With every passing month in America's "jobless recovery," more jobs are lost. Lost jobs in the U.S. quickly morph into uninsured lives. In April 2008, the Kaiser Family Foundation calculated a metric that showed a 1 percent increase in the unemployment rate leads to a 1.1 million person increase in the uninsured and a 1 million person increase in Medicaid enrollment.

That was April 2008 -- this is November 2009. State governors, who fund one-half of Medicaid, are hard-pressed to absorb these hundreds of thousands of lives. Then what? The number of the uninsured increases.

"I'm insured, so should I care?" ask Harry and Louise. Based on recent surveys on American attitudes about the health-care safety net for people 'other than me,' it appears the European model of social insurance is seen by many American health citizens, still, as socialism, not insurance.

The sooner we get uninsured people covered -- while rewarding quality care, not paying for poor outcomes, moving our paper-based system to digital platforms and better managing the allocation of scarce health resources -- the better. Yes, it's complicated. But with each passing month in the jobless recovery, more people will move into the uninsured pool of Americans. Watch for emergency room waits and hospital/provider bad debt to grow.

I am pro-life. It is a huge issue with me. I hold all life sacred and consider the moment of conception as the creation of human life. I am also an advocate for universal health care for Americans similar to what is offered in other developed western nations. There is no evidence that indicates there is an increase in abortion rates in these nations in comparison to the United States. Tying abortion to health care in America however, will only hinder progress on reform.

A law restricting abortion in the House health-care bill prevents the abortion debate from side-tracking efforts to pass much needed reform including a public option for millions of Americans. In fact, without abortion restrictions, the health-care bill could prove to be a back door opportunity for pro-choice proponents to use taxpayer money to fund abortions.

With the issue taken out of reform by law, the focus can be on providing health care for all Americans. Health-care reform will allow us to address the needs of all reproductive age women and ensure the health of mother and baby regardless of socioeconomic status.

It is my hope that publicly funded health care be made available to all citizens and legal residents of the United States, and that includes the unborn.

Rep. Bart Stupak's amendment did not make abortion illegal. And it did not block the federal government from subsidizing abortion. All it did was block it from subsidizing abortion for poorer women.

Stupak's amendment stated that the public option cannot provide abortion coverage, and that no insurer participating on the exchange can provide abortion coverage to anyone receiving subsidies. But as Rep. Jim Cooper points out in this interview, the biggest federal subsidy for private insurance coverage is untouched by Stupak's amendment. It's the $250 billion the government spends each year making employer-sponsored health-care insurance tax-free.

That money, however, subsidizes the insurance of 157 million Americans, many of them quite affluent. Imagine if Stupak had attempted to expand his amendment to their coverage. It would, after all, have been the same principle: Federal policy should not subsidize insurance that offers abortion coverage. But it would have failed in an instant. That group is too large, and too affluent, and too politically powerful for Congress to dare to touch their access to reproductive services. But the poorer women who will be using subsidies on the exchange proved a much easier target. In substance, this amendment was as much about class as it was about choice.

(Originally published here.)

Opponents of the various Democratic health-reform proposals spend a lot of time talking about how people should be free to purchase whatever kind of insurance they want. Except, it turns out, if those people are women.

Going into Saturday's debate on the House health-care bill, the measure included provisions designed to maintain the status quo against federal funding for most abortions. It took steps to ensure that federal subsidies to purchase insurance wouldn't be used to pay for abortion coverage. It required that every exchange include one plan that did not cover abortions, so that no one would be forced to subscribe to a plan that violated anti-abortion beliefs. That wasn't enough for the anti-abortion crowd, including the Catholic bishops. So House Speaker Nancy Pelosi (D-Calif.) was backed into a corner, facing the loss of anti-abortion Democrats unless she acceded to an amendment offered by Rep. Bart Stupak (D-Mich.) that effectively prevents insurance companies participating in the new insurance exchanges from covering abortions. It passed, 240 to 197, with 64 Democrats voting in favor.

Under the Stupak amendment, no plan that accepts people eligible for federal subsidies is permitted to cover abortions. It's hard to imagine a plan participating in the exchange that refuses to accept people with subsidies, since the vast majority of people in the exchanges will receive subsidies. Therefore, no abortion coverage in the exchange -- except to save the life of the mother or in cases of rape or incest. If you are a woman whose health is endangered by a pregnancy, you'll have to pay for an abortion out of pocket. Same if you are carrying a fetus with severe birth defects.

Stupak supporters argue that women will still be able to obtain abortion coverage by purchasing a separate rider to the policies. As if people plan ahead to have abortions. As if insurance companies will go to the trouble -- and risk the controversy -- of providing such riders.

It wasn't worth torpedoing health reform over this issue, so I understand Pelosi's choice. It's outrageous, though, that she had to make it.

Originally published on the opinion blog Post Partisan, updated daily at washingtonpost.com/postpartisan.

I could tell you how wonderful Canadian health care is by recounting my experience with it spanning four decades. I could tell you that because of the Canadian health-care system, my dad went into remission from non-Hodgkin's lymphoma for ten years, that my mother survived both breast and lung cancer and my niece survived childhood leukemia. Perhaps I could tell you that my huge network of family and friends in Canada have no complaints and get regular check ups and treatments.

Some of you might prefer to hear that health care is only 10 percent of Canada's GDP while American's spend almost 16 percent of their GDP on health care. Or you might like to know that Canada has afforded health care and still has had a surplus in its budget for the past eleven years. Instead I want to tell you something about Canadian health care that you may not have considered: the fact that Canadians totally take their universal one-payer system for granted.

Health care is something most Canadians don't even think about. If someone loses his job he doesn't have to worry about getting the money to pay for COBRA. If a couple wants to buy a house they don't have to consider a smaller mortgage to ensure they can cover their monthly health care premium. A single mother doesn't have to stay up all night wondering if she should rush her sick child to emergency because she can't afford health care and doesn't have the money to go to a doctor during regular hours. Any twenty-something university graduate in Canada can see a doctor for infections and sprains and the little things American youth try to live with because they are no longer covered under their parent's plan. This is what is most wonderful about Canadian health care. There is no reason that Americans can't develop a one-payer universal system similar to Canada's unless of course they like to worry about health care.

Often when I tell someone how wonderful the Canadian health-care system is I am told that I should go back to Canada if I like it so much. Well, actually that is my back-up plan. What's yours?

Democrats on the Senate Finance committee squandered a historic opportunity. 

For the past year, Finance Chairman Sen. Max Baucus was a lonely Democratic voice on the need to not just expand coverage but to fundamentally change the delivery system.  He never bought into the ridiculousness of "health insurance reform."  In fact, he released thoughtful papers with serious ideas on how improving the quality of care would not only improve patient safety but lower costs at the same time.  It appeared that he understood that insurance was not an island unto itself, but that insurance is merely a reflection of the delivery system.  

Unfortunately, as the process wore on, the Finance Committee ultimately side-stepped delivery reforms.  Worse, it devolved to the left's tried and true formula to expand coverage: higher taxes and more government.  You need not look any further than the CBO estimate from last week to see that there are no delivery reforms at all.  Just look at its evaluation of section III of the bill, "IMPROVING THE QUALITY AND EFFICIENCY OF HEALTH CARE, SUBTITLE A-TRANSFORMING THE HEALTH CARE DELIVERY SYSTEM."  The CBO estimates that all of these self-described transformations--hospital value-based purchasing, quality infrastructure, the oxymoron of a CMS Innovation Center--will save a grand total of $7.3 billion over the next ten years.  That is decimal dust when we may spend upwards of $35 trillion during that span. 

A trillion-dollar bill that masks its true costs with budget gimmicks (doesn't fix doctor payment; pushes tens of billions in costs to states; accounts for ten years of revenue but only seven years worth of costs) is not the kind of "reform" our system needs.

I'll defer to National Federation of Independent Business (NFIB's) official statement, from Susan Eckerly, Senior Vice President:

"Today's Finance Committee vote is pivotal as we evaluate the future of comprehensive health-care reform. NFIB appreciates the many provisions in this package that reflect small businesses' needs, which are rooted in approaches that aim to lower cost, increase coverage options and provide real competition in the private marketplace.

"We commend committee members for ensuring that an employer mandate and public option were excluded from the revised package. While NFIB greatly appreciates efforts to hold the line on these issues, we have strong concerns that, moving forward, attempts will be made to weaken the framework established by the Finance bill. We deeply believe that if any of those attempts are successful, they will derail health-care reform altogether.

"This is the only comprehensive health-care reform bill that provides a meaningful pathway to achieve the goals long supported by NFIB, including:

-- Individual and Small Group Market Reforms - Federal rating reforms in the individual and small group markets are essential to any reform effort, and must include protections against pre-existing conditions. It is imperative that the variation for age, geography, family composition and personal behavior are preserved or strengthened, but not lowered, as this legislation moves forward.

-- Health Insurance Exchange - An exchange modeled on provisions under the SHOP legislation (S. 979) will improve competition, allow small businesses and individuals a broader choice of plans and create a simpler and more efficient way to purchase insurance.

-- National Plans/Interstate Sale of Insurance - Allowing national benefit plans to be purchased across state lines can and will produce competition. The interstate purchase of insurance has been proven to foster competition in the marketplace, and gives additional options to consumers.

"NFIB has been a constructive participant in the health-care debate and has spent more than a decade voicing our need for reform. As floor debate begins, small business must weigh the benefits of reform against the potential new costs of doing business. Small businesses will have a difficult time supporting a final health reform package if its long-term costs outweigh the benefits we have worked to secure.

"NFIB remains committed to supporting reform efforts that provide more affordable and accessible health-care options for small employers and their workers. It is essential that a final bill makes their core needs and common-sense solutions a priority."

Today's vote is a huge and helpful step for America's families, and it is truly historic. Never before has the Senate Finance Committee adopted meaningful health insurance reform. Never before have all five congressional committees with jurisdiction over health care adopted measures designed to make high-quality, affordable health coverage available for America's families. And never before have we reached the point that both the Senate and House are poised to debate and adopt health insurance reform. These are clear signals that passage of health insurance reform is virtually inevitable this year -- and it couldn't happen too soon.

Although the Senate Finance Committee moved its health-care reform bill forward with bipartisan support, we still have a significant distance to travel on the road toward true health-care reform. History and the present-day conditions of countless Americans dictate that we do more than provide surface talk on health disparities, pre-existing conditions and access to care. There must be a paradigm shift in how we value and promote health in America--whether we regard ourselves as one nation or a nation of independent individuals accountable only to one's self. Will we stand true to universal coverage? To health and wellness? Or will lip-service be our homage to this life and death issue? To reach the destination called "Reform," we must answer the hard questions and make the tough decisions that will in the long-run benefit the health and wellbeing of our nation. Otherwise, we will continue on the same prohibitive cost trajectory that has displaced so many individuals out of the health care (insurance) market. And that is a future that is unsustainable.

The best Senate Finance Committee bill is a done bill. In order to move forward, we needed to get it out of committee.

I'm not satisifed with this version of health-care reform, but everyone needs to
remember: the final health-care reform bill will not be a Xerox of the Baucus bill. When the Senate HELP bill, the Senate Finance Committee (Baucus) bill and the House
legislation merge, provisions from all of the bills will make their way into the final
health-care reform bill.

Will the Baucus bill trump the others? Much depends on whether the White House exerts its weight in those final discussions. The House bill, endorsed by three House committees, is much closer to the administration's vision of heatlh-care reform. It includes a public sector insurance plan that would set a high benchmark for affordable, high quality, comprehensive care.

According to the Commonwealth Fund, savings from administrative costs alone would mean that a public sector plan would cost a family at least $2000 less than a private sector plan.

Under health-care reform, medical care does not have to be more expensive. If it's done right, it will be less expensive and our health-care system will be better, both for patients and for doctors. Physicians will be paid more for delivering better care, which is what the vast majority of doctors want to do.