An Open Letter to President Obama

The Honorable Barack Obama

The White House

Washington, DC

Dear President Obama:

I've lost count of the number of times I've written you, Melody Barnes, Kareem Dale, and Nancy DeParle without receiving a single response. You aren't listening and it's costing you.

I'm a devastatingly sick lawyer who runs a small nonprofit called Advocacy for Patients with Chronic Illness. You want stories about why we need health insurance reform? I have so many that Senator Dodd actually told one of them on the floor of the Senate. You need a new approach. Please, please listen.

Eliminate the CLASS Act. I don't know how much money it would save, but it would be a bundle and we can afford to cut it loose.

Write a short, uncomplicated bill -- no pre-existing condition exclusions, no lifetime caps, no annual caps, no premium rating based on gender or health history. Have a national high risk pool for people with pre-existing conditions until the new rules kick in. Cap the premiums and out-of-pocket expenses for the high risk pool on a sliding scale based on income. That would be enough to give people with pre-existing conditions an option almost immediately.

Create an Exchange (at this point, I don’t care if it’s state or national) solely so people can shop for insurance and see what their options are. No required benefit package for now. No mandates for now. Just a place where people can shop and see what their options are.

I understand -- the insurance companies won't go along with this without a mandate. But you can't get Republican votes for a mandate, and you can't have a mandate without subsidies, and you can't get Republican votes for subsidies. So shove it down the insurance companies' throats. Nobody will care about them if Senators Snowe and Collins, and possibly others, vote for this modest plan. Nobody will be able to lie about a government take-over because it will be modest. It will just eliminate unfairness and create a marketplace with transparency.

If you sat where I sit and took the calls all day that I take, you would know that this smaller set of reforms would make a real difference. Is it enough? No, we should have single payer universal health care! But can we get this? I believe you would have enough Republican votes to pass a simple bill that did nothing but reform the insurance industry and make it easier for consumers to see their options.

Then soon, but separately, plug the doughnut hole in Medicare Part D so disabled and elderly people with Medicare can afford their medication.

Then maybe a little later, you can come back to an individual mandate and subsidies.

Believe me -- I am grieving this loss deeply. But since you weren't in Massachusetts when you should have been, and the Democratic Party completely dropped the ball, you now have to pass what you can. If Barney Frank is saying we have to defer to Senator-elect Brown, then that's the answer -- no more progressive member of Congress can be found. We have to scale back, and really, it’s okay if you would just focus on the things that are most critical.

So eat crow. Let go of the big stuff. Pass insurance reform. Keep it simple. Let the Republicans say what they will -- you would get Senators Snowe and Collins and maybe others if you just did insurance reform.

I'm begging you, please. I can't keep taking phone calls every day from people who've lost their jobs and their insurance and their houses and I have nothing for them. I get calls from people living in cars. I know a larger response is required. But for whatever reason, the opportunity is now lost and you have to do what you can. Please, Mr. President. Please hear me. I speak for many thousands of people when I say that if you did nothing other than insurance reforms, an Exchange, a national high risk pool with sliding scale premiums, and plugging up the doughnut hole in Medicare, you could declare victory and we would stand with you.

Please, please hear me. I am desperate. My clients are desperate. Please help us.

Thank you.

Sincerely,

Jennifer C. Jaff