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To: MSI who wrote (18045)11/29/2003 8:09:21 AM
From: LindyBill  Respond to of 793640
 
Condition of health care system has been upgraded

By NEWT GINGRICH


Former House Speaker Newt Gingrich is the founder of the Center for Health Transformation (healthtransformation.net) and the author of "Saving Lives & Saving Money."


The historic Medicare and health savings account legislation that the House and Senate have passed, and which President Bush has promised to sign, is an extraordinarily important first step in the transformation of the American health and health care system that will save lives and money.
First and most significant, the legislation will add for the first time an overdue prescription drug benefit for seniors and do so at a reasonable price. Had pharmaceuticals been as fundamental to staying healthy in 1965 -- when Medicare was created -- as they are today, there is little doubt that they would have been included in the original legislation. Over the years, as the drug industry developed more and more life-saving and life-enhancing drugs, the absence of affordable drug coverage for seniors became a glaring shortcoming of Medicare.

For example, it was increasingly nonsensical that Medicare would pay billions for kidney dialysis but not pay the pennies per day for the preventive-care drugs that let many people keep their kidneys healthy. Similarly, it made little sense for Medicare to pay billions to cover open-heart surgery but not cover the couple of dollars a day for statin drugs so that people could avoid surgery in the first place.

In this respect, the drug benefit not only will help keep our seniors healthy, but it will also save money in many cases by preventing health crises that require costly interventions for seniors.

However, the impact of this legislation extends far beyond the drug benefit. Through its creation of health savings accounts, the measure will begin to address the crisis in health care that affects all Americans.

These portable accounts will allow individuals to deposit and grow money tax-free, and to withdraw that money tax-free to pay for qualified medical expenses, including health insurance premiums and deductibles, prescription drugs and long-term care services (including long-term care insurance). As such, HSAs, which are owned by individuals, are the first completely tax-free account in American history.

If you are a fiscal conservative who cares about balancing the federal

budget, the new legislation may have no more important feature than the health savings accounts. The new account will begin to move us away from the current model in which insurance companies dominate the health care transaction. Instead, the HSA will enable transactions between doctor and patient in which the patient controls how dollars are spent.

With health costs accounting for nearly 14 percent of U.S. gross domestic product, the HSA represents the single most significant transformation that can be made in saving the country from skyrocketing health costs and steadily increasing calls for taxpayers to finance more and more of the health care system through higher taxes. Transformation of this nature is a practical need when so many Americans are without health insurance (including 9 percent of Georgians) and when those with (or supplying) insurance coverage have experienced double-digit premium increases for three years in a row.

High deductibles beneficial|

A worker sets up an HSA by buying a health insurance policy with a relatively high deductible. The minimum deductible for an individual is $1,000; the maximum is $2,500. The minimum for a family is $2,000; the maximum is $5,050. The worker can set aside, tax-free, the full amount of his deductible each year and draw on that money to pay health-related expenses. Some may wonder why the deductible seems so high. The answer is that increasing the deductible to such levels sharply reduces the cost of insurance premiums for the worker or his employer.

Health savings accounts hold a tremendous advantage for younger workers by enabling this comparatively healthy group to accumulate substantial sums of money over a lifetime of work. And for seniors 55 and older, the new legislation allows them to catch up on HSA advantages by allowing this group to make extra contributions of up to $500 annually (increasing to $1,000 by 2009) to help them accumulate more rapidly tax-free health dollars for retirement.

The next balanced budgets will only be possible once there is a transformation of the health system, and part of the key to this transformation will be the existence of health savings accounts. Without the first dollar interest in the payment of health expenses, there is little incentive on the part of the patient/consumer to scrutinize a doctor's bill.

And without transparency in costs, as well as cost comparison information, it is even more difficult for individuals to assess the true value of a health service and either challenge the bill or decide to take their health business to a different provider who offers better value.

Promoting wise purchasing|

Health savings accounts will encourage individuals to shop for health plans that best fit their needs and to make cost-conscious decisions about how they spend their own health dollars as opposed to a third party's money. Individuals who control their own health dollars will be wise purchasers of health services.

Transformation in health care is also a moral imperative when poor quality-control systems, scarce information about expected outcomes, unacceptable error rates and lack of consumer choice combine to threaten the safety of patients and limit the opportunities for individuals to find appropriate and affordable treatment. The new legislation begins to tackle these problems by correcting the current practice in which quality outcomes have no bearing on the reimbursement structure. A provision in the bill will give hospitals incentives to invest in information technology and report on quality outcomes, so people will be able to compare quality outcomes among hospitals.

The natural order of the 21st century economy is continually to have more choices, of greater quality, at lower costs. It is what 70 million baby boomers have come to expect in most areas of their lives, with the health and health care system a glaring aberration.

While a completely transformed health system will take more time and require a great number of additional steps, President Bush, House Speaker Dennis Hastert (R-Ill.) and Senate Majority Leader Bill Frist (R-Tenn.) have delivered on the all-important first step.

Seniors will receive long-overdue prescription drug assistance and all Americans will receive the opportunity to take control of their own health care spending so that they can provide better health for themselves and contribute to the better health of the economy.

Find this article at:
ajc.com



To: MSI who wrote (18045)11/30/2003 2:36:50 AM
From: LindyBill  Read Replies (1) | Respond to of 793640
 
Watch out, MSI. These people catch up with you, they will trample you to death!

Lindybill@thunderingherd.com



washingtonpost.com
Election Is Now for Bush Campaign
Early Efforts Aim To Amass Voters

By Dan Balz and Mike Allen
Washington Post Staff Writers
Sunday, November 30, 2003; Page A01

President Bush's reelection team, anticipating another close election, has begun to assemble one of the largest grass-roots organizations of any modern presidential campaign, using enormous financial resources and lack of primary opposition to seize an early advantage over the Democrats in the battle to mobilize voters in 2004.

Bush's campaign has an e-mail list totaling 6 million people, 10 times the number that Democratic presidential candidate Howard Dean has, and the Bush operation is in the middle of an unprecedented drive to register 3 million new Republican voters. The campaign has set county vote targets in some states and has begun training thousands of volunteers who will recruit an army of door-to-door canvassers for the final days of the election next November.

The entire project, which includes complementary efforts by the Republican National Committee (RNC) and state Republican parties, is designed to tip the balance in a dozen-and-a-half states that both sides believe will determine the winner in 2004.

"I've never seen grass roots like this," said a veteran GOP operative in one of the battleground states.

Dean, a former governor of Vermont, has made major strides in organizing a grass roots-based campaign in a bid for his party's nomination. His advisers say it is the largest in the history of presidential politics.

While saying he is not familiar with all the details of Dean's grass-roots and Internet efforts, Bush campaign manager Ken Mehlman said, "Our goal is for the largest grass-roots effort ever."

Organization alone cannot elect Bush to a second term. Given the reality that the president's campaign team cannot control such potentially decisive factors as the economy or events in Iraq, officials are determined to maximize their advantage in areas they can control. Rarely has a reelection committee begun organizing so early or intensively -- or with the kind of determination to hold state party and campaign officials, and their volunteers, accountable for meeting the goals of the Bush team.

In Ohio, for example, more than 70 elected officials and volunteer workers dial into a conference call every other Wednesday at 7 p.m. to report on their efforts to recruit leaders and voters, and to hear updates from Bush's campaign headquarters in Arlington. Roll is called, which initially surprised participants used to less regimented political operations.

The massive ground war now in the early stages underscores the latest turn in political campaigns, in which there is renewed interest in applying the shoe-leather techniques of an earlier era, enhanced with advances in technology. Campaigns, both Democratic and Republican, have rediscovered the importance of putting people back into politics, after years of focusing on television commercials.

"We live at a time of the greatest proliferation of communications technology in history, and in an ironic way, that technology has taken us back to the politics of an earlier time," said Ralph Reed, former Georgia GOP chairman and now a regional official in Bush's reelection campaign.

Having the biggest presidential campaign treasury ever -- more than $105 million raised already and heading toward $170 million -- and no primary opposition gives Bush the luxury of focusing now on general-election organizing. The RNC and the Bush team have begun planning across a wide range of fronts, even including an analysis of which supporters are likely targets for absentee ballots or early voting, an increasingly critical aspect of turning out the vote.

The Bush campaign not only has started early, but also has set deadlines for developing its organization. In Ohio, there is a Dec. 1 deadline for recruiting county chairmen in the state's 88 counties. In Florida, the first three of a dozen planned training sessions have been held, and two campaign staffers are working out of an office in Tallahassee; county offices -- complete with plenty of lines for phone banks -- are scheduled to open shortly after Jan. 1.

In Iowa, the campaign's state chairman, David M. Roederer, said volunteers have been identified in all 99 counties, and they are working to expand their rosters down to the precinct level.

The Bush team hopes to build on techniques first employed in 2000 and honed in 2002 through what is called the "72-hour project," which is shorthand for mobilization operations during the final days before the election. Democrats acknowledge these techniques proved highly effective as a counter to their mobilization efforts in earlier campaigns.

"They've proven they can do it," said Gina Glantz, of the Service Employees International Union, who will join the Dean campaign as a senior adviser next month.

The absence of unlimited "soft money" donations to parties and tighter rules on coordination between a presidential campaign, the national committee and state parties -- all part of the new campaign finance law -- make this organizing more difficult and put a premium on volunteer labor. Mehlman said that, despite those challenges, "we want to take it a step further in this campaign" than in 2002.

Republican officials say these efforts are necessary to counteract voter mobilization by Democrats and their allies in organized labor and liberal interest groups, who plan to spend substantially more than $100 million on get-out-the-vote efforts.

Although Republicans have their own network of outside groups, from the National Rifle Association and the National Federation of Independent Business to the Christian Coalition, GOP strategists say privately that none of them comes close to matching the resources, sophistication or fealty of organized labor and liberal groups.

"This party has no infrastructure," one Bush adviser said. "We have to build it from the ground up."

Both parties have rediscovered the importance of communicating personally with people, rather than assuming that television ads or direct-mail brochures will motivate someone to vote. From their analysis of previous contests, including this month's gubernatorial elections in Mississippi and Kentucky, GOP officials said someone who votes only infrequently is four times more likely to go to the polls after having a face-to-face conversation with a campaign volunteer about a candidate than after receiving a phone call or direct-mail brochure.

Thus, the Bush team is trying to build an army of millions of volunteers to go door-to-door next year to talk to potential voters. Officials have concluded that old-fashioned literature drops should be replaced by in-person contact with voters whenever possible, and they are trying to change old habits among veteran GOP workers in the states.

The Bush campaign will devote a portion of the estimated $170 million it will raise during the primary season to grass-roots organizing, although spending on television ads will still outstrip expenditures for the ground war. Any excess money in the Bush account can be given to the RNC at the time of the national convention next summer for get-out-the-vote efforts for Election Day in November.

The Bush campaign is focused now on building its state organizations, while the national committee is working on a variety of organizing efforts, including voter registration. Registration is important because, at a time when Bush enjoys about 90 percent support from self-identified Republicans, GOP officials believe there is no surer way of producing votes than getting more people registered with the party. The party is registering voters at NASCAR events and naturalization ceremonies, on college campuses and in targeted precincts.

The RNC has set state-by-state goals for registering voters, based on a formula that attempts to determine Bush's maximum potential vote percentage, all with an eye toward turning states that he narrowly lost or won in 2000 into winners next year.

In Oregon, which Bush lost to Al Gore by about 7,000 votes in 2000, the national committee's goal is to register 45,000 GOP voters by next year, enough to provide a cushion in a close election.

Republicans are using several techniques to reach and register voters. In New Hampshire, new homebuyers receive a postcard from the state GOP welcoming them to their neighborhood, explaining the party's historic opposition to higher taxes and urging them to register as Republicans. Party officials follow up with phone calls, often from volunteers in the same community, and next spring will begin going door to door.

In Arkansas, RNC officials recently hosted a breakfast for nearly 100 ministers, outlining ways they can assist parishioners in registering. Party officials plan to follow up by identifying volunteer coordinators in the churches to oversee those efforts.

In Illinois, Republicans have hired field operatives who will concentrate their efforts -- by telephone and sometimes face-to-face -- to identify and register likely GOP voters.

"If you've got a precinct where 50 percent [of registered voters] are Republicans and 30 percent are independents, there's probably gold to be mined in that precinct," said Bob Kjellander, one of 11 regional chairmen for the Bush reelection committee.

The campaign has staged splashy events to announce leadership teams in 16 of its targeted states, usually featuring Mehlman or campaign chairman Marc Racicot. The campaign's ambitions are evident from the depth of the organizations being assembled.

In each county, for example, the Bush operation will include an overall chairman; chairmen for surrogates, volunteers and voter registration; and an "e-chairman," whose responsibility is to communicate with supporters registered with the campaign Web site.

Campaign officials look for specific tasks to keep people involved. Team leaders have been asked to recruit five other team leaders and sign up 10 friends to receive campaign e-mails.

The campaign Web site includes an easy way for supporters to send letters in support of Bush's policies to local newspapers and has generated 28,000 letters since August. At training sessions, campaign workers are urged to help recruit participants for coalitions the campaign plans for teachers, farmers, Hispanics, African Americans, disabled people, law enforcement officials and sportsmen.

Bush officials say they have one advantage over Democrats: Enthusiasm for the president among the GOP base makes it far easier to organize a grass-roots army.

Sally D. Florkiewicz of Cleveland has signed up 196 people since mid-September to serve on Bush's committee, and has a list of 225 more e-names she wants to call.

"They're so surprised we're calling them this early," she said. "I tell them it's going to be a very, very close election."
washingtonpost.com