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AMERICAN POLITICAL HEALTH HISTORY

The Trump Impeachment - President Trump has been impeached by the House of Representatives on the slimest of of testimonD and allegations. What is clear is that the Democrats will never work with this President on health care. impeachment was a game changer for us, becuase we previuosly thought that reason may eventually prevail in health reform. It will not. So, there is no way for us to get health reform unless and until we vote to let Republicans take back control of the House, keep control of the Senate and we re-elect President Trump for another term in office. 

A Political History Summary -  The preamble of the U.S. Constitution says in order to form a more perfect Union, We the People declared that we would allow our governement to promote our general welfare. This is the CONSTITUTIONAL IMPERATIVE. In accordance therewith, the Mission Statement of our Health and Human Services Department (HHS) is to Enhance and Protect the Well-Being of All Americans by providing effective health and human services and fostering advances in medicine, public health, and social services. These commitments form the core of our National Policy on health care.

Our government functions to reconcile the differences we may have in the support of our constitutional responsibilities. On a bipartisan basis, we have made great progress in improving the health and well being of the people. In 1945, after the Second World War, Democrat President Truman was the first President to propose a national health plan. He was unsuccessful. In 1965, Democrat President John F. Kennedy also made an unsuccessful attempt to get a national health care program for seniors. After Kennedy’s assassination, Democrat President Lyndon B. Johnson was able to expand a modest program we had for military dependents into the beginnings of the Medicare program for seniors that we have today.

The Democrats worked with Republicans in 1973 when Democrat Senator Edward M. Kennedy sponsored the HMO Act that was signed into law by Republican President Richard M. Nixon. The bill authorized the first federal governement contracts with Health Maintenance Organizations (HMO's). The goal of this legislation was for the federal governement to save money in the administration of Medicare. It was followed by The Tax Equity and Fiscal Responsibility Act (TEFRA) in 1982, sponsored by Democrat Pete Stark of CA and signed into law by Republican President Ronald Reagan. TEFRA was a big deal. It closed some tax loopholes to stem a rapidly increasing budget deficit but the most important thing it did was to create Medicare + Choice demonstration programs (which were the first Medicare Advantage plans). Again, the key goal was for the federal governement to save money in the administration of Medicare. These programs later blossomed full flower into the Medicare Advantage plans we know today under the 1997 Balanced Budget Act, which was introduced by Republican John Kasich and signed into law by Democrat President Bill Clinton.

But before that, Democrat President Bill Clinton, who had campaigned heavily on health care, shocked the nation in 1993 by putting the First Lady, Hillary Rodham Clinton in charge of a task force to reform our health insurance system. At the very end of her effort, Hillary proposed to name her health plan MEDICARE PART C. Thus, was born the concept that our Medicare Program could be expanded beyond Medicare Parts A and B, into a new arena of universal health insurance coverage under this banner on Medicare Part C. After Hillary Clinton's efforts narrowly failed and as a result of the success of the HMO Act and TEFRA, managed care took off. Medical care providers and health insurance companies rapidly expanded managed care services throughout the nation. The national health care annual rate of inflation, which was routinely in double digits annually when Bill Clinton came into office, were reduced to single digits. And, the public pressure and congressional interest in health reform subsided for another twenty (20) years. But, Medicare Part C was born.

It is astonishing to realize that every single major piece of federal governmental health legislation since President Lynden B. Johnson first created Medicare, has been enacted for the principal purpose of SAVING the American tax payers money by reducing the amount we needed to spend on the Medicare program! This is why Congress created the Medicare Advantage plans. You would think that eventually we Americans would wake up and realize that our national political health history shows that we were working toward the right answer all along! And, we have been doling it by sponsoring and passing federal legislation that made Medicare more affordable, in a bipartisan collegial manner. This is the tradition that we need to continue. Obamacare and "Medicare for All" are just steps to bring us the the right answer, which is MEDICARE PART C - A MEDICARE ADVANTAGE FOR ALL that will reduce our National Health Care GDP to the lowest of all the developed nations of the world.!

Enter Democrat presidential candidate Hillary Rodham Clinton, in her now infamous 2016 campaign, in which she claimed that Obamacare was called Hillary Care before it was called Obamacare! She was right. In 2009, the First Lady Hillary Clinton supported a Public Option which was in the House of Representatives version of the original Obamacare / ACA Bill. That provision was subsequently stripped out of that Senate bill at the last minute by Democrat Senator Joseph Lieberman of CT, because they thought it was too close to traditional Medicare and would confuse people. In 2016, Hillary "again" supported a Public Option in her primary race for President against Senator Bernie Sanders. Senator Sanders was then, and still is today, the campaign of “Medicare for All.” Both Bernie and Hillary are both on the right track!

Ever since Medicare was enacted, Congress has been trying to get the cost of the program under control. The creation of the Medicare Advantage plans, twenty (20) years ago was an important part of that effort. These Acts of Congress which shaped the Medicare program, as you can see by the political history, were enacted with broad bipartisan support. The Medicare Advantage program still benefits from strong allegiances on both sides of the aisle. The challenge that the American electorate faces today is how to take the next big step in the development of the Medicare program. The Medicare-Advantage-For-All family believes that the United States of America does not need MORE THAN FOUR (4) PARTS to OUR MEDICARE PROGRAM. We are the innovators, are we not? We Americans create and deliver the best health care the world has ever known. Our Medicare Program already has a FOUR (4)Parts. Now it is our job, and indeed that most critical business for our life, liberty and future success, to figure out how to make these FOUR parts work to give us BETTER HEALTH and BETTER HEALTH INSURANCE. We, the electorate, must motivate our officials to accept our uniquely American health care system and give WE THE PEOPLE  the health and health insurance that we deserve. How many Parts of Medicare does it take to change the health care "light bulb" in Congress? They need to call the experts. And, that is one of the things Representative Primala Jayapal and Senator Bernie Sanders are doling with their Bills.

The next Congressional Act should be to re-engineer affordable universal Medicare Advantage Plans for All Americans. This is the last and greatest piece of our Truly great American health care system mosaic that should be the burning desire of both political parties to complete. See Edition Five of the True American (May, 2019) for the details of the Legislation we require.

TRUMP MEDICARE ADVANTAGE PLAN FOR ALL

The HMO Act sponsored by Senator Edward M. Kennedy was a brilliant piece of legislation that materially improved the health and well being of All Americans forever. He sponsored that legislation because Harvard Medical School had pioneered on e of the first medical organizations dedicated to the concept of health maintenance. This was new way of insuring and managing health care for people. The Harvard Community Health Plan (HPHC) was founded in Cambridge, MA in 1969. It's medical practice mirrored successful medical clinics like the Mayo Clinic in Rochester, NY in 1889 and the Lahey Clinic in Boston, MA in 1923. For first time in the United States, HPHC offered medical care to the general public in an health insurance product. This was re-structured group medical practice, under one roof, coordinating a rubric of practices and protocols that would later become known as Health Maintenance Organizations (HMO). Later this style of medical practice would form the basis for managed medical care. At the time, the insurance product was considered revolutionary but in reality it was more of a metamorphosis of the existing group practice of medicine being packaged in an insurance product.

This was a lot cheaper in those days. A fully comprehensive group insurance contract offering coverage for 100% of all health care expenses for a Family Membership cost $64.00 a month in Boston, MA. Although this type of insurance product is no longer available, HCHP is still in business. It has grown to become the Harvard Pilgrim Health Plan which is one of the largest and most successful Health Maintenance Organizations (HMO) operating in all of the New England states. Todays monthly Family Membership for that old 70's insurance product would be more like $1,400 per month.

LOOK AT THE HISTORY OF THE PENSION PLANS: Traditional Medicare can be compared to the old Defined Benefit Pension Plans that dominated (60%) of the pension market in the early 1980s. Now, these Plans represent only 4% of the pension plan market. They have been replaced by Defined Contribution Pension (401k) plans, in the same way, that Medicare Advantage Plans are replacing Traditional Medicare. Medicare-Advantage-For-All (MAA) is the next generation of Defined Contribution health insurance reform that we must embrace in the United States. This is not because the traditional Defined Benefit Pension Plans were bad. It was because the 401k Plans are better. They are more affordable. They appeal to more people. They offer Americans more investment choices and flexibility. They can be financially sustained by businesses that offer them. And, the money is segregated so employees can rely on 401k plans in the long run and they have a personal stake in the program.

Medicare Advantage For All Plans (MAA) are just like these new 401k Defined Contribution Pension Plans which are the standard way in which almost all retirements are managed today. MAA will be designed with the latest New Paradigm medical protocols, supported by the most up to date reimbursement practices and an integral health and wellness component. The principals of Predictive Preventive Personalized Medicine (PPPM) will be supported and rewarded. This will allow medical practitioners to begin to adjust their practices to support more patient education, early intervention, monitoring and maintenance. Health and wellness will be built into the insurance program such that participation in these plans will naturally improve a person health. This is the first generation Defined Contribution health insurance product which we can extend to All Americans before the end of this century (2020).

 TRUMP MEDICARE ADVANTAGE :The Trump  Medicare Advantage Plan will be the second genenration health plans to respond positively to those people who are willing to take an active role in improving and maintaining their health with tangible insurance benefits. Just like the Health Maintenance Organizations (HMO) of the 1970's, the people that choose these plans will get more benefits and pay less for their health insurance. The Apollo Medicare Advantage Plans will be the ultimate Defined Contribution health plans of the future. These plans will have the latest innovative design that allows the health benefits to respond to the person choosing to buy the plan. Just like Defined Contribution pension plans, depending upon which plan one chooses and how much one is willing to put into it; will determine how much one pays for it and how much they get out of it. The more you are willing to put into it, in terms of effort, time, health maintenance and life-style changes, the more you will get in terms of health benefits and how much the plans will cost.

Alternatively, the Defined Benefit Health Plans, like tradional Medicare and Obamacare will not adjust to your health status, your exercise routine or your diet. Those people that buy the traditional Defined Benefit plans will continue to pay insurance benefits regardless of their health. Everyone in these plans will be charged the same premiums and the healthy people that have these plans will be making contributions to the plan that are going to be directed to pay for those people who are sick. No matter how much more you put into that plan, you will never get any more out of it.

And, as an American consumer, you will be free to choose the plan that is best for you (REALLY). Both Medicare plans and our Pension plans are now conscientiously and scrupulously regulated by the federal government and that will continue. The states will continue to regulate the medical profession and the insurance companies in their states. All of these products will be safe, sound and reliable. Coverage for all health care services will be state regulated and coverage will vary from state to state. Apollo Medicare Advantage is the New Paradigm in health insurance that can be made into a program to cover All Americans today.

CURRENT POLITICAL CLIMATE ON HEALTH CARE

In 1909 Congress passed Obamacare by one vote. President Obama promised the American people repeatedly that if they liked their health plan, they could keep it. He promised it would save money. Both claims were supported by the CBO and they proved to be false: million of Americans, the vast majority of whom were happy with their plans, lost access to them. In 2018 Congress failed to repeal Obamacare, also by one vote. our political parties are deeply divided amongst themselves and between each other over this issue. Obamacare enrolled over 13 Million people and has become the most expensive health plan on the planet earth. Enrollment is down to 8.4 Million and the rate increases have been 105% over the last four years. The ACA did get about 10 Million people onto Medicaid but in 2019 we have 30 million American without health insurance and that number is expected to grow to 35 Million by 2030. National Health Care cost are out of control. The NHC-GDP is 18% at $3.65 Trillion Dollars and is projected to increase by 5.5% annually.

We are a divided people and we have a divided Congress. The house and Senate leadership favor amending Obamacare. Progressive Democrats favor Medicare for All and Republicans are still searching for an acceptable alternative that will be fiscally responsible. Before the end of this decade, the American people will find it necessary to have real health insurance reform that gives everybody the security of knowing that when they get sick, they will be able to get the professional help they need to get better. Their biggest fear is not knowing how are they going to get the health care they need and how much they are going to have to pay for it? We Americans want direct and immediate access to the best health care in the world! This should be the highest priority of the every representatives we send to Washington D.C. on both sides of the aisle.

As Susannah Luthi recently wrote in Modern Healthcare, "In appealing to the Democrats' moderate wing, the healthcare industry is relying on the electoral maps of 2018 and 2020 almost as totems to ward off momentum for single-payer and focus instead on more industry-friendly and less controversial ACA fixes. That approach has the support of the moderate New Democrat Coalition, now more than 100 members strong, and the group's centrist healthcare task force. (The progressive Medicare for All caucus has nearly 80 members.) “I think realistically if you're looking at the House, Democrats know that in order to protect their seats in 2020 we absolutely need to keep a centrist, moderate message,” one lobbyist said. She noted that the Democratic House pickups from 2018 track with the Electoral College map the party needs to win for 2020: largely moderate districts that could easily swing red."

A majority of Americans polled in 42 States think Medicare for All is a good idea. But, in the very same polls, a very clear majority of them do NOT want their taxes to increase in order to pay for it. A Kaiser Family Foundation survey finds that a majority of Americans would oppose Medicare for All by a margin of 60 to 32 if it threatens the current Medicare program. The Heritage Foundation has done some recent citizen forums in battle-ground states that show a striking lack of knowledge as to what the Democrats are actually proposing. Basically, the American public and some of the politicians that represent us, have little or no real understanding of what they are proposing, how it would work and how it works in other developed nations of the world.  Senator Bernie Sanders and Primala Japapal's Medicare for All Bills have required the "Secretary" of Health and Human Services to (be the magician) work out the details?

U. S. SENATE: To take a Page out of Senator Bernie Sanders proposed legislation, We at Medicare-Advantage-For-All. Com want Congress to pass legislation that immediately authorizes the Secretary of Health and Human Services, to within six (6) months, consult with all of the relative Departments, Agencies, and entities of the federal governement and all the immediately applicable interests and entities of our private health care economic sector to derive a plan. The "Secretary" is then to report back to Congress on the rules and the necessary criteria for extending Medicare Advantage to ALL Americans in an affordable, accessible, universal and feasible fashion. Such Report must contain a firm and reasonable proposal and time frame for implementation. The Report must be debate-ready to allow Congress to debate and act in a timely fashion, in accordance with and recognition of the provisions of the Constitution of the United States of America.

Universal Health insurance is viewed by many as a litmus test for Democrat presidential hopefuls and Elizabeth Warren, Cory Booker, Kamala Harris and Kristen Gillibrand and 10 other Senators immediately signed on as co-sponsors of Bernie Sanders newly introduced Medicare For All Senate Bill. There are 63 National organizations, including some major Unions that have endorsed the Sander's Bill. All of the Democrat presidential hopefuls raised their hands in the first primary debate to support health care for illegal aliens. Just the introduction of Bernie's newest Bill handily sliced-off over 40 Billion Dollars in health insurance company market share stock values in April 2019. The democratic leadership, inclding almost all of the party whips are still in favoe of preserving some role for private inursurance in the mix of alternativesw to improve the system. The insurance industry is generally in favor of shoring up the Obamacare, balancing the risk pool and increasing the federal funding for the program. The Presdient is also focused on the politics of the issue going into his 2020 re-election bid and has consistently advocated improving in the programs for All Americans. The Republicans are in a holding pattern, prudently waiting on the United States Supreme Court decision on laws suit started in Texas challenging the constitutionality of the Affordable Care Act. Why amend something that will be struck down by the Courts? Most legal pundits believe the Supreme will uphold the ACA. WE at Medicare-Advantage-For-All, we firmly believe just the opposite. In 2020, the Affordable Care will be found unconstitutional and the law itself will be struck down. The obvious next question is, "What do we do then?"

TRUMP MEDICARE ADVANTAGE FOR ALL: The intent of the Democrats Medicare for All legislation is single payer, which Republicans have characterized as Socialism. We have a pretty firm estimate that Senator Sander's "Medicare for All" Plan will cost the nation $32.6 Trillion Dollars over ten years, under current circumstances and that would destroy Medicare as we know it today. This amount of money handily exceeds the current U.S. national debt level. This program is un-sustainable. We can not simply "just pay for it" as the Honorable Alexandria Ocasio-Cortez (AOC) has suggested, because we just simply can't afford it! The current Medicare Trust Fund, which pays for the Medicare for 59.8 Million American seniors, is actually rapidly running out of money as it is. The OASDI (Medicare Trust) Fund Actuaries have predicted that the program will be bankrupt in 2026. Before it goes bankrupt, we will need to come up with a plan for additional funding for Traditional Medicare under current circumstances. The CBO just issued a extensive Report in May 2019 on a Medicare For All type single-payer health care system, concluding the shifting the U. S. to a governement-run program would likely lower administrative costs but increase wait times and reduce access and quality of health care for the American people.

The trump Administration continues to work aggressively to lower the cost of prescription drugs, fight the Opioid Crisis and reduce unnecessary and harmful federal regulations. They remain committed to replacing Obamacare with a State Block Grant solution and the President and the Republican leadership has pledged to continue coverage that will ensure that Americans with pre-existing conditions have access to care. Whatever we do; Medicare-Advantage-For-All can be a stable transition from the ACA, even if it is just consumers making a better decision as to how they want to spend their money. Our Medicare-Advantage-Plan-For-All should peacefully co-exist with the ACA, so there will be no need to repeal Obamacare. If the law is found to be unconstitutional; some hitherto unconsidered compromises to the replacement programs may be possible.

The one exciting thing about all of this is the fact that the Democrats are all fired up. They may not believe it, but this may be their best hot button political issue going into 2020. Nancy Pelosi is committed to helping the Democratic party continue to connect with voters on health care. They are doing things; introducing bills, engaging the American people and advocating change. Despite the potential affordability issue with "Medicare For All" remains an important focus for the party. Senator Bennet (D-CO) and Senator Tim Kaine (D-VA) have also introduced Medicare X Choice Act (which is Obamacare on steroids) and several other democrat proposals include "Medicare Buy Ins". Elizabeth Warren's has introduced legislation to change insurance plan MLR's, which is inflationary.  Cory Booker says he supports Medicare for All but that he would be a pragmatist in "steering" U.S. health reform, if elected. I think this is code for a continued role for private insurance. To listen to Senator Chuck Schumer talk about health care reform is like listening to most Republicans. There are a lot of ideas floating around, Medicare-Advantage-For-All being just one of them.

Kamala Harris is most concerned about universal access to health care, which is also a critical key objective. The California Senator is rolling out her "Medicare for All" proposal ahead of the Presidential detail debates, the week of July 29th 2019. Politico Pulse headlined KAMALACARE -- Effectively creating "Medicare Advantage for All": Harris would allow private insurers to participate in her system, invoking the popular MA program that currently  covers about one-third of the Medicare Beneficiaries. As a result, Americans would be able to choose between a public plan and a certified Medicare plan. This is the most significant endorsement of our proposal for Medicare-advantage-for-all.com to date.

But, ALL of the other proposals (except Kamala's) do not have is a twenty year history, a solid track record improving the health of their members, saving the federal governement and the American tax payers tons of money. The biggest thing that our proposal has that NONE of the other proposals have is our Medicare- Advantage-For-All with an integral health and wellness component gets at the root cause of the high cost of health care which is the need improving our health. The health care savings that can reasonably associated with this program will more than pay for the cost of the program. Medicare Advantage has 22.6 Million Americans enrolled in the program. It is the fastest growing health insurance program in America! No other program can beat that, and in fact, no other program can even come close!

The Pew research Center's Alec Tyson recently released a study of Partisan Politics, which was reported in "Fact Tank" on June 19, 2019. What he learned was Republicans think the Democrats should be listening to their positions and cooperating with them. Democrats think that Republicans be listening to their positions and cooperating with them. And, each party does not think it should give in to the other party on anything. A sizable majority of all adults (68%) say it is very important that elected officials treat their political opponents with respect, but less than 50% of both Republicans and Democrats believe it is "very important" for elected officials to make compromises. With this kind of caustic atmosphere, we will NEVER get anything constructive on anything accomplished for the good of the (We the People) country, and that incudes healthcare.

U. S. HOUSE OF REPRESENTATIVES: On the House side, former Representative John Conyers (D-Mich.) introduced H.R. 676 every year since 2003. Consequently, this Bill is the most important House Bill. It essentially accomplishes many of Senator Bernie Sanders key objectives. From the beginning, the goal of this bill was to create a Big Governement non-profit entity to handle a universal single payer health care system for all. H.R. 676 has traditionally had an impressive array of powerful democrat endorsements and in the 115th Congress, Seventy-Seven (77) members were formerly signed on as co-sponsors . Representative Keith Ellison (D- Minn.) took over responsibility for H.R. 676 - the Expanded and Improved Medicare For All Act, which was under consideration of the 115th Congress (after John Conyers was forced to resign). In the 116th House of Representatives progressive Democrats Ro Khanna from California and Pramila Jayapal of Washington State are the leading Representatives proposing a new "Medicare for All" program, which Pramila was quick to point out, goes well beyond the original eight page Conyers H.R. 676. The new Bill, H.R 1384 has picked up well over 100 Democrat sponsors. There are so many sponsors that just listing them all takes a full page of this Bill. The plan was introduced in March and has just had it's first Hearing in May 2019.  The refreshing thing is that Democrats are all looking for the answers and even though they do not seem to have any firm ideas of how to pay for it, they have successfully seized on health care for 2020.

The House has several other Bills on healthcare, including notably in February, 2019 Brian Schatz D-HI and Ben Ray Lujen D-NM re-introduced the "State Public Option" Bill which would allow states to create universal Medicaid Buy-In programs. This Bill started out with 61 Sponsors. A 50% cost share between the federal and state government which is a huge problem for budget strapped state budgets. Recently Seema Verma has been vocal on the danger of any Public Option programs. She cited the Obamacare public option programs which cost the federal government $2.5 Billion Dollars in start-up dollars and all but four of them went bankrupt. This left the federal tax payers on the hook for close to $1 Billion dollars in unpaid debt. These programs try to do a better job that private insurance carriers in delivering health insurance. The Directors of CBO have for years touted the private sectors skill at negotiating with providers to lower the cost of health care. These public option Obamacare programs left 1 Million Americans without health insurance after they got them to changed to their programs. It is hard to image how a government run program would be able to do a better job than private insurers that successfully manage coverage for about 180 Million Americans through one or another program.

THE PRESIDENT: We hear that President Trump wants to make the Republican party, the party of Health Care. Well, Mr. President, the Trump Medicare Advantage For All is the way to do it! The President has specifically referred to Medicare Advantage in at least two of his Rallies' (in Topeka, Kansas and Richmond, Kentucky) running up to the 2018 elections. His message has been very consistent since the day he was elected. In his letter to us, dated November 29th he states, “As President, I am committed to providing Americans with more affordable health insurance, access to more choices and quality care.” This has been his position since taking office.

He has repeatedly stated his full support for a solution that would be better for All Americans. He is serious and about to issue his own plan, which we introduce the Trump Medicare Advantage plan we describe in the Trump Medicare Plan Page. feels that the Democrat opposition to whatever plan would be counter productive. The only absolute certainty is that nothing but nothing is going to get through the 116th Congress if it is not bipartisan.

The Republican Study Commitee has issue a framework for Personalized, Affordable Care plan which allows for health plans like TMA and other plans to be a part of the Republican solution. Though neither President Trump nor members of Congress have had any time to seriously consider the problem of the Medicare Trust Fund going bankrupt in 2026, the current law will shortly require it. For the second consecutive year, the OASDI (Social Security) Trustees project that Medicare will have to draw 45 percent of its money from general funds within seven years. That circumstance triggers a Medicare Funding Warning, which requires the president to submit to Congress proposed legislation that is responsive to the problem "within 15 days after the submission of the 2020 Budget." Congress is then required to consider the legislation on an expedited basis.

WHAT ARE OTHER DEVELOPED HIGH-INCOME NATIONS DOING

The most common misconception among U.S. Policy makers and U.S. citizens is that most industrialized countries with national health care systems have centralized single-payer systems. This is not true. Each of the twelve High-Income countries recently studied by the Commonwealth Fund have significant variations in how they set policy and how services are funded and delivered. As we have been explaining to our membership and the political establishment in Washington, D.C., these nations generally "backed into" their national health systems. Each of them uniquely reflects the underlying structure of their governments and social welfare systems. Consequently, our American national health insurance system must be designed (as it is) to uniquely reflect our American health care system and our social background. So, our American political health history, including our experience with Obamacare, matters!

For instance, Canada does not have a national health insurance system. Instead, their provincial governments administer their systems and they receive federal financing in the form of per-capita block grants. Where have you heard that before? We are told that the parking lots of medical facilities in states bordering Canada are regularly inundated with cars with Canadian license plates? In Canada, two-thirds of the population holds private health insurance, which they get mainly through their employers. This Canadian federal financial system is very much like the way HHS pays insurance companies for Medicare Advantage (MA) plans and how the Graham-Cassidy Bill proposed they pay our states for their Medicaid programs. Canadian federal financing is contingent on the Canadian Provinces maintaining a nearly uniform level of benefits, similar to the way in which HHS requires conformity from Medicare Advanatge  carriers and to a lesser degree, state Medicaid programs. This will be especially important, if we go to a state block grant system, especially with the integral health and wellness program that we need to lower the cost of health care in the United States.

The Democrat proposals for their Medicare for All seek to create a Big-Governement single-payer system, rendering private health insurance unnecessary. However, nearly every high-income nation incorporates private insurance into their systems. Even when they have public coverage, their citizens may choose to purchase complimentary private health insurance to cover out of pocket expenses, in exactly the same way our Medicare beneficiaries procure Medicare Supplemental Plans. Ever major American insurer offers Medicare Supplementary coverage. These Supplemental Plans are highly regulated by the federal governement, uniform in nature and are offered by private insurance carriers that openly compete with one another on price and administration.

Canada, England, Germany, the Netherlands, Norway, Singapore, Sweden and Taiwan all have Supplemental private plans in additon to their national health service. France has a completely complementary private health insurance plan. Australia and Denmark have complimentary and supplimental plans. Switzerland (which has the next highest health care GDP-12%) has one mandatory governement-subsidized private health insurance program that comprises their entire national health insurance scheme. In Australia, England and Germany, citizens may also purchase private health insurance that fully substitutes for the public insurance program. In Australia, the purchase of such substitute coverage is actually encouraged by the governement through tax incentives (like our mortgage interest deduction) and penalties or the Individual Mandate under Obamacare.

We won a Revolutionary War with England 236 years ago. We do not have copy their health system, which hasn't changed since World War II. In England when they say a citizen has the right to healthcare, what they really mean is the English have given their government the right to kill them. Two recent examples of this are Alfie Evans and Charlie Gard, both of whom had the promise of medical care in other countries that may have prolonged their lives but were denied access to that care by the British Courts. This would have never happened in the United States. In fact the hospital management where one of the boys was being treated actually criticized the United States for even offering the chance of life giving treatment to the family. The obviuos question is, where does it stop? That very question was one of the principal reasons that Hillary Clinton Health plan failed to be adopted 25 years ago. In those days there was talk of a federal death squad. We are freedom loving Americans and we are not going to allow that kind of a system to be set up in the United States of America.

Given that most of the other developed high-income countries have achieved "universal" coverage using a combination of public and private systems, it behooves our law makers to realize that a Big-Governement single-payer system is NOT the only way to go. Our politicians are so focused on the minutia of insurance company loss ratios and administrative expenses that we are missing the bigger picture. Medicare Advantage is the Most Popular health insurance program in America. It preserves our unique and valuable health care system and offers us the opportunity to reduce the U.S. Health Care GDP to a competitive world market level.

HEALTH CARE FOR ALL SHOULD BRING US TOGETHER AS A NATION

Our understanding of ourselves and our need for health care SHOULD NOT divide us as a people. It should bring us together because it is in our shared interest. The Affordable Care Act (aka Obamacare-covering only 8.4 Million federally enrolled citizens) has unfortunately not been as successful as we had hoped. It has certainly divided our political parties. Obamacare is not giving enough Americans the health security we need. The Per Member Cost of Obamacare far exceeds the benefits being provided to the American tax payers and the unsubsidized American citizens covered by the program. The biggest challenge the Medicare-Advantage-For-All.Com family faces is convincing the American public that Medicare-Advantage-For-All is the Best program for covering the 30 Million Americans, who cannot or will not buy health insurance. The latest Gallup Survey data indicates that 13.7% of Americans were uninsured in the fourth Quarter of 2018 (vs. 18% in 2013 before the ACA). Gallup suggested  that the rise in premiums and the dwindling participation in the ACA exchanges were the biggest factor driving the  uninsured rate. The latest CBO projection in May 2019 has that the Obamacare enrollment would steadily decline over the next decade, while the number of uninsured Americans will rise from 30 Million to 35 Million.

We believe that modifying the ACA will NOT go far enough to solve this problem. However, our Medicare Advantage (MA) program is “A Program That Really Works” (MA covers over 22 Million Americans over age 65) giving seniors immediate access to medical care, financial security, affordability and peace of mind. Medicare-Advantage-For-All is our Movement to extend this program to everybody, ensure our domestic tranquility and secure the blessings of this liberty for All.

Obamacare has a lot of public support, but it is not the program that voters are supporting. The American people are empathetic with the effort being made to provide health insurance for those citizens that can’t afford it. In a Pew Research Center poll, the percentage of respondents that approve of the ACA Law has gone from 45% in 2015 to 56% in 2017. Likewise, the respondents that disapprove of the ACA Law has fallen from 53% in 2015 to 38% in 2017. The Pew research shows that 44% of Democrats think the ACA is mostly positive, but 35% of Republicans think it is mostly negative with 14% claiming they just don’t know. Unfortunately, the mindset of most Americans is that Obamacare is the only way to do it and without Obamacare, they would have nothing. The man on the street does not know why Obamacare is so expensive. What they do know is that, before Obamacare there were a lot of people, who could not get health insurance because of a pre-existing condition and even more people, who couldn’t afford it. That is the way it was for decades leading up to the ACA and the blame for those circumstances goes all around!

A Texas law suit was filed challenging the ACA's constitutionality. In March 2019, the Department of Justice (DOJ) sided with a Federal District Court ruling that found the Affordable Care Act unconstitutional.  We recall that the United States Supreme Court narrowly upheld the constitutionality of the ACA Law based on the fact that the federal government had the right/power to tax the people. The Trump Administrations Tax Cut legislation eliminated the federal Obamacare Tax penalty, which was the tax that allowed the law to survive the first constitutional challenge. Once it was eliminated, the law became vulnerable again and it has been challenged successfully in the U.S. District Court. It has been appealed to the U.S. Supreme Court and many organization have filed representation. There is considerable legal opinion that even with the mandate/tax being removed, the rest of the law should stand. The DOJ has decided not to try and defend the law and we believe it will be struck down in 2020. However, despite what the Democrats are saying, pre-existing condition will remain covered by most, if not all, insurance plans, even if the ACA Law is struck down.

The general public's perception is that the Republicans want to take health care away from the people. Most people believe that Republicans want to allow insurance companies to exclude pre-existing conditions. Even though all of the leading Republicans, from the President on down, have clearly and unequivocally stated that want to cover pre-existing conditions! The main stream media and Fake News outlets have half convinced the American people that this is NOT true. It is also rumored that Republicans want to cut back entitlements and that this includes Medicare, Social Security, and Obamacare. This ignores the bipartisan American Political Health History of Medicare legislation. Every piece of legislation passed by the U.S. Congress, since the enactment of Medicare, has been supported by both Democrats and Republicans together. In one way or another, most every piece of legislation was an effort to reduce the cost of the traditional Medicare program. Democrats and Republicans alike can NOT ignore this history. It is the common sense we need to address the fiscal crisis we have with our entitlement programs. And, there are certainly members of both parties, and a lot of tax payers, who want the government to spend less money!

It is also true that there are Democrats (who may know what is wrong with Obamacare) who are convinced that the health insurance companies by their very business model, are the cause of the high cost of health insurance. Their proposed solution is to eliminate the health insurance companies and replace them with a single payer Medicare for All system, like the rest of the industrialized world. The problem with that thinking is that the government hasn’t been that successful in controlling the cost of any of the programs that they manage now. Medicare is almost bankrupt. Obamacare rate increases have averaged over 100% over the last four years. Health care systems in the industrialized world are a mixed bag, with no two systems doing it the same way and with varied success. What we are engaged in, is an effort to do it the American Way! The MOST IMPORTANT thing to keep in mind, is the results of a Quinnipiac University poll in September 2017. Americans were asked if expanding Medicare to cover every citizen was a good idea, and 46% said Yes, 41% said No, and 13% were undecided. However, when this same group of Americans was asked if it was a good idea if the governement removed all health insurance premiums but had to increase taxes, only 41% said Yes and 50% said No, and 9% were undecided. The bottom line is that we All like the idea of universal health care, but we don’t want to pay for it! So, what we MUST DO is make it economical feasible to offer Medicare-Advantage-For-All Americans with an integral health and wellness component to it. This proposition is exactly the way to do it. This proposal is the Truth, the Light and the American Way!

Our Supporters are informed and sympathetic with the opinions BOTH political parties. The reason that Congress passed Obamacare with only a one-vote margin and then failed to repeal it, also by only one vote, is that the moderates on both sides of the political spectrum do not know what to do about these problems. In support of Medicare-Advantage-For-All, we are just trying to be reasonable. We do not have an ax to grind on this subject and we do not have a horse in this race. You can criticize our positions and claim bias but the only thing we are trying to do is make sense of what to us, should be a well-recognizable fact. We have the facts on our side. We and every True American want All our people to be healthy, productive and experience well-being.

We think we know how to make that happen. We think we know how to lower the cost of health care in the United States. We agree with Warren Buffet, who recently said," If the private sector doesn't supply (change) over a period of time, people will say 'We give Up. We've got to turn this over to the Governement,' which will probably be worse."

Medicare Advantage is the most successful health insurance program our government has ever sponsored. It is well regulated, fair, equitable and practical. It was created to save money, and unlike some government-sponsored programs, this one does what it was intended to do. We think it makes sense for Congress to recognize that this successful program is Best Bipartisan Solution to address the health care concerns on both sides of the aisle. The current programs are not solving the problems and the federal government is wasting time and money pursuing the old, tired, wrong Defined Benefit solutions. Everyone is arguing with one another. We don’t expect unanimity on this very complex and difficult issue. Our Supporters desire to get everyone; policy makers, politicians, Health and Human Services and the President to take a step back for a moment and take a deep breath and realize where we have been, what it has cost us to get here, what we have done right in the past and where we have to go in the future. We believe that if we, as a nation, do that honestly, we will see that Medicare-Advantage-For-All is the right program to take us All where we want to go. It is that simple!

Understanding this brings us back to the two basic concerns of the American people:
1.) How am I going to get the health care I need? And,
2.) How much is it going to cost?

If we are honest with ourselves, we know that we will NOT get the highest quality of health care in the United States if the system is socialized and run by the government. You can argue about which system produces the highest quality health care, but one thing we can not argue about is the fact that government can’t do the job right! They can't. Every law we have passed since the inception of Medicare has been an attempt to contain it's cost, except for Obamacare which created the most expensive health plan in the history of the world. In the United States, we know a lot about expensive health care. We have the highest cost of health care in the world. So, if we are going to make our health care accessible to All, the logical thing to do is choose a program that we know will deliver the highest quality health care for the lowest possible cost, and that program, which we have irrefutably demonstrated is Medicare Advantage. 

HOW CAN WE EXPECT "MEDICARE for ALL" TO FIX THE SYSTEM?

Senator Bernie Sanders, in his presentation of S. 1129 to the American people on Wednesday, April 10, 2019, was very honest about his motives. He said, "In my view, the current debate over "Medicare for All" really has nothing to do with health care." For Senator Sanders, it has, "nothing to do with health care." By Senator Sander's own admission, it is all about greed and profit-driven health insurance corporations. With all due respect to Senator Sander's, that is just not good enough! A national health care plan should be all about improving the health of the American people and making health care more affordable for everybody. He has a beef with the establishment. I get it. He complains that, "He wrote the damn bill" as though it was some kind discomforting impossion. He says it that way all the time. No offense to Senator Sanders, but  I am curoius  after being covered by BlueCross BlueShield FEP High Option program, paid for by the federal governement for his entire political career, was there any other defining element of his experience that informed him in this endevor?

We do not have 30 million Americans without health insurance because of the greed of health insurance companies. In fact, if there was any way for them to make money from those uninsured Americans, we think the "greedy" health insurance comanies would welcome the opportunity. BlueCross BlueShield was one of the first organizations to help fix the system, just as United Healthcare and many other health insurance companies jumped in when we launched Obamacare. But the governement had to offer them 3 R risk sharing programs to get them the help they needed covering the risk of a population that in some cases had never had health insurance. We hoped Obamacare would fix the system. However, because of the way we regulated the program to handle those risks, we actually broke the system. Fortunately, the expericne has taught us how to do the job right this time.

In fact, we figure that the New Member uninsured and disaffected American market is approximately 29.9 Million people that covering this population is worth an annual premium of $22.5 Billion Dollars. Almost half of these people already have health insurance coverage, so there is no question they can pay something for health insurance, if governement subsidies are maintained at their current levels. The Kaiser Family Foundation (KFF) has determined that 8.4 Million of the uninsured population are between jobs or working for employers that do not offer group insurance, so they are earning an income. KFF also estimates that an additional 5.3 Million uninsured in this market are eligible for federal tax credits, but have still failed to buy their own health coverage. Only about 45% of the uninsured market say they have tried to buy health insurance and could not afford the coverage. The failure of Obamacare has taught us how to successfully approach this market. All we need now is define an appropriate level of supervision and continue the premium subsidies.

Senator Elizabeth Warren is also a prminent proponenet of the "bath water dirty, through the baby out" syndrome. She believes the profit motive of health insurance companies creates a business model that prevents companies, including the not-for-profit BlueCross BlueShield system, from satisfying the health care needs of the American people. We beleive she may be a little short sited with that predisposition. Health Insurance companies are not exactly like banks. A properly structured health insurance company business model incentivizes thenm to maintain and improve the health of the American people, as is the case with most Medicare Advantage programs. Banks and credit card companies, of which Senator Warren is very familiar, are certainly profit oriented, but the work of health insurance companies is more personal. Their currency is a persons health, not their money.

The federal government treats health insurance comnpanies like banks and that is part of the problem. A properly structured health insurance program that pays carriers a capitation fee, so that the healthier their population gets, the more money they make, helps both them and the American people they serve. Demonizing the industry, especially the not-for-profits (that are helping) and trying to replace them all, is ludicrous. The reason we have 30 Million Americans without health insurance is largely because they can't afford the health insurance and we cannot expect the tax payers to buy it for them.

The Medicare Trust Fund is not running out of money is NOT because of greedy insurance carriers or overpaid health care professionals. In addition to paying for a lot of stuff we don't need, a huge contributing factor is that the health condition is of that the American people is so Deplorable! Our health status is the main reason that our health care costs are going through the roof. The very people that don't have health insurance are suffering the most. All Americans are paying for their care and suffering right along with them, because we have to pay. We All pay for their uninsured poor health. We are also paying for our insured's poor health. And, we are paying for our governments inability to create healthy lifestyles and use our limited health care resources to effectively address these problems.

We have ninety percent (90%) of the health care dollars being spent on the treatment of chronic illness, eighty percent (80%) of which is preventable. As a nation, there is a huge amount of waste and dysfunction in the health care system that is creating the affordability problem. See our Executive Summary Page for a curreent status report. And, on top of all this, we are not being honest about the nature of the problems (in fact we lie about them all the time) and consequently we are not able to really do anything about them. As Warren Buffet has implied, when the federal government takes over, it makes matters worse. That is exactly where we are with health insurance today in the United States and it is most unfortunate!

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ROAD MAP TO THE DEMOCRAT AND REPUBLICAN HEALTH REFORM PLATFORMS

To understand where the Democrats and the Republicans are coming from leading up to the 2020 elections, please see a complete review of their relative positions to date at: https://tcf.org/content/commentary/roadmaps-democratic-republican-health-reform-platform-2020/.

CONSIDERING"SINGLE PAYER" PROPOSALS IN THE U.S.: LESSONS FROM ABROAD

Countries differ in the extent to which financial and regulatory control rests nationally, regionally or locally. Virtually ALL national systems incorporate private insurance. U.S. policymakers can learn a lot about what we should be doling to extend universal coverage to every American: https://www.commonwealthfund.org/publications/2019/apr/considering-single-payer-proposals-lessons-from-abroad/

THE REPUBLICAN OPTIONS FOR STATE BLOCK GRANTS

We are cautiously optimistic about the State Block Grant proposals, however, we firmly believe that the only way we are going to be able to lower the cost of health care in the United States is by improving the health and well being of the people. The most obvious low hanging fruit in this environment is the incidence of chronic illness, which accounts for over 5% of our annual health care GDP. One of the key programs in reducing the incidence of chronic illness is a comprehensive wellness program, which can be effectively initiated at the federal level, but at the State level, we are NOT so sure. If the State programs that become the recipient of federal tax dollars CANNOT support such programs, we are NOT in favor of them. Read the following article on a potent ail republican platform for health reform and decide for yourself: https://www.commonwealthfund.org/publications/journal-article/2018/nov/getting-ready-health-reform-2020-republican-options/