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Sunday, December 20, 2009


by JC Leahy

Current Democratic health care "reform" proposals, including both the Senate and House health care bills, assume that (1) everyone needs health insurance, (2) competition occurs when consumers have choices among health care insurance plans (3) health care spending in America is at PROBLEM levels and needs to be reduced (beginning with a $500 billion medicare hit on our parents) (4) an amazingly huge Federal bureaucracy is needed to manage distribution of health care resources, and (5) the Federal Government is capable of safeguarding our funds to pay for health care.

By contrast, the Leahy Health Care Reform Vision assumes that (1) everyone needs access to health CARE, (2) health care spending is a GOOD thing as long as the consumer is getting a good value for his/her money, (3) individual people and their families are the best judges of good value, (4) competition occurs when patients select specific health care services and products DIRECTLY FROM PROVIDERS based on benefits and PRICES (5) paying a huge, expensive Federal and insurance bureaucracy to spend our very own health care money would be fundamentally stupid, and (6) money for helath care is best safeguarded by private ownership.

Here are some advantages of the Leahy Vision:

** Complete portabality when you change jobs.
** No exclusion of pre-existing conditions
** Patients, not bureaucrats, decide what is covered.
** No new Federal bureaucrats are required.
** Medicare is strengthened and preserved, not raided.
** Our childrens' future is not mortgaged to the Chinese .
** Employers become freed to create jobs.
** Health care prices are controlled by supply and demand.
** Wealth is safeguarded by private ownership.
** Without regard for private-pay status, everyone pays fair prices.

12-Point, 2-Page, Leahy Health Care Reform Vision:

1. Reform Health Care Cafeteria Plans – Step one is to remove the use-it-or-lose-it provisions of health care cafeteria plans! (See earlier Journal article for an explanation of health care cafeteria plans.) All you have to do is allow unused balances at the end of every year to carry forward, and allow them be managed exactly like 401k’s.

2. Create Corresponding Plans for the Self Employed

3. Mandate Health Care Savings - Collectively, the plans contemplated in #1 and #2 we will call, Neighbor Bill Accounts. Every man, woman, and child in America who is legally employed will be highly incentivized to contribute not less that 9% and not more than 15% of gross earnings to a Neighbor Bill Account. Every self-employed person will be likewise incentivized to deposit the same percentages to Neighbor Bill Account based on Schedule C gross margin, but only to the extent that there is a business net profit.

4. Provide for Management and Expenditure of Health Care Savings - We will employ a special VISA-like debit card to spend from our Neighbor Bill Accounts. This debit card will be spendable exclusively at places that exclusively sell health care services or products. For example, your VISA debit card could be used at a hospital, a doctor’s office, a healthcare-only website, or a healthcare-only counter at a local pharmacy. Using a simple VISA card will free doctors and hospitals of their claims-processing nightmare. Insurance administration costs will fall to near zero.

5. Provide for Control by the Little People - At their owners’ discretion, Neighbor Bill Accounts may be used to pay for one’s own health care expenses – or one’s spouse, or child, or brother, or niece, or mother-in-law, or lover, or significant other, or even for the health care expenses of a neighbor. The only restrictions will be that (1) funds may only be used for health care, (2) with an important exception I’ll detail below, funds may not be used to pay health insurance premiums, and (3) the owner of the funds may not receive any sort of goods, services, tax deductions, or other kickbacks for paying others’ health care expenses. The reward for such payments is simply not to be in this world.

6. Tax Employer-Provided Health Insurance - Currently, if an employer provides health insurance to employees, the employer is allowed a tax write off for 100% of the insurance cost; and, the employee does not have to include the corresponding amount in his taxable income. This asymmetry is unusual in the tax code and amounts to a special subsidy of employer provided third-party-reimbursement-type health care. This subsidy has created the current, insane societal reliance on employer-provided health insurance. Remove the subsidy. This will gradually free employers of their nightmarish burden of health care costs In the meantime, it will also generate tax revenues.

7 Mandatory Catastrophic Health Care Insurance - Every man, woman, and child in America who has a Neighbor Bill Account must pay for private catastrophic health care insurance. This is the only type of insurance premium that may be paid out of Neighbor Bill Account funds. People with families must have policies that cover their children and non-working spouses. Health care expenses in excess of a high deductible amount will be covered in full by these insurance policies. The annual deductible amount will be $2,000 per person or 5% of the beginning-of-year balance of their Neighbor Bill Account, whichever is higher. The $2,000 amount will be indexed for inflation each year. This universal, mandatory private catastrophic health care insurance will protect the little people from financial wipe-out. The cost to Government will be around zero.

8. Simple Tort Reform - A shockingly large percent of health care services are performed not for clinical expediency but to shelter providers from malpractice trial lawyers. Congress will reform this paradigm by legislating that if you sue anyone in Federal court for malpractice or negligence, and you fail to win on at least one, single point, you will pay half of the defendant’s legal fees and other associated costs. In this way, litigants with slam-dunk-valid claims will be free to pursue them in court, but others will think twice before filing frivolous lawsuits. We, the Clark Kents of America, must force our individual state governments enact that identical rule for state courts.

9. Restrict Employer Write off of Health Insurance Expenses - Currently, certain business expenses are not fully deductible for income taxes. For example, business meals generally are only 50% deductible. In like way, make the employer’s expense for employee health insurance only 50% deductible. This will produce tax revenues and gradually encourage the shift away from employer-provided third-party-payment plans to individually-controlled-and-safeguarded Neighbor Bill Accounts.

10 Abolish the Self Employed Health Insurance Deduction - The Neighbor Bill Account deduction replaces the Self Employed Health Insurance Deduction. The former encourages third-party-payment plans, while the latter is individually controlled.

11. Maintain and Strengthen Medicare-Medicaid - Medicare and Medicaid are in danger of eventual collapse because (1) the population is aging, and (2) they are third-party-payment plans. We can save Medicare and Medicaid with the following just and simple rule: Anyone who has a balance in a Neighbor Bill Account must use those funds before tapping Medicare or Medicaid. This will relieve pressure on Medicare-Medicaid resources, and save the safety nets for those who need them.

12. Establish a commsssion to evaluate existing barriers to the education of physician specialists, and to propose solutions to free medical students to enter the spcialty of their choice.

The Leahy Vision will gently transform our failed health-care financing system dominated by institutional players and third party payers, to a system of individuals and families in control of their own destinies and  empowered by their own resources. The royalty of the health care financing bureaucracy will be de-throned. The future will be free to blossom. Vast sums of money will be set aside for health care and safeguarded by vigilant owners. These sums of health care money with stay with its owners no matter how often they change jobs -- providing complete portability.  It will always be available to cover preexisting conditions.  Catastrophic health insurance will protect us from financial wipe-out. Medicare and Medicaid will protect the poor and the elderly. Most payment processing will be as simple as swiping a VISA card. The little people will spend and save health care resources as they think wise. They will never again be told, like my late neighbor Bill, that treatment they desperately need is not covered by the plan, or can only be obtained by lengthy waiting for complicated appeals. Employers will no longer stagger under the burden of health care costs. Job-creating small employers will get their second wind from a reduction of their income and self-employment taxes. Large employers, over time, will have the crushing burden of employee health care expenses lifted from their shoulders. Medicare and Medicaid will be secured. Doctors and hospitals will be cured of the expensive headache of filing and collecting insurance claims. They will, however, need to produce price estimates and bills that patients can understand and accept.

The future is exciting. It only requires is that you – personally – somehow, in your own way, with your own talents, stop masquerading Clark Kent, get off your haunches and make it happen – starting now, starting today. To Nancy Pelosi, Barack Obama and Hillary Clinton, we must say: YES WE CAN!!!! 


Contact your senator and congressional representatives. Tell them to scrap the current bills. Demand they study the Leahy Health Care Reform Vision.

Raise awareness: Email a link to this article to everyone you know.

Today, please.

JC Leahy

Saturday, December 19, 2009


Hi Everyone!!! Merry Christmas and Happy Holidays!!! Dali and; I went to Tennessee
this past week for our daughter Jessica's nursing school graduation -- which went smoothly. Yeah!! Yesterday, we cut our trip short to try to race back to Maryland ahead of the blizzard. It caught us before we could even get out of Tennessee!!! We traveled 8 miles in 9 hours. Dozens upon dozens of other cars slid off the road into ditches and onto the snowy roadside. Eighteen wheelers one after another came to a stop witout even pulling off the roadway. We finally managed to limp into a (thankfully) large and comportable Marriott convention center at 4am this morning and got the LAST available room. This afternoon, Interstate 81 is closed to the north of us, and according to the news, some motorists have been in their cars for 24 hours. We'll stay here until the roads seem safe -- probably leaving Sunday or
Monday.  When we get back, we'll play catch-up on Christmas preparations. I'm going to make my famous whiskey bread pudding -- which is always well received and fasteaten. :)

Happy Holidays! Stay well, and if you can, stay off the roads during this blizzard.

Yours sincerely,
JC Leahy

Thursday, December 17, 2009

from the mailbox...

I will be making a conscious effort to wish everyone
A Merry Christmas this year ...
My way of saying that I am celebrating
The birth Of Jesus Christ.
So I am asking my email buddies,
If you agree with me,
To please do the same.
And if you'll pass this on to
Your email buddies, and so on...
Maybe we can prevent one more
American tradition from being lost in the sea of
"Political Correctness".


Monday, December 14, 2009


You can support the Journal and simultaneously save money, hassle, gasoline and carbon footprint. Simply do your shopping at and ALWAYS enter through any of the Amazon links on the Journal's website (type or It's that simple! You get easy selection, rock-bottom prices, free shipping and generally no sales taxes. At no cost to you, your whole shopping session will generate a sales referral commission paid to the Journal.

Thank you!
JC Leahy


I ran across this link to a free version of Currency Trading for Dummies. Sounds interesting. I've only scanned my copy, but it looks like a good read, so I'll pass it on to you. Let me know what you think.
The the link was sponsored by -- which, of course, wants to facilitate your international currency trading.
JC Leahy

Sunday, December 13, 2009


AlabamaShelby, Richard C. (R)
Stevens, Ted (R)
Kyl, Jon (R)
McCain, John (R)
Bumpers, Dale (D)
Hutchinson, Tim (D)
Boxer, Barbara (D)
Feinstein, Dianne (D)
Dodd, Christopher J. (D)
Lieberman, Joseph I. (D)

Biden, Joseph R., Jr. (D)
Graham, Bob (D)
Coverdell, Paul (R)
Inouye, Daniel K. (D)
Craig, Larry E. (R)
Kempthorne, Dirk (R)
Moseley-Braun, Carol (D)
Grassley, Chuck (R)
Harkin, Tom (D)
Ford, Wendell H. (D)
McConnell, Mitch (R)
Breaux, John B. (D)
Collins, Susan (R)
Snowe, Olympia J. (R)


Mikulski, Barbara A. (D)

DC Office:
503 Hart Senate Office Building, Washington, DC 20510
Phone: (202)224-4654
FAX: (202-224-8858

Annapolis District Office:
60 West Street, Suite 202, Annapolis, MD 21401-2448
Phone: (410)263-1805 or 410-269-1650
Baltimore District Office:
1629 Thames Street, Baltimore, MD 21231
Phone: (410)962-4510 or (410)962-4512

Greenbelt District Office:
6404 Ivy Lane, Suite 406, Greenbelt, MD 20770-1407
Phone: (301)345-5517

Hagerstown District Office:
32 West Washington Street, Room 203, Hagerstown, MD 21740-4804
Phone: (301)797-2826

Cardin, Benjamin L. (D)

DC Office:
500 Hart Senate Office Building
Washington, DC  (202)224-4524

Kennedy, Edward M. (D)
Kerry, John F. (D)
Abraham, Spencer (R)
Levin, Carl (D)
Grams, Rod (R)
Wellstone, Paul D. (D)
Cochran, Thad (R)
Ashcroft, John (R)
Bond, Christopher S. (R)
Baucus, Max (D)
Burns, Conrad R. (R)
Kerrey, J. Robert (D)
Bryan, Richard H. (D)
Reid, Harry (D)
New Hampshire
Gregg, Judd (R)
Smith, Bob (R)
New Jersey
Lautenberg, Frank R. (D)
New Mexico
Bingaman, Jeff (D)
Domenici, Pete V. (R)
New York
D'Amato, Alfonse M. (R)
Moynihan, Daniel Patrick (D)
North Carolina
Faircloth, Lauch (R)
Helms, Jesse (R)
North Dakota
Dorgan, Byron L. (D)
DeWine, Mike (R)
Nickles, Don (R)
Wyden, Ron (D)
Santorum, Rick (R)
Specter, Arlen (R)
Rhode Island
Chafee, John H. (R)
South Carolina
Hollings, Ernest F. (D)
Thurmond, Strom (R)
South Dakota
Daschle, Thomas A. (D)
Frist, William H. (R)
Thompson, Fred (R)
Hutchison, Kay Bailey (R)
Bennett, Robert F. (R)
Hatch, Orrin G. (R)
Jeffords, James M. (R)
Leahy, Patrick J. (D)
Robb, Charles S. (D)
Warner, John W. (R)
Gorton, Slade (R)
Murray, Patty (D)
West Virginia
Byrd, Robert C. (D)
Rockefeller, John D., IV (D)
Feingold, Russell D. (D)
Kohl, Herb (D)
Enzi, Mike (R)
Thomas, Craig (R)

Monday, November 30, 2009


As you plan your income tax return, don't forget about money you have shelled out to buy, sell, and manage your investments. I categorize investment-related expenses into 4 categories, all of which are treated differently on your tax return:
• Category I: Those that you just can't claim
• Category II: Those that relate to buying and selling particular investments
• Category III: Those that relate to buying, selling, and managing your investments in general
• Category IV: Those that relate to royalty income and real estate rentals.

Costs specifically related to tax-exempt investments can't be claimed on your tax return at all. Congress' reason for making it this way is that if you're not going to have to include the income on your tax return, you shouldn't be able to include the deductions either. That makes sense.
However, here's one little point to remember: IRA's and 401k's and similar vehicles are NOT tax exempt!! They are tax DEFERRED. This means that outlays related to managing your IRA are, indeed, tax deductible if other requirements are met. On the other hand, outlays related to managing your tax-exempt municipal bonds are NOT.
Travel costs to attend an investment seminar, conventions, or stockholder meetings, or to investigate potential rental property are generally NOT tax deductible. Congress made it this way because they noticed that these activities so often occur in warm, sunny vacation locations. That makes a certain amount of sense.
Another investment related outlay that can't be deducted is one that you didn't pay. For example, if your brother Bob paid your annual IRA management fee, you can't deduct it. (Neither can your brother Bob, by the way.) That makes sense.
This leads to one important point of caution, however. If, Bob doesn't pay that IRA management fee, and the IRA management company simply takes it out of your IRA account, you can't deduct it. Why? Because technically, although you control your IRA, you don't own it; it is owned by a trustee. Therefore, if the fee is simply deducted from your IRA account, YOU didn't pay it! Always pay your IRA related expenses from a source outside the IRA; that way they will be deductible!!
Another expense that you just can't deduct is any part of the basic monthly fee for the first telephone line in your house.

Outlays related to buying any investment are capitalized as part of the investment, increasing its cost, or "basis". This reduces the amount of any gain when you ultimately sell the asset.
Outlays related to selling any investment are subtracted from the selling price, reducing it to the "net amount realized." Again, this lowers the amount of any taxable gain when you sell the asset.


Unless you're a "real estate professional" or professional securities trader, which is pretty narrowly defined, all these expenses of owning and managing your investments go on Schedule A (Itemized Deductions) of your Form 1040 as "Miscellaneous Itemized Deductions" -- all except expenses related to royalties and real estate rentals, which go on Schedule E. We'll talk about Schedule E expenses later; let's focus on Miscellaneous Itemized Deductions for now. Almost anything you can think of could be included here as long as these conditions are met:
• You must itemize your deductions using Schedule A of Form 1040.
• You must literally "pay or incur" the expense yourself.
• The expense must be "ordinary and necessary."
• The relationship between the investments and the expense must be "reasonable and proximate."
Here's a partial list of deductions to think about:
  • Fees for investment advice
  • Subscriptions to investment or financial publications
  • IRA setup and custodial fees
  • Software or online services to manage your investments
  • Safe deposit box fees if used to store investment related documents
  • Transportation costs to and from your broker or advisor's office – including mileage
  • Attorney, accounting, or clerical costs
  • Charges for automatic investment services or dividend reinvestment plans
  • Costs to replace lost security certificates
  • Straight-line depreciation on your computer and peripherals to the extent they were used to manage investments
  • Bank deposit losses if not FDIC insured
  • Casualty or theft of non-rental, non-royalty investment property
  • Investment fees for non-publicly offered mutual funds shown in Box 5 of Form 1099-DIV
  • Proxy fight expenses related to non-frivolous policy disputes
  • Salary of a bookkeeper, secretary, or other employee to keep track of investments
  • Investment property management expenses
  • (Investment interest is also deductible but is reported differently that other "investment expenses."  It is NOT included under "miscellaneous itemized deductions;" instead, it has a separate line on Schedule A and potentially requires a Form 4952 to compute its limitations.)
Once you have compiled your list of Miscellaneous Itemized Deductions and investment interest, the amount you can actually deduct is subject to a series of different limitations:
FIRST of all, the amount of any investment interest you are claiming cannot exceed the following amount: investment income minus the deductible portion (after 2% AGI floor) of other related investment expenses.. . This excess investment interest, if any, can be carried over and deducted on your tax return in some future year. There is no limit to the number of years you can carry it forward until you get a chance to use the deduction.  You may be required to submit a Form 4952, "Investment Interest Expense Deduction" do compute and document all of this.
SECOND, most Miscellaneous Itemized Deductions, including investment expenses, are subject to a "2% of AGI Floor." This means that you multiply your adjusted gross income by .02 and subtract that figure from your investment expenses and other Miscellaneous Itemized Deductions.
The only people who don't have to worry about the 2% of AGI reduction are professional securities traders, who can put all their expenses on a Schedule C. These insiders have no reduction or limit on their investment expenses writeo-off at all. (Go figure!!!)
THIRD: If there is anything left after applying the first two limitations, it is subject to being reduced by a "phase out" of your total itemized deductions. Phase-out of miscellaneous itemized deductions occurs if your Adjusted Gross Income exceeds certain thresholds. These thresholds are:
If your filing status is "married filing separately" $79,975
Single $159,950
Head of Household $159.950
Married Filing Jointly $159,950
(2 Singles living together out of wedlock = $159,950 x 2 $319,900)
(Do you see the big marriage penalty in those numbers?)
Generally, for your 2008 return, 27% of itemized deductions above these thresholds evaporate in this sneaky Congressional take-back called the "phase-out" of itemized deductions. Gambling losses, medical expenses (minus 7.5% of AGI "floor"), and casualty/theft losses (minus a series of limitations that apply only to casualties and thefts) are not subject to "phase-out."
And again, there is no phase-out for the insiders who are able to list their investment expenses on Schedule C.
FOURTH: If there is anything left of your Miscellaneous Itemized Deductions at this point, it is now subject to the Alternative Minimum Tax -- which completely disallows all of your investment expense deductions.
Have you heard the term "shell game"???!!!!. Thank Congress! LOL!

Royalty and real estate rental expenses, which appear on Schedule E, must meet the same requirements as the Schedule A expenses, namely:
• You must literally "pay or incur" the expense yourself.
• The expense must be "ordinary and necessary."
• The relationship between the investments and the expense must be "reasonable and proximate."
In order to limit the amount of royalty and rental expenses you can deduct, Congress came up with a scheme that classifies all income into 3 categories: "Earned Income," "Portfolio Income" and "Passive Income." . Earned Income includes wages and the net income (or loss) from conducting a business or a farm and certain other things like unemployment compensation. Any other income, in Congress' view, is "Unearned." Unearned income is divided into Portfolio Income and Passive Income. Portfolio Income is interest and dividends stocks, bonds, and bank accounts. Passive Income relates to things such as real estate rental and royalties. The tricky part about Passive Income is that if your expenses exceed your revenues, the resultant loss CANNOT be deducted unless you have another passive activity that is producing an equal profit – which is referred to as a "passive income generator," or PIG. In most cases, because of depreciation of high-cost assets such as buildings, rental activities generate only a small profit, or, more often, a nondeductible loss. This is to say that the deduction for passive investment expenses is limited to the amount of passive revenue. The excess can be carried over to future years until either the asset is sold, in which case the accumulated carried forward losses become part of a capital transaction, or a PIG comes along.
There is one important exception to the limitation of deducting real estate rental losses. If you have more than 10% of a real estate rental and you help manage it in a "active" way, and if your "Modified Adjusted Gross Income" is less than certain thresholds, you may use up to $25,000 of rental loss to offset other non-passive income, such as a salary. The thresholds are:
Married filing separately Zero
Married filing separately as abandonded spouses $50,000
(But the exception amount is $12,500 each, not $25,000)
Single $100,000
Head of Household $100,000
Married Filing Jointly $100,000
(2 Singles living together out of wedlock = $100,000 x 2 $200,000)
(Anybody see a marriage penalty in these numbers?)
Between $100,000 and $150,000, the $25,000 exception is phased down to zero.
Another exception relates to "qualified real estate professionals." These insiders can deduct their real estate losses fully every time without limit.

The bottom line to all of these complexities, is to keep careful track of all those investment related expenses and consult your tax advisor about how to best use them. For assistance with your income tax filings, you may wish to contact Maximum Legal Refund ™ at or telephone (301)537-5365.


by JC Leahy

For Cyber Monday, Black Friday, and the rest of your Holiday Shopping, remember that you support the Journal when you shop With many purchases, you get the advantage of no shipping charges or sale tax -- that's in addition to getting rock-bottom, below-retail prices. Simply use the Amazon link below (or ANY of the Amazon links contained in the Journal) to enter the Amazon website. That way, your whole shopping session will be attributed to the Journal for a commission to the Journal of up to 15% on everything you buy -- at no cost to you!!

Thursday, November 19, 2009


by JC Leahy
Sigma Theta Tau's "100 Most Extraordinary Nurses Award"

I am writing these details while they are fresh in my mind. I just arrived home from a very unusual doctor visit. I am a registered nurse. I have seen many doctors interview many patients and I have never witnessed anything as bizarre as today's visit with Dr. Korbine. You may actually find it hard to believe:

My insurance company, Northwestern Mutual Life Insurance, wanted me to have an evaluation of a neck injury. They steered me to Dr. Kobrine. The waiting room was nearly empty: me and one other patient attended by 3 staff members. I am, by nature, a friendly guy. At work I smile and say hello to people I pass in the hallway, whether it's Bert the cleaning guy or the hospital chief of surgery, or patients. So, when Dr. Kobrine entered the exam room this morning, I gave him a bright "good morning" and a broad smile.

"Good Morning!" I said.

Dr. Korbine closed the door behind himself, sat down silently, a dour facial expression, avoiding eye contact. Silently, he opened my file and began to read.

It's unfortunate how so many people at so many levels in this world feel entitled to be rude.  I felt awkward that he hadn't responded to my greeting. I tried to recover. "How are you this morning?" I smiled. No response. Only silence.

After reading for a while silently, he asked, "You work for the Department of Veterans Affairs?"

"Yes, I do!!" I responded enthusiastically. " I take care of veterans at the VA Medical Center on Irving Street." I smiled again and held out my Veterans Affairs professional business card.

Dr. Kobrine glanced coolly at my hand but did not take the card from it. "I don't need your business card.".

"Oh....okay....." This WAS awkward!! I placed my card back in my pocket. Dr. Kobrine continued to silently flip through my file.

"Dr. Kobrine," I said politely. "I must say, I find you dogged silence and refusal to interact to be a bit rude. Are you having a bad morning or do you treat all of your patients this way?"

He looked up from his reading, glaring. He looked like he had just been kicked in the stomach. There was anger in his eyes. "WHAT did you just say???!!!"

"I believe you heard me, Dr. Kobrine."

"Let me tell you something!!! I'm not here to be your buddy!!!! I don't need your friendship!!! I don't need your business card!!! I'm here to evaluate your neck!!!! Frankly, I find YOU rude for saying what you just said!!!"

"Please don't misunderstand me, Doctor!! I'm trying to HELP!!! Your waiting room is not exactly overflowing.  Your poor professional demeanor CAN'T be good for your practice! ! And besides, life is too short to be acting like that, don't you agree?"

"Well I don't need your help! I do NOT need your help!!"

"Okay, Doctor. I stand admonished. Proceed with your evaluation."

"I think YOU are the rude one!!!"

"Very well, Doctor. Proceed."

He gave me a little physical exam. Zero small talk. Very tense. When he was finished, he said simply, "That's all."

He turned and left the exam room leaving me sitting there in my undershirt with no good-bye or instructions to go to the front desk or anything at all.

How needlessly unpleasant was Dr. Kobrine!!!!  In short, the good doctor Kobrine exhibited a personality somewhere between Colonel Klink and a dead fish dressed up like Glenn Beck's photo on his new book Arguing With Idiots. I'm not saying Dr. Kobrine is incompetent -- that may or may not be, but it's not my point-- I'm just saying that a patient would have to be a masochist to tolerate his extremely unprofessional bedside manner!!! It takes more than technical skills to be a physician, and Dr. Kobrine simply does not measure up.

Here are his contact data, as listed on his business card:

Arthur I. Kobrine, MD, Ph.D.
Diplomate (sic) American Board of Neurological Surgery
2440 M Street, NW, Suite 315
Washington, DC 20037
Tel. 202-293-7136

Tuesday, November 17, 2009


November 17, 2009

PO Box 2400
Long Beach, CA 90801

Dear Sirs:

Ref. Account #311985804

My AARP membership renewal form is enclosed herewith. Are you kidding??!! After the AARP's baldfaced support of the Democrats' so-called health care reform bill (House version), do not EVER again mail anything to my address!!!

Very sincerely,
2009 "100 Most Outstanding Nurses" Award, Wash, DC

Sunday, November 15, 2009


By JC Leahy

Maybe I was ripped off. You decide. I went to Castle Ford for a "free" oil change. A year's free oil changes had come with my new car. While I was there they gave me a sales pitch for putting nitrogen in my Mustang's tires. It sounded like a novel idea and seemd to make some sense, so I said okay. That cost me around $70. It was a year and a half ago.

Since then, I have done a little research. Replacing air with pure nitrogen in tires was not exactly a novel idea -- just new to me. Nitrogen in tires is common in race car driving and commercial fleets. For race cars, small changes in tire pressure are really important. Race car tires get warm from friction as the car races around the track. Normal air contains water vapor -- humidity -- which expands and contracts a lot more than pure nitrogen. If small changes in tire pressure are important to you -- as they are is in NASCAR racing -- nitrogen makes a lot of sense. On the other hand, if you're just commuting to work, you might not care.

For commercial fleets, nitrogen has other advantages. First, although normal air is 78% nitrogen, it also contains 21% oxygen, a little CO2, a little water vapor (humidity), and minute amounts of noble gasses such as neon and argon. Nitrogen molecules are relatively large. Because of the larger molecular size, the theory is that nitrogen won't seep through the tires as fast as oxygen. That means that tire pressure will be more stable over time, leading to improved fuel efficiency, better tread life, and predictable handling (safety).

Also, because pure nitrogen doesn't contain water vapor or oxygen, there is no oxidation of the tires or the aluminum or steel rims. After all, you can't have oxidation without oxygen. Low oxidation is supposed to reduce tire aging and wheel corrosion.

The National Transportation Safety Administration has confirmed that nitrogen does, indeed, reduce tire aging in commercial fleets. Personally, the tread of my own tires has always worn down long before aging of the rubber ever became an issue. Whether or not reduced tire aging would benefit you is something for you to decide. There is some theoretical benefit.

Consumer Reports conducted a study to determine if nitrogen-filled tires held pressure better than air-filled. They filled 31 assorted tires with nitrogen and 31 matching tires with air. Then they put them outdoors for a year and checked the pressure afterwards. Air-filled tires lost an average of 3.5 psi and the nitrogen tires, 2.2 psi. So, yes, nitrogen tires will hold pressure better. The Consumer Reports study was flawed because their 62 tires were not mounted on cars and driven -- they were just sitting there. It is possible that under actual use, the relative benefit of nitrogen would be greater.

Driving my own Mustang, I noticed no difference in handling between tires filled with air and tires filled with nitrogen. I did imagine I saw a little increase in fuel efficiency, but not much. My preception may have been wishful thinking.

I have concluded that the important goal is to maintain proper tire pressure. Proper tire pressure will give you safer handling, better tread life, and better fuel efficiency. Nitrogen in your tires will do no harm and may help your tires maintain pressure. Nitrogen is not, however, a substitute for regular checking of your tire pressures.

Bottom line: Get yourself a good tire pressure gauge, keep it in your glove compartment, and use it. Buy your tires at somewhere like Costco that will fill your tires with nitrogen for FREE and refill them with nitrogen FREE for the life of the tire. And, by the way, Costco will also give you a pretty great Costco tire warranty on your tires and rotate them free anytime you say, and not charge you anything for mounting and balancing. You can have nitrogen re-filling done while you shop. I would NOT again pay $70 for nitrogen in my tires -- I believe Castle Ford got me on that one. :)

Saturday, November 7, 2009


By JC Leahy is my favorite online shopping web site because they have EVERYTHING and the prices are low. Also, there is usually no sales tax. If you sign up for their "Amazon Prime" deal, you can even get free shipping on anything Amazon sells. Returns are generally simple. And you don't have to drive around town spending time and gasoline. This makes Amazon far better and "greener" than brick-and-mortar retail shopping for most purchases. The exception is with items of clothing that I really want to see, feel, and try on before you buy. Even then, I will often buy, say shoes, hats, shirts, or outdoor jackets online and just return them if I don't like them. In your own Holiday Shopping, or in general whenever you shopl, go to by FIRST going to At Jaitoday, go to the bottom of the page to the the "Amazon Gift Card" link. Click that link to enter the Amazon shopping site. No, you don't have to buy a gift card. This link will take you to the website and you can proceed to shop and buy anything you want. The special deal is that, because you entered Amazon through Jaitoday, Amazon will pay a sales commission to the Journal of American Ideas Today for every item you buy. This commission can range as high as 15%. This way, you can support the Journal at NO COST to you!! Your shopping support will be greatly appreciated!!


JC Leahy, Editor

PS - You can also use any other link located in WWW.JAITODAY.COM. For example, there are links in certain articles to buy books, etc. The Journal will get the commission from any of these links, too. --- JCL



WHATEVER you may think about the current 2000-plus-page health care "reform" bill, TODAY is the time to contact your congressional representative and senators. Here is an easy link for your convenience. And forward this link to EVERYONE YOU KNOW!!!!!!!!!! As the Nike slogan says, Just do it !!!!!!!!!!!!!!!



Saturday, October 31, 2009


by JC Leahy
What a good deal!!! Pay your medical expenses AND save Federal income tax, AND save payroll taxes, AND save State income tax all at the same time!!! Just be careful not to bite the razor blade in that apple!!

As writer Dachary Carey observed, "When you're thinking about ways to manage your medical expenses, one option that many people fail to consider is the flexible spending account." Flexible spending accounts were created by Congress eons ago. They help people pay their families' unreimbursed medical expenses such as co-pays, orthodontics, chronic diabetes or asthma medications, eyeglasses, any sort of surgery, hospitalization, or other medical and drug expenses. A flexible spending account (FSA) is sort of like a 401(k). A certain amount of money is withheld from your paycheck each month, free of income taxes or payroll taxes. Usually you can set aside, by installments each paycheck, $4,000-$5,000 per year. The beauty is that for every $1,000 you put into your FSA, you save 28% or 15% (depending on your tax bracket) of income tax. PLUS Social Security tax of 6.2%, PLUS Medicare tax of 1.45%, PLUS your State income tax. This means in the 28% bracket you save $356.50 in taxes for every $1,000 of medical expenses you channel through your FSA!!! In the 15% bracket it's $226.50. If you sock away $5,000 to FSA, you save $1782.50 or $1,132.50!! Plus State income tax!! What a great tool to ease the burden of medical expenses!!! What a rosy apple Congress had dropped into your bag!!!

There is one problem. In true Lex Luthor fashion, Congress has inserted a razor blade into your apple!! The razor blade is this: When you set aside money for your family's medical expenses in an FSA, and you don't spend it ALL by 12/31 (or whatever your annual deadline is) the institution holding your money gets to confiscate the whole balance. Thousands upon thousands of people lose their entire FSA balances to managing institutions every year!! Do you find that harsh? Hard to believe? Unjust? Do you think it would make more sense to just let folks keep their own money in their FSA for rainy-day medical expenses?
Well, with that caveat, the FSA is a really smart way to help pay family medical expenses. You can use it for medical expenses of you, your spouse, and your dependents. Check with your human resources department about how to begin, because there is usually an annual election made sometime before January 1 -- or sooner. And don't bite into that razor blade!!

PS -- Congress is about to take away, or cap, and/or tax FSA's. As one arrogant SOB, Ron Lieber, wrote in the New York Times, "Use the tax break before you lose it, because many of you probably don't deserve to have it in the first place." Is that arrogant or WHAT??

You might want to e-mail and/or telephone your senators and congressional representative about this. Tell them to leave your FSA alone and get the razor blade out of the damn apple!!! Here's the link for that:



Thursday, October 22, 2009


by JC Leahy

PLEASE take a look at Canada's single-payer health-care system. That type of single-payer system is the STATED goal of Barack Obama, Hillary Clinton, and many influential reformers in the United States.

The Montreal Gazette, a liberal Canadian newspaper, believes that Americans are mis-informed about Canadian health care. A link to that article is below. Believe it or not, the Gazette's DEFENSE of Canadian health care financing goes like this:

1. Health care waiting lines in Canada are "horrible" and getting worse.

2. There is "something fundamentally wrong when individuals in this country (Canada) are forbidden from spending their own money on their own health - unless they go abroad."

3. HOWEVER, the US system is worse because the US has lower life expectancy and higher infant mortality rates.

Hmmm...This assumes that life expectancy and infant mortality depend on the health-care financing system. Actually, however, infant mortality depends largely on low-birth-weight babies, the prevalence of which, in turn, depends very much on race. Life expectancy also, statistically, varies by race. For example, the United States' longest-living group seems to be Japanese Americans. If a single-payer system would make people live longer, Japanese in Japan would live longer than Japanese in America. However, Japanese live about the same length of time whether in Japan or America. Canada's population is mostly white with some Asian, but few blacks. That actually accounts for the differences in infant mortality and life expectancy.

On the other hand, what the Motreal gazette calls "horrible" waiting lines are definitely caused by the single-payer system. Everyone knows and admits this. Also, the ban on spending money on one's own health care results from the single-payer system. After all, if there are "horrible" waiting lines, wouldn't it be unfair to let the "rich" jump to the front of the line just by paying for their own health care??

The Canadian single-payer health care financing system is bad for Canadians. Even it's advoates admit that it creates "horrible" waiting lines. Also it forces many sick people to seek health care outside Canada -- or worse, to die waiting for care. Barack Obama's brand of health care reform is a giant step along the pathway to a Canadian style single-payer system. Democrats are trying to rush this plan through passage before we have a chance to debate it or even to read the legislative bill!! They need to be stopped immediately!!!!

Please, shake off your apathy (if any) and call every senator and congressional representative that you can!!!!!!!!!!!! Now. Here's the link to contact them:

Friday, September 25, 2009


JC Leahy

If you want a little getaway from the city without having to cross the Maryland Bay Bridge or drive all the way to Pennsylvania, you might want to consider the St. Mary's County Fair this weekend. Sunday looks like the best driving day, with rain clearing early. St. Mary's County is Amish country, so watch out for horse-drawn buggies as you drive the rural roads, especially Route 5. A county fair in a rural setting with Amish presence AND a farming community AND a commercial fishing community should be very interesting. For example where else could you witness a major oyster shucking contest!! :)

Besides the fair, there are lots of other things to see in St. Mary's County. You might want to start with the county tourist information center, which is not far from the fairgrounds, located at 37575 Charlotte Hall School Road, Charlotte Hall, MD 20622. From there you can find details on other interesting things like Historic St. Mary's City (first capitol of Maryland), Patuxent River Naval Air Museum, Sotterley Plantation, Smith Island cruises, restaruants, fishing opportunities, and on and on. You could easily make a drive to St. Mary's County an enjoyable weekend getaway with lots to do and places to relax.

For information about the St. Mary's County Fair, see this link:

Tuesday, September 15, 2009


JC Leahy, Accountant on the Scene, Washington, DC

Based on on-the-scene evaluatioin lasting until 1:30 pm on 9/12, the Journal of American Ideas Today originally estimated a 9/12 March on Washington total attendance of a million to 1.2 million. This compared with other estimates ranging as high as 2 million. However, our best current information is that Pennsylvania Avenue is 180 feet wide including sidewalks. We know from having walked the entire walk that folks were not marching on the sidewalks. Allowing for 40 feet of sidewalks, the march's pathway would be 140 feet wide. If Pennsylvania Avenue is only 140 feet wide, then 70 marchers passing over an imaginary intersecting line at any given moment might be too high a figure because that would be one person every 2 feet. We therefore reduce the figure of 70 to 50 marchers passing at any given moment at a speed of approximately 2 miles per hour. It would take only a second for each set of 50 to pass over the imaginary line, making the rate of passage 3,000 per minute. This rate happens to agree with the rate estimated by a videographer whom JC Leahy interviewed at the scene. We know from actual observation that the march ended at 1pm but that the density of marchers was much less by that time. Our best on-the-scene information is that the march went at "full volume" for 2.5 to 3 hours and tapered off after that. If we say, 2.5 hours at full volume at 1.5 hours tapering off to zero at a linear rate, at a "full" rate of 3,000 per minute or 180,000 per hour, that give us: 180,000 x 2.5 plus 90,000 x 1.5 = 585,000 marchers arriving via Pennsylvania Avenue. Some marchers arrived by other routes. If we allow 10%, or 58,500, from other routes, this gives us 643,500 attendees. Round it to 640,000 -- that is the Journal of American Ideas Today's revised attendance estimate for the 9/12 March on Washington. I would add that there is a zero percent chance that fewer than 100,000 attended, as reported my many in newspapers and broadcast.

Monday, September 14, 2009


"I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretence of taking care of them." Thomas Jefferson

Submitted by James Louloudes, Silver Spring, MD

Sunday, September 13, 2009


by JC Leahy, Washington, DC

If you want an exciting day-trip with friends, white water rafting is definitely something to consider. From the Washington-Baltimore area, it makes an easy day trip. I tried white water rafting for the first time recently and it was breathtaking!

(Nurses, with yellow helmets, left to right in above photo: JC Leahy, Janice Zarrabi, Carole Daley, Peggy Cannon, and Nell)

Unless you're really experienced, your best bet is to sign on with any number of guide companies. Some of these are better than others. For example, my daughter and her husband have rafted with several guide companies. One of them sent the raft full of inexperienced rafters out into the rapids and the guide shouted instructions from the shore. That's not a real confidence builder, and not really that helpful. My son in law said that one of the rafting guide companies did a very safe and professional job. When Peggy, my nurse co-worker, got the itch to go rafting, I phoned my son-in-law and got the name of the rafting company he liked. It was Laurel Highlands River Tours, in Ohiopyle, PA.

Five of us left early on a Saturday morning. Laurel Highlands had told us we would spend 6 hours on the river, including a company-provided lunch. My GPS said that Ohiopyle, PA, was 3 hours driving time away. I allowed a half hour to get lost or delayed. With a 10am rafting start time, that meant departure from my house at 6:30am. We departed on time.

It was an interesting ride. Janice and Nell sat in the back seat of my Explorer with Carole between them. All the way to Pennsylvania (and back) they debated something...politics, marriage, sexual issues, and on and on and on. I wish I could talk without any gaps of silence like that. Carol sat between them and as each spoke, Carole looked very interested and earnest, turning her head from one to the other as each spoke. I thought her neck would get sore. Peggy and I sat in the front chatting.

When we arrived, we were given lifejackets, paddles, and an introductory speech that led us to believe that death awaited us on the river. We were offered a chance to back out without shame. As a matter of fact, it's probably safer to fly a commercial airliner; the speech is mostly just a part of the excitement package. At least, that's what I assured the 4 nurses in my party.

We paid a few buck extra to have a guide in the boat with us. Good move. Really good move!! Unless you're experienced, don't go without a guide inside your boat, please. Nell sat in the back of the boat a bit sour that the rapids weren't bigger. She expected more and she wanted to let us all know. Wouldn't you know --- it was Nell who fell out of the boat into the raging rapids. Our guide grabbed her and dragged her back into the boat before the rest of us noticed she was missing.

Lunch was nothing fancy -- sandwiches and juice. I was rafting with 4 women, and I felt a little put-off when the head guide announced that ladies would go first to the food. "Ladies first!! Ladies first, please!! I'm sorry, ladies first --- PLEASE!!! Ladies, kindly fall in line here, make a sandwich and bring it to your man. Then make one for yourself!" LOL! That's river humor. Let me know if they use the same joke when you go.

When we finished, I tipped our guide $20. Nell paid extra.

This company is Laurel Highlands River Tours. The river is the Youghiogheny River.

(At left: JC Leahy and Peggy Cannon on the Youghiogheny River.)

Saturday, September 12, 2009


JC Leahy, 9/12/09, Washington, DC

I made my way downtown early this morning with low expectations. I thought the "March on Washington" would be small. What I encountered was the experience of a lifetime!!!!

I got up early and put on my best lab coat. The sky threatened rain. I phoned the Army and Navy Club to find out whether I could drive or needed to take the Metro subway. The roads were reported clear. That reinforced my expectation of a small turnout of demonstrators. I down 16th Street to the Club two blocks from the White House, left my car with the valet, and strolled off in the direction of Freedom Plaza. As I passed the White House, I encountered the first of the demonstrators. They were in small groups, ranging from 3 or 4 to 20. Some were posing for photos in front of the White House. I mistook them for the main gathering, and thought that this would be a small demonstration, indeed. My hands were full with my camera, a shoulder bag, and 500 flyers about health care and JITODAY.COM. I began passing out flyers and talking to folks. Everyone was friendly. Everyone was polite. Most of them were actually engaging. Woah! Friendly? Polite? Engaging? I began to wonder where they were from.

I continued on towards the "advertised" gathering point at Freedom Plaza, a couple of blocks east. The crowd at Freedon Plaza was huge. I commenced to chat with various people and pass out flyers I asked them where they came from. They came from Florida,Texas, Massachusetts, New Jersey, San Fransisco, Georgia, Arizona, the Carolinas, Ohio. Panama City Panama., and many other places. There were mothers with babies in strollers (even some double strollers!!), parents and children strolling along together, friends chatting as they walked, and a wheelchair-bound folks of different ages, all moving along together. My 500 flyers were gone as fast as I could separate the pages and hand them out. I talked with an easy 600 people. There was no one there from Washington, DC.


(Photo at right: The crowd encircled the massive reflecting pool and stretched all the way to the steps of the Capitol and around to the sides!!! )

As I walked along Pennsylvania Avenue towards the Capitol, the throng of people was so thick that I had difficulty positioning myself to take pictures. I began to marvel at how many people there were! One woman with a video on a tripod at the roadside said at 11:20AM that she had been video taping the crowd for an hour and 23 mintues straight and still couldn't see the end of the line. Wow! That's going to make a really interesting home video! But -- I had the impression I was near the front of the parade. I had no idea that there were at least and hour and 23 minutes of crowd in front of me. That meant this was a really big crowd. I walked along and found another guy with a video on a tripod. He had been taping the parade for an hour and a half. He told me that at least 3,000 people per minute were passing. Wow! Another great home video! Three thousand a minute?? I thought that must be wrong, so I stopped and watched. I imagined a straight line drawn across the street. I estimated that at any point in time, there must be at least 70 people stepping over the line -- maybe more. It didn't take them more than a second to pass over the line. 70 people times 60 seconds was...4,200 people a minute. Wow! If he had been video taping for 1.5 hours and there were 4,200 people a minute passing....there were at least 378,000 people in front of me!! And at 4,200 people per minute, that's 252,000 people per hour marching down Pennsylvania Avenue for hours. Woah! This was getting interesting! Later I would learn that the Daily Mail newspaper had each estimated a total crowd of 2 million!!! (But I'm the accountant, right? My estimate is that around 951,000 people arrived by Pennsylvania Avenue and some arrived by other routes. I say, a million to 1.1 million people attended. That's the official Journal of American Ideas Today estimate.)

As I said, the crowd was strikingly well behaved. I talked with hundreds and hundreds of people, and encountered 30-40 health care professionals, mostly doctors and nurses but there were a significant number of occupational therapists and EMT's. I joked with them that we ALL should have worn our lab coats to show that many health professionals are opposed to President Obama's scheme. They all laughed and agreed. I didn't see any other lab coats in the crowd but mine. As a result, a number of people wanted to take my picture or have their picture taken with me, What fun!

When I reached the Capitol's reflecting pool, I was dumbstruck by the vastness of the crowd. How spectacular!! The crowd encircled the entire pool and extended all the way to the steps of the Capitol and around its sides. It was awesome! I worked my way around the pool, trying to capture the vastness of the crowd on film. I'm not sure that I succeeded.

Eventually, I decided to leave early before the rest of the crowd and before any rain might fall. It was 1pm. I was shocked to discover that the throng of marchers was still arriving down Pennsylvania Avenue!! I took another street back to the Club, past Freedom Plaza where it had all started. The crowd was gone from Freedom Plaza -- gone to the Capitol. I made a mental note that someone must have cleaned the Plaza already because except for some overflowing trash cans, it was remarkably litter-free.

What an amazing and uplifting time!

PS - In case you have an interest, I took the above photos with a Canon Elan IIE camera with a 28-135mm zoom f3.5-5.6 lens and Kodak print film.

Friday, September 11, 2009

Now, A Word About Health Care :)


As a registered nurse and masters-educated accountant, and simply as an interested citizen, I have been reading about health care reform for years. I have noticed something pretty important: Some of the words used by reformers, including President Obama, do not mean what you might think they mean. For example, if I told you that bread cost too much and I wanted to reduce the cost of bread, you would probably think I wanted to lower the price-per-loaf of bread. That might be a good thing. However, in the realm of health care financing, they don't talk about price; they talk about COST. It's not the same thing at all!!! In the health-care-system analogy, the principal way of reducing the cost of bread is to either give you less bread or to make sure the supermarket only collects a dime for each loaf of bread it delivers to you. Either way, you get less bread. Key point: price and cost mean different things. Health care reformers talk about costs, not prices. Theoretically, the health care reformer could reduce the cost of your bread to zero by simply not giving you any bread! The problem is that when they reduce the cost, you eventually pay the price. Having learned from Marie Antoinette's misfortune, however, the wise health care regulator would never say, "Let them eat cake!" but rather would provide just enough bread to avoid revolution -- which is not a pleasant prospect for folks needing health care!! Americans can do better than that!!

I want to talk to you about health care reform. We can learn from each other. Please join me at my blog site, and or e-mail me at



The March on Washington tomorrow (9/12) looks interesting -- lots of speakers & entertainment - plus a chance to march down Pennsylvania Avenue from the White House to the Capitol. I think I'll wear my lab coat, bring my camera & go downtown to check it out.

Here's the link to the event website if you're interested.

PS - If you're interested in going downtown together, shoot me an email. :)

Nurse JC Leahy
2009 "100 Most Outstanding Nurses" Award, Wash, DC

Thursday, September 10, 2009


September 9, 2009

Madam Speaker, Vice President Biden, members of Congress, and the American people:

When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression. We were losing an average of 700,000 jobs per month. Credit was frozen. And our financial system was on the verge of collapse.

As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods. A full and vibrant recovery is many months away. And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes. That is our ultimate goal. But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.

I want to thank the members of this body for your efforts and your support in these last several months, and especially those who have taken the difficult votes that have put us on a path to recovery. I also want to thank the American people for their patience and resolve during this trying time for our nation.

But we did not come here just to clean up crises. We came to build a future. So tonight, I return to speak to all of you about an issue that is central to that future — and that is the issue of health care.

I am not the first president to take up this cause, but I am determined to be the last. It has now been nearly a century since Theodore Roosevelt first called for health care reform. And ever since, nearly every president and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way. A bill for comprehensive health reform was first introduced by John Dingell Sr. in 1943. Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.

Our collective failure to meet this challenge — year after year, decade after decade — has led us to a breaking point. Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy. These are not primarily people on welfare. These are middle-class Americans. Some can't get insurance on the job. Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer. Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.

We are the only advanced democracy on Earth — the only wealthy nation — that allows such hardships for millions of its people. There are now more than 30 million American citizens who cannot get coverage. In just a two year period, one in every three Americans goes without health care coverage at some point. And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone.

But the problem that plagues the health care system is not just a problem of the uninsured. Those who do have insurance have never had less security and stability than they do today. More and more Americans worry that if you move, lose your job, or change your job, you'll lose your health insurance too. More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care. It happens every day.

One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn't reported gallstones that he didn't even know about. They delayed his treatment, and he died because of it. Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne. By the time she had her insurance reinstated, her breast cancer more than doubled in size. That is heartbreaking, it is wrong, and no one should be treated that way in the United States of America.

Then there's the problem of rising costs. We spend one-and-a-half times more per person on health care than any other country, but we aren't any healthier for it. This is one of the reasons that insurance premiums have gone up three times faster than wages. It's why so many employers — especially small businesses — are forcing their employees to pay more for insurance, or are dropping their coverage entirely. It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally — like our automakers — are at a huge disadvantage. And it's why those of us with health insurance are also paying a hidden and growing tax for those without it — about $1000 per year that pays for somebody else's emergency room and charitable care.

Finally, our health care system is placing an unsustainable burden on taxpayers. When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid. If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined. Put simply, our health care problem is our deficit problem. Nothing else even comes close.

These are the facts. Nobody disputes them. We know we must reform this system. The question is how.

There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone. On the right, there are those who argue that we should end the employer-based system and leave individuals to buy health insurance on their own.

I have to say that there are arguments to be made for both approaches. But either one would represent a radical shift that would disrupt the health care most people currently have. Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch. And that is precisely what those of you in Congress have tried to do over the past several months.

During that time, we have seen Washington at its best and its worst.

We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform. Of the five committees asked to develop bills, four have completed their work, and the Senate Finance Committee announced today that it will move forward next week. That has never happened before.

Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies — many of whom opposed reform in the past. And there is agreement in this chamber on about 80 percent of what needs to be done, putting us closer to the goal of reform than we have ever been.

But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government. Instead of honest debate, we have seen scare tactics. Some have dug into unyielding ideological camps that offer no hope of compromise. Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge. And out of this blizzard of charges and countercharges, confusion has reigned.

Well the time for bickering is over. The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care.

The plan I'm announcing tonight would meet three basic goals:

It will provide more security and stability to those who have health insurance. It will provide insurance to those who don't. And it will slow the growth of health care costs for our families, our businesses, and our government. It's a plan that asks everyone to take responsibility for meeting this challenge — not just government and insurance companies, but employers and individuals. And it's a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans — and yes, from some of my opponents in both the primary and general election.

Here are the details that every American needs to know about this plan:

First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.

What this plan will do is to make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies — because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.

That's what Americans who have health insurance can expect from this plan — more security and stability.

Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange — a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. It's how everyone in this Congress gets affordable insurance. And it's time to give every American the same opportunity that we've given ourselves.

For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need. And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned. This exchange will take effect in four years, which will give us time to do it right. In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. This was a good idea when Senator John McCain proposed it in the campaign, it's a good idea now, and we should embrace it.

Now, even if we provide these affordable options, there may be those — particularly the young and healthy — who still want to take the risk and go without coverage. There may still be companies that refuse to do right by their workers. The problem is, such irresponsible behavior costs all the rest of us money. If there are affordable options and people still don't sign up for health insurance, it means we pay for those people's expensive emergency room visits. If some businesses don't provide workers health care, it forces the rest of us to pick up the tab when their workers get sick, and gives those businesses an unfair advantage over their competitors. And unless everybody does their part, many of the insurance reforms we seek — especially requiring insurance companies to cover pre-existing conditions — just can't be achieved.

That's why under my plan, individuals will be required to carry basic health insurance — just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still cannot afford coverage, and 95 percent of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements. But we cannot have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees. Improving our health care system only works if everybody does their part.

While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses to purchase affordable coverage, and a requirement that people who can afford insurance get insurance.

And I have no doubt that these reforms would greatly benefit Americans from all walks of life, as well as the economy as a whole. Still, given all the misinformation that's been spread over the past few months, I realize that many Americans have grown nervous about reform. So tonight I'd like to address some of the key controversies that are still out there.

Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Such a charge would be laughable if it weren't so cynical and irresponsible. It is a lie, plain and simple.

There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false — the reforms I'm proposing would not apply to those who are here illegally.

And one more misunderstanding I want to clear up — under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.

My health care proposal has also been attacked by some who oppose reform as a "government takeover" of the entire health care system. As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly sponsored insurance option, administered by the government just like Medicaid or Medicare.

So let me set the record straight. My guiding principle is, and always has been, that consumers do better when there is choice and competition. Unfortunately, in 34 states, 75 percent of the insurance market is controlled by five or fewer companies. In Alabama, almost 90 percent is controlled by just one company. Without competition, the price of insurance goes up and the quality goes down. And it makes it easier for insurance companies to treat their customers badly — by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.

Insurance executives don't do this because they are bad people. They do it because it's profitable. As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill; they are rewarded for it. All of this is in service of meeting what this former executive called "Wall Street's relentless profit expectations."

Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. The insurance reforms that I've already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear — it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5 percent of Americans would sign up.

Despite all this, the insurance companies and their allies don't like this idea. They argue that these private companies can't fairly compete with the government. And they'd be right if taxpayers were subsidizing this public insurance option. But they won't be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers. It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities.

It's worth noting that a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight. But its impact shouldn't be exaggerated — by the left, the right, or the media. It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it. The public option is only a means to that end — and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have.

For example, some have suggested that that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others propose a co-op or another nonprofit entity to administer the plan. These are all constructive ideas worth exploring. But I will not back down on the basic principle that if Americans can't find affordable coverage, we will provide you with a choice. And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need.

Finally, let me discuss an issue that is a great concern to me, to members of this chamber, and to the public — and that is how we pay for this plan.

Here's what you need to know. First, I will not sign a plan that adds one dime to our deficits — either now or in the future. Period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize. Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for — from the Iraq War to tax breaks for the wealthy. I will not make that same mistake with health care.

Second, we've estimated that most of this plan can be paid for by finding savings within the existing health care system — a system that is currently full of waste and abuse. Right now, too much of the hard-earned savings and tax dollars we spend on health care doesn't make us healthier. That's not my judgment — it's the judgment of medical professionals across this country. And this is also true when it comes to Medicare and Medicaid.

In fact, I want to speak directly to America's seniors for a moment, because Medicare is another issue that's been subjected to demagoguery and distortion during the course of this debate.

More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years. That is how Medicare was born. And it remains a sacred trust that must be passed down from one generation to the next. That is why not a dollar of the Medicare trust fund will be used to pay for this plan.

The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies — subsidies that do everything to pad their profits and nothing to improve your care. And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.

These steps will ensure that you — America's seniors — get the benefits you've been promised. They will ensure that Medicare is there for future generations. And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pocket for prescription drugs. That's what this plan will do for you. So don't pay attention to those scary stories about how your benefits will be cut — especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past, and just this year supported a budget that would have essentially turned Medicare into a privatized voucher program. That will never happen on my watch. I will protect Medicare.

Now, because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody. We have long known that some places, like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania, offer high-quality care at costs below average. The commission can help encourage the adoption of these common sense best practices by doctors and medical professionals throughout the system — everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.

Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan. Much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers. This reform will charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money — an idea which has the support of Democratic and Republican experts. And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long-run.

Finally, many in this chamber — particularly on the Republican side of the aisle — have long insisted that reforming our medical malpractice laws can help bring down the cost of health care. I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine. I know that the Bush Administration considered authorizing demonstration projects in individual states to test these issues. It's a good idea, and I am directing my Secretary of Health and Human Services to move forward on this initiative today.

Add it all up, and the plan I'm proposing will cost around $900 billion over ten years — less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the beginning of the previous administration. Most of these costs will be paid for with money already being spent — but spent badly — in the existing health care system. The plan will not add to our deficit. The middle-class will realize greater security, not higher taxes. And if we are able to slow the growth of health care costs by just one-tenth of one percent each year, it will actually reduce the deficit by $4 trillion over the long term.

This is the plan I'm proposing. It's a plan that incorporates ideas from many of the people in this room tonight — Democrats and Republicans. And I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open.

But know this: I will not waste time with those who have made the calculation that it's better politics to kill this plan than improve it. I will not stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what's in the plan, we will call you out. And I will not accept the status quo as a solution. Not this time. Not now.

Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it most. And more will die as a result. We know these things to be true.

That is why we cannot fail. Because there are too many Americans counting on us to succeed — the ones who suffer silently, and the ones who shared their stories with us at town hall meetings, in e-mails, and in letters.

I received one of those letters a few days ago. It was from our beloved friend and colleague, Ted Kennedy. He had written it back in May, shortly after he was told that his illness was terminal. He asked that it be delivered upon his death.

In it, he spoke about what a happy time his last months were, thanks to the love and support of family and friends, his wife, Vicki, and his children, who are here tonight . And he expressed confidence that this would be the year that health care reform — "that great unfinished business of our society," he called it — would finally pass. He repeated the truth that health care is decisive for our future prosperity, but he also reminded me that "it concerns more than material things." "What we face," he wrote, "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."

I've thought about that phrase quite a bit in recent days — the character of our country. One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government. And figuring out the appropriate size and role of government has always been a source of rigorous and sometimes angry debate.

For some of Ted Kennedy's critics, his brand of liberalism represented an affront to American liberty. In their mind, his passion for universal health care was nothing more than a passion for big government.

But those of us who knew Teddy and worked with him here — people of both parties — know that what drove him was something more. His friend, Orrin Hatch, knows that. They worked together to provide children with health insurance. His friend John McCain knows that. They worked together on a Patient's Bill of Rights. His friend Chuck Grassley knows that. They worked together to provide health care to children with disabilities.

On issues like these, Ted Kennedy's passion was born not of some rigid ideology, but of his own experience. It was the experience of having two children stricken with cancer. He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick; and he was able to imagine what it must be like for those without insurance; what it would be like to have to say to a wife or a child or an aging parent — there is something that could make you better, but I just can't afford it.

That large-heartedness — that concern and regard for the plight of others — is not a partisan feeling. It is not a Republican or a Democratic feeling. It, too, is part of the American character. Our ability to stand in other people's shoes. A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand. A belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise.

This has always been the history of our progress. In 1933, when over half of our seniors could not support themselves and millions had seen their savings wiped away, there were those who argued that Social Security would lead to socialism. But the men and women of Congress stood fast, and we are all the better for it. In 1965, when some argued that Medicare represented a government takeover of health care, members of Congress, Democrats and Republicans, did not back down. They joined together so that all of us could enter our golden years with some basic peace of mind.

You see, our predecessors understood that government could not, and should not, solve every problem. They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom. But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited. And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes for wisdom; and we can no longer even engage in a civil conversation with each other over the things that truly matter — that at that point we don't merely lose our capacity to solve big challenges. We lose something essential about ourselves.

What was true then remains true today. I understand how difficult this health care debate has been. I know that many in this country are deeply skeptical that government is looking out for them. I understand that the politically safe move would be to kick the can further down the road — to defer reform one more year, or one more election, or one more term.

But that's not what the moment calls for. That's not what we came here to do. We did not come to fear the future. We came here to shape it. I still believe we can act even when it's hard. I still believe we can replace acrimony with civility, and gridlock with progress. I still believe we can do great things, and that here and now we will meet history's test.

Because that is who we are. That is our calling. That is our character. Thank you, God bless you, and may God bless the United States of America.