetings to say how horrified we are, and absolutely in awe of the ideas about universal health care.

It's not perfect, but I pay $50.00 a month for basic health care and sleep well knowing that I can get health care as a basic human right.
Americans are so adamant about the "right to bear arms'. How about the right to be unwell??

K

corvedacosta   August 22nd, 2009 1:46 pm ET

WoW
I loved your letter. This is something that mind you we should have heard a long time ago. The polls are against him and the reports coming out of Washington contains all the compromises that will go on to make a bill pass. The striking thing that separates Obama from Bush is not that they support different parties but it's that Bush would lead and force his policies through even though he didn't win with a huge majority. Obama won with a huge majority and is acting like he won with a minority of votes. We need to see how passionate Obama can be, the opponents are very passionate. I can understand with Obama where he wants to have Rep support but that will be like pulling teeth, he won't. I would love if he would show us some guts, and have one message emanating from the Whitehouse. He needs to really regroup and give us what he wants.
We know Hillary is tough lol your turn Obama.

marcus/arkansas   August 22nd, 2009 2:16 pm ET

I can't believe how easy people are swayed in thier opinions day to day by media news outlets.obama got the worst job as president coming in behind president (num nuts)-but still has manage to give a better outlook for the future than i thought possible.an as for micheal jackson media domination. a king-a legend -a ICON- a 45 year superstar to the end-the reason mtv made it-world wide domination tha scared the religuos set-the most unique human being of anytime-honored by -reagan -bush sr.-clinton-.-the savior of his industry more than once-given every award known to man. the only truly global star of anytime.the reason many tv shows survived(nancy grace an more). i could go on an never repeat my self when it comes to this (black man). but this is enough that yes the world should have stould steal upon his passing. an they did. thank you micheal.god finaly said well done my son come on home they need not whip on your name any more. p.s. humanatarian as a word shoul have his photo by it forever.

Roddy   August 22nd, 2009 2:28 pm ET

That letter is ridiculous! People... always trying to voice their grief. And that will never change.

Lori   August 22nd, 2009 2:33 pm ET

Dear Tom,
I am not convinced he can recover from spending so much money during his first 200 days of leadership in the Big City then, without skipping a beat, taking control of key industries. He is asking Americans to agree with policy that no one seems to clearly understand. This is asking for more than we can give right now. Successful leaders understand the importance of circumstances and timing and I think he is is own worst enemy.

In my humble (and I admit politically ignorant) opinion success is not a matter of winning or losing battles on the larger issues straight out of the gate. It should be a matter of strategy – understanding what needs to be done and taking small steps toward that goal. It is more important to never loose ground from the small steps you've made. Those add up over the long term. He as three more years. Why is he rushing?

Mike in NYC   August 22nd, 2009 2:44 pm ET

Tom's love letters to the Great One are embarrassing, as much for their feminine quality as for their in-your-face partisanship.

Libs would have had a field day with any journalist penning this kind of stuff for Bush. (Not that he deserved it.)

CNN is, for all intents and purposes, a propaganda arm of the White House.

Ron Green   August 22nd, 2009 3:28 pm ET

OMG, If the Gov’t cant do anything right, lets privatize, education, homeland security, the military, air traffic control, police, fire…etc.
Obviously the health of the nation needs to be part of the Govt’s purvue. Lets start paying for it with some of the massive profits the insure companies make off of the American workers.

Roseprophecy   August 22nd, 2009 3:44 pm ET

These are all professional paid for and supported and financed crusifixtions by my promoter and his gorup who organize and create idols merely to bring down and slander and ridicule for this is their job to do and they take it serious too! All presidents and I are in danger of negative propaganda of one man who finds his satisfaction by tearing honorable people down and in many cases come back and be their savior the kind of savior he and his group became for Michael Jackson who was so pushed into corner that he collapsed with the help of those he was obviously having problems with saying they are killing me! The statement I am hearing from myself every day while my promoter is maliciously censors and silences me while he uses his toxic access and opportunity platforms to promote my clones fo the past 12 years and there is noone asking him what are you doing exactly? Because everyone is busy covering themselves and he has braught them down from their pedestol after he puts them there to see them struggle in adversity he and his bodies create in a magical but fake and yet dangerous organization that does not leave a peaceful and civil environment for honorable people to hreathe in! The media especially in minority that only have one am radio in 670am kirn s filled with prostitutes who are helping him lie and give people lie news and promote plagiarists like Farhang Holaquie every day who steals from me slanders me and tells people they should deny me and pretend I do not exist so that he can go on especially now that he has written a book claiming my life work and it is a translanton so with heavy silencing and censorship of me it is easy to steal and up for grabs by all those who see the ocean of treasures of pioneering unpresedented work and are willing to lie and deny me and claimit and make history! So, those silencing me are the same as defaming presidents Bus hand Obama and makes them pawns of the molas who want nothing changed so that they keep putting the oil money to hollywood for slandering me and the rest of it in their swiss bank accounts for they know unless they build their atomic weaponry and become independent of other commodities they need they are falling and people are rising with defenate alternative these media keep away from them which means the author of 9 books and leader of the new movement for creating compassion democracy and freedom without war and violence but they say in the radio why do I want to be a leader while they make thieves and dictators leaders and promote them they slander me! I am a leader because I am the pioneer of unpresedented scientific and divine knowledge as Jesus Christ was and people are waiting for me for decades while my promoter is selling prostitutes in my place! I have been brutially censored when I should speak and let the people be the judge not some plagiarists! My lifework is being used and prosperous for all who slander against me so it is true and it works and brings more freedom and civility!

BR   August 22nd, 2009 3:53 pm ET

If we move the US HEALTHCARE (doctors, hospital ) off US SOIL then i am 110% convinced we could provide better level of care at one third the current cost. Too many greedy systems and people in the US. Health care is a service and the practice of medicine is an art and not an exact science. 1+1 is not always 2 in medicine.

Maria Villamil   August 22nd, 2009 3:54 pm ET

Dear President Obama,

Please keep up the fight!!!! We need Health Care Reform!!! It's now or never!!!
To all those that keep saying that your plan will take our choices away, just ask them what choices do they have now??
The choices offered to us by our companies are based on what is best for the companies not for the employees. WE do not have a choice in Doctors, treatments or deductibles. Our rates keep going up and our benefits keep diminishing.
All I want is the same goverment option all our "elected" lawmakers have for them and their families. They do not seem to mind their goverment plan.
Just get all the lawmakers together and asked them what they want their legacy to be??? Do not cave in to all the lobyists and step up to the plate.

Thanks for fighting for us!!!

Maria Villamil

tina tuna   August 22nd, 2009 4:10 pm ET

70% of americans believe in creationism as opposed to evolution. let the meritocracy continue before the chinese take over. or didnt the bible say "the yellow race shall rule."

Dayna   August 22nd, 2009 4:30 pm ET

I agree wholeheartedly with this blogger.
I am a primary care physician who is frustrated because I can't offer the appropriate standard of care to my uninsured patients. I see health care reform as necessary. The public option is just that--an option against all that the private insurers offer. I see it as public school free for all until high school except this will not be free but dependent on one's income. The repulicans speak of family values and Christian values. I am a Chrisitian and as such the public option will not help me but it will help my uninsured fellow citizens of these great United States. I wish the republicans would stop using fear tactics to fight but fight clean. Tell the truth about what is proposed in theupcoming bill. Have u ever asked yourself where did the money termed the deficit go? perhaps into the hands of the 2% at the top who the new admin is trying to tax who won't feel the pinch as my neighbour is who lost his job and can't get private health insurance because he has medication controlled hypertension. Please let's be honest with ourselves. Let's be true to what we say we stand for. Christian values and family values? Then let's be kind and considerate to teachers and police officers who have lost jobs and need the public option to get by until.........

laurie carlo   August 22nd, 2009 6:19 pm ET

I agree! My Irish grandmother use to say, "don't mistake my kindness for weakness", which applies here. His strength showed up when he spoke up on the NAACP anniversary dinner. I have not seen it since! I know it's in there just waiting to come out, but for some reason, he's being too nice.

He should just hold a debate as he did during the campaign with McCain and instead, bring in name calling, myth makers, birthers like Palin, a few elected officials, and idiots like Glen Beck, Hannity and Lou Dobbs. Give them one question each and 5 minutes of talk time with a moderator that calls, "TIME" and then shuts of their microphone! I want to see him mad!!

Karin Connolly   August 22nd, 2009 7:26 pm ET

Anderson,
Today I watched the presentation that Josh made about federal employees having the greatest health care plans. I want to let you know this is completly false. It is so far as you can get from the truth. Please spread the accurate facts when you give this information to the people in the United States watching CNN!
I held a position in our rural cooperative HMO in Ohio. The small rural hospitals came together with an existing HMO in Newark,Ohio. I reviewed and coordinated with my physician any referrals for specialists.
I am a nurse practitioner at the VA and our health care plans are the worst I've ever seen. I have been at two VA Medical Centers and until four years ago we had "NO DENTAL BENEFIT". Yes, my husband and I paid a private broker for our dental care insurance. I spoke to a postal worker about how we both felt the federal health care benefits were horrible. You know that wages for postal workers are not very high. The gentleman told me he pays $245.00 every pay check for the HMO. Our premiums in 2009 have doubled. The Aetna HMO went from $436 a month to greater than $800, Blue Cross Blue Shield required you pay out of your pocket $7500 a year before they would pay a claim. My coworkers said one insurer wasn't paying any of their claims to those who chose that plan.
We have a very limited choice of plans. In 2006 we had a very reasonable priced HMO ,Blue Cross, and a few other choices. In the fall of 2007 I made a call to our human resource department because our new premiums were not available yet. I was directed to the GAO site. When I looked the GAO chart for 2008 , the VA employees at Ohio the Dayton and Cincinnati VA paid "DOUBLE" the premiums of VA employees at Columbus,Cleveland,Toledo, and Chillicothe. I called and wrote my congressmen:
*Mike Turner:turfed me back to his office receptionist in our rural farming community of Wilmington, Ohio.She said "I can call the insurance comapny for you".
*George Voinivich: I engaged in what I thought was a very productive conversation with his Washington DC staffer , but I never received a return call or letter.
*Sherrod Brown's: He did not respond to my voice mail or the letter I sent them.
I began to compose a complaint to the Inspector General when I emailed my director. She had no idea that we were paying double premiums. She did followup and called the insurance companies and higher VA offices that handle this matter.She was told we had a higher utilization of health care in our area, and this is completely false. I called my HMO to request the insurance claim data use for the Cincinnati and Dayton VA's and was told I couldn't have that information.
In 2002 Hagit Limor the Emmy Award winning investigative reporter from channel 9 in Cincinnati completed an investigation and documentery on a law suit that involved the physicians against the corporate insurance companies. The physician's in Cincinnati were paid half of their billable charges compared to those in Columbus,Cleveland,Toledo and the rest of Ohio cities. Cincinnati was losing the best and the brightest physicians to other cities and other states. The physician's won their lawsuit and my husband's physician said, "you know that your paying higher premiums to pay us equal pay from that lawsuit."
Please report the facts to the people in our country who are agitated and receiving extremely large amounts of false information.
Your are our voice for great reporting.

Syvell   August 22nd, 2009 8:03 pm ET

I voted "Democrat" like most Americans, not because of race, economic status or because I just wanted to follow the crowd. We voted "Democrat" because we just got tired of a weak, shoot from the hip white house with no clear goals or purpose other than going to "War". President Obama laid out a plan of action that we all agreed would be better than the status quo that "McCain" promised. He never said it would be easy; Infact, he indicated the exact opposite. I guess the average Americans' attitude is " I'm willing to accept difficult times and discisions so long as they don't effect me".

As it stands know, the "Conservative" machine has effectively run a media blitz smear campaign aimed at "Health Care" reform. Has anyone asked the question, "why would (Americans) deliberately want to deny access to basic medical care" to a group of (Americans) that can't afford it. I'm a state employee with wonderful health care benifits. I couldn't imagine moving into a public option plan. According to President Obama, I won't have to either. I can accept that. My taxes may increase yes. However, with the mess the "Bush" administration left us in, are there idiots out there that truely believed they wouldn't? But oh yes, the "Conservative" machine would like you to think "Obama Care" cause a significant tax increase. Kinda like "Cash for Clunkers" caused the auto industry to fail (right). It's interesting that a number of "Republicans" have taken advantage of the program to upgrade to fuel efficient automobils that they've faught so desperately for the past three decades to keep off the market. Ask the EPA (Environmental Protection Agency) that was always the first to lose funding during their administrations.

Bush/Chaney took the United States to war based on false and fabricated threats to our peaceful existance. That is fact! I won't argue that "Sadam" didn't need to be taken out of power. But, it didn't take a "Military" invasion and countless "American" lives to do so. Why didn't Bush/Chaney just simply have the guy assassinated? I know it's against our laws, however, it wouldn't have been the first time the Bush/Chaney administration violated constitutional and international law to achieve its' agenda. We would then have plenty of money for "Obama Care".
The Irony is, had the Bush/Chaney administration done this "Obama" probably would not have won.

nea   August 22nd, 2009 8:04 pm ET

No matter what anyone may say some of you have even gave up on this President but i have not, not until GOD say so, before i even voted for this President i prayed just to make sure that i was voting for the right person. Even when the right was trying to make him look like an terroist,and Guess What im still praying for him and truly believe he is doing the right thing for this country yes there will always be oppostion and fear mongering used against him but no matter what i will still support him and pray for him and i do believe that GOD is on this President side and when GOD is on your side he is more than the whole world against you!

Dulcie - Denver   August 22nd, 2009 8:33 pm ET

Truly excellent! I think this is one of your best letters yet. The advice is spot-on.

Thanks!

Barbara Maguire   August 22nd, 2009 8:53 pm ET

how about funding a "cleveland clinic" in every county for public use.

Girlie58   August 22nd, 2009 9:08 pm ET

Nice letter..it would have been more appropriate if given to a president that truly was loyal to this country and truly had the american people at his best interest. Unfortunately, it appears that the president has been exposed for his socialist ideas and is coming to realize that the american people will not tolerate the kind of change that would make them lose or give up their rights and freedom. This is why the president is looking weak.The american people are fighting back. As we all know by now, and if you don'know it yet, open your eyes, and you'll see how this country is being shredded piece by piece starting with the stimulus pkg, takeover of the auto industry, bailouts to cronies, appointments of czars some of who are communists(Van Jones), the dismissal of the 2 panthers(no accountability for Eric Holder, president's buddy), and alot more. More importantly, the attempt to take over and control the american people by means of Healthcare public option. I believe in providing insurance to all, but not hru the public option. There is potential for a healthcare reform that everyone can live with, but congress will not accept anything other than a public option.Preferably partisan.

Paul d'Amore, D.D.S.   August 22nd, 2009 9:21 pm ET

Anderson,
Here is somthing that will cost anyone with a library card NOTHING, and is one way to reduce health care costs and increase the health of all Americans: read "The China Study". Let's be honest, if every member of Congress has not read this book in order to become informed about juried studies about nutrition in the past 40 years, if YOU, Anderson, haven't (you shouldn't even be hosting the program I am watching now), if our President hasn't been informed of the bottom line research which is simply just science, this whole discussion is another example of the definition of ignorance. I hate to write "stupidity", I give a few ot these people some credit ot indpendent thought which seems now to be an un-American trait: informed, measured, and considered thought. Maybe we should take pause and ask, "What would Jefferson do?" Not what Washington is doing now, obviously! Tommy would probably get information and read what I call, "a book".
The paradox: This isn't really that hard! Every individual should take some responsibility for their own health as part of this "discussion" and exhibit some backbone to do the hard thing. That will increase overall health exponentially. We just don't want to do the work. The "discussion" has gotten so far afield! Political systems enable a fast-food-information-text-message-tweetintg-society. There really isn't any mystery to diabetes, heart disease, the third cause of death in America–doctor visits, etc. We just don't want it to be so. Well it is so. Deal with it! Start with information, not hysteria, read! It used to be "first do no harm". That's back when life was simple (and it hasn't really changed, just our perspective). Now it's "know where the information you're being fed is really coming from, AND the specifics about the studies..."...and then just ignore all of it and choose what you want/wish/desire/need the "correct" path to be...and then fight for it. Hey, that's your right. Who needs objective, juried studies?
Just pick up this book and READ it! THEN, enter this debate with some fodder for informed thought. AND, our tax money paid for most of these studies...
This whole "debate" is extremely funny and embarrassing: it no longer has anything to do with health. It's great to be an American!
Paul d'Amore, D.D.S.

riza   August 22nd, 2009 9:22 pm ET

hi anderson cooper! how are u doin? weekend eh. .

BERNICE HORN   August 22nd, 2009 9:29 pm ET

Why can we not have the same insurance program that congressmen have. They are happy with it, it's apparently cost effective and it's already funded 70% by the public. Why should there be a two-tired insurance plan: one, the top tiered for congressman, one for the general public, 2nd best.
Does Canada, Francc, England have two separate universal health plans, one for the privledged (paid mostly by their constitutents), and another one for the general population?

c drew   August 22nd, 2009 9:37 pm ET

Tonight (sat), I heard it said that it is not at all clear that reforming health insurance can reduce costs. I also heard that in the US, we pay more for health care and we live shorter lives. It was said that comparative advantage is measurable, but cost reduction is not. That was pessimistic and cynical, and misinformed. You're program was missing expertise regarding the economics of health care. So of course, we can reduce the rate of health care inflation, and make it more in line with the rest of the industrial world. That's realistic optimism. Clearly when there are fewer private insurers with greater profits and higher salaries, and at the same time a higher percent of personal budgets are spent for health care, there is a means to reduce the cost of health insurance. The concurrent attitude among your guests, that it is difficult to know if costs can be reigned in was astonishing. I have to ask what is the conscious or unconscious vested interest that purports that notion. Adverse selection, an important rule of insurance, compels the insurance companies to best serve the healthy and the wealthy. The public option, designed to be an option, is the best method to reduce the rate of health care inflation.

S Gomez   August 22nd, 2009 9:43 pm ET

Wow Tom didn't expect to ever hear any of this out of you. I guess stuff happens, it's nice when it all happens at young age. I sure hope that's not the norm now, you haven't gotten into it with anyone lately right. llooll

Elle Rogers, Wheeling WV   August 22nd, 2009 10:13 pm ET

I'd like to post an open letter to the President too. Can you post this, or send it along to the Poesident?

Dear President Obama,

You and I have never met and probably never will. Life has been what most people would call "hard" for me. I voted for you, but I don't look like you, dress like you, or drive the same car; actually I don't have any car, which I why I hope you or one of your staff read this letter, and take action.

My needs are simple. Can I please have one of those clunker cars that people trade in for not getting good enough gas mileage? I would take very good care of it, and do everything to get the gas mileage as good as it can get for a clunker.

The reason I need the car is this: A decade ago, I left a potentially violent place with only my car and the clothes on my back. I drove all night not knowing where I was going or where I'd end up. I ended up in Wheeling WV, about 350 or so miles from where I started. By then the car and me were both in pretty bad shape.

A domestic violence shelter took me in. I didn't have much money and the shelter didn't have a parking lot. I had to park on a meter. which would be a real financial hardship for any recently abused and now-homeless woman but especially for me, as I had no family or friends on which to call for help.

Long story short, the car went by-bys.

Life is difficult for most people without a car, but it is harder for those of us who work. I work evenings and nights as a janitor, and the lack of a car has affected me ability to get home safely. I have to pass through what I call "the juggernaut", as my employer's building is surrounded by drugs and open prostitution. If only I had a car, I wouldn't have to worry every step along the way. And by the way, I a janitor now, but what I REALLY am is a digital prepress specialist; my employer had me change my job for what they calimed were financial reasons. Prepress is a job in which most jobs offered are for evening and night work–when public busses do not run. I wish I had a car. If I did, I could seek work matching my skills. I could, after nearly a decade, finally move out of the homeless shelter. I'm only homeless, after all, not hopeless.

Thank you for your time.

With admiration and determination,

Lauren J. Rogers
Wheeling, WV

Muin   August 22nd, 2009 10:15 pm ET

Remarkable advice for president

lampe   August 22nd, 2009 10:23 pm ET

What would be real encouraging, would be if Obama stopped blaming the Republicans for the mess of his own party. This HealthCare has nothing at all to do with the Republicans. Dems have enough votes to pass so they say, well pass the thing already, get it over with, stop standing around pointing the finger at everyone else. Maybe if he had one plan, and explained everything clearly, elderly people would better understand, and not be so afraid.

Elle Rogers, Wheeling WV   August 22nd, 2009 10:44 pm ET

I'd like to post an open letter to the President too. Can you post this, or send it along to the Poesident?

Dear President Obama,

You and I have never met and probably never will. Life has been what most people would call "hard" for me. I don't know that it's "hard", but there ya go I voted for you, but I don't look like you, dress like you, or drive the same car; actually I don't have any car, which I why I hope you or one of your staff read this letter, and take action.

My needs are simple. Can I please have one of those clunker cars that people trade in for not getting good enough gas mileage? I would take very good care of it, and do everything to get the gas mileage as good as it can get for a clunker.

The reason I need the car is this: A decade ago, I left a potentially violent place with only my car and the clothes on my back. I drove all night not knowing where I was going or where I'd end up. I ended up in Wheeling WV, about 350 or so miles from where I started. By then the car and me were both in pretty bad shape.

A domestic violence shelter took me in. I didn't have much money and the shelter didn't have a parking lot. I had to park on a meter. which would be a real financial hardship for any recently abused and now-homeless woman but especially for me, as I had no family or friends on which to call for help.

Long story short, the car went by-bys.

Life is difficult for most people without a car, but it is harder for those of us who work and who rely on homeless shelters as a primary residence. I work evenings and nights as a janitor, and the lack of a car affects my ability to get home safely. I have to pass through what I call "the juggernaut", as my employer's building is surrounded by drugs and open prostitution. But it's more than just my safety. This is about dignity. If only I had a car, I wouldn't have to worry every step along the way about needing to ask someone for their help, which gets to feel pretty demeaning when it's something you HAVE to do several days a week, 52 weeks a year. And by the way, I'm a janitor now, but what I REALLY am is a digital prepress specialist; my employer had me change my job for what they claimed were financial reasons. Prepress is a job in which most jobs offered are for evening and night work–when public buses do not run. I wish I had a car. If I did, I could seek work matching my skills. I could, after nearly a decade, finally move out of the homeless shelter. I'm only homeless, after all, not hopeless.

Thank you for your time.

With admiration and determination,

Lauren J. Rogers
Wheeling, WV

Elle Rogers, Wheeling WV   August 22nd, 2009 11:11 pm ET

I'd like to post an open letter to the President too. Can you post this, or send it along to the Poesident?

Dear President Obama,

You and I have never met and probably never will. Life has been what most people would call "hard" for me. I don't know that it's "hard", but there ya go. I voted for you, but I don't look like you, dress like you, or drive the same car; actually I don't have any car, which I why I hope you or one of your staff read this letter, and take action.

My needs are simple. Can I please have one of those clunker cars that people trade in for not getting good enough gas mileage? I would take very good care of it, and do everything to get the gas mileage as good as it can get for a clunker.

The reason I need the car is this: A decade ago, I left a potentially violent place with only my car and the clothes on my back. I drove all night not knowing where I was going or where I'd end up. I ended up in Wheeling WV, about 350 or so miles from where I started. By then the car and me were both in pretty bad shape.

A domestic violence shelter took me in. I didn't have much money and the shelter didn't have a parking lot. I had to park on a meter. which would be a real financial hardship for any recently abused and now-homeless woman but especially for me, as I had no family or friends on which to call for help.

Long story short, the car went by-bys.

Life is difficult for most people without a car, but it is harder for those of us who work and who rely on homeless shelters as a primary residence. I work evenings and nights as a janitor, and the lack of a car affects my ability to get home safely. I have to pass through what I call "the juggernaut", as my employer's building is surrounded by drugs and open prostitution. But it's more than just my safety. This is about dignity. If only I had a car, I wouldn't have to worry every step along the way about needing to ask someone for their help, which gets to feel pretty demeaning when it's something you HAVE to do several days a week, 52 weeks a year. And by the way, I'm a janitor now, but what I REALLY am is a digital prepress specialist; my employer had me change my job for what they claimed were financial reasons. Prepress is a job in which most jobs offered are for evening and night work–when public buses do not run. I wish I had a car. If I did, I could seek work matching my skills. I could, after nearly a decade, finally move out of the homeless shelter. I'm only homeless, after all, not hopeless.

Thank you for your time.

With admiration and determination,

Lauren J. Rogers
Wheeling, WV

madmilker   August 22nd, 2009 11:13 pm ET

well, i put a comment on tis site jus yesterday and for sum reason it didn't appear....guess tat black and white is more black than white....but you know as well as anyone....the truth hurts!
your find tat out at the pearly gates...

KIm   August 22nd, 2009 11:18 pm ET

We're getting Universial Health Care and will build on the current system. The fact checks are finally in for clarification to eliminate all the myths and confusion flying. We need a flow chart but the outline is there to review. The American input is the sound of democracy and it's important to listen to those who don't agree with ideas to make it better.Gotta problem,find a better solution ! It's a dance marathon ! "Land of A Thousand Dances" for a 1000 pages and a and flow chart is your admission.

alia Jacksonville, FL   August 22nd, 2009 11:22 pm ET

The only problem I see Prez Obama is facing is being able to match the rudeness of his adversary.
He is taking gloves to deal with the roughians in the republican party.

Bonnie   August 22nd, 2009 11:41 pm ET

Anderson,

My feeling is that it isn't really about health care – isn't it about our faith in our government? The nations in the world in which universal health care is working are not afraid of their government. Many in this country simply do not vote. We are a country that is afraid of what our government will do to us and not in control of what we want our government to do. The bottom line is that we all need to be involved and voice our opinions. We really have lost that ability. I am sorry to say that this is not a repulic for the people and about the people, it is about a small view and no one is willing to change that. Universal health care is about and for the people. We have lost our sense of each other and our sense of community. When is someone going to stand up and change that!

Kenneth   August 22nd, 2009 11:54 pm ET

Tom,

I hope he reads your letter of tenacity and takes it to heart. I am sick at seeing lesser souls trying to undermine a truly good person in his efforts to right the wrongs in our country. I cheer for his success everyday and would love to fight the battles with him because I know he is waging this battle for all the right reasons.

Health care reform is an imperative that would provide benefits to everyone. The present system is broken. We cannot tolerate it any longer. Too many lives are being lost and wasted.

Mr. President do not give an inch to any of those in Congress who would like to see you fail or desire to weaken the health care bill that you believe the country needs. The last man standing is the one who wins. That should be you.

Catherine Smith   August 23rd, 2009 12:00 am ET

The president says that the health care bill will not cover illegal immigrants, But I don't believe that there is anything in the bill that says they will check on a person's citizenship before receiving health care. Won't that automatically allow illegals to get the coverage?

lynn cornelius   August 23rd, 2009 12:01 am ET

Whathappens when you have two gov. programs for healthcare, one Humana(Right Source) and VA when something is changed no matter what all of that will stop and be changed, will it not?

Mariam   August 23rd, 2009 12:06 am ET

Currently our Health Care System is a joke. So why are people fussing about? For example in California the inmates receive better medical care than most of us.

mary lee   August 23rd, 2009 12:10 am ET

What a great concept to devote your time and effort in a town known for moving on when there's not an easy solution. Perhaps the President needs to reread some of his stump speeches that touch on the subject of persevering. Maybe he ought to check out the quote from President Calvin Coolidge.

Janet   August 23rd, 2009 12:11 am ET

Tom this isexcellent advice. Our President must, must stand up tall and strong, no matter if fellow Democrates are behind him or not. We elected him and expects him to stand up for what the American people are demanding. Don't be a sellout to the insurance companies and allow them to keep, keeping all of the money. They deny billions of dollars worth of healthcare every year. All of these people end up beaten, and on Medicare/Medicade or Social Security Disability/Social Security Insurance because they are too sick to work. This is what is making the government healthcare system stay in the red. We need healthcare reform now. Too many of us are counting on him to get this Bill passed.

I hope he reads these or someone in his cabinet does.
Even if they hate you in Washington Mr. President, you can always come to your loyal supporters for lunch.

Patricia Young   August 23rd, 2009 12:14 am ET

I am currently on Disability. Due to a life-changing presciption medication I am now healthy enough to return to work and I prepared myself with the necessary degree to get a job.
The trouble is a job will cause me to lose my healthcare and the ability to pay for the medication that has given me my life back.

Janet   August 23rd, 2009 12:31 am ET

I should not be on Social Security Disability and Medicare. I should not be a government problem. The worker's compensation insurance company, my employer paid should be taking care of me.

The government allows these insurance companies to have their own rules. A Social Security Judge, Lawyer, and 3+ spine sugerons all said I would never work again. The fall caused too much damage. I had already had spine surgery 2 years prior to the fall. But the insurance company said you can go back to work. My employer said "Do not come on the property until I had a release from a doctor." The insurance company sent me to 3 of their doctors. 1 in Texas, Louisiana, and Mississippi. One finally said I could work, but would not provide me with a written excuse. I lost my job, benefits, and my health. everything. I worked hard and slipped and fell in water at work @ 7:00 pm doing overtime. I've been victimized by the insurance company, their doctor, my former employer, and yes our government. Yes our government for allowing them to have these rules. They will send you to their list of doctors until one writes the report they want to see. Then you are screwed no matter what your doctors say.

Again, I should not be a government problem. 48 years old and forced to retire.

maggi jacks   August 23rd, 2009 12:33 am ET

Re your report on government subsidised healthcare

re your report on the America healthcare system: I am a happy, fit, and healthy 60 yr. old Canadian, living with government medicare. I believe that the U.S. should have a serious look at our system.....namely the one in place in the province of British Columbia, which is the best place on earth! Our system requires every resident to pay into healthcare (max $74. monthly for a single person), and then it is indexed according to the number of people in your family, and your annual income. If your annual income is below $18K , your medicare is free. This includes ALL aspects of medical care, except for optional plastic surgery and such, and some prescription drugs, as well as some prothsesis and eyeglasses, where healthcare professionals and government agencies can make exceptions. This even includes counselling and treatments for obesity, which is an escalating problem in the U.S., as well as in Canada. My cousin, who lives in Arizona, is an American by birth, and a former Canadian, is self employed, and she and her self employed husband, do not have any healthcare whatsoever. They both earn well, but because they are self employed, and still provide jobs for others, are penalized. I believe that the U.S., and her ciitzens, and President Obama should study our system well, and perhaps mimick it, and if not, learn by it. I had emergency neck (spine) surgery last year for a herniated disc (my left side became paralyzed within 36 hrs.) My doctor had me in the hospital and in the O.R. within 24 hrs. of diagnosis, and it did not cost me a dime, even tho' my annual income is over $75K. It does not get better than that! Please look at the Canadian model, and ask your elected representatives to lobby congress to vote YES for universal healthcare. Another good model to look at is Germany....even better than our Canadian one! I hope that you will consider my comments in your next discussions.
Thank-you!
Maggi Jacks North Vancouver, B.C. Canada

;

Marlene Axe   August 23rd, 2009 12:36 am ET

Mark,

Just wanted wanted to reassure you forever, even if you cant find me til afer the summer of '69, and I'm not home when when you get there, I'l always be kibbutzing always with my mother wither ny mother on her front porch, where you can always find me, and sh'll get up and go check on the stove from another Jewish dish you never tried before and you can take her place until dinner's ready, but don't tell your mother ever where you are going while your spreading out your arms to fly there from Grosvenor.

Love,

Eve

4Told   August 23rd, 2009 11:54 am ET

With 250 plus jobs lost every month along with that health coverage how can the house not reconize that healthcare form is needed now.

4Told   August 23rd, 2009 12:01 pm ET

Pretty soon people are going to turn to medicaid, so prepareing a plan now is one of the few options to consider to avoid health care chaos is how i see it.

Holly Waddles   August 23rd, 2009 1:12 pm ET

Hey Tom I really liked your witty letter! I agree with what you said and thought you put it into words very well. Let's face it the President has a job that none of us probably would want to take on especially in this crazy economic times, but do not under estimate Obama. He is clear spoken and speaks from the heart with much conviction. He will not make everybody happy because that's just a cold hard fact, however I for one am between jobs and not quite retirement age, and without health care. I believe that we are in the state we are in because there has not been the regulations in effect to have kept healthcare costs down, and affordable for everyone. I was highly disappointed to see today US Chamber of Commerce opposing the Presidents plan to make healthcare better for all. Do they really think things are great the way they have been for the last 8 years? They truly do not have the best interests of the American people as they claim. What are they afraid of? Could things be possible worse? And why do people keep saying slow down & take your time? These cannot be people with inflated hospital bills or routine office visit doctor bills in front of them with 30 days to pay. So Tom please keep encouraging not only the President to press on in this fight, but also your friends, neighbors, and relatives, and I will do the same.

Vicki   August 23rd, 2009 2:07 pm ET

Enjoy the vacation 1000's of grandmothers are paying for it. Whne you go to dinner I will be going to 2nd job. Oh yea I knew I couldn't get a goverment job I pay my taxes

Richard Remington   August 23rd, 2009 3:52 pm ET

Absent from the discourse is the 60% bite the health insurance companies are taking out of the total expenditure. A public company working 10% could offer the same care and give a 50%rate cut to all insured citizens. A substantial 10% reduction to all insured citizens would seem to leave sufficient revenues to give health care to all the others. We had health care before we had insurance. It should only exist to lower overall costs by spreading the risk. It clearly does not . This spring the small company I work for was hit with a 30% premium increase. In searching for a better option we found that all the companies had raised their prices at the same time. There is no reason to believe that this will not happen again and again unless there is true competition.

Mrs. McCray   August 23rd, 2009 4:15 pm ET

Love you Pres Obama! Enjoy your vacation and Family! MR Pres it is time to show everyone that you have try to do it with both parties. I knew when McCain said, " he will go across the stand and help, I knew he was not telling the truth! Mr Pres. O, just keep your eyes towards the hill and keep the the faith God wants you to have. They all wants to sit back and judge you, when God said, " let no man judge or you will be judge. They have this report card on you, but God have a better report. Don't listen to the negative of any man, because if they have a plan to get all of us out of this mess, they would of step up to the issues, and lay it out to someone to see how much anyone was willing to paid. Jesus paid a price for our sins, now I pray that you stay force, because God will see you through this. US needs to get over the color of a man skin. Let us all work together for the good. TOM leave the dog alone, try Jesus instead of man or animals! Pres. O, the US should now that you are trying. Why, no one did a report card on the Bush run office, he did not know gas was 4.00 dollars.

JR   August 23rd, 2009 5:43 pm ET

I wonder how Tom would have advised President Bush? He was roundly criticized for his stubborness by his detractors. So is a vice in one president now a virtue in another?

Stephen J Dunston   August 23rd, 2009 7:06 pm ET

Regarding Healthcare: The numbers are important. The French have the best system in the world for everyone in their country and they spend in money that is the equivalent of $3374.00 per person. In America we don't cover everyone spend an average of $6402.00 per person and our healthcare system is ranked a very poor 37th in the world. To fix our system, let's play COPYCAT and create a system just like the French system for everyone in America

Karin Connolly   August 23rd, 2009 9:19 pm ET

Everyone,
There is no reason to re-invent the wheel. We have health care cooperative models out there already that work.
We don't have to be crazy blaming anyone or any entity. There are cooperative rural and city HMO's models already in place.
In Wilmington,Ohio (yes as seen on 60 minutes) we have and I'm sure all across the country there great models already there both rural city that have proven excellence in care and outcomes It is far more fiscally responsible to fund existing models and emulate them with public option funds.It is not cost-effective to re-invent everything all over again. I am going to describe the models we have in our rural farming community.
- DHL had a new and cutting edge innovative model for delivering health care at a cost-effective way. They opened a clinic right in the companies, hired physicians,nurse practitioners,nurses and ancillary personnel. They not only performed employment physicals,worker's compensation, but also chronic illness care.They saw the employees,their husbands,wives and children including their children in college at no charge. They practiced and taught disease prevention with weight loss and fitness,high blood pressure,cholesterol and diabetic teaching,etc.
-Clinton Memorial Hospital in Wilmington,Ohio, a rural hospital participated in a cooporative HMO with seven other rural hospitals. Claims were processed and paid at the small CHPO HMO in Newark,Ohio, The individual hospitals managed the day to day referrals and utilization review when referrals were required. It worked; however, this small HMO didn't have the huge billions dollars in premiums,10 million dollar CEO salaries or lobbyist in congress. This is a great HMO model, it just needs to be funded by the federal government. We have to create competition against the out of control big insurance companies. The federal government doesn't want to manage our healthcare; there are models out there that work already.
-Kaiser Permante has had a program that has been there for many years that works.They provide health insurance and hospital care ,outpatient treatments,primary care physicians and specialist. Their model and center for excellence should be looked by the president and congress.Not only can the employees pay premiums and get the healthcare, it is also open to the community companies big and small and self-employed businesses. It works!

Nurse Practitoner

david oklahoma   August 23rd, 2009 9:27 pm ET

On Democrat and Repulican...... If we the people want bipartisianship then we don't need a two party system.. lets have a king and his servants then.. I love freedom and i hope partisianship will still deliver the debate that made this country great not two partys giving and taking to get deals done by stealing the taxpayers money.... to buy votes

Mark from Saint Louis   August 24th, 2009 12:29 am ET

Oh Tom, that was so great, I think the President will greatly benefit from your advice. Keep fighting and don't listen to what the critics say to you, even if it's true.

Randy Mahan   August 24th, 2009 7:58 am ET

Please give media coverage to HR2962. I truly believe one of the number one reasons health care costs have risen at such rapid rates is the increased use of expensive imaging such as CT,MRI, and PET scans. This is why I support HR2962. What is the major cause of increased utilization? Study after study has shown that self referral by doctors is behind much of the rapid increase.

More and more internists are buying CT scanners. Whether consciously or not these internists start ordering more expensive CT’s once they own the equipment. If you have new toy, why not use it? Do you have mild abdominal pain which is probably gastritis or heart burn? Do you have mild diarrhea that is probably viral enterocolitis? In most cases, as long as there were not any serious signs, the internist would use conservative therapy for a few days and in most people it would pass. If the symptoms failed to pass then he or she would think about expensive imaging/workup. Now a days, since the internist owns the scanner, they may scan on day 1. Light excuses can be used for justification such as “My patient is elderly, I would not want to miss something life threatening." Deep inside they know nothing is wrong. Other times it is just plain conscious greed. Even if the scan is negative he or she makes his money. As an added bonus patients often feel better because they feel something is being done to address their complaint. In fact patients often request a scan.

Orthopedic surgeons, neurosurgeons, and neurologists are buying their own MRI machines and ordering more and more MRI’s. Oncologists are buying PET scanners and ordering more and more PET scans. Studies have shown that when these doctors order much fewer tests when they do not own the scanners and do not have the financial incentive. They actually only order the tests when they feel it is necessary.

Overutilization is causing a big strain on the healthcare system. HR2962 is supposed to close the loophole in the Stark law for in office imaging such as CT,MRI, and PET. Please try to give media attention to this bill as it would greatly reduce the unnecessary spending that goes on today. I understand many physicians will not support this bill because their pocket books will be effected. The only physicians who will support this will be radiologists who see day and day the countless pointless studies being performed. However passage of this bill is paramount to slowing down healthcare costs.

As one example as to how ridiculous self referral has become I offer this example. There is a group of neurologists in our town who previously made 200-250k a year, which is slightly above average for that field. They recently bought 2 MRI scanners and are now making 500 to 700k a year. They are doing chart reviews and ordering MRI’s every 6 months even if not needed just to keep the revenue stream alive. This is the kind of behavior that is bankrupting our system. Please give media attention to HR2962.

Greg f   August 24th, 2009 9:08 am ET

Yes President Obama, ignore the critisism, the majority opposition, and good old common sense and just go ahead and bankrupt the country. Our enemies will thank you for it.

David - TN   August 24th, 2009 9:31 am ET

My BIG idea,

By attaching a small tax to all tickets sold for sporting events such as baseball, football, basketball, and hockey…And by attaching a small tax to all movie tickets, theater tickets, concert tickets, and movie rentals. And by attaching a small tax to all lottery tickets sold, we could pay for health care reform and make it deficit neutral! As you can see, these are all non-necessity items. So what do you think America?

Medicare Patient/Satinder   August 24th, 2009 11:04 am ET

Tom;
First let me tell you that I have listened to you.You are one of the best like AC.
I am going to be in Illinois and Calif.travelling leaving NY State health care problems behind.But let me tell you that an issue that everyone seems to just skim thru is SUPPLY of Primary Care doctors and Staffing of ER.
People say -our health system is great.Yes it was great in 80's-when the primary care doctors provided 24/7 service at their office/telephone or hospital.COSTS were much lower in 80's.
Go to an ER on Sunday afternoon in Johnson City's hospital and you will get true picture of what went wrong.
1) Primary care doctors do not offer service on weekends.
2)ER do not enough Staff.Waiting time is around 5 hours and then you get to see a Nurse–who takes 3 hours to diagnose the problems as she /he runs from one patient to another and consults COMPUTER for treatment/prescriptions as she/he has 2 years training. ER doctors only see life threatening cases.
3) If you are insured-which our family is–pay 150$ Co-Pay and rest paid by the best insurance from a top co.
4) Problem in Central NY–started when IBM shrank.Higher Mix of medicaid to others created problems for doctors and hospitals reimbursement mix.
5) Paperwork increased a lot-adding 5-10 min. of doctor's time.
6) Electronic Medical records are the answer for lower costs by cutting back on duplicate tests.–DO YOU REALIZE that someone has to enter the information.One member was supposed to find about a test within 24-36 hours–has not found it in 5 days.
7) The Electronic Records have a package that includes entering history/symptoms,which then walks you thru various questions–a great teaching tool for nurses and fresh MD's–but wastes 5-10 minutes of experienced doctors time.Yes-it may be a nice way to blame the Computer if sued.Well the lawyers and Judge will not blame the Computer–but hold a doctor responsible if he/she did not do the MRI to detect 0.01% chance of some problem.
TOM–please send a reporter on SUNDAY to Johnson City hospital.Why Sunday–that is the day–primary care doctors are closed and some one who is sick on Friday night or Saturday decides that they can not wait till Monday.So the overload from 80% who have a primary care doctor. TEST an ER at Peak Time–like you do for a Toll line or any other service line.
If not,pass this message to AC. Thanks.

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