Tuesday, June 16, 2009

President Barack O at the American Medical Association

Globalbelai7 the new Millennial Renaissance Vision for the Globe
Our Passion is to reach our individual and collective potential-Always for All!

Dear Patriotic Global Citizens and Friends of African Union and Ethiopia:

It is with great honor and pleasure that I present to you the words of the Genius American President as he addresses one of the most powerful Lobbiest in the world, the American Medical Association.

Please see C-Span for actual impact, but the words are here for your to review.

This is the chance for America to get out of the most disfunctional heatlh care system in the world, wher it gets paid for doing more procedures and keeping patients in misery than providing safety and well being.

The President shows has nimble and smart he is with the medical facts, with the politics and economics of health and how he literally outsmarted the smartest people on earth.

Here is BHO for you at his best. The question is will he really translate all these words into action. I am worried by the negative campaign of Bill Mahrs of HBO and the like who can netatively impact the debate.

All the same here is Barack for posterity. For many of us who have been actively camapigning for prevention focused heatlh care, this is a great time in history. Wait until the Republicans and their lobbiest derail this one too.

I am hoping aginst hope, that if it ever happens in USA, heatlh care reform or change in paradim will happen during Obama's time.

let us see, time will tell and here is Barack telling it all to the professionals!

Dr B

If applause means any thing, he has got it. There was a boo too!

June 16, 2009 – 4:45 p.m.
CQ Transcript: President Obama Speaks to the American Medical Association
CQ Transcriptswire


[*] OBAMA: Please, everybody, be seated. Thank you very much. You’re very kind. Thank you.


Let me begin by thanking Nancy for the wonderful introduction. I want to thank Dr. Joseph Heyman, the chair of the board of the trustees, as well as Dr. Jeremy Lazarus, speaker of house of delegates. Thanks to all of you for bringing me home, even if it’s just for a day.


You know, from the moment I took office as president, the central challenge we’ve confronted as a nation has been the need to lift ourselves out of the worst recession since World War II. And in recent months, we’ve taken a series of extraordinary steps, not just to repair the immediate damage to our economy, but to build a new foundation for lasting and sustained growth.

We’re here to create new jobs, to unfreeze our credit markets. We’re stemming the loss of homes and the decline of home values. All this is important.

OBAMA: But even as we’ve made progress, we know that the road to prosperity remains long and it remains difficult. We also know that one essential step on our journey is to control the spiraling cost of health care in America. And in order to do that, we’re going to need the help of the AMA.


Today, we are spending over $2 trillion a year on health care, almost 50 percent more per person than the next most costly nation. And yet, as I think many of you are aware, for all of this spending, more of our citizens are uninsured, the quality of our care is often lower, and we aren’t any healthier. In fact, citizens in some countries that spend substantially less than we do are actually living longer than we do.

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Make no mistake: The cost of our health care is a threat to our economy. It’s an escalating burden on our families and businesses. It’s a ticking time bomb for the federal budget. And it is unsustainable for the United States of America.

It’s unsustainable for Americans like Laura Klitzka, a young mother that I met in Wisconsin just last week, who’s learned that the breast cancer she thought she’d beaten had spread to her bones, but who’s now being forced to spend time worrying about how to cover the $50,000 in medical debts she’s already accumulated, worried about future debts that she’s going to accumulate, when all she wants to do is spend time with her two children and focus on getting well. These are not the worries that a woman like Laura should have to face in a nation as wealthy as ours.


Stories like Laura’s are being told by women and men all across this country, by families who’ve seen out-of-pocket costs soar and premiums double over the last decade at a rate three times faster than wages. This is forcing Americans of all ages to go without the checkups or the prescriptions they need, that you know they need. It’s creating a situation where a single illness can wipe out a lifetime of savings.

Our costly health care system is unsustainable for doctors like Michael Kahn in New Hampshire, who, as he puts it, spends 20 percent of each day supervising a staff explaining insurance problems to patients, completing authorization forms, writing appeal letters, a routine that he calls disruptive and distracting, giving him less time to do what he became a doctor to do and actually care for his patients.


Small-business owners like Chris and Becky Link in Nashville are also struggling. They’ve always wanted to do right by the workers at their family-run marketing firm, but they’ve recently had to do the unthinkable and lay off a number of employees, layoffs that could have been deferred, they say, if health care costs weren’t so high.

Across the country, over one-third of small businesses have reduced benefits in recent years and one-third have dropped their workers’ coverage altogether since the early ‘90s.

Our largest companies are suffering, as well. A big part of what led General Motors and Chrysler into trouble in recent decades were the huge costs they racked up providing health care for their workers, costs that made them less profitable and less competitive with automakers around the world. If we do not fix our health care system, America may go the way of G.M.: paying more, getting less, and going broke.

When it comes to the cost of our health care, then, the status quo is unsustainable.


So reform is not a luxury; it is a necessity. And when I hear people say, “Well, why are you taking this on right now? You’ve got all these other problems,” I keep on reminding people I’d love to be able to defer these issues, but we can’t.

OBAMA: I know there’s been much discussion about what reform would cost, and rightly so. This is a test of whether we, Democrats and Republicans alike, are serious about holding the line on new spending and restoring fiscal discipline.

But let there be no doubt: The cost of inaction is greater. If we fail to act...


If we fail to act -- and you know this, because you see it in your own individual practices -- if we fail to act, premiums will climb higher, benefits will erode further, the rolls of the uninsured will swell to include millions more Americans, all of which will affect your practice.

If we fail to act, $1 out of every $5 we earn will be spent on health care within a decade. And in 30 years, it will be about $1 out of every $3, a trend that will mean lost jobs, lower take-home pay, shuttered businesses, and a lower standard of living for all Americans.

And if we fail to act, federal spending on Medicaid and Medicare will grow over the coming decades by an amount almost equal to the amount our government currently spends on our nation’s defense. It will, in fact, eventually grow larger than what our government spends on anything else today. It’s a scenario that will swamp our federal and state budgets and impose a vicious choice of either unprecedented tax hikes, or overwhelming deficits, or drastic cuts in our federal and state budgets.

So to say it as plainly as I can, health care is the single most important thing we can do for America’s long-term fiscal health. That is a fact. That’s a fact.


It’s a fact. And -- and the truth is, most people know that it’s a fact. And yet, as clear as it is that our system badly needs reform, reform’s not inevitable. There’s a sense out there among some -- and perhaps some members who are gathered here today of the AMA -- that, as bad as our current system may be -- and it’s pretty bad -- the devil we know is better than the devil we don’t. There’s a fear of change, a worry that we may lose what works about our health care system while trying to fix what doesn’t. I’m here to tell you, I understand that fear, and I understand the cynicism. They’re scars left over from past efforts at reform. After all, presidents have called for health care reform for nearly a century. Teddy Roosevelt called for it; Harry Truman called for it; Richard Nixon called for it; Jimmy Carter called for it; Bill Clinton called for it.

But while significant individual reforms have been made -- such as Medicare and Medicaid and the Children’s Health Insurance Program -- efforts at comprehensive reform that covers everyone and brings down costs have largely failed.

And part of the reason is because the different groups involved -- doctors, insurance companies, businesses, workers, and others -- simply couldn’t agree on the need for reform or what shape it would take. And, if we’re honest, another part of the reason has been the fierce opposition fueled by some interest groups and lobbyists, opposition that has used fear tactics to paint any effort to achieve reform as an attempt to, yes, “socialize medicine.”

And despite this long history of failure, I’m standing here because I think we’re in a different time. One sign that things are different is that, just this past week, the Senate passed a bill that will protect children from the dangers of smoking, a reform the AMA has long championed...


... this -- this organization long championed. It went nowhere when it was proposed a decade ago. I’m going to sign this into law. Now, what makes this...


What makes this moment different is that this time -- for the first time -- key stakeholders are aligning not against, but in favor of reform. They’re coming out -- they’re coming together out of a recognition that, while reform will take everyone in our health care community to do their part -- everybody is going to have to pitch in -- ultimately, everybody will benefit.

And I want to commend the AMA in particular for offering to do your part to curb costs and achieve reform. Just a week ago, you joined together with hospitals, labor unions, insurers, medical device manufacturers, and drug companies to do something that would’ve been unthinkable just a few years ago.

You promised to work together to cut national health care spending by $2 trillion over the next decade relative to what it would otherwise have been. And that will bring down costs; that will bring down premiums. That’s exactly the kind of cooperation we need. And we appreciate that very much. Thank you.


Now, the question is, how do we finish the job? How do we permanently bring down costs and make quality, affordable health care available to every single American? That’s what I’ve come to talk about today.

We know the moment is right for health care reform. We know this is an historic opportunity we’ve never seen before and may not see again.

But we also know that there are those who will try and scuttle this opportunity no matter what, who will use the same scare tactics and fear-mongering that’s worked in the past, that will give warnings about socialized medicine and government takeovers, long lines and rationed care, decisions made by bureaucrats and not doctors.

We have heard this all before. And because these fear tactics have worked, things have kept getting worse.

So let me begin by saying this, to you and to the American people: I know that there are millions of Americans who are content with their health care coverage. They like their plan, and, most importantly, they value their relationship with their doctor. They trust you.

And that means that, no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period.


If you like your health care plan, you will be able to keep your health care plan, period.


No one will take it away, no matter what. My view is that health care reform should be guided by a simple principle: fix what’s broken and build on what works. And that’s what we intend to do.

If we do that, we can build a health care system that allows you to be physicians instead of administrators and accountants, a system that gives Americans...


... a system that gives Americans the best care at the lowest cost, a system that eases up the pressure on businesses and unleashes the promise of our economy, creating hundreds of thousands of jobs, making take-home wages thousands of dollars higher, and growing our economy by tens of billions of dollars more every year.

That’s how we’ll stop spending tax dollars to prop up an unsustainable system and start investing those dollars in innovations and advances that will make our health care system and our economy stronger.

That’s what we can do with this opportunity, and that’s what we must do with this moment. Now, the good news is that, in some instances, there is already widespread agreement on the steps necessary to make our health care system work better.

First, we need to upgrade our medical records by switching from a paper to an electronic system of record-keeping. We’ve already begun to do this with an investment we made as part of our Recovery Act.

It simply doesn’t make sense that patients in the 21st century are still filling out forms with pens on papers that have to be stored away somewhere. As Newt Gingrich has rightly pointed out -- and I don’t quote Newt Gingrich that often...


... we do a better job tracking a FedEx package in this country than we do tracking patients’ health records.


You shouldn’t have to tell every new doctor you see about your medical history or what prescriptions you’re taking. You shouldn’t have to repeat costly tests.

OBAMA: All that information should be stored securely in a private medical record so that your information can be tracked from one doctor to another, even if you change jobs, even if you move, even if you have to see a number of different specialists. That’s just common sense.


And that will not only mean less paper-pushing and lower administrative costs, saving taxpayers billions of dollars. It will also mean all of you physicians will have an easier time doing your jobs.

It will tell you, the doctors, what drugs a patient is taking so you can avoid prescribing a medication that could cause a harmful interaction. It will help prevent the wrong dosages from going to a patient. It will reduce medical errors, it’s estimated, that lead to 100,000 lives lost unnecessarily in our hospitals every year. So there shouldn’t be any argument there, and we want to make sure that we’re helping providers computerize so that we can get the system up and running.

Now, a second step that we can all agree on is to invest more in preventive care so that we can avoid illness and disease in the first place.


That starts with each of us taking more responsibility for our health and for the health of our children.


It means quitting smoking. It means going in for that mammogram or colon cancer screening. It means going for a run or hitting the gym and raising our children to step away from the video games and spend more time playing outside.


It also means cutting down on all the junk food that’s fueling an epidemic of obesity...


... which puts far too many Americans, young and old, at greater risk of costly, chronic conditions. That’s a lesson Michelle and I have tried to instill in our daughters. As some of you know, we’ve started a White House vegetable garden. I say “we” generously, because Michelle has done most of the work.


That’s a lesson that we should work with local school districts to incorporate into their school lunch programs.

Building a health care system that promotes prevention rather than just managing diseases will require all of us to do our parts. It will take doctors telling us what risk factors we should avoid and what preventive measures we should pursue.

It will take employers following the example of places like Safeway that is rewarding workers for taking better care of their health while reducing health care costs in the process.

If you’re one of three-quarters of Safeway workers enrolled in their Healthy Measures program, you can get screened for problems like high cholesterol or high blood pressure. And if you score well, you can pay lower premiums. You get more money in your paycheck. It’s a program that has helped Safeway cut health care spending by 13 percent and workers save over 20 percent on their premiums. And we’re open...


We’re open to doing more to help employers adopt and expand programs like this one.

Now, our federal government also has to step up its efforts to advance the cause of healthy living. Five of the costliest illnesses and conditions -- cancer, cardiovascular disease, diabetes, lung disease, and strokes -- can be prevented. And yet only a fraction of every health care dollar goes to prevention or public health.

Now, that’s starting to change with an investment we’re making in prevention and wellness programs that can help us avoid diseases that harm our health and harm the health of our economy.

But as important as they are, investments in electronic records and preventive care, all the things that I just mentioned, they’re just preliminary steps. They will only make a dent in the epidemic of rising costs in this country.

Despite what some have suggested, the reason we have these spiraling costs is not simply because we’ve got an aging population. Demographics do account for part of rising costs because older, sicker societies pay more on health care than younger, healthier ones. And there’s nothing intrinsically wrong in us taking better care of ourselves.

But what accounts for the bulk of our costs is the nature of our health care delivery system itself, a system where we spend vast amounts of money on things that aren’t necessarily making our people any healthier, a system that automatically equates more expensive care with better care.

Now, a recent article in the New Yorker, for example, showed how McAllen, Texas, is spending twice as much as El Paso County, twice as much, not because people in McAllen, Texas, are sicker than they are in El Paso, not because they’re getting better care or getting better outcomes. It’s simply because they’re using more treatments, treatments that in some cases they don’t really need, treatments that in some cases can actually do people harm by raising the risk of infection or medical error.

And the problem is, this pattern is repeating itself across America. One Dartmouth study shows that you’re less likely -- you’re no less likely to die from a heart attack and other ailments in a higher spending area than in a lower spending area.

There are two main reasons for this. The first is a system of incentives where the more tests and services are provided, the more money we pay. And a lot of people in this room know what I’m talking about. It’s a model that rewards the quantity of care rather than the quality of care, that pushes you, the doctor, to see more and more patients even if you can’t spend much time with each, and gives you every incentive to order that extra MRI or EKG, even if it’s not necessary.

It’s a model that has taken the pursuit of medicine from a profession, a calling, to a business.

That’s not why you became doctors. That’s not why you put in all those hours in the anatomy suite or the O.R. That’s not what brings you back to a patient’s bedside to check in or makes you call a loved one of a patient to say, “It’ll be fine.”

You didn’t enter this profession to be bean-counters and paper- pushers. You entered this profession to be healers, and that’s what our health care system should let you be.


That’s what this health care should let you be.


Now -- now, that starts with reforming the way we compensate our providers, doctors and hospitals. We need to bundle payments so you aren’t paid for every single treatment you offer a patient with a chronic condition like diabetes, but instead paid well for how you treat the overall disease.

We need to create incentives for physicians to team up, because we know that, when that happens, it results in a healthier patient. We need to give doctors bonuses for good health outcomes, but we’re not promoting just more treatment, but better care.

And we need to re-think the cost of a medical education and do more to reward medical students who choose a career as a primary care physician and choose to work in underserved areas instead of the more lucrative paths.


That’s why we’re making a substantial investment in the National Health Service Corps that will make medical training more affordable for primary care doctors and nurse practitioners so they aren’t drowning in debt when they enter the workforce.


Some back there is drowning in debt. They...


The second structural reform we need to make is to improve the quality of medical information making its way to doctors and patients. We have the best medical schools, the most sophisticated labs, the most advanced training of any nation on the globe; yet we’re not doing a very good job harnessing our collective knowledge and experience on behalf of better medicine.

OBAMA: Less than 1 percent of our health care spending goes to examining what treatments are most effective, less than 1 percent. And even when that information finds its way into journals, it can take up to 17 years to find its way to an exam room or operating table.

As a result, too many doctors and patients are making decisions without the benefit of the latest research. A recent study, for example, found that only half of all cardiac guidelines are based on scientific evidence, half.

That means doctors may be doing a bypass operation when placing a stent is equally effective or placing a stent when adjusting a patient’s drug and medical management is equally effective, all of which drives up costs without improving a patient’s health.

So one thing we need to do is to figure out what works and encourage rapid implementation of what works into your practices. That’s why we’re making a major investment in research to identify the best treatments for a variety of ailments and conditions. Now...


Now, let me be clear. I just want to clear something up here. Identifying what works is not about dictating what kind of care should be provided. It’s about...


It’s about providing patients and doctors with the information they need to make the best medical decisions.

See, I have the assumption that if you have good information about what makes your patients well, that’s what you’re going to do.


I have confidence in that.


We’re not going to need to force you to do it. We just need to make sure you’ve got the best information available.

Now, still, even when we do know what works, we are often not making the most of it. And that’s why we need to build on the examples of outstanding medicine at places like the Cincinnati Children’s Hospital, where the quality of care for cystic fibrosis patients shot up after the hospital began incorporating suggestions from parents, and places like the Tallahassee Memorial Health Care, where deaths were dramatically reduced with rapid response teams that monitored patients’ conditions and multidisciplinary rounds, with everyone from physicians to pharmacists, and places like Geisinger Health System in rural Pennsylvania and Intermountain Health in Salt Lake City, where high-quality care is being provided at a cost well below the national average. These are all islands of excellence that we need to make the standard in our health care system.

So replicating best practices, incentivizing excellence, closing cost disparities. Any legislation sent to my desk that does not these -- does not achieve these goals, in my mind, does not earn the title of reform.

But my signature on a bill is not enough. I need your help, doctors, because, to most Americans, you are the health care system. The fact is, Americans -- and I include myself, Michelle, and our kids in this -- we just do what you tell us to do. That’s what we do.

We listen to you; we trust you. That’s why I will listen to you and work with you to pursue reform that works for you.


Together, if we take all these steps, I am convinced we can bring spending down, bring quality up. We can save hundreds of billions of dollars on health care costs while making our health care system work better for patients and doctors alike. And when we align the interests of patients and doctors, then we’re going to be in a good place.

Now, I recognize that it will be hard to make some of these changes if doctors feel like they’re constantly looking over their shoulders for fear of lawsuits. I recognize that.


Don’t get too excited yet.


All right. Now, I understand some doctors may feel the need to order more tests and treatments to avoid being legally vulnerable. That’s a real issue.

Now, you know, just hold onto your horses here, guys.


I want to be honest with you. I’m not advocating caps on malpractice awards...


... which I believe -- I personally believe can be unfair to people who’ve been wrongfully harmed.

But I do think we need to explore a range of ideas about how to put patient safety first, how to let doctors focus on practicing medicine, how to encourage broader use of evidence-based guidelines. I want to work with the AMA so we can scale back the excessive defensive medicine that reinforces our current system and shift to a system where we are providing better care simply -- rather than simply more treatment.

So this is going to be a priority for me. And I know, you know, based on your responses, it’s a priority for you.


And I look forward to working with you, and it’s going to be difficult. But all this stuff is going to be difficult. All of it’s going to be important.

Now, I know this has been a long speech, but we’ve got more to do. The changes that I have already spoken about, all that’s going to need to go hand in hand with other reforms. Because our health care system is so complex and medicine is always evolving, we need a way to continually evaluate how we can eliminate waste, reduce costs, and improve quality.

That’s why I’m open to expanding the role of a commission created by a Republican Congress called the Medicare Payment Advisory Commission, which happens to include a number of physicians on the commission.

In recent years, this commission proposed roughly $200 billion in savings that never made it into law. These recommendations have now been incorporated into our broader reform agenda, but we need to fast- track their proposals, the commission’s proposals, in the future so that we don’t miss another opportunity to save billions of dollars as we gain more information about what works and what doesn’t work in our health care system.

And as we seek to contain the cost of health care, we also have to ensure that every American can get coverage they can afford.


We must do so in part because it’s in all of our economic interests. Each time an uninsured American steps foot into an emergency room with no way to reimburse the hospital for care, the cost is handed over to every American family as a bill of about $1,000 that’s reflected in higher taxes, higher premiums, and higher health care costs. It’s a hidden tax, a hidden bill that will be cut as we insure all Americans. And as we insure every young and healthy American, it will spread out risk for insurance companies, further reducing costs for everyone.

But alongside these economic arguments, there’s another, more powerful one. And it is simply this: We are not a nation that accepts nearly 46 million uninsured men, women and children. (APPLAUSE)

We are not a nation that lets hardworking families go without the coverage or turns its back on those in need. We’re a nation that cares for its citizens. We look out for one another. That’s what makes us the United States of America. We need to get this done.


So -- so we need to do a few things to provide affordable health insurance to every single American.

The first thing we need to do is to protect what’s working in our health care system. So, just in case you didn’t catch it the first time, let me repeat: If you like your health care system and your doctor, the only thing reform will mean to you is your health care will cost less. If anyone says otherwise, they are either trying to mislead you or don’t have their facts straight.

OBAMA: Now, if you don’t like your health coverage or you don’t have any insurance at all, you’ll have a chance under what we’ve proposed to take part in what we’re calling a health insurance exchange. And this exchange will allow you to one-stop shop for a health care plan, compare benefits and prices, and choose a plan that’s best for you and your family, the same way, by the way, that federal employees can do, from a postal worker to a member of Congress.


You will have your choice of a number of plans that offer a few different packages, but every plan would offer an affordable, basic package.

Again, this is for people who aren’t happy with their current plan. If you -- if you like what you’re getting, keep it. Nobody’s forcing you to shift. But if you’re not, this gives you some new options. And I believe one of these options needs to be a public option that will give people a broader range of choices and inject competition into the health care market so that force -- so that we can force waste out of the system and keep the insurance companies honest. Now...


Now, I know that there’s some concern about a public option. Even within this organization, there’s healthy debate about it. In particular, I understand that you’re concerned that today’s Medicare rates, which many of you already feel are too low, will be applied broadly in a way that means our cost savings are coming off your backs. And these are legitimate concerns, but they’re ones, I believe, that can be overcome.

As I stated earlier, the reforms we propose to reimbursement are to reward best practices, focus on patient care, not on the current piecework reimbursements. What we seek is more stability and a health care system that’s on a sounder financial footing.

And the fact is, these reforms need to take place regardless of whether there’s a public option or not. With reform, we will ensure that you are being reimbursed in a thoughtful way that’s tied to patient outcomes instead of relying on yearly negotiations about the sustainable growth rate formula that’s based on politics and the immediate state of the federal budget in any given year.


Now, I just want to point out: The alternative to such reform is a world where health care -- health care costs grow at an unsustainable rate. If you don’t think that’s going to threaten your reimbursements and the stability of our health care system, you haven’t been paying attention. So the public option is not your enemy; it is your friend, I believe.

Let me also say that -- let me also address an illegitimate concern that’s being put forward by those who are claiming that a public option is somehow a Trojan horse for a single-payer system.

Now, I’ll be honest. There are countries where a single-payer system works pretty well. But I believe -- and I’ve even some flak from members of my own party for this belief -- that it’s important for our reform efforts to build on our traditions here in the United States.

So when you hear the naysayers claim that I’m trying to bring about government-run health care, know this: They’re not telling the truth. What I am trying to do...


What I am trying to do -- and what a public option will help do -- is put affordable health care within reach for millions of Americans. And to help ensure that everyone can afford the cost of a health care option in our exchange, we need to provide assistance to families who need it. That way, there will be no reason at all for anyone to remain uninsured.


Indeed, it’s because I’m confident in our ability to give people the ability to get insurance at an affordable rate that I’m open to a system where every American bears responsibility for owning health insurance, so long as we provide...


... so long as we provide a hardship waiver for those who still can’t afford it, as we move towards this system.

The same is true for employers. While I believe every business has a responsibility to provide health insurance for its workers, small businesses that can’t afford it should receive an exemption, and small-business workers and their families will be able to seek coverage in the exchange if their employer is not able to provide it.

Now, here’s some good news. Insurance companies have expressed support for the idea of covering the uninsured, and they certainly are in favor of a mandate. I welcome their willingness to engage constructively in the reform debate. I’m glad they’re at the table.

But what I refuse to do is simply create a system where insurance companies suddenly have a whole bunch of more customers on Uncle Sam’s dime, but still fail to meet their responsibilities. We’re not going to do that.


Let me give you an example of what I’m talking about. We need to end the practice of denying coverage on the basis of pre-existing conditions.


The days -- the days of cherry-picking who to cover and who to deny, those days are over.


I know -- I know you see it in your practices and how incredibly painful and frustrating it is. You want to give somebody care, and you find out that the insurance companies are wiggling out of paying.

This is personal for me, also. I’ve told this story before. I’ll never forget watching my own mother, as she fought cancer in her final days, spending time worrying about whether her insurer would claim her illness was a pre-existing condition so it could get out of providing coverage.

Changing the current approach to pre-existing conditions is the least we can do for my mother and for every other mother, father, son, and daughter, who has suffered under this practice, who’ve been paying premiums and don’t get care. We need to put health care within the reach for millions of Americans.


Now, even if we accept all of the economic and moral reasons for providing affordable coverage to all America, there’s no denying that expanding coverage will come at a cost, at least in the short run. But it is a cost that will not -- I repeat, will not -- add to our deficits. I’ve set down a rule for my staff, for my team, and I’ve said this to Congress: Health care reform must be and will be deficit-neutral in the next decade.

Now, there are already voices saying, “The numbers don’t add up.” They’re wrong. Here’s why.

Making health care affordable for all Americans will cost somewhere on the order of $1 trillion over the next 10 years. That’s really money, even in Washington.


But remember: That’s less than we are projected to have spent on the war in Iraq. And also remember: Failing to reform our health care system in a way that genuinely reduces cost growth will cost us trillions of dollars more in lost economic growth and lower wages.

That said, let me explain how we will cover the price tag. First, as part of the budget that was passed a few months ago, we put aside $635 billion over 10 years in what we’re calling a health reserve fund. Over half of that amount -- more than $300 billion -- will come from raising revenue by doing things like modestly limiting the tax deductions the wealthiest Americans can take to the same level that it was at the end of the Reagan years, same level that it was under Ronald Reagan.

And some are concerned this will dramatically reduce charitable giving, for example, but statistics show that’s not true. And the best thing for our charities is the stronger economy that we will build with health care reform.

But we can’t just raise revenues. We’re also going to have to make spending cuts in part by examining inefficiencies in our current Medicare program. There are going to be robust debates about where these cuts should be made; I welcome that debate.

OBAMA: But here’s where I think these cuts should be made. First, we should end overpayments to Medicare Advantage.


OBAMA: Today, we’re paying Medicare Advantage plans much more than we pay for traditional Medicare services. Now, that’s a good deal for insurance companies. It’s a subsidy to insurance companies. It’s not a good deal for you. It’s not a good deal for the American people.

And, by the way, it doesn’t follow free-market principles, for those who are always talking about free-market principles. That’s why we need to introduce competitive bidding into the Medicare -- the Medicare Advantage program, a program under which private insurance companies are offering Medicare coverage. That alone will save $177 billion over the next decade, just that one step.


Second, we need to use Medicare reimbursements to reduce preventable hospital readmissions. Right now, almost 20 percent of Medicare patients discharged from hospitals are readmitted within a month, often because they’re not getting the comprehensive care that they need. This puts people at risk and drives up costs.

By changing how Medicare reimburses hospitals, we can discourage them from acting in a way that boosts profits, but drives up costs for everybody else. That will save us $25 billion over the next decade.

Third, we need to introduce generic biologic drugs into the marketplace.


These are drugs used to treat illnesses like anemia. But right now, there is no pathway at the FDA for approving generic versions of these drugs. Creating such a pathway will save us billions of dollars.

We can save another roughly $30 billion by getting a better deal for our poorer seniors while asking our well-off seniors to pay a little more for their drugs.

So that’s the bulk of what’s in the health reserve fund. I’ve also proposed saving another $313 billion in Medicare and Medicaid spending in several other ways.

One way is by adjusting Medicare payments to reflect new advances and productivity gains in our economy. Right now, Medicare payments are rising each year by more than they should. These adjustments will create incentives for providers to deliver care more efficiently and save us roughly $109 billion in the process.

Another way we can achieve savings is by reducing payments to hospitals for treating uninsured people. I know hospitals rely on these payments now legitimately because of the large number of uninsured patients that they treat.

But if we put in a system where people have coverage and the number of uninsured people goes down with our reforms, the amount we pay hospitals to treat uninsured people should go down, as well. And reducing these payments gradually as more and more people have coverage will save us over $106 billion, and we’ll make sure the difference goes to the hospitals that need it most.

We can also save about $75 billion through more efficient purchasing of prescription drugs. And we can save...


And we can save about $1 billion more by rooting out waste, abuse, fraud throughout our health care system so that no one is charging more for a service than it’s worth or charging a dime for a service that they don’t provide.

Let me be clear: I’m committed to making these cuts in a way that protects our senior citizens. In fact, these proposals will actually extend the life of the Medicare Trust Fund by 7 years and reduce premiums for Medicare beneficiaries by roughly $43 billion over the next 10 years. And I’m working with AARP to uphold that commitment.

Now, for those of you who took out your pencil and paper, all together these savings mean that we’ve put about $950 billion on the table, and that doesn’t count some of the long-term savings that we think will come about from reform, from medical I.T., for example, or increased investment in prevention. So that stuff, in congressional jargon, is not scorable. The Congressional Budget Office won’t count that as savings, so we’re setting that aside. We think that’s going to come, but even, separate and apart from that, we’ve put $950 billion on the table, taking us almost all the way to covering the full cost of health care reform.

In the weeks and months ahead, I look forward to working with Congress to make up the difference so that health care reform is fully paid for in a real, accountable way.

And let me add that this does not count longer-term savings. I just want to repeat that: By insisting that the reforms that we’re introducing are deficit neutral over the next decade and by making the reforms that will help slow the growth rate of health care costs over the coming decades, bending the curve, we can look forward to faster economic growth, higher living standards, and falling, instead of rising, budget deficits.

Now, let me just wrap up by saying this. I know people are cynical whether we can do this or not. I know there will be disagreements about how to proceed in the days ahead. There’s probably healthy debate within the AMA. That’s good. I also know this: We can’t let this moment pass us by.

You know, the other day, a friend of mine, Congressman Earl Blumenauer , handed me a magazine with a special issue titled “The Crisis in American Medicine.” One article notes “soaring charges.” Another warns about the “volume of utilization of services.” Another asks if we can find a “better way than fee-for-service for paying for medical care.”

It speaks to many of the challenges we face today. The thing is, this special issue was published by Harper’s Magazine in October of 1960, before I was born.


Members of the American Medical Association and my fellow Americans, I’m here today because I don’t want our children and their children to still be speaking of a crisis in American medicine 50 years from now. I don’t want them to still be suffering from spiraling costs that we did not stem or sicknesses that we did not cure. I don’t want them to be burdened with massive deficits we did not curb or a worsening economy that we did not rebuild.

I want them to benefit from a health care system that works for all of us, where families can open a doctor’s bill without dreading what’s inside, where parents are taking to their kids and getting them to get regular checkups and testing themselves for preventable ailments, where parents are feeding their kids healthier food and kids are exercising more, where patients are spending more time with their doctors, and doctors can pull up on a computer all the medical information and latest research they’ll ever want to know to meet patients’ needs, where orthopedists and nephrologists and oncologists are all working together to treat a single human being, where what’s best about America’s health care system has become the hallmark of America’s health care system.

That’s the health care system we can build. That’s the future I’m convinced is within our reach. And if we’re willing to come together and bring about that future, then we will not only make Americans healthier, we will not only unleash America’s economic potential, but we will reaffirm the ideals that led you into this noble profession and we’ll build a health care system that lets all Americans heal.

Thank you very much, AMA. Appreciate you. Thank you.




Jun 15, 2009 13:33 ET .EOF

Source: CQ Transcriptions

© 2009, Congressional Quarterly Inc., All Rights Reserved

Thursday, June 11, 2009

An Ethiopian Scientist: Gebisa Ejeta, a plant breeder and genticist wins the World Food Prize

GlobalBelai7: the new Millennial Renaissance Vision for the Globe
Our Passion is to reach our Individual and Collective Potential-Always!

June 11, 2009

Purdue sorghum researcher wins World Food Prize
WEST LAFAYETTE, Ind. - Gebisa Ejeta

Gebisa Ejeta, Distinguished Professor of Agronomy at Purdue University, on Thursday (June 11) was named the recipient of the World Food Prize for research leading to the increased production and availability of sorghum in his native Africa.

Ejeta, a plant breeder and geneticist, developed sorghum varieties resistant to drought and Striga, a parasitic weed. Sorghum is a major food crop for more than 500 million people on the African continent.

The World Food Prize is considered the Nobel Prize of agriculture. It is awarded each year by the World Food Prize Foundation to individuals who have advanced human development by improving the quality, quantity or availability of food worldwide. Norman E. Borlaug, winner of the 1970 Nobel Peace Prize, established the World Food Prize in 1986.

The award announcement was made at the U.S. Department of State in Washington, D.C., by Secretary of State Hillary Clinton and World Food Prize Foundation President Kenneth Quinn. Ejeta will receive his $250,000 award at an Oct. 15 ceremony in Des Moines, Iowa.

Ejeta is the second Purdue professor to receive the World Food Prize in three years. Philip Nelson, the Scholle Chair Professor in Food Processing and former head of Purdue's Department of Food Science, won the award in 2007 for developing aseptic bulk storage and distribution, a technology for transporting processed fruits and vegetables without product spoilage.

"I'm pleased that the selection committee found my work significant enough to choose me as the 2009 World Food Prize winner," Ejeta said. "It is a great honor."

Purdue President France A. Córdova said Ejeta's research is making a difference in the world and that he is deserving of the World Food Prize.

"We're very proud of Dr. Ejeta and the work that he has done and are thrilled that he is receiving the 2009 World Food Prize," Córdova said. "This is a sterling example of Purdue's commitment to helping resolve the global challenges of world hunger."

Jay Akridge, the Glenn W. Sample Dean of Agriculture at Purdue, agreed.

"Dr. Ejeta's work on the development of new sorghum varieties is a powerful demonstration of the difference agricultural research can make in creating a more secure and consistent food supply for millions of people," he said.

Sorghum is among the world's five principal cereal grains. The crop is as important to Africa as corn and soybeans are to the United States.

A native of Ethiopia, Ejeta witnessed the devastating effects of drought and Striga on sorghum crops in his own country and several others in eastern and western Africa.

"I focused my research on sorghum because I'm originally from Africa, and I've known about the importance of the crop to the people there," Ejeta said. "So I wanted to work on improving sorghum."

Five years of research in rain-starved northern Sudan produced his first breakthrough in sorghum research in the early 1980s, when Ejeta developed the drought-tolerant cultivar Hageen Dura-1, the first commercial sorghum hybrid in Africa.

Hageen Dura-1 produced yields up to 150 percent higher than traditional sorghum cultivars. About 1 million acres of the drought-tolerant sorghum is grown in Sudan annually.

Ejeta then focused on Striga. Commonly known as witchweed, the insidious weed attacks nearby sorghum through the plant's root system. The almost microscopic Striga seeds germinate and then send out rootlets, which find sorghum roots and work their way into the host plant. Once inside, the parasitic weed removes valuable nutrients.

Striga is especially troublesome because the weed's seeds can remain viable for up to 20 years. Striga-related losses of 40 percent are possible in non-resistant sorghum crops.

Working with late Purdue colleague Larry Butler, Ejeta identified the exudate - chemical signal - from sorghum that is picked up by Striga rootlets. From there, he was able to develop a biological mechanism for interrupting the exudation process.

"The parasitic weed work took nearly 15 years to come to fruition," Ejeta said. "The novel approach that we developed was a totally new paradigm on how to dissect this complex trait into simpler components. After that, we didn't need to go to Africa to do Striga research. We were able to do this work in a laboratory at Purdue University."

In 1994 eight tons of Ejeta's drought-tolerant and Striga-resistant sorghum seeds produced at a Purdue agricultural research farm were distributed to Eritrea, Ethiopia, Kenya, Mali, Mozambique, Niger, Rwanda, Senegal, Somalia, Sudan, Tanzania and Zimbabwe. Farmers reported yields of as much as four times larger than traditional sorghum crops.

Ejeta is not finished with sorghum genetics or international development work.

"The need out there is great, so there is more to do," he said. "We need to extend the results of our work to more programs and more nations. We need to build stronger human and institutional capacity in African nations to help people feed themselves. We need to encourage the development of similar advances in maize, millets and other crops of Africa."

Ejeta received his master's and doctoral degrees in plant breeding and genetics from Purdue in 1976 and 1978, respectively. He joined the Purdue faculty in 1984.

More information about the World Food Prize Foundation and Prize is available at http://www.worldfoodprize.org

Writer: Steve Leer, 765-494-8415, sleer@purdue.edu

Sources: Gebisa Ejeta, 765-463-4245 (June 11), 765-494-4320 (after June 11), gejeta@purdue.edu

Justin Cremer, World Food Prize Foundation, 515-779-4028, 515-245-3794, jcremer@worldfoodprize.org

Craig Beyrouty, head of the Purdue Department of Agronomy, (contact Steve Leer at 765-494-8415, sleer@purdue.edu for contact information)

Ag Communications: (765) 494-8415;
Steve Leer, sleer@purdue.edu
Agriculture News Page

Note to Journalists: Broadcast-quality video can be downloaded at ftp://news69.uns.purdue.edu/Public/ in a folder called World Food Prize 2009. For more information, contact Jim Schenke, Purdue Marketing and Media, at 765-494-6262, jschenke@purdue.edu

Ethiopian scientist named
2009 World Food Prize Laureate
Gebisa Ejeta of Purdue University developed drought- and weed-resitant sorghum, enhancing food supply in sub-Saharan Africa


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Gebisa Ejeta will receive the $250,000 World Food Prize on October 15 at the Iowa State Capitol

The 2009 World Food Prize will be awarded to Dr. Gebisa Ejeta of Ethiopia, whose sorghum hybrids resistant to drought and the devastating Striga weed have dramatically increased the production and availability of one of the world’s five principal grains and enhanced the food supply of hundreds of millions of people in sub-Saharan Africa.


Ejeta as a grad student at Purdue in 1974 Born in 1950, Gebisa Ejeta grew up in a one-room thatched hut with a mud floor, in a rural village in west-central Ethiopia.

His mother’s deep belief in education and her struggle to provide her son with access to local teachers and schools provided the young Ejeta with the means to rise out of poverty and hardship.

His mother made arrangements for him to attend school in a neighboring town. Walking 20 kilometers every Sunday night to attend school during the week and then back home on Friday, he rapidly ascended through eight grades and passed the national exam qualifying him to enter high school.

Ejeta’s high academic standing earned him financial assistance and entrance to the secondary-level Jimma Agricultural and Technical School, which had been established by Oklahoma State University under the U.S. government’s Point Four Program. After graduating with distinction, Ejeta entered Alemaya College (also established by OSU and supported by the U.S. Agency for International Development) in eastern Ethiopia. He received his bachelor’s degree in plant science in 1973.

In 1973, his college mentor introduced Ejeta to a renowned sorghum researcher, Dr. John Axtell of Purdue University, who invited him to assist in collecting sorghum species from around the country. Dr. Axtell was so impressed with Ejeta that he invited him to become his graduate student at Purdue University. This invitation came at a time when Ethiopia was about to enter a long period of political instability which would keep Ejeta from returning to his home country for nearly 25 years.

Ejeta entered Purdue in 1974, earning his Ph.D. in plant breeding and genetics. He later became a faculty member at Purdue, where today he holds a distinguished professorship.

Developing Drought-Tolerant Crops for Africa

Gebisa Ejeta conducting sorghum research
(click photo to enlarge)
Upon completing his graduate degree, Dr. Ejeta accepted a position as a sorghum researcher at the International Crop Research Institute for the Semi-Arid Tropics (ICRISAT) office in Sudan. During his time at ICRISAT, Dr. Ejeta developed the first hybrid sorghum varieties for Africa, which were drought-tolerant and high-yielding.

With the local importance of sorghum in the human diet (made into breads, porridges, and beverages), and the vast potential of dryland agriculture in Sudan, Dr. Ejeta’s drought-tolerant hybrids brought dramatic gains in crop productivity and also catalyzed the initiation of a commercial sorghum seed industry in Sudan.

His Hageen Dura-1, as the hybrid was named, was released in 1983 following field trials in which the hybrids out-yielded traditional sorghum varieties by 50 to 100 percent. Its superior grain qualities contributed to its rapid spread and wide acceptance by farmers, who found that yields increased to more than 150 percent greater than local sorghum, far surpassing the percentage gain in the trials.

Dr. Ejeta’s dedication to helping poor farmers feed themselves and their families and rise out of poverty propelled his work in leveraging the gains of his hybrid breeding breakthrough. He urged the establishment of structures to monitor production, processing, certification, and marketing of hybrid seed—and farmer-education programs in the use of fertilizers, soil and water conservation, and other supportive crop management practices.

By 1999, one million acres of Hageen Dura-1 had been harvested by hundreds of thousands of Sudanese farmers, and millions of Sudanese had been fed with grain produced by Hageen Dura-1.

Another drought-tolerant sorghum hybrid, NAD-1, was developed for conditions in Niger by Dr. Ejeta and one of his graduate students at Purdue University in 1992. This cultivar has had yields 4 or 5 times the national sorghum average.

Using some of the drought-tolerant germplasm from the hybrids in Niger and Sudan, Dr. Ejeta also developed elite sorghum inbred lines for the U.S. sorghum hybrid industry. He has released over 70 parental lines for the U.S. seed industry’s use in commercial sorghum hybrids in both their domestic and international markets.

Defeating the Scourge of Striga

Ejeta with Striga-stricken sorghum in Niger
(click photo to enlarge)
Dr. Ejeta’s next breakthrough came in the 1990s, the culmination of his research to conquer the greatest biological impediment to food production in Africa – the deadly parasitic weed Striga, known commonly as witchweed, which devastates yields of crops including maize, rice, pearl millet, sugarcane, and sorghum, thus severely limiting food availability. A 2009 UN Environmental Programme report estimated that Striga plagues 40% of arable savannah land and over 100 million people in Africa.

Previous attempts by African sorghum farmers to control the deadly weed, including crop management techniques and application of herbicides, had failed until Dr. Ejeta and his Purdue colleague Dr. Larry Butler formulated a novel research paradigm for genetic control of this scourge. With financial support from the Rockefeller Foundation and USAID, they developed an approach integrating genetics, agronomy, and biochemistry that focused on unraveling the intricate relationships between the parasitic Striga and the host sorghum plant. Eventually, they identified genes for Striga resistance and transferred them into locally adapted sorghum varieties and improved sorghum cultivars. The new sorghum also possessed broad adaptation to different African ecological conditions and farming systems.

The dissemination of the new sorghum varieties in Striga-endemic African countries was initially facilitated in 1994 by Dr. Ejeta, working closely with World Vision International and Sasakawa2000. Those organizations coordinated a pilot program, with USAID funding, that distributed eight tons of seed to Eritrea, Ethiopia, Kenya, Mali, Mozambique, Niger, Rwanda, Senegal, Somalia, Sudan, Tanzania, and Zimbabwe. The yield increases from the improved Striga-resistant cultivars have been as much as four times the yield of local varieties, even in the severe drought areas.

In 2002-2003, Dr. Ejeta introduced an integrated Striga management (ISM) package, again through a pilot program funded by USAID, to deploy in Eritrea, Ethiopia, and Tanzania along with the Striga-resistant sorghum varieties he and his colleagues had developed at Purdue. This ISM package achieved further increased crop productivity through a synergistic combination of weed resistance in the host plant, soil-fertility enhancement, and water conservation.

Empowering Farmers, Inspiring Young Scientists

Ejeta working with students at Purdue University
(click photo to enlarge)
By partnering with leaders and farmers across sub-Saharan Africa and educational institutions in the U.S. and abroad, Dr. Ejeta has personally trained and inspired a new generation of African agricultural scientists that is carrying forth his work.

Dr. Ejeta’s scientific breakthroughs in breeding drought-tolerant and Striga-resistant sorghum have been combined with his persistent efforts to foster economic development and the empowerment of subsistence farmers through the creation of agricultural enterprises in rural Africa. He has led his colleagues in working with national and local authorities and nongovernmental agencies so that smallholder farmers and rural entrepreneurs can catalyze efforts to improve crop productivity, strengthen nutritional security, increase the value of agricultural products, and boost the profitability of agricultural enterprise – thus fostering profound impacts on lives and livelihoods on broader scale across the African continent.

Gebisa Ejeta will receive the $250,000 World Food Prize on October 15 at the Iowa State Capitol

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Wednesday, June 10, 2009

Health Reform in the 21st Century- An Idea whose time has come!

Globalbelai7 -the new Millennial Renaissance Vision for the Globe!

Our Passion to reach our individual and collective potential-Always!

Cradle to Grave Universal Health care, where Annual Birthday health screening based care , is supported with mobile digital health information system; and preventative health care is provided in the respective home environment of patients, is the wave of the future health care reform in the USA and across the Globe.

The new vision should be about evidence based care that is portabile, regular pre-emptive annual health screening; and mobile web data base that is available to the patient, physician and public health system at the same time so as to develop an evidence based health care system that is individualized to the specific needs of each person and citizen.

Yes we can, health care is a human right and we need to protect and promote it at all cost!

I am a public health physician, and scientist currently working in the health field; as the Corporate Director for over 12 home health care agencies in the Metropolitan Washington, DC; Denver, Colorado Springs, Grand Junction and Delta region of Colorado, Los Angeles, California and Allentown, Pennsylvania.

We provide skilled and non skilled health care to patients in their own homes at the direction and guidance of their attending physician.

This makes care available to patients in their own home environment as well as reduce cost to care due to hospitalization and institutionalization.

Our service is considered as Boutique Medicine by some circles but we refer to it as Human Touch and back to the future when the Attending physician used to visit patients in their own homes some 50 years ago, before the advent of modern gigantic and complex hospitals, and their associated expensive and at times high risk accessories. As such, we take modern heatlh care and associated technological advancement to people's homes and their environment where they heal and recover faster.

Prior to coming to the USA in 1993, I was working with the British National Health Service and when I discovered President William Clinton was proposing a heatlh care reform, I wrote to the then health care reform team and was invited to come to the USA and present my own paper to First Lady Hilary Clinton team entitled : Crade to Grave- Health Care Reform, An Idea Whose Time Has Come. I reviewed the global health care system, by focusing on Scandinavian, British, German, Canadian and Japanese Health Care Systems and comparing them with the US Health Care System.

My focus was on making Preventative Medical Care Universal and mandatory to all according to their age and sex and current health status. Just like the Car Industry, the Insurance System should be made to work for people to keep them healthy and not wait until they are too sick to benefit from preventative heatlh care.

As such I proposed that at each Birthday, every citizen should get a letter from his attending physician, summarizing his or health risk factors, current status and future prospective and invite them for annual Birth Day health Check. Obviously the content of the screening will vary according to the age, sex and predisposing factor of each individual. I also suggested A Portable Medical Record System that each patient is given at the end of each visit and can take with him or her to any future visit.

The Medical System will be portable, electronic and will be available to each patient, attending physician and national data base. As a Public Health Physician and Medical Scientists who have worked in Africa, Europe, Asia and North America, the most critical deficit in all health systems is that there is viable data about prospective patient needs, based on lifestyle, behavior, and current disease spectrum.

All the CDC and NIH data bases are using out of date mortality data that does not reflect morbidity and risk factors for each age group, as such they are planning for the dead people and not for living populations.

The Patient Communication Log or Portable Medical Record will change this frustrating situation by providing up-to-date Evidence based medicine and preventative care that is tailored to the specific needs of each patient, reviewed at least once a year at their birth day. I wrote a proposal to the NIH Research Team about making such Portable Data Base available to patients, physicians and the public health system but unfortunately failed to implement it due to lack of sponsorship and resources.

I believe the current health care reform, should address health safety and well-being of each citizen both tat the Management Information System i.e the Medical Record System level as well as making health care available based on evidence that is collected on each Citizen's Birthday at annual basis with all appropriate physical and emotional evaluation.

Then the health care reform will be guided by the notion of making every citizen healthy with the advanced medical technology; and not wait until the patient had all the symptoms and signs of death. Yes, Health Care Reform is needed to ensure that we pay for staying healthy and productive; and not for healing after we get sick alone. This is a big paradigm shift from the current out of date and callous system, and the Medical profession and interest groups such as Insurance companies who make money out of the misery of people will not like it. However, if they know healthy people will work and pay for their insurance and dead people cannot afford health care, then they will change their mind and work on keeping each citizen healthy as they get their payment for keeping the citizen healthy instead of documenting pathologies.

This preventative, safety and well-being based care is already happening for all our technologies such as cars, houses and electronic gadgets, that we pay to have the best utility and function and not wait until they broke down. Fortunately, current up-to-date knowledge about our physiology and immune system supports this idea. We are designed to live up to 120 years with fairly good health if we know how to look after our emotional, behavioral, physical and psychological health.

We need to practice evidence based health care and that can only happen if every body is given at least annual Birthday health screening and relevant evidence based care while they are still healthy and able to enjoy life. When we get sick as we all do, we need to get modern first class medicine in our own home setting and not wait to get into the health institutions which are filled with iatrogenic infections which are more difficult to treat.

I trust it is clear that the Cradle to Grave Health Care System, is medically and fiscally sound idea and most importantly creates a healthy thriving community that continues to be productive until 120 years of life span. So, I say, let us modify both the health information system, annual birthday health screening and care for people in their own homes. It is fiscally, medically and culturally appropriate to do so.

I will be happy to furnish you with additional information at your convenience. Thank you and wish all the best. Learn from President Clinton and involve every one in all your deliberations and report to us on a regular basis and ask for our participation as you are doing now. Bless you.
Belai Habte-Jesus, MD, MPH Global Strategic Enterprises www.Globalbelai4u.blogspot.com Globalbelai7@gmail.com voice: 703.933.8737 and 571.225.5736


Statement by
Kathleen Sebelius,
U.S. Department of Health and Human Services

Health Reform in the 21st Century

Committee on Ways and Means

Wednesday, May 06, 2009

Chairman Rangel, Ranking Member Camp, members of the Committee, thank you for this opportunity to join you for a critical conversation about health reform in America. Health reform has advanced thanks to your work and willingness to move forward together with other House Committees. We appreciate your hard work to enact reform. It is urgently needed.

Health care costs are crushing families, businesses, and government budgets. Since 2000, health insurance premiums have almost doubled and health care premiums have grown three times faster than wages. Just last month, a survey found over half of all Americans, insured and uninsured, cut back on health care in the last year due to cost. And behind these statistics are stories of struggles for too many American families.

Families who face rising premiums – now over $12,000, when it was $6,000 a decade ago. Parents choosing between health insurance and their mortgage because they can’t make ends meet because their paycheck is standing still but health care costs are rising much faster than inflation. Today health care costs are the big squeeze on middle class families and these challenges are growing as the economic picture worsens. And on top of all of this, in the last eight years an additional seven million Americans have become uninsured.

And we know that during this recession, hundreds of thousands of people are losing health insurance as they lose their jobs.

Even families who do have some coverage are suffering. From 2003 to 2007, the number of “under-insured” families – those who pay for coverage but are unprotected against high costs – rose by 60 percent.

Still, we have by far the most expensive health system in the world. We spend 50 percent more per person than the average developed country. The U.S. spends more on health care than housing or food.

And the situation is getting worse. The United States spent about $2.2 trillion on health care in 2007; $1 trillion more than what was spent in 1997, and half as much as is projected for 2018.

High and rising health costs have certainly contributed to the current economic crisis. Rising health costs represent the greatest threat to our long-term economic stability. If rapid health cost growth persists, the Congressional Budget Office estimates that by 2025, 25 percent of our economic output will be tied up in the health system, limiting other investments and priorities.

This is why I share the President’s conviction that “health care reform cannot wait, it must not wait, and it will not wait another year.” Inaction is not an option. The status quo is unacceptable, and unsustainable.

We are already on our way to making health reform a reality. In just over 100 days, this President has made great strides to advance the goal of reducing costs, guaranteeing choice and assuring quality, affordable health care to all Americans.

Within days of taking office, the President signed into law the reauthorization of the Children’s Health Insurance Program. This program’s success in covering millions of uninsured children is a hallmark of the bipartisanship and public-private partnerships we envision for health reform.

The President then signed the Recovery Act, which includes essential policies that will protect health insurance for the American people, support groundbreaking research, and make important investments in our health care infrastructure.

And just last week, members of Congress passed a budget that includes an historic commitment to health reform.

Delivering on this commitment and enacting comprehensive health reform is one of my top priorities. The Obama Administration is focused on passing health reform legislation that will end the unsustainable status quo and adhere to eight basic principles.

First, we believe that reform must reduce the long-term growth of health care costs for businesses and government. The high cost of care is crippling businesses, who are struggling to provide care to their employees and remain competitive. It is driving budget deficits and weakening our economy. We must pass comprehensive reform that makes health care affordable for businesses, government, and families.

Second, we must protect families from bankruptcy or debt because of health care costs. Today, too many patients leave the hospital worried about paying the bills rather than returning to health. They have reason to be concerned. In America, half of all personal bankruptcies are related to medical expenses. It’s time to fix a system that has plunged millions into debt, simply because they have fallen ill.

Third, we will guarantee choice of doctors and health plans. No American should be forced to give up the doctor they trust or the health plan they like. If you like your current health care, you can keep it.

Fourth, we will make sure that Americans who lose or change jobs can keep their coverage. Americans should not lose their health care simply because they have lost their job.

Fifth, we must end barriers to coverage for people with pre-existing medical conditions. In Kansas and across the country, I have heard painful stories from families who have been denied basic care or offered insurance at astronomical rates because of a pre-existing condition. Insurance companies should no longer have the right to pick and choose. We will not allow these companies to insure only the healthy and leave the sick to suffer.

Sixth, we must assure affordable, quality health coverage for all Americans. The large number of uninsured Americans impose a hidden tax on other citizens as premiums go up, and leaves too many Americans wondering where they will turn if they get sick. A system that leaves millions of Americans on the outside of the doctor’s office looking in is unjustifiable and unsustainable.

Seventh, we must make important investments in prevention and wellness. The old adage is true – an ounce of prevention truly is worth a pound of cure. But for too long, we’ve sunk all our resources into cures and shortchanged prevention. It’s time to make preventing illness and disease the foundation of our health care system.

And finally, any reform legislation must take steps to improve patient safety and the quality of care in America. Our country is home to some of the finest, most advanced medicine in the world. But today, healthcare associated infections – infections caught in a hospital or other settings -- are one of the leading causes of death in our nation. 98,000 Americans die each year as a result of these and other medical errors -- more than car accidents, breast cancer, or AIDS. These numbers are not acceptable for the world’s richest nation. We must sharply reduce the number of medical errors, keep patients safe and ensure all Americans receive high-quality care.

As we work to enact policies that adhere to these principles, the President is committed to hearing from people in communities across the nation and on both sides of the aisle. In March, he held a White House health care forum and several regional forums in places like Michigan, Iowa, Vermont, North Carolina and California. There, bipartisan forums brought together people from all perspectives – across the political spectrum and representing all people with a stake in the system – to focus on solutions.

I look forward to continuing this bipartisan process and I am eager to work with this Committee and your colleagues in the House and Senate to deliver the reform we so desperately need.

Again, Mr. Chairman, thank you for the opportunity to participate in this conversation with you and your colleagues. I look forward to taking your questions.

Last revised: June 05,2009