Copays seemingly go up every year, and hopefully insurers will take notice of this study as well, and do something about rocketing copayments.

The study had participation by nearly 900,000 seniors in 36 Medicare Advantage plans during 2001 to 2006.  Half of the plans raised their copays for office visits, and researchers were able to build statistical models which showed patterns of procrastination among the group in the higher copays.  Prescription drug coverage was not tested in the study, but if they were to study it, I can tell them the results.  Generics, Canada, and going without.

In the study, it seems that copays doubled from around $7 for the primary and $13 for the specialist to about $14 and $22 respectively, remember this is 2001 to 2006, and for the control group their copays stayed low at $8.33 at the primary and $11.38 at the specialist.

The results?  For every 100 people that enrolled in the plans that had increasing copays there were on average 20 fewer office visits but 2 additional hospital admissions and 13 more hospital days per year for this group then the control group.

The study also showed that the increases in copayments had the most profound effect on the poor and minorities in low income neighborhoods.

If you think about it the copayment system runs counter-intuitive to the entire idea of managed care, which is supposed to encourage preventative medicine.  Insurance Companies, I hope you are reading this.

Anyone that thinks it is the health insurance industry that is ruining our health care system is quite plainly uninformed.  Someone is certainly guilty, but I am quite certain it is not the health insurance companies.

Cigna Corp. swung to a fourth-quarter profit as the picture for health-plan enrollment showed signs of improvement.

The Philadelphia-based insurer reported a profit of $330 million, or $1.19 a share, compared with a net loss of $209 million, or 77 cents a share, a year earlier caused by losses in the legacy reinsurance business. Revenue declined 4.2% to $4.6 billion.

While overall enrollment in the company’s health plans followed the downward trend reported by other insurers, membership in Cigna’s highly profitable business of fully insured corporate plans started to grow on a quarter-to-quarter basis for the first time since mid-2008.

Aetna Inc.’s fourth-quarter earnings fell 15%, despite prior-year investment losses, as the health insurer continued to feel the effects of inadequate pricing that battered its underwriting margins.

The Hartford, Conn., company also projected a decline in 2010 earnings. The outlook follows a rocky 2009 in which Aetna’s medical costs outpaced premium increases, and the industry felt pressures from the broad economic downturn.

Aetna continues to see 2010 as a “repositioning year,” Chairman and Chief Executive Ronald Williams said on a conference call Friday.

“The State We’re In” is being published during a time of great uncertainty for states; federal reform is still under consideration and the state role in implementing proposed changes is not yet clear. If comprehensive or incremental federal reform passes, it will surely impact state public programs, insurance markets, and delivery and payment systems. Tremendous intellectual and financial resources would be needed to implement the types of sweeping reforms that are being contemplated. States also continue to face economic uncertainty; while the economy appears to be improving, is it unclear how quickly employment levels and state revenues will recover. More cuts are likely to be necessary and many states are already operating with very limited resources.
Even in a challenging environment, states continued to show leadership in 2009. Indeed, the financial strain has forced states to be resourceful. At a time when all eyes are on the federal government, policymakers would still do well to look at the examples of leading states. We believe “The State We’re In” is a valuable resource to that end.

Surveying the Landscape

While the prospect of federal health reform loomed for the better part of 2009, states worked to protect the safety net in the face of some of the worst state budget deficits in recent memory. The dire state of the economy put a damper on most state attempts to expand coverage, although there were a few success stories, both comprehensive and incremental in nature. Throughout the year, high unemployment, lagging wages, and troubled state budgets reminded all too many Americans of the often precarious nature of the nation’s health coverage system.
In light of the national recession, state officials worry that much of the progress made during recent years could be threatened by severely strained state budgets. Two key federal-level measures have helped to mitigate this concern: first, the Children’s Health Insurance Program Reauthorization Act (CHIPRA), which strengthened the Children’s Health Insurance Program (CHIP) in February and, second, the American Recovery and Reinvestment Act (ARRA), signed in February by President Obama.3,4 CHIPRA has aided states in increasing coverage to children and pregnant women through both Medicaid and CHIP.5 ARRA allocated $140 billion in overall fiscal relief for state governments to help balance their budgets and minimize cuts to public services—with $87 billion directed to a temporary increase in the federal share of Medicaid costs from October 2008 through December 2010.
This section uses a range of data sources to explore the current landscape and discuss some persistent trends. Given that data sources typically lag current conditions by a year, the numbers do not paint a true picture of today’s reality—particularly when it comes to the rates of uninsurance. In this section, various facets of the nation’s struggling economy are examined within the context of previous trends and with an eye toward their potential impact.
In a reversal from the decline of uninsured people seen in 2007, the number of people without health insurance rose from 45.7 million in 2007 to 46.3 million in 2008. The uninsured rate increased from 15.3 percent to 15.4 percent; however, that change is not statistically significant.8 While the decline in the number of uninsured in 2007 was an anomaly in the midst of a steady upward trend in uninsurance, the increase in the number of people without health insurance in 2008 partly reflects the initial effects of the recession, along with the long-term trend of a steady erosion of employer-sponsored coverage. Nearly 6.6 million more people were uninsured in 2008 than in 2001, when the previous recession was at its worst.
Undoubtedly, the 2008 uninsured data do not reflect the true toll of the recession,9 given that the unemployment rate has grown substantially over the last year, from 7.6 percent in January 2009 to 10.0 percent in December 2009.10,11 The worsening economy and rising unemployment numbers will likely mean a significant increase in the number of uninsured in 2009.12
The recession intensified the loss of health insurance nationwide in 2008, but the percentage of Americans without health insurance has been on a near constant rise since 2001 as employer-sponsored coverage has gradually eroded.Yet,the overall percentage of people without insurance remained constant in 2008 because the decrease in employer-sponsored insurance was offset by increased enrollment in public insurance programs.
The 2008 Census data also reveal a growing lack of health insurance, or adequate health insurance, across a number of sub-populations, as well as ongoing variation in the uninsured rate by race. Minorities remain much more likely to be uninsured, with almost one-fifth (19.1 percent) of African-Americans and nearly one-third (30.7 percent) of Hispanics uninsured last year. This is relative to an uninsured rate of 17.6 percent for Asians and 10.8 percent for non-Hispanic whites. However, the percentage of people without health insurance is increasing fastest among non-Hispanic whites.

Another growing problem is high out-of ­pocket costs relative to income that leave many people effectively underinsured. The Commonwealth Fund estimates that, in 2007, there were 25 million underinsured people— representing a substantial increase from 16 million in 2003. The ongoing increase in the number of uninsured and underinsured has serious financial and health consequences for families across the country and underscores the need for a national health care reform plan to assist people in meeting their medical needs during a time of slow income growth and rising health care costs.

The story of employer-sponsored health insurance, as of late, is one without surprises in that the slow erosion of employer-sponsored coverage continued in 2008, as did the steady increase in average premiums. Most non-elderly people (61.9 percent) were covered by an employment-based health insurance plan for some or all of 2008, down from 62.9 percent in 2007 and 67.0 percent in 2001.17 Family premiums rose about 5 percent in 2009, which is much more than general inflation and stands in contrast to the 3.1 percent rise in workers’ wages. Since 1999, family premiums have increased by 131 percent, workers’ wages are up 38 percent, and inflation has been 28 percent. Drew Altman, the Kaiser Family Foundation’s President and CEO, suggested that this sort of imbalance goes far in explaining why we are having a health reform debate because “when health care costs continue to rise so much faster than overall inflation in a bad recession, workers and employees really feel the pain.”
A positive aspect of the 2008 data is that the number of uninsured children declined from 8.1 million (11 percent) in 2007 to 7.3 million (9.9 percent) in 2008. The number of uninsured children fell by more than 800,000 from 2007 to 2008 due to an increase in Medicaid and CHIP coverage which more than offset declines in employer-provided health insurance among children. In 2008,
1.7 million children were newly enrolled through Medicaid or CHIP.

 
In spite of state budget deficits, the vast majority of states have managed to hold steady on children’s health coverage and almost half implemented changes or enacted legislation to increase the number of children and families receiving health coverage through Medicaid and CHIP. Today, all but three states provide or have adopted plans to provide coverage to children with family incomes up to 200 percent of the federal poverty level (FPL). While CHIPRA and the economic recovery package have assisted states in their coverage expansion efforts for children, there are still 7.3 million U.S. children who remain uninsured.

States Continue to Flounder Under Recessionary Pressures

States continue to experience substantial fiscal distress. At the start of the 2010 fiscal year, the combined estimate of the budget gap for fiscal years (FY) 2009 and 2010 was more than $350 billion. The roughly $140 billion in federal fiscal relief provided by ARRA managed to reach states quickly and proved critical in helping address budget shortfalls, preserve Medicaid eligibility, and temper spending cuts.23 The recovery package continues to assist states in this manner, but many state officials still expect that they will have to make budgets cuts in FY 2011.24

Presently, the state revenue situation is bleak. Many states depend heavily on sales taxes for state revenue but this is not a reliable source of funds during a recession, as both personal consumption and business purchases are decreasing. States are faced with a substantial decline in revenue, and continued job losses will depress revenues still further. At the same time, more people are finding themselves and their families without employer-provided coverage and therefore are turning to public programs like Medicaid and CHIP for health coverage.

Demand for Medicaid Grows

Financed by both the federal government and the states, Medicaid provides comprehensive health and long-term care coverage to 60 million low-income Americans. While some recent economic indicators show that the recession is coming to an end, any impact on unemployment rates with their related increases in Medicaid enrollment will lag behind other improvements in the economy.

Enhanced federal Medicaid funds provided through ARRA included an estimated $87 billion for a temporary increase in the federal share of Medicaid costs. In order to qualify for these funds, states were not permitted to restrict their eligibility levels or enrollment processes. Due to this requirement, 14 states reversed and 5 states abandoned plans to restrict eligibility. Medicaid spending and enrollment growth accelerated in FY 2009 and FY 2010 due to effects from the recession. Enrollment growth was also higher than in previous years; the average increase in FY 2009 was 5.4 percent, and an additional 6.6 percent is predicted for FY 2010. With the increased caseload, total Medicaid spending growth averaged 7.9 percent in FY 2009. This was the highest rate of growth in six years.

Medicaid ARRA funding began in October 2008 and ends December 2010. Given this timeframe, states are worried that they will have to cut back on Medicaid eligibility if the supplemental funding is not extended. States are already considering this deadline because they are legally required to balance their 2011 budgets by July 2010. While at least 48 states addressed or are facing budget shortfalls for fiscal year FY 2010, 39 states have already looked ahead and foresee deficits for the fiscal year.
In 2009, state fiscal assistance from ARRA was instrumental in somewhat alleviating both state budget cuts and state tax increases. It has allowed states to close 30 to 40 percent of their state budget gaps, which in turn has preserved hundreds of thousands of jobs and prevented further distress to the national economy.
Economic forecasters have worked to determine the extent to which budget cuts and tax increases at the state level will negatively affect the economy. Estimates show that state deficits for FY 2011 will total at least $180 billion, with about $40 billion of ARRA funding likely available to states in the same fiscal year. The remaining $140 billion deficit in FY 2011 is projected to equal about 0.9 percent GDP, which could cost the economy about 900,000 jobs.30 With this loss would come a rise in the uninsured and thereby a greater demand for public health insurance programs, such as Medicaid.
In the area of Medicaid, the President’s Council of Economic Advisors has found a strong relationship between the fiscal relief funding provided through state Medicaid programs and the retention of jobs over the last year. There is great concern that the majority of states will be unable to maintain current income eligibility levels when Medicaid fiscal relief from ARRA ends during the middle of the states’ fiscal year on December 31, 2010. If states cannot soon expect that they will receive more fiscal relief, then they will have to start making plans for budget cuts and tax increases to take effect in FY 2011.31 While federal plans for state fiscal relief in FY 2011 is one major uncertainty for states, the other major uncertainty is the many different aspects of what will be expected from states if federal health reform legislation passes.
While state Medicaid officials are generally supportive of an expanded role for Medicaid as one approach to expanding health coverage to more people, states have serious concerns about their ability to take on the fiscal and administrative burden that could potentially be placed on them.
For states, 2009 has been a year truly unlike any other in history. They entered the recession with the largest reserves on record and since then have experienced an unprecedented decline in revenue. In the midst of this, most states have put on hold any plans for state health reform as they look to what will come of federal health reform legislation.32 States will potentially need to transition from coping with budget shortfalls, to swiftly—in partnership with the federal government—taking on new challenges and responsibilities.

Meanwhile, people are dying everyday because of young residents who on average stay awake 30 hours during a shift and work up to 100 hours a week.  And who is working the most hours?  The newest residents who have the least experience.

Ms. Helen Haskell who lost her son to a situation like this has started a new organization called MAME (Mothers Against Medical Errors) as a way of coping with her loss and helping others avoid these volatile circumstances.

Doctors are most prone to errors from fatigue than they are inexperience, and the results can be a car crash, or a medical accident, and the personal cost can be even more savage.  Depression is a prevalent side effect in young residents, and suicide rates are frighteningly high.

MAME and other organizations have been lobbying the ACGME which sets the parameters for resident training programs, to limit the sleep deprivation schedule imposed on residents to no more than 16 hours.

Activists are urging the Accreditation Council for Graduate Medical Education (ACGME), which controls medical residency training programs, to limit the amount of time residents go without sleep to 16 hours and to increase supervision of the residents. This would bring prevailing rules in line with recommendations outlined in a 2008 Institute of Medicine (IOM) report on resident duty hours.

The average shift for residents is 30 hours!  The average work week is an unimaginable 90 hours.  If there were a union in this industry there would have been a revolution years ago.

The NTSB which ensures safety in transportation has named fatigue as a significant contributing factor to the crash of a commuter jet in Buffalo.  Of course in order to have any kind of perceptible change made the walking orders will probably need to come from Congress.  And they are pretty busy right now screwing up health reform.

Residents have more than suicides to worry about though, traffic accident rates are so high amongst this group that one resident puts his car into park at every traffic light to avoid falling asleep at the wheel after an average shift.

“My body is not made to work 30 hours or more,” said Dr. Dan Henderson, health justice fellow with the American Medical Student Association. “If I’m truly going to do no harm as I pledged, I need a system to protect patients against errors caused by my fatigue. If ACGME isn’t willing to do the right thing hopefully consumers and lawmakers will be ready to step in.”

A new strategy has developed from the Republicans which would allow them to stop being the party of no, and also at the same time allow them to pretend to be pro active on health insurance reform.  In reality however, they are advancing this idea which will allow them to appear to be pro reform, while knowing that the Democrats will never agree with them on the basis of their reform proposals.

The Republicans first notion is that the Democrats simply discard the last year of the health reform battle, and instead begin bipartisan negoations to develop a more scaled back approach to health care reform.  Translation?  Lets do nothing!

The majore issues to the Democrat Senate bill is that firstly the Massachusetts Senate race went to the Republicans which effectively ended the Democrat super majority in the Senate and ended the filibuster free negotiations for the Democrats.  Now, even though this has happened there is still a way to pass the Senate bill which would involve using special budget rules before passing it through the House, but the manuever has already run into serious issues, the most intimidating being a lack of inter party support. 

Bascially the liberal House members want to strip out the Cadilac tax and add a Public Option (the right thing to do here in our opinion) while the Moderates are scared of losing their seats in the Mid Terms and ending up like Martha “I suck at Running for Office” Coakley.

The Republicans who are never shy about exploiting Democrat weakness have already begun the smear campaigns after being emboldened by the Massachusetts Senate outcome.

“We’ve seen all week Speaker Pelosi, Majority Leader Reid continuing to scheme and plot trying to find some way to get their big government takeover of health care enacted,” said House Minority Leader John Boehner (R-Ohio). “Republicans are going to continue to be vigilant in exposing this.”

Even after Massachusetts, Boehner continued, “They are still trying to find a way to shove this down the throats of the American people.”

This kind of nonsense it typical of Republican ignorance and arrogance.  Health care is bankrupting us both ethically and financially, and if something is not done premiums will keep rising as more and more people either lose health insurance entirely or end up with absurdly non comprehensive policies.

Scott Brown, the Republican Golden Boy was found urging the Democrats to be more vigilant in listening to his uninfomred party on health reform, because they are “upset by the backroom deals,” especially the CornHusker kickback which is a special Medicaid provision for Nebraska included in the Senate bill to win the support of Sen. Ben Nelson (D-Neb.).

“Go back to the drawing board and do it in a transparent, bipartisan manner,” Brown asserted.

Easy for you to say Scott, you didn’t waste a year and millions of taxpayer dollars in producing this stricken legislation.

Guess Who Else Has Had Enough of Health Reform?

Senior White House adviser David Axelrod told the NBC show “Meet the Press” that Obama would continue to push for a health-care overhaul, as part of an effort to address root causes of the current economic crisis.

“The president is determined that we deal with the problems in front of us and health care is one of those problems,” Axelrod said. “The American people aren’t saying let’s walk away from health insurance reform.”

White House spokesman Robert Gibbs, appearing on the CNN program “State of the Union,” refused to concede even that prospects for completing a bill had greatly dimmed. “We are still inside the five-yard line,” Gibbs said. “We’re one vote away in the House of Representatives from making…health care reform a reality.”

House and Senate leaders are aiming to determine by the end of the week whether passing the Senate bill is a viable option.

“We’re still looking at a way to do comprehensive legislation,” said Rep. Chris Van Hollen (D-Md.), a member of House Democratic leadership, told Fox News. “Certainly, certain provisions have to be dropped out. The Nebraska deal and other portions of that — even Senator Nelson has said he doesn’t want that in the bill. So there are certainly changes that need to be made.”

Van Hollen added, “People were justifiably upset about certain things like that deal. But the goal is still to try to get comprehensive health care passed.”

The bleak news from Washington is not hampering the conjecture and lies coming from Democratic Congressional leaders who are still insisting health reform will get done which can only lead to one guessing that they are sitting in a garage somewhere with the car running.  Where are the votes?  

“It’s very possible that health care is just a stalemate and you can’t solve it this year,” said Sen. Mark Pryor, D-Ark.

So what does no health bill mean to the economy and our mounting deficits?  Probably the same thing as having health reform, the main difference would have been more people would have had access to medical coverage.

Medicare and Medicaid would still be going bankrupt, health care costs would still be rising, and deficits would keep increasing.

The State of the Union

Obama still pushed lawmakers to advance health reform, but there can be no doubt that it no longer tops his domestic agenda.  More importantly he provided no course of action to lawmakers who have no idea how to pass health reform with no votes and no plan.

Still the Senate Democrats have been huddled all week trying to chart a course and were promising to have some sort of strategy by weeks end. 

Senate Democratic leaders huddled Thursday afternoon to try to determine how to proceed, emerging to report progress, and the White House remained engaged in the negotiations. A Senate aide said lawmakers were hoping to decide on a legislative strategy by the end of next week.

Republican senators said senior White House officials had reached out to several in their ranks, including some conservatives, despite the unanimous GOP opposition to the far-reaching bill.

Sen. Jim DeMint, R-S.C., who last year said stopping Obama on health care could be his Waterloo, said Thursday, “What I was saying was if he continued to push this massive takeover that it could be his Waterloo, and now it very well could be.”

In a sign of how far health care had fallen since Obama campaigned on it, Senate Democrats devoted a weekly policy lunch Thursday to discussing jobs, not health care. In a letter to supporters outlining Democrats’ 2010 agenda, House Majority Leader Steny Hoyer didn’t even mention health care, although a spokeswoman said the e-mail was sent by Hoyer’s campaign team and was not meant to be an exhaustive list of priorities. House and Senate leaders insisted success on health care was still in reach.

“We’re going to move forward on health reform. We’re going to do health care reform this year,” said Senate Majority Leader Harry Reid, D-Nev.

House Speaker Nancy Pelosi acknowledged in her weekly news conference that plenty of work remained if the House was to agree to changes to the Senate bill.

“We will go through the gate. If the gate is closed, we will go over the fence. If the fence is too high, we will pole vault in. If that doesn’t work, we will parachute in,” Pelosi said. “But we are going to get health care reform passed for the American people.”

Just two weeks ago House and Senate leaders were working round the clock at the White House, with Obama personally involved, to merge legislation passed separately by each chamber and finalize a bill for Obama to sign in time for his State of the Union speech. That effort was upended when Republican Scott Brown claimed the Senate seat long held by the late Edward M. Kennedy.

Since then Democrats have struggled to find a way forward. The leading strategy is for the House to pass the Senate bill along with a package of changes approved by both chambers, but that idea is fraught with difficulties both political and substantive. Some Democrats favor retreating from a comprehensive overhaul and taking a less ambitious approach with a series of individual initiatives or a smaller bill.

“Is there a gate someplace to get through and try to save some common areas of health care reform in both the House and the Senate bill? We’ll see,” said Sen. Byron Dorgan, D-N.D.

The powerful seniors’ lobby AARP weighed in Thursday, urging lawmakers in a letter to “continue to work together to enact comprehensive health care reform legislation this year.”

As Democratic leaders sought a way through the health care logjam, they reminded the rank and file that there are no easy solutions, politically or otherwise.

Two unpleasant choices face Democratic lawmakers who voted for the health care changes last year and who now worry about their re-election prospects this fall.

If a bill becomes law, they will have to convince a doubting public of its benefits, and conservatives are bound to keep up the attacks. If no bill passes, it’s possible that public anger over the health care issue will subside a bit. But many Democratic strategists say GOP challengers will constantly remind people of the incumbents’ votes, and Democrats will seek re-election with nothing to show on health care despite controlling the House, Senate and White House — and with hefty majorities.

Compounding the problems was growing distrust between the House and the Senate.

While lawmakers struggle, Wall Street is celebrating the sinking prospects for a sweeping overhaul that would put new taxes and requirements on insurance companies. Insurers have opposed the overhaul even though it aims to insure more than 30 million people over the next decade with a new requirement for nearly everyone to be covered.

Democrats Put Lower Priority on Health Bill, File Documents Right Next to Area 51 Report

The New York Times quoting a few big name Senators and House members including Senator Harry Reid, House Speaker Nancy Pelosi, Evan Bayh, Blanche Lincoln, and others, are all saying pretty much the same thing, and that thing is changing the subject.

Health Reform has now officially reached back burner status, and with no clear path forward for the legislation, the brakes have been slammed on President Obama and his agenda.  After months of missing health reform deadlines the representatives in Washington no longer feel pressure to advance health reform.

This is neither surprising nor good.  When the Senate Majority leader comes out and says, that “we are not on health care now,” it is time to pack up and go home.  I only wonder what kind of things I will be blogging about now that we are doomed to higher health care costs and people dying from lack of medical care.

Perhaps I will blog about about all the health insurance industry abuses that go on everyday and uncover all the pain and suffering caused in the name of profits.  Or maybe I just won’t give a hot damn anymore because it is more than a little obvious that America could give a bleep.

Why did you abandon me?

Two Democrat Senators who just happen to be up for re-election are promising to vote against any bill that is rushed through with reconciliation.  For the record they are Blanche Lincoln and Evan Bayh two midwestern state representatives who will for sure lose the mid term elections if they push this bill through.  On the other hand maybe they would get a good night sleep, but who am I to advance the notion of a clear conscience.  They would most likely end up as health insurance industry lobbyists anyways when they lost.

All of this of course dates back to last Monday when the Democrats lost their 60th vote in Massachusetts to a Republican in what was considered a Democratic stronghold state.

What does this mean for the Presidents State of the Union?

Shame certainly comes to mind, as it is becoming more and more apparent that besides rescuing Wall Street from its own self inflicted demise, Barack Obama did nothing with his first year in office.

“I would be surprised if he says specifically exactly how he hopes to get health care done,” said the House majority leader, Representative Steny H. Hoyer, Democrat of Maryland.

Of the various options available to lawmakers, including the use of budget reconciliation, none seem viable at the moment. Some lawmakers said they expected that Congress would try to adopt a vastly pared-down bill once they returned to the issue.

“Frankly, we’re trying to figure out what is possible,” Mr. Hoyer said. “Senator Reid needs to determine what is possible on his side of the aisle — you know, what kind of support he can get. And we’re trying to figure out as well what we can pass.”

Speaker Pelosi has said House Democrats will not simply vote to approve the health care bill adopted by the Senate on Dec. 24, and send it directly to Mr. Obama for his signature.

But a plan to win over House members by adopting changes to the Senate bill through the budget reconciliation process ran into substantial resistance on Tuesday.

Mrs. Lincoln, who faces one of the toughest re-election bids among Democrats, said, “I am opposed to and will fight against any attempts to push through changes to the Senate health insurance reform legislation by using budget reconciliation tactics that would allow the Senate to pass a package of changes to our original bill with 51 votes.”

Mr. Bayh said, “It would destroy the opportunity, if there is one, for any bipartisan cooperation the rest of this year on anything else.”

Even if Democrats could agree on using reconciliation to adjust the health care bill, the House and Senate have yet to resolve major policy differences between the House and Senate measures, including a dispute over a proposed tax on high-cost insurance policies, and provisions related to insurance coverage of abortions.

Senator Sherrod Brown, Democrat of Ohio, said he favored a two-step process, under which the House would pass the Senate bill and Congress would then revise it using fast-track budget procedures that would require only a simple majority in the Senate. Republicans adamantly oppose that approach.

Senator Joseph I. Lieberman, independent of Connecticut, urged caution. “The White House and Democratic leaders should reach out one more time to Republicans to see if they can find a common ground,” Mr. Lieberman said.

Senator Dianne Feinstein, Democrat of California, said Democratic leaders were assessing their options on health care.

“It’s a timeout,” Mrs. Feinstein said. “The leadership is re-evaluating. They asked us to keep our powder dry.”

Mrs. Feinstein said Congressional leaders should simplify the gigantic health care bill and try to pass parts of it that would be understandable to the public. But she also acknowledged that the odds were long for a far-reaching measure.

“I think big, comprehensive bills are very difficult to do in this environment,” she said.

The Senate Republican leader, Mitch McConnell of Kentucky, said White House comments on health care suggested that President Obama was not listening to the American people.

In Elyria, Ohio, on Friday, Mr. Obama said he was not going to “walk away” from the fight for major health legislation. If the bill becomes law, White House officials said, Americans will see its benefits and will embrace it.

But Mr. McConnell said, “This a clear sign that the administration has not gotten the message, that it’s become too attached to its own pet goals, that it’s stuck in neutral when the American people are asking it to change direction.”

The Republican leader said Mr. Obama should “put the 2,700-page Democrat health care plan on the shelf” and “move toward the kind of step-by-step approach Americans really want.”

Republicans, however, have not come forward with any new proposals, and Mr. McConnell has said he hopes the health care bill is now dead.

So where we at?  Well with the election of Senator Brown in Massachusetts, the best bet for saving health reform is the House passing the Senate bill with some changes to pacify more liberal House.  Supposedly this is the week that the bill is to be presented to the House, but to me the prospects seem rather dim.

This strategy is risky and certainly very risky as the majority of voters who although favoring expanded coverage and slowing costs, just don’t trust these two bills from the Senate and House.  Here are some stats that were published by the  Washington Post:

-33 percent of respondents said they believed their access to care would be worse if a health care overhaul occurred, a jump from 25 percent in the poll released last month. Thirteen percent said they thought they would have better access to care in a remade system, about the same as last month.

-30.5 percent said their personal finances would be worse under a health care overhaul, compared to 24.5 percent last month. Eleven and a half percent said their personal finances would improve, compared to 14 percent last month.

-35 percent said the country’s access to health care would be worse under a health care overhaul, compared to 30 percent last month. Around 38 percent said it would be better, around the same as last month.

-42 percent said the country’s finances would suffer under a health care overhaul, compared with 34.6 percent last month. Thirty percent said matters would improve financially, compared to 32 percent last month.

News flash to Obama, East Coast Health Insurance agrees with you.  The health care industry has the right to decline medical insurance to the people that need it the most.  More than anything else this needs to change, and in light of the Senate election results in Massachusetts, I imagine the insurance companies and the health insurance brokers are throwing little parties celebrating the fact that more Americans will continue to be denied access to medical services when they need it most.

Obama makes a valid point that I don’t think many people, including selfish health insurance brokers would argue, “health insurance companies take advantage of people.”

In the face of the growing contempt for politicians and politics in this age of big business politics, Obama is now trying to at least get something to through the House that has at least some kind of reform built in.  I believe him when he says that,

“The problem is: the things that are non-controversial end up being the things that don’t solve the problem.”

So what now?  With health care reform looking less likely then a virgin at a retirement home, and health insurance brokers dancing a celebratory dance, and the sick and the needy just waiting for health coverage, is there any light at the end of the tunnel?

In short, no.  The House is not going pass the Senate bill, no way, not with the elections around the around the corner and with Coakley getting trounced in Massachusetts, House Democrats are terrified of losing their seats, and then not being able to earn millions of dollars from lobbyists.  This entire system disgusts me.  Congratulations America, I can’t wait till you get sick.

I guarantee that everyone that voted against this bill already had health insurance, and in Massachusetts they could care less as they already have public health insurance.  If this bill would have passed it would have made their own system worse, because they would have been subsidizing the health care programs of other states.  One has to wonder if this Senate seat would have gone Republican in a real Blue State.  Remember Gallup released a poll yesterday that showed that only 35% of Massachusetts residents identified themselves as Democrat with a very large amount of Independents.  Of course the poll also showed that the split in America was about 50/50 in support of this health reform bill.

I just wish that my fellow health insurance brokers cared at all about the fact that this current system is going to break people’s hearts.  East Coast Health Insurance is one of the only companies that never hangs up the phone on uninsurables, and nor do we sell any crap discount plans.  We teach our brokers to sell products that fit, and when they don’t they are armed with every public health care option and the contact numbers for these programs, as well as the financial constraints that it takes to get them.  And remember our website has the largest government public assistance section period. It is because I hated telling people that they would not be able to get help, no matter how irresponsible that they were in not getting health insurance before they needed it.  Our current system is not only unfair but unsustainable, and I am not a political prognosticator and have no idea what the Democrats have up their sleeves to deal with this stunning blow to all the hard work they have put in to get us this far, but I hope they have something.

If you don’t have health insurance and need it, I want you to call East Coast Health Insurance at 888 803 5917, and even if you can’t afford it, we can direct you to a place where you will get coverage, we believe there is some kind of program public or private for everyone regardless of your financial situation.  We want to help.