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Obama healthcare RX: not this summer, say congressional leaders

Undated file photo ofCleveland Clinic in Ohio, which President Obama toured July 23, 2009

President Obama was in Shaker Heights, Ohio, today, pitching his healthcare proposal at a town-hall meeting, taking questions from voters concerned about escalating costs and cuts in reimbursements.

While Obama was touring the Cleveland Clinic with Ohio Gov. Ted Strickland, leaders in the Senate pulled the plug on the president's hopes to complete reform before Congress takes its August recess.

“Working with Republicans, one of the things that they ask is for more time,” Senate Majority Leader Harry Reid told reporters. “The decision was made to give them more time … I don’t think it’s unreasonable. This is a complex, difficult issue.”

Over on the House side, Speaker Nancy Pelosi said she was open to putting off a vote on that side until after the recess. And good thing too, because the House Energy and Commerce Committee -- home to many of the Blue Dog Democrats who are dubious about the high price tag on reform -- canceled its hearings on the topic again today.

Arriving at Shaker Heights High School, Obama shook the hands of voters who seemed thrilled to see him. In fact, the Cleveland Plain Dealer reported that the audience was filled with many campaign supporters and that hundreds more stood in line despite cloudbursts of rain just to catch a glimpse.

At last night's press conference, Obama spoke policy, in effect pitching Congress on his healthcare reforms. Today, he turned up the heat, pitching populist themes to the public, trying to move the needle on polls that show public support falling.

He won huge applause when he said, "Never again will anyone in America be denied coverage because of previous illness or injury."

He won sympathetic laughter when he chided critics, saying some of them who enjoyed the congressional spending spree during the past administration have "a lot of nerve" to complain about how much healthcare reform would add to the deficit. “Folks have a lot of nerve who helped get us in this fiscal hole and then go around trying to talk about fiscal responsibility,” he said. “I’m always surprised people don’t have a little more shame.”

And he won cheers when he insisted on getting a bill this year. Referring to today's decision by congressional leaders to delay reform until after the August recess, Obama said he can live with the delay as long as the committees keep working and the process keeps going.

"That's OK, I just want people to keep working," he said. "I want the bill to get out of committees, I want that bill to get to the floor, I want it done by the end of this year."

Then Obama, perhaps mindful that he had just given opponents permission to drag the debate out,  amended his statement. "I want it done by the fall," he said.

Asked if he was willing to urge Reid and Pelosi to stay in Washington over the summer, Obama further explained his position. "I want to get it right, but I also want to get it done promptly," he said. As long as Congress is "working diligently," Obama said, he has no problem. "It's complicated," he said. But he added, he won't abide any delays "just because of politics."

Read his full remarks below.

-- Johanna Neuman

Photo: The Cleveland Clinic surgical room. Credit: The Cleveland Clinic / Getty Images

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President Obama Delivers Remarks on Health-Care Reform at Town Hall
Shaker Heights, Ohio
CQ Transcriptions
Thursday, July 23, 2009 2:17 PM

PRESIDENT OBAMA: It's good to be back in the great state of Ohio. I know there are those who like to focus on the political back and forth in Washington. But my only concern is the people who sent us there: the families feeling the pain of this recession; the folks I've met across this country who have lost jobs and savings and health insurance, but haven't lost hope; the citizens who defied the cynics and the skeptics who went to the polls to demand real and lasting change. This change was the cause of my campaign, and it is the cause of my presidency.

When my administration came into office, we were facing the worst economy since the Great Depression. We were losing an average of 700,000 jobs per month. Hundreds of thousands of Ohioans have felt that painful loss first-hand. Our financial system was on the verge of collapse, meaning families and small businesses could not get the credit they need. And experts were warning that there was a serious chance that our economy could slip into a depression. But because of the action we took in those first weeks, we have been able to pull our economy back from the brink.

Now that the most immediate danger has passed, there are some who question those steps. So let me report to you on exactly what we've done.

We passed a two-year Recovery Act that meant an immediate tax cut for 95 percent of Americans and for small businesses. It extended unemployment insurance and health coverage for those who lost their jobs in this recession, and provided emergency assistance to the states to prevent even deeper layoffs of police, firefighters, teachers and other essential personnel. At the same time, we took needed steps to keep the banking system from collapsing, to get credit flowing again, and to help responsible homeowners hurt by falling home prices to stay in their homes.

In the second phase, we now are investing in projects to repair and upgrade roads, bridges, ports, and water systems and in schools and clean energy initiatives throughout Ohio and the country. These are projects that are creating good jobs and bring lasting improvements to our communities and our country.

There is no doubt that the steps we have taken have helped stave off a much deeper disaster and even greater job loss. They have saved and helped create jobs and have begun to put the brakes on this devastating recession. But I know that for the millions of Americans who are looking for work, and all those who are struggling in this economy, full recovery can't come soon enough. I hear from you at town hall meetings like this. I read your letters. These stories are the first thing I think about in the morning and the last thing I think about at night and the focus of my attention every day. The simple truth is that it took years for us to get into this mess, and it will take more than a few months to dig our way out of it. But we will get there, and we are doing everything within our power to get people back to work.

We also have to do more than just rescue this economy from recession; we need to address the fundamental problems that allowed this crisis to happen in the first place. Otherwise, we'd be guilty of the same short term thinking that got us into this mess. That's what Washington has done for decades. That's what we must change.

Now is the time to rebuild this economy stronger than before. Strong enough to compete in the 21st century. Strong enough to avoid the waves of boom and bust that have, time and again, unleashed a torrent of misfortune on middle class families across this country. That's why we are building a new, clean energy economy that will unleash the innovative potential of America's entrepreneurs and create millions of new jobs, helping to end our dependence on foreign oil. We are transforming our education system, from cradle to college, so that this nation once again has the best-educated workforce in the world. And we are pursuing health insurance reform so that every American has access to quality, affordable health coverage.

I want to be clear: reform isn't just about the nearly 46 million Americans without health insurance. Though I realize that with all the charges and criticisms being thrown around in Washington, many Americans may be wondering, "How does my family, or my business, stand to benefit from health insurance reform? What's in this for me?"

I want to answer those questions today.

If you already have health insurance, the reform we're proposing will give you more security. It will keep the government out of your health care decisions, giving you the option to keep your coverage if you're happy with it. And it will keep the insurance companies out of your health care decisions, too, by stopping insurers from cherry- picking who they cover, and holding insurers to higher standards for what they cover.

You won't have to worry about receiving a surprise bill in the mail, because we'll limit the amount your insurance company can force you to pay out of your own pocket.

You won't have to worry about pre-existing conditions, because never again will anyone in America be denied coverage because of a previous illness or injury.

And you won't have to worry about losing coverage if you lose or leave your job, because every American who needs insurance will have access to affordable plans through a health insurance exchange, a marketplace where insurance companies will compete to cover you, not to deny you coverage.

If you run a small business and you're looking to provide insurance for your employees, you'll be able to choose a plan through this exchange as well. I've heard from small business owners across America trying to do the right thing, but year after year, premiums rise higher and choices grow more limited. That's certainly the case here in Ohio.

And if you are a taxpayer concerned about deficits, I want to reassure you, I am too.

In the eight years before we came to office, Washington enacted two large tax cuts, primarily for the wealthiest Americans, added a prescription drug benefit to Medicare, and funded two wars, without paying for any of it. The national debt doubled, and we were handed a $1.3 trillion deficit when we walked in the door, one we necessarily had to add to in the short term to help break the back of the recession. I believe we have to restore a sense of responsibility in Washington. We have to do what families and businesses do, cutting the things we don't need to pay for the things we do.

That is why I have pledged that I will not sign health insurance reform that adds even one dime to our deficit over the next decade. And I mean it. We have estimated that two-thirds of the cost of reform to bring health care security to every American can be paid for by reallocating money that is simply being wasted in federal health care programs. This includes more than one hundred billion dollars in unwarranted subsidies that go to insurance companies as part of Medicare, subsidies that do nothing to improve care for our seniors. We ought to take that money and use to actually treat people and cover people, not line the pockets of the insurers. I'm pleased that Congress has already embraced these proposals. And while they are currently working through proposals to finance the remaining costs, I continue to insist that health reform not be paid for on the backs of middle-class families.

In addition to making sure that this plan doesn't add to the deficit in the short-term, the bill I sign must also slow the growth of health care costs, while improving care, in the long run. I just came from the Cleveland Clinic where I toured the cardiac surgery unit and met some of the doctors and nurses achieving incredible results for their patients; there's important work being done there as well as at University Hospitals and MetroHealth. Cleveland Clinic has one of the best health information technology systems in the country. This means that they can track patients and their progress. This means that they can see what treatments work and what treatments are unnecessary. And this means they can provide better care to patients with chronic disease like diabetes, high blood pressure, asthma, and emphysema by coordinating with doctors and nurses both in the hospital and in the community.

And this is the remarkable thing: often better care produces lower, not higher, expenses. Because better care leads to fewer errors that cost money and lives. You, or your doctor, don't have to fill out the same form a dozen times. Medical professionals are free to treat people, not just illnesses. And patients are provided preventive care earlier, like mammograms and physicals, to avert more expensive and invasive treatment later.

That's why our proposals include a variety of reforms that would both save money and improve care, and why the nation's largest organizations representing doctors and nurses have embraced our plan. Our proposals would change incentives so that doctors and nurses are finally free to give patients the best care, not just the most expensive care. We also want to create an independent group of doctors and medical experts who are empowered to eliminate waste and inefficiency in Medicare, a proposal that could save even more money. Overall, our proposals will improve the quality of care for our seniors and save them thousands of dollars on prescription drugs, which is why the AARP has endorsed our reform efforts.

The fact is, lowering costs is essential for families and businesses and our economy. Here in Ohio, for example, over the past few years premiums have risen nearly nine times as fast as wages. That's something Rick and his wife are very familiar with. As we meet today, we're seeing double-digit rate increases on insurance premiums all over America. There are reports of insurers raising rates by 28 percent in California; seeking a 23 percent increase in Connecticut; and proposing as much as a 56 percent increase in Michigan. If we don't act, these premium hikes will be just a preview of coming attractions. That's a future you can't afford. That's a future America can't afford.

We spend one of every six of our dollars on health care in America, and that's on track to double in the next three decades. The biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid. Small businesses struggle to cover workers while competing with large businesses. Large businesses struggle to cover workers while competing in the global economy. And we will never know the full cost of the dreams put on hold, the entrepreneurial ideas allowed to languish, the small businesses never founded, because of the fear of being without insurance, or having to pay for a policy on your own.

That is why we seek reform. And in pursuit of this reform we have forged a consensus that has never before been reached in the history of this country. Senators and Representatives in five committees are working on legislation and three have already produced bills. Health care providers have agreed to do their part to reduce the rate of growth in health care spending. Hospitals have agreed to bring down costs. The drug companies have agreed to make prescription drugs more affordable for seniors. And the American Nurses Association and the American Medical Association, which represent the millions of nurses and doctors who know our health care system best, have announced their support for reform.

We have never been closer to achieving quality, affordable health care for all Americans. But at the same time, there are those who seek to delay and defeat reform. I've heard that one Republican strategist told his party that even though they may want to compromise, it's better politics to go for the kill. Another Republican senator said that defeating health reform is about breaking me, when it's really the American people who are being broken by rising health care costs and declining coverage. And the Republican Party chair, seeking to stall our efforts, recently went so far as to say that health insurance reform was happening too soon.

I thought that was a little odd. We've been talking about health reform since the days of Harry Truman, and he's saying reform is coming too soon. Too soon?

I don't think it's too soon for the families who've seen their premiums rise faster than wages year after year.

It's not too soon for the businesses forced to drop coverage or shed workers because of mounting health care expenses.

It's not too soon for taxpayers asked to close widening deficits that stem from rising health care costs, costs that threaten to leave our children with a mountain of debt.

Reform may be coming too soon for some in Washington, but it's not soon enough for the American people.

We can do this. For this nation never shrinks from a challenge. And we were reminded of that earlier this week, when Americans and people all over the world marked the fortieth anniversary of the moment that the astronauts of Apollo 11 walked upon the surface of the moon. It was the realization of a goal President Kennedy had set nearly a decade earlier. There were those at that time who said it was foolish, even impossible. But President Kennedy understood, and the American people set about proving, what this nation was capable of doing when we set our minds to doing it.

Today, there are those who see our failure to address stubborn problems as a sign that our best days are behind us; that somehow we've lost that sense of purpose, that toughness, that capacity to lead. Well I believe that this generation, like generations past, stands ready to defy the naysayers and the skeptics. That we can once again summon this American spirit. That we can rescue our economy and rebuild it stronger than before. And that, yes, we can achieve quality, affordable health care for every single American. That is what we are called upon to do. And that is what we will do.

 
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Solving the health care dilemma in the United States can actually be a "simple fix". Here's how:

Step 1) Keep Health Insurance in the private realm (not the public-funded arena).

Step 2) And instead, use the Federal government's power to regulate that the entities in that private realm related to direct health care services are Non-Profit organizations (insurers, hospitals, clinics, doctors, etc.).

Step 3) Done.


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About the Columnist
A veteran foreign and national correspondent, Andrew Malcolm has served on the L.A. Times Editorial Board and was a Pulitzer finalist in 2004. He is the author of 10 nonfiction books and father of four. Read more.
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