Archive for March, 2007

Marie Antoinette would gasp at the mean-spiritedness of Delegate Peter Hammen’s attempt to blame and punish the uninsured for the train wreck that is our health-care system.

Hammen’s proposal would require anyone earning four times or more the official poverty level ($40,840 a year for an individual) whose employer does not provide health insurance, to purchase coverage at his own expense. Proof of coverage would have to be submitted along with one’s state income tax returns. Individuals failing to purchase health insurance for themselves could be fined as much as $2,000. (Note: this part of Hammen’s bill has been shelved for now, but will be put back on the table for consideration in 2008.)

He didn’t say what the state would do for individuals who were forced to buy health insurance and whose insurance companies refused to pay when they did get sick. (E.g., http://www.usatoday.com/printedition/news/20070129/1a_cover29.art.htm.) This is not a trivial matter. If you want to hear some colorful language, the next time you go to a party, ask the people there what they think of their HMO’s. There is more than a bit of truth to the old joke that the only thing worse than not having health insurance is having health insurance.

But it has become fashionable as of late to blame the uninsured, and why not? They have no expensive lobbyists to speak for them, and most of them are too busy trying to keep a roof over their heads and keep their cars running to do much speaking for themselves. [Disclosure: I have not availed myself of the services of the medical profession for years. I currently pay over six hundred dollars a year for an insurance policy with a $10,000 deductible (not a typo) that I will probably never use.]

The uninsured are maligned as irresponsible carefree grasshoppers, happily fiddling away while those industrious ants, the insured, are footing the bill for their health care.

What utter nonsense. In the first place, the uninsured are, pretty much by definition, working for a living and paying taxes. (Those who are not are covered by either Medicare or Medicaid.) So the uninsured are paying for health care for all those who are on Medicare or Medicaid. They are paying for health care for all the government bureaucrats who keep us waiting in line at the Post Office, who keep us waiting in line at the DMV, and who keep us waiting on hold when we call the IRS and try to find out how much we owe in taxes. They are also paying for health care for Delegate Peter Hammen and his family.

What’s more, who are the uninsured, after all? They are the temps, the contractors, the consultants, the free-lancers, the adjunct faculty members, the “part-time” employees who often work longer hours than the “full-time” ones, usually for less pay and no benefits. They are the ones who are keeping our public and private institutions solvent so they can afford to pay health insurance for their “full-time” employees.

It’s quite true, as the talking heads like to remind us, that if you have a life-threatening condition and lack insurance, all you have to do is go to the emergency room of any hospital and they cannot refuse to treat you. That does not mean you can refuse to pay. The hospital will charge you several times what they charge the insurance companies for the same services and hire bill collectors who will hound you to the grave. Then what they can’t collect from the estate they write off as a tax deduction – and the uninsured foot the bill for that, too, since, as we have already noted, they are pretty much by definition working for a living and paying taxes. So don’t buy the myth that the insured are paying for the uninsured. It’s exactly the other way around. It’s the uninsured who are paying for everyone else’s health care.

We may as well get on with it and move to a single-payer system, as they have in Canada. There is no point in arguing about the merits of the free market versus socialized medicine. That train has already left the station. There is probably no aspect of our economy that is more heavily regulated and subsidized than health care. We already have socialized medicine. It’s just administered in a preposterously inefficient and unfair manner. And please don’t yelp about how, under single payer, we will ration health care. Every economic system is, at bottom, a means of rationing goods and services, because our desires are infinite and our means to satisfy them are not. So we will ration health care, and every other product and service, under any and every conceivable economic system.

Our current health care system wastes resources on an almost unimaginable scale. We spend $4,500 per capita per year on health care – more than any other nation in the world, and almost twice as much as the number-two spender, Canada. And what do we get for our money? In Costa Rica they spend $300 dollars a year per capita on health care, and their life expectancy is just eleven months less than ours.

The typical physician in this country pays in excess of $100,000 a year in malpractice insurance. Out tort system is designed to make tort lawyers rich, not to protect patients. We need to find a better way to weed out incompetent medical practitioners. People also need to accept that much of what physicians do could be done as well by nurses or other lesser-paid professionals.

More generally, we need to fundamentally re-think our approach to disease and health. The era of the great plagues that sweep through the population, carrying away the just and unjust alike, is gone. People need to accept that for most of us, throughout most of our lives, health is a matter of personal choice.

It’s no coincidence that we have an incredibly destructive war on drugs going on at the same time Big Pharma is spending millions of dollars a year on advertising, trying to get us all hooked on some sort of drug(s) or another. Both phenomena are symptoms of a medical-industrial complex that has by and large lost sight of its original mission, which is helping people to healthier lives.

Individuals need to take as much responsibility as they can for their health. We’re not talking anything drastic here, just a few common-sense rules – exercise every day, get lots of rest, eat a sensible diet, refrain from smoking and drinking and drugs, and cultivate a positive mental attitude. Millions of people have been infantilized into believing they can’t function without their “meds.” What ever happened to building character?

We need to accept that we live in a universe of finite resources and that every dollar we spend on health care is a dollar that cannot be spent on education, on infrastructure, on research and development, on plant and equipment – and that all these things have a much greater impact on both quality and duration of life than health care. We need take a good hard look at expensive medical procedures whose contribution to quality and duration of life are questionable. Heart transplants and weight loss surgery come to mind.

Most importantly, people need to accept that death is not some rare and preventable anomaly. It is the natural and inevitable end of life, and there is a huge difference between prolonging life and prolonging dying. Too many of our nation’s best and brightest are working as physicians, hovering over elderly patients hooked up to expensive Japanese machines, when many of these patients would prefer just to have a loved one sit by their bedsides and hold their hands as they slip gently into that good night.

Al this will require a sea change in people’s attitudes towards health and disease, and towards life itself. And every one of the changes proposed here will be vigorously opposed by well-heeled interests. So don’t expect to see any of these changes coming soon. It’s a lot less trouble to blame the latest scapegoat, the uninsured.

“Go ahead. Call me the b-word. Make my day.

That may not be the most appropriate way to ask your supervisor for a promotion, but many women in business would agree that the b-word is nothing to avoid being called. On the contrary, some would say it’s actually worth blood, sweat and tears to be “boss.”

(For those who were expecting a different word, one that rhymes with “witch,” you’re probably not alone).

However, statistics show that although women have made some strides over time in the corporate arena, too many have simply been running in place. The majority of women employed at Fortune 500 companies have been getting stuck at the bottom of the leadership totem pole over the last decade, according to a census study released in 2006 by Catalyst, an organization that tracks women in business.

If this rate of progress continues, according to the study, it could take 40 years for women to achieve parity with men in corporate officer positions. So what is the secret to level the playing field and catch up with the men?

“Women still have to work harder [than men],” said Dr. Adele Scheele, a career coach and author of “Skills for Success for Men and Women.”

“Anyone who wants to change the status quo has to work harder – is it fair? It is not – but it is the reality.”

What status quo are women professionals up against? The Catalyst census found that:

-The average Fortune 500 company had 21.8 corporate officers in 2005 and that women held only 3.6 of these positions.

-More than one-half of the Fortune 500 had fewer than three women corporate officers.

-Women occupied only 9.4 percent of titles higher than vice president.

-Only eight companies in the Fortune 500 were led by a woman CEO in 2005, and none of those companies was among the Fortune 100.

-Women held only 6.4 percent of top earner positions, up just 1.2 percentage points from 2002. And 75 percent of Fortune 500 companies reported no women as top earners.

Scheele said women seeking professional advancement should concentrate on working with their male counterparts rather than isolating oneself from them or viewing them as the enemy.

“Women who can join men where men are more relaxed … like on the golf or tennis court … do better. They may not want to – but those who do see results. Have one or two really good alliances with men,” she said.

In other words: If you can’t beat ‘em, ladies, at least grab a golf club and try your best to.

Questions? Comments? E-mail them to herbusiness@foxnews.com

The Bright Side

And now it’s time for some good news. More data from Catalyst offers evidence that it often pays to buck the trend. According to another Catalyst study, Fortune 500 companies with the highest percentages of women corporate officers yielded, on average, a 35.1 percent higher return on equity and 34 percent higher total return to shareholders than those with the lowest percentages of women corporate officers.

In 2006, a few powerful women climbed into the driver’s seat at major corporations. Indra Nooyi took over as CEO at PepsiCo (PEP), the giant food and beverage company, and Irene Rosenfeld took the reins as CEO of Kraft foods (KFT), the world’s second-largest food company and the nation’s largest. And (talk about making a comeback) Patricia Woertz ended a brief retirement and became CEO of Archer-Daniels-Midland (ADM), a firm at the heart of the country’s foray into renewable fuels.

Women also are busy on Main Street: Women in the United States are launching small businesses at more than twice the rate of men each year.

“Women have come a long way in only three decades … the Glass Ceiling has been cracked open,” Scheele said. But, she added, although cracks have been made, women haven’t necessarily made it through them.

“Many women have hit their heads in the process and left to start their own [successful] businesses. Many have left to join smaller firms where they are more valuable. Others have sued, a painful, yet necessary, road to have taken.

“We [women] need to be so much more self-confident, become much more visible, get more public speaking under our belts. In business and professional life, women are now just getting to be taken seriously enough to run their professional associations.

Success Secrets From My Former Ms. Boss

How can female professionals climb past the status quo and get to the top of the corporate ladder? Out of my last five bosses, only one was a woman. Here are some examples of lessons I learned from her:

Keep your cool: I was always amazed at the calm nature my boss (an MBA and public relations executive) kept amid any set of circumstances. She never lost her cool, never appeared to be rattled, even when things were coming loose at the seams.

At times I wanted to run into her office and yell, “Fire in the building! Run!” to see if she might lose her cool for even a second. But, I also wanted to keep my job. My wishes for the latter kept me from ever trying my luck at the former. In preparing to write this column I asked her about the secret to always being in control and I found out that, as I suspected, sometimes my perception wasn’t the reality.

“Yes, I have been in situations where I have felt overwhelmed. … The best way to handle the pressure is to be well-prepared,” she said. “If you are leading a group and mayhem erupts, the worst thing you can do is lose your composure. Your group will be looking to you to guide them through the storm. So, if you lose your composure, the group will fall apart and your leadership will be eroded.”

She also taught me the importance of prioritizing. Being able to separate crucial tasks from the small stuff makes the difference between getting ahead and running in circles.

And, speaking of b-words, she said there is a fine line between being assertive and being that word that rhymes with “witch.”

“As a leader, you have to give direction, manage personalities and get results. That requires the ability to be direct — assertive — provide advice and set deadlines and boundaries with employees. It also requires honesty and integrity,” she said.

“On the other hand, being verbally abusive when the job isn’t done to your satisfaction, publicly berating your staff or conniving to get an undesirable employee or competitor demoted or fired is unacceptable. That’s not leadership. That’s a bitch.”

E-mail me at herbusiness@foxnews.com and tell me the success secrets you have learned from a female boss, or from being the female boss, and next column I’ll select some of your e-mails and share them.”

This message was distributed in an e-mail from Progressive Democrats of America. As a nonprofit, nonpartisan organization, UP is not formally endorsing this message.

” There are times in American history — “perfect storms,” if you will — when forces are in alignment for the passage of a momentous reform that makes our country qualitatively better. In the 1930s, we won union rights and Social Security. In the 1960s, civil rights and
Medicare.

Is this our moment to finally win Universal Health Coverage — improved and expanded Medicare for All? Or at least wage a campaignso powerful that victory will be just around the corner?

We have a Democratic-majority in Congress. A profound crisis with 50 million uninsured Americans, and a similar number under-insured. A New York Times columnist declaring last week that the health insurance business is “a racket.” A presidential campaign in which candidates
are being confronted by voters up close.

And most importantly, we now have the re-introduction of Rep. John Conyers’ HR 676
{http://capwiz.com/pdamerica/webreturn/?url=http://thomas.loc.gov/cgi-bin/query/z?c110:H.R.676: }: The United States National Healthcare Insurance Act — enhanced
Medicare for All.

Please encourage your Congress member to co-sponsor the bill http://capwiz.com/pdamerica/issues/alert/?alertid=9420616&type=CO }
, now — our goal is to quickly double the current 55 co-sponsors.

Progressive Democrats of America is committed with our friends in Congress, labor unions, the Healthcare-Now coalition and nurses and doctors groups to mounting the biggest fight ever for HR 676, a single-payer system of privately-delivered, publicly-financed healthcare.

This approach has been endorsed by Consumers Union, 20,000 physicians, 232 labor unions, and even corporate CEOs tired of being fleeced by private insurance companies and their bureaucracy and waste.

. Get your state legislature to endorse HR 676. The state of Kentucky just did so!
{http://www.pdamerica.org/articles/news/2007-02-13-07-49-57-news.php}

. Challenge presidential candidates to endorse HR 676. Iowa voters recently told Hillary Clinton
{http://www.pdamerica.org/articles/news/2007-02-02-15-29-38-news.php}
they backed Medicare for All.

. Contact Diane@pdamerica.org {mailto:Diane@pdamerica.org} to join our “Healthcare for All” Organizing Team.

And spread the word about PDA {http://pdamerica.org/}. Our “inside-outside” strategy of working inside the halls of Congress, and outside in social justice movements is building momentum on issues from Iraq to universal healthcare to election protection.
Join us! {http://pdamerica.org/join-ind.php}”

Tim Carpenter
PDA Executive Director

Although every college student nearing graduation jokingly mentions the impending “real world” with a sense of doom, nothing prepared me for the reality that hit once my student loan bills started rolling in. While I was in high school, the mantra was “go to the college you feel best about – it will pay off in the end.” What no one tells you is that if you choose to go to a smaller private liberal arts school, you will regret it (at least every time anything with a dreaded Sallie Mae logo on it arrives).

I do not come from either a wealthy or poor family, but even with financial aid and scholarships, I came away from my undergraduate schooling with a B.S., as well as over $70,000 in loans. And in no way does my degree even guarantee me a job. I studied video production and Spanish. Perhaps had I chosen a more traditional study, such as accounting or law, I might have a job in my career after graduation. Maybe. But then I would have to take into consideration graduate school, as well as how highly competitive it is to get well-placed internships within these fields. Not to mention, I would have hated it. This causes me to wonder exactly what my degree is in: is it a Bachelor of Science, or did I pay over 100 grand for a bunch of BS?

Right now I’m working two jobs, at least six days a week. Neither job is within my chosen career field. I plan to move to Los Angeles within the next few months to pursue a career that utilizes my degree, but the problem is that in addition to paying my bills, I need to save enough money to make the move. Most of my friends who moved to Los Angeles or New York City were not able to find jobs immediately, so I need to be sure that I have enough to support me while I job search.

Even those of my friends who are lucky enough to have found work usually have to find a second part-time job or rely on parental help. More and more recent grads are simply moving home after graduation. The salaries that most entry-level jobs pay are not nearly enough to cover the costs of living, regardless of whether you live in New York City or Des Moines.

Obviously, I am not alone in my post-graduate stress. What I wonder is, what happened to the security that is supposed to come with a college degree? I feel less secure than I ever have. For all the high school guidance counseling and university career centers, why are the majority of college graduates sent out into the world clueless? No one is teaching courses on how to adapt to life outside of school. Like the primary school obsession with test scores, colleges are fixated on “job placement.” How many schools brag about the percentage of grads that are gainfully employed a year later? Simply being employed is not the same as having a fulfilling career that pays a fair amount.

I would never take back those four years, but I wish that someone would have told me how painfully hard the struggle after graduation can be. I rather feel like I was lied to, or at the very least, misled. I always thought that going to college would result in a life of relative ease. I guess that life of ease is many years down the line, if it exists at all.

By: Andrea L. Adams
Ithaca College 2006

After a 28-year professional and rewarding career in the title insurance industry in San Francisco, I headed to the east coast to tend to elderly parents. Not having sought employment in many years (I was the one who was always approached by employers) I have been flabbergasted by many aspects of the job seeking and application process of today.

First of all, the amount of information required up front is outrageous. I have had to supply social security number, passport, driver’s license number, references, urine specimen, authorize credit check and background check, etc. etc., just to fill out an application, including for 6 and 7 dollar an hour jobs at grocery stores and nursing homes.

Not to mention all of the online submissions of my resume. All of this info provided not even an interview! If my identity is not stolen it will be a miracle. A staffing agency sent me to three interviews, one at a credit union and two at real estate information services firms. Thinking these would be right up my alley, I was shocked to be told I was “overqualified.”

I find myself in a down market in an economically depressed area (Pittsburgh) where there are very few middle management office jobs. I have discovered I am a dinosaur, and not sure what, exactly, to explore as a new career.

In the meantime, I cannot land entry level low paying jobs (I made more money babysitting in high school) because I am overqualified. I have to get my thinking cap in high gear and come up with a new profession pretty quick, just when I should be planning my retirement. News flash to job seekers: don’t move to Pittsburgh, Pa.

” … Kathleen Poe , who is graduating from MIT’s Sloan School of Management in June, had the unexpected luxury of three job offers this winter — more than six months before she plans to start working.

Poe, 31, narrowed her choice to two before settling on Innosight, a Watertown consulting firm that helps companies adapt their businesses to new technologies. Attracted to the variety of the Innosight job, she passed up an offer from Internet search giant Google Inc. “It’s amazing to be turning down a company like that,” she said.

Five years after the dot-com bust ravaged the technology industry, erasing tens of thousands of jobs in Massachusetts, the “Help Wanted” signs have been pulled out of storage. State figures released Thursday show several high-tech job categories growing at more than triple the rate of overall employment over the past 13 months.”

Click on link to read entire article

” … Just been fired? Don’t worry, your future is wide open

Annabelle Gurwitch spins “Fired” tales of woe into book, Showtime film

Annabelle Gurwitch says she didn’t want to write her book. And you don’t want to feel like you need to read it, but you should.

If she offers the comic relief you’re looking for, it might be because you’re walking the streets and trolling the Internet looking for a job. If not, chances are you’ve been there before - or will get there someday.

In “Fired,” published last year and recently released in paperback, the actor told the story of her firing from a Woody Allen play and collected job-loss tales from two dozen A-list and B-list celebrities who happen to be her friends.

Bob Saget recounted his pre-”Full House” career on a short-lived morning talk show, including the day he arrived to discover he no longer had a chair on the set.

Tim Allen remembered getting complimented for being both popular and creative at the same moment he was being fired.

Ann Meara dished a story about being canned from her hospital kitchen job by a nun for singing show tunes while she delivered meals to patients.

All three also are featured in the film version of “Fired” set to debut March 29 on Showtime. It seems getting the boot was a good career move for Gurwitch, who also produced a stage version, “Fired: Tales of Jobs Gone Bad,” that has appeared off-Broadway and at venues nationwide.

But it didn’t feel that way a few years ago, when Woody Allen fired Gurwitch from an off-Broadway play. She experienced a career high and low all in one work episode.

“Being hired by Woody Allen, it’s like - Say, you’re in IT and Steve Jobs says you’re terrific and you get hired by Steve Jobs, and then you get told you’re terrible by Steve Jobs,” Gurwitch said last week during a talk from her Los Angeles home.

And then there’s the personal and public shame:

“You’ve probably told every person you know you have the job,” she said. “Now you have to tell everyone you know that you don’t have the job.”

Gurwitch said she went through what most people experience when they lose a job: anger, sadness, a sense of loss.

“I cried, cursed the world, cursed Woody Allen, cursed my fate, drank a little too much, ate a lot of French fires, wandered the streets,” said Gurwitch, who is a writer and commentator on NPR.

In time, she stopped cursing the world and gorging on fries, and began the work that eventually would become her “Fired” multimedia adventure, including her website.

“I’ve been doing projects like this on NPR on my show “Day to Day,” where I take things that happen in my own life and put them in the context of the larger cultural issues, so this is not unknown territory for me,” she said. “Clearly, I got obsessed by this topic.”

In a sense, “Fired” could be labeled a self-help book.

“It was really my hope that by putting this book together it would help people to feel better if they had been, like me, fired because they were in the wrong job, or if they had been outsourced, downsized or outplaced,” Gurwitch said.

“My firing was very dramatic for me because I was 40 when I was fired. I think that when you get fired when you’re younger it can be a fantastic learning experience, as it can be when you’re older. But the gravitas really sets in when you’re an older and you’re fired.”

Gurwitch toured the country talking with HR groups and gathering tales about people coping with job loss for her film. She found that even celebrity “fired” stories have universal appeal.

“As an actor, I think a lot of people have the impression that it’s very glamorous. I believe it’s glamorous for six people - those were the cast of “Friends,” said Gurwitch, now 45.

“For the rest of us, if we don’t work job to job … when I lose my job, I’m in the same boat as many people in the country, where I’m thinking. ‘How, first of all, will I pay my mortgage? How will I qualify for my health care?’”

Gurwitch had savings so she and her husband, who have a young son, were able to make ends meet. But she’s come to better appreciate what it’s like to confront job loss. After meeting “Nickel and Dimed” author Barbara Ehrenreich at a book signing, Gurwitch joined the advisory board of United Professionals (www.unitedprofessionals.org), a nonprofit advocacy group Ehrenreich founded that helps white-collar workers.

“I felt a certain amount of patriotic spirit as I’ve gone around the country and met people because we’re all talking about jobs and what it means to work and be a productive member of society,” Gurwitch said.

“All the people that I’ve met really want to work. They want to be useful. They want to provide for their families. And we’re really united by this sense of insecurity. Just being able to get together and laugh about it is very helpful. It’s comedy in the face of a very serious subject, laughing through the tears.”

And you have to learn to laugh, especially when you hear about the latest euphemism for being fired.

“I met someone in HR recently who told me what they’ve been saying lately is, ‘We’re freeing you up for your future.’ I said, ‘Oh, my god! Don’t tell me you really say that.’”

Mike Cote is the editor of ColoradoBiz. E-mail him at mcote@cobizmag.com.

I am writing from New York City.

Two lifeboats for the unemployed are no longer afloat. 1. temp and low paid
work. 2. The civil service.

1.You can no longer walk into a temp agency and expect to be hired. The temp agencies have relationships with organizations or schools or government agencies that train and do background checks and physical exams. The temp agencies and employers get tax breaks and the like in return for this exclusive. This applies to hiring by Best Buy, Circuit City, the Fast Foods, etc.

2. There are no longer any must-hire-when-your-name-comes-up civil service lists. They take whom they like — friends, relatives, friendly referrals. Like the temp agencies they also have their organizational feeds. The one out of three rule permits them to everlastingly exclude someone who has a perfect test score in favor of someone with a lower score. There are people who will be always number 3 out of 3 and this person never gets hired; when the agency runs out of openings or wants new blood, they start another list. There is also the Provisional racket where the connected few are hired in bulk long before a new
list is promulgated. When the list appears, any passing grade makes them permanent and often an experience paper is the test.

The American Dream is no more and the fact that this colossal change is permanent has not sunk in; I sympathize with the denial. At any age, any experience or educational level, it is hard to get a secure, civilized job. Lose such a job and it can be like losing your life, forever stuck at a low economic level.

The media and government lie in unison. Many college grads, even at the master’s level, have to be supported by their parents for months after graduation. This applies to new lawyers who have passed the bar and received their license.

If these are good times, what will bad times be like?

At the local supermarket, an elderly woman, easily in her mid to late 70’s is bundling groceries. An equally elderly man who obviously has great trouble walking is manning a register at a large chain home improvement center. A 75-year-old “retired” teacher with 35 years experience diagnosed with prostate cancer almost 10 years ago, is still at work in a local coffee shop making coffee and tending to the dining room, aka bussing.

A 4 year stroke survivor in her 70’s is still forced to work part time as an interpreter at a local historic museum, talking to the public for over six hours at a time. These, and thousands (?) of others, fall into a category we choose to call The Near Dead Working Poor, one of the shames of modern American society.

How has this come about? We are the “retired” teacher and museum interpreter. Irwin, a teacher for over 35 years, has a relatively small pension and Social Security. I receive Social Security also, but having been a homemaker who raised a family, that is a small amount with which I couldn’t survive if my husband predeceased me.

When we were younger, we figured our two children would be out of the house by the time we would be in our mid-40’s and life would be a snap — but we find we are still waiting for those Golden Years seen promoted in glossy AARP magazines and the like.

Although our income is fixed, the cost of living has zoomed out of sight. We do not own a home and our rent is almost half of our take home income let alone heating bills and gasoline costs that continue to rise daily. We find it necessary to work more and more just to stand still. Must we work until we die on the job?

Ironically, we often find we fall between the cracks earning too much to qualify for such things as elderly housing and other so-called benefits for the poor. Another interesting situation involves disability. Since my stroke I have extremely limited use of my right hand and leg and my speech is not what it used to be. Regardless, applying for disability I am not eligible because after the age of 65 you’re considered retired.

In short, we are probably better off than many of our age, but for many hundreds of thousand like us, those Golden Years are tarnished.

Here we are AGAIN! Over 46.6 million Americans were without any form of health insurance in 2005. Even the ones who qualify for such programs such as Medicaid don’t have the access to medical care they really need. This problem just seems to get bigger and bigger and NO ONE is doing what is needed to solve this dilemma.

Where to begin? How can we design and enact a healthcare system that will assure that all Americans are covered, and all Americans can get the care they need whenever they need it? As a physician—someone who works in the “system”– over the years I have come to realize that before we ever make any changes in healthcare we have to agree that our health care system is broken and in need of drastic change. All too often the opinions we hold about our health care system depends on where we sit economically. Too many of us cannot “see” the problem unless we are affected directly.

Case in point is the current plan offered by the current administration to solve the problems of people who don’t have health insurance. A “tax break” has been proposed so that in certain circumstances the cost of a health insurance policy can be deducted from one’s income taxes. This “solution” misses the whole problem of people who simply cannot afford to pay for a health insurance policy. Getting a “tax cut” for something you do not have and cannot buy in the first place is meaningless!

If our healthcare problems are ever going to be tackled, Americans will have to face the very ugly and persistent problems involving poverty in this country. We may all believe fundamentally that healthcare is a right, but we will never really obtain this dream unless we are all willing to pay for it!

The truth of the matter is that the system as it stands now simply cannot afford to provide “healthcare for all.” Even though most of us are covered by health insurance it is becoming more and more apparent that “we” can no longer turn a blind eye to “others” situations. One of the reasons this topic has even surfaced again is because of the increase in number of people who are falling out of the middle class and into “the working poor.” Health insurance is now a luxury for many who used to be covered.

What we expected from our employers—health care insurance— in many cases is no longer being offered. If our employers cannot afford to pay for this insurance, then who can? It may sound silly but I don’t believe that our healthcare system problems will be fully addressed until people are rioting in the streets, or marching on Washington to get the universal healthcare coverage we all expect.

Before that happens, I want to start the open dialog, the “brainstorming” if you will that we have to do in order to make meaningful change. I will continue to ask the hard questions: Is healthcare a “right.” Are we all “entitled” to “top of the line” healthcare? Are Americans willing to pay for a system that delivers this promise?

I want to hear your answers, your ideas!

Who knows, maybe we can get down to making real efforts to end this problem before we are parading on the Monument’s Mall, shaking our fists at a system that has let so many fall though the cracks.