I have written to both my Senators and my Congressman to express my opinions regarding the Healthcare Reform Debate.  Today I received an email reply from Senator Jeff Merkley (D-Oregon since 2008).  First, I applaud Mr. Merkley for responding.  Neither my Senior Senator, Mr. Wyden, nor my Congressman, David Wu, has taken the time.  Though I am aware that this is a form letter prepared and sent by a staffer, I’m impressed that Mr. Merkley at least made the effort.  What does not impress me is the content of the letter.  Below I reprint the letter with my notes in (parentheses and bold).


Dear Tom,

(I have asked a staff member to send you one of my letter templates to acknowledge receipt of your letter on 7-23)

Thank you for sharing with me your concerns about health care reform. (good start) As my colleagues and I debate this important issue in the United States Senate, I value knowing your thoughts. (If I get a slew of similar input, my staff will tabulate it.  If it looks like I am on the wrong side of this issue and it could endanger my reelection in five and a half years, I may modify my position which, frankly, is just the position I must take to retain my power as a Democrat in the Senate.)

I have serious concerns about our nation’s health care system.  With health care costs spiraling upwards the number of uninsured Americans without access to basic health care services continues to grow.  It has become increasingly difficult for working families to pay for doctor visits and essential medicine.  According to the Kaiser Family Foundation, over half of American households cut back on health care due to cost concerns last year.  Of the 50 million uninsured Americans (This line drives me nuts.  It is used over and over, again and again by everyone who wants to sell you on the government controlling all healthcare in our country.  If, by “Americans”, he means citizens, then he is already about 12 million high in his estimate.  There are at least that many resident aliens in that count.  Statistics that I have read indicate that over 15 million of these are people who have made the choice to do other things with their money.  That alone adds up to 27 million of the 40 to 50 million that you hear quoted by Mr. Obama and others selling government control of healthcare.  It also makes the assumption that everyone should have basic health care services.  I think everyone would be better off if they had three healthy meals a day but it would be pure folly to legislate that.) , eight out of ten come from working families (What does “working families” mean?  Does he mean that those people have jobs but are not covered by some sort of healthcare system?). Even those with health insurance have suffered due to the high cost of medical care. Sixty percent of bankruptcies in the United States are due to health care costs, even though seventy-five percent of those individuals had health insurance. (This was written to drive me nuts again – the 60% number is actually 62.1% and it represents the total of bankruptcies that were contributed to by any of nine different factors related to medical costs, according to one badly flawed study.  The study, which I think is highly biased with the intent of showing medical costs as the cause of bankruptcies, can be seen here.  I have printed at the bottom of this post the table from which the 60% number is taken (by those who want to control your medical care)).

The American business community is also adversely affected by rising health care costs. Large American corporations are becoming less competitive internationally due to the large financial burden of providing health care coverage for their employees (Don’t mention anything about the Union and Government driven increases in what must be offered and covered by insurance.  Don’t mention that about half the cost of healthcare insurance today (that is my estimate) would go away if the government would get out of mandating coverages just to pay back the lobbies that contribute heavily to their election campaigns). Even more concerning, however, is the crippling economic impact on the backbone of our economy, the American small business. The current economic crisis has forced one in three small businesses to cut health care benefits in order for their businesses to stay financially afloat.  (Talk about deceiving with statistics – please show me the studies that show that one in three businesses would not be in business had they not reduced their healthcare benefit expenditures.)

I believe we must take action to address this situation. However, I recognize that there are many people in Oregon who are content with their current health care coverage and are concerned about future changes to the health care system.  For this reason, I worked with my colleagues on the Senate Health, Education, Labor, and Pensions Committee (HELP) to address these concerns. The comprehensive health care reform legislation, the Affordable Health Choice Act, approved by the HELP Committee would ensure that those who are happy with their health coverage would be able to keep their insurance. (for how long? Just read section 102 of the House version of the current healthcare reform act (printed below and available at this site) and tell me if you think you will be able to keep your current plan for 5 more years….or one more.  It reads to me that the intent of allowing grandfathered plans is only to sell this plan.  The grandfathered plans must conform to the Federal plan or they can no longer be offered.  In my view that means, ‘you can’t keep your old plan.’) Additionally, the act would help lower costs through stronger prevention and disease management, better quality of care (evidence please.  “Better,” as in the USPS does a better job of delivering packages than UPS or public schools do a better job of educating than private ones?), use of information technology, and protection from fraud and abuse (Is it not true that Medicare billing is typically thought to be as much as 25% fraudulent claims?). The legislation also increases choice of health insurance coverage by creating a new affordable marketplace where both private and public plans are available for individuals and small businesses (and from a first reading of the House version of the bill, all must have most of the ridiculous mandated coverage that has driven the cost of healthcare to its current heights.  It also appears that whatever ‘private’ offerings are available, they will be tightly controlled by the government or in my view, not private at all).

Health care touches everyone and people have very different perspectives on how to best tackle the health care crisis.  It is valuable for me to hear those different views and I appreciate your taking the time to contact me.  Oregonians can always expect me to listen to their concerns and be honest and straightforward with my answers (if your above letter is an honest reply, you must be exceedingly careless not to notice the major flaws in the arguments and data you present.  Either your reply is disingenuous or you are not interested enough to adequately represent our State in the Senate.) I hope you will continue to keep me informed about the issues that matter most to you.

All my best,

Jeff Merkley

United States SenateMerkley

Attachment 1

Table 2 Medical Causes of Bankruptcy, 2007*

Percent of All Bankruptcies

Debtor said medical bills were reason for Bankruptcy – 29.0%

Medical bills $5000 or 10% of annual family income – 34.7%

Mortgaged home to pay medical bills – 5.7%

Medical bill problems (any of above 3) – 57.1%

Debtor or spouse lost 2 weeks of income due to illness or became completely disabled – 38.2%

Debtor or spouse lost 2 weeks of income to care for ill family member – 6.8%

Income loss due to illness (either of above 2) – 40.3%

Debtor said medical problem of self or spouse was reason for bankruptcy – 32.1%

Debtor said medical problem of other family member was reason for bankruptcy – 10.8%

Any of above 62.1%

*Percentage based on recent homeowners rather than all debtors.(my emphasis) (Ttoes note – this little asterisk by itself invalidates this entire ‘study.’ To choose the people who are recent homeowners only for this survey is stupid or intended to gain the highly deceptive result they got.  By choosing the new homeowners who have filed bankruptcy, those who devised this survey/report were selecting people who have proven they can’t handle money.  A very large number of the bankruptcies were for owners of homes where the new owner borrowed more than the value of the home, bought a home above their means, and in all other ways were living beyond their means.  If it took only $5,000 in medical bills to put them into bankruptcy, in my view, the medical bills were not the reason for the bankruptcy.)

Attachment 2.


(a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term `grandfathered health insurance coverage’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:


(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

(B) DEPENDENT COVERAGE PERMITTED- Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.

(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.

(3) RESTRICTIONS ON PREMIUM INCREASES- The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.

(b) Grace Period for Current Employment-based Health Plans-


(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.

(B) EXCEPTION FOR LIMITED BENEFITS PLANS- Subparagraph (A) shall not apply to an employment-based health plan in which the coverage consists only of one or more of the following:

(i) Any coverage described in section 3001(a)(1)(B)(ii)(IV) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).

(ii) Excepted benefits (as defined in section 733(c) of the Employee Retirement Income Security Act of 1974), including coverage under a specified disease or illness policy described in paragraph (3)(A) of such section.

(iii) Such other limited benefits as the Commissioner may specify.

In no case shall an employment-based health plan in which the coverage consists only of one or more of the coverage or benefits described in clauses (i) through (iii) be treated as acceptable coverage under this division

(2) TRANSITIONAL TREATMENT AS ACCEPTABLE COVERAGE- During the grace period specified in paragraph (1)(A), an employment-based health plan that is described in such paragraph shall be treated as acceptable coverage under this division.

(c) Limitation on Individual Health Insurance Coverage-

(1) IN GENERAL- Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.

(2) SEPARATE, EXCEPTED COVERAGE PERMITTED- Excepted benefits (as defined in section 2791(c) of the Public Health Service Act) are not included within the definition of health insurance coverage. Nothing in paragraph (1) shall prevent the offering, other than through the Health Insurance Exchange, of excepted benefits so long as it is offered and priced separately from health insurance coverage.