07/10/2009 05:12 am ET Updated May 25, 2011

Obama to Kennedy/Baucus: Get Health Care Reform Passed

Probably unnoticed is a June 3, 2009 letter President Obama sent to Sen. Kennedy and Sen. Baucus on their respective committees' efforts to reform health care. It can be found at, This was sent at the same time that the media is reporting that Senator Kennedy is floating a "draft of a draft" of a proposed health care reform bill emanating from his H.E.L.P. subcommittee.

Obama says in his letter, in bullet point fashion, the following:

1. Americans must have choices in acquiring a health care plan, including a public plan option.
2. Any plan should be available notwithstanding pre-existing conditions.
3. A "hardship" waiver should be available for those Americans who cannot afford health care coverage (how about starting with the 45-50 million citizens who can't afford insurance now).
4. Employers should be responsible to support health insurance for their employees, but small businesses should be exempt.
5. Health care reform should be deficit neutral, and not add to deficits over the next 10 years.
6. Cut and eliminate waste, inefficiencies and fraud in the present health care delivery system system.
7. Reduce Medicare and Medicaid spending by $200-300 billion over the next 10 years.
8. Have better control over unmanaged chronic diseases, unnecessary medical testing and hospital readmissions.
9. Complete health care reform by October of this year.
10. Making every American "responsible" for having health insurance coverage.

It is this last point that is puzzling. President Obama indicates that Sens. Kennedy and Baucus are moving toward the idea of a "shared responsibility" and he (Obama) is open to ideas on the concept of shared responsibility. Huh? If all Americans must be covered and if 50 million or so are not presently covered, how can there be a "shared" responsibility in paying for health care reform? To pay for reforming health care must come from not only subsidies to cover those Americans who cannot pay for adequate coverage, but also from reducing expenditures in the present delivery system that cause waste and inefficiencies. And what about a tax on products that cause us Americans to lead an unhealthy lifestyle -- like tobacco, alcohol, unhealthy foodstuffs or their ingredients. After all, if any health care reform must include wellness and prevention, and we as a nation cannot even maintain a body weight suggesting health and being fit, why not make the products that make us unhealthy cost more, so that we think twice about purchasing them?

So this idea about a "shared responsibility" seems more political rhetoric than a useful and meaningful inquiry to Sens. Kennedy and Baucus. Let's hope we all find out what this means before it is too late.