ABC News' Jake Tapper, Rachel Martin, Jon Garcia, and Sunlen Miller report:
GREEN BAY, WISC — Green Bay is one of those rare parts of the country where health care providers and employers have worked together to successfully control health care costs while improving quality of service, so it was only natural that President Obama would take his health care message there.
The bottom line, the president told residents of the Badger State: the time is now. He wants a health care reform bill on his desk by October.
“This next eight weeks is going to be critical,” the president said. “And you need to be really paying attention and putting pressure on your members of Congress to say, there's no excuses. If we don't get it done this year, we're probably not going to get it done. “
Arguing that the nation should study and replicate Green Bay’s success — which has come through transparency, digital technology, preventive care and greater physician cooperation – the president said, “We have the most expensive health care system in the world. We spend almost 50 percent more per person on health care than the next most costly nation. But here’s the thing, Green Bay: we’re not any healthier for it."
The president today said a future "Health Insurance Exchange" would allow consumers "to one-stop shop for a health care plan, compare benefits and prices, choose the plan that's best for you. If you're happy with your plan, you keep it." None of the plans, the president said, would be allowed to deny anyone coverage on the basis of pre-existing conditions – a personal issue for the president, whose mother was denied insurance because the carrier argued that her ovarian and uterine cancers constituted pre-existing conditions.
The Debate Over a Public Plan
Legislation is making its way through committees on Capitol Hill, the president noted –“It turns out Congress doesn't really like you to just tell them exactly what to do,” the president joked, in his most recent allusion to the failed health care reform efforts of the Clintons in 1993 – with many members of Congress discussing whether a government-run health care plan should be an option.
It's a suggestion that's raised the ire of many Republicans on Capitol Hill who say Obama's reforms would ultimately end up with nothing less than a government takeover of the health care industry.
“If you have a government competitor, virtually every study I'm aware of says that half of the people that get their coverage through their employer now would opt for the cheaper government competitor,” said Rep. Roy Blunt, R-Mo., today, “and, of course, that destroys the system and then you don't have any competitors.”
Even thought a public option is not yet officially part of any legislation, the president today mounted a vociferous defense of it.
“Right now, a number of my Republican friends have said, ‘We can't support anything with a public option,’” Mr. Obama said. “It's not clear that it's based on any evidence as much as it is their thinking; their fear that somehow, once you have a public plan, that government will take over the entire health care system.”
Previewing this as a “significant debate” in the pending health care legislative tug-of-war, the president said, “what we're trying to explain is, is that all we're trying to make sure of is that there is an option out there for people…where the free market fails. And we've got to admit that the free market has not worked perfectly when it comes to health care, because you've got a lot of people who are really getting hurt: 46 million uninsured, a whole bunch of more people who are underinsured who are seeing their premiums and deductibles rise. “
The American Medical Association, to whom the president will speak on Monday, has also voiced its opposition to a public plan, telling the Senate Finance Committee in a document obtained by ABC News that the “introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.”
The AMA suggested that because such a plan would likely receive “special advantages and government subsidies that would not be available to private insurers” in turn “private insurers would be pushed out of the market entirely. A crowd-out of private insurers and the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers.”
The physicians’ organization also suggested that if the government were to use its authority to artificially hold prices below market rates for this public plan, as it has done with Medicare and Medicaid, “the country could see an increase in cost shifting to private carriers and providers” which would lead “to higher costs for consumers in private plans.”
Reform Fight Heating Up
Today’s town hall meeting took place as the health care reform fight is beginning to heat up.
A new TV ad from a group called Conservatives for Patients' Rights claims that the public health insurance proposal being debated in Congress "could crush all your other choices, driving them out of existence, resulting in 119 million off their current insurance coverage.” That’s a number the author of the Lewin Group study being cited calls overstated, and a claim that Factcheck.org calls misleading since few political observers think a plan like that in the study – a Medicare-like program open to anyone who wants it – would make it through Congress.
Forces on the left are playing hardball as well. A group called “Change Congress” has exerted a great deal of pressure on moderate Sen. Ben Nelson, D-Neb., in recent weeks, who last month called a public plan a “deal breaker.” Change Congress mounted a campaign involving internet ads and direct mail informing Nelson’s constituents of significant political donations he’s received from health and insurance interests. “After an intense 11-day battle with Nelson, he's now publicly ‘open’ to the public option — and this week, he made more news by saying he won't join a filibuster of Obama's plan,” crowed the head of Change Congress in a column at the Huffington Post.
In addition, top aides to Sen. Max Baucus, D-Mont., the chair of the Senate Finance Committee, this week cautioned Democratic lobbyists to tell their health care clients not to meet with Senate Republicans today. “They said, ‘Republicans are having this meeting and you need to let all of your clients know if they have someone there, that will be viewed as a hostile act,’” a Democratic lobbyist who attended the meeting told Roll Call.
The president also pushed back against the idea that he wants to run health care, saying despite recent federal government control of AIG, Citigroup, and General Motors – to say nothing of other recipients of federal bailout dollars – the idea he likes running things.
“I'm always puzzled when people…go out there creating this bogeyman about how, you know, ‘Obama wants government-run’ — I don't want government to run stuff,” he said. “I've got enough stuff to do. I've got North Korea, and I've got Iran. And I've got Afghanistan and Iraq. I don't know where people get this idea that I want to run stuff, or I want government to run stuff. I think it'd be great if the health care system was working perfectly and we didn't have to be involved at all."
Concluded the president: "That would be wonderful. That's not how it's worked.”
The President also preempted the arguments that will no doubt come up on the Hill in the weeks ahead: that the price of health care reform is too great.
“You'll hear during this debate over the next several weeks is people will also say ‘The deficit and the debt are skyrocketing, and that's the reason why we can't afford to do health reform." So I just want to repeat the single biggest problem we have in terms of the debt and the deficit is health care, it's Medicare and Medicaid.”
Focusing quite a bit on preventive care, the president said there "is nothing wrong with us giving a little bit of a nudge in moving people in the direction of healthier lifestyles."
Drop the Tater Tots, Kids
He said that needed to begin with adults teaching children to lead healthier lifestyles.
"The cheapest way to feed all the kids is to have the frozen tater tots…and then you've got pizza and fries," he said. "And then the soda companies, they all say, we'll put in a free soda machine in there so the kids can have as much soda as they want. And pretty soon our kids are seeing their rates of Type 2 diabetes skyrocket. They're not getting the exercise, because a lot of schools are running out of money when it comes to PE. Kids are sitting in front of the TV all day long."
The President said that if health care reform is passed this year that families will get some immediate relief, but the whole system realistically would not be “perfectly” set up until four or five years from now.
“If we wait, if we said, ‘well, you know, since we're not going to get it right, right away, let's put this off until two or four or five years from now’ — it's never going to happen. That's what's been going on for the last 50 years now — people have said, we can't do it right now. And as a consequence, it never gets done. Now is the time to do it.”
- Jake Tapper, Rachel Martin, Jon Garcia, and Sunlen Miller