Shocking weekly remarks! Do Obama, GOP agree on health reform?

Of course, saying agreement and doing it are two different things in Washington.

But if the weekly remarks of the Republicans' representative, Dr. Charles Boustany of Louisiana, and President Obama are any indication, there seems to be some ground at least for agreement on reforming the nation's overburdened healthcare system. We also have video of both men's remarks below.

Weekly Remarks by President Obama, May 15, 2009

Good morning. Over the past few months, as we have put in place a plan to speed our economic recovery, I have spoken repeatedly of the need to lay a new foundation for lasting prosperity; a foundation that will support good jobs and rising incomes; a foundation for economic growth where we no longer rely on excessive debt and reckless risk -- but instead on skilled workers and sound investments to lead the world in the industries of the 21st century.

Two pillars of this new foundation are clean energy and healthcare. And while there remains a great deal of difficult work ahead, I am heartened by what we have seen these past few days: a willingness of those with different points of view and disparate interests to come together around common goals -- to embrace a shared sense of responsibility and make historic progress.

Chairman Henry Waxman and members of the Energy and Commerce Committee brought together stakeholders from all corners of the country -- and every sector of our economy -- to reach....

...an historic agreement on comprehensive energy legislation. It’s another promising sign of progress, as longtime opponents are sitting together, at the same table, to help solve one of America’s most serious challenges.

For the first time, utility companies and corporate leaders are joining, not opposing, environmental advocates and labor leaders to create a new system of clean energy initiatives that will help unleash a new era of growth and prosperity.

It’s a plan that will finally reduce our dangerous dependence on foreign oil and cap the carbon pollution that threatens our health and our climate. Most important, it’s a plan that will trigger the creation of millions of new jobs for Americans, who will produce the wind turbines and solar panels and develop the alternative fuels to power the future. 

Because this we know: The nation that leads in 21st century clean energy is the nation that will lead the 21st century global economy. America can and must be that nation -- and this agreement is a major step toward this goal.

But we know that our families, our economy, and our nation itself will not succeed in the 21st century if we continue to be held down by the weight of rapidly rising healthcare costs and a broken healthcare system. That’s why I met with representatives of insurance and drug companies, doctors and hospitals, and labor unions who are pledging to do their part to reduce healthcare costs.

These are some of the groups who have been among the fiercest critics of past comprehensive healthcare reform plans. But today they too are recognizing that we must act. Our businesses will not be able to compete; our families will not be able to save or spend; our budgets will remain unsustainable unless we get healthcare costs under control.

These groups have pledged to do their part to reduce the annual healthcare spending growth rate by 1.5 percentage points. Coupled with comprehensive reform, their efforts could help to save our nation more than $2 trillion in the next 10 years -- and save hardworking families $2,500 each in the coming years.

This week, I also invited Speaker of House Nancy Pelosi, Majority Leader Steny Hoyer and other congressional leaders to the White House to discuss comprehensive health reform legislation. The House is working to pass a bill by the end of July -- before they head out for their August recess.

That’s the kind of urgency and determination we need to achieve comprehensive reform by the end of this year. And the reductions in spending the healthcare community has pledged will help make this reform possible.

I have always believed that it is better to talk than not to talk; that it is far more productive to reach over a divide than to shake your fist across it. This has been an alien notion in Washington for far too long, but we are seeing that the ways of Washington are beginning to change.

For the calling of this moment is too loud and too urgent to ignore. Our success as a nation -- the future of our children and grandchildren -- depends upon our willingness to cast aside old arguments, overcome stubborn divisions, and march forward as one people and one nation.

This is how progress has always been made. This is how a new foundation will be built. We cannot assume that interests will always align, or that fragile partnerships will not fray. There will be setbacks. There will be difficult days.

But we are off to a good start. And I am confident that we will -- in the weeks, months, and years ahead -- build on what we have already achieved and lay this foundation which will not only bring about prosperity for this generation, but for generations to come. Thanks so much.   ###

Weekly Remarks by Republican Rep. Dr. Charles Boustany of Louisiana

Hello, I’m Charles Boustany, a doctor and member of the House Republican Health Care Solutions Group. (For video of these remarks scroll down.)

We all know that in this troubled economy, American families are increasingly worried about their healthcare. In my home of Louisiana, I hear constantly from families and small businesses about rising costs and fears of losing coverage, and as a physician I saw this first-hand. 

Let me be clear, Republicans want to work with President Obama and other Democrats to ensure that every American has access to affordable, high-quality health coverage.  

Despite our differences on some important healthcare-related issues, we are convinced there are areas offering potential for common ground on healthcare reform among the two parties.

We believe we must make quality healthcare coverage affordable and accessible for every American, regardless of preexisting health conditions. 

President Obama has called for a plan that "puts us on a clear path to cover all Americans," and said "no American should be denied coverage because of preexisting conditions."

Republicans agree.

We believe healthcare reform must let Americans who like their healthcare coverage keep it, and give all Americans the freedom to choose the healthcare plan that best meets their families’ needs. 

The president has said Americans "should have the option of keeping their employer-based health plan," and said reform "should provide Americans a choice of health plans and physicians." 

Republicans agree.

We believe healthcare reform must improve Americans’ lives through effective prevention, wellness and disease management programs, while developing new treatments and cures for life-threatening diseases, and respecting the value of human life. The president has said healthcare reform must address "cost drivers" in our system such as "obesity, sedentary lifestyles, and smoking." 

Republicans agree.

We believe it is possible -- and necessary -- to achieve these objectives through common-sense reforms without raising taxes, rationing care, eliminating employer-sponsored health benefits for working families, empowering government bureaucrats at the expense of patients and doctors, or adding even more to our ever-growing national debt.

 At the same time, Republicans are concerned about news reports indicating that some Democrats favor a policy called a "government" or "public" option. We need to be clear about what this means.

From my former practice, I know allowing the government to replace the health coverage that more than 100 million Americans currently have through their jobs could have devastating consequences. 

A government takeover of healthcare will put bureaucrats in charge of healthcare decisions that should be made by families and doctors. It will limit treatment options and lead to rationed care.

And to pay for government healthcare, your taxes will be raised. That is something we cannot support, and frankly, it would clearly violate some of the principles the president himself has endorsed.

That having been said, I want to reiterate Republicans’ sincere desire to work with President Obama and Democrats to find common ground on the issue of healthcare reform. Despite our differences, we are convinced there are areas of common-sense agreement on healthcare reform among Republicans and Democrats. 

This issue is just too important to let partisanship or blind ideology get in the way. Let’s all work together to do the right thing for the American people. Thank you for listening.   ### 

OK, now that that's over you can click here to get automatic Twitter alerts of every new Ticket item. Or follow us now@latimestot

Photo credits: Ron Edmonds / Associated Press; Office of Rep. Charles Boustany.

Comments

[Jeff in Miami Beach]

No one and I mean no one has explained how the National Healthcare will work. It will not work and cannot work without a national ID. This has in the past been the sticking point to Healthcare. Without a national personal ID there is no way to guarantee the health records belong to the person in the office.

This ID becomes a tracking device for the Federal Government. Every time someone visits a doctor, a pharmacy, chiropractor, PA, Physical Therapy etc the government will know exactly where you are and what you are doing. Then if the ID becomes the replacement for the driver’s license where it is used to open a bank account, fly on an airplane, cash a check, get a job etc. The government now is Big Brother.

Let’s say that Joe the Plumber had a national healthcare card that tracked his movements. We know that his tax records were illegally used against him by over zealot workers, what is there to stop this kind of action if the government knows every single detail about an individual. What is to stop an employer from gaining access to the medical records to make sure they are not on anti depressants, infected with AIDS, pregnant or in the process of invetro treatment to become pregnant. I would love to say that I trust the government to keep a secret but there is nothing that they have done recently to make any thinking person agree that they can keep any secrets.
Take the current government interference in contract law with AIG bonuses, corporate law with bond holders of Chrysler or the termination of Wagner at GM. There is no law that is being upheld by the government. Who is to say our records of medical care will not be made public when it is expedient of the government to do so. Let’s say you are running for President and the sitting President brings up that you had an STD when you were 18 years old. Though not pertinent to a person who is now over 40, it is an issue that would not be there under our current medical care.

Now for a non ID card healthcare system. A person who is addicted to pain killers could and would go to several doctors with the same symptoms and different names to gain the prescriptions they desire. Though this fraud could happen with a national ID card they would have to create this card which should be pretty hard. Then if a person is nearing their maximum coverage for say a back problem they will just use a relative’s access to continue treatment.

[Robert]

Real Healthcare Reform:
Changing Priorities, Incentives and the Rules of the Game; Creating an Electronic Health Record for Every Citizen Who Wants One

If you have the financial resources of Bill Gates or Warren Buffett you needn’t pay money to a health plan each month, since if you get sick or injured – even very seriously - you have more than enough money to pay all your medical bills yourself.

But those of us who have significantly less financial resources must find some other means of dealing with the thousands or even hundreds of thousands of dollars or more of medical expenses that we might incur should a serious illness or injury be our fate.

Enter the concept of “health insurance”.

Large numbers of individuals and/or their employers pay some money each month into one or another big pot called a “health plan”. Those individuals who remain essentially very healthy for many years and then suddenly die or perhaps leave a particular health plan for some other reason – if they have put more money into the pot than was taken out to pay all their medical expenses - wind up helping to pay the medical bills of those members of the health plan who become seriously ill or injured and incur a lot of medical expenses.

Many Americans covered by some form of health insurance don’t seem to fully understand or perhaps choose to ignore the fact that if they become seriously ill or injured, for the most part their medical bills will be paid by the members of their health plan who have remained healthy. Keeping members of a health plan healthy by preventing illness and injury is critically important, but is something not currently given the high priority and attention it deserves.

Some Americans believe that healthcare should become a “right” of every American citizen. If a nationalized single payer health plan were enacted, every American citizen who became ill or injured - for any reason whatsoever - and incurred significant medical expenses would for the most part have his or her medical bills paid by U.S. taxpayers. Many Americans oppose such a system for America recognizing that significant difficulties such as long waiting periods and rationing of care exist in such types of all inclusive government healthcare systems that currently operate in other countries such as Canada and the United Kingdom.

For any health plan to work which has a large number of people pooling their money to essentially pay the medical bills of whichever members of the plan become seriously ill or injured, rules must be established as to when and how much money may be taken out of the pot e.g. “legitimate” doctor bills and hospital bills. Equally important is keeping track of the amount of money that is being put into the pot each month in premiums paid by health plan members or their employers. If too much is being paid out in expenses as compared with the amount being received in premiums, the pot will soon become empty and the health plan will go broke.

As previously mentioned, the monthly premiums paid by individuals or their employers go into a health plan’s big pot from which “covered” healthcare expenses are paid. But also from this pot are paid all the health plan’s administrative expenses including what may be big salaries and golden parachutes for CEO’s and other “healthcare executives” – individuals who may be paid to find technicalities of one sort or another in the health plan’s agreements so the health plan can deny or reduce payments, raise premiums, cancel insurance, or in one way or another minimize or exclude “bad risks” from the health plan. All such questionable business practices are done to enable the health plan to make a profit and remain in business.

Currently we are experiencing continual increases in healthcare costs that are unsustainable and which, if unchecked, will soon seriously threaten the future of the entire American economy. Healthcare costs must be controlled, but how? If a healthcare system made up of health plans is going to have a chance of both meeting the needs of health plan members and simultaneously develop the ability to keep costs under control, priorities, incentives, and the rules by which the game is played all must be changed.

The good news is that a lot of illnesses and many injuries are actually preventable. But how will prevention ever become a top medical priority when doctors, hospitals, and other providers get paid largely for diagnosing and treating illness and injury, not for preventing it?

Although health promotion and disease and injury prevention receive fashionable and socially acceptable lip service, the fact is that most of the participants in what should be more appropriately called our “sickness and injury care system” actually have no significant financial incentive whatsoever to spend any significant time and energy in genuinely promoting health and helping to prevent disease and injury.

Much to the contrary. Other than the actual members of a health plan – patients and potential patients - and their employers and perhaps the employees of some health plans, most participants in our sickness and injury care system - because of the way they are paid - have an enormous (if unspoken) financial incentive for massive amounts of disease and injury – much of which is preventable – to continue to occur in America. Strictly from a financial point of view, for those whose incomes come solely from the treatment – not the prevention - of illness and injury, the more illness and injury that occurs, the better. And if the illness or injury is serious and requires perhaps many expensive tests, multiple surgical procedures, and other very complicated prolonged treatment in an intensive care unit, so much the better; just as long as those unfortunate individuals who happen to be ill or injured are “covered” by “good insurance”, i.e. health plans that are reliable bill payers.

This is not to say that there are not some excellent very dedicated and hardworking doctors and other health professionals - although they are paid on a fee for service basis to care for illness and injury – who nevertheless attempt to essentially work themselves out of a job by making health promotion and disease and injury prevention a top priority with their patients.

It should also be recognized that some existing health plans – e.g. Kaiser and Group Health - combine insurance, doctors, and hospitals into a single entity in such a way that provides everyone - including all the health plan’s doctors - a real incentive to spend time and effort with patients on health promotion and disease and injury prevention as well as on early diagnosis and treatment. But unfortunately the above examples represent only a small part of the sickness and injury care system that currently exists throughout America.

For the most part - because of the way they are compensated – the majority of doctors and other professional providers, acute care hospitals and long term care facilities, pharmaceutical manufactures and pharmacists, medical and surgical equipment manufacturers and personal injury and malpractice attorneys - among others - depend mightily on massive amounts of disease and injury occurring in America; and these participants in our sickness and injury care system would be significantly negatively impacted if a lot of the preventable illnesses and injuries were actually prevented. This must be changed.

Unless the incentives and rules are changed to give as many participants as possible a real financial stake in health promotion and disease and injury prevention, in early diagnosis and treatment, and in maximizing health and minimizing disease and injury, healthcare costs in America will never be brought under control. Making appropriate changes in the incentives and the rules of the game is the real task and challenge of “healthcare reform”.

What about financial incentives for individual health plan members? Should individuals receive a financial incentive to be healthy? It is well recognized that engaging in regular exercise, abstaining from tobacco, and eating moderately so as to maintain a reasonably normal body weight are all significant factors in helping to promote an individual’s health and wellness. These healthy behaviors can all be confirmed by simple tests performed or ordered in a doctor’s office. Why shouldn’t those individuals who practice these health promoting behaviors and comply with recommended immunization schedules and appropriate preventive screening examinations such as for colon cancer and breast cancer pay significantly less in premiums to their health plan each month than those who don’t?

To really reform healthcare we must find ways – through changes in incentives and the rules of the game - to actually prevent what is preventable, to maximize early diagnosis and treatment, and minimize disease and injury with all its associated cost. We must find ways for participants to be part of our “healthcare system” and not just a part of our “sickness and injury care system”.

Significant changes in the rules of the game for our legal system – tort reform – is also critically important so that the gaming of the system now being done by personal injury and malpractice attorneys and their clients can be ended and so that the exorbitant costs to physicians and other professionals for malpractice insurance can be dramatically reduced.

Truly transforming our “sickness and injury care system” into a “healthcare system” by making significant changes in the incentives and the rules of the game may seem to be a formidable task and one that probably has never really been done before on a large scale anywhere in the world. But it is a worthy task and a critically important task for the future of America and its people.

One significant part of this process is developing the capability of creating an electronic health record for every American citizen who wants one. We need a standardized framework that will allow every American citizen to have an individual electronic health record – a computerized medical record - that can be accessed by all the doctors who care for a particular individual, regardless of wherever on the planet the doctors or the patients happen to be. It would be like having your own personal online banking account that only you have the password to, but which you can share with the doctors who are caring for you, wherever you or they may be.

I applaud those who are using their energy and expertise to upgrade our deplorable current paper medical records system and bring medical records in America into the 21st century. Developing a standardized framework for an electronic health record - for every citizen who wants one – created by your doctor with your assistance, with proper security and safeguards - is something that our national government can and should do as a part of healthcare reform.

If done well, electronic health records will be transformational in helping doctors efficiently and effectively care for patients and will save an enormous amount of time, effort, and money which is currently wasted on needless and frequently inaccurate duplication. And having an accurate electronic health record for an individual will also facilitate appropriate health promotion and disease and injury prevention for that individual. Like the telephone and the computer, someday we will all wonder how we ever got along without individual electronic health records.

But all this requires action, not just words. Now is the time for Americans and their leaders and doctors and other health professionals to step up to the plate and begin the process of transforming our “American Sickness and Injury Care System” into an “American Healthcare System” that is worthy of our great country.

Robert Westafer M.D.

[George in Miami]

Talking about controlling health care costs without discussing rationing of care is dishonest. Both private and public systems do this.

I'm not sure if its better if "bureaucrats" or corporate managers, answering to stockholders do this, but to suggest that you're going to control costs without rationing is not being on the level with the American people.