Far from reining in costs, the 2010 health care law is creating a confusing and unpredictable labyrinth of regulations and discouraging small businesses from creating new jobs. Says Phil Kennedy, owner and president of Comanche Lumber Company Inc. in Lawton, Oklahoma, about fines levied on 50-plus employee firms that don’t provide coverage: “I do not want to lose anyone on my payroll, but if it comes down to laying off a few employees or being saddled with these fines, I won’t have a choice.”

by Blair Latoff

by Abram Olmstead

You ever wonder how much impact a single person has on the economy?  Yesterday the Phoenix Center reported that on average, “eliminating the job of a single regulator grows the American economy by $6.2 million and nearly 100 private sector jobs annually.”  Hard to believe that a single nameless, faceless Washington bureaucrat holds that much sway over our economy.

From health care to small business to veterans’ issues, voices from all across the Chamber filled the airwaves of Minnesota this morning thanks to longtime Chamber ally Dan “the Ox” Ochsner.  The radio host from KNSI 1450-AM in St. Cloud, MN traveled to Washington with a contingent from the St. Cloud Chamber and broadcast his radio show live this morning from the Chamber’s Communications Operations Center.

Worksite wellness programs continue to be a vitally important mechanism to improve health and control costs. These programs keep employees healthy, and studies demonstrate that healthier employees are more productive at work.

Finally the end is in sight on the 1099 repeal bill. After months of discussion, the Senate will begin debate on H.R. 4, the House-passed repeal of the 1099 mandate, and an amendment by Senator Robert Menendez (D-NJ) that could leave the onerous 1099 provision intact.

“For 44 years we have helped people build it right.” That’s the moto of Phil Kennedy, owner and president of Comanche Lumber Company Inc., which is located in Lawton, Oklahoma.

by Blair Latoff

One year in, has the health care law lived up to the promises made by its supporters? Consider the facts.

A day before the one-year anniversary of the health care law, Starbucks chief executive Howard Schultz said in an interview with the Seattle Times that he’s now worried about what will happen when the health care law takes full effect in 2014:

To mark the one-year anniversary of the health care law, the U.S. Chamber is running ads in Beltway publications this week against the “higher than expected costs and the wave of crushing new regulations” from the law:

One year later, the health care caw is still a bad prescription

by Blair Latoff

As Democrats continue to tout the passage of Obamacare, The Washington Post online edition ran an interesting story today on the realities of the law and the number of jobs being destroying as a result.

Referencing Senate floor remarks by Sen. Mitch McConnell, the Post points out that

Though outright repeal of the Patient Protection and Affordable Care Act (PPACA) is a political pipedream, opponents are making progress in stripping it of its most onerous provisions.

Here’s the legislative scorecard for those tracking from home:

In case you missed it, in testimony before the House Budget Committee last week, Congressional Budget Office Director Douglas Elmendorf, in response to a question from Rep. John Campbell, said that the health care law would reduce employment by 800,000 in ’20-’21.

The U.S. Chamber today submitted testimony to the House Small Business Committee for their hearing, “Buried in Paperwork: A 1099 Update,” calling on Congress to repeal the 1099 reporting mandate. To ensure that the committee hears from small businesses in their own words on what the 1099 reporting mandate would mean for them, the testimony includes quotes from small business owners and local chamber executives located in districts representing the Members of the House Committee on Small Business.

U.S. Chamber of Commerce Executive Vice President for Government Affairs Bruce Josten issued the following statement today ahead of the Senate vote to repeal the burdensome health care law:

Today the Senate will have an opportunity to end the misguided health law and begin an effort to bring real reforms that lower costs.

At a House Ways and Means Committee hearing on the health care law’s impact on jobs, employers, and the economy yesterday, the U.S. Chamber’s witness, Scott Womack, testified that:

Earlier this week, as part of his annual State of the Union address, President Obama expressed his willingness to work with Congress to pass medical malpractice reform legislation in 2011.  He now joins with many members of the new Congress who are already committed to reforming America’s broken medical liability system.

by Greg Galdabini

The House was smart to pass legislation this week repealing the health care reform law enacted last year. The law is so flawed  and complex that even a provision as seemingly beneficial to small businesses as the 35% tax credit for the purchase of employee health care has turned out to be major disappointment to some.

by Blair Latoff

U.S. Chamber of Commerce Executive Vice President for Government Affairs, Bruce Josten, issued the following statement today on the House vote to repeal the burdensome health care law:

"Today's vote sent an important message to the American people that Congress is listening to their call for health care reform that truly lowers cost and improves quality without irreparably damaging our economy and inhibiting job creation.

by Blair Latoff

American businesses of all sizes are being hindered by skyrocketing health care costs, while shouldering the responsibility of driving economic recovery and job growth.

The Patient Protection and Affordable Care Act (H.R. 3590) is fatally flawed and an irresponsible bill that America's businesses and working families can't afford to pay.

Do what's right for our nation. Support American businesses, save our jobs, and promote economic growth by going back to the drawing board.

by Pat Cleary

Yesterday, the Business Roundtable (BRT) issued its "Roadmap for Growth", a self-described "Plan to Drive Economic Prosperity in America." The plan focuses on 5 key "pillars":

by James Gelfand

This morning's "Newsweak" story by Joel Schectman berates limited benefit health plans (which offer very limited coverage for a very small cost to workers), while also beating up on the Administration. Here is a short excerpt:

by Pat Cleary
 
Interesting opinion piece and accompanying article in The Economist about the running debate playing out in Washington these days, i.e., the relative friendliness or unfriendliness of the Administration toward business.

Peter Suderman opens the festivities: 

A growing crescendo of voices from small businesses and their representatives are sending a clear, unequivocal message to Congress: Repeal the 1099 mandate and do it without raising taxes on business.  Today the Chamber sent the latest installment of a National Petition letter to Congress—more than doubling the number of signatures that were on the original letter. The message for repeal continues to grow and Senators will be able to show these hardworki

From the AP:

When a government report found that President Barack Obama's health overhaul would modestly raise the nation's total health care tab, the White House responded with a statistic suggesting costs would go down...It turns out that may be fuzzy math.

The small business community is outraged over the 1099 mandate that was tucked away in the recently passed health law and by all rights they should be. This mandate will require government, non-profits and businesses of all sizes, 40 million entities in all, to report on all non-credit card transactions totaling over $600 in a calendar year. The provision would create a paperwork nightmare for many of America’s job creators.

Earlier this week, the respected medical journal Health Affairs published a study that estimates the negative cost of America’s broken medical malpractice system at $55.6 billion a year. By any measure this is a huge number, greater than the combined 2009 budgets for the Departments of Commerce, Interior and State and the entire legislative and judicial branches. It’s also greater than the cost of 270,000 houses at the current U.S. median price for new homes.

Randy Johnson and James Gelfand write on The Daily Caller:

Keith Hennessey looks at the CBO's annual summer baseline update:

At WebCPA Roger Russell looks at the 1099 reporting mandate in the health care bill, and the American Institute of Certified Public Accountants take on it:

Joseph McCafferty reports in CFO "A brief provision in the health-care reform law could create big reporting problems for small businesses."

Politico reports:

Sigh.

The Journal Star opines:

by Blair Latoff

There was much celebration last week, in some quarters, surrounding the latest Medicare trustee report which showed "how the Affordable Care Act is helping to reduce costs and make Medicare stronger." The problem is that actually, it didn't.

Free Enterprise Magazine that is:

All you need to know is unknown, via the Politico:

Don’t bother trying to count up the number of agencies, boards and commissions created under the new health care law. Estimating the number is “impossible,” a recent Congressional Research Service report says, and a true count “unknowable.”

My latest on the National Journal Health Care Experts Blog, in response to the questions "What's Next To Change In The Health Reform Law?" Click through for supporting links.

// Below is my National Journal Health Experts answer to "Will New 'Public Option' Fare Better?"

It's almost as if they want to give the GOP an excuse to make the election even more about health care than it's already going to be... maybe they really do believe that the bill is going to be a net positive in the eyes of voters.

Jim Wordsworth, small business owner and U.S. Chamber Council on Small Business member has a great op/ed today in the Richmond Times-Dispatch:

Yesterday the Chamber co-hosted a forum on the impacts of health care reform on small businesses (bookmark this site). Many problems were discussed, big and small, here is one of the big ones:

Next Monday, July 26th, the U.S. Chamber of Commerce will partner with the National Federation of Independent Business and the American Action Forum to host a forum entitled "Behind the Curtain: The Health Care Law’s Impact on Small Business".

One of the first regulations out of the gate from the recently passed health care reform bill has small business owners furious and even some Democrat supporters of the bill concerned. One of the few non-healthcare related provisions, this provision is supposed to raise $17 billion dollars to help pay for the bill.

According to the Small Business Administration, small firms:

• Represent 99.7 percent of all employer firms;
• Employ just over half of all private sector employees;
• Pay 44 percent of total U.S. private payroll; and
• Have generated 64 percent of net new jobs over the past 15 years.

So how do we reward our small businesses who drive job creation and economic growth? With onerous new reporting requirements!

From the Washington Post:

Over at the National Journal Meghan McCarthy asks:

Should Congress or new authorities created by the law take additional steps to reduce the deficit through policy changes? Should certain provisions be abandoned, even if it means less federal savings?

Job Creation

I watched the [Chamber’s Governors Summit] on C-SPAN and can’t tell you how impressed I was with the discussion content. I have downloaded the Enterprising States study and shared it with several key members of our community. I am chairman of Centralina Workforce Development, and the content of this document will be discussed at our upcoming retreat. The study is a must read for those of us who are interested in creating jobs in our community.
—Bob VanGorden, Concord/Charlotte, NC

Over on the National Journal I talk grandfathering:

A quick wrap up of yesterday's health reform rules release:

Kaiser Health News

In case you missed it in the late Friday news dump:

Jennifer Haberkorn reports in the Politico:

ca•ve•at (kv-ät, käv-, kv-t)  1) a. A warning or caution; b. A qualification or explanation

On health care reform for (a) make sure to look at the (b)s.  Two examples, my italics. 

First to the New York Times:

Rasmussen results via the WSJ:

President Obama has made a full-court press to sell ObamaCare since it was passed ten weeks ago. But the program appears more unpopular than ever. A new Rasmussen Research poll finds that fully 63% of voters favor repeal, up from 54% to 58% just after the bill was enacted.

Good intentions + bad legislation = "Tax cut math doesn't add up for some"

From the WSJ Health Blog:

Discretionary spending could add another $115 billion-plus to the 10-year cost of health-care overhaul, the Congressional Budget Office said yesterday...The A.P. notes that the costs weren’t included in earlier CBO estimates because the funds are considered discretionary, to be approved by Congress as needed.

Then:

[Reconciliation Bill] SEC. 1005. IMPLEMENTATION FUNDING.

(a) IN GENERAL.—There is hereby established a Health Insurance Reform Implementation Fund (referred to in this section as the ‘‘Fund’’) within the Department of Health and Human Services to carry out the Patient Protection and Affordable Care Act and this Act (and the amendments made by such Acts).

Great reminder from Jennifer Haberkorn in this morning's Politico Pulse:

Andrew Villegas, from Kaiser Health News, posts on NPR:

Health Care

I have been a successful business owner for 30 years, and I can tell you without doubt that this bill will kill businesses, which will kill jobs, which will kill your big-money people who you are relying on to pay for a huge portion of this bill, etc., etc. It will be a chain reaction that will ultimately bankrupt the country— it’s basic economics and Mathematics 101.
—Mike Kelsey, Northridge, CA

U.S. Chamber Begins Work to Mitigate New Law’s Impact

By Thomas J. Donohue, President and CEO, U.S. Chamber of Commerce

The Chamber is disappointed with the outcome of the health care reform bill. The new law fails to fix what is broken and will break what already works well in American health care. It will increase costs, impose new mandates and reporting requirements, and send the deficit soaring.

Today the Chamber held an event, and released this booklet, "focusing on the issues and timeline surrounding businesses complying with the new health care law." C-SPAN was there:

Good nurses are worth their weight in gold. Not only are they the patient’s primary advocate, they are the eyes and ears of the physicians. Nurses have difficult jobs, are dedicated to their craft, are vital to public health, and deserve our gratitude. But what about a bad nurse? Someone who intentionally hurts people, uses drugs on the job, falsifies records and preys on people under their care?

We were told that once health care reform passed we would get to find out what's in it. From the AP:

Sometimes facts are hard to ignore and the headlines on April 12,13, and 14th are clearly distressing: the "U.S.

Now that both the “Patient Protection and Affordable Care Act” (PPACA) and the reconciliation “fixer” bill, the “Health Care and Education Reconciliation Act” have been signed into law, employers must take a new look at the offering of health insurance benefits.

Now that both the “Patient Protection and Affordable Care Act” (PPACA) and the reconciliation “fixer” bill, the “Health Care and Education Reconciliation Act” have been signed into law, employers must take a new look at the offering of health insurance benefits. Yesterday we looked at "To Offer, or Not to Offer?" Up today is "Managing Plan Costs and Avoiding Penalties."* 

Now that both the "Patient Protection and Affordable Care Act" (PPACA) and the reconciliation "fixer" bill, the "Health Care and Education Reconciliation Act" have been signed into law, employers must take a new look at the offering of health insurance benefits. This below is not legal advice, but is intended to serve as an outline to the new realities employers face in this landscape of compliance responsibilities. Businesses face important choices to include:

In an op-ed in the St. Petersburg Times, Florida Senator George LeMieux explained how the new health care bill will affect Floridians, including forcing people out of their existing plans, reducing benefits, and increasing taxes and the national debt.

The new law does all of this without addressing fundamental problems with the current health care system - costs are still rising!

Earlier this week Megan McArdle wrote:

I sometimes get emails forwarded to me originating from the Big Labor front group American Rights at Work (ARAW). The latest one opens with:

Want to know what's next on the U.S. Chamber's agenda? Spending $50 million on political races to "play a major role in this year's midterm elections on a scale to rival the nation's two main political parties!" Read all about it, then take a stand by signing our Not My Chamber pledge TODAY!

There is much uncertainty about how the recently passed health care reform bill(s) will affect small businesses. And it is an uncertainty that isn't going away anytime soon as the thousands and thousands of pages of regulations implementing the bill(s) have yet to be written. But James Gelfand has been making the rounds seeking to educate business about what's on tap. First up the Wall Street Journal:

USA Today and Gallup find:

After meeting with President Obama on healthcare, the head of the AFL-CIO, Richard Trumka, set aside his concerns and agreed to support the President’s plan for reform. This is the plan that carries a hefty excise tax on union members’ healthcare benefits and is likely to raise deductibles, increase co-pays and reduce quality of care. So, why are Trumka and his executive council endorsing legislation that other labor leaders have called a travesty? Perhaps there are other factors at play.

In the clip below CNBC's Jane Wells talks to Madelyn Alfano, owner of a nine-restaurant chain and board member of the California Restaurant Association, about the health care reform bill's calorie count requirement and other concerns:

Since our 100-year quest for universal health coverage is over (the hopefully not 100-year quest for choice and affordability in health coverage has just begun) let's see what candidate Woodrow Wilson thought about Teddy Roosevelt's Progressive Party run in 1912:

We have heard many times the claim that the health care reform legislation passed by the House yesterday does not represent a government takeover of health care. Usually left out is the qualification to make the claim true.  PolitiFact, while perhaps not grasping the fact, does get it right in the first of their "Top 10 facts to know about health care reform"

Perspective from the New York Times:

The House made a wrong and unfortunate decision that ignores the will of the American people.

Many, many, many have written about the accounting gimmicks used in the current flawed health care reform legislation (our key vote letter here) in order to game the CBO into reporting that it reduces the d

Below, and here, is the U.S. Chamber's key vote alert that was sent to all members of the House today expressing strong opposition to both the Senate-passed version of H.R. 3590 and the related budget reconciliation legislation. The Chamber will include votes on, or in relation to, this legislation—including on the rule, or other procedural votes—in our annual How They Voted scorecard.

The Tax Policy Group at Deloitte had a look at the taxes in the current health reform package, read the whole thing...a few snips:

Tell your Representative to be responsible, tell them to vote "no" and start over.

From Philip Klein:

The New York Times today on health care reform:

The Orange County Register:

The AP fact checks claims of lower health care premiums:

I recently had the pleasure of speaking with a new Chamber member in the healthcare sector and got his first-hand account on concerns related to the current healthcare legislation being considered in Congress.  Bob Baumgartner is the CEO of Center for Diagnostic Imaging (CDI), which is headquartered in Minneapolis, MN, and has approximately 800 employees working at 58 locations across 10 states.  Baumgartner made it clear that he and the CDI team pride themselves on two basic core principles: exceptional patient centered care and a passion f

A week ago when OpenCongress posted on plans for "Passing the Health Care Bill Without Actually Voting on It" the idea of using a "self-executing" rule to pass health care seemed absurd, and yet, with House votes to pass the Senate bill still not there and public opposition clear, things are getting truly bizarre here in Washington.

The Washington Post is rather polite:

On health care this is what a yes vote is for:

First subsidize coverage so much that costs explode, raise taxes as much as possible to pay for it, and when that isn't enough hand power to an unelected committee to limit treatment and control prices by government order.

On March 10th David Plouffe, President Obama's former campaign manager and current White House advisor, sent out an email with a set of facts on behalf of Organizing for America about the "President’s Proposal" for health reform – which is, in actuality, a proposal for the House to pass the same bill that the Senate passed on Christmas Eve, and then for the Senate to pass a "fixer" bill using the nuclear option, budget reconciliation, with 51 votes.

The below letter was sent today to the members of the U.S. House of Representatives:

Yesterday the CBO released updated numbers for the health care reform bill which passed the Senate in December. Here are three (2010-2019): Gross cost: $875 billion; Increased revenues: $473 billion; Deficit reduction: $118 billion.

Patrick Caddell and Douglas Schoen deliver the news in tomorrow’s Washington Post:

First the bad news -- we gave them an extra day to work but it looks like Progressive fact checkers agree with our post from Tuesday that "If the Senate bill is passed into law with the President’s reconciliation adjustments, the following dangerous policies will become law: You cannot keep the plan you have; Your taxes will increase; and Medicare will be cut by $500 billion."

And that's not what we are seeing. Bruce Josten spoke with Neil Cavuto yesterday on health care:

Read more and take action here.

So I saw this video yesterday (h/t everyone in the @chamberpost Twitter stream) and assumed that it was a joke taken out of context, I mean it had to be right?  Come to find out this morning, in reading the full remarks, that no, Speaker Pelosi meant it when she said: "But we have to pass th

The Employers for a Healthy Economy and Start Over! coalitions today launched a new television ad urging Congress to begin listening to the American people and start over to get health care reform right. Some members of the coalition sum it up:
 

After months of posturing, the President has made it clear: the Senate bill is the final bill. The bill that narrowly passed the Senate on Christmas Eve by a partisan vote (prior to the election of Republican Scott Brown from Massachusetts), will more or less be the final bill. The only way the massive 2700-page health care bill will become law, is if the House now passes the Senate-passed bill.

CBO Director Doug Elmendorf, via Real Time Economics:

From the Wall Street Journal:

Having nothing positive to say about the current health reform legislation its supporters are, again, trying talk about anything but in order to distract people long enough to ram it through.

Bruce Josten released the following statement today after the President's call for “up-or-down-vote” (read reconciliation) on health care:

The Politico reports: "Harkin: Reconciliation is a go."  So let's go to GradeGov.com:

The Washington Post editorial board today acknowledged that "many" constituents are "justly worried" about "enacting an expensive new entitlement at a time of rising debt."

by Bruce Josten
 
Today's summit was a chance to have an open dialogue and discuss real solutions to improve our current health care system and lower costs. If Congress agrees to start over, there are clearly many areas of agreement where targeted legislation could achieve the results Americans want and the shared goals of both political parties. Some of those items include: cutting down on waste and fraud; new pooling options for small businesses; relief for individuals with pre-existing conditions; and medical liability reform.

Watching the summit so light posting today.  Follow along @chamberpost, @usccmiller, and @LegalReform

A few weeks ago Nancy Pelosi vowed to go over, around, or through the wishes of the American people to pass a health care bill they don't want, and can't afford. Now -- only a few days before the planned health summit with congressional leaders, the President has unveiled his massive $950 billion proposal, building on the flawed legislation passed by the House and Senate last year.

The Politico reports:

The business coalition, StartOver, criticized President Obama's proposed reform legislation for raising costs on businesses and not doing enough to make health care more affordable. The 10-member organization, which includes the Chamber of Commerce wrote:

This morning the White House released their proposed plan for health reform. Unfortunately, instead of building a new moderate, limited plan, the White House instead endorsed the Senate-passed bill, with a few changes. This is the same Senate bill that was pushed through on Christmas Eve.

Over the weekend James Gelfand wrote at the Center for Health Transformation's Online Health Summit:

With Congress out this week, much of the town is preparing for major events next week, including the president's bipartisan health care summit on Thursday. Ahead of the event, President Obama will take matters into his own hands and put forward a comprehensive health care bill on Monday that's intended to bridge differences between the Senate and House measures.

As a celebration that my internet connectivity is back I give you:

I normally avoid correcting mistakes by the SEIU's bloggers -- who has the time -- but since the snow is blowing sideways and my kids are rebelling against more quality time at the moment, let's take a look at this post regarding a health care op/ed by Bruce Josten which appeared in The Hill. The gist of their post is that you can't trust Josten's claim that "For nearly two years, the U.S.

Starting with The Politico:

"President Barack Obama is planning to host a televised meeting with Republican and Democratic congressional leaders on health care reform."

Then to the Washington Post:

President Obama has noted many times -- and correctly -- that we must get health care costs under control. So how do the current reform proposals do in this regard? Let's have a look:

The National Journal asks the experts "Scrap Health Care Reform?" the answer to which is (a qualified) no. We need reform and we need to control costs. As James Gelfand tells Congress, it's time to "Scrap Your Bills, Back to Basics"

Scott Brown won the Massachusetts election just last night and already the entire DC establishment is in rapid-fire spin-mode to explain away what happened.

CNN may not care that the public hates the current health care legislation, but David Brooks gets it:

Blair emails:

During his campaign for office President Obama said during a speech on August 2, 2008, "When special interests put their thumb on the scale, and distort the free market, the people who compete by the rules come in last."

The President to bankers yesterday:

"What I’d say to these executives is this: Instead of setting a phalanx of lobbyists to fight this proposal or employing an army of lawyers and accountants to help evade the fee, I’d suggest you might want to consider simply meeting your responsibility"

The view from Colorado, via the New York Times, my bold:

There's somewhat of a revolt brewing among the states over the pending health care bill. Yesterday California Gov. Arnold Schwarzenegger sharply criticized the legislation for the financial burdens it poses on his state -- and he's not alone. Time magazine reports there are four reasons why many states aren't keen on the bill, all involving how it will make the states' financial conditions worse:

And all it took was a massive recession!  My latest on the National Journal regarding health care reform legislation:

At the doctor. In the drugstore. In the hospital and in your paycheck. They're hidden. But you'll pay. New hidden taxes that Congress wants on your health care. Hidden health care taxes on medicines, medical devices and health insurance. Hidden health care taxes in the middle of a deep recession. Call Congress. Tell them, no hidden health care taxes in a recession.

One of the few prominent Republican supporters of the health care reform effort -- California Gov.

• Government Funding Increases Healthcare Costs - "a guaranteed prescription"
• The Visa fees article - I would note that IKEA (and others?) do offer debit incentives
• Read a book you think you'll hate in 2010 - Suggestions?

As members of Congress try to merge their divergent health care bills (more than 50 “topline differences”), they can do so with the latest read on health care spending and the economy. According to new government figures, health care spending rose at the lowest rate on record in 2008 – just 4.4% -- but still reached $2.3 trillion and constituted 16.2% of the economy.

As the House and Senate struggle to merge their respective health care bills, taxes are taking center stage, as they might throughout this year in a number of different ways. The House version calls for a 5.4% surtax on the rich, not adjusted for inflation, while the Senate bill would impose higher Medicare taxes on the wealthy, a new tax on so-called “Cadillac” plans, and taxes on medical equipment manufacturers and others.

On health care Ezra Klein thinks:

The bill that just passed the Senate was effectively the Massachusetts reform plan brought to national scale...

The New York Times op-ed columnist Bob Herbert writes, "There is a middle-class tax time bomb ticking in the Senate’s version of President Obama’s effort to reform health care." Herbert details the tax on so-called "Cadillac plans," which he claims is designed to tax the middle class. He argues that the first year would affect relatively few people in the middle class because their health plans would not rise to the level government deems taxable.

Despite numerous polls showing the majority of Americans are opposed to the Senate health care bill, sixty senators chose to ignore their objections. The business community has been consistent in calling for health care reform, but the bill that was passed by the Senate today is counterproductive, does little to lower the cost of health care, and it is not reform. It implements crippling new taxes, and hurts our ability to create jobs at the worst possible time for the economy.

Many are claiming that the Senate health care bill is "the largest deficit reduction plan in a decade" and long-term deficit reductions of "more than a trillion dollars."  It is true that CBO says the bill will reduce the deficit by $132 billion over the next 10 years. However, the predictions of long-term savings are speculative at best—as shown by the fact that the CBO this weekend had to revise its forecast to correct for a $500 billion margin of error. 
 
Are projections for deficit reductions realistic?

Now that sixty Senators have decided against using their opportunity to improve the latest version of health care reform, it appears the concerns of the broader business community will not be addressed. We recognize the inclusion of a few improvements in the nearly 400-page Manager's Amendment, which was revealed Saturday morning and voted on Sunday night.

Far from responsible health reform, if passed, the Senate health care bill will:

From the Wall Street Journal:

Read our letter below and send your message to the Senate today.

TO THE MEMBERS OF THE UNITED STATES SENATE:

by Brad Peck

Senate Democrats will drop their plan to include an expansion of Medicare in the health care bill, helping to clear a major hurdle to its passage. Politico reported last night that the White House instructed Harry Reid to cut a deal with  Sen. Lieberman, no matter what it takes.

Like the joke about the weather in Chicago, if you don't like a certain aspect of the health care bill just wait 15 minutes and it will probably change. For example, the Senate legislation will now allow caps on annual insurance benefits where it didn’t before. That move drew condemnations from the American Cancer Society.

The AMA and the American Hospital Association are not very happy about the provision in the Senate deal (that essentially erases the public option from the health care bill) allowing people 55 and older to buy into the Medicare program. The Washington Post is also sounding a note of caution about that expansion. The paper opines today:

// Update: Don't miss Health Reform We Support

Talking Points Memo:

First the news, key group of Senate Democrats reached an agreement to abandon the public option in favor of a new national plan administered by the Office of Personnel Management, run by nonprofit entities set up by the private sector, and available to the public on new insurance exchanges. If the private plans didn’t work or didn’t attract customers, then the traditional public option would kick in. The compromise would also open Medicare to those between the ages of 55 and 64. Reaction to the deal, so far, is mixed, with Harry Reid saying it moves the ball significantly forward, Sens.

Health care legislation passed another important hurdle recently when the Senate voted to begin debating it. So what does the U.S. Chamber think of the Senate bill, and what happens next?

WSJ's Editorial Page Editor Paul Gigot talks to SEIU President Andy Stern:

MR. GIGOT: So what would be your two or three big priorities? I assume one of them would be universal health care.

David Brooks on health care reform:

The U.S. Chamber's Bruce Josten made the following statement today regarding Senate Majority Leader Harry Reid's announcement that he will amend the health care legislation on behalf of Senator Ron Wyden to include a provision which would allow certain employees to demand a cash-out from their employer's health plan. This cash-out would be used to purchase insurance on the government-run exchange and would encourage employees to abandon their employer's plan.

The SEIU’s broadside, clichéd attack on the Chamber’s position regarding legislation creating a new mandate for paid leave related to the H1N1 health crisis is missing just one important element: facts. The U.S.

The Washington Post opines:

Chart with the Budget Committee’s estimate of the score of the Reid bill after 10 years of full implementation. Interesting to note that because the bill pushed back implementation of the major provisions until 2014, the true cost of 10 years of implementation—$2.5 trillion. (as a PDF)

"Chamber Of Commerce Solicits Money For Economist Who Will Give Bad Review Of Health Care Bill" screams the headline on The Huffington Post, a scream dutifully echoed by its progressive minions on Twitter and elsewhere. But the best thing about Huffington Post stories is how often they self-rebut, sometimes even in the lead sentence (italics mine throughout):

The Wall Street Journal takes over from Cato and the National Review:

One of the media narratives in the health care debate is that the battle is between astroturfing special interest groups and benevolent activists only interested in the public good. Enter Stephen Spruiell writing in the National Review:

James Gelfand explains:

Samuel Rosenberg writes to the NY Times:

With the passage of H.R. 3962, the health care bill, the House missed a significant opportunity to advance reasonable and meaningful health reform that fundamentally changes how the health care system operates and changes the overall upward trajectory in spending.  American employers and employees want an improvement in the nation's health care system, not an unsustainable, unaffordable overhaul.

Edward M. Levy from Cincinnati writes to the Wall Street Journal:

It's D-Day minus 1 and counting! A vote has been set for tomorrow for the House health care bill, endorsements are coming in, moderates are being whipped (perhaps literally!), questions are being raised, promises are being broken, protests are erupting, and victory is being predicted. The negotiating and arm twisting over the particulars of bill continue, as well. Controversial issues like access to care for illegal immigrants and abortion funding could trigger revolts among certain Democratic members if not resolved to their satisfaction.

From the AP:

In the Wall Street Journal, Heather Richardson Higgins, of the Independent Women's Forum, muses on the political ramifications of a new poll by her group concerning women and health care, but let’s just take a look at the numbers from her piece:

A new coalition of leading employer associations representing hundreds of thousands of businesses of all sizes from all 50 states and nearly every sector of the economy today launched a nationwide advertising campaign targeting the health care bill in the House of Representatives. Employers for a Healthy Economy strongly supports health care reform that lowers costs and provides access to health care for millions of Americans.

Title from a piece that the Chamber's Bruce Josten has this morning in the Politico:

There:

“In the past requirements to make financial savings often resulted in hospitals stopping routine surgery for a couple of months before the end of the financial year.”

Here:

Over at Cato, Michael Tanner addresses those who still buy into "the myth that the public option is, well, an option."

From Politico's Live Pulse:

Today I had the opportunity to listen to the President speak on health care. My first impression was that he understood the reason I was there. I am a small business owner in Illinois, my company, Edwards Creative Services, is a small graphic design company with fewer than ten employees. Because of our size we cannot find affordable health care for our staff.

Today I had the opportunity to go to the Executive Building and meet with a group of other Small Businesses from across the country and listen to the President speak about health care and other small business issues. I represent a company called ESJ Freight Management from Cincinnati, Ohio and being in the transportation industry we see many alarming issues heading our way.

The Wall Street Journal had a superb op-ed piece today on a new study by WellPoint on the impact of current healthcare proposals on insurance premiums. The study says that current proposals could dramatically increases premiums for everyone. Predictably, the reaction from the Hill and the White House was harsh and immediate, with proponents of the current bills analogizing WellPoint's research to that of the Tobacco Institute.

I answer that question over on the National Journal:

Former Clinton Labor Secretary Robert Reich says Obama made a fundamental mistake by trying to pass health care reform during the worst recession since the Great Depression. He writes:

Health reform is critical to the business community – businesses voluntarily pay over $500 billion every year for employees’ health insurance, and cannot afford the cost increases. We support reforming the health system with a simple three-pronged approach:

1) Get costs under control. Use an all-of-the-above strategy.

AEI President Arthur Brooks in the Wall Street Journal looks at "Why Government Health Care Keeps Falling in the Polls."

Robert Samuelson on the public option:

Fred Hiatt on the public option:

One of my favorite things about Washington is the cavalier way large sums of money are bandied about and their complete opaqueness.  Take the recent health care discussions – we hear over and over again that the solutions which have been worked out which will reduce the federal deficit – which is true, kinda.  It doesn’t actually reduce spending, it merely reduces the amount of money that we said we were going to spend – and raises taxes enough that the Feds have to borrow a little less later on.  Try this at home*:

A few days ago when we pointed out that the word “compete” deserved no place in a question about the creation of a government-run health insurance plan one of our commenters complained that we were using a slippery slope argument -- that such a plan could eventually lead to single-payer government-run health care.

It is not often that these words appear here on ChamberPost, but Harold Meyerson is right:

one way to help Americans get the best deal for health coverage is to establish insurance exchanges where consumers can compare plans online.

and then wrong:

"Public option gains support - CLEAR MAJORITY NOW BACKS PLAN" says the Washington Post this morning based on their new poll done with ABC News. With polling of course it is all in how you ask the question. Let's have a look, with my italics:

Two courtesy of Don Boudreaux, first John Nye on income differences and the quest for status and "positional goods."

A quick wrap on the health reform debate, first up two from the Politico's Pulse:

From the Washington Post yesterday:

Lawmakers could save as much as $54 billion over the next decade by imposing an array of new limits on medical malpractice lawsuits, congressional budget analysts said today -- a substantial sum that could help cover the cost of President Obama's overhaul of the nation's health system.

As Congressional members witnessed first-hand during their August town hall meetings, the American people overwhelmingly support medical liability reform as a way to reduce costs and improve the quality of care. Unfortunately, as this debate approaches the finish line, it seems that the trial lawyer lobby is cashing in all its political chips to retain the status quo.

The Wall Street Journal, in praise of U.S. medicine and immigration:

Hats off to Elizabeth Blackburn, Carol Greider and Jack Szostak, the three American scientists awarded the 2009 Nobel Prize in medicine yesterday. Their cell research demonstrates that we're on the cusp of an era of medical innovation that could radically improve lives and life spans, if government lets it blossom.

The health care reform debate has had more plot twists and drama than a soap opera--and there's more to come! The latest development is passage of a bill by the Senate Finance Committee. Although it is the best bill yet, the committee missed an opportunity to craft truly bipartisan legislation. Here's what the U.S. Chamber likes and doesn't like about it.

On CNBC Al Martinez-Fonts, a fellow at the U.S. Chamber of Commerce, discusses whether corporate America is ready for the second wave of H1N1. Don't panic but do prepare yourself and your business with "It's Not Flu as Usual," a preparedness guide written for businesses of all sizes.

Many experts are predicting that the H1N1 flu will peak in the United States in mid-October.  To prepare for this, the Business Civic Leadership Center is hosting a free webinar Tuesday, September 29, 2009 2-2:30 p.m. Eastern that is designed to give companies and local chambers of commerce a unique look at the H1N1 threat through the eyes of a company on the front line of tackling the challenge.

The webinar will provide you with:

There are several outstanding amendments of concern that were introduced but have not yet been considered by the Senate Finance Committee. We don’t know when or if these will come up when the Committee returns on Tuesday but to us the three below are the most significant altering amendments.  Here is a rundown I received from Bruce Josten, our head of Government Affairs:
 
Rockefeller C1 – Applying new rating rules to the large and self-insured (ERISA) market.

One of our commenters thinks we should "prove some of your statements in your ads." Well, there are entire groups dedicated to this sort of fact checking, but since they appear to be skimping on research, here is one stone for two birds:

CBO: "Legislation Would Raise Insurance Premiums"

From Bruce Josten's letter to Senators Baucus and Grassley on the America's Healthy Future Act, (details on the positives and the negatives).

From Bruce Josten's letter to Senators Baucus and Grassley on the America's Healthy Future Act, see also the positives.

From Bruce Josten's letter to Senators Baucus and Grassley on the America’s Healthy Future Act. (Update: the negatives)

The Gallup poll out this morning shows that Americans still believe the Democrat health care plans will increase their health care costs (by two to one) and reduce the quality of their health care. And they believe their coverage will suffer and insurance company requirements will be more onerous than under current law.

Former Missouri Governor Matt Blunt shows Congress how to do malpractice reform in the Wall Street Journal:

In July we charted the House health reform bills. Now on to the Senate. Below is the current government regulation of health plans and below that what government regulation looks like in the Baucus health care reform bill. Click here to read both charts, with notes. Then go back and check out the House again.

This is pretty self-explanatory:

The U.S. Chamber today released "It's Not Flu as Usual," which is an H1N1 preparedness guide written for businesses of all sizes. Obtain an electronic version of the guide (PDF) and check out the accompanying press release for more information. This guidance is intended to provide recommendations on how businesses can:

James Gelfand on Fox Business on the Baucus Bill:

The business community has strongly advocated for health care reform and the Senate Finance bill is the best effort to date. We applaud the provisions in this bill that will lower health care costs, increase coverage, and improve the quality of care. These range from fairly regulating the insurance market to enacting tax parity for small businesses and the self employed. We strongly support allowing plans to be sold nationally, and allowing individuals to purchase health insurance across state lines.

Political analysts and commentators continue to critique President Obama’s major health care speech. Columnist Mark Steyn wonders why Obama can’t close the deal. He writes:

President Obama plans to authorize demonstration projects in states to test potential medical malpractice reforms which is an encouraging acknowledgement of the problem of medical liability lawsuits. While his demonstration program might be a step in the right direction, the devil is in the details.

Warning that more Americans would die if Washington does nothing to reform health care, President Obama tried to sell his ideas for reform last night before a joint session of Congress.

Politico's Playbook reports:

Earlier today White House Press Secretary Robert Gibbs reported that President Obama will address medical liability reform in tonight’s speech to Congress. We are encouraged that President Obama understands the tremendous burden that medical malpractice lawsuits place on the nation’s health care system, and are hopeful he will propose meaningful reforms tonight to limit the impact of these lawsuits on patients, taxpayers, and medical providers.

In August, former Vermont Governor and Democratic National Committee Chairman Dr. Howard Dean made a telling statement when he answered a question at a Congressional town hall meeting about the lack of medical liability reform in the current healthcare reform proposals. Dean responded, "The reason that tort reform is not in the bill is because the people that wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on, and that is the plain and simple truth."

Congressional recesses serve a valuable purpose. They provide members of Congress with extended periods back in their states and districts, where they can connect with constituents and find out what’s on their minds.

At no time was this truer than with the recess just ending. Constituents packed town hall meetings in numbers never seen before. Most came to express serious concerns about the direction Congress is headed on health care. There’s plenty to be concerned about.

There are hardly enough hours in the day to address the sheer volume of disinformation coming out of the SEIU, but I have a few minutes, so let's look at this post:

Politico reports the White House is ready to change its approach to health care – it says Obama will now get more heavily involved and more specific about the confines of a compromise. The most interesting part:

The lastest Ad from the Campaign for Responsible Health Reform. Join today and make sure Congress doesn't sell us short.

Small Firms Asked to Pay for New Programs

By Thomas J. Donohue, President and CEO, U.S. Chamber of Commerce

As Congress debates health care, climate change, unionization, and other tax and regulatory measures, who is taking a step back and weighing the cumulative impact of all these proposals on America's small businesses and entrepreneurs? The U.S. Chamber is, and what we see is very troubling.

Kevin Ganster

There are various reports about the number of uninsured Americans - some news outlets have cited a number as high as 47 million. Soon the U.S. Census Bureau will issue their annual report on health insurance coverage. This is sure to garner quite a bit of coverage, but it is important to understand what the big numbers actually mean; the following is an actual breakdown from the Census Bureau of uninsured Americans:

The daunting "46 million" is misleading:

As supporters of government-run health care ramp up the efforts, let’s look at the government decision process:

Katie Hays, our lead lobbyist on health-care reform spoke yesterday at an event presented by the Catawba County Chamber of Commerce:

He's being called the greatest senator of our time, the "Lion of the Senate," and the last of an extraordinary generation of Kennedy's who transfixed the public and changed the world. The end of Camelot -- Sen. Ted Kennedy, dead at 77.

The Washington Post did a series of articles today on H1N1, some good stuff:

• What We Need To Know Now - answers to some common questions about swine flu.

• Swine Flu Could Infect Half of U.S. - Presidential Panel's Estimate Is First To Gauge Possible Impact of Pandemic

The president’s effort to pass health care reform legislation has fallen into a familiar pattern – one step back, then two more steps back. Yesterday Gang of Six member Chuck Grassley made his most definitive statements yet against a public option, saying, "Government is not a competitor, it's a predator. We'd have 120 million people opt out [of private insurance], then pretty soon everyone is in health care under the government and there's no competitor."

Jonathan Martin talks to Rep. Allen Boyd (D-Fla.) about the depth of the unease spurred by the health care debate:

by Brad Peck

From the Independant Women's Forum:

The Chamber's Ann Beauchesne joined a panel, hosted by HHS, discussing new federal guidelines to help employers and businesses prepare for and respond to the upcoming flu season.  More at www.flu.gov

Yesterday House Speaker Nancy Pelosi made her most explicit statement yet about a public option in the health care reform bill – drop it and kiss any chance of comprehensive reform goodbye. Said the speaker to a San Francisco audience: "There is no way I can pass a bill in the House of Representatives without a public option."

Rep. Henry Waxman, Chairman of the House Committee on Energy and Commerce, and Rep. Bart Stupak, Chairman of the Subcommittee on Oversight and Investigations, sent a friendly little letter to a number of health insurance companies today (PDF here).

Although Harry Reid, Sen. Chuck Grassley, and others say the Gang of Six continues to make progress on reaching a bipartisan agreement on health care, the major media are saying it ain’t so.

Earlier today Commerce Secretary Gary Locke, Homeland Security Secretary Janet Napolitano and Health and Human Services Secretary Kathleen Sebelius held a joint news conference to announce new federal guidelines to help employers and businesses prepare for and respond to the upcoming flu season. 

The updated guidance includes additional strategies to use if flu conditions become more severe and new recommendations regarding when a worker who is ill with influenza may return to work.

Bob Beckel takes on health reform's taboo topic, partly for the wrong reasons, but hey, we'll take it:

A New York Times story today hints that Democrats may abandon efforts to win Republican support for a health care bill and go it alone. Many observers say House Democrats never gave Republicans a second thought in crafting and passing their bill anyway, and that the Senate’s problems lie largely with its own members -- as noted in the article:

Today in urging public plan proponents to give it up already Steven Pearlstein gives an assist to Ezra Klein, who basically sums up this fascinating post from Mark Schmitt, a snip:

This has always been our position, today Steven Pearlstein agrees:

Over the weekend the Obama Administration tried again to bring the health reform debate back from the ideological fixation on government-run care to the issue of real health reform, with predictable results -- a ste

Carrie Budoff Brown writes in the Politico:

President Barack Obama and his top aides are signaling that they’re prepared to drop a government insurance option from a final health-reform deal if that’s what’s needed to strike a compromise on Obama’s top legislative priority.

There has been a lot of talk about misinformation in the health reform debate – fishy emails, conflicting statements by politicians, allegations. The U.S. Chamber of Commerce provides the following information to shed some light on the business perspective on the probable effects of the Affordable Health Choices Act.

Health reform is critical to the business community – businesses voluntarily pay over $500 billion every year for employees’ health insurance, and cannot afford the cost increases. Bruce Josten will offer the voice of the business community in a discussion about health care on Meet the Press this Sunday. The panel on-set will include Senator Coburn, Dick Armey, MSNBC’s Rachel Maddow, and Tom Daschle.  The show airs at 10:30 a.m. EDT in New York and Washington and 9:00 a.m. EDT across the rest of the country on NBC.

Tut-tut NYT - "There also seems little doubt that the small business community would be one of the biggest winners from health care reform."

That should be "could be."  It all depends on the final legislation now doesn't it?  Picking best case scenarios and declaring anything else scare tactics is hardly honest. But, I forgive you for this bit of good news.

As mentioned last night, our first TV ad calling for responsible health reform. As you can see, it is not "critical of President Barack Obama's effort" as some have described, but critical of the current proposals in Congress. 

Coming soon to a TV near you:

The U.S. Chamber of Commerce will begin airing 30-second ads in about 20 states Wednesday criticizing the Democratic proposal to offer optional government health coverage...The ads show a balloon being inflated until it bursts. The ad says, "Big tax increases, huge deficits, expanded government control of health care. Call Congress."

Though I certainly wouldn't use some of his phrasing, Matthew Yglesias makes several good points in this post today: "people need to keep their eyes on all aspects of the ballgame. There’s important stuff happening in this area and members of congress need to hear that people want it done right."

by Patrick Kilbride
 

Standing next to Canadian Prime Minister Harper yesterday, President Obama noted that the "single payer" system in Canada is not suitable for the United States, which he noted has widespread employer-provided coverage. 

Today the White House rolled out their "Reality Check" web site for health reform (trying again to rebrand it health insurance reform) which they claim is intended to "mythbust" detractors’ criticisms of health reform legislation. The web site, however, does not bust any myths – in fact, it perpetuates them. Since the beginning of this debate on health reform, the White House has sought to lay out principles and platitudes, none of which have had any impact on pending legislation in the House and Senate.

The US Chamber's role in the health care and regulatory reform fights is profiled in an AP story.

A recent email purportedly sent by a Dr. Stephen Fraser, an anesthesiologist located in Indiana, made a number of claims about H.R. 3200, the House Democrat health reform plan. A number of organizations have issued responses that claim Fraser’s email was inaccurate.

Buried within the selective memory and partisan finger-pointing Paul Krugman makes an admission and asks a question:

For the most part, the protesters appear to be genuinely angry. The question is, what are they angry about?

Perhaps Scott Rasmussen can explain:

First, the question at the heart of protests around the country remains unanswered. The Hill reports "The White House refused Thursday to say whether President Barack Obama would sign a healthcare bill that doesn't include the public option plan the president supports." Press Secretary Robert Gibbs "declined to say whether Obama would veto or sign a bill that doesn't include a government-run public option plan, which the Senate Finance Committee is reporte

After a brief statement of purpose the Declaration of Independence makes a bold affirmation:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

HHS Secretary Kathleen Sebelius has a 720 word op-ed in the Washington Post today arguing that the status quo in health care is unacceptable and that we need reform. Sold. We need reform. The problem, of course, is the two little words which don't appear in Sebelius' piece "public plan." That is what the American people are oppose to, and that is what is generating so much anger.

As befits a major piece of legislation which affects all Americans and a nice chunk of our economy, Speaker Pelosi had planned to jam the Affordable Health Choices Act through the House as quickly as possible. The plan worked, on purely partisan votes in the House Ways and Means and Education and Labor Committees -- actually there was bipartisan opposition, but it still passed both, quickly.

"I don't think we're going to be able to eliminate employer coverage immediately, there's potentially going to be some transition process, I can envision a decade out or 15 years out or 20 years out." (Candidate Obama)

According to Wikipedia:

With most members of Congress back in their home districts for the August recess, now is an ideal time for citizens to personally lobby them on key issues and to participate in town hall meetings and other issue-related community events.

• Repealing Erisa II - The House bill would harm businesses’ ability to offer insurance.
• Tax Burden of Top 1% Now Exceeds That of Bottom 95%
• Construction Unions Posture for Pension Bailout?

Everyone agrees that the health care status quo is unsustainable, quite simply we need health reform -- correction -- we need health reform that works.

Senator Mitch McConnell thinks something's missing:

 
"The Chamber is gravely concerned by the process and the product thus far. As badly as [health care] reform is needed, we cannot support reform just for the sake of reform."
—Randy Johnson, U.S. Chamber senior vice president of Labor, Immigration and Employee Benefits, quoted by Dow Jones Newswires, June 11, 2009

"The Chamber's 'Campaign for Free Enterprise' attempts to weave together a coordinated response to the many regulatory and other threats that worry business interests."
—BusinessWeek, June 11, 2009

Roll Call is reporting that House Speaker Nancy Pelosi is urging House Democrats to go on the offensive against the health insurance industry over the August recess saying, "They are the villains in this," and blasting the industry as "immoral."

Randy Johnson was on Fox Business today talking about concerns we have with the current health care proposals and our letter to Congress on the subject.

A couple of good comments on James Gelfand’s post outlining new burdens on employers in the House health bill. Roy Hunt wrote:

Our company is an 87 year old entity. We have provided health insurance for our employees since 1950. Until recently, we paid the entire premium. There is no way we can afford the proposed House health care proposal…

The Service Employees International Union's messages on most issues are as popular as, well, unionism among private sector workers.

• Captive To Corn – This post reminded me of a pundit who quipped during the Waxman-Markey debacle that "Congress would vote for a bill appointing Satan as dictator if it included more farm subsidies."

After more than six hours of negotiations with White House Chief of Staff Rahm Emanuel, House Democratic leaders and key Blue Dog Democrats ended discussions last night without a deal on health-care reform.

• Cost control: Liability limits needed in reform

• In Health-Care Policy, as in Hollywood, Nobody Knows Anything

Some may remember the old country song “Looking for Love in All the Wrong Places.” Something similar is happening in Washington today—politicians are looking for recovery in all the wrong places, namely, more government programs and spending. Instead, they should look to small businesses, which have led us out of the last seven recessions and create 60% to 80% of net new jobs.

"Chamber: Speed health care up" was the headline from a USA Today blog post on our letter yesterday to Senate Finance Committee, a theme also pushed by several other news outlets.

One of the fundamental laws of business is the The Law of the Unattainable Triad. In brief, three objectives in the development of anything are Price, Speed, and Quality -- you can achieve any two, but the third must be sacrificed. Of course public policy is not private enterprise and typically we see all three go out the window when Congress gets involved -- legislation takes a long time to create, is often more expensive than necessary, and usually pretty ineffective. This summer the House of Representatives is proving itself extraordinary by actually achieving one of the objectives.

Sigh...

During his speech at a National Press Club luncheon, the chairman of the House Judiciary Committee, Democratic Congressman John Conyers (D-Mich.), questioned the point of lawmakers reading the health care bill.

"I love these members, they get up and say, 'Read the bill,'" said Conyers.

It appears no one can agree on health care reform legislation – not Democrats amongst themselves, not Congress and the White House, not the White House and the CBO, and certainly not Republicans and Democrats.

The U.S. Chamber sent a letter tonight, to every member of Congress, signed by more than 1,000 businesses, groups, state and local chambers expressing concern with the current health care proposals moving through Congress. The letter in full:

July 24, 2009

TO THE MEMBERS OF THE UNITED STATES CONGRESS:

Bruce Josten spoke with NPR's All Things Considered on the importance of responsible health reform for America's businesses -- listen here.  A few selections:

It's official – the full Senate will not be voting on a health care reform before the August recess. At a town hall meeting, President Obama said it was "OK" if the Senate missed that deadline, but he added that he still wants to sign a bill into law this fall.

Rep. Jim Cooper, D-Tenn., is asking the question this week on the Health Experts Blog:

Just the facts, a breakdown of the new burdens on employers in H.R. 3200, the cuddly-named "America's Affordable Health Choices Act of 2009"

• All employers with total payroll over $250,000 will be required to provide “Qualified Health Benefits” for their employees and their dependents or pay a pay-roll tax of up to 8% of payroll.

• Further, employers will be required to pay 72.5% of premiums for their employees.

The first line of the first paragraph of the first story on the first page of the Washington Post this morning is wrong:

Even as the national business lobby ramps up its opposition to health-care reform...

President Obama made an urgent case for health care reform last night, saying the remarkable thing wasn’t how far negotiators have yet to go, but how far they have come. He is confident a bill will be passed this year. He repeatedly cited support for the current legislation from the drug makers, doctors, hospitals, and AARP, and faulted Republicans for opposing the bill for political advantage.

Click for a full sized image and read more here, here, here, and here.

Nobody else does. Really. Seriously. Nobody.

Esquire gives out their Dubious Achievement Awards at the end of the year, but it appears that the U.S. House of Representatives has a lock on "worst piece of legislation ever."  But which "worst" will walk away with the prize? Will it be health care?

Democratic divisions on health care were on clear display yesterday as the wheels of President Obama's runaway health care freight train starting slipping off the tracks. First, the House Energy and Commerce Committee postponed its vote on the tri-committee bill so its members could visit the White House for an arm-twisting session.

Tom Donohue wrote today:

From the Wall Street Journal (my italics):

Today over on the NationalJournal.com John Maggs asks: "Even without a health care reform, Obama would shift a higher burden of taxation on the top 1 or 2 percent of earners. Is this efficient? Is it fair? What will be the impact on recovery and growth?" Bruce Josten answers (in part):

David Broder presents the choice:

Healthcare reform is needed, everyone is in agreement on that, nobody is arguing for the status quo on this one. So now the hard part; first we need to set goals, then figure out the best way to achieve them while maximizing the return on our investment.

From the Wall Street Journal:

Health care. Just as Democrats began building up a head of steam toward passage of their health care plans, the Congressional Budget Office is letting some of the air out. CBO Director Douglas Elmendorf said the legislation would not rein in spiraling health care costs and, at least initially, isn't likely to significantly lower premiums for the majority of Americans with employer-sponsored health insurance.

Randy Johnson didn’t know whether to laugh or cry at the health reform proposals introduced this week. See also the letter, the chart, and a glimpse into the future.

Below is a chart showing the current regulation of health plans. Roll over it to see what government regulation looks like in House healthcare reform bill.  Then roll out, then over, then out, then over…makes you kind of nauseous doesn't it?  Actually just sitting on the second one makes me queasy. Click on the image or here to read both charts.

Is the message today from Tom Donohue in the USA Today:

The conclusion of our letter today to Reps Rangel and Camp:

Robert Reich writes today:

It's the most blatant form of Robin-Hood economics ever proposed. The universal health care bill reported by the House yesterday pays for the health insurance of the 20 percent of Americans who need help affording it with a surtax on the richest 1 percent.

Take action now to oppose flawed health care proposals and avoid this:

"Since when does our great free-market country punish success?" was the question U.S. Chamber President Tom Donohue posed yesterday when confronted with a health reform plan financed on the backs of small business owners. Support for the plan was lukewarm, and certainly not bi-partisan, but David Axelrod, Obama’s senior political strategist points out “Ultimately, this is not about a process.

by James Gelfand
 
The Senate Health, Education, Labor and Pensions Committee has just passed the "Affordable Health Choices Act", a bill that is not affordable for the country and may severely restrict patients' and doctors' choices. The bill may lead us to government-run health insurance, will hurt the economy, and for many Americans, will jeopardize the quality health insurance they have now.

Reuters reports: "The U.S. House of Representatives healthcare overhaul bill expected to be unveiled on Tuesday will include surtaxes on the wealthy starting in 2011 and rising in 2013 if more money is needed to pay for its programs" -- with the wealthy being defined as families making more than $350,000 dollars a year. As the Wall Street Journal reports:

by David Chavern
 

Every so often there is someone who likes to try and poke holes in the small business job creation statistics that form the foundation for public policy.  Today it was Steven Pearlstein’s turn in his article "Small Business, Big Fable."  Pearlstein's "sound economic logic" goes like this: 

Sen. Kent Conrad said his fellow members of the Finance Committee are having second thoughts on imposing a tax on high-end insurance coverage that workers receive on the job. Apparently they were spooked by polling data from a number of sources showing Americans didn’t fancy that idea. It’s unclear whether that means another alternative – a 4% surtax on adjusted gross incomes of more than $200,000 -- is gaining further traction. That could raise as much as $850 billion over the next decade.

Kaiser Health News checks in with the Chamber's James Gelfand:

Q: Many argue that a public option would provide a cheaper alternative to small businesses who struggle to afford health care. Why is the Chamber opposed?

As reported in the Wall Street Journal:

It is more important that health-care legislation inject stiff competition among insurance plans than it is for Congress to create a pure government-run option, White House Chief of Staff Rahm Emanuel said Monday. "The goal is to have a means and a mechanism to keep the private insurers honest," he said in an interview. "The goal is non-negotiable; the path is" negotiable.

Getting caught up with the (non-Palin) news. This is good...

A revamped Senate bill aimed at improving the nation's health system would cost $611 billion over a decade, congressional number crunchers estimate, down from $1 trillion two weeks ago.

Right?

I spent yesterday morning with a good child visiting a good doctor at a good clinic so here is my message to Congress -- please don't screw that up. You can generate your own message to Congress here and join the many others who have already done so, as reported this morning in the Politico's Pulse:

Randy Johnson on Washington Journal talks about employer mandates, government run universal health care and other health reform issues.

Employer Mandate Is a Misstep

By Thomas J. Donohue, President and CEO, U.S. Chamber of Commerce

After months of discussions with senior Senate Democrats on health care reform, the Chamber was greatly disappointed with the first draft of the legislation. The bill is inconsistent with reducing costs and increasing access to health care.

I have no words, and it wasn't just these two.

James Gelfand looks at health care employer mandates on the National Journal's Health Care Experts Blog:

In a column yesterday, George Will said Americans are rapidly coming to the conclusion that health care reform envisioned by Congress and the president isn’t worth it. He cites three reasons: 1) As societies become richer, it’s natural they spend more on health care – as well as symphonies, universities, and museums. The Hudson Institute says that in 1960 the average American household spent 53% of its disposable income on food, housing, energy, and health care.

Robin from Dallas Tweets on our conference call today: "US Chamber threatened not 2 run truth aware ads on #Health Care Reform.

Here is a copy of a letter in which a Teamster pension manager writes (my emphasis throughout):

The Politico Pulse reported this morning that:

Gail Collins questions David Brooks on his excellent column this week regarding the Obama health care plan and Brooks ups the excellence with this response:

by Kevin Ganster

President Obama was warmly received by members of the AMA yesterday in a speech focused squarely on health care reform. The president blamed some of the spiraling costs of health care on a reimbursement system that he said pays for the number of tests and services provided, regardless of what is needed.

by James Gelfand

Yesterday I participated in a Senate HELP* Committee roundtable on legislative options for health care reform. With the president pushing the Congress to deliver a health care bill before the August recess, we are reaching a critical moment in the national debate. I appreciated the invitation to participate on behalf of the business community, which provides a large portion of the nation's health benefits to citizens. One of the options being discussed is a mandate that would force almost all employers to sponsor health insurance. From my written statement:

Andy Begneaud, Begneaud Manufacturing in Lafayette Louisiana, talks about building a workforce and cutting health care costs by creating understanding.

One of the lazier debating tactics is the "if you are not for X, you are against Y" argument. The Chamber has been a frequent target for this type of attack around the Waxman-Markey energy and climate bill and I am sure that we will being seeing it again as health reform moves forward.

It’s been 16 years since legislation has been introduced to fundamentally reform the nation’s troubled health care system. Now, a new bill spearheaded by Sen. Kennedy is beginning to take shape, with the ultimate goal of passing it in a bipartisan fashion in a lightning-fast timeframe of just a few months.

Yesterday Jim Wordsworth, small business owner and Chairman of the Chamber’s Small Business Council, gave testimony on behalf of the Chamber before the House Small Business Committee on Common Ground: Finding Consensus on Health Reform, the Small Business Perspective.  From the testimony:

In the comments Joellyn Robinson asks a very good question after reading Newt Gingrich and David Merritt's post on employer pay-or-play health care mandates:

Of all the proposals floating around the health reform debate to expand insurance coverage, there is one in particular that should give American businesses pause: the employer pay-or-play mandate.  Businesses would be required to offer either health insurance coverage to their employees or pay them (or a government entity) a prescribed amount toward their care.  This would turn employer-sponsored care from a voluntary benefit, which it has been for more than 60 years, into a federal requirement.  This is not only bad policy, it is currently illegal.

There is a lot of debate right now about how we will pay for health reform – no easy task considering cost estimates of the yet-to-be-revealed legislation range from $1.2 trillion, to $1.5 trillion, to more than $1.7 trillion!

Every invention starts with an idea – ideas that must be respected, encouraged, and protected. Strong intellectual property (IP) laws provide the incentive to transform ideas, from a back-of-the-napkin concept to the most complex mechanical designs or chemical formulas, into products and services to improve and enrich our lives. Key examples include life-saving medicines, software, and other technologies that help us address health, energy, climate change, and agricultural challenges.

In a recent piece (Health-Care Hardball) in the Manhattan Institute's City Journal, David Gratzer writes about the dangers Democrats will face in trying to pass health reform through the reconciliation process, which would require them to get only 50 votes, instead of the usual 60 needed to break a Senate filibuster:

by Brad Peck
 
Sitting out at the Salesgenie.com Cyber Café but can still feel the energy in the room, very excited crowd. David Chavern opened the festivities today with a very nice introduction of U.S. Senator Mary Landrieu. 
 

Promoting wellness in the workplace is an important step toward addressing our health care challenges and building a better health care system. It should be a health care reform we can all agree on. From the NY Times:

Healthcare economist Len Nichols scared me a bit here with this line:

A public health insurance plan would reassure those who mistrust private insurance that their insurance product is accountable to elected officials and not to corporate stockholders or the proverbial bottom line.

Pulled this together a little late last night to post, so here is yesterday's news from the CDC.

H1N1 Flu Investigation: The CDC continues to take aggressive action to respond to an expanding outbreak caused by novel H1N1 flu.

I had the pleasure of giving testimony before the Senate Finance Committee today -- complete testimony here -- both applauding Congress' efforts to achieve access to affordable health care coverage for all Americans, and urging caution as proposals are crafted which could prove harmful to the U.S.

The H1N1 virus is spreading person-to-person like a regular seasonal influenza virus, with 286 confirmed cases in 36 states and 20 different countries.  After a nearly a week, there is cautious optimism because we haven’t seen a very large increase in the numbers of infected people or in the severity of the disease.  However, this can change quickly, so we’re continuing to monitor the situation.

As Americans we are resilient, unless ill with the H1N1 flu virus we will go about our normal lives despite what Joe Biden says -- I kid, Mr. Vice-President, thank the President for the shout out -- and continue to fly on planes, take public transportation and eat our BLTs!  Below is some recent news about the H1N1 virus.

Even in the midst of implementing their own continuity of operations to prepare for the H1N1 flu, companies are finding opportunities to help those affected.  Take the following three examples:

1. Abbott has sent more than $860,000 in antibiotics, pain medication and pediatric and adult nutritionals to Mexico through its partners AmeriCares and Mexican Order of Malta.

2. Merck's Mexico office made a donation of 80,000 doses of PULMOVAX (local brand of Pneumovax to treat secondary lung infections following swine flu infection) to the Mexican government.

It is truly sad that I must post this, but, as noted below, the legal landscape is not going away just because there is a possible pandemic. Here is a helpful primer from McKenna Long & Aldridge, a member of the Chamber's National Security Task Force.  I suppose that I also must note that this is for educational purposes only.  Here is the guide:
 
H1N1 FLU AND PANDEMIC PLANNING: ACTIVE PARTICIPATION IS CRITICAL

//All H1N1 update posts

Encourage your Employees to Plan

by Ann Beauchesne

//All H1N1 update posts

Border Restrictions: Not an Effective Means of Preventing the Spread of Swine Flu

An editorial this week from the Washington Post (not exactly a conservative publication) does a good job of laying out the reasons why a "public option" (code word for government-run health plan) should be left out of health reform. They even recognize that the public option is a backdoor way to bring America to single-payer, government-run, socialized medicine. I will let the editorial speak for itself, but here is a taste:

//All H1N1 update posts

As the H1N1 virus continues to cause harm and concern here are the quick four tips from the CDC to stay healthy:

by Ann Beauchesne

//All H1N1 update posts

The U.S. Chamber of Commerce continues to monitor the increase of human cases of swine influenza A (H1N1) virus infection in the U.S., Mexico, Canada and across the world.

//All H1N1 update posts

This article is not about Health IT, but this picture makes the point. From the caption: "Tina Oliver, a medical office rep, estimates that the HealthServe Community Clinic has about 15,000 current patient charts crammed into their office.

by Taryn Bird

In the midst of the current financial environment, many organizations and individuals have bunkered down to focus solely on “our issues” -- things that affect them in the immediate future. One has to ask, in these situations how will the emerging economies around the world that depend on ODA (overseas development assistance) and FDI (foreign direct investment) be affected? How will the development agendas of corporations, nonprofits, and aid agencies fair in this global economic situation?  

The administration is taking some flack over the president's new science adviser characterizing global warming as so severe a problem we should consider geoengineering the climate – perhaps shooting pollution particles into the upper atmosphere to reflect the sun's rays. “It's got to be looked at," said John Holdren. "We don't have the luxury of taking any approach off the table … [global warming is like being] in a car with bad brakes driving toward a cliff in the fog."

According to John Vandeventer on the SEIU’s blog, it is imperative that we have a new "public" (read: government-run) health plan in order to reform the health care system. To demonstrate this, Vendeventer makes two points:

In an April 2nd op-ed in the New York Times, Philip Howard, who is the chairman of Common Good (a legal reform group), talked about creating health courts. The Chamber has for some time been intrigued by the idea of reducing the randomness of medical liability cases by removing them to special courts, the same way we do with banking and admiralty cases.

In November 2007, following the publication of Leading by Example, the U.S. Chamber co-founded the U.S. Workplace Wellness Alliance with Partnership for Prevention.

Fresh off posts on single-payer Fabians and the Bay State Bait and Switch; James Gelfand opens the discussion on: "Employer mandates, a staple of Democratic health care reform proposals..." at the National Journal:

The Wall Street Journal had an excellent editorial about the Massachusetts health reform plan, and what we are learning from that undertaking. They seized on the extreme cost overruns the state is now facing:

This month I interviewed Jeff Shuman, vice president of human resources and corporate relations for the Harris Corporation.

Political analysts are having a field day debating the administration's response to the AIG bonuses, which has veered from blaming someone else to accepting responsibility; from saying it was no big deal to saying Americans are right to be really angry about it; from saying their hands were tied to saying they were doing everything in their power to claw them back.

Earlier this week, on the National Journal Health Care Expert Blog, Marilyn Werber Serafini asked:

Should the federal government tackle major Medicare reform this year, separate from the general health care reform legislation Congress is working on?

and I responded, both to the question and the other respondents:

Multidrug-resistant tuberculosis, also known as MDR-TB, is a form of tuberculosis (TB) that develops as a result of resistance to rifampicin and isoniazid, the two strongest treatments for TB.  According to the World Health Organization (WHO), an estimated half a million new cases of MDR-TB are diagnosed every year, and in 2008 the rate of MDR-TB was the highest ever recorded. 

AIG’s announcement that it would honor its contracts and award $450 million in bonuses, including to employees in its financial products unit, dominated the headlines and Sunday talk shows yesterday, sparking outrage and an exchange of letters between AIG CEO Ed Liddy and Treasury Secretary Geithner.

A few weeks ago I warned about backdoor attempts to move toward a government-run health care system and the need to debate all reforms openly and honestly. After all, health care spending represents about 16% of our economy. Any successful attempt to reduce costs, improve service, and expand coverage will require broad consensus.

A few weeks ago, in defending Medicare's proposal to not pay for virtual colonoscopies, the New York Times opined that: "Eliminating unproven procedures and reducing needless costs is necessary if the nation is to improve the quality and lower the cost of care over all...Even if Medicare decides that virtual colonoscopies are clinically effective, it would then need to determine whether they are cost-effective compared with other screening options.

We need to stop saying it’s not our fault there is no infrastructure to deliver healthcare and start saying, 'Who can we work with to ensure that the infrastructure does exist?'

Powerful words from a company that is not just talking the talk but walking the walk. 

A few years ago, in a discussion on the relevance of unions in America, Service Employees International Union president Andy Stern had this to say:

Wall Street Journal: If you could gather the country’s top CEOs in one room, what would you tell them?

At the White House summit on health care yesterday, President Obama reiterated his call for a comprehensive overhaul of the U.S. health care system, warning that soaring medical costs present "one of the greatest threats not just to the well-being of our families…but to the very foundation of our economy."

As the administration hosts a health care summit today, The Washington Post reports that industry is surprisingly sanguine about Obama's health care plans so far, especially drug makers who feared price controls.

Over at Cato Doug Bandow reviews and recommends Sally Pipes’ book "The Top Ten Myths of American Health Care", while we don't agree with all of Pipes' points -- efficient prevention and Health IT programs would reduce costs -- it is a good read, here are some bits:

Our $2.2 trillion health care system represents 16% of our economy. While polls consistently find that health care is a top national concern, many Americans are increasingly frustrated that nothing is being done. The truth is there are many changes taking place under the radar, and not all of them are good.

Marilyn Werber Serafini asks "Is Health Reform Still Possible this Year?"

The worsening economic situation and the withdrawal of the Daschle nomination appear to have slowed down momentum for health care reform. Do you think there still is enough time to complete health care reform this year?

President Obama notched another legislative victory yesterday when he signed into law a $35 billion expansion of the State Children's Health Insurance Program. The increase will be financed with a 62-cent-per-pack increase in the federal cigarette tax.

• The Incredible Shrinking World
• U.S. Trade Deficit Graphs - received via email: "Good graphs. Terrifying."

Marilyn Werber Serafini asks: "Barack Obama and key members of Congress say they want to jumpstart efforts on health information technology by including it in the stimulus package. The idea is to bypass budget rules that would make it harder to spend the money later...What do you see as the pros or cons of including $10 billion a year for health information technology in the stimulus package? Are there any reasons to be cautious about moving forward with this initiative?"

So let’s say that you have existing program(s) to improve access to health insurance for low-income individuals. And let’s say that there are 11 million people – including 6 million children – that are eligible for the program(s) but are not enrolled.  Do you:

A) Make the program(s) more efficient to increase the number of people who are enrolled? or
B) Increase the number of people who are eligible to enroll?

Marilyn Werber Serafini asks "What's Wrong With COBRA?"  Here is part of my response:

Over on the National Journal's Health Care Experts blog James Gelfand takes a look at the ghosts of health care past:

HHS Secretary Leavitt makes some important points in this Washington Post piece today. The over-arching takeaway should be that simply rushing to pass some kind of health information technology bill is not enough -- we need to be careful, and we need to be precise. The wrong legislation could do more harm than good, be it from onerous privacy regulations or from lack of interoperable standards.

An editorial today in the Boston Globe gushed over the possibilities presented by a new reform proposal developed by Americas Health Insurance Plans (AHIP), the trade association that represents private health insurance plans.

As a result of the current economic crisis many are wondering if we are going to be able to address some of the other big challenges facing our nation. As evident by both columns in the Dear44 series on the Politico, the answer on health care is a resounding yes.

It is great to see the issue of health care reform getting the coverage it deserves during this election season. I would just like to clear up one misperception we have noticed in the last few weeks. The U.S. Chamber does not endorse presidential candidates, nor have we specifically supported either candidate’s health care platform. As Tom Donohue, president and CEO of the Chamber, often states:

Apparently everyone read Tuesday's New York Times article on John McCain's health care plan which contained the quote:

A quick wrap of non-finance activities.

ADA amendment signed into law:

We are on record that stabilizing the global financial system and preventing a systemic collapse of our capital markets must remain the government’s top priority. Contrary to the "us versus them" coverage, a complete meltdown of the financial system would be a catastrophic event for both Wall Street and Main Street.

The veracious parade continued today on Capitol Hill, as small business owner Patricia Owens testified on behalf of the U.S. Chamber during a health care reform hearing before the House Energy and Commerce’s Health Subcommittee. 

From Odd Numbers:

Robert Samuelson has a good column on health care this morning in the Washington Post. He goes beyond the 46 million number and addresses both root causes and the socioeconomic perspective (more context here).

Business bashing has long been a favorite pastime by many in the mainstream media. The business community has its share of rotten apples like any other profession, and the media are right to report on them, even if their coverage is often sensationalized. But the media have a responsibility to report both sides of every story—something they fail to do with business. In fact, they virtually ignore the enormous contributions businesses of all sizes make to society every day.

The Census Bureau reported last year that almost 47 million people were uninsured in America for at least part of 2006. The report for 2007, issued last month, showed a slight drop to 45.7 million. While we welcome the decline, we need to fix the problem that there are millions of Americans who do not have the level of health care coverage they need. But what if it is not one problem?  Let’s take a closer look at the numbers:

After a restful night in Flagstaff, Arizona we were up early this morning and on the road for the five hour drive to Las Vegas. The temperatures soared as we rolled through Nevada and pulled into town. Vegas is famous for fantasy and illusion, but real people with real lives do real work here, and they face the same challenges as Americans everywhere, challenges such as health care.

After five days of intense fighting, Russian President Dmitry Medvedev has ordered an end to military operations in Georgia, leaving many analysts to wonder just what Russia was trying to accomplish. Medvedev said: "The aggressor has been punished and has incurred very significant losses.

It what’s becoming a familiar pattern, oil was down yesterday and stocks were up. Oil fell another 59 cents a barrel and the Dow rose 40 points. Investors were pleased by improved earnings by Cisco Systems and talk of a mega share buyback plan at Microsoft.

Johan Norberg, author of In Defense of Global Capitalism, sits down with reason.tv's Michael C. Moynihan to sort out the myths of the Sweden's welfare state, health services, tax rates, and its status as the "most successful society the world has ever known."

From the Wall Street Journal Health Blog "In Canada, Doctors Use Lottery to Drop Patients"

Canada’s medical system is radically different from ours, but there’s at least one thing we have in common: a shortage of primary care doctors.

A N.Y. Post column today looks at the 17th International AIDS Conference in Mexico City, "where some attendees argue that pharmaceutical patents are the main barrier to getting medicines to the poor."  We hear this argument often.  In his column however, Thompson Ayodele, Executive Director of Initiative for Public Policy Analysis, a public-policy think tank based in Lagos, Nigeria, digs deeper:

Socialized medicine advocates have worked themselves into a huff in the wake of a recent report by the Commonwealth Fund that cites a scary-sounding new statistic:

"As of 2007, more than 75 million adults—42 percent of all adults ages 19 to 64—were either uninsured during the year or underinsured"

Yesterday both houses of Congress overrode President Bush’s veto of a Medicare bill that would prevent a cut in reimbursements for physicians of Medicare patients at the expense of the Medicare Advantage program.

Speaker Pelosi says she is working on a second stimulus package and hopes to attract bipartisan support.

The Bush administration has decided not to take any new steps to regulate greenhouse gas emissions before the president leaves office, despite pressure from the Supreme Court and broad accord among senior officials that new regulation is appropriate now. EPA plans to announce today that it will seek months of further public comment on the threat of global warming.

Yesterday the Senate passed legislation updating the Foreign Intelligence Surveillance Act. The vote was 69-28. The bill would renew the legal backing for the federal government's warrantless surveillance program and protect from civil lawsuits telecom companies that helped the government wiretap Americans without court authorization after the 9-11 attacks. About 40 such lawsuits have been filed.

The Chamber's Bruce Josten sent the below letter to the members of the U.S. Senate on the "Medicare Improvements for Patients and Providers Act of 2008"

The latest in the Dear 44 series, our effort with the Center for American Progress Action Fund and Politico to put some policy in politics, is on health care. Bruce Josten, Executive Vice President for Government Affairs at the Chamber had this to say:

It seems preposterous when it comes to health care, to say that we have only one need, but that is what it boils down to. The United States needs to have the best health care system in the world, period.  The trick is figuring out how to build it, how to maintain it, and how to improve access, quality, and affordability for all.

Legislation designed to ease the pain in the housing market cleared a major hurdle in the Senate yesterday when lawmakers overwhelmingly voted to bring the measure up for a vote.

Freedom of Business Speech (Wall Street Journal)

The Chamber's Bruce Josten sent a letter today to Rep. Nydia Velazquez, Chairwoman of the Committee on Small Business thanking her for:

With all of the campaign talk of government run universal health care, let's have a look at how well the U.S. Senate does in managing a services group, courtesy of the Washington Post:

A small, but vocal, group of protestors have not prevented SEIU’s Andy Stern from getting his way at the union’s convention. His slate of candidates for the executive board is virtually unchallenged, and he rammed through provisions shifting further power from the local unions to the national, including one that requires local unions to send a small percentage of their budgets to the national union for organizi

Progress on Health Care, Education

Paul S. Speranza Jr.
Chairman of the Board
U.S. Chamber of Commerce

As my year as volunteer chairman of the U.S. Chamber board of directors concludes, I feel proud to have played an important role in strengthening the organization and in advancing a few of its key policy priorities.

Oil prices fell sharply yesterday -- $4.41 a barrel -- after the government said a decline in crude supply was due to temporary import issues, and a sign of a stronger U.S. economy that could shore up the weak dollar.

• On the Case for Free Trade
• Can you be a "Budget Hero"?
• Don’t blame Big Oil or Arabs for high gas prices

On May 14th, Chamber President and CEO, Tom Donohue spoke before the Emergency Department Practice Management Association's Solutions Summit; the theme of the event was "Strategies to Manage Health Care Change". His posts on the subject are available here, here, here and here.

Below is a bit from the Q&A on defensive medicine and systematic legal reform.

The New York Times reports today that the SEC is now telling companies that they must allow shareholders to vote on proxy proposals advocating in favor of "universal health insurance coverage."  This is because the SEC has now determined, after years of holding to the contrary, that the issue is now a "significant social policy issue" as informed by the SEC's expert analysis of "changing societal views."

The government said Friday that it would halt deliveries to the Strategic Petroleum Reserve beginning in July and ending in December. Many lawmakers had been calling for such a move, but most experts say it will make very little difference in gas prices.

Now, in the context of today’s limited and incomplete health care debate, some will react to the areas of change and reform I have suggested by saying that this is all small stuff — that what we really need is that sweeping, top-down upheaval in American health care that can only happen through a federal solution.

They want that one big stroke that would provide an instant panacea. And I understand that, even from some of my own members who are drowning under a tidal wave of health costs.

To build a better health care system we need to start with two key elements, dramatically reducing costs, and developing a more consumer driven system.

Let’s start with the single biggest barrier that puts coverage out of reach for many families and employers and threatens to drag down our economy—costs.

In the face of the challenges on health care I outlined earlier today, we are having the wrong conversation about health care in this country; or, at best, an incomplete conversation. Quite simply we are setting the wrong expectations for the American people, and nowhere is this more evident than on the campaign trail.

The wrong conversation focuses inordinately on the uninsured, while offering only lip service to spiraling costs, medical accidents, frivolous lawsuits, and the need to focus on wellness and prevention.

I gave remarks yesterday to the Emergency Department Practice Management Association's Solutions Summit which this year focused "Strategies to Manage Health Care Change".  I took one look at the title and I thought that’s ambitious...managing change in something as complex and multi-faceted as our health care system, a sector that accounts for 16% of our $13 trillion economy.  It brings to mind the question "How do you eat an elephant?", the answer of course being "one bite at a time".  Let's look at our biggest health care challenges for our first seven

Former Fed Chairman Paul Volcker suggested the failures in the credit markets were widespread, ranging from regulation to basic economic problems such as the rising U.S. trade gap. He endorsed the idea of the Fed becoming the principal financial regulator, although he cautioned that the central bank "is not equipped to do it now." He said a greater oversight role for the Fed would require the creation of a new position filled by an official who is held accountable.

by David Chavern

I usually try to avoid using blog posts to highlight dumb ideas – simply because it tends to draw more attention to such ideas than they deserve. However, some things are so misguided that they deserve special attention.

I have to go do just that, so here is Thomas Friedman from today's New York Times:

Here's an update on the presidential race … In the latest sign the mainstream media views the Democratic primary all but over, the cover of next week’s Time magazine will feature a cover photo of Barack Obama with the caption "And the winner is …"  In an interview yesterday, Obama sounded more and more like the nominee of his party, talking about his priorities as president. He also narrowed Clinton leads in declared super delegates to just seven.

A few weeks ago, the U.S. Chamber hosted Dr. Dora Akunyili - the director general of Nigeria's National Agency for Food and Drug Administration and Control - for a discussion about Nigeria's efforts to combat counterfeiting and piracy. Dr. Akunyili highlighted some of the chief barriers to medical access in Nigeria - corruption and inadequate infrastructure.

The New York Times reports that a fight has broken out in Congress over whether drug makers and other companies should be allowed to keep patents they obtained by misrepresentation or cheating. The issue has emerged as part of legislation to overhaul patent laws. In several cases, the courts have voided patents after finding that companies intentionally misled the Patent and Trademark Office.

We are having the wrong conversation on health care in this country. Or, at best, an incomplete conversation. And we are setting the wrong expectations for the American people.

Energy is once again dominating headlines, this time with dire predictions of $200 a barrel oil and $10 a gallon gasoline. Algeria's energy minister, who serves as president of OPEC, says oil prices could top $200 a barrel and there wouldn’t be a thing the cartel could do about it. He attributed sky-high prices to the weak dollar and global political insecurity. That, along with a possible global recession, means OPEC won’t be boosting production anytime soon.

The House voted overwhelmingly yesterday to block Medicaid rules that would cut federal health-care spending on the poor and likely shift billions of dollars of costs to states. The vote was large enough to override a threatened White House veto.

• "Marxism brought us the Gulags. The worst that most commentators can say about free enterprise these days is that it brought us McDonalds."
• Protectionist Congress Losing Latin America

//Update: video and photos now available.

David Chavern introduced our first speaker, U.S. Senator Ben Nelson, Democrat from Nebraska.  Senator Nelson is a good friend of the U.S. Chamber, a true consensus builder able to work across party lines to get things done.

Health representatives from the three presidential campaigns traded barbs as they offered differing visions of the future of the U.S. health care system at the annual meeting of the U.S. Chamber’s Council on Small Business.

Today President Bush is expected to outline the way he thinks the U.S. can reduce greenhouse gas emissions, and challenge lawmakers on climate change legislation up for debate in June. The Wall Street Journal says Bush will propose stopping growth in U.S. greenhouse-gas emissions by 2025 and signal that he is open to lawmakers reining in pollution from power companies.

The Chamber's Bruce Josten sent a letter today to Senator Enzi and Senator Nelson to thank them for introducing S. 2818, the "Small Business Health Plans Act of 2008."  From the letter:

The Dow was down 23 points on disappointing results from Wachovia and fresh record highs for oil and gas. There was a slight uptick in retail sales – 0.2% -- but it was primarily the result of gas station sales driven by the higher oil prices. Business inventories grew again in February.

For the past five consecutive years, employers have seen double-digit health care premium increases. At least 1.5 million Americans are sickened, injured, or killed each year by errors in prescribing, dispensing, and taking medications. Nearly 47 million Americans still lack health insurance. The United States has the world’s best health care, but the delivery system is wasteful and inefficient. Congress must take steps now to improve our broken health care system.

Yesterday I learned that my son's internist physician is going to have his St. Luke's Clinic closed because Medicare reimbursements are insufficient to keep the facility from losing money.  Most internist patients are older people who are having serious problems, my son being an exception.  The Siouxland Chamber has talked about this situation over and over again, with no meaningful action. 

With just under seven months to go in the elections, everyone is focused on the question: How will health care reform impact small and medium businesses?

On April 16, in conjunction with America's Small Business Summit, the Chamber's Council on Small Business will host a live webcast featuring Humphrey Taylor, chairman of the Harris Poll, and often-quoted expert and author on health care reform.

Barun Mitra had an interesting article in the Des Moines Register yesterday on the false promise of compulsory licensing.  Mitra writes:

Thailand's health minister recently announced that the nation's state-run drug manufacturer, the Government Pharmaceutical Organization, would continue to violate the patents on four key cancer drugs.

Yesterday I had the privilege of speaking at the US Chamber and PhRMA sponsored event, "Counterfeit Pharmaceuticals: The Scope and Effects of the Epidemic". I joined Billy Tauzin, President and CEO of PhRMA, and Brad Huther, Senior Coordinator of Anti-Counterfeiting and Piracy, US Chamber of Commerce Global Intellectual Property Center.

• Gore launching $300 million awareness campaign - praise was, I suppose, a given
• Three Fingers Pointing Back at Me - No, seriously, it was the banks that made me borrow

I just returned from the spring ‘08 meeting of the Research Advisory Board for Boston College’s Center on Aging and Work/Workplace Flexibility which was co-hosted by GlaxoSmithKline (GSK) in Durham, North Carolina. North Carolina has become one of America’s "hot spots" for retirees. And it was no coincidence that GSK co-hosted this meeting.

• Shocking Story - South Korea Lifts Tariffs to Fight Inflation
• Card Check: Now That's Confidence....or Hubris
• Union growth and standards must go hand-in-hand - "counter to the Stern regime's elitist assumptions"

• Costs and Benefits of the Patent System - a book review
• Tax Threat to American Innovation, Part III - a video review
• A Solution, Courtesy of the MIT Faculty - a fantasy review

My little "on this date" calendar tells me that on March 14, 1950 the FBI began releasing their "10 Most Want Fugitives" list; which is online now.

To commemorate this little bit of public relations, here is Chamber's "10 Most Wanted" as of today, in no particular order.

We have seen over the past few years misguided and increasingly misplaced calls for the abandonment of intellectual property protections.  As media coverage swirls about the state of the economy a few facts come to mind:

• Union War Erupts In Ohio - SEUI's troubles continue
• Bill Gates: We Need Immigrants - "Congress’s failure to pass high-skilled immigration reform has exacerbated an already grave situation,"

Saying he was “deeply sorry” he didn’t live up to what was expected of him, Eliot Spitzer resigned as governor of New York yesterday effective Monday. He will be succeeded by Lt. Gov. Jim Paterson, a blind African-American who is well-liked and respected by both sides of the aisle. Spitzer is still in talks with federal prosecutors over a plea agreement.

• Disconnect on Drug Patents
• H-1B Visas, Creating More Jobs for Americans

One of the key opportunities for both the U.S. health care delivery system and the business community is to develop programs to maximize the capabilities of health information technology and its adaptation to various provider sectors, as well as ensure a nationwide interoperable electronic system. The goal of using health information technology is to dramatically increase transparency and enhance healthcare quality and value.

An explosive device caused minor damage to an empty military recruiting station in Times Square early Thursday, shaking guests in hotel rooms four blocks away. Police blocked off the area to investigate the explosion, which occurred at about 3:45 a.m. ET, shattering the station's glass entryway. No one was injured.

AFL-CIO Union Movement Embarks on Massive Drive for Employee Free Choice - promises to respect democracy in the morning

After Traveling to Colombia, Free-Trade Sentiment - Bi-partisan support for Colombia

• Is Capitalism Immoral? - No.
• Will Socialized Health Care in the US Kill Canadians? - Yes
• The health costs of defensive medicine - give me one of everything, stat!

This afternoon the Chamber sent a key vote letter to the full House of Representatives indicating that policymakers who support the irresponsible House mental health parity legislation may be judged on it in our annual How They Voted publication.

• And a one - a two - a three on trade

by Len Nichols - Dir. Health Policy Program, New America Foundation

Solving our health system woes requires an integrated strategy. We must cover all Americans, and we must reduce cost growth.

The medical costs of treating the uninsured are shifted to the rest of us. Economic losses from premature death and prolonged illnesses stemming from a large number of uninsured are an even greater cost to our society. Therefore, covering all is both a moral and an economic imperative. 

by Grace-Marie Turner - President, Galen Institute, Inc.

Voters in 2008 will be asked to decide between two very different philosophies on health care policy: a much larger government role or a truly competitive market that produces affordable choices.

A Healthier America at a Lower Cost

Paul S. Speranza Jr.
Chairman of the Board
U.S. Chamber of Commerce

"Imagine" is the most powerful word in the English language. Imagine a healthier America at a lower cost.

• 20 Surprising Ways Wal-Mart Clinics Will Affect US Healthcare
• Opting out of NAFTA - "Knowledgeable observers would have to take note of the fact that we are the largest supplier of energy to the U.S." - Oh yeah, well take your energy and, um, sell it to us.

Just a reminder, you have until March 11th to submit a nomination for the Inaugural Christopher Columbus Foundation–U.S. Chamber of Commerce Life Sciences Awards.

Click on the appropriate Award below to start a Nomination.

Tim Russert debated Hillary Clinton and Barack Obama in Cleveland last night, or moderated the debate, depending on your perspective.  Health Care and trade were the big topics, with small differences between the two.  Not quite the "kitchen sink" but Clinton did question Obama's campaign et

- Our post from last week "About Those Trial Lawyers" appeared today in the Washington Examiner.  Comment here.

• State Attorney Generals Abuse Their Power - I need to set this phrase up as an auto-complete
• Fake Chinese Anti-Malarial Drug Makers Apprehended - IP theft isn't just music downloads kids

• A new entry into the health care debate  – O.k. let's again review exactly what “insurance” is and is not.

• "In my opinion, unilateral sanctions never work." - Tom Donohue doesn't mince words on Cuba (or immigration)

• Momentous USSC decision in Riegel v Medtronic and more.
• "You do what's right for the kids."

Last week we examined the strengths and weaknesses of the U.S. health care system. We pointed out that while America is home to some of the finest medical facilities and innovations, care is too expensive and our health care information technology (IT) is badly outdated. While we manage to cover about 85% of our people, too many Americans are without insurance for various reasons. Our system is plagued with too many lawsuits and a lack of personal responsibility.

by Ricardo Harvin

Arbitration and health care

Bush administration asks Supreme Court  to take on new Guantanamo case.

...yeah me too, what restaurant?

The U.S. Chamber of Commerce is partnering with the Christopher Columbus Fellowship Foundation (“Foundation”), a Federal government agency, to create and present four new Life Sciences Awards.  “Life sciences” refers to industries dedicated to testing, manufacturing and marketing of biomedical products for human health. This includes drug, biologic, vaccine, medical device and diagnostics manufacturers, as well as supporting venture capital companies.

For those with short attention spans, sign up to get the Very Short List.

My grandmother's doing it in June.

Would Reagan still be electable?

You looking at me? I love technology, but...

by Tom Donohue

Reforming health care has been a major issue in the presidential campaign. What the debate has lacked is an honest appraisal of the strengths and weaknesses of our health care system.

Economic Growth In Mexico Said To Be Slowing Illegal Migration To US - No doubt the best way to resolve the immigration issue is to have strong economies and stable societies on both sides of the border.

Hollywood's lasting labor pains

Huck Plays The USSR Card

by David Chavern

Here are three interesting, and related articles about healthcare. The first is a recent article about rising healthcare costs around the world, the second is about the most expensive medical conditions and the third is a NYT article from 2006 that makes interesting points about the significant value of all healthcare spending. These articles point to some truths about healthcare spending that few policy makers and politicians like to talk about:

by Ricardo Harvin

An Op-Ed in today's Wall Street Journal puts forth the argument that it's not health care companies that are responsible for increases in health insurance costs, it's politically mandated coverage.

UPDATE: Senate Passes Stimulus Plan; House Leaders Plan Quick Action

McCain speaks, and has George Allen's support

Another reason why free markets rule

Smoke 'em if you got 'em?

• Putting Exxon's Tax Bill In Perspective
• Lots of reasons to worry about union organizers - but perhaps the biggest reason to worry is that this guy is one of them.

• Drugs and Money - I have been watching this discussion, glad to have a summary to link to.
• Only the slim will be allowed to dine in public! - 40 sit-ups or no fries for you.  (h/t/ Reason)

There weren’t too many surprises in President Bush’s State of the Union address last night. As expected, he focused on the economic stimulus package, clamping down on earmarks, the war on terrorism, and other unfinished business. One of the more significant new proposals was a $300 million initiative to help provide choices for kids trapped in struggling inner-city public schools. Bush expressed concern about the declining number of faith-based and parochial schools in inner cities and in low-income neighborhoods.

• Tom Donohue's Friday Interview on Bloomberg TV
• Employee Free Choice Act Would Disenfranchise 105 Million Workers
• "I think comprehensive immigration reform in 2008 is going to be very hard to come by" - Pelosi and Reid on Immigration

In the current political debates, there is considerable discussion about “health insurance for all” and “affordable health insurance.”  Good and interesting concepts that, unfortunately, really have nothing to do with insurance.  In healthcare debates, “insurance” has become a proxy for “cost” – with payments for “insurance” considered a form of pre-paid healthcare.

• "Does the law of unintended consequences mean that the government should never try to regulate complex systems?  No, of course not, but it does mean that regulators should be humble (no trying to remake man and society) and the hurdle for regulation should be high." (h/t Econlog)

American Psychiatric Association President James Scully appeared on The Hill's Congress Blog yesterday to complain about employers who voluntarily offer health benefits to their employees. He claims they offer less coverage for mental health conditions than for other conditions – which in some cases may be true.

From the Financial Times, 'Court intervenes over US lawsuits ', courtesy of MSNBC:

The US Supreme Court decided to intervene in several important business disputes, on Friday...Robin Conrad of the National Chamber Litigation Center, the US Chamber of Commerce's legal arm, welcomed the decision to hear the Wyeth case and other business cases on Friday.

Yesterday Safeway CEO Steve Burd gave a speech in Arizona on market-based healthcare which led to this response:

"Clearly the corporate sector are reading the tea leaves and feel compelled to find solutions to America's broken health care system."

Today’s Wall Street Journal (or read it here) contains a strong criticism of individual health care mandates – forcing everyone to buy health insurance – penned by the Hudson Institute’s Betsy McCaughey. She points out that individual mandates create artificially lower health insurance costs by ripping off the young:

Next Tuesday, January 8th, I will be delivering my annual State of American Business address, laying out the Chamber's agenda for the year ahead.

For some reason, if all you saw was political news, you would think that the pharmaceutical industry was made up of inhuman robots who only care about vacuuming up gold ducats wherever they find them.  The rhetoric – even coming from some supposedly responsible presidential campaigns – is so overheated and so does not square with my personal experience, that I felt like surely someone would set the record straight.  However, I have yet to see anything that really does the job, so until the definitive rebuttal comes along, here is my two cents.

America is home to some of the finest medical facilities, technologies, innovations, treatments, and human talent. We cover 85% of our people, and the health sector is generating thousands of new jobs. At the same time, too many Americans are without insurance for various reasons, costs are too high, and our system is plagued with outdated information technology, too many lawsuits, and a lack of personal responsibility. So where do we go from here?

Let me suggest five core ideas that can guide our nation to more affordable and accessible quality health care.

By Tom Donohue

In recent months I’ve been traveling around the country delivering a series of speeches on challenges America must meet and master in order to succeed in a tough global economy. Together, these challenges comprise the Chamber’s competitiveness agenda. Over the next five years – and beyond – we plan to focus extraordinary resources to advance these issues because they hold the key to our nation’s future economic success.

Over the past few months, I've written often about the competitive challenges facing our economy in today's global world—challenges like energy, infrastructure, legal reform, education, and immigration. But health care is a competitive challenge unlike any other.

Education, Health Care, and Chamber Cooperation

By Paul S. Speranza Jr.
Chairman of the Board
U.S. Chamber of Commerce

Applying Criteria to a Flurry of Proposals

By Thomas J. Donohue, President and CEO, U.S. Chamber of Commerce

The old saying "if you don't like the weather in Chicago, just wait five minutes and it will change" is now applicable to health care policy. If you don't like the latest proposal from the president or the physicians association, wait a few minutes and another one will pop up.

A Chamber Member's Story

Pamela Green-Jackson responded to a family tragedy by creating an after-school program to keep youngsters healthy and fit.

Pamela Green-Jackson knows firsthand the potentially life-threatening effects of obesity. In February 2004, her only brother, Bernard, 43, died from complications of obesity-related illnesses.

Boost Employee Safety and Health

Ed Grady
Director of Business Development Quest Diagnostics  Employer Solutions

Here's a sobering thought for employers: Three out of every four adult drug abusers are employed. 

Substance abuse slows productivity, increases the number of accidents, hurts employee morale, and blows holes through the company's bottom line. 

A Chamber Member's Story

Many business owners are finding that the cost of providing health care coverage is no longer affordable. "There are very few choices of health insurers for small businesses like mine, and the cost of employee premiums seems to double every year," says Anthony Montville, president & CEO of HealthTek Solutions in Norfolk, Virginia.

Understanding and Implementing HSAs

By Kate Sullivan Hare
Executive Director of Health Policy, U.S. Chamber of Commerce

A Chamber Member's Story

As the chief executive officer of America's Blood Centers (ABC), Jim MacPherson's secret to success is keeping ABC's word. "We deliver on what we promise." Established in 1962, ABC is a network of 76 nonprofit, community blood centers that operate more than 600 collection sites in 45 states and provide nearly half of the United States' volunteer donor blood supply. ABC members subscribe to a community-based blood banking philosophy, ensuring that donor blood reaches community members first and that any excess goes to other communities in need.

Finding a Broker Who's Right for You

By Shannon DiBari
U.S. Chamber of Commerce's Vice President of Human Resources
The second of two articles.

When looking at your company's benefits program, you may want to consider working with an  insurance broker. Obtaining good advice up front can save you money and time-and produce better results. Start by thinking about the following two questions:

What are the benefits of working with a broker? 

Getting More Bang for Your Buck

By Shannon DiBari

The first of two articles.

Your benefits program can differentiate you from your competitors and help you keep valuable employees and recruit top talent. Following are some points to consider: