(Image: ThinkStock)

Before the last of the Thanksgiving leftovers have even been gobbled up, the big announcement came that retailers just enjoyed their “biggest Black Friday ever!” Rather than hit the gym to work off those yummy candied yams and pies (pecan, apple, sweet potato… Oh, my!), Americans raced to…. the malls! Or, they just sat back at home, scratched their full bellies, and chugged antacids as they shopped online, getting their Cyber Monday fix on early. The final tally? More than $50 billion in total sales for the “holiday” weekend, up from $45 billion last year!

Major network news correspondents, otherwise credible financial analysts, and so-called money-honeys of all genders, sizes and hues, treated this bit of shopping trivia like it was a great big Christmas present! Despite still outsized unemployment, foreclosure, homelessness, and national debt statistics, legitimate journalists actually posed the question: “Does this mean our economy is finally turning around?”

I love Christmas (and a killer sale) as much as anybody, and I hate to be a Scrooge, but bah, humbug, and let’s be serious, folks! The fact that 227 million of us opted to go out and shop the day after Thanksgiving (and the day after that, and the day after that…) is an indicator of little else other than the fact that it’s what we’ve been successfully conditioned to do—even in the face of crisis. In fact, especially in the face of a crisis!

After all, isn’t that exactly what we were urged to do by none other than then-president George W. Bush in the immediate aftermath of 9/11? He didn’t suggest that we batten down our financial hatches in preparation for the colossal war bill we’d be facing, or that we collect goods from our already overflowing closets and cupboards to help sustain those with less in our communities, or to send to troops and their families. No. He said, go out and shop!

And we did.

Then, we kept on doing it. For the last decade, we have spent money and racked up debt at record levels—and why wouldn’t we when at every turn, when the economy has stalled, disaster has loomed, and the so-called great financial minds of the world are thoroughly stumped, they say the same thing: Go shopping.

Click here to continue reading…

(Image: ThinkStock)

This message has been so consistent and all-consuming, that holidays from the most pedantic (President’s Days) to the most frivolous (Halloween) to the once most holy (Easter) have become little more than consumer-fests. And technology has taken this all over the top. Forget store catalogs and paper sales circulars; retailers begin their constant assault of sales promos in October and they don’t stop until the holiday clearance racks have been emptied in mid-January. My email inbox overflows with them, as does my phone, which delivers no fewer than three texts a day with “special” sales codes and “exclusive” deals. There is no avoiding it, or the mark it leaves on you whether in the time it takes to view and delete items, or the I’ve-gotta-have-it desire to not miss a grand shopping opportunity. For better or worse, the retailers approach works!

So, I got to thinking, what if we were able to duplicate their very successful strategies in the areas of our lives that truly need improvement? Those areas that wouldn’t just benefit us individually, but collectively, as communities and as a nation? Here are a few ideas that quickly came to mind:

• Education: What if all private schools from nursery through college offered a buy-one-get-one-free deal so that if you pay full price for one child to attend, the next child goes for nothing? You’d get four diplomas for the price of two, six for the price of three and so on. It would encourage family unity and institutional loyalty, and it would enable more families to educate multiple children without breaking the bank.
• Volunteerism: The point of volunteering is, of course, to give of your time for giving’s sake. But what if we incentivized things like teaching prison inmates to read, leading fun activities at eldercare centers, or maintaining community gardens and parks? What if for every 20 hours a month you spent donating your time and talents to the betterment of your community you received an income tax rebate or a post-graduate tuition discount or a gift card for a free checkup that you could use yourself or re-gift to someone who has no healthcare insurance?
• Health: Ever watch The Biggest Loser? It’s incredibly inspiring to witness the morbidly obese overcome years (in some cases, lifetimes) of poor eating and exercise choices and towering self-doubt in a 13-week television season. But let’s be clear about their motivation: Cold, hard cash. One of the greatest cripplers of our economy are our nation’s healthcare costs and they keep climbing higher, as all that ails us keeps getting worse, even as we live longer. Wouldn’t it be cheaper to actually pay people to get healthy? The looming threat of stroke, heart disease, disability and premature death if you don’t get healthy has made little impact. But what if you received a text today guaranteeing you an actual cash prize if you did get healthy? How much would it take for you to make some key changes in your lifestyle? Probably less than you think.

I could go on, but you get the idea. A great education accessible to the masses, stronger, more interactive communities, better physical and emotional health, these are truly the gifts that keep on giving. We just need a better marketing plan—and maybe a few cash incentives—to get the message across. We could start by putting the Thanks back in Thanksgiving. Clearly, we’ve got the giving—and getting at a bargain—part down.

Nelson Mandela turns 93 (Photo by Media24/Gallo Images/Getty Images)

• Happy Birthday Nelson Mandela!

The anti-apartheid activist Nelson Mandela turns 93. In honor of the South African Leader’s birthday, the UN acknowledges July 18 as “Nelson Mandela Day,” in recognition of the former South African president’s crusade for freedom, peace and equality.

See Mandela’s legacy in 10 Ways Nelson Mandela Changed History

• White House Rejects Linking Debt Limit to Balanced Budget, Threatens Veto

The White House formally threatened Monday to veto a Republican measure requiring congressional approval of a balanced-budget amendment to the Constitution before the nation’s debt ceiling can be raised.

House Republican leaders denounced the veto threat and said they would go ahead with a scheduled vote Tuesday on the proposal, which would impose strict new spending caps and require that Congress give the balanced-budget amendment the two-thirds vote necessary to send it to the states for ratification before the debt limit could be raised.

Read more at The Washington Post…

• UConn Alumna Starts Petition to Reinstate 13-Year-Old Whiz Kid

Two weeks ago, the University of Connecticut rescinded the acceptance of 13-year-old Autum Ashante, declaring her not “academically ready”— although she has an IQ test score of 149.

Autum’s father, Batin Ashante, was reportedly enraged by the university’s decision, calling it “B.S.” He told reporters that his daughter was “devastated.”

However, the Ashante’s weren’t the only ones outraged by such news.

Josephine Minnow, a University of Connecticut alumna, discovered Autum’s story and immediately responded.

Read more at NewsOne…

• In Sierra Leone, New Hope for Children and Pregnant Women

Country after country in sub-Saharan Africa has waived medical fees in recent years, particularly for women and children, and while experts acknowledge that many more people are getting care, they caution that it is still too early to declare that the efforts have measurably improved health on the continent.

In Sierra Leone, though, it seems clear that lives are being saved, providing an early and concrete lesson about the impact of making health care free for the very poor and vulnerable.

Read more at the New York Times…

• ‘Single Ladies’ Gets Another Season on VH1

VH1 announced Stacy A. Littlejohn’s hour-long scripted series, Single Ladies, will begin production of a new season later this year, with new shows scheduled to air in 2012. The romantic comedy—which gains an abundance of Twitter buzz during each episode—has its fair share of displeased viewers and overall supporters, but the numbers don’t lie, with the show gaining a cumulative 2.8 million viewers. It’s also showing great popularity amongst the 18-34 female demographic.

(Image: Thinkstock)

Sure, health reform was signed into law a year ago on Wednesday and meant to make health care and health insurance more accessible and affordable for more Americans. But many of the enactment’s provisions don’t kick in until 2014. In the meantime, here are eight ways you can save money–right now.

1. Lock in That Rate. When you’re purchasing private health insurance for yourself or your family, keep in mind that your insurance company may periodically increase your monthly premiums. One way you can temporarily protect yourself is to look for a “rate guarantee” when shopping for coverage. Work with a licensed broker who represents a large variety of health insurance companies to find out which companies offer rate guarantees. Some carriers may automatically lock in your rate for the first year of your policy.

2. Right-size Your Health Insurance Plan. If your current plan is getting too expensive to keep, but you’re afraid of being declined for new coverage based on your medical history, make sure you explore your options. Work with a broker who has the experience and resources to negotiate with your carrier directly. You may be able to stay with the same insurer and transfer to a more affordable plan without undergoing medical underwriting and running the risk of being declined. There are trade-offs, of course. You may need to accept a higher deductible in return for a lower monthly premium. But the new plan may still provide you with valuable protection in case of serious illness or injury, and you may be able to trim a substantial amount from your monthly bill. Make sure you ask questions and get as much information before making a final decision.

3. Negotiate Your Medical Bills. Did you know that you can potentially shave up to 30% off your medical bills by negotiating with your medical care provider? Health insurance allows you to benefit from discounted rates for health care services. Chances are, your insurance company has negotiated discounts with providers ahead of time. If you’re currently uninsured, you’re not benefiting from those discounted rates, so the charges listed on your medical bill may be substantially higher than others are expected to pay. Talk to your doctor or your hospital’s billing department to see if you can negotiate a discount by paying up front or creating a payment plan. Even if you have health insurance, that doesn’t mean all your medical procedures are automatically covered. If you’re seeing an out-of-network physician or receiving medical services not covered by your insurance plan, you may be charged the full rate. In these circumstances, even insured patients should negotiate their bills.

To learn more about negotiating medical bills, visit the Healthcare Blue Book website, where you can find suggested prices for many standard medical services. If you’re surprised by an especially high medical bill and you need help negotiating payment, you can work with a professional medical bill negotiator. Some negotiators are paid only on a contingency, based on how much they are able to save you.

4. Consider Generic-only Prescription Drug Coverage. Find out if health insurance companies in your area offer generic-only prescription drug coverage. If you rarely use prescription drugs but don’t want to go entirely without drug coverage, you may be able to save on your monthly premiums. As a supplement to your insurance coverage, a prescription discount card may help mitigate the cost of a brand-name drug, should it become necessary to take one. Just be sure that any discount card you purchase is accepted by your local pharmacy.

5. Look into a Health Savings Account (HSA). An HSA is a tax-advantaged savings account used in conjunction with a health insurance plan. Account contributions, qualified distributions and earnings are all tax-exempt. An HSA allows you to deposit a portion of your pre-tax income into a savings account and use those funds to pay for qualified medical expenses. Unused money can be invested and accrue from year to year. If you have an HSA, be sure to deduct your contributions up to federally prescribed limits. Contributions to your HSA designated for 2010 and made before April 18, 2011 can be counted toward your 2010 federal taxes. According to IRS Publication 969, HSA contributions for the 2010 tax year are capped at $3,050 for individuals and $6,150 for families.

6. Shop Smart When Shopping a la Carte. When shopping for private health insurance, you can save money by only considering plans that offer the specific benefits you need. For example, a 2010 survey from eHealthInsurance showed the average individual health insurance customers saved $77 per month on premiums when they selected an insurance plan without maternity benefits (in states where these plans are allowed). By selecting an insurance plan that excludes benefits like robust maternity coverage (not necessary for a single male, for example) or chiropractic and mental health coverage, you may see significant savings on your monthly premiums. Given the choice between going uninsured and cutting benefits for services you may not need, limited coverage is better than none at all.

7. Look Beyond Your Employer’s Plan. If you can no longer afford your share of the premium for an employer group health insurance plan, consider your options in the private health insurance market during your next open enrollment period. While it may not always offer the same benefits, coverage purchased on your own is sometimes less expensive than what your employer may require you to contribute toward your monthly premiums. Employer-sponsored coverage is especially valuable for those with pre-existing medical conditions who may be declined for coverage elsewhere, but healthy individuals should consider all of their options before selecting a health insurance option.

8. Split up the Family. Different people have different health insurance needs. This is true within families too. You may be able to save money by covering family members under two or more separate health insurance plans. For example, if one family member has heart disease or diabetes, you’ll want to keep that person covered under an employer-sponsored health plan or COBRA, since they could be declined for coverage elsewhere. However, you may want to cover your healthy teenager, for example, under a more affordable individual health insurance policy of his or her own.Ask your human resources representative or benefits administrator for more information about how much you can save by removing a dependent from your employer-sponsored plan. Then go to an online marketplace with a large selection of health insurance plans in your area to compare that amount to quotes for privately-purchased health insurance. Be sure not to drop any existing coverage for a dependent until he or she is officially accepted for coverage under a new health plan.

Keith Mendonsa is a consumer health insurance specialist with eHealthInsurance.com, a website where consumers can get quotes from leading health insurance carriers, compare plans side by side, and apply for and purchase health insurance.

Job opportunities in healthcare are projected to grow in coming years.

I attended a very intimate and interesting panel discussion last week on innovative healthcare technologies, specifically the implementation of electronic medical records (EMR) in hospitals and private practices. It was surprising and fascinating to learn that the health IT sector is booming despite the economic depression. This is mainly because of the $19 billion set aside for health information technology from the American Recovery and Reinvestment Act (ARRA) that was signed into law last year. This money is estimated to create 100,000 new jobs, such as medical transcriptionists or computer information systems managers, and more higher education programs nationwide.

Dr. Glenn Laffel, senior vice president of clinical affairs at Practice Fusion, a free web-based EMR company that hosted the event I attended at Macy’s in New York City, explained that this technology is designed to help practitioners make better decisions as it relates to improving the safety, quality, and efficiency of patient care. According to a 2009 CDC report, only 6.3% of physicians reported having a fully functional electronic health records system in use, and 20% report having some basic system in place. The panel of doctors all agreed that this is mainly due to the high cost tech companies try to charge physicians. But Practice Fusion is on a mission to change that reality, adding 200 new medical professionals each day to a community of 43,000 users by providing free software to doctors.

Laffel not only believes that EMR technology enhances communication between caregivers and patients and promotes collaboration between doctors, but also eliminates medical errors and disparities that usually occur with paper records and charts.

According to HealthGrades, 195,000 deaths a year are attributed to preventable medical errors that can be reduced by making patient data (past medical history, allergies, diagnoses, information on chronic diseases) digitally available in the case of an emergency or referral.

As far as patient privacy is concerned, apparently, digitizing your records is much safer than relying on paper. The panelists shared that, more commonly, security breaches occur from the theft of a physical object such as a patient’s chart or a physician’s unsecured laptop.

It definitely looks like EMR is the way of the future that will both benefit the physician and patient experience long-term, and help reduce the nation’s healthcare costs.

Annya Lott is the careers editor at Black Enterprise.

Make a difference in the healthcare field as a physical therapist

For the next eight years, the healthcare industry will be the largest supplier of employment opportunities. But Meredith Harris knew healthcare would be the best place to develop a fulfilling career long before recent projections.

Originally planning to embark on a career in pediatrics, Harris, then 16, applied for and got a summer job at Children’s Hospital in Boston as a nurse’s aid. As she observed her surroundings, she caught wind of a new career route she didn’t know much about but was intrigued by: physical therapy.

Physical therapists (PTs) treat individuals, from newborns to the elderly, who have illnesses or injuries that limit their ability to move and function efficiently in their daily lives.  Common functional problems that PTs provide care for include back and neck injuries; sprains, strains and fractures; and work- and sports-related injuries.  They also care for burn and stroke victims, amputees, and those with medical conditions, such as arthritis, multiple sclerosis, cerebral palsy, diabetes, and obesity.

According to the Bureau of Labor Statistics, the demand for physical therapists is expected to grow by 30% between 2008 and 2018 – a much faster than average rate. As of 2008 there were 185,500 licensed physical therapists in the U.S. That number is expected to spike to 241,700. Demand will be driven by the increasing elderly population, who are vulnerable to chronic and debilitating conditions, and Baby Boomers who are increasingly suffering heart attacks and strokes, increasing the demand for cardiac and physical rehabilitation. Trauma victims and newborns with birth defects will also require the attention of physical therapists.

Harris reflects on her career as one that has enabled her to “thrive in several areas.” She has focused half of her 43-year career on working with children who have cerebral palsy. And in the 1980s, as the Bronx, New York, became an epicenter for HIV- and AIDS-related cases, Harris dedicated herself to working with young children who were diagnosed with the disease, since they would be faced with various types of neurological and cardiac problems.

In the second half of her career, Harris has been working with elderly people prone to falling. She has collaborated with the National Institutes of Health in reviewing proposals for rehabilitation research, is currently an associate professor of physical therapy at Northeastern University, and recently accepted a traditional Fulbright Scholar Award. Next year, Harris will be in South Africa for six to 10 months, working with colleagues at the Nelson Mandela Metropolitan University to conduct research on the impact of exercise on people with HIV/AIDS.

“Physical therapy can be such a powerful profession,” says Harris, who adds that people who are generally interested in working with people, can be team players, and are skilled listeners would be a fitting candidate in the field. “It’s important to be sensitive to what people need. You get to use all those years of training and education, [and utilize] problem solving skills to make a significant change in the way someone moves.”

At a Glance:

Salary: The median annual income for PTs is between $60,000 and $86,000.

Education and advancement: PTs must have a master’s degree, at minimum, but a majority of them have doctorates in physical therapy. An undergraduate degree is required for a PT accredited master’s program. It is crucial to have volunteer experience in physical therapy before applying to a program. Harris suggests shadowing a physical therapist in your area.

PTs will also need to pass the National Physical Therapy Examination, as well as a state exam. You can also consider becoming a physical therapist assistant, which only requires an associate’s degree.

To find an accredited program, check out the American Physical Therapy Association’s Student Resources.

The Jones family during happier times. And (inset) Jennifer smiles through the difficulties of cancer treatments. (Photo by Ryan Smith)

Jennifer Jones Austin thought she just had a stomach virus. The married mother of two and senior vice president of community investment for the United Way of New York City attributed her sickness to her busy schedule. But as Jennifer became weak and suffered blurry vision, vomiting, and temperatures as high as 103.5 degrees over nearly five days, she and her husband, Shawn, knew her illness was more serious.

On Sept. 23, 2009, Jennifer’s diagnosis was in: she had adult acute myeloid leukemia, a type of blood and bone marrow cancer.

“It felt like having all the air sucked out of you,” recalls Shawn, 43, about getting the news. (At press time, Jennifer was hospitalized and unable to comment.) “As the day wore on, it began to sink in and she wondered if she would be around for her kids.”

Jennifer, 41, needed a bone marrow transplant. Her siblings were tested but weren’t a match. The next option was to find one through The National Bone Marrow Donor Program’s (NMDP) Be The Match Registry.

Currently, the registry is made up of more than eight million people. “We assumed it was no big deal to find a match,” says Shawn. But that would be no easy task. African Americans are significantly underrepresented as bone marrow donors. They make up roughly 7% of the registry, compared with 74% whites and 10% Hispanics.

Because tissue types are inherited, patients are most likely to match the tissue type of someone who shares their racial or ethnic heritage. Currently, the likelihood of finding at least one potential match on the registry ranges from 60% for African Americans to 88% for whites. To increase the chances of finding someone with similar markers, more black people need to register. Donating marrow benefits patients with more than 70 diseases, including leukemia, lymphoma, and sickle cell anemia.

Mary Halet, director of recruitment and community development for the NMDP and its registry, believes bone marrow transplantation has not reached the same level of awareness that other health issues have within the black community. Additionally, there is a perception that donating is painful.  However, registering as a donor starts with swabbing cells from the inside of your cheeks. If later confirmed as a match, you will be prepped for donation, which includes taking a physical exam and giving a blood sample. For the actual donation, the patient’s doctor will choose between two methods, based on what’s best for the patient: bone marrow (a surgical procedure performed in a hospital with general or regional anesthesia) or peripheral blood stem cells (an outpatient procedure similar to donating plasma). Short-term side effects may include headache, muscle aches, or fatigue.

In 2009, more than 50,000 potential African American donors joined the national registry, 5,000 more than in 2008, according to the National Bone Marrow Donor Program. And in some states, expectant parents have the option of donating their baby’s umbilical cord blood. (About 7% of cord blood units on the registry identified as black).

Friends, colleagues, and the community rallied around Jennifer, holding more than 200 events across the country that recruited nearly 13,000 people to the registry. Jennifer received a transplant from umbilical cord blood on Feb. 24. Though at press time she was battling post-transplant complications, Shawn says she is expected to make a full recovery.

Click here to register as a marrow donor.

In a Rose Garden ceremony attended by lawmakers and business owners, Obama warned that the HIRE Act was just a first step and that greater participation from the private sector would be required. “Government can’t create all the jobs we need or repair all the damage that’s been done by this recession,” he said. “We can help to provide an impetus for America’s businesses to start hiring again. We can nurture the conditions that allow companies to succeed and to grow.”

The $17.5 billion act, which the Senate passed on Wednesday with the support of 11 Republicans, has been criticized for focusing more on tax breaks than job creation. “I think they’re right, but I’m not against anything that could get more people working,” said Rep. Keith Ellison (D-Minnesota), who attended the bill signing ceremony. “It’s a good thing, but not nearly enough.” Ellison added that the Local Jobs Act, of which he is a primary sponsor, “is the right bill.”

Other critics have said that the provision to exempt payroll taxes through the end of 2010 for employers who hire workers who’ve been out of work for at least two months is not a big enough incentive to hire. Not so, says Charles Baker, president and CEO, MCB Lighting & Electrical in Owings, Maryland. He is preparing to hire 80 employees who will earn $76 per hour for an upcoming project in California.

“The payroll tax burden for that is a significant dollar amount for me. Multiply it by 80 and that’s a lot of money a week. But this almost allows me to hire another five people for the same dollar amount,” said Baker. “It’s a tremendous incentive, and since I do government contracting, it also gives me a competitive edge.”

Rep. Emanuel Cleaver (D-Minnesota), who co-chairs the Congressional Black Caucus jobs taskforce, said the CBC is not ready to relent on its push for legislation that more closely targets the communities many represent. “Issues for the minority community always seem to be a step down the line. When will we be the first step?” he asked.

White House Begins Education Reform
The Obama administration sent to Congress this week a blueprint for reform of the Elementary and Secondary Education Act (ESEA). It essentially would overhaul the controversial No Child Left Behind, the ESEA legislation that former President George W. Bush touted as a significant contribution by his administration to education reform. But NCLB was roundly criticized by lawmakers, educators and states for being punitive and focusing too narrowly on testing.

In testimony this week before both House and Senate education panels, Education Secretary Arne Duncan said that the Obama administration’s blueprint centers on three primary goals: raising standards; rewarding excellence and growth, and increasing local control and flexibility while maintaining the focus on equity and closing achievement gaps. It also aims to ensure that by 2020, all high school students graduate prepared to compete and succeed in college and/or the workplace. Under the Obama proposal, schools that are making the most progress will be rewarded. Underachieving schools that improve student performance will receive credit if they still missed their targets. In addition, teacher and principal performance will be measured and held accountable to certain standards.

Rep. Robert Scott (D-Virginia), a member of the House Education Committee, said that Congress must work with the administration to not only identify problems but also prescribe solutions. For African American communities, the most important goal is closing the chronic achievement gap between white and black students through such measures as equitable funding, qualified teachers, and equal access to the same resources that enable high-performing schools to soar. In fact, Scott says, denying minority students an equal educational opportunity and allowing the achievement gap to continue for so long is a constitutional violation of Brown v. Board of Education. “When people say it costs a little more [to close the gap], well, we’ve been there before. Special needs students are [legally] entitled to a ‘free and appropriate education,’ and ‘we can’t afford it’ is not a defense.”

HHS Secretary Discusses Impact of Healthcare Reform for Blacks and Small Businesses

Health and Human Services Secretary Kathleen Sebelius

By most accounts, the healthcare reform bill that Congress is expected to pass in the next few days is by no means a panacea. There’s no public option, it doesn’t sufficiently rein in costs, and its impact on the deficit will be felt for years. But if Congress fails to pass a bill, warns Health and Human Services Secretary Kathleen Sebelius, the implications for minorities—already overrepresented among the nation’s uninsured–could be even costlier.

First, she noted in a roundtable discussion with black reporters at the White House this week, prohibitive rate increases are forcing more and more people out of the market. In the past 10 years, premiums have doubled, and Sebelius estimates that at the end of the next 10 years, the average policy could cost as much as $30,000. She recounted an insurance company representative telling a congressional panel that profitability trumps keeping customers. African Americans, she added, also disproportionately suffer from chronic diseases and other health conditions that push them into a high-risk pool. “So a larger percentage of minorities are going to be on the wrong end of the puzzle in a market that is unattainable or unaffordable and there’s, frankly, nothing that stops that,” Sebelius said.

Small business owners also often feel squeezed in the marketplace, she added. Without the bargaining power of larger firms, they face the highest rates from providers, doctors, and drug companies. If even one of their employees becomes seriously ill, their rates will jump up.

Reform legislation will enable small businesses to become part of an exchange that will enable them to negotiate competitive rates, and their lower wage employees will get direct subsidies to help pay for coverage. Sebelius also said that there’s a new provision under the bill being considered that will require insurance companies in the small-group market to adhere to a medical loss ratio that, with the exchange, would prevent end-of-year surprise rate increases.

“They’ll have to spend at least 80% of what they take in on health benefits and only allow 20% to go to profit, overhead, and administrative costs,” said Sebelius. “If they don’t make that medical-loss ration, they’ll have to rebate money, which will prevent this extraordinary differential we see in the market with jacked up rates.”

Getting to Yes
With less than 48 hours to go before the U.S. House of Representatives votes on the Senate healthcare bill, Democratic leadership was still furiously whipping up votes to get the 216 needed for passage.

According to Rep. G.K. Butterfield (D-North Carolina), a designated vote counter, members were wavering for a variety of reasons. They included the abortion language in the bill and the employer mandate, which some lawmakers are arguing is too stringent and will affect employers’ profitability. “I don’t buy the argument but it’s one some moderates are making,” Butterfield said. “At the end of the day, leadership is going to be able to reconcile all of these concerns and get a bill. Right now we’re right on the mark, but I’m confident that by Sunday afternoon we’ll have maybe two or three more than the 216.”

Rep. Bobby Rush (D-Illinois) is one Democrat who’s leaning no because a provision in the Senate bill that would have extended an outpatient prescription drug discount program to hospital inpatients has “disappeared” from the version being considered by the House. Rush said it would save $1.7 billion over 10 years and help millions of people struggling to pay for prescription medicine. His stand has caught the attention of President Obama, who Rush said called him this morning. “The president called me this morning and said he’s going to look into it and get back to me,” said Rush. “It’s the only thing holding me back.”

Butterfield said that some carrots are being given out in exchange for much-needed votes, but leadership is also wielding a few sticks when necessary. “This is about more than one member’s particular interests. It’s about fixing a broken healthcare system that disproportionately affects African Americans, poor people, and working families,” Butterfield said. “I know that Speaker Pelosi has explained to members, particularly those from safe districts, that they need to step up to the plate and join Barack Obama and the Democratic majority.”

But as Rep. Henry Cuellar (D-Texas), an undecided member from a pretty safe Texas district, told a scrum of reporters today, “At the end of the day, when we take a vote, Obama is not going to be out there supporting and running my election. It’s going to be up to me to decide on my own if this is in the best interest of my district.”

Faced with the reality that there remained at day’s end profound disagreement on how to move forward, Obama seemed to have come to terms with the fact that a divide remained. He issued an ultimatum to members of both parties, saying that if Republicans could not find ways to work with Democrats to create a comprehensive bill in the next six weeks, his party would have to go it alone.

“We cannot have another yearlong debate about this,” the president said.

It’s a risky proposition, given that many lawmakers are concerned about the political ramifications they may face during November’s midterm elections. All House members and a third of the Senate are up for re-election. But Obama thinks it’s a risk well worth taking, noting “that’s what elections are for.”

The summit was premised on the idea that there was perhaps more common ground between Democrats and Republicans than they realized. In his opening remarks, the president stressed how everybody is faced with the challenges of healthcare costs and recalled his own personal experiences with family medical emergencies, such as the time his daughter Sasha had meningitis as a baby.

“I remember thinking, while sitting in the emergency room, what would have happened if I didn’t have reliable healthcare,” Obama said. He added that “everybody understands the problem is not getting better; it’s getting worse,” but also acknowledged that there was a possibility that Democrats and Republicans would remain deadlocked.

One of the most fundamental differences to emerge during the summit was whether to pass one big bill or a series of bills that attack issues one-by-one. Throughout the day, Republicans repeated a mantra to “scrap” the House and Senate bills already on the table, to “start over” and take a “step-by-step” approach.

Senator Lamar Alexander (R-Tennessee), a former governor, said that the Democrats’ proposals include too many tax increases and spending cuts on Medicare and would dump millions of Americans into a Medicaid program. Likening the summit to a Detroit auto show where customers leave unimpressed with the newest model, he said, “This is a car that can’t be recalled and fixed, and we ought to start over.”

A few areas of agreement did emerge, such as greater provider regulation, which would enable children to stay on their parents’ plans longer. Lawmakers agreed on allowing consumers to buy coverage across state lines and allowing small businesses to form purchasing pools, but they differed on how to accomplish that and how much government involvement there should be.

(Continued on next page)

Lawmakers agreed that consumers shouldn’t be denied coverage or penalized because of pre-existing conditions or if they fall sick. But Democrats believe that’s why coverage should be mandated while Republicans countered that there should instead be high-risk pools [JJ2] from which people could buy coverage. Democrats who think such pools would come with an astronomical cost that few people could afford decried the latter notion.

Republicans also argued against the White House proposal [JJ3] delivered earlier this week, which is closely based on the Senate bill and would cover more than 30 million people over 10 years, saying it was unaffordable.

“Today’s summit should have been used to start anew because Americans simply don’t agree with the Democrats’ approach,” said Rep. Tom Price (R-Georgia), who chairs the Republican Study Committee[JJ4] . “Amidst all the talk, one contrast stood out with crystal clarity. The Democrat plan operates on the assumption that Washington knows best while we believe the best solutions will be found by putting patients first. This fundamental divide has been the basis of debate for the past year. All we saw today was another seven hours of it.”

“One of the repeated references throughout the day is that the American people don’t want this,” said Dr. Henrie Treadwell, director of Community Voices at Morehouse College of Medicine. “I think when they say that it’s a way of segregating Americans who are people of color and who work in jobs that don’t provide insurance or who’ve been chronically unemployed for so long that nobody counts them anymore, but they still get sick.”

Treadwell added that many African Americans who don’t get coverage at work actually buy insurance, but the deductibles are so high that they get little or no value for the dollars spent.

A huge majority of the 30 million people that Obama’s plan proposes to cover would be African Americans and other minorities, and includes significant emphasis on wellness and prevention, said Rep. Elijah Cummings (D-Maryland).

“That’s very important in our community because one of the many reasons we have such a high level of health disparity between whites and blacks is because, so often, we get treatment late. And that’s a problem,” Cummings said. “So we go in sicker and it takes a lot more to get us well.”

(Continued on next page)

Cummings does not suffer any illusions that Republicans will get on board with a comprehensive plan.

“We’re at a point where we have no choice but to proceed without the Republicans, period. If the day brought out anything, it’s that the Republicans want to obstruct what the president is trying to do.”

But the best way to move forward is still a big question. House Majority Whip James Clyburn hinted Thursday night that there are enough votes in the House to pass the Senate version of the bill, which Obama has said he wants to see happen.

Throughout the summit, however, Republicans warned of the perils of using the controversial reconciliation procedure, which would allow the Senate to pass a bill with a simple majority of 51. Senate Majority Leader Harry Reid told Republicans to “stop crying” about it, noting that they’d used the procedure 21 times, more than any Democratic majority has.

Stay tuned.

Here is a list of top healthcare professions:

Pharmacist
Average Annual Salary: $85,000

They’re instrumental in interpreting medical instructions, dispensing medication and providing other health services. Requires a Doctor of Pharmacy degree and accreditation by the Accreditation Council for Pharmacy Education (ACPE).

Healthcare Administrator
Average Annual Salary: $73,000

They are the business and management backbone of healthcare and no institution is run effectively without one. Their responsibilities include overseeing personnel, adaptation of hospital’s policies and guidelines and supervising the delivery of health care.  As the fundamentals of healthcare changes, they will be responsible for coordinating and implementing new systems.  Requires Masters Degree as Medical or healthcare manager.

Physician Assistant
Average Annual Salary: $70,000

More doctors’ offices are relying on these health professionals to assess conditions and deliver treatment and follow-up care for minor illnesses. Careers are expected to increase by over half in the next ten years.  Requires completion of 2-year program.

Physical Therapist
Average Annual Salary: $66,000

Physical therapists restore mobility and motor function, help patients recover from physically debilitating injury or pain and promote good overall health.  Employment of physical therapists is expected to grow 27% through to 2016. Requires Masters Degree and state licensing.

Registered Nurse
Average Annual Salary: $60,000

The severe shortage of nurses in the US and the increase of a wide array of health issues guarantee the continued growth and demand of this profession for the foreseeable future.  Jobs open in a variety of fields such as oncology, neurosurgery and general practice. Advanced degrees, teaching or corporate position are available.  Requires nursing diploma, BSN or ADN degree; state license and certification for specialty.

MRI Technician/Sonographer
Average Annual Salary: $57,000
One of the most lucrative, in-demand fields, sonographers enjoy job stability and flexibility in a variety of health settings including hospitals, laboratories, and physician’s offices.

Dental Hygienist
Average Annual Salary: $56,000

Essential to the field of dentistry, they are responsible for the care and maintenance of patients’ oral health and consequently are in high demand. Requires an Associate degree, at minimum and state licensing.

Dietician/Nutritionist
Average Annual Salary: $43,000 – $100,000

With the increased need to develop and maintain healthy eating and lifestyle habits, this has become of the fastest growing careers in healthcare. Jobs are available in hospitals, schools, nursing homes and in private companies and households.  Requires a Bachelors or Masters Degree in dietetics, foods and nutrition, food service systems management, or other related area and state certifications and license.