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In his speech last night accepting the Democratic nomination for President, Barack Obama called for universal health care and slammed insurance companies that discriminate against the sick and dying.  Said Obama: “Now is the time to finally keep the promise of affordable, accessible health care for every single American.  If you have health care, my plan will lower your premiums.  If you don’t, you’ll be able to get the same kind of coverage that members of Congress give themselves.  And as someone who watched my mother argue with insurance companies while she lay in bed dying of cancer, I will make certain those companies stop discriminating against those who are sick and need care the most.”  Here’s the full text.

As we reported earlier this week, the U.S. Census Bureau released data (full report) showing that the number of people without health insurance fell nearly 3% to 45.7 million in 2007, with the entire improvement coming from government-sponsored programs as opposed to market-based solutions.

Here’s what some industry representatives, researchers, politicians, and policy wonks had to say about the results:

Karen Davis, president, The Commonwealth Fund: “Today’s data release shows the importance of the nation’s safety net insurance system—Medicaid and the State Children’s Health Insurance Program.” (press release)

Karen Ignagni, chief executive, America’s Health Insurance Plans: “While the Census Bureau reports a modest decline in the uninsured rate, this does not reduce the urgency of the crisis….We need coverage for all Americans, coverage they can afford, and coverage they can keep.” (press release)

Nancy Nielsen, M.D., president, American Medical Assn.: “Employer-based health insurance is no longer an option for many workers and their families, as employment-based coverage continued to decline in 2007, dropping to 59.3 percent….We advocate for a shift in tax incentives for health insurance so lower-income Americans get money to purchase coverage. We also want insurance market reforms to provide individuals more choices and ensure coverage for high-risk patients.”

U.S. Senator John McCain (R-AZ): “My health care plan will substantially reduce the rolls of the uninsured by providing a $5,000 per family refundable tax credit that will help more Americans get the coverage they need or maintain the coverage they already have.” (press release)

U.S. Senator Barack Obama (D-IL): “Between 2000 and 2007, an additional 7.2 million Americans have fallen into the ranks of the uninsured. This is the largest increase in the number of people without health insurance of any Presidential Administration on record. ” (press release)

Jared Bernstein, senior economist, Economic Policy Institute (as quoted in the New York Times): “The data in this report refer to last year, when everything was different….This year, we’re losing jobs on a monthly basis, inflation is running well over 5 percent, and unemployment was last seen at 5.7 percent and rising.”

Devon Herrick, health economist, National Center for Policy Analysis: “Despite claims that there is a health insurance crisis in the United States, the number of U.S. residents without health insurance actually fell in 2007….The slight increase in the number of uninsured over the past decade is largely due to immigration and population growth—and to individual choice.” (press release)

As expected, Hillary Clinton had a lot to say about healthcare last night in her speech at the Democratic national convention.  Here’s the full text courtesy of the New York Times, and below is the video version.  Some of her healthcare-related comments, which received wide applause, included the following:

- “I will always remember the single mom who had adopted two kids with autism. She didn’t have any health insurance, and she discovered she had cancer. But she greeted me with her bald head, painted with my name on it, and asked me to fight for health care for her and her children.”

- “I will always remember the young man in a Marine Corps T-shirt who waited months for medical care. And he said to me, “Take care of my buddies. A lot of them are still over there. And then will you please take care of me?”

- “I cannot wait to watch Barack Obama sign into law a health care plan that covers every single American.”

An interesting take on rising healthcare costs appears in the book The Trillion Dollar Meltdown: Easy Money, High Rollers and the Great Credit Crash (PublicAffairs, 2008), by Charles Morris.  The book is a wonderfully cogent take on the sub-prime mortgage meltdown.  But it also addresses larger themes, including a call for stepped up regulation of financial markets and the likelihood of a pendulum swing toward increased government participation in healthcare.  Writes Morris:

“Economic theory, in fact, suggest that health care should be expanding rapidly.  The richer you get, the more you are likely to favor life-extending spending over additional consumption.  The extra enjoyment from one more toy, in other words, can’t begin to match up against an extra year of life to enjoy all of your toys.  Even at moderate-to-low rates of economic growth, there is no reason why the economy couldn’t support the expansion of health care to 25 percent or 30 percent of GDP, as I expect will happen by 2030 or so….

“But having said all that, American health care is also extremely wasteful and is an operational mess.  At twice the per capital level of spending as in other advanced countries, we are not getting a good deal.  Much of the problem stems from the insistence that health care is just like any other consumer market.  It’s not….

“I won’t speculate on possible solutions, but they will inevitably involve an expansion of government.  We should stop fighting ideological battles over whether government should have any role and start concentrating on how to make it effective and efficient.”

Interesting analysis in Health Affairs suggesting that “the cost of expanding coverage to the 16 percent of Americans who are uninsured would add 5 percent to national health spending.”  Authors Jack Hadley, John Holahan, Teresa Coughlin, and Dawn Miller write: ”People uninsured for any part of 2008 spend about $30 billion out of pocket and receive approximately $56 billion in uncompensated care while uninsured. Government programs finance about 75 percent of uncompensated care. If all uninsured people were fully covered, their medical spending would increase by $122.6 billion. The increase represents 5 percent of current national health spending and 0.8 percent of gross domestic product.”

Good news on the uninsured front.  The U.S. Census Bureau reported (full report) that the number of people without health insurance fell nearly 3% to 45.7 million in 2007, compared to 47 million in 2006.  No doubt you can thank the consumer-driven healthcare revolution for increasing the availability and affordability of health insurance through competitive market-based solutions aimed at a growing number of Americans.  Actually, no.  Rather, the number of people enrolled in government-sponsored health insurance programs accounted for the entire improvement, increasing by 2.7 million to 83 million in 2007.  The best part?  The number of unsinsured children fell 7%.  Enrollment in private health insurance, i.e., the market-based stuff, was pretty much unchanged.

U.S. Sen. Edward Kennedy (D-MA), who is battling brain cancer, gave an impassioned speech (full text) at the Democratic national convention in Denver last night calling for universal healthcare and supporting Barack Obama for President.  Said Kennedy: “This is the cause of my life-new hope that we will break the old gridlock and guarantee that every American-north, south, east, west, young, old-will have decent, quality health care as a fundamental right and not a privilege.  We can meet these challenges with Barack Obama.”

Jay Khosla, mouthpiece on healthcare for John McCain, and David Cutler, mouthpiece on healthcare for Barack Obama, debated the role of government in healthcare with The Wall Street Journal.  A transcript of the debate ran in today’s Journal.  It’s about what you’d expect.  Khosla (McCain) wants market competition to reduce healthcare costs.  Cutler (Obama) wants a bigger role for government.  They each slam the other camp’s healthcare proposals pretty hard.  Read it and weep.  It’s a perfect example of why if you really want to understand the healthcare crisis and how to solve it, don’t listen to these guys.  Do your own homework.

You can find a thoughtful—albeit thoroughly depressing—analysis of the financial problems facing Medicare (and Social Security) in the book “Where Does the Money Go?  Your Guided Tour to the Federal Budget Crisis“  (HarperCollins, 2008), by Scott Bittle and Jean Johnson. 

The authors write, “The part of Medicare that covers hospital costs for older Americans already pays out more than it takes in from payroll taxes….Medicare already collect taxes on nearly everything everyone earns….Older people already pay monthly premiums to cover doctor’s visits (Medicare Part B), premiums that increased annually by double digits from 2001 to 2006….We’re not trying to suggest that raising Medicare taxes, premiums, and fees should be off the table….But politically speaking, the system has already been there and done that….

“The big wrinkle here is that we haven’t yet come up with foolproof ways to hold down health care costs without harming patients or thwarting new medical breakthroughs.  In the last couple of decades, experts have pinned their cost-cutting hopes on HMOs, preferred provider plans, more preventive care, and other ideas, but health care costs have continued to climb.”