Dear Senator Johanns

Senator Mike Johanns (R-NE) sent an email message to those who have communicated with him.  In the message, he outlined the reasons why majority rule and an up or down vote on healthcare is a dangerous thing. This was my caustic reply.

You are badly misreading the American public if you believe we have turned against healthcare reform.  Large majorities of Americans want an end to pre-existing condition exclusions and rescissions.  To do that requires all of us to be covered. Universal coverage requires subsidies for those who cannot afford coverage.  America needs the health reform bill to become law.   My friend (name redacted) needs the health reform bill to become law.  Her COBRA coverage expires in September.  She is currently being treated for thyroid cancer, and is out of work.  She has no prospects for being able to buy individual health insurance at the age of 57 with a cancer history, even though she has had health insurance for her entire life.  America can do better than leave a 57 year old woman with cancer uncovered when she is most in need of coverage.

We desperately need to slow the growth in healthcare spending, which, as Warren Buffett has pointed out clearly, is making our nation uncompetitive in the world.  All of our competitors have much lower health costs as a percentage of Gross Domestic Product (GDP).  We spend more than anyone else in the world (17% of GDP) to have the 37th best health system in the world, which is not as good as Costa Rica, and is only incrementally better than Slovenia. Meanwhile, Japan, with the 10th best health system in the world spends only 8.2% of GDP on healthcare; Germany, with the 25th best health system spends but 10.7% of GDP on healthcare, the United Kingdom, with the 18th best health system spends only 8.2% and France, with the world's best healthcare spends only 11.2% of GDP on health.   Healthcare costs are a cancer that is destroying our ability to compete in the world, and to recover from the Great Recession.

The Republican Party is standing in the way of what is best for America. So I completely disagree with your party-fed talking points that reconciliation is a bad way to pass refinements to healthcare reform. In case you have been asleep, the bill passed the Senate on December 24.  All that remains is to reconcile differences between the House and Senate versions.  Since that involves primarily financial issues, it is a completely acceptable way to deal with the intransigence of the Republican Party. 

I fully support reconciliation as an effective means to get health reform passed.