Last week, the National Journal invited health care advocates and industry experts to weigh in on whether health care reform was still possible in 2009. They also asked, "Does health care reform have to be bipartisan in order to move forward?" and, finally, "Does it still make sense for the next nominee for HHS secretary to also head the White House Office on Health Reform?" SEIU President Andy Stern's response is below:

"Fixing health care isn't just possible this year - it's absolutely necessary. Every day, people are losing their jobs and their health care. The swelling ranks of uninsured threaten to put more strain on state programs and push the entire system to the breaking point. If health care isn't fixed, the risk is a growing catastrophe on top of the ones we already face. The unemployment rate is now 7.6% --- up from 4.9% a year ago. For every 1 percentage point rise in unemployment, another 1.1 million people lose their health coverage. Clearly, the time to act is now. As President Obama put it: "In order to fix our economic crisis, and rebuild our middle class, we need to fix our health care system, too."

"Health care reform can happen this year if lawmakers, business, labor, health care providers and activists come together to advance a common goal: quality, affordable health care where everyone pays their fair share. It can happen if we agree to build on existing coverage arrangements instead of disrupting them - the current system of employer-sponsored coverage and public programs such as Medicare, Medicaid, SCHIP. Reform should also include ending discrimination by insurance companies, offering financial assistance, and rewarding providers and insurers for quality instead of quantity of services provided. We know that when everyone participates, shared accountability works.

"The future Health and Human Services Secretary will no doubt be a partner in the movement to fix health care. But, real change comes from the ground up. It comes from workers saying enough to surging health care costs and shrinking benefits. It comes from doctors and nurses saying enough to a system that puts profits ahead of patients. The reauthorization of SCHIP and inclusion of health information technology in the recovery act are already significant downpayments on broader health care reform. Let's not stop now. All across the country, voters sent a clear mandate this fall to make the American Dream affordable again - and put an end to Washington's bickering-as-usual. A health care system that works for everyone is essential to building an economy with lasting strength."

This week, the National Journal asked health care advocates and experts to weigh in on the issue of health IT as part of the larger economic recovery package. The Journal asked, "What do you see as the pros or cons of including $10 billion a year for health information technology in the stimulus package? Are there any reasons to be cautious about moving forward with this initiative?"

SEIU President Andy Stern responded below:

Cross-posted from the National Journal's health care blog. The Journal posed this question:

Yes, make COBRA easier to get and easier to use. People are losing their jobs and losing their coverage, so there's no time to waste. With unemployment at a 16-year high, expect the ranks of the uninsured to swell, putting more strain on state programs that help those in need. COBRA - if made to work - can literally be a lifeline.

Part of the problem with COBRA is that many workers don't qualify as it is - if their employers don't offer coverage in the first place or if their employers go out of business.

What's more, COBRA is unaffordable even to those who are eligible, as the Families USA report makes clear. People who are unemployed are often barely able to pay their mortgages, much less the full cost of a health care premium. Even 20% of the premium would be a financial strain on most unemployed workers, given that the cost of an individual premium is more than $4,000 and family coverage exceeds $12,000.

The solution:

- Allow workers who don't have access to COBRA the opportunity to enroll in Medicaid with a small premium contribution - no more than 5% of their income.

- Provide COBRA-eligible workers with a subsidy or tax credit that covers 80% of the premium.

- Expand the time period for COBRA eligibility - currently 18 months in most cases - to 36 months, given the severe economic downturn. Older workers in particular may have the hardest time finding another job.

Rising unemployment is making our health care crisis even worse, highlighting the need for comprehensive reform. We can't get the economy back on track without fixing health care, and workers can't get back to work if they're sick or have lost their homes due to medical debt. Let's fix COBRA now, so the downturn doesn't push more families into financial ruin.

This week, the National Journal invited key health care advocates and experts to respond to the following question:

What early health care victories should President-elect Obama and Congress seek before Washington works on broad health care reform legislation?

My response is below:

As the economy sputters, fixing health care becomes more and more urgent. President-elect Obama has made clear that solving our health care crisis is crucial to repairing our economy. He's right. Let's get to work.

Any health care remedies need to be part of a comprehensive solution to bring down costs, make health care accessible to everyone, and improve quality. First up, working families need fast action to keep our broken health care system from backsliding further, including:

- Reauthorize SCHIP, the State Children's Health Insurance Program. Even with SCHIP, nearly 8 million children don't have health insurance - children whose parents make too much money to qualify and yet still can't afford coverage. As the economy slows, more parents risk losing their jobs and losing their health care - or having their hours cut and losing their health care. Certainly, at a minimum, Congress should quickly reauthorize a proven program with broad support that offers a lifeline to low-income families - even as we push forward with making sure millions more uninsured children enroll in good health care. Only by insuring the uninsured can we eliminate income and racial disparities in the incidence of chronic disease and bring down health costs overall.

- Increase FMAP, the Federal Medical Assistance Percentages program, so states can preserve crucial services. Again, now is not the time for backsliding. We need to shore up programs that work and build on them, or else the downturn will sink more families and communities already nearing the breaking point.

How much does health reform really cost, and what are the best and worst ideas for achieving it?

"The failures of our current system are already costing us billions. If we do nothing and let health care continue on its current course, the cost would be greater than the cure," writes SEIU President Andy Stern yesterday on NationalJournal.com's Health Care Expert Blog.

Read the rest of Stern's response addressing the real cost of health reform:

As it is, health care costs are going up every year, threatening the economic security of working families and hurting business productivity. As costs rise, more and more Americans are forced to drop their health coverage -- resulting in people getting sicker, showing up at hospitals without insurance, and driving up costs for everyone. Meanwhile, U.S. business spending on health care is nearly twice as much per person as our OECD competitors. The longer we wait to fix health care, the worse it will get.

That's why Sen. Baucus's "Call to Action" is so timely -- and such an important step to move this process forward. We at SEIU were especially pleased to see strong support for access and coverage -- including a public plan option that ensures coverage for every American -- plus, strategies for cost containment, payment and delivery system reform, transparency, and more options for long-term care. We agree that the only way to fix the problem is to address access, quality, and cost together.

The New America Foundation estimates that our economy loses as much as $200 billion a year because of the poor health and shorter lifespan of the uninsured -- far more than the price of reform.

So, if it's cost we're talking about, we can't afford not to fix health care.

Check out Andy Stern's post on National Journal here - and then please make the pledge to help keep health care on the map in 2009.

"This election showed that American workers are struggling with the rising cost of everything -- from food to fuel to housing to health care. They know that skyrocketing health costs are shrinking their paychecks, and if they lose their jobs they lose their health care," writes SEIU President Andy Stern on NationalJournal.com.

"...[T]oo many Americans fear they are just one health care crisis from financial ruin." Read the full response here.