03/18/2010 05:12 am ET Updated May 25, 2011

Mr. President, Will You get Pissed off for Once?

Dear Mr. President:

You now have returned from Copenhagen. How about staying around until health care reform gets to your desk, if it gets to your desk at all. In the meantime, know that it is finally time to roll up your sleeves (as you did it many times on the campaign trail when you were seeking our votes) and get your hands dirty. After all, mouthing the word "change" takes more than reading a teleprompter or saying it with a microphone in your hand; change is the grease that gets underneath your fingernails.

You have a job to do and it is not being critical of Sen. Joe Lieberman (I-Conn.) or Ben Nelson (D-Neb.) or even a Blanche Lincoln (D-Ark.). And who cares about the antics and the juvenile behavior of the Republicans. Just ensure they keep out of your way. The only pleasure all of us have with you at the helm is to simply ignore those who wish to see you fail. You must be as focused as a laser now, guiding you to your target.

For starters, I commend you to take a look at an analysis of what the present Senate bill has that is good for us all. Andy Kurz a former CFO for Blue Cross in Wisconsin, prepared a marvelous chart this reflects this; it can be found at We all know Wendell Potter formerly of Aetna, but Andy is equal to the task with his expertise as an industry insider. He explains and shows graphically the impact of the Senate and House bills. Have your staff look at Andy's work product.

I need not tell you that we are in the red zone (to coin a football term), with less than one minute to go in the game. What you need to do is get mad, get angry, even pissed off, at what you see not occurring. You need to concentrate on the following and make those in the Senate (and certainly in the House) understand that what they can achieve is what you want. They will get your message loud and clear, so long as you go in with grease underneath your fingernails. Here are your points:

1. Ensure a medical loss ratio of 90%.
2. Ensure lifting of the antitrust exemption for insurance companies.
3. Eliminate the taxing of benefits, like on high-end insurance plans.
4. Ensure that there are cost controls in place from when you sign a health care bill until its effective date. This will prevent insurers from gouging consumers with ridiculous premiums levels. If insurers want a mandate, then they have to freeze premiums to 2008 levels.
5. Provide seed money for a not-for-profit insurance company so that there will be considerable competition once health reform becomes effective.
6. Don't make Americans pay anything extra for the insurance reforms you want, like no pre-existing condition barring coverage.
7. Ensure that there are no caps on annual and lifetime benefits---without qualification or words reflecting qualification.
8. Don't disgrace being an American woman of childbearing age by telling them they cannot use their own money to terminate a pregnancy.

Thank you for listening Mr. President.