Health and Human Services Secretary Kathleen Sebelius issued reports on Friday detailing the problems with the “health care status quo” across the country. You can find the reports at HealthReform.gov. The report for Iowa is here, and I’ve also posted it after the jump. Among other things, it shows the percent increase in family health insurance premiums since 2000 and the percentage of uninsured Iowans.

A couple of points jumped out at me:

• Choice of health insurance is limited in Iowa. Wellmark BC and BS alone constitutes 71 percent of the health insurance market share in Iowa, with the top two insurance providers accounting for 80 percent.11

Iowa is not unusual in this regard. Most insurance markets in the United States are dominated by one or two companies. My family’s Wellmark premiums went up 10 percent this year alone. Speaking of which, the annual salary of Wellmark’s CEO has “nearly doubled” in the past five years to about $2.5 million.

• Choice is even more limited for people with pre-existing conditions. In Iowa, premiums can vary, within limits, based on demographic factors and health status, and coverage can exclude pre-existing conditions or even be denied completely.

I know a family in Des Moines who were unable to purchase health insurance at any price because the mother has a thyroid condition. They are now covered through the father’s employer, but if he loses his job they will have no health insurance options.

Two more reasons why we cannot settle for health care reform without a public option, or with a fake public option. I was glad to see several House Democratic caucuses affirm that they will fight any health care bill lacking “a real and robust public option that lives up to our criteria”.

Click “there’s more” to read the whole report, with supporting footnotes.

House Republican leader John Boehner was on CNN Sunday morning:

“We’ve got the greatest health care delivery system in the world,” he added. “Why do we want to jeopardize that with a big government run health care system?”

Because our health care delivery system directs about 31 percent of total health spending to administrative costs.

Because our health care delivery system makes Americans more likely to go without certain medical procedures despite astronomical per capita spending on health care.

Because our health care delivery system leads to overuse of emergency rooms by insured as well as uninsured Americans.

Because our health care delivery system leaves uninsured trauma patients 50 percent more likely to die than trauma patients covered by insurance.

Because our health care delivery system causes uninsured people to be denied organ transplants on the grounds that they will lack the capacity to pay for anti-rejection medications.

Because our health care delivery system prompts insured as well as uninsured Americans to delay medical treatment for chronic illnesses.

Because our health care delivery system makes uninsured people much more likely than insured people to be diagnosed with “advanced cancers […] that could have been detected early through proper screening.”

Because our health care delivery system puts paperwork from insurance companies rather than a doctor’s recommendation in charge of the timetable for cancer surgery.

Because our health care delivery system can force cancer patients to forgo radiation or chemotherapy if they lose their insurance.

Because our health care delivery system can leave insured as well as uninsured people with crushing debts after completing cancer treatment or care for a medical emergency.

Feel free to add your own answers in the comments.

UPDATE: MyDD user Trey Rentz adds that medical bills are the leading cause of bankruptcy in the U.S.

Last year at this time I was scrambling to make as many phone calls and knock on as many doors as I could before the Iowa caucuses on January 3.

This week I had a little more time to reflect on the year that just ended.

After the jump I’ve linked to Bleeding Heartland highlights in 2008. Most of the links relate to Iowa politics, but some also covered issues or strategy of national importance.

I only linked to a few posts about the presidential race. I’ll do a review of Bleeding Heartland’s 2008 presidential election coverage later this month.

You can use the search engine on the left side of the screen to look for past Bleeding Heartland diaries about any person or issue.

From Daily Kos user rok for dean:

In 1950, the average pay of an S&P 500 CEO was less than 30 times that of an average U.S. worker; by 1980, prior to the “Reagan Revolution,” the average pay of the S&P 500 CEO was approximately 50 times higher than that of an average U.S worker.  But by 2007, the average pay of an S&P 500 CEO had soared to more than 350 times as much as that of an average U.S. worker.

This is both immoral and unsustainable in a democracy.  By way of comparison, in Europe, an average CEO only makes 22 times as much as an average worker, and in Japan, only 17 times as much.

If America wants to be competitive again, we need to reduce CEO pay to a level comparable to CEO pay in Europe and Japan.  I know exactly how to accomplish this feat.  The [United Auto Workers] should agree to immediately lower U.S. union worker pay to a level equal to the level paid by their non-union, non-American competitors.  In return, auto CEO’s must agree to permanently lower their compensation to only 20 times that of an average union worker.

Sounds fair to me. How many Republicans who’ve been beating the war drums about excessively generous pay to union workers would agree to those terms?

It’s true that union workers get paid more than non-union workers (though strong unions are associated with higher average wages even for non-union workers in the same area). But in a country where two-thirds of our gross domestic product depends on consumer spending, higher wages are not a bad thing.

In any event, unions are not primarily to blame for the auto industry’s current problems. Toyota is about to post its first operating loss in 70 years despite having an entirely non-union workforce. The tough economy has diminished demand for new cars.

American automakers also have to bear the burden of our broken employer-based health insurance system, but that’s a topic for another diary.

The same Republicans who claim they’d never raise taxes on Americans are only too happy to slash the wages of middle-class auto workers. As rok for dean says, let’s call their bluff and see if they would be willing to tie executive pay to a reasonable multiple of the average worker’s salary in the company.

Side note: my dad was a Republican, but it really bothered him when corporate executives would receive exorbitant salaries and bonuses even as they were driving their companies into the ground. Rewarding good performance is one thing, but paying incompetent managers obscenely high salaries is another.  

The Principal Financial Group lowered the boom on 300 workers in central Iowa yesterday:

Principal Financial Group laid off 550 employees Tuesday, including 300 in its Des Moines headquarters, the company said.

Principal, one of the area’s largest employers, has approximately 16,400 employees worldwide and 8,000 in the Des Moines area. […]

The Des Moines-based insurance and financial services company said the cuts are due to continued deterioration of U.S. and global markets.

Principal reported a net income of $90.1 million for the third quarter, a 61 percent decrease from $232.3 million in the same period a year ago. Principal also told a state development agency last month that it is no longer interested in receiving tax incentives in exchange for creating 900 jobs in Iowa.

The last day for most affected employees will be Dec. 31, and all affected employees will receive severance and career assistance, the company said.

It’s great that people will receive severance pay and career assistance, but they will be entering a very tough job market. Other local employers, including Wells Fargo Home Mortgage, have already laid off workers this fall. Finding a job with pay and benefits comparable to what Principal offered won’t be easy.

This isn’t just an issue for central Iowa. As nyceve writes in her latest diary, rising unemployment is expected to greatly increase the number of Americans lacking coverage for basic health care. Add that to the list of problems with our costly and inefficient employer-based health insurance system.