From 1999 until 2005, I was involved with an organization in DC called Project Northstar. Its mission was to provide tutoring and mentoring to children living in homeless shelter in Washington, DC. The organization made a profound difference in children's lives because so many of them lived in homeless shelters for YEARS (because the housing situation is DC is unspeakably bad). These shelters often do not provide adequate support for children (not blaming them -- its often a function of funding), and so the kids are mostly left to their own devices while growing up in some of the most hellish environments imaginable.

Project Northstar connected each kid to a mentor who met with the child at least once weekly, one-on-one, for an entire year (and often for many years) to help with homework, and more importantly to build a relationship with an adult in the community. These relationships became lifelines for many children, and helped them to develop the resources they needed to succeed in schools, develop goals for themselves, and ultimately find paths out of the shelter. It was like Big Brother/Big Sister, except that the tutoring sessions were held on a regular day and time each week, and school buses were provided by the organization to pick up the kids and take them to the tutoring session. The group also provided books, pencils, and other supplies the kids needed -- because so often children in shelters are forced to do without the basic necessities in school. We also provided a hot meal to the kids during the tutoring session.

I was very saddened to learn this week that because of the troubled economy, Project Northstar's funding stream has collapsed and the organization shut its doors after more than 15 years in operation. It's just so sad that as the economy worsens, those who need support most are not getting it... and now the staff members of this organization (and many like it, I'm sure) are losing their incomes and health insurance, when they were already making do with so little.

Because of my involvement with Project Northstar, I was inspired to go back to school to earn a Masters in Social Work. I know many other volunteers decided to pursue careers in helping professions as a result of their experience with this group. I hope that this group and others like it can be revived through service grants from the Obama Administration. Volunteers are the backbone of these programs, but money is needed to provide kids with the basic necessities. Kids can't learn without proper nutrition, school supplies, eyeglasses, etc. And when these are provided in the context of a supportive, nurturing, mentoring relationship, it makes all the difference -- for the children AND the volunteers.

This is a great idea. I agree that this forum does provide one opportunity for sharing ideas... but the fact is that it takes money and time to really do the research, crunch the numbers, and refine ideas into strategies that can be implemented. In my state, a large nonprofit organization funded this kind of a think tank one summer, where several well known researchers in health care policy (from a variety of disciplines) were paid to spend a summer wrestling with the problem of how to expand health care access in the state. Their results were really interesting and instructive (and could have been implemented if there had been ANY political will in the state legislature).

It does leave us with one important lesson, though -- great ideas are one thing, but there must be political will to implement them. If the NII idea takes hold, it would need some kind of built in process by which results would be reported to the various stake holders, including to Congress AND to the rest of us via a forum like this, so that we can make sure that good ideas actually get implemented.

I really do hate the idea of bailing out the Big Three, just as I hate the idea of bailing out the big banks. I think the executives of those companies should be held accountable for their reprehensible disregard for the risks they were taking -- risks that hurt their employees and the ordinary American citizens way more than they ever hurt the executives.

On the other hand, I do believe that the economy would be in even worse shape if we let these companies go belly up. Further, sacrificing the Big Three automakers would mean permanently moving the U.S. out of that sector of industry. I think a better idea would be to stipulate that any loans we make be used to spur innovation in automotive technology. Use the cash to move American automakers to the forefront of green energy research and design efforts. This crisis represents a HUGE opportunity: if investments are made in developing green technology AND in providing tax credits for buyers -- that is, if the American equivalent of a Prius was made affordable to ordinary American citizens -- we would boost the economy, bolster our national security (by reducing dependence on foreign oil), and address the climate change head-on. At the same time, we would also reestablish our position as a global leader in innovation.

YES YES YES. The Boston Globe had an op-ed piece saying just this a couple days ago. It's so true. We frame health care as a response to illness... when in fact we create illness with our unhealthy urban environments, our sedentary lifestyles, and our failure to allow for equal access to preventative care and screening. It's a complex, systemic issue, one that requires a comprehensive effort to improve the conditions in which people live, and the degree to which people feel empowered to make healthy choices.

I am also really amazed that our country under values health care personnel... people in helping careers... so much. Firemen, nurses, social workers (like me)... we're all horribly underpaid, and not even given access to health care. How ironic and tragic is it that a NURSE can't get proper health insurance??? We need to fix this NOW.

It is short-sighted to believe that simply denying insurance to an ill person will save you money. The fact is that when people with serious illnesses are left to manage without insurance, they inevitably end up tapping emergency care rather than managing their illness with regular doctor visits, medication and preventative care. The costs of these emergency room visits are passed on to the rest of us through increased hospital costs -- basically, all the unpaid hospital bills get charged off, and the budget deficits are covered by increased costs for x-rays, MRIs, and other routine hospital services.

It is much cheaper in the medium- and long-term for society to cover everyone, with a focus on preventative care and screenings to catch diseases early -- when they are cheaper to treat. If everyone is covered, hospitals and insurance companies don't have to jack up the prices on services to the healthy people to offset the unpaid bills of those who can't afford -- or simply aren't eligible for -- private health insurance.

By the way, I would also argue that it is more ethical to make sure that people get basic health care. But if it's pure economic self-interest that drives you, the numbers clearly support development of some kind of universal health care system that does NOT exclude people who are living with illnesses and disabilities.

Actually, Medicare -- though not perfect -- is one of the most successful, popular social policies we've ever had in this country (just ask any older adult whether they would give up their Medicare in exchange for a private plan). Sorry to have to say this, but it IS socialized medicine. Obviously it would be a challenge to expand Medicare to cover all Americans, but the fact is that we do have examples here in our own country of government-run programs that work.

I agree that portability is a major concern -- fear of losing health insurance ties too many Americans to jobs that don't pay well, are too far from home, or hold them back professionally. We should not have to worry that a pre-existing condition will exclude us from care, and even from jobs as well (because the employer is worried about increasing health care costs by taking on an employee with health care needs).

I am also deeply concerned about the privatization trends in recent health care policies. Several recent studies have shown that the switch to private insurers for Medicare has resulted in increased costs with no gain -- or even losses -- in coverage. Rather than lining the pockets of private insurance company CEOs, we need to find a way to cut costs while increasing access to quality health care (including preventative medicine and prescription drugs).