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The Denver Forum will, on occasion, feature recent speeches delivered before members and guests. These speeches are offered as a public service – and in furtherance of the dialogue of democracy. Why the Christian Right is Wrong by Dr. Robin Meyers Senior Minister – Mayflower Congregational Church, Oklahoma City The State of American Medicine by Dr. J. Edward Hill Immediate Past-President American Medical Association Why the Christian Right is Wrong by Dr. Robin Meyers Senior Minister – Mayflower Congregational Church, Oklahoma City First of all, thank you for being here – I'm grateful for this invitation, and I never take the audience for granted. There are plenty of other things you could have done today besides come here to listen to me talk about this book. Plus I got to meet the irrepressible George Mitrovich, who makes it all happen, and enjoy a lively, stimulating dinner conversation last night. But let's get right to it, because there's a lot to talk about. My new book is called "Why the Christian Right is Wrong: A Minister's Manifesto for Taking Back Your Faith, Your Flag, Your Future." This is my fourth book, but it came about in a most unusual way and that's the story I want to tell you. As most of you know if you have ever tried to get a book published, there is a standard way of going about it. You come up with some brilliant idea, and then write a manuscript, and then you hope that someone beside yourself will also find it brilliant! My first three books all fit that publishing model. The first was called "With Ears to Hear: Preaching as Self-Persuasion," and it was a book about the lost art of preaching--and I do think preaching is a lost art--especially prophetic preaching. The second was called "Morning Sun on a White Piano: Simple Pleasures and the Sacramental Life," a book about how to slow down, live in the moment, and take pleasure in simple, spiritually enriching things, like reading, writing notes by hand to your loved ones, and making time to listen to music, especially live music. It was published in 1998 by Doubleday of New York, and helped along considerable by an endorsement from Bill Moyers. The third book was called "The Virtue in the Vice: Finding Seven Lively Virtues in the Seven Deadly Sins" – a book with a rather odd thesis, namely that virtue and vice are not polar opposites, but in fact lie on the same bed together. It's all about how the universal human appetites and desires are expressed, in what context, and with what integrity, or lack thereof. So I took the world's most famous Do Not Do List, the Seven Deadly Sins, and extracted from each one a lively virtue, as life giving and holy as the deadly sins are death dealing and demonic. The first question I usually get about this book is, "What did you do with Lust?" But the book I’ve come to speak to you about today is a book I never intended to write--but which has now changed my life. It was not a book I proposed, but rather a book that was demanded of me by the critical and dangerous times in which we live. That it would come out of Oklahoma, and out of the mouth of a minister no less, continues to amaze people – which only confirms how mixed up, self-serving, and hapless organized religion has become in our time. I lead a church of 700 members in the most conservative state in America, and I teach full-time in the philosophy department of Oklahoma City University, where I teach rhetoric to students who have never head that word used in a positive context. I am also a husband of 30 years, and the father of three children. In my spare time, I write a syndicated newspaper column for the Oklahoma Gazette, an alternative news weekly where I have been aggravating readers for nearly a decade now with what is apparently an absolutely astonishing and even dangerous claim: that you can be a minister of the gospel, and not be a right-wing Republican! For this I have been called names that can't be repeated in polite company, and charged with leading people straight to hell – which I don't believe in anyway so it really doesn't have the desired effect. In my column, which is called Rhetoric and Reality, because I'm fascinated by the relationship or lack thereof, between the two, I published a column four years ago that almost got me arrested. It was called "Using the f-Word," and in it I made the claim, before the Iraq war had even started, that the climate of fear in this country after 9/11 would be co-opted by men whose way of governing was increasingly fascist. So far as I know, I was the first Christian clergyman in the country to say this in print, and to preach it from my pulpit. The term I used was Christian Fascism, and it did not go unnoticed among my peers, or the powers that be. The response, in fact, was outrage. How could I consider using the f-word--a word so vulgar, and so violent, that it could not possibly be used to describe the direction that America is moving? But in that column, and now in this book, I included a list of 14 characteristics that any nation is moving in a fascist direction, according to a political scientist named Lawrence Britt. When I first read them, it sent a chill down my spine. Listen. READ. When the column first appeared four years ago, readers wrote letters to the editor demanding that I apologize--but that was four years ago. And what a difference four years makes for those of us who have always opposed this war, and tried to warn people that the country we love was being hijacked. Now whose warnings from the likes of Colin Powell, who said recently that we are losing our moral authority in the war against terrorism. And Kevin Phillips, a former Republican strategist for Nixon (author of the infamous Southern Strategy), who calls the current Republican Party America’s first religious party. You know the litany. First it was Jerry Falwell blaming 9/11 on abortionist, witches, and homosexuals. Then Pat Robertson recommended that we assassinate Hugo Chavez because he is a Leftist--he said this on television, in the name of Jesus. Meanwhile, James Dobson, head of Focus on the Family, called elected judges (most of them Republicans) "vermin in black robes." They are "vermin" of course, because they don't vote like he wants them to, according to what he calls "biblical law." For this reasons, the Christian Right has declared what it calls a "war on the Judiciary." You've got to hand it to these Christians. They love war. --The question that now confronts us is not whether we are liberal or conservative, red or blue, pro-life or pro-choice, but rather how can anyone, whether he or she is religious or not, remain silent when both religion and politics are being so fundamentally corrupted in the pursuit of power. You used to be able to count on people of faith to say, "Fear not." Now all you hear is "be afraid; be very afraid." Just over two years ago (assuming we will ever know exactly what went on in Ohio), we re-elected a president who had already confessed that the premise of the invasion and occupation of Iraq, this misbegotten war, this horrific downward spiral that has already killed or maimed tens of thousands, many of them innocent civilians including women and children, was false. What Aristotle calls the First Premise, that on which the entire argument is based was a lie, and then it was sold to the American people through an elaborate deception: Although you know these finding, the bear repeating: No WMD’s, no imminent threat, no connection whatsoever to Al Qaeda, or 9/11. This president, who said once that Jesus is the philosopher who has had the most influence on his life, mocked this deadly mistake by crawling around under his desk and joking that perhaps he would find the WMD’s there. This as American soldiers were being blown to bits – and innocent Iraqi’s were watched their nation turn into a pile of rubble. Now we have what I have called "a war in search of a reason" (because it is constantly being retrofitted to protect the guilty rather than spare the innocent). After admitting that we were wrong on MWD's, and wrong on the connection to Al Qaeda and 9/11, the president made this astonishing statement, "But now no one will ever doubt the word of the United States." What he meant, of course, was that when we say we're going to do something, no matter how wrong it might be, how illegal, how deadly and destabilizing--you can bet we intend to go through with it. The world has been put on notice. We are the most powerful rogue nation on earth. We'll do as we please with or without a "permission slip." So many lies have poured forth from this administration, and the president has cried wolf so many times that he has lost his voice and most of his audience. "Oh what a tangled web we weave when first we practice to deceive." At no time did this most overtly Christian administration in history ever consider that they were bearing false witness, or failing to practice the church's most durable wisdom: that confession precedes redemption. The truth is we did not invade Iraq to get Saddam, or to spread freedom and democracy throughout the world. The American people would never have signed on to this, especially if it meant giving up our own freedom and civil liberties at home. If this president, who admits to not being a reader, were only to read some basic histories of war and democracy, he would have known that no successful, autonomous democracy has ever been established in the history of the world through invasion and occupation—in other words, democracy has never succeeded as a colonial project. You may recall that right after the 2004 elections, voters who were asked to name the most important thing they considered before casting their vote for president said it was "moral values." That's what made the difference, many of them said, the promise by Bush to restore "integrity to the White House." And among all demographic groups, the most loyal Bush supporters were married white males who attended church regularly. After the Monica Lewinsky affair, they were eager to have what they called a "man of God" in charge again. Just imagine, if you will, what my life is like as a liberal minister in the state of Oklahoma? Where I live and work, more people voted for Bush, per capita, than in any other state. By the way, the day that story appeared in our local papers, there was another story that was also on page one: Oklahoma also has the most number of mentally ill people, per capita, than any other state--so go figure! But what I couldn't figure out, for the life of me, was what moral values were those voters talking about? Because we don't get to make them up as we go along – we have an inherited tradition of morality, especially as it is shaped by religious faith. Whether we are liberal or conservative, or like most Americans, someplace anxiously in-between, we don’t get to retrofit the concept of morality to fit the latest rationale for immoral behavior. Nor can we claim that Jesus is on our side regardless of what side we are on. In fact, although we love to be tolerant people in America, especially those of us who are proud to be religious progressives--it is patently absurd to surrender Jesus to all possible moral positions, as if the gospel has no essence, no real message – but is rather like a lump of play dough – a kind of infinitely malleable form of neutral energy. Fragrant and harmless – even edible! This is not just about "different strokes for different folks," or "who am I to tell you what to believe?” There is something commendable, of course, about being gracious in our age-old disagreements over matters of faith and doctrine, but whatever one’s position on the virgin birth, for example, most Christians would find it strange to enlist Jesus of Nazareth in the cause of an unjust war. He was, and is, the Prince of Peace. Regardless of one’s position on the miracles reported to us in the Bible, (whether, for example, they are true suspensions of natural law, or the loving and well-intentioned exaggerations of loving disciples), most Christians would agree that we are supposed to pray for our enemies, not taunt them. Just try to imagine Jesus, the president's favorite philosopher, saying to the Babylonians: “bring em’on!” Or standing on the shore of the Sea of Galilee and instead of going to the "other side" to heal and preach to the stranger, he said instead, "Either you with us, or you're with the Gentiles!" While the church has struggled for centuries to understand the mystery that was Easter morning, or what it means to say that one has taken up the cross to follow Jesus, most people would agree (inside the church or out), that you can’t simply dress up greed, plain old-fashioned avarice and make believe that it's a Christian virtue, instead of one of the Seven Deadly Sins So that any administration, for example, that pours all its energy into trying to completely eliminate the estate tax on billionaires while failing to raise the minimum wage for working people now for over a decade, cannot call itself either moral or Christian. Why do I say this? Because Jesus was a friend of the poor—not because you see it that way, or I see it that way – but because he was! And what I want to know is: Where has the church been while these merchants of death have been retrofitting Jesus? Yet to my way of thinking one of the saddest legacies of this reputedly Christian administration is the way it has used gays and lesbians as political scapegoats. Knowing that issues of human sexuality operate for all of us at the most visceral level, homophobia works, in the dark mind of Karl Rove, as a political strategy. He doesn’t even try to keep it a secret, admitting that in 2004 he needed to turn out four million additional evangelical Christian voters. So he placed the anti-gay marriage card, in the form of 13 anti-gay marriage amendments on 13 state constitutions – and it worked. After the election, we never heard about gay marriage again, because it was never about gay marriage. It was about energizing the base. In the next election, it was about who could protect us best. Either way, it's always about fear. Whatever your position on the issue, it seems to me neither moral, nor Christian to pretend that politically motivated hysteria is now a Christian virtue. Neither does it seem particularly moral to accelerate the destruction of the only planet we have by being both the world's largest polluter, and its most recalcitrant player in the international effort to turn back global warming just so your benefactors can make more money than they can ever spend. Nor does it seem very moral to put the giant millstone of the national debt around our children’s necks, when Jesus seemed to care so much about little ones – and Republicans seems so enamored of the idea of family values. This is a strange way to love our kids – by mortgaging their future. What’s more, when I think of a follower of Jesus, I see a humble person, not an arrogant one. I see someone who resists the idea that God is their co-pilot, but rather remembers the wisdom of the Tao: that when you think you know, that is when you do not know; but when you know that you do not know, that is when you know. . People who are petulant, impatient, suspicious of their critics, and paranoia to the point that they will destroy their enemies instead of praying for them may call themselves Machiavellians, or Neoconservatives or Tories, or whatever seems right to them, but they should leave Jesus out of it. Because Jesus is not a form of neutral energy, blessing whatever it is we are up to. Like STP, Jesus is a subversive form, a radically disturbing presence. Not long ago, the Pentecostal preacher Jimmy Swaggart, who had a weakness for prostitutes and young girls said in a recent sermon to his congregation that if a gay man looked at him the wrong way, he’d kill him, and "tell God he died." With friends like this in the church, who needs enemies? With the nation’s first fundamentalist Christian un-recovered alcoholic in the White House, who needs a real leader? The answer, my friends, is we all do. We all do. In a country that was founded on the magnificent wisdom of the separation of church and state, which is called a myth by the Christian Right, we need to face what Bill Moyers calls the “fiercesome” truth: Bill Moyers, who is the high priest of our movement, said this in one of his recent speeches: “One of the biggest changes in politics in my lifetime is that the delusional is no longer marginal. It has come in from the fringe, to sit in the seat of power in the Oval Office and in Congress.” We need the truth now, because whether you’re in the church, our out of the church, or just in therapy (which covers most Americans), you know that without confession there is no recovery. Without an end to deception, whether you own, or collectively as a nation, there is no healing, no hope, and no reconciliation. The fiercesome truth is that we have set in motion terrible forces that threaten all life on the planet. In the name of religion, of all things, we are pursuing the anti-gospel, the most irreligious of all ideas – that violence saves, when in fact, as Dr. King tried to tell us, violence is a downward spiral. From my pulpit last September, remembering the 5th anniversary of 9/11, I said that if hatred is what makes the enemy, then hatred is the enemy. Fighting terrorism cannot be only reactive, but must be proactive, addressing the conditions that produce terrorists in the first place. The president's plan to kill terrorists faster than we are creating them isn't working, and we are running out of time. We are also losing our soul as a nation. Without a draft like we had during Vietnam when I was in college . . . Rich old men can protect their own children while cheering poor young boys on their way to the killing fields to preserve their way of life, an then refuse to let the rest of us see their flag-draped coffins coming home. Look away they say – and keep on shopping. I hope you don't think that I wrote this book to pass judgments on the faith of other people, even when it is configured very differently than my own. I respect the faith of others, and no that many whose beliefs are different from mine are fine human being trying to make sense of life, and be what God intends for them to be. But faith can never be used as a cover for cruelty, for ethnocentricity, or for cultural genocide. Which one of you sitting in this room would ever have believed that we would be having a debate in this country over whether or not we ought to torture people? Or leave a president in office who has spied on us without judicial warrant – and who daily reveals that he considers himself above the Constitution and above the law? And how is it that we can impeach a president for lying about sex, but not a president who lied the whole nation into war? If this truth is painful so be it. It is our own hope. “You shall know the truth, said Jesus of Nazareth, and the truth shall make you free.” To put it in the language of the 12-step program, we need to do an intervention on ourselves. As for these United States of America, the most important quote I’ve read in a long time came from Kurt Tucholsky, quoted in Harper’s magazine a few months ago in that magnificent article by Lewis Lampham called “The Case for Impeachment: "Why America Can No Longer Afford George W. Bush”: Tucholsky said: “A country is not only what it does, it is also what it puts up with, what it tolerates.” So I wrote this book, and I'm talking to you right now--quite simply because I find the present situation intolerable – and I want you to find it intolerable too. I love my country and I love the church—but I hardly recognize either one these days. One of my favorite NYT’s columnists put it this way. In 2004, we voted to return to the White House, a man whose entire domestic agenda was “to save us from gay married terrorists.” So how, I wondered, how on earth did these men, and this administration persuade so many Americans that a vote for them was a vote for moral values? That was the question that was on mind when I sat down in a coffee shop in Norman Oklahoma, to write a brief speech that might rally like-minded students at the University of Oklahoma to start thinking differently, to stop believing the lies they were being told, and start asking the question, “Who Would Jesus Bomb” as something more than just a rhetorical exercise. That speech, only ten minutes long, and just over 1,400 words was the beginning of something that changed my life, and whose ending has yet to be written. What happened to that speech is one of the strangest and most mysterious things that ever happened to me—and it continues to amaze me. That speech is the reason that I’m here talking to you—a brief speech, written on a yellow legal pad just an hour before I delivered it, listed 17 reasons why I believe that not only is the Bush administration not restoring Christian moral values to this nation, but is, in fact, acting immorally. That speech, given on a rainy Sunday evening in a college town in one of America’s most conservative states would grow in a matter of weeks into a worldwide internet phenomenon. After the speech was over, and we marked around the campus by candlelight to protest the war, a couple of students asked me if they could have a copy of the speech to share with other. So I handed them my notes, and they must have gone home and typed up the speech on their computers and started sending it out--to their parents, their siblings, their friends, their professors, even their ministers – to offer up a second opinion on this crazy world from what they must have considered a rather unlikely source—a minister from Oklahoma! I thought nothing of it until, after a few weeks went by, I started getting emails from people all over the country. Just a few a first, and then the volume started growing – at first it was ten a day, then 20 a day, then 50 a day, then a 100 emails a day--until the university where I teach was forced to set up an automated response mechanism to keep their server from crashing. I tried to answer them all, but the task was consuming hours every day. So I printed them all out, and now have boxes and boxes of those letters in my office, and they are an amazing and inspiring collection of voices. All of them said the same thing, just in different ways: thanks for saying what I have thinking but didn't know how to say. Now I know I'm not crazy. Some even said that if their minister would say such things from the pulpit, they might even go back to church! Then the phone rang one night, and an elderly woman with a wonderful Jewish accent asked me if I was the minister from Oklahoma who wrote what she referred to as “the speech.” She said are you Robin Meyers? Are you really a minister? Are you really from Oklahoma! She said, "You don't know me, but I'm the literary agent for Barbara Kingsolver, and she said, Rev. Meyers, everywhere I go in NYC people were talking about “the speech.” She had even taken it with her on a visit to a death row inmate and read it to him through the bars of the prison. She said that he kept interrupting her, again and again, to say “Amen.” That's when I realize that what was happening was bigger than just my opinion on things, as if that even matters. What I had touched, without knowing it, was what I now believe is the nerve of the true silent majority. “You have to do something with it, Robin,” she said. “Do something with it?” I replied. I already did something with it—I gave it." “No, No Robin,.but with all do respect, you have to do more with it – expand it – that speech is too important to too many people. You need to take it, line by line, and turn it into a book. So I drew up a brief proposal for a book which I first called The Speech Heard Round the World. . .and a brilliant young editor from Jossey Bass named Julianna Gustafson saw the proposal, believed passionately in what the book was about, and sold it to her publisher, Jossey Bass of San Francisco, a division of Wiley and Sons. I signed the contract just in early July 2005 – agreeing to write a 240 page book with a full reference section, and have a completed rough draft done in 14 weeks – so that the book could come out in time for these crucial mid-term elections. And so here it is, a book that we know has a different and more provocative title, but was written with the conviction that we do not have unlimited time, nor do we have the option of remaining silence or intellectually aloof. It is my dissent over both the theft of the essence of the gospel to which I’ve given my life, and the dangerous redefinition of America’s role in the world based West Texas rhetoric, neo-conservative fantasies, and the most irreligious of all ideas—that you frighten the world into submission by killing more terrorists than you are creating, or that you can export democracy by force while undermining your own democracy at the same time. The book is meant to build a fire under those of us who have been silent too long, or feared that if we fought back would begin to resemble those with whom we disagree. Its thesis is that silence is a form of complicity, and complicity with a government this corrupt would make us all accessories to a crime. Reinhold Niebuhr said once the “Sometimes the worst evil is done by good people who do not know that they are not good.” And a man I have long admired, Ramsey Clark, captured the mood of the book I have tried to write perfectly when he said, “The immediate question [given the threat we are facing to our way of life and our most cherished values] is whether We, the People of the United States of America believe the future of our country is a spectator sport, or whether we will players.” This book is my answer that to that question. It calls on us all to dare not sit out this period in American history – but to be players. We can play fair, and we can play hard – but we must also play to win – because in the end, this is about the future we make for our children, for the idea of fairness, dignity, human rights, not to mention this imperiled experiment in freedom we call the United States. All I really want you to promise me is that if you agree with me, or even if you just mostly agree with me, that you will not do anything. Because the time for doing nothing has passed. And this book is not a rant – it is a call to action, with an entire section at the end designed to help you know what positive, proactive steps you can do to start turning this country around. I gave my speech, and then wrote this book because, quite frankly, I don't know where all the protestors have gone--but it’s time to march again my friends. Time to withdraw our compliance. Even time, if you are so moved, to commit acts of non-violence civil disobedience. Neil Postman said that we no long a nation of citizens, but of consumers, busy "amusing itself to death." More people voted on who should be the last American Idol than voted in the last presidential election. If that frightens you--good. If it moves you to act, even better. Because doing nothing, in critical times, is a form of complicity. It gives those in power permission to do what we have let them get away with. So put down the remote, and do what you believe you are being called to do with dignity and hope. Make trouble for the right reason. And remember; do not be afraid, because fear is the enemy of the moral life. I have it on good authority that the opposite of love is not hate, but fear. Because we have just passed the observance of the life of Dr. Martin Luther King, Jr., let me close with his words about the futility of violence: The ultimate weakness of violence is that it is a descending spiral; begetting the very thing it seeks to destroy. Instead of diminishing evil, it multiplies it. Through violence you may murder the liar, but you cannot murder the lie, nor establish the truth. Through violence you murder the hater, but you do not murder hate. In fact, violence merely increased hate. Returning violence for violence multiples violence, adding deeper darkness to a night already devoid of stars. Darkness cannot drive our darkness; only light can do that. Hate cannot drive out hate; only love can do that. My friends, if you love this country, and the only world we have, then do not go gently into this dark night. Rage, rage against the dying of the light. Go in peace, pray for peace, and love one another. Amen. 18 January 2007 The State of American Medicine Dr. J. Edward Hill Immediate Past-President American Medical Association It is a privilege and an honor to speak to The Denver Forum, an organization dedicated to the dialogue of democracy. Obviously, democracy works best with an informed electorate. And, speaking on behalf of the nation's physicians, I would add, democracy works best with a healthy electorate, as well. It is a pleasure to be here and to represent the American Medical Association, and the nation's more than 800,000 physicians and surgeons. As I have traveled up and down the nation these last several months, I've listened to a large number of individuals, from presidents to ordinary citizens in every walk of life. And I've learned a number of things: * First, I've learned that average America is in real pain. Two trillion dollars a year is a mighty hefty price to pay for health care in this country. A Gallup poll tells us the second most important financial problem households face is health care costs, second only to the specter of bankruptcy, itself. But, when I dig down beyond the data to the people themselves, I have found some real surprises which I will share with you in a minute. * Second, I've learned that nearly 47 million Americans without health care insurance constitute not a challenge so much as a national disgrace. That works out to 769,000 uninsured are right here in Colorado, 17 percent of your non-elderly population. * Third, I've learned people are quite concerned about the future of Medicare and Medicaid, that when they learn that Congress has mandated cuts in the payments to be made to physicians under the Medicare system, and that those cuts translate into potential harm to seniors as more and more physicians can no longer afford to see new Medicare patients. When people learn that, they become very upset. * And, fourth, I've learned people are going to have to take the initiative in dealing with these concerns, about costs, about the uninsured, about the fate of Medicare and Medicaid. There is a broad streak of common sense and common decency in this great democracy of ours. And those two characteristics lead Americans to see that their health care system is tragically disordered, seemingly designed with a helter-skelter magnificence that gets in the way of patient care, and that this has got to change. Uninsured For some time now, the AMA has warned America of the dire consequences of the grow health insurance gap in this country.Today 46.6 million Americans are uninsured and another 15 million are under-insured; a fifth of the nation standing as living testimony to that prediction. As I said, 770,000 of your neighbors live sicker and die younger for want of health care insurance coverage. That unpleasant truth today stares us in the face. America's physicians have a plan to correct the situation. After years of study and analysis, the AMA has proposed a series of steps to leverage free-market economics in battling the uninsured problem. First, we believe there should be direct cash payments to those least able to afford insurance, to give them the wherewithal to buy their own policies, minimum coverage, preventive care and coverage for their children. That will mean, second, regulatory reform so that health insurance firms can come up with creative, tailored policies matching the special needs of those with the fewest resources. Third, we've urged the states to take the lead in experimenting with these ideas, and several test-bed projects are under way. Lastly, the AMA believes those who have the resources, but have not bought insurance, should be given incentive to buy coverage. Specifically, we believe those making five times the Federal Poverty Level, that means individuals making $49,000 a year, or more, and families of four brining in $100,000 a year or more, These middle class Americans should be required to own health insurance. All of these programs, taken together, would eliminate the billions of dollars drained from the economy every year by treating the uninsured only when they show up in the emergency rooms of America. I admit, 47 million Americans is a large population to treat. But, trusting to free-market economics is a proven strategy, a winning strategy, and one we are advocating right now to begin wiping out this national disgrace. Medicare There is another potential national disgrace on the horizon. And it has the name "Medicare." As you well know, Medicare is our nation's experiment with socialized medicine. And, as with all so-called single payer systems, this approach has produced rising prices and shortages. Strip away all the rhetoric about Medicare and single payer systems, and you'll find, at heart, they are just 25-dollar words for "price controls." And price controls produce only two things in any economy, anywhere, at any time in history. They produce shortages, which means Black Markets, and they produce higher prices, in the name of controlling costs. In the case of Medicare: * Premiums that seniors pay will go up later this year. Medicare revenues aren't covering costs. * Second, means-testing is inevitable and, combined with higher premiums, are the early warning signs of an impending financial tsunami. * Medicare payments to physicians, meanwhile, are scheduled to be cut, nearly 40 percent by 2015, 5 percent next year alone, unless Congress acts. Those statistics take on real meaning when translated into terms Coloradans can understand. From 2007 to 2015, Medicare payments in Colorado will be cut by $1.61 billion; $28 million of it next year alone. Ten percent of your state population, 481,000 men and women are Medicare beneficiaries. Where will they get care if the physicians of this state can no longer afford to take new Medicare patients? And a cumbersome, costly bureaucracy gobbles up tax dollars and, predictably, end up wasting from 30 to 40 cents of each Medicare dollar, according to two recent studies. Today we have shortages of primary care and key medical specialties, with a projected shortage of 166,000 doctors by the year 2020. And we have yet to feel the impact of the Baby Boomers turning 65. The Center for Studying Health System Change tells us nearly 30 percent of American physicians cannot afford to accept new Medicare patients now. Imagine what the figure will be if Congress follows through on physician payment cuts now scheduled through the Year 2015, as much as 37 percent at the same time the costs of operating a practice are to increase 22 percent or more. So, the AMA is working to establish reasonable prices, stable prices and predictable prices, in a badly under-funded Medicare system. Trillion dollar solution There is a third potential revolutionary change badly needed in this country. It's a trillion-dollar solution to part of the cost problem, as well. I'm talking about the unhealthy lifestyle choices so many of our fellow Americans are making. We've compiled a list of estimates of the societal costs, not just health care costs but lost wages, lost taxes, lost investment from the eight scourges of public health: * Violence and abuse, $300 billion in medical and societal costs; * Alcohol and other drug abuse-another $246 billion; * Traffic accidents, $150 billion; * Work-related accidents, $156 billion; * Tobacco, $182 billion; * Obesity, as much as $102 billion. * And, unfortunately, there are no estimates for the social impact of teen pregnancy, STDs and suicide. Now, I must qualify these numbers by saying the sources are many and varied, and so are the methods used. But the magnitude is unmistakable. The fact is that proper choices by individuals, can dramatically reduce those societal costs and the suffering and priceless loss of life. To change these behaviors, we have to change habits. Take alcohol abuse. Drilling down into the numbers, you discover nearly 10 percent of 4th graders in this country, for example, one in 10, have started drinking. One study found that alcohol use among those 4th graders will triple by 6th grade. That is an epidemic, and we don't seem to care. Well, I care. I am a passionate advocate for comprehensive school health education. Children need to know how to read food labels, which now include information on things like fat content, an advance the AMA supported. Evidence suggests, that healthy habits must be set early, because by the age of 7 or 8, patterns have been set for a lifetime. That's why we should start with pre-K students and go straight through high school. We need full funding for health education teachers, counselors, physicians, nurses and others, to develop classes and courses in everything, from the food pyramid to understanding what health insurance will mean for them when they get out in the real world. The Centers for Disease Control has developed and refined a comprehensive curriculum over the last 35 years. Well, then, how can we afford such a new, major, labor-intensive addition to our school curriculum, staffing and budgets? Here's an idea. Why not adapt the state-federal highway construction model to push funding for comprehensive programs? Why not give matching funds to states or school districts that fit a federal framework? And why not expect our children to profit from comprehensive health education? The idea is apolitical. I've found interest in Washington from the left and the right, from Democrats and Republicans. Moreover, the idea does not rely totally on Washington. It's grassroots nature means it can bubble up rather than percolate down. Further testimony to the power of individual action, individual accountability and the force of local activism. Hollandale I have seen local accountability work before. Way back in the 1960s, my new partner and I were opening our little clinic in Hollandale, Mississippi. For those of you unfamiliar with the area, Hollandale, Mississippi, was almost a forgotten third-world corner of America. One day, I became acutely aware of conditions that simply had to change. That day, a farmer called me at my clinic. The wife of one of his hands had delivered a baby at home two days earlier. She was still bleeding, and couldn't get out of bed. When I got to the farm, I saw a woman couldn't lift her head without losing consciousness. Her blood pressure was too low to measure. I couldn't move her. We had no suitable emergency transportation. With some difficulty, I drew a tube of blood and sped back to town to have it typed and matched, and to get a bigger car. When I returned, I hung a unit of blood from a nail in the wall. We then put the woman into our station wagon and drove her to Hollandale, where she quickly recovered. That evening, I went home and turned on the television. It was July 20th, 1969, the day Neil Armstrong took that giant leap for humankind. And I thought, "We have the technology to put a man on the moon. But here on earth, in the United States of America, a woman almost bled to death because she lacked access to the most basic medical care." Things had to change in Washington County, Mississippi. It then was among the worst in America in infant death rates. So we went to work, with the state health department. We got donations from churches and from the March of Dimes, hired certified nurse midwives, and developed a very strict protocol under which they acted. We trained women with not even a high school diploma to do home visiting including prenatal, perinatal and postnatal visits. We educated and communicated and, in short order, infant mortality rates dropped below the national average and have stayed there to this day. Activism at the local level The moral of the story: All health care is local. And, when folks at the local level get moving, they solve their problems. First, at the local level, then across the continent. When we mobilize, the results can be revolutionary. The American Medical Association recognizes that. And we have developed plans and programs that are beginning to ring true in the ears of America, an America that is ready for major change. America is asking, no pleading for leadership And that is why this afternoon I want you to think about what I consider to be the coming revolution in U.S. health care. In so many ways, the U.S. health care system is the envy of the world. Life expectancy is up significantly since we opened our clinic in Mississippi back in the 1960s, now 77.9 years, 12 percent longer life. Americans might not know all the statistics. But, they value the quality of care they are receiving. Two statistics tell the story. And I would guess these are numbers you have not heard before. The first one has to do with the trust Americans place in their physicians. The AMA and Harris Interactive conduct a quarterly survey, a rock-solid piece of research, asking Americans how much trust they have in their primary care physician. Quarter by quarter, year-by-year, the numbers are the same: More than 85 percent of Americans trust their physician. A quarter say they have complete trust, and more than 40 percent, a great deal of trust. I'm sure you're familiar with the kinds of trust numbers Congress and lawyers and other groups receive. Not even close to 85 percent. But, a second statistic is even more dramatic, in my mind. And that has to do the value Americans place on their personal health care. Again, the AMA turned to Harris Interactive to measure just how Americans rate the value of each dollar they spend on health care. One in 10 Americans told us they value their health care investment as an excellent investment. Twenty-seven percent rated it a good investment. Thirty-three percent, a fair investment. That means 7 out of 10 Americans believe they are getting their money's worth. To me, this is a dramatic finding, in the wake of all the negative press about rising health care costs, the waste in health care spending, the seemingly exorbitant profits of big health care insurers. Those concerns are valid concerns, but maybe they are blown out of proportion. Just maybe a healthier and wealthier country sees additional spending as wise investment, not unreasonable cost. Health care is a terrific investment but is locked between the jaws of two price control mechanisms, The Federal government's Medicare pricing mechanism and the insurance industry's pricing schedules that are a mirror image of it. Nobel laureate Milton Friedman recently told an interviewer, "We have a socialist-communist system of distributing medical care. Instead of letting people hire their own physicians and pay them, no one pays his or her own medical bills. Instead, there's a third party payment system." And, I would add, those third parties are very resistant to change. Their solution is not less regulation but more, not free-market pricing but price controls. Such that those who provide medical and health care have been eating the payment cuts they impose. And everyone wonders, "How long can we sustain a system that relies on good will and the benevolence of physicians, nurses and others more interested in serving patients than in their own ledger sheets and quarterly earnings statements? " Change The forces of free market economics are working their magic in health care. We for our part have always trusted that our approach is the right one. One which welcomes change and embraces free-market forces. One which focuses on patient needs and the technology that best serves it. A simple approach I describe as care-based costs rather than cost-based care. We believe millions of uninsured Americans can be taken from that list with a few simple changes. We believe Medicare can be saved, can be put on a sound fiscal basis, by prior funding mechanisms rather than the hand-to-mouth system now in place. We believe Medicare physician payments need to be fair and equitable, and an incentive for doctors to see new Medicare patients, not a penalty situation. And, we believe healthy lifestyles, wholesome choices, can not only save hundreds of billions of dollars, But make life richer and more meaningful for millions of Americans. O.K. Corral Let me wind things up with a brief lesson from history. On this day in 1881, 925 miles southwest of here, in Tombstone, Arizona, the Earp brothers shot it out with the Clanton-McLaury gang at the O.K. Corral. Historians say both sides were looking for revenge for what they perceived as pretty serious insults over the years. It was a classic zero-sum game. No one knows who drew first. But when the 30-second fight ended, The Earps were bloodied but alive. Billy Clanton and Tom and Frank McLaury lay dead or dying. Well, today, I am not proposing a zero-sum O.K. Corral scenario. I'm proposing a win-win scenario. One in which free-market solutions begin to take effect at the margin. One that puts patients back in the driver's seat, determining for themselves how their dollars will be spent, how their trust will be used, how the future course of medicine should proceed. One, finally, that eliminates waste and errors, embraces new technologies and innovation, and relies on local decisions not arbitrary dictates from Washington or a corporate headquarters. One that relies on the innate intelligence of the American people not ledger sheets and earnings statements, not politics and tax revenues and Congressional spending impulse, but the good judgment of you and your neighbors. The power of one So the basic question, at last, becomes: Well Doctor Hill what can I do? What can just one person do? Well, what could Rosa Parks do about segregation? What could Gandhi do about imperialism? What could you, one of our nation's leaders do? The answer is: A great deal. Begin with your intellect and your circle of friends. Talk about these ideas, and especially talk about bringing comprehensive, and mandatory, health education back into the schools. Talk with your elected representatives, especially those in Washington. The AMA has a very effective, million-person grass roots advocacy program you might consider. If you want to join, just go to www.ama-assn.org, and enter the words: "Patient Action Network" in the search box. You will find direct channels to e-mail your members of Congress. And you'll be adding your voice to the chorus of individuals call for change. No issue is more critical and far-reaching in America today than health care. We are at a desperate time in history where leaders have to step up to the plate. Denver and Colorado and America need you. And, I salute you for your efforts We all need the absolute best that is in you. 25 October 2006