In the scope of national politics, it is easy equate the House with likes of Nancy Pelosi or John Boehner and forget that the House of Representatives was long considered to be “the peoples’ house” due to the populist nature of the representation – smaller districts and two-year terms. Members of the House of Representatives pride themselves on providing constituent services for the folks back home.

The House gave a glimpse of its roots last week when it unanimously passed a bill co-sponsored by Rep. Steve Kagen, D-Appleton, and Rep. Ron Kind, D-La Crosse that extends the $8,000 tax credit for first time home buyers to service members overseas.

Kagen’s involvement in the legislation was sparked by a call from a constituent, Jerry Kavanaugh of Kaukauna, with a problem. His son was called to active duty in April as a member of the Wisconsin National Guard’s 32nd Infantry Brigade Combat Team in Appleton. His unit returns from Iraq in January, too late to take advantage of the tax credit.

Think about it. Men and women risking their lives fighting in Afghanistan and Iraq or serving in other overseas posts would miss the deadline for applying for the home buying stimulus tax credit that was available to civilians until Nov. 30 because of their tour of duty.

The bill moves to the Senate for action and if passed goes to President Obama for signing.

“It’s an honor to be able to deliver for Dave and his family after all they have done for our country,” Kagen said. “Our men and women in uniform and their families have sacrificed so much. They should not have to miss out on this opportunity.”

Well done, Congressman, well done.

Now, if only health care was that simple.

The Final Thought: It is appropriate for Congress to give those serving in the military overseas the opportunity to take advantage of the homebuyer tax credit plan.

“I think that Wall Street should participate in the recovery of the American economy,” the Appleton Democrat told reporters during a conference call, arguing that questionable practices by those investors sparked the economic collapse last year.

Kagen said a fee of 0.25 percent on all trades would generate more than $100 billion annually, providing critical access to citizens in need of health care.

Kagen said he couldn’t speculate on the fate of a public option after the Senate Finance Committee approved their version of the health care bill Tuesday, without a public plan. But as House and Senate leaders work to merge the bills in the coming weeks, Kagen said, “I think there has to be something like a public option, regardless of what you call it.”

Kagen also touted yesterday’s report on the impact of federal stimulus spending in Wisconsin, saying that the thousands of jobs created by the spending included “putting money where it really belongs” — into public safety and education.

Congressman Steve Kagen met with 45-year-old Platoon Sergeant Lyle Spurgeon of Phelps, at the Walter Reed Medical Center in Washington D.C. last night.

The Congressman says Spurgeon is healing rapidly and looks forward to joining his fellow soldiers as soon as possible.

Spurgeon is one of 100 soldiers from the 951st Sapper Company deployed to Afghanistan.

He’s a combat engineer with the 951st and was injured last Friday.

Spurgeon was flown from a hospital in Germany to Walter Reed on Monday night.

The Company conducts route clearance operations for the Army’s 101st Airborne Division.

A popular tax credit for first-time home buyers will be extended for soldiers serving overseas. It’s an idea that came from a Kaukauna man.

With a son fighting in Iraq, Jerry Kavanaugh took up a fight with Congress.

The tax credit, worth about $8,000, faces an expiration date. Kavanaugh wanted an extension for service members.

“I think it’s a huge deal. It’s a huge deal. It’s going to help prop up the housing industry when there’s over 3,000 Guard members gone with Dave, and if just half of them come home and half to buy a house in the Valley here, in Wisconsin, it’s going to be a huge deal,” Kavanaugh said.

Dave Kavanaugh of Kaukauna left on his second tour of duty last February.

Right now he’s planning to buy a house. so his dad didn’t want the tax credit to vanish while his son was fighting overseas.

After a call to Representative Steve Kagen, Congress took action and voted to give soldiers a one-year extension.

“You can call it Jerry’s bill, but the important thing is, this is just a good example of how legislation starts from our cities and towns and moves right up here to Washington,” Congressman Kagen (D- 8th Congressional District) said.

“I emailed him last night and told him what his dad did for him and all the men and women, serving our country so they can reap what they deserve,” Kavanaugh said.

As a result, 350,000 soldiers deployed right now are eligible for the tax break.

It’s a victory, Kavanaugh says, that’s fitting. “Yeah, I’m just absolutely tickled pink that it worked out the way it did.”

“Our men and women in uniform and their families have sacrificed so much - they should not have to miss out on this opportunity,” said Kagen. I am working hard to guarantee that our veterans receive the benefits they have earned. This bill will help our economy by stimulating housing sales and help our veterans build a better future for themselves when they return. They have our backs and we must have theirs.”

Kagen authored the bill (H.R. 2562) with Wisconsin Congressman Ron Kind.

The Service Members Home Ownership Tax Act of 2009 will extend the $8,000 first-time home buyers tax credit for one year for members of the Armed Service who deployed overseas for 3 months or more in 2009, waive the repayment clause if a service member has to sell their house within 3 years due to official orders and ensures that certain payments from the Department of Defense Housing Assistance Program (HAP) are exempt from taxation.

Congressman Kagen was inspired to write this legislation in April after hearing from Jerry Kavanaugh of Kaukauna. Jerry is the father of Dave Kavanaugh, who is a member of the National Guard serving in Southern Iraq with the 32nd Infantry Combat Brigade out of Appleton. Dave wants to be able to purchase a new home for his family when he returns from his deployment, but under current law, he will not qualify for the tax credit when he returns home next spring. The $8,000 non-refundable tax credit will help Dave, and thousands of other men and women serving overseas, buy their first homes.

“It is an honor to be able to deliver for Dave and his family after all they have done for our country,” said Kagen.

There are about 350,000 service men and women deployed overseas who might be eligible to take advantage of this program.

1.4 million people have taken advantage of the tax credit since enactment. The cost of home ownership is estimated to have decreased 5% in Mid-west as a result of this the First Time Homebuyers Tax Credit. The National Association of Realtors estimates that 350,000 people bought a new home solely because of this tax credit.

“This will get money directly into the pockets of our dairy farmers,” said Kagen. “Many of our farms are family-owned small businesses. This will help these families during these uncertain economic times. As we take action to put our economy on the road to recovery, I am working hard to sustain the industries that are the backbone of our communities in Northeast Wisconsin.”

An agreement was reached last week with House and Senate negotiators for the Agriculture Appropriations bill to contain $350 million in aid to the dairy industry. The agreement has $290 million to be dispersed to dairy farmers through a process that will be determined by the United States Department of Agriculture. $60 million will be used to purchase dairy products, such as cheese, in an effort to reduce surpluses that have driven down farmer’s income. Today’s actions are the final steps to pass the Agriculture Appropriations Bill.

Last week, Kagen met with members of Wisconsin’s agriculture industry to discuss the circumstances affecting the dairy industry locally. Congressman Kagen is the only Wisconsin member of Congress serving on the House Committee on Agriculture, and he is on the Subcommittee on Livestock, Dairy and Poultry.

“We are very proud of Wisconsin’s heritage as America’s Dairyland. I want to thank Senator Herb Kohl and Congressman Dave Obey for their leadership in this effort. Together, we will preserve our dairy farms for future generations,” said Kagen.

During fiscal year 2009, more than $143 million has been given to Wisconsin farmers in MILC payments through the U.S. Department of Agriculture’s Farm Service Agency. Kagen fought for a provision in the 2008 Farm Bill to include feed prices as part of the calculation for MILC payments

Congressman Kagen and other members of the House Dairy Caucus held a meeting with U.S. Agriculture Secretary Tom Vilsack last week to talk about what can be done to aid the dairy industry. Kagen made suggestions to Secretary Vilsack on how to distribute the $290 million for dairy farmers.

“This is further evidence that the health care system in this country is unsustainable and badly in need of reform. I am working hard to get the job done in Washington, knowing that the health of our economy and our families depends upon securing guaranteed access to affordable care for all of us,” said Dr. Kagen.

According to Medicade rules, the BadgerCare Plus Core Core Plan must be budget neutral, meaning that there is a set amount of money that to be spent on the program. The state estimates that BadgerCare Plus Core Plan can afford to cover approximately 54,000 individuals and so far over 60,000 applications have been received.

“Wisconsinites will not be helped if we do nothing. We know there is a better way of delivering quality health care to all American citizens at a price we can all afford to pay. Now we need the will to enact it,” said Kagen.

The state is strongly encouraging individuals who have yet to apply to do so online, because of the high demand expected in the remaining days of enrollment. You can apply online at www.access.wi.gov.

Kagen continued, “A generation ago, during our nation’s moment of greatest despair, President Franklin D. Roosevelt asked Congress to take bold actions. He said, ‘take a method and try it. If it fails, admit it frankly and try another. But above all, try something.’ What kind of nation would we be if we did not care for our neighbors?”

Individuals may wish to consider applying for the BadgerCare Plus Core Plan if they:
• Are a U.S. Citizen or qualifying immigrant;
• Do not have dependent children, under age 19, living with them and are not pregnant;
• Are a Wisconsin resident between the ages of 19 through 64;
• Have a monthly family income at or below 200% of the federal poverty level ($21,660 per year for a single person and $29,139 per year for a married couple);
• Do not have health insurance or have not had access to employer subsidized health insurance during the previous 12 months, with a few exceptions; and
• Are not enrolled in or able to enroll in BadgerCare Plus, Medicaid or Medicare.

The purpose was to educate the public on the progress on health care reform efforts, and allow Kagen to outline what he believes is vital to proper reform

Kagen says, “it has to be a price we can afford to pay. We need to fix what’s broken, improve on what we already have, and make sure we can afford what we’re trying to do. And the three most import essential elements are no discrimination against anyone because of preexisting medical condition. Second, would be transparency, where the prices are always openly disclosed, including on the Internet. And then the lowest price accepted as payment in full from any customer, should be every customers price at that location.”

Not everyone at the forum though supports the measures like a new, public insurance option.

Mike Keene says, “my concern was also is a public option. I believe that government has a less than adequate care compared to the private companies. And I judge that based on care given to our veterans, which I honor and I respect. But the reality is the VA is not a place where people line up for their treatment.”

To ensure the atmosphere did not become contentious, participants were asked to write out their questions to Kagen in advance.

“We need to fix what’s broken, improve what we have, and…eliminate wasteful spending,” Kagen said. He stressed three “critical, essential elements” that he believes need to be in the legislation passed by Congress. One, he suggests there needs to be “no discrimination against anyone due to a pre-existing condition.” Two, that there is “complete transparency” by insurance companies, particularly regarding prices. And, three, that a “standard health-benefit plan” is established for all citizens.

“With these three essential elements, it would effectively do what the public option would attempt to do,” Kagen said.

Although the public option was rejected by the Senate Finance Committee earlier this week, when asked about the future of the government-run plan, Kagen said, “I believe the House will have a bill with the public option,” and that the differences between the House and Senate versions will have to be tackled in conference committee.

“One of the great difficulties of debating the public option is … it’s a blank piece of paper,” he added.

Dr. Jan Sarnecki, a local doctor from Wisconsin on the call, addressed the “inequity in pricing” by insurance companies and said he recognizes “enormous waste in two areas–insurance administration and in tests and procedures that provide no value to the patient.”

Kagen addressed the benefits and improvements for small business owners and employees that proposed health care legislation would bring. He also said, “Seniors have to understand that they are going to benefit,” referring to the fear many senior citizens have expressed about health care reform.

He also said he recognized that a lot of people across the country may feel “very comfortable” with the insurance they have right now, but warned that these Americans need to realize that they may lose their insurance coverage at any time; and, therefore, “by doing nothing at all, your family will pay about $1,800 more” in the next year.

“Congress needs to make health care more affordable and give people the freedom to chose coverage,” a Wisconsin nurse who was also on the call said. “I’m very passionate about President Obama’s plan…trying to work out viable options. We need to get a handle on the United States now–we can’t wait.”

Kagen added, “In my view and the view of patients…we want the insurance companies to be processing paper, not practicing medicine. We want the highest quality care at the lowest possible price. We can do this by working together.”

Wisconsin’s Organizing for America, a grassroots organization supporting the president’s agenda for health care reform, held the press conference call.

Republicans, of course, have used their own doctors to argue against the reform Democrats are pushing. Rep.Charles Boustany, for example, gave the response to President Obama’s joint address to Congress.

The 28-year-old Merckx and her husband, Nick, pay $350 per month for an insurance plan with a $4,000 deductible that doesn’t cover her prescriptions.

Merckx says she and Nick are close to becoming casualties of the system, because they make too much money to qualify for government programs but can’t afford to pay for adequate coverage.

“We make too much to qualify for any state programs, county programs or federal programs, but we’re just barely over the edge,” Merckx said. “It’s just impossible to make ends meet. We have this huge chunk out of his paycheck each month and we don’t see it. It’s like ‘Do we get birth control or do we get food?’”

Merckx needs a prescription for a condition she was diagnosed with as an 18-year-old and she takes birth control pills because she says she and Nick aren’t financially ready to start a family.

The medication her doctor recommended for her condition would cost $120 per month under their current plan, so she took the next best option for $40 per month. Birth control would cost her $60 per month so instead she uses the reproductive clinic at the Oneida County Health Department, which bills on a sliding scale.

“It’s tough. You have the insurance but it’s a double-edged sword because you pay so much a month but it doesn’t cover anything,” Merckx said. “We can’t even afford the medication I need to be on.”

The Merckxs find themselves in a category of working Americans often referred to as “the underinsured.” The health insurance they can afford has such a high deductible that they can really only use it for catastrophes.

“How many people want to pay $350 out of pocket for the doctor to say it’s a virus and you have to wait it out?” Merckx said. “I was talking to my husband the other day and saying maybe we should drop our health insurance. With the economy the way it is we really have to assess what’s more important. It’s a sad thing if you have to decide between a roof over your head or health insurance this month.”

Merckx said she has never been a political person and hasn’t kept close track of the debate in Congress over different health care bills.

“It is what it is and right now nothing has changed,” said Merckx. “I’ll just wait around until it does change. We don’t have any other option.”

Merckx said her current predicament really hit home when she had an allergic reaction to aspirin that closed her throat.

“We actually sat down and debated whether or not to go to the hospital. It was like ‘Will this go away?’ We know we can’t afford to go to the hospital right now. None of it was covered because we hadn’t met the deductible,” Merckx said.

But Merckx said she needs healthcare, pointing out that women need annual check-ups and she has her prescriptions to think about.

Her husband rarely goes to the doctor.

Nick’s use of the coverage has been limited to a hernia operation and an accident in which he lost the tip of his finger.

But in addition to her prescriptions and doctors’ visits, Necia also went to St. Mary’s Hospital for a urinary tract infection and ended up having her appendix removed at a cost of $26,000.

“You never know what’s going to happen. What accidents might happen. When you need to go to the hospital next, so we have to have it,” she said.

Five years ago, before she was married, Merckx had her own insurance. She paid $50 per pay period for comprehensive coverage with a $500 deductible.

“I don’t know why insurance went up so much, but it would be nice to know. Did it go up because the insurance companies are padding their pockets? Or because the cost of everything else went up?” Merckx said. “If you make it more affordable people are going to pay. If it’s reasonable there won’t be all these outstanding debts.”

Dr. Terrance Moe of Country Doc’s in Eagle River runs an independent general medicine practice. Moe is all too familiar with cases like Necia Merckx’s.

“Even when they do have insurance they’re undercovered. They end up with a deductible that’s so high they refuse to get healthcare. They start making bad decisions,” Moe said.

Moe has been a doctor for 35 years and has run his current practice for the last five. He said his decision to open an independent practice was based on his desire to espouse older values that govern the doctor/patient relationship.

“I’m projecting an image of the old country doctor that everyone could rely on and would put their concerns first and treat them as human being not as a piece of cattle with a number,” Moe said.

Moe has strong feelings about what Congress should do to solve the problem of providing more affordable healthcare to its workforce. He believes insurance companies have engineered a system that puts too much emphasis on profit and not enough on care. The effect is the emergency rooms and general practice physicians end up treating people who can’t pay them.

“I just get by. I’ve given an incredible amount of free care because people come in without insurance and they run up a bill and I treat them and they can’t pay and then I don’t see them again,” Moe said. “I have a tremendous amount of uncollected bills. If we had a single payer system there wouldn’t be any unpaid bills.”

Moe concedes that the political climate may not support a single payer system, but he still thinks there needs to be a public option or standard low-cost insurance plan in Congress’ healthcare reform package.

“Single payer makes the most sense, but it appears to be too radical a concept for the present climate. The alternative is a strong public option that would provide competition with the insurance companies and result more affordable coverage for everyone,” Moe said.

Moe believes the first step in the solution should be preventing insurance companies from denying coverage on the grounds of pre-existing conditions.

“They’re not in the business of providing insurance anymore. They’re in the business of denying coverage,” said Moe. “Instead of spreading out the costs across the population that’s insured, they want to cherry pick the healthy ones and keep the profits for themselves.”

When insurance companies “cherry pick” the result is higher costs for consumers, because the risk associated with covering people with health issues is not spread across the system. Moe said he has seen lots of people like Merckx in his practice.

“She’s screwed. The way our system is right now she can end up being one of the bankruptcies that occur every year. One half of the bankruptcies that occur happen because of medical bills. That’s insanity,” Moe said.

Moe said the American healthcare system will not suffer as a result of a public option.

“Will you have to wait longer for an elective procedure? Yes. But that’s a small inconvenience compared to someone going bankrupt because they don’t have insurance,” said Moe. “The whole thing can be done revenue neutral. All you do is extend the benefits of Medicare to age 45 and sell it at cost to the people between 45 and 50.”

Moe said he is disappointed with the stances of some Democrats in Congress who have backed off supporting a public option.

“The Republican leadership isn’t the issue,” Moe said. “The issue is the blue dog Democrats being funded by the healthcare industry.”

The term “public option” is a catch-all phrase for a plan that would create a standard low-cost health insurance plan available to anyone, with the costs of the system being shared between Medicare and private insurers.

Democrats in the House of Representatives have supported that kind of proposal, but their colleagues in the Senate have remained split on the idea. Republicans in both houses have mostly rejected the idea.

An alternative option that would create state-level non-profit cooperatives with federal money has been presented in the House. These “exchanges” would allow for the creation of regional buying pools that could negotiate independently with insurance companies for lower rates on healthcare services.

Pete Biolo has served as president of the Oneida County Republicans and he has taken an active role in the political debate over healthcare reform. Biolo concedes that there are gaps in the current healthcare system, but he objects to proposals that include a public option for health insurance.

“I think you can show in polls that most Americans are satisfied with the quality of our healthcare,” Biolo said. “What we would have to deal with is the cost or our healthcare and there’s a number of ways to do that.”

Biolo said Republicans are not rejecting reform initiatives — pointing to Newt Gingrich’s Center For Health Transformation plan and to Congressman Paul Ryan’s (R-Janesville) “Patients’ Choice Act” — but instead are rejecting solutions that interfere with a market-based approach.

“One of the big misconceptions is that the Republicans are the ‘no’ party and don’t want to do anything about it,” Biolo said. “Where the Republicans and the Democrats in control disagree is they want the government in control of healthcare and we would like to see the market work these things out.”

Biolo said the tenets of such a proposal would entail tax breaks for small business, legal reform to limit medical malpractice suits, and systemic reforms to eliminate waste in Medicare and open up competition between insurance companies across state lines. Biolo believes the Democrats are rushing to ram a bill through Congress before the costs of their proposals can be analyzed.

“One of the concerns I have in this whole healthcare debate is I don’t know what the rush is. The president wanted this done before the break but there’s people on the Democrats side also who are saying we should wait and see what all these measures are going to cost,” said Biolo.

Biolo acknowledged that right now people like Merckx are struggling to pay for insurance.

“I think we could all agree that people that are down and out a compassionate society would want to take care of their healthcare, but the debate should be about how we are going to pay for them,” Biolo said. “We need to engage in these specific kind of arguments and we haven’t really done that. It sounds cold, but I don’t know of anything in the Constitution that guarantees the right to healthcare.”

Biolo said the current debate over different reform initiatives is not transparent because there are too many different versions of bills in both houses of the legislature.

“I think they ought to have one bill, get it written, and then let people know what it’s going to cost with hard, solid facts,” said Biolo.

Biolo said part of the pushback from Republicans in the rank and file is based on a cumulative mistrust of overspending in the past two administrations accentuated by the way the stimulus package was created. He sees the issue as part of a larger struggle to contain the growth of federal government.

“The conservative concept is not as much about healthcare as it is about control,” Biolo said. “Once the government has control of the system instead of the market, that is a really big concern.”

Congressman Steve Kagen (D-Appleton) ran on the issue of fixing the healthcare system and as a physician he has taken a leading role in writing legislation in the House. On Friday morning, Kagen was busy drafting an amendment to a resolution that would create a “standard plan” for the health insurance system.

“There will be a public option in the House bill,” Kagen said.

Kagen has pushed for a reform package that contains three fundamental features — no discrimination due to pre-existing conditions, pricing transparency for healthcare services across the system, and a standard plan for insurance that would create competition between government and private providers.

“When each and every insurance corporation has to offer a standard insurance plan, then we as consumers can compare the prices and services,” Kagen said. “We already have achieved that in Wisconsin with our auto insurance and it should be the same with health insurance.”

Kagen believes the three features of his plan are linked, because they would together force insurance companies to compete with one another on a level playing field.

“In my lifetime our insurance companies divided our communities. They separated mother from child,” Kagen said. “When America begins to stop pointing fingers and start solving problems as a community then we can move forward on this issue.”

Kagen wants to see a system in which the prices for all healthcare services — from prescriptions to tests to treatments — are advertised so that they can be compared side-by-side with the lowest price becoming the standard for a region.

“Today we don’t have a medical marketplace,” Kagen said. “The price today is whatever they can get.”

Kagen pointed to Merckx’s hospital visit.

“Did she ask them to negotiate the price?” Kagen said. “What your readership needs to understand is that the hospitals are charging what they can get. I would ask, ‘What’s the lowest you’ve charged in the past for that procedure?’”

Kagen admitted the specifics of the healthcare debate are complex. He pointed to Wisconsin’s Senior Care program as a success story for the type of state-level insurance cooperative outlined in the plans calling for “exchanges.” The program has allowed around 100,000 low-income seniors to obtain cheaper prescription drugs by negotiating as a large purchasing pool.

According to Kagen, the plans he supports would allow small businesses to purchase insurance in similar purchasing pools. Kagen said his sources have told him that about 50 members of the Senate currently support some kind of public option but that Sen. Max Baucus’s (D-Montana) Senate Finance Committee has voted against the creation of a standard plan for coverage.

“When people look at this issue they’ve got to start saying, ‘Who’s side are you on?’ I’m working hard to make sure that there’s a bill in the House that works because small businesses can’t hold their heads above water any longer and people can’t continue to pay exorbitant prices for insurance,” Kagen said.

In the House, Kagen said the process continues to be fast-moving and fluid.

“I’m confident we will pass a bill. I’ve yet to see a final language and it’s still in flux,” Kagen said.

In the meantime, the Merckx family and a whole host of other people are waiting and watching to see if healthcare reform will actually result in affordable health insurance.