Ian Morrison speaks in a light Scottish brogue so charming that he can say just about anything and get away with it.

And on Jan. 24, boy did he ever.

An internationally known author, consultant and futurist specializing in health care, Morrison was the featured speaker at the Community Hospital of the Monterey Peninsula’s annual meeting, held Monday at the Monterey Conference Center.

His topic: The future of the healthcare marketplace, or as he calls it, “life in the gap,” or life between now and the full implementation of President Barack Obama’s Patient Protection and Affordable Care Act.

(An example of his wit: “A futurist is an economist who couldn’t handle the calculus.”)

Morrison launched into the heavy topic with an explanation of global economics “until recently” that included a 10-point checklist. That list started with “Hard working people in communist countries (e.g. China and Vietnam) made good cheap products and exported them to America at a profit,” worked its way to “they loaned their money to U.S. banks and government” and it ended with U.S. banks leveraging that money so Americans could buy houses they really couldn’t afford and fill them with “good cheap products made by hardworking people in communist countries.”

Morrison, who holds an interdisciplinary Ph.D., understood that his mostly moneyed audience (the CHOMP board, for one) wasn’t necessarily comfortable hearing that America is falling behind so many countries it’s used to feeling superior to, but he used that witty list to launch into hard numbers that nobody can deny.

The economic meltdown saw 7 million people lose employment-based health insurance in 2009 alone, and Morrison pegs the number of uninsured in America at about 50 million, maybe more. According to Morrison, health care spending per capita in 2007 ranked the highest, at $7,290, on a list of most of the G8, with Australia and Spain thrown in for good measure. But the U.S. also is dead last on a list of 19 countries ranked by deaths amenable to health care.

“Every health care system in the world is an ugly compromise,” he says.

It just happens to be uglier here, he continued.

“The average family cannot afford the average premium,” Morrison says. The average premium for a family in California is $18,000, while the average household income is about $50,000.

“That does not compute,” he adds.

Nearly a year after health care reform was passed, the debate and rhetoric is still raging in all corners of American politics.

Hospitals like CHOMP are quietly going about their business, providing excellent care while at the mercy of insurers, and implementing the steps necessary under the act, such as electronic medical records.

But the Republicans, it seems, won’t be placated.

In between bouts of crying, John Boehner maintains that killing the health care reform act is his priority. He’s taking time away from that in April, though, to give the keynote address to about 1,000 members of the “Big I,” – the Independent Insurance Agents & Brokers of America.

Just a few hours after his speech, those agents will hit Capitol Hill to lobby Congress, senators and staffs on issues relevant to the insurance industry.

On Jan. 20, House Republicans passed what is, in the end, a symbolic repeal of the act with a vote of 245-189, mostly split on party lines. The move was symbolic because the House has yet to float a viable plan of its own, and it’s unlikely the Senate will go along.

In a poll this month by the Harvard Public School of Health and the Henry J. Kaiser Family Foundation, 29 percent of Americans want to expand the law, 19 percent want to leave it as it is, 23 percent want to repeal it and replace it with the yet-to-be-written Republican-sponsored alternative and 20 percent want to repeal it and replace it with nothing. About 77 percent of those who identify as Republicans want some sort of repeal, while 51 percent who identify as Democrats want the law expanded.

But most Americans – 62 percent – agree that lawmakers need to stop using the appropriations process to slow down the implementation of the law. And about four in 10 say they disapprove cutting off funding as a way to stop some or all of health care reform from being put into place.

When the brilliant futurist Morrison talks about life in the gap, what’s going on in Washington these days is probably not what he had in mind at all.

How can they keeping saying no without offering an alternative?

MARY DUAN is the Weekly’s editor. Reach her at mary@mcweekly.com