As politicians go round and round talking about how health reform legislation will increase or decrease the deficit, or how a win on this bill will help or hurt Democrats, I think it’s worth mentioning again that there’s one really huge number that matters: 62.

Sixty-two is the the percentage of U.S. personal bankruptcies in which medical bills were a leading contributor, according to Dr. David Himmelstein, who wrote two major studies on the topic. And 62 is a scarily high number, but even scarier when you consider that 62 percent of total bankruptcy filings works out to about 900,000 cases and – with each case affecting about 2.7 people – in total, about 2.4 million people who would be affected.

We could talk about how these 2.4 million folks – who have had their legs kicked out from beneath them – then become an additional burden on the system. But I think it’s worth spending a little more time thinking about what that means to those affected families.

As Himmelstein points out in this article, those people suffer long-lasting effects, not the least of which is shame that they’ve been bankrupted. They continue to have trouble getting medical care, but they’re also skipping meals, seeing their utilities shut off, and they’re losing their homes. Life that’s already hellish because of medical bills becomes even more hellish.

Well-educated, middle-class, home-owning Americans who already have insurance may view these numbers with concern – and well they should. A clinical research study of medical bankruptcy by research at Harvard Medical School, Ohio University and Harvard Law School found that

• “most medical debtors were well educated, owned homes and had middle-class occupations,” and
• “three quarters had health insurance” but were bankrupted anyway due to the costs of co-payments, deductibles and because of their policies didn’t cover enough services.

Our takeaways?

• It’s not enough to just extend coverage to more Americans, as promised by legislation currently being considered by Congress. Health reform needs to promise standards for health plans – standards that could be set through the establishment of a health insurance exchange system.

and

• Having coverage now is not a guarantee of security tomorrow, or next year, or in five years. Skyrocketing premiums mean that your ability to pay for coverage now doesn’t mean you’re safe down the line.

Sixty-two.

We thought this editorial cartoon in the Kansas City Star was pretty good – and not just because we agree with them on that whole Global Warming thing. We also got a chuckle because it hit so close to home in terms of the ongoing health reform debate.

We’d rewrite the caption to read, “If being cold means there’s no such thing as global warming, does the fact that some folks say they’re happy with their health insurance mean there’s no health care crisis?”

The answer is that the apparent adequacy of employer-sponsored health coverage for millions does not mean that our system is A-OK. Far from it, in fact. The skyrocketing premiums promised for customers of Anthem Blue Cross last week are evidence that those nutty health reformers were really on to something when they said the sky was falling.

And it’s not just Anthem. As health policy experts continue to point out, the individual health insurance market is “fundamentally broken.” Rates are soaring in a growing number of states. Increased insurance costs are hitting small employers. Folks who signed up for private plans through Medicare are facing “sharp increases” in their premiums.

Who’s not in trouble? As much as the industry protests, we’re not convinced it’s hurting – or just getting by – when we see numbers like this.

Now, Democrats AGAIN see an opening. (If they didn’t see it, we’d be sending them to the optometrist post haste.) They’re lining up again to support a public option that would give consumers affordable options to plans that seem destined for luxury status. (It’s bad enough that some folks don’t consider health insurance a right. But should it really be a luxury reserved for Americans with higher incomes?)

President Obama and supporters of his health reform agenda are about to meet (we hope) in a summit with opponents of his proposals. We hope they can have a healthy dialogue, but frankly, we’re not optimistic.

If the two sides can’t find common ground, it’s time for proponents to do whatever it takes – even if it means going it alone – to move forward and get reforms passed.

Because – let’s face it – the sky really IS falling.

The headline in the StarTribune says “Health care for poor may get axe.” Minnesota’s Governor Tim Pawlenty, a 2012 Presidential hopeful, is set to veto a bill that would pay health care costs for 85,000 of the state’s poorest and sickest residents.

The bill he is threatening to kill is a stripped-down version of a similar bill he vetoed last year.

The thing that raises our gall is how this politician is going to be all over the airwaves next year courting the “Christian Conservative” vote. And what’s worse, this move will likely endear him to those folks.

Pawlenty is far from being the only politician guilty of this; their ranks are legion. Their opposition to abortion, but acceptance of war – if it’s on someone else’s soil – is incongruous. Their vilification of those whose definition of love does not fit theirs is unfortunate. But their disregard for the health of those on the fringes of society is inexcusable.

I don’t care if someone is Christian, Jewish, Muslim, Buddhist, Hindu or anything else. Whatever brings comfort and meaning to someone’s life is between them and their own personal god(s). But this hijacking of any religion for political reasons is nauseating.

Here’s a little preemptive advice to all candidates for any office:  If your own personal religion can be summed up with the words “no taxes,” don’t use churches and clergy for photo ops and don’t use religion as an excuse for your stance on any issue. Don’t give speeches about “values.”

It would be refreshing to hear a politician who opposes health care for the less fortunate to simply say that their lower taxes are more important than the life of an elderly person who cannot provide for himself  or herself. Or to say that political contributions to their campaigns are more important than legislative changes that would let those with pre-existing conditions purchase coverage in the open market, thus avoiding bankruptcy.

There are plenty of voters in the “Selfish Bastard Party.” Just look at the comments to any story about health care reform in any major newspaper. Or tune your radio to a talk station. If you promise to lower their taxes, and to be against anyone who doesn’t fit their socio-economic group, they will be with you forever.

“Who would Jesus insure?” Leave religion out of your campaign and you won’t have to look in a mirror and ask yourself this most inconvenient question.

There’s a lot of debate today over what President Obama was saying to his supporters last night when he described what he thinks needs to happen with the health reform legislation from here on in.

The point he made that seems to be drawing the most speculation is this passage:

“That’s why I think it’s very important for us to have a methodical, open process over the next several weeks and then let’s go ahead and make a decision. And it may be that if Congress decides, if Congress decides we’re not going to do it, even after all the facts are laid out, all the options are clear, then the American people can make a judgment as to whether this Congress has done the right thing for them or not.”

Greg Sargent speculates that the President is “raising the possibility that health reform may not happen.” Jonathan Chait thinks the President was saying that Congress can’t ignore the bill and “let it die.”

My take on it is simply (and perhaps over simplistically) this: that Obama is telling Congress

1. that once the facts are laid out and discussed in public, Americans will see that the legislation is worthy of passage and

2. if Congress STILL is somehow unable to pass the legislation, they’re going to be held accountable by their voters.

Which is pretty much what we said earlier today.

We don’t like the phrase, “It’s now or never,” especially when it comes to the health reform battle. If legislation doesn’t succeed now, it doesn’t mean the nation’s health care system can never be improved.

Even with a complete failure by the Democrats, the system could conceivably gradually evolve into something better over time with incremental legislated improvements to the system. But we’re not at all convinced even that will happen, and even if it does, it will surely take another generation or two – or  longer, if the mid-term elections end up bouncing weak-kneed Dems out of office.

When will be there be enough evidence to convince Democrats that reform this year is critical? How much more evidence of our failing system do they need? Even the Wall Street Journal is now saying what is becoming more and more obvious: that our economy won’t be hurt by health reform; it will be hurt without health reform.

As Ezra Klein points out, this really is the Democrats’ window of opportunity. Jonathan Cohn wants to know whether the President will give them the shove they need.

Democratic Sen. Al Franken yesterday told the Administration to get off its butt. Even Sen. Ben Nelson, who has helped delay legislation as much as anyone, says that without reform, the national deficit will swell.

And really: will the Democrats’ legislation ever be good enough for Republicans? Based on compromises Democrats have already made and the fact that Republicans are still threatening to kill the bill, we suspect it’s a game Democrats can’t win.

The message to Congressional Democrats and our Democratic administration? You’re THIS CLOSE to failing. Miserably.

So yeah. It really is now or never.

Conservatives for Patients' Rights declared in a full-page ad today that the public option is dead.

The current status of the health reform legislation in the nation’s capital reminds of us the popular quizzes that challenge players to speculate as to whether celebrities are dead yet.

If you asked opponents of health reform, they’d surely tell you that – like the failed health reform efforts of 1994 – the current Democratic proposals  never really had a chance of survival. But following the recent Massachusetts special election that eliminated the Democrats’ supermajority, opposition was definitely ready to pronounce the legislation dead as a doornail and publish the obit.

Dead.

Today, Conservatives for Patients’ Rights, one of the loudest voices against the Democrats’ proposals, did just that. In a full-page ad, the group announced that a key element of the legislation – the controversial public option – is already dead and buried.

It’s not surprising that opposition is delivering “last rites,” but Speaker of the House Nancy Pelosi yesterday also agreed that  there’s “no hope” that a public option will be part of any legislation that moves ahead.

Not dead.

The good news is that Pelosi’s statement reasserts her belief that health reform legislation – minus the public option – is still breathing. She’s not alone, of course, with President Obama still optimistic, and still urging his party to “finish the job” on health care.

Democrats do still have a plan to keep their patient alive by working around a promised Republican filibuster. The Republicans, naturally, have their own plan to facilitate a slow, painful death for the legislation.

Will health reform die? We won’t know for sure for a while, since Democrats are currently regrouping to determine the best strategy for moving ahead.

But for now, at least? Definitely not dead yet.

In the days following last week’s special election in Massachusetts, it wasn’t surprising at all to hear opponents of health reform announcing that America had – loudly and clearly – told Congress to start over on health reform.

But here’s the thing: If the Democrats had barely eked out a win, opponents would have said the same thing. If Brown had lost by 10 points, opponents would have gloated that – even in the Democratic stronghold of Massachusetts – voters were giving health reform efforts a big thumbs down. The message would have been the same, regardless of the outcome.

Of course, we’re not buying it. First of all, it was not a national referendum. It was a vote in Massachusetts. Second, there was definitely more on Massachusetts voters’ minds than health reform. Personalities, for instance, were a huge factor.

But more importantly, Americans have, for months, said that they’re ready for health reform. National polls have repeatedly revealed a public that wants health reform. Even a poll of voters for Brown after his election showed that while they wanted Scott Brown, they wanted him to work with the Democrats on health reform.

And groups that have been working with the Obama administration for months STILL want health reform.

Who’s been calling for Democrats to start over on health reform? The same folks who’ve been putting up roadblocks – and not just since the legislation was introduced last year, but for YEARS.

It IS time for our elected proponents of health reform to listen, but not to the pundits who are predicting that the next election will spell their doom. It’s definitely not time to listen to renewed suggestions that less is somehow more. Less is definitely less.

It’s time for legislators to listen to the very words that propelled them to the one-yard line of health reform success, because the rationale they have used for months to support their efforts still holds true: The system is still broken. Millions are still uninsured. People without coverage continue to die every day.

If they do listen to the opposition, we hope they’ll listen closely, because they’ll hear the real message loud and clear:

Starting over will be the beginning of the end of health reform.

“It’s all about the health benefits.”

I personally have heard it dozens of times from friends and family, who make it painfully clear that they’re not banging on the door of Corporate America because they’re dying to work in a cubicle. They tell me they’re reluctantly looking for gigs in big business because that’s where they can get approved easily for health insurance – and where they can get it cheap.

We pointed out last fall that without health reform, the American dream will be a nightmare for entrepreneurs. It’s scary enough making the leap to a job without a steady paycheck; it’s even scarier when you face high premiums – or worse, the prospect of denial – on the private market.

This morning, Kristen Gerencher said it again: health reform could “pry open” job lock in the United States.

“We’re finding reasonably consistent evidence that people who are employed are delaying or not starting a business because of their fear of losing health insurance,” says economist Robert Farlie in Gerencher’s report.

How profound is the job lock? As Gerencher points out, “the U.S. has among the lowest share of employment in small businesses compared with its international peers.” And apparently, job lock has the potential to convince some folks that “the American Dream” may not actually be available in … um … America. Ouch.

How would reform help?

1. Gerencher says reform legislation promises to provide tax credits to help small-business owners buy coverage for their worker.
2. In a few years, the self-employed and most small businesses would be able to buy guaranteed coverage on new insurance exchanges.
3. Self-employed people would benefit from a new requirement that health insurers take all applicants regardless of their pre-existing medical conditions.

For the self-employed, those promises relieve a huge psychological burden. Or, as Economist Jonathan Gruber notes, “What this bill is going to accomplish more than anything else is mental well-being.”

Jonathan Cohn of the New Republic said today what a lot of liberals have been saying about the Senate bill. Basically, it’s been stretched and pulled like a gob of saltwater taffy as it morphed into something barely acceptable to barely enough Democrats, but also largely disappointing to a large contingent of other liberals (and completely offensive to most conservatives).

But Cohn also asks the important question, which is whether the bill is still a decent bill – even after a kitchen cram-packed with cooks alternately spiced up and watered down the original recipe until it was, in the eyes of many, not fit for consumption.

So he looked at what the Senate bill would do to families. He took calculations from a pointy headed health care expert from MIT named Jonathan Gruber, who based his calculations on CBO official cost estimates. The result was this nifty chart.

And it doesn’t look … ah … not fit for consumption. In fact, in each of the four scenarios (ranging from 150% of the federal poverty line to 350% of the federal poverty line) examined, the annual premium dropped, the annual out-of-pocket max dropped and the total percentage of income used for health care dropped.

Could it be better? Cohn says, yeah, it could. But should the bill be scrapped, as some liberals have charged? Nope. As Cohn concludes, “we should also recognize the Senate bill for what it is: A measure that will make people’s lives significantly better. Surely that’s worth a little enthusiasm.”

You’ve got our enthusiasm, Jonathan.

Another great question is whether the health reform is ultimately going to look completely different from the proposals President Obama envisioned and talked about during his Presidential campaign. And the answer there, too, is “not so much” (we’re paraphrasing), according to health reform pundit Ezra Klein.

Klein actually says this:

But the basic structure of the proposal is remarkably similar. Here’s how it was described in the campaign’s white paper:

The Obama-Biden plan provides new affordable health insurance options by: (1) guaranteeing eligibility for all health insurance plans; (2) creating a National Health Insurance Exchange to help Americans and businesses purchase private health insurance; (3) providing new tax credits to families who can’t afford health insurance and to small businesses with a new Small Business Health Tax Credit; (4) requiring all large employers to contribute towards health coverage for their employees or towards the cost of the public plan; (5) requiring all children have health care coverage; (5) expanding eligibility for the Medicaid and SCHIP programs; and (6) allowing flexibility for state health reform plans.

So if we stay with our food analogy, Colonel Obama’s Original Recipe may be a little more crispy, but it’s still basically got the core herbs and spices.

We still don’t know what ultimately is going to end up on our plate. Opponents feel they need to continue to fight until the bitter end in the Senate. And then, if the legislation survives the Senate, there’s still the challenge of merging it with the House bill.

The cooks aren’t done tinkering with health reform. It could end up a little spicier. It could end up a little more bland. But for now, at least, we haven’t lost our appetite for change.

Anyone who thought passage of a health reform bill in 2009 would be easy, given the Democratic majority in Congress, was deluded. To think that all of Congressional Democrats – and the Independents they court – would vote in lock step was just plain fantasy.

But even Democrats who knew reform legislation would be all about compromise seem to be completely flattened by this week’s impasse with Sen. Joe Lieberman, who just last week forced Democrats to push aside dreams of a robust public option and drove them to create a “Grand Compromise.” Now that compromise, too, is a non-starter for Lieberman, who promised to vote against the bill if it included an expansion of Medicare.

Progressive Democrats and reform proponents are pretty ticked at Lieberman (one blogger calling him the “Worst Person in History of Universe”) who yesterday said that he was optimistic about an even more stripped-down version of the legislation. “Put me down as encouraged in the direction these discussions are going,” he said. No public option? Great. No expanded Medicare? Even better.

Now, Democrats – who seem more and more like the hapless residents of Whoville – appear ready to roll with the latest punch from Joe and to move on with their ravaged bill, worrying out loud that no bill by Christmas could mean no reform bill at all. Not in during this administration, at least.

The question is whether Lieberman is finished – as Ezra Klein said yesterday – “torturing Liberals.” But it’s also, who will torture the Liberals next? If Lieberman finally steps aside, will Sen. Ben Nelson step in?

I guess, in the spirit of the holidays, what we’re really asking here is:

Will the REAL Grinch please stand up?