On Thursday, numerous blogs highlighted John Goodman’s bizarre claim that everyone in America actually has health insurance. Goodman, “who helped craft Sen. John McCain’s health care plan,” suggested that since “anyone with access to an emergency room effectively has insurance,” the government should “cease and desist from describing any American — even illegal aliens — as uninsured.”

Goodman assumes that the 45.7 million Americans without insurance — in fact, all Americans — don’t really need preventive care or regular check-ups; after all, doctor visits only drive-up medical costs.

In fact, earlier this month, Goodman explained that health care costs too much because employers often subsidize “bells and whistles” coverage. McCain’s plan would put an end to this:

The tax credit “would not subsidize bells and whistles [marriage counseling, acupuncture, etc.] as the current system does,” Mr. Goodman said in an e-mail.

And while the McCain campaign has issued a statement distancing itself from Goodman — by claiming that Goodman’s “philosophy on health care” was “out of step with John McCain — McCain’s plan is deeply influenced by Goodman’s thinking. In July, another McCain health care adviser, Al Hubbard, compared “Americans’ use of the health care system to shoppers who indiscriminately buy caviar while someone else foots the bill”:

So every time you go to the grocery store you just take out your food insurance card, you give it to the cashier, she scans it, and you’re out of there. Pretty soon, you would start buying caviar, expensive steak, and you start buying more than you need.

Even McCain himself has argued that if Americans paid more for coverage, they would use less care:

“If that money [for health care] is coming out of your pocket, you would be more careful about it.” [Town Hall, 6/23/2008]

As Jonathan Cohn points out, emergency-only care is no substitute for real preventive medicine. Like the McCain health care plan, it does little for Americans who actually need to see the doctor.

Unfortunately, for McCain to truly distance himself from Goodman’s “philosophy on health care,” he would have to abandon his entire health care plan.

While running for governor in 2006, Gov. Sarah Palin (R-AK) portrayed herself as a pro-life feminist who opposed abortion but supported contraception. From Anchorage Daily News:

Palin said last month that no woman should have to choose between her career, education and her child. She is pro-contraception and said she’s a member of a pro-woman but anti-abortion group called Feminists for Life.

“I believe in the strength and the power of women, and the potential of every human life,” she said.

But Palin’s support for contraception clashes with McCain’s ignorant record of voting against expanding access to affordable birth control.

As the Wonk Room previously pointed out, in 2007, McCain admitted to reporters that he was “not informed” about “whether I support government funding for them [contraceptives] or not,” and expressed doubts about the effectiveness of condoms.

McCain also voted against requiring insurance companies to cover prescription contraception in both 2003 and 2005, consistantly opposed funding health care services for women, and even supported abstinence-only programs that censored “information about birth control.”

Despite their differences on contraception, however, McCain and Palin would both deny women around the world the right of choice. During her campaign for governor, Palin made it clear that “she is opposed to abortion, even in cases of rape or incest.”

Thus, even with Palin, McCain is still not what women want.

Digg It!

In choosing Gov. Sarah Palin (R-AK) as his running mate, Sen. John McCain (R-AZ) has found someone who shares his vision of a radically different health care system which shifts the financial incentive and risk from the insurance company to the patient.

While McCain seeks to do-away with consumer protections, deregulate the insurance industry, drive Americans into scantier coverage, and inevitably phase-out the current employer-based system, Palin has similarly called for “flexibility in government regulation that allow competition in health care.”

As governor, Palin sought to push for greater commodification of health care by establishing the Alaska Health Care Strategies Planning Council and, after introducing a transparency act, promised to build “on the work they have done.”

Palin’s council promoted consumer-driven health care. Here are some highlights from the report:

- Increase the place of consumerism in health care purchasing by giving people control over their health care dollar…

- Reduce potential for financial impact from catastrophic loss by supporting new and innovative approaches to insurance for individuals, which would be consumer-owned, portable, and purchased with pre-tax dollar

- With respect to lowering costs, insurance that is portable and consumer-owned plays a central role, and requires much more discussion at the state level.

- Consumerism is an essential component of bringing rationality to the health insurance structure in Alaska…insurance must be consumer-owned, market-responsive and portable;

But ironically, consumers are often dissatisfied with “consumer-owned” plans. Thirty-three to 42% “of people in consumer-driven health plans are extremely or very satisfied with their health plans, compared to 63 percent of those with traditional plans” and Americans in such plans are twice as likely to report delaying or avoiding care and about three times as likely to report paying a large fraction of their income on health costs as those in comprehensive insurance.

What’s more, “enrollees in consumer-driven health plans appear to be significantly healthier than others. As sicker workers stay in traditional plans, the cost of such plans will go up, causing such plans to become unaffordable for workers and employers. This erodes group purchasing power, leading to even higher prices, and possibly more uninsured Americans. It could also undermine Medicare as it expands there.”

Unfortunately, in treating health care like any other consumer good, both McCain and Palin are placing ideology ahead of improving access and expanding health care coverage. Since “health care is ultimately about preserving life and delaying death,” “buying health care may not be the same as buying an iPod” — McCain and Palin should take note.

During his appearance at the Livestrong Presidential Forum in July, Sen. John McCain (R-AZ), who had supported a $1.10-per-pack tax hike in 1998, refused to consider increasing the tax on cigarettes because he believed that some of the funds were diverted away from tobacco control programs:

MCCAIN: I don’t think I would, [raise the federal tax on tobacco] because I don’t think the money is being spent on the state taxes right now. [...]

ZAHN: So is there any circumstance that could be proven to you, if there was a direct correlation between taxes going up and the use of tobacco going down?

MCCAIN: It would have to be proven and frankly the constitution of this Congress, they couldn’t prove it to me, because I don’t believe them. I don’t… And by the way, I’m not for raising anybody’s taxes. I think, right now with these economic problems we have, lower taxes is what we need

Watch it:

A new study has proven just that. According to new research, despite some diversion of funding, California’s anti-tobacco program — which “was funded with a constant tax of $0.05 per pack” — yielded a 50-to-1 return, saved $86 billion in personal health care costs, and “prevented 3.6 billion–yes, billion with a “b”–packs of cigarettes from being smoked in 15 years.”

So will McCain raise taxes to save money and reduce tobacco consumption or stick by his ideologically-driven ‘no new taxes’ pledge?

The decrease in the number of uninsured — from 47 million to 45.7 million — underscores the importance of public health care programs. As Len Nichols of the New Health Dialogue Blog rightly notes:

…a weakened economy and rising health care costs have led fewer Americans to buy private insurance and more Americans to turn to the government for safety net coverage. Let’s keep in mind, however, that the numbers released today are for 2007, before the economy really took a turn for the worse. Therefore, we can expect the reduction in private coverage enrollment and increased dependence on Medicaid to be magnified in 2008. This path places increasing strain on local, state, and federal governments who are already grappling with tough budgetary constraints.

Indeed, while conservatives continue to fear-monger and misrepresent public health programs as “inefficient rationed care,” “government run” or “controlled,” Americans are turning to them in greater numbers.

According to the new census data, in 2007 the percentage of people with private coverage dropped from 67.9% to 67.5%, while the number of Americans with government-provided health coverage increased from 27.0% to 27.8%. The number of children with private insurance also fell by 0.4%, and 1.2% more children received coverage through public programs.

This greater availability of care is the result of state, not federal, progress. President Bush’s refusal to adequately fund SCHIP and expand public health programs has forced state governments to pick up the slack. While the economy tempers prospects “for further progress,” “state efforts to expand Medicaid and SCHIP during 2007 reached a level not seen since the late 1990s.”

During 2007, “governors in 34 states offered plans to reduce the number of uninsured children, parents, adults, aged and disabled in their state through Medicaid expansions, SCHIP expansions…market-based approaches.”

The Kaiser Foundation offers this chart:

In fact, according to the new data, Massachusetts health reform — which has insured 439,000 new residents and cut the number of uninsured nearly in half — is responsible “for 24% of the decline nationally in the number of uninsured.”Last week, the Robert Wood Johnson Foundation released a report that underlined the important role public health programs like SCHIP and Medicaid play in providing health care to children. As the CEO of foundation pointed out, “programs like SCHIP are a true lifeline for vulnerable children. Hard-working parents need these programs, and their children benefit greatly because of them.”

Yesterday’s census numbers suggest that public health programs are a “lifeline” for all Americans who cannot afford private coverage.

The following post is a dispatch from Peter Harbage, a Senior Fellow at the Center for American Progress Action Fund. Peter is attending the Democratic National Convention in Denver, Colorado.

Some of America’s greatest health care leaders gathered in Denver, today, to call for national health reform. Called “Winning Health Care Reform in 2009,” the event is sponsored by Families USA and SEIU.

The crowd was fired-up as the event kicked off with Ron Pollack, long-time health care warrior and head of Families USA, talked about the need for health reform. He lead off talking about how the slight dip in the number of uninsured reported by the Census Bureau just yesterday highlights how much ground we have lost since 2000. Pollack pointed out that today there are more uninsured in the US than the combined population in 24 states.

Pollack also featured the new Harry and Louise (www.harryandlouisereturn.com ) ad. The transformation of Harry and Louise from icons of the battle against the Clinton health reform effort to symbols in support of health reform in 2008 shows how bad the health reform has become. The website features a video where the actors talk about their personal experience with the broken health care system.

Andy Stern, President of SEIU International, followed Pollack by pumping up the crowd as only a labor leader can. He focused on one top message: Get health care done in the first 100 days of the Obama administration.

Rep. Hilda Solis (D-CA), kicked off the speakers talking about the fight for the SCHIP reauthorization last year, which was twice vetoed by President Bush.

Then came Rep. John Dingell (D-MI), Chairman of the House Ways and Means Committee, whose father lead the fight in support of health reform under President Truman. Dingell, who has lead the fight in the House of Representative for as long as anyone, said that he is “Ready to work his heart out,” for health reform under President Obama.

Gov. Kathleen Sebelius (D-KS) focused on the moral and financial urgency for health reform. She talked about the ‘hidden tax’ in health care where those with insurance already pay for care from the uninsured in a way that is hidden. The point: all of us already pay for the uninsured, and we all need to pull together to fix the broken system.

Stay tuned for more updates from the “Winning Health Care Reform in 2009″ event!

Before officially announcing new regulations to protect “federally funded health care providers’ right of conscience” by allowing them to opt-out of providing abortion and contraceptive services, Health and Human Services Secretary Michael Levitt argued that the new rule was necessary to protect the “freedom of expression and action” of medical professionals:

I want to reiterate. If the Department of Health and Human Services issues a regulation on this matter, it will aim at one thing, protecting the right of conscience of those who practice medicine. From what I’ve read the last few days, there’s a serious need for it.

But Leavitt’s claim is sensationalistic. On his own blog and in the press release announcing the regulation, Levitt undermines the necessity of the regulation by admitting that there are “clear provisions in three separate laws protecting federally-funded health care providers’ right of conscience.” These provisions already protect “freedom of expression”:

- The Church Amendment of 1976: “prevents the government (as a condition of a federal grant) from requiring health care providers or institutions to perform or assist in abortion or sterilization procedures against their moral or religious convictions. It also prevents institutions receiving certain federal funds from taking action against personnel because of their participation, nonparticipation or beliefs about abortion or sterilization.”

- The Coats Amendment of 1996: prohibits the government from “discriminating” against medical residency programs or other entities that lose accreditation because they fail to provide or require training in abortion services.

- Hyde/Weldon Conscience Protection Amendment of 2004: “forbids federal, state and local governments from requiring any individual or institutional provider or payer to perform, provide, refer for, or pay for an abortion. This goes well beyond the Church Amendment.”

Leavitt’s rule would be redundant if it weren’t so expansive. By using an “opinion put forth several months ago by the American College of Obstetricians and Gynecologists” as pretext to issue new regulations, Leavitt is potentially expanding the existing conscience exemption. As Jessica Arons points out, by failing to provide a clear, medically-accepted definition of abortion and leaving the door open for refusers to self-define “abortion,” the new rules enable individuals to “deny women access to oral contraceptives, emergency contraception, and the IUD, among other commonly used methods of birth control.”

In short, the purpose of the regulation — which violates White House Chief of Staff’s Josh Bolten’s requirement that new regulations be proposed by June 1, 2008 — is to muddy the waters and allow opponents of abortion and contraceptive services to obstruct women’s access to reproductive health care.

UPDATE: On Friday, during an interview with NARAL’s Mary Alice Carr about the new regulation, Laura Ingraham falsely claimed that “pro life doctors who refuse to provide abortions may finally get some help from the federal government”:

Our guest blogger is Jessica Arons, the Director of the Women’s Health and Rights Program at the Center for American Progress Action Fund.

HHS has released its proposed regulation to “help protect health care providers from [religious] discrimination.” The good news is it no longer attempts to re-define abortion to include birth control. But don’t breathe a sigh of relief just yet.The regulation no longer defines pregnancy or abortion at all. But in a telephone news conference, Sec. Mike Leavitt left open the possibility that individuals might be able to define those terms for themselves in determining what they find morally objectionable, which means they still may be able to deny women access to oral contraceptives, emergency contraception, and the IUD, among other commonly used methods of birth control.

And that’s just the beginning.

While most of the regulation limits the scope of allowable moral objections to training, performing, counseling, or referring for abortion and sterilization, some sections are not so restricted.

Entities to whom this subsection 88.4(d) applies shall not require any individual to perform or assist in the performance of any part of a health service program or research activity funded by the Department if such service or activity would be contrary to his religious beliefs or moral convictions.

That seems to be an exception you could drive a truck through.

Also note the objections can be based not only on religious beliefs but on any personal moral convictions. This is much broader than the traditional conscience clauses, including those that allowed for conscientious objectors during the Vietnam War.

Finally, the proposed regulation would extend protection from doctors and nurses to just about anyone who might come into contact with a patient, and even some who might not.

[A]n employee whose task it is to clean the instruments used in a particular procedure would be considered to assist in the performance of the particular procedure.

By that logic, an ambulance driver, a receptionist, and even the person who processes health insurance forms might be able to refuse to perform their jobs if related to a health care service they find morally objectionable. Volunteers are explicitly protected too.

The public may submit comments on the regulation during the next 30 days to http://www.Regulations.gov or via email to consciencecomment@hhs.gov.

UPDATE: NFPRHA has more.

Yesterday, in an answer to a question about providing affordable care to Americans with disabilities, Sen. John McCain (R-AZ) said he would “encourage home health care as opposed to institutional care”:

And we need to have policies that encourage home health care as opposed to institutionalized care. And we need to treat people on an outcome basis, that don’t pay for every test or every procedure, every visit to the doctor; but treat them for a period of time and then pay that provider.

McCain’s answer may have surprised disability advocates. Just last month, during a Town Hall event in Denver, McCain expressed strong opposition to the Community Choice Act, which would make more home care available to people on Medicaid.

After the audience member asking the question explained that the act — which has a total of 113 co-sponsors in the House and 21 in the Senate– “would end the institutional bias and allow people with disabilities to chose where we would live and receive services,” McCain expressed no support for home-based care and instead insisted that he “will not” support the act “because I don’t think that it’s the right kind of legislation.”

Watch both answers:

During the event in Denver in July, McCain implied that he had discussed the act with advocates in April. But by June, McCain seemed to have forgotten about the legislation. When an audience member asked the senator “would you support the Community Choice Act, Senate Bill 799,” McCain said, “I’m not sure which — I don’t know bills by their numbers” and instead touted his support for the Americans with Disabilities Act, which did nothing to promote home care.

The Commonwealth Fund released a new report today documenting the difficulty American families face in keeping up with the ever-growing costs of health care. In 2007, nearly 66 percent of Americans “were either uninsured for a time during the year, were under-insured, reported a problem paying medical bills, and/or said they did not get needed health care because of cost”:

- Since 2003, the “proportion of adults with high deductibles nearly doubled.”

- Half of adults with low income lacked coverage at some point during the year.

- 41 percent: of working age adults “reported a problem paying their medical bills”

- 33 percent: “spent 10 percent or more of their income on health insurance and health care, up from 21 percent in 2001″

The high costs of the current system ration care. The 47 million Americans without health insurance and the 25 million who don’t have enough insurance, lack access to needed services and are often forced to use expensive emergency care as a measure of last resort.

But in Massachusetts, health care reform is reducing the number of uninsured and increasing access to care.

According to new data released by Gov. Deval Patrick’s administration, “nearly three-quarters of previously uninsured Massachusetts residents now have medical coverage.” Half of the newly-insured “are enrolled in private health insurance and employer-sponsored plans” — coverage that does not cost the state money. Meanwhile, “the number of visits to hospitals and community health centers by the uninsured declined by 37 percent,” saving the state an estimated $68 million.

As Americans around the country are losing health coverage, Massachusetts residents are enjoying greater access and improved health outcomes. Opponents of comprehensive health reform should sit up and take notice.

During a conference call promoting the new Harry and Louise ads, Ron Pollack, the Executive Director of Families USA, revealed that the National Federation of Independent Business — a group which strongly opposed President Clinton’s health reform effort but now promotes changing “the status quo” — supports expanding public health programs:

In the conversation I had with Todd [Stottlemyer]….when I talked about…the problems with private health programs and their failure to meet people who in no doubt need support… I said to him that that it was a top priority for Families USA in terms of seeing change…[to expand public health programs]… He was not aware of that…[I told him] we are going to push really hard for that and he said he would support it.

Stottlemyer’s endorsement of an expansion of public health programs is a significant development and a welcome reversal from the group’s insistence that “Americans should receive their health insurance and healthcare through the private sector.”

Read more about the importance of public programs here.

Our guest blogger is Adam Jentleson, the Communications and Outreach Director for the Hyde Park Project at the Center for American Progress Action Fund.

In their new ad, Harry and Louise – older and more mature than they were in 1993 – seem to go to great pains to stay neutral and avoid favoring either candidate’s position on health care. But despite their efforts to stay neutral, their new ad reveals one of the glaring flaws in John McCain’s radical health care plan.

In the ad, Harry mentions a friend who was recently diagnosed with cancer, but doesn’t have insurance. Under McCain’s plan, this “friend” would find it extremely difficult, even impossible, to get coverage.

Watch it:

Because his employer doesn’t cover him, the friend Harry describes has to shop for health care on the individual market, where he is at the mercy of the insurance companies. Under McCain’s plan, he would stay there, but he would have even less leverage to negotiate a fair deal for himself than he does now – because McCain’s plan would de-regulate the individual market, and give the insurance companies even greater leeway to deny people coverage or hike up their premiums even more.

Under McCain’s plan, the only option for Harry and Louise’s friend would be a high-risk pool – but in practice, high-risk pools have proven woefully ineffective at meeting the needs of people with cancer and other Americans in desperate need of care.

The friend in this ad may be fictional, but his crisis is not. In fact, there are 56 million Americans with chronic conditions who would be at risk of losing their coverage under McCain’s plan, and finding themselves in the exact same situation. Those 56 million Americans are very real – and so is the crisis they could face under John McCain’s health care plan.

Harry and Louise are back, but this time they’re saying that “the status quo is no longer an option.”

Fifteen years after falsely suggesting that President Clinton’s efforts to reform the health care system would undermine existing coverage and leave health care decisions in the hands of government bureaucrats, Harry and Louise — now “older and wiser” — are demanding that the next president “bring everyone to the table and make [health reform] happen.”

Watch both the 1993 and 2008 ads:

Former opponents of Clinton’s health reform locked arms with the plan’s proponents to finance the new ads, which will run on CNN, MSNBC, and Comedy Central during the Democrat and Republican conventions.

The effort is co-sponsored by the Cancer Action Network, American Hospital Association, The Catholic Health Association, Families USA, and the National Federation of Independent Business and is also supported by America’s Health Insurance Plans, the insurance industry front group behind the original advertisements.

AHIP President and CEO Karen Ignagni openly admitted her organization’s change of heart at the unveiling of the new ad and promised to “strongly support the coalition’s activity”:

This is a very different time [than 1993] and we are making a strong commitment…to work collaboratively [with this group].

In an exchange with the Dallas Morning News, McCain health policy adviser John Goodman admitted that McCain’s plan to give families $5,000 to buy health insurance would drive Americans into scantier coverage:

The tax credit “would not subsidize bells and whistles [marriage counseling, acupuncture, etc.] as the current system does,” Mr. Goodman said in an e-mail.

Goodman’s comments echo the McCain campaign’s false ‘caviar health care’ argument — which compares “Americans’ use of the health care system to shoppers who indiscriminately buy caviar while someone else foots the bill” — and fundamentally misrepresent the causes of rising health care costs.

Despite the campaign’s insistence that an over-reliance on “marriage counseling” and “acupuncture” is driving-up health care costs, the fact remains that 80 percent of the health care costs “are incurred by the sickest twenty percent of Americans, those whose doctors order expensive treatments for difficult diseases such as cancer” — “acupuncture” or “marriage counseling” are rarely prescribed.

In fact, with family insurance premiums exceeding $12,000, it’s unclear which services Goodman would be willing to trim to get to $5,000. Which half should go? Wellness and prevention programs? Cancer screening and testing? Maternity care?

But with McCain, “everything is on the table.”

After bitterly deriding so-called government-run health care on the campaign trail, Sen. John McCain (R-AZ) today vehemently defended the concept in a speech before the Veterans of Foreign Wars National Convention:

I will make sure that Congress funds the VA health care budget in a sufficient, timely, and predictable manner…I believe the VA should always be there to provide top-quality care for our veterans. And I believe that the VA should continue to provide broad-spectrum health care to eligible veterans, in addition to specialized care in areas such as spinal injuries, prosthetics, and blindness — services in which the VA sets the standard in medical care. [...]

They will not signal privatization of the VA. And they will not replace any scheduled expansion of the VA network — including those facilities designed to serve veterans living in rural and remote areas.

And while McCain’s warm embrace of the popular government health care program may have pleased the VFW — which opposes the senator’s Veterans Health Access Card proposal — his comments likely surprised audiences across America, to whom McCain delivered a different message.

In fact, throughout the campaign and in numerous Town Hall events, McCain has consistently claimed that government involvement in health care sacrifices “the most essential value of American lives– freedom”:

- We’ve got to have incentives for people to make their own decisions about their own health care. Families should be making the decisions and not government. [Town Hall in Denver, 7/7/2008]

- We’ve had hours and hours of discussion on health care, but to sum it up, I want the families to make the choices on health care in America, and not the government. Thank you. [NALEAO Conference, 6/28/2008]

- I offer a genuinely conservative vision for health care reform, which preserves the most essential value of American lives — freedom…In health care, we believe in enhancing the freedom of individuals to receive necessary and desired care. We do not believe in coercion and the use of state power to mandate care, coverage or costs. [Des Moines, 10/11/2007]

Unfortunately, McCain, who has himself benefited from government-funded health services, is trying to have it both ways on health care.

Sen. John Cornyn (R-TX) is disputing the Houston Chronicle’s characterization of his claim that the Texas health care system — despite having the highest uninsured rate in the country — should serve as a model of reform:

Needless to say, the headline did not accurately reflect Senator Cornyn’s views…Instead, while relating several reasons why Texas’s economy is in better shape than most other U.S. states, he mentioned the 2003 law reforming medical malpractice law in Texas [Proposition 12]. Since its passage, doctors and medical school graduates have been flocking to Texas, providing health care services in underserved areas and improving patient access in others.

But as the Boston Globe points out, even as “doctors move into Texas in far greater numbers, they tend to locate in the same urban areas – undercutting one of the strongest arguments for Proposition 12.”

Indeed, while the number of physicians practicing in Texas has increased, “under-served areas” remain under-served:

During debate over the proposition, proponents of cutting jury awards in malpractice claims argued that “malpractice laws were responsible for shortages of doctors in rural” and specifically highlighted “152 counties that did not have an obstetrician.” But as of September 2007, “the same number of counties remains without one… [and] 124 counties have no obstetrician, neurosurgeon, or orthopedic surgeon.”

On Thursday during an interview on Fox News, Neal Cavuto took McCain Senior Economic Adviser Douglas Holtz-Eakin to task for dodging simple questions on McCain’s economic plan:

CAVUTO: We have a candidate who claims that his opponent, his Democratic opponent, is a tax-hiker. Yet, we have a candidate, in your guy, John McCain, who cannot account for his spending with the aggressive tax cuts he`s planning. Which goes? Which is real?

Watch it:

Cavuto is right. On issue after issue, McCain’s campaign is trying to have it both ways:

– McCain wants “everything on the table” to fix social security, but says any slight tax increases on the rich are “out of the question.”

– McCain’s health care plan is either a budget busting expenditure or a tax hike on the middle class, but his campaign insists it’s neither.

– McCain’s tax cuts for corporations and the wealthy would blow a hole in the deficit, but McCain promises to balance the budget by 2013.

As Douglas Holtz-Eakin went on the attack instead of explaining his candidate’s plan, Cavuto shouted “I’m begging you to stop.” We know how you feel, Neal.

Acid reflux, a benign condition which afflicts about 50 percent of infants, can exempt otherwise healthy babies from coverage in the individual insurance market place, the Pittsburgh Post Gazette reports.

Consider the story of Cecilia Kownacki, a 7-month old baby (pictured on the right), who was denied coverage by a Pittsburgh insurer because she was unable to digest milk and often spit up:

Cecilia Kownacki found out the hard way. The denial letter from Highmark arrived last month: “Dear Ms. Kownacki: [We] are sorry to inform you that your application does not meet our underwriting criteria for approval,” the letter said…Her parents, Frank and Susan Kownacki, were considerably more distraught. Their baby daughter was uninsured, starting Friday.

“When we got the rejection letter,” said Mrs. Kownacki, of the North Side, “I was in tears.”

[...] whether you’re 70 years old or 7 months young, when you move away from one plan and try to enroll in an individual plan, you can be subject to health screenings if you want to enjoy a low-premium policy.

Unfortunately, Cecilia is not the exception; nearly 90 percent of people seeking coverage in the individual market “never end up buying a plan, finding it either very difficult or impossible to find one that met their needs or is affordable.” From a recent Commonwealth study:

In “most states, individuals with preexisting conditions are denied coverage, have conditions excluded, or face much higher and often unaffordable premiums.” Insurance companies will disqualify patients from coverage for undergoing caesarean sections, or “for just taking certain medicines because of the possibility of future costs, including common drugs as Lipitor, Zocor, Nexium, and Advairpre.”

As Julia Eisman of Stand Up For Health Care notes, “when the insurance company practice of cherry-picking the healthiest among us is so picky not even baby Celia can get coverage, there’s something wrong with this picture.”

Our guest blogger is James Kvaal, a Senior Fellow at the Center for American Progress Action Fund.

Earlier today, McCain advisor Douglas Holtz-Eakin answered critics of McCain’s health care plan, who say it could raise taxes on millions of middle-class families. He said:

[The McCain plan] is a transformation of the tradition of a tax subsidy to private insurance to make sure that subsidy is fair, both in the sense that it is available to every American regardless of the source of their private insurance and that every person gets the same amount — $5,000 for a family, $2,500 for an individual. The Obama campaign has chosen to characterize only one piece of a comprehensive health care reform as a tax policy and thus try to hit John McCain with it. It is classic political rhetoric at odds with the reality of dealing with an important problem, like the underinsured in America.

Actually, considered as a whole, McCain’s plan will raise taxes on millions of workers for two reasons. First, his plan would tax workers’ health benefits, which are largely tax-free today. Although he also creates a new tax credit for insurance premiums, many workers will pay more in taxes on their insurance then they get from the new credit.

Second, the value of McCain’s credit will erode quickly. While health care premiums are expected to grow by 7 percent a year, McCain’s credit will increase by only about 2 percent a year. In contrast, current tax benefits keep up with rising premiums.

More details on the tax implications of McCain’s health care plan are available here.

On Tuesday, Sen. John Cornyn (R-TX) claimed that “Texas is a national model for improving access to health care because it limited lawsuits against doctors”:

We have created greater access to quality health care in Texas…How did we do it? Well, we passed Proposition 12…So, you have to understand what I mean when I say I want to make Washington, D.C., and the rest of our country more like Texas [because], frankly, we know the policies that actually work.

But Texas, which has the highest uninsured rate in the nation, is hardly a model of “quality health care.” In fact, if the national rate were the Texas rate, 29 million more Americans would lack health insurance.

As the Houston Chronicle points out, “malpractice issues are a small scab on Texas’ ailing health care system. The cancer is the number of uninsured. Increasing the number of doctors and specialties only does so much good when many Texans can’t afford to make an appointment.”

Indeed, despite assurances that malpractice reform would improve access to health care, after voters approved Proposition 12 in September 2003, little changed:

- 25 percent: or 5.6 million Texans are uninsured, the worst rate in the nation.

- 35 percent: of small businesses in Texas offer health insurance.

- 54 percent: of Texans under 65 have employer-sponsored coverage, “8 percentage points below the national average.”

- 48th in health care quality and efficiency: on the Commonwealth Fund’s State Scorecard “avoidable health costs” dimension – a measure that speaks to efficiency within the health care system.

- 1.8 percent: increase in direct care physicians between 2004 and 2006, “which is slower than it was pre-Proposition 12.”

For his part, Cornyn received a score of 0 from the American Public Health Association (APHA) (indicating an anti-public health record), initially voted against legislation that would have blocked a scheduled cut in the reimbursement rates of physicians treating Medicare patients and “was among 18 members of the 100-member Senate who opposed a huge expansion of the Children’s Health Insurance Program.”

Unfortunately, Cornyn doesn’t “know policies that actually work.”