'Countdown with Keith Olbermann' for March 18th, 2010
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Special Comment: (replay)
Health Care Reform: The Fight Against Death
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Re-air of Keith's Special Comment on Healthcare Reform, which originally aired October 7th, 2009.

KEITH OLBERMANN, HOST: Good evening from New York.

Since August 23rd of this year, I have interacted daily with our American health care system and often done so to the exclusion of virtually all other business. It's not undercover reporting. It's not an expert study of the field.

But since that day when my father slid seemingly benignly out of his bed onto the floor of his home, I've experienced with growing amazement and with multiplying anger the true state of our hospitals, our doctor's offices, our insurance businesses, our pharmacies. My father's story is a patient, and mine as a secondary participant and a primary witness has been eye-opening and jaw-dropping, and we are among the utterly lucky ones. A fact that by itself is terrifying and infuriating.

And thus, tonight, for all those we have met along the way, those with whom we have shared the last two months inside the valley of the beast, and for everyone in this country who will be here and write soon, tonight, Countdown will be devoted entirely to a "Special Comment" on a subject of health care reform in this country.

I do not want to yell. I feel like screaming but everybody is screaming. Everybody is screaming that this is about rights or freedom or socialism or the president or the future or the past or political failure or political success. We have all been screaming.

I have been screaming and we have all been screaming, because we do not want to face - we cannot face what is at the heart of all of this, what is the unspoken essence of every moment of this debate. What about which we are truly driven to such intense, ineffable, inchoate, emotions? Because ultimately, in screaming about health care reform - pro or con - we are screaming about death.

This ultimately is about death. About preventing it, about fighting it, about resisting it, about grabbing hold of everything and anything to forestall it and postpone it even though we know that the force will overcome us all, always will, always has.

Health care is at its core about improving the odds of life in its struggle against death, of extending that game which we will all lose, each and every one of us, onto eternity, extending it another year or month or second. This is the primary directive of life, the essence of our will as human beings. All perhaps it is measurable of our souls, the will to live.

And when we go to a doctor's office or a hospital or storefront clinic in a ghetto, we are expressing this fundamental cry of humanity: I want to live. I want my child to live. I want my life to live. I want my father to live. I want my neighbor to live. I want that stranger I do not know and never will know to live.

This is elemental stuff, our atoms in action, our survival mode in charge. Tamper with this and you are tampering with us. And so we yell and scream and try to put it all into political context or expand it to some great issue of societal freedom or dress it up in something that would be otherwise farcical like a death panel, but this issue needs no expansion and no dressing up. The Democrats need to draw no line in the sand, and the Republicans need to calculate no seats to be game and the blue dogs need to anticipate no campaign contributions lost.

This issue is big enough as it is. This is already life and death.

Of all the politicians of the previous century, none fought harder to prevent an administration that had promised to involve itself in health care from ever gaining power than in England's Winston Churchill. He equated his opponents to party that sought to introduce the national health to the Gestapo of the Germans that he and we had just beaten, just as those opposing reform now have been invoke Nazis as frequently and as falsely as if they were invoking zombies.

Churchill caused himself the election because he did not realize he was overplaying an issue that people were already damn serious about.

Irony this, because a decade earlier, Churchill had made the greatest argument ever for government intervention in health care, only he did not realize it. He was debating in parliament the notion that the British government could not increase expenditures on military defense unless the voters specifically authorized it. Just as today's opponents of reform are now claiming they speak for the voters of today, even though those voters spoke for themselves eleven months ago.

Churchill's argument was this, quote, "I have heard it said that the government had no mandate. Such a doctrine is wholly inadmissible. The responsibility for the public safety is absolute and requires no mandate."

And there is the essence of what this is. What on the eternal list of priorities precedes health? What more obvious role could government have than the defense of the life of each citizen?

We cannot stop every germ that seeks to harm us any more than we can stop every person that seeks to harm us, but we can try, damn it. And government's essential role in that effort, facilitate it, reduce its costs, broaden its availability, improve my health and yours seem ultimately self-explanatory.

We want to live. What is government for if not to help us do so? Indeed, Mr. Churchill, the responsibility for the public safety is absolute and requires no mandate, and yet, today at this hour, somebody, somewhere in this country, is arguing against or protesting against or yelling against health care reform because the subject is really life and death, and they're scared and they've been scared and they've been misled by the overly simple words of one side and misinformed by the overly complex words of the other side.

And that one person - at least that one person - who is tonight so scared that somehow sickness and pain and death will come sooner to them because of reform they do not understand, that one person if his or her argument is successful and reform is again squashed, that one person arguing against health care reform will die sooner because they argued against health care reform - just as you and I have largely failed to understand the terror, the fear of death that underlies this debate in the minds of so many.

The leadership of the reform effort has also failed to understand it and failed to lead, not just in practical terms but in rhetorical ones.

If you did not know what something called the "public option" was, you might instinctively oppose it. Option - my health care is now optional? Doesn't that mean it can go away somehow? Doesn't that mean that when I need it, it won't be there? Doesn't it mean somebody is trying to take it away from me?

And this insurance that might go away is public? I'm giving control the government somehow? No private, just public?

And so, in seconds, with mental reflexes as acute and natural as any mechanism of fight or flight, something that will expand health care and reduce its costs, something that will help fight death and pain becomes misunderstood as exactly the opposite.

You can blame the one doing the misunderstanding all you want, but the essence of communication is reducing the chance of misunderstanding, and the term the "public option" has been as useless and as full of holes and as self-defeating as has been the term "global warming."

It is political speak. It is legalese. It is designed not for the recipient but for the speaker. It is the ego of the informed strutting down the street and saying, "Look at me, I talk smart."

Just as global warming is really bad climate change, the public option is, in broad essence, Medicare for everybody. Frame it that way, sell it that way, and suddenly, it doesn't sound like a threat turning the seemingly solid insurance which people have now, for better or worse, into something optional and turning anything private into everything public.

Once you said "Medicare for everybody," there would be just as much to explain. If you were under 65, you'd paying pay for it. You wouldn't have to buy it. You wouldn't have to change from whatever you have now. There are just as many caveats. Still, the intent of this all would be clearer.

Much of the criticism of health care reform is coming from those who have or are about to get Medicare, and in confusion, in fear and in the kind of indescribable realization that we are far closer to the end than we are to the beginning, they are suddenly, mortally afraid that health care reform will take it away from them.

"Medicare for everybody" may not be literally true, but instead of terrifying, it would be reassuring and the explanations and the caveats would be listened to and not shouted down as anger and fear.

Fear - remember - of death. Fear that swells up inside.

This rhetorical ship, of course, has sailed and, frankly, those leading the effort to reform health care have been so outflanked, out-argued, out-terrorized by its opponents that their reflexes seem shot. They are to use to Mr. Lincoln's words about General Rosecrans, "Frozen in place like a duck hit on the head."

And yet, even from the most insurrectionary of the infamous town halls of August, there came report after report of proponents of health care reform responding to tea-partyists and the genuinely confused, in voices calm with genuine empathy and honest inquiry, by asking, "What are you afraid of? What do you think we do to improve health care?"

Setting aside the professional protestors, the shameless mercenaries of this equation, the LaRouche bags and the hired guns, the results were uniform and productive. Dialogue, conversation, admission of fear, admission that we are indeed talking about pain and sickness and life and death - admission that we are seeking the same things and that this should not be left to the politicians who almost to a man reek of the corruption of campaign contributions from the very monopolies they are supposedly trying to control.

And something else would come up - something that you'd never hear included in the debate over reform, in the debate about insurance and bankruptcy, and even in the debate over the remorseless, rapaciousness of companies that are forever increasing premiums and deductibles while reducing what they give back to the person who is sick. What you never hear about is the person who is sick.

Have you ever stayed overnight in a hospital? All data suggests that in a given year, only about one in 10 of us do. It's not a universal experience.

Could you sleep in a hospital - with constant noise, with sharing a room with strangers perhaps, with contemplating mortality, and more immediately, the fog of germs in the place with staff infections and MRSA, and nursing staffs cut to the minimum, and overworked doctors and medical record-keeping so primitive it might as well be done on blackboards?

And the bills? What about the person who is sick and the bills? How are they supposed to get better while they are sitting there inside a giant cash register? How do you heal? How do you kill a cancer when the meter is running so loudly you can hear it?

When a system of health care has been so refined, so perfected as to find a way to charge for almost everything and to reimburse for almost nothing - how does the person who is sick not worry always, always, about where he is going to get the money? And how is somebody worrying always about where he's going get money supposed to also get better?

Yet, our neighbor in that hospital bed hoping tonight half for health and half for the money to pay for it is still in better shape than at least 122 Americans who might be watching this right now and who will not be with us tomorrow because they will die - because they do not have insurance.

I will pick it up there and then move onto the question of whether if health care is not reformed, we should force the issue by bailing out of this stylize blackmail that is insurance.

(COMMERCIAL BREAK)

OLBERMANN: Sometime around 1:00 in the morning on Saturday, the 22nd of August of this year, my father struggling with knee problems, of generalized weakness, lack of appetite and lethargy, tried to use the portable urinal he kept by his bed to limit those middle of the night trips to the toilet. It sounds a little gross, I know. But certainly not when the alternative is a 10- or 20-minute ordeal of struggling to the bathroom and wondering what in the hell you're going to do if you don't make it there in time.

But that night, there was an additional problem. He was having trouble going. He tried to adjust his position sitting on the edge of the bed and suddenly, the mattress shifted underneath him and deposited him gently on the floor. He might have been in nothing more threatening than a seated position there.

With his knees as bad as they are, there was almost no chance he was going to get out of it without help. For reasons that would later become apparent, my father would pretend to himself that wasn't true. He decided to believe that he would soon be feeling better and would be able to get up on his own. He thinks he dozed much of the night.

As it got light out, he realized his cell phone was within grasp and he called me. Not to say he was in trouble, he never mentioned it. But only about the move we were planning for him to his own place closer to me, he never mentioned the precariousness of his position. He'd now been stuck on the floor for about seven hours.

Sometime in the afternoon, between the dehydration and exhaustion, the hallucinations started. He heard my sister and her family in the hallway outside his bedroom. He could feel the vibration of the footsteps of his grandkids running up and down.

In a startling tribute to the imagination's ability to make hallucination like this one completely self-contained and impervious to logic, he heard his daughter say, "Don't bother, Grandpa. He's resting."

He thinks he smelled cooking. My sister and her kids were in fact in Upstate New York at the time. My dad found himself increasingly angry and finally, sometime after midnight on the morning of Sunday, August 23rd, he phoned her and demanded to know why she had been in the house without so much as giving him the courtesy of peeking her head in to see if he was all right.

Only after her repeated insistences that she had been and was 330 miles away and had been all day did reality regain control. My father apologized. My sister called the neighbor. The neighbor called the cops.

There was never an official diagnosis of just that one incident that night. But I've gone into such excruciating detail because of what I was told that night by the doctors at the E.R., which I joined my father and what I have been told by other health professionals since. The hallucinations almost certainly will provoke by dehydration, and if not renal failure per se, and certainly, a kind of temporary shutdown of the kidneys.

By the time he got there, it had been more than 24 hours since he had triggered this cascade of problems by trying to adjust the position of his body so he could urinate. And still he had not done so. My father's kidneys were in trouble. Considering the kidney disease was what killed his father, this was very bad news.

We heard just yesterday about kidneys and insurance. The Waddington brothers, Travis of New York, Michael of Santa Fe, "The New York Times" reported their dad, David, needed a kidney transplant because of congenital renal disease. Each of the sons was ready to donate, of course, but they were warned not even to get tested to see if they matched for if they did, transplant or no, they would conceivably be denied insurance for the rest of their lives because they might test positive for the same congenital renal disease that threatened their father and thus, they would have a pre-existing condition.

And still, the Waddingtons and their dad and my dad were all luckier than at least 45,000 Americans, because as discovered in a new study conducted by Harvard University and the Cambridge Health Alliance, that's how many of us are dying each year because we don't have insurance.

The number is horrible. But when it's contrasted to what faced my father that night, it is unforgivable, because as Cambridge's summary of the findings put it: deaths associated with lack of health insurance now exceed those caused by many common killers such as kidney disease.

My father had less to fear that night from bad kidneys than he would have if he hadn't had insurance. And yet we let this continue. You and I, this society, our country, Democrats and Republicans, this is the study that congressman from Florida quoted, about which the Republicans demanded an apology when they should have been standing there shrieking, demanding that we fix this.

Uninsured working age Americans have a 40 percent higher risk of death than their privately insured counterparts. People, in short, are dying for lack of money.

Dying as surely as they did when Charles Dickens wrote about the exact same problem, a boy who couldn't get sufficient medical care for his affliction, of the underprivileged suffering not just privation but death as an uncomfortable mode silently and unseeingly through the streets of London. The book was called "A Christmas Carol" and the boy Dickens imagined was called "Tiny Tim." And it was published on the 19th of December, 1843.

It is 166 years later and the problem is not only still with us, it is getting worse. The mortality rate among Americans under the age of 65 who are uninsured is 40 percent higher than those with insurance. In 1993, a similar study found the difference was only 20 percent. We are moving backwards.

We are letting people die because they do not have insurance? What's worst is that barring meaningful health care reform now, this will only grow. The difference between the surveys from 1993 and now suggest: this fatal insurance gap is growing by about 1 percent per year. Your chances of dying because you don't have insurance are now 40 percent higher than those who have it. By extrapolation, three years from now, your chances will be 43 percent higher.

Your chances of dying because you used to smoke compared to those who never smoked, are only 42 percent higher. You heard that right. At the current rate in 2012, you will be more fortunate, more secure, more long lived if you used to smoke than if you don't have insurance. It is mind-boggling and mindless.

This is the country you want? This is the country you will accept? Do those other people in this country have meaning to you? Or are they just extras in your movies? Backgrounds in your painting? Choruses in your solo?

Without access to insurance for all of us, and the only way we get it is with the government supplying the gaps - just like it does in flood insurance for God's sake - that fatal gap will just keep growing. The 45 percent higher likelihood of death for the uninsured compared to the insured by 2014. By 2022, the figure will be 53 percent higher - 53 percent.

In the 1840s, as Dickens wrote "Christmas Carol," in a time at which we now look back with horror, the city of Manchester in England commissioned a crude study of mortality among its residents, a doctor, P.N. Haland (ph), categorized the sanitary conditions of the houses in the streets of Manchester into three classes. And when he compared the death rate in the first class houses in the first class streets to the death rate in the second class houses in the third class streets, he found mortality in those worst locations was 53 percent higher.

If we do not reverse this trend in 14 years time, we will not be living in the America of 2022. The shadows of the things that may be tell us that we will instead be living in an insurance-driven version of the Dickensian England of 1843 - again.

God bless us, everyone.

Tonight's "Special Comment" continues after this.

(COMMERCIAL BREAK)

OLBERMANN: I told my father the other night that the insurance I really want to get for him and me is called corporate-owned life insurance, C-O-L-I, COLI, like an E. coli. How fitting.

With or without your consent, your employer is permitted by law to take out life insurance on you. It can, in fact, take out life insurance on everybody who works for it. Who gets the money when you all die? Your employer does.

Dad pointed out that, theoretically, this would give them motivation to kill you. That, of course, would be for the same reason as Michael Moore points out in his new movie, "Capitalism: A Love Story," that you can't buy fire insurance on the house of the guy who lives next door to you. Golly gee, that's right. Suddenly, you'd have a motive to burn down his house and the world is already too much like that symbolically to make it a little bit like that in reality.

No, it's really unlikely that even the most evil corporation would think of killing you to get a payout from the COLI insurance plan. It exists for much more mundane and passive reasons. You're going to die any way and the tax laws of this country are such that if your company has 100,000 employees, it can take out small whole life policies on everybody, and just let the actuarial tables do the work for it, 10,000 bucks here, 20,000 there, maybe 50,000 back here and all of it is tax-exempt.

And your employer can borrow the money to pay the premiums on secret insurance it has on you, and the interest on that loan is tax deductible. And your employer can, in essence, overpay the premium it has on you and your fellow drones, and the extra money in the kitty is called "cash value." And it can be stuck into a pension benefit plan or other product of the mad, mad world of accounting, and "cash value" is also tax-deferred. It can be returned to your employer later as a tax-free loan. And if your employer goes bankrupt, the "cash value" in those insurance policies is protected by tax laws by creditors.

In short, your employer can get a tax deductible loan to my insurance on you that until this past June, they didn't mean to tell you about and the money is first tax-deferred and then tax-free and then when you die, the payoff it gets is tax-exempt and when the company dies, the boss still gets to keep the money anyway from the creditors even if somehow, you, the guy on whom your boss has surreptitiously taken out an insurance policy, you happen to be one of the creditors, tough.

And even though it's based on insurance on your health and your life, all that tax-free, tax-exempt, tax-deferred money not only does not go to you, it also does not go to the government. And so, if we really are ever going to do anything about federally-supported health care as an alternative to these private insurers, there is that much less tax money to do that with. And some of the money that isn't going to you and isn't going to the government is going to strengthen the already monolithic insurance companies.

And just in case this isn't a sweet enough deal, the government is almost silent about telling that employer of yours what kind of health insurance it must give you. And year after year, the companies get smarter and more audacious about either cutting what your health insurance covers or cutting the number of employees the health insurance covers, or both.

And if that is still not sweet enough, there is also something called the National Association of Insurance and Financial Advisers, and it has a political action committee, IFAPAC. And last year, IFAPAC had $1,492,000 worth of campaign money with which to buy politicians. And you'd be amazed how many of them you can buy with even $1,492,000.

And these are the same people who are not only influencing the health care debate, spending more than $1 million a day to defeat reform, they are also the same people who by raising your premiums and cutting your reimbursements, who by manipulating prices at hospitals and doctor's offices for everything from tongue depressors to enemas, who by influencing health care in this country more effectively and more selfishly than a dictator could ever do, these are the people who decide what kind of health care you get, how much you pay for it, and whether or not they would rather not see you get it.

It is your skin, literally, and it is the hands of people, insurance companies, who can still make money by betting against your good health. There's only one comfort here and it's cold, indeed. Profit while you can, insurers. Sickness and death wait not just for your customer. They also wait for you and they are double parked.

The doctor who treats you and the pharmacist who makes you pay through your nose are not your enemies in this. It proves they are as much victims as you and I are. The time has come to realign this battle here so that it is not just us versus the entire medical and health care establishment. It's us and the doctors and the nurses and the pharmacists and maybe even some of the hospitals against the real enemy, the insurance companies.

The insurance companies who are right now at war against America.

That's where I'll pick it up when this Special Comment continues.

(COMMERCIAL BREAK)

OLBERMANN: Dr. Albert Sabin was, by his own description, pretty full of himself when he managed to temporarily stop the testing of Salk Polio Vaccine after a bad batch sickened and killed some children early in the first tests in the 1950s. Sabin recounted this in a TV interview in the '80s. He was weeping.

He had believed he was doing right. He had convinced himself that the fact that Salk's vaccine, the so-called inactivated Polio vaccine, had been chosen for use instead of Sabin's own live polio vaccine was irrelevant to his efforts.

He was weeping as he recounted this too. Ultimately, there proved nothing wrong with Salk's vaccine. The one batch had been improperly handled and manufactured. Sabin and others delayed all further testing for weeks.

Sabin was weeping as we remembered for that. For in 1983, Dr. Sabin had contracted a rare disease of his own. Surgeons operated, relieved the intense pain and muscle weakness, and then ten days later, it came back, ten times worse, enough for him to be yelling and crying virtually all the time. The pain, he said, made me want to die.

And Dr. Albert Sabin suddenly remembered that the stopping of the Salk vaccine experiments had led to death, death of children. More immediately, though, it had led to pain, physical and emotional for the children and the parents. And he said it had not occurred to him then that the first thing doctors must do, the first thing the health care system must do is stop pain.

He vowed to spend the rest of his life relieving pain. His own searing agony and paralysis gradually, inexplicably faded.

They moved my father this afternoon. I don't mean they moved him to another hospital. They moved him in his bed into a different position. It was agony for him. Agony enough that he could barely see us. Agony enough they had to give him all of the pain killer he could handle and he couldn't talk anymore.

Another moment when somebody like me wonders about what it would be like if he was going through that I was watching worrying about whether we could afford the pain killers, or the doctors, or that hospital, or any treatment at all.

And what kind of society we live in where we millions of us face questions like that, and politicians goodly talk about incremental improvements, while they slowly reshape the new laws that are supposed to reduce the number of us faced with pain untreated do to money into laws that take more money out of our pockets and give it the corporations who are profiting off health care, without contributing one second to the relief of pain or the curing of disease.

The pimps of the equation taking their 20 percent off the top, the health insurance cartel.

How would our politicians react if there were millions of Americans in pain getting insufficient care to relieve that pain because of interference from insurance corporations and those millions just had been injured in a natural disaster or an attack on this country? How fast would the politicians rush their portable podiums to the driveways outside the emergency rooms? How quickly would the money come?

You know the answer. And you know what the answer has been about rushing to help those millions of Americans in pain tonight. Attacked not by another country or a terrorist or even a flood, but attacked merely by life. Half of the politicians are dedicated to protecting the corporations against having to help our relatives and our neighbors in pain. The other half are calculating how far they can anger our insurance overlords before our insurance overlords stop contributing to their campaigns.

Might all their CEOs, might all the wavering political frauds get ten minutes of Dr. Sabin's pain or my father's.

That's another part of the story you just haven't seen, the doctors. For all of the jokes over all of the years, these guys really are on our side in this, especially the ones in the hospitals, especially the ones without whose skills you would heal up just as fast in a bowling alley as in the best of the medical centers.

The man who took out my appendix two years ago, a messy, dangerous job that took more than two hours, from which I recovered fast enough that I only missed four days of work, and who left three little scars, one of which I can't find anymore. I wrote all the checks. I know how much he got out of the whole price, about 10 percent.

A very good friend of mine is a doctor in California. He wrote me about all of this the other day. You can see, he said, why doctors who want to make a living or cover increasing costs, labor, overhead, et cetera, have only have one choice: see more patients, spend less time, answer fewer calls, because there is no other way to increase revenue.

Plus, he wrote, if you order tests, patients think they're getting better care, and doctors thinking that testing saves them time in thinking or talking with people. You have chest pain? Instead of asking you questions, why don't we go ahead and do this stress test that I get paid much more than some little office visit to do, and make sure it's not your heart.

And so, like us, the doctors are slaves to insurance. That's not even talking about malpractice. We have to help them on that. Maybe we do need to cap damages. We do it, though, maybe where everybody benefits. You set up the cap wherever it works out to be now and then you lower it each year by exactly how much the entire cost of a patient's health care is lowered in this country. Incentivize the doctors to help make health care available to everybody.

We patients and the doctors have to be on the same side again, to stop pain, to heal disease, and not to be customers and salesman. And to help the thinking long-term too.

People do want to discuss their end of life preferences, prospectively, my friend the doc says. And doctors should be paid to have these discussions.

And then he wrote something that hadn't occurred to me. "We spend a lot of money on doing things that people would not have wanted us to do to them."

That hit home. My mother died in the spring. Bless her. She lived without symptoms until nearly two weeks before she went, and we had all talked about what to do and when to do it and what not to do. And so when they said there's breast cancer and there's five lesions in her brain and there's nothing we can do that will wake her, but we can do a lot to lessen her pain, or we can do things that might extend her life, but also won't cure and also won't wake her, but might be hurting her - we can't tell - it took five seconds to decide.

And then I thought of all the people who never had that discussion with their mother or father, who don't know that those are the choices they might face, and how it might help to have a doctor who says, blandly, here it all is. You say, doc, thanks. I have decided I still want you to keep me alive forever, even if I'm suffering and comatose. He says, got it.

Only, now he can send you a bill and you can have insurance pay you back for it. So your mother and you will know, when the time comes, exactly what each choice would bring. And some buffoon decided to call that a death panel.

On the list of preventable deaths, Diabetes, stroke, ulcers, appendix, pneumonia, we're 19th in the world. Canada is 6th. England, 16th. We're 19th. Portugal is 18th. You're better off in Portugal.

Death panels? We have them now. They're called Wellpoint and Cigna and United Health Care and all of the rest.

Ask not for whom the insurance companies cash register bell tolls. It tolls for thee.

What you and I might yet be able to do about all of this when my Special Comment continues.

(COMMERCIAL BREAK)

OLBERMANN: I do not know who the two women were, yet they are indelibly burned into my memory now. They stood outside on a crisp New York morning last week, middle aged, short, looking more than a little wary. They were wearing lab coats, and they were leaning against what those coats told me was their place of employment, the Mortimer B. Zuckerman (ph) Research Center at Memorial Sloan Kettering Cancer Center.

The women in the cancer researcher lab coats were smoking cigarettes. I've seen a lot of startling things in my more than 40 days and 40 nights alongside my ailing father inside this nation's fractured health care system, but not seemed to me to better symbolize the futility, the ram your head against the wall futility of this gigantic medical entity that we created, that seems to not only broken free from human control, but which has, to some great measure, enslaved us.

Twenty three stories tall, built partly with a 100 million dollar gift from the publisher of the "New York Daily News" and "US News Magazine" and two of the cancer researchers are standing in front smoking.

That isn't the only picture that haunts my dreams. A man walking out of another hospital, casual, purposeful, in control. The red stitches on the left side of his shaved head outlining a space as big as a large potato and at least an inch higher than the rest of his skull. I don't if he was getting better or he was getting worse. I don't know if he had just gotten good news or bad. I don't know if tonight he's healthy or he's dead.

Months ago, I got in line at a drug store here. A woman ahead of me, obviously a familiar figure to the young pharmacist behind the country, trying, with mixed success, to take in the gentle explanation. You have maxed out your prescriptions on that insurance, the professional said slowly. I can't give it to you.

The customer shook her head in resignation. It was like the Medieval Courts of Chancery (ph), where if you were poor, you could take your lawsuit against the rich or the government and hope that when they hear the handful of cases to be heard that year, they picked somehow yours.

If they didn't, you could try again next year or, in some cases, every year for 20 next years.

The woman who needed the prescription spoke even more slowly than the pharmacist just had. She almost had no hope in her voice. Try the Cigna please.

Another drug store late at night and the pharmacist there was a friend of mine. "You have to do something about this," he said loudly as he handed me my refill. He reached for somebody else's prescription. "You see this? Anti-fungal cream. I just filled this. You know what this cost wholesale? Four dollars. You know what I sell it for? Two hundred sixty three dollars. I sell it for less and I get fired, and maybe we lose our license."

And then this. Last Saturday, I leave my father 24 hours after serious surgery that probably saved his life, serious enough that he was still under sedation, and it would be another 24 hours before he knew where he was or who I was. Yet I knew he was OK, because I had gotten him the best care in the world. Literally, his surgeon is considered among the top five guys in his field alive today. Even I can tell you absolutely nailed the operation.

And I know that after my father was to wake up, when post-operative

fluids would get into his lung and he had trouble breathing and he had to

inhale after every word, they would give him a drug called Lasigs (ph) that

would start to drain the fluids. And within five minutes, he would be

breathing easier. And within 15, it would be like nothing was ever wrong,

and that this was just one of 20 drugs they can use on him, not just to make him better long-term, but, just as importantly, and twice as imperatively, to stop his pain short-term.

I marveled that we had come so far that you can barely take care of your life like he would admit he hasn't for 80 years. You can even be as dumb as those two women outside of the cancer research center smoking away. And there's still a kaleidoscope of drugs and therapies and nurses and diagnosticians and psychiatrists and X-Ray techs and surgeons, and all of them are capable of undoing the pain and curing the sickness and forestalling death.

As I walked down the hallway from my dad's room, I allowed myself a brief moment of selfishness. I'm sorry. I'm sorry that I'm happy that I can spend whatever it takes to help my dad get better, to keep him around.

But maybe I can atone for that selfishness by making this case tonight to you, to whoever sees this, that we have to make these wonders of life and health and peace of mind and control of pain available to everybody.

And this is boiling in my brain that day. I take the shortcut out to the street through the emergency room. And that's when I hear my name called. It's a man roughly my age and he looks worried to death and really familiar.

I haven't seen him in 32 years. He was the nephew of the two brothers from Brooklyn who used to run the baseball card shows when we were both kids. His uncles were businessmen. But he, like me, we were the kids collecting mostly for the fun of it. It's amazing to see him again, joyous almost, just for the sake of the continuity, that the accident of us running into each other provides to us both.

And he asks what I'm doing there. I tell him. He smiles, because my father used to go to those card shows with me. Mike remembers him.

Then I ask Mike why he's there. "My daughter is in ICU," he says.

Three weeks now. The worried look returns to his face. "Lyme disease." It's one thing they knocked that down and then it's another. There's a brief pause. "Tomorrow I will have to sell my farm. Did you know I had a farm?" I don't have to ask him why.

He then goes the next step. "You want to buy my card collection? I have got some great stuff."

We must reform a system that lets my father get better care than yours does or better care than Mike's daughter does because of the accident of life that I make more money than he does or my checkbook could hold out longer than his does or yours does, as the bills come endlessly, like some evil version of the enchanted water buckets from "Fantasia."

The resources exist for your father and mine to get the same treatment, to have the same chance, and to both not have to lie there worried about whether or not they can afford to live.

Afford to live. Are we at that point? Are we so heartless that we let the rich live and the poor die and everybody in between become racked with fear, fear not of disease but of deductibles?

Right now - right now, someone's father is dying because they don't have that dollar to spend. And the means by which the playing field is leveled, and the costs that are just as inflated to me as they are to you are reduced, and the money that I then don't have to spend anymore on saving my father can go instead to saving your father, that's called health care reform.

Death is the issue. How can we not be united against death? I want my government helping my father to fight death. I want my government to spend taxpayer money to help my father fight to live. I want my government to spend taxpayer money to help your father fight to live.

I want it to spend my money first on fighting death. Not on war. Not on banks. Not on high-speed rail. Spend our money. Spend my money first on the chance to live.

And we must be unanimous in this, not to achieve some political triumph for one side against the other, but to save the man or the woman or the child who will be dead by morning in this country, in this century, on our watch, because we're not spending that money tonight.

I will not settle for a compromise bill. I will extend my hand to those who are scared of the inevitability of death, but who have been told they are scared of reform, those who been exploited by the others, paid or forced to defend the status quo.

We must recognize the enemy here. It's an enemy capable of perverting reform meant for you and me into its own ATM that mandates only that more of us become the slaves to the insurance company, the monied interests that have bled their customers white, and used their customers money to buy the system, to buy the politicians, to buy the press.

It cannot now even be checked by the government. Ordinarily the solution would be obvious. We would have to do it for the government. We would have to bring insurance companies to their knees, to organize, to pick a date to say enough, to, at a given hour, on a given day, stop paying the premiums: an insurance strike.

But the insurance company's strangle hold on us is so complete right now that lives would be risked. Lives would be lost by the very act of protest. What parent could risk the cancellation of their child's insurance? What adult could risk giving his insurer the chance to claim that everything wrong with him on the day of an insurance strike was now suddenly a preexisting condition.

Even as the payouts move inexorably downwards to being less than what you have paid in over the years, we are such surfs to the insurance companies that just to invoke the true spirit of the founding of this nation is to give them more power and not less.

So I propose tonight one act with two purposes. I propose we, all of us, embrace the selfless individuals at the National Association of Free Clinics. You know them. They conducted the mass health care free clinic in Houston that served 1,500 people.

I want a health care clinic every week in principle cities of the states of the six senators key to defeating a filibuster against health care reform in the Senate. I want Senators Lincoln and Pryor to see what health care poverty is really like in Little Rock.

I want Senator Baucus to see it in Butte.

I want Senator Ben Nelson to see it Lincoln.

I want Senator Landrieu to see it in Baton Rouge.

I want Senator Reid to see it in Las Vegas.

I'll donate. How much will you donate? We enable thousands of our neighbors to have just a portion of the bounty of good health, and we make a statements to the politician, forgive me William Jennings Bryan, "you shall not press down upon the brow of America this crown of insurance. You shall not crucify mankind upon a cross of blue."

We think these events will be firmed up presently. You will be able to link from our website. Trust me. I will remind you.

Because in one party, in one demographic, in one protest movement, we're all brothers and sisters. We are united in membership in the party that insists that every chance at life be afforded to every American seeking that chance. We are united in membership in the party that insists on the right of everyone to the startling transcendent the blessings of the technological advance of medical science.

We're united in membership in the party that is for life, that is against death, that is for lower premiums, that is against higher deductibles, that is for the peace of mind that can be provided only by the elimination of the fear that costs will decide whether we live or we die.

Because that's the point, isn't it? It is hard enough to recover, to fight past pain, and to stave off death, if just for a season or a week or a day. It is so hard that eventually for you, for me, for this president, for these Blue Dogs, for these protesters - it is so hard to recover that, for all of us, there will come a time when we will not recover.

So why are we making it harder?

On behalf of both of the Olbermanns, good night and good luck.

And now here's my dear friend, Rachel Maddow. Good evening, Rachel.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. END