Obama Will Attempt to Take the Lead Over Health Care Reform, in a Speech This Week
EmailABC News' Kristina Wong reports: This Sunday, White House advisers and lawmakers previewed a big week ahead for President Obama, who will attempt to take the lead on health care reform, and regain momentum after a summer marked by heated, partisan and confusing debate.
White House Press Secretary Robert Gibbs and senior White House adviser David Axelrod sounded confident ahead of Obama’s big speech to Congress this Wednesday evening, to be televised live to the nation. In the speech, they said, Americans would hear exactly Obama stands on health care reform.
“They'll leave that speech knowing exactly where the president stands, exactly what he thinks we have to do to get health care reform done this year,” Gibbs said on ABC News’ “This Week.”
The president has an opportunity on Wednesday to speak to the nation and the Congress on this,” said Axelrod on NBC’s “Meet the Press.” “We've been through a long debate now. All the ideas are on the table. It's time to bring the strands together and get the job done for the American people here.”
Liberals, Conservatives Unwilling to Back Down Over Public Option
So far, consensus has been difficult to achieve, with lawmakers divided on multiple party and intraparty fault lines over the best way to lower private insurance costs, and how to pay for health care reform in light of an economic recession and a skyrocketing budget deficit.
The president is stuck in the middle, between Senate Republicans that could block much of what the President wants, and liberal supporters who want it all. Republicans reject the president’s idea to create a the public option – a government-run insurance exchange intended to compete with and lower the costs of private insurance. House democrats overwhelmingly favor the idea. Progressive democrats say they will not pass a bill without it.
“We support what the president has said all along he'd like to see, and that is a robust public option. He campaigned on it. He continues to talk about his support for it. And we're going to stand behind him. Nancy Pelosi has said that nothing is going to pass that floor without a public option,” said Rep. Maxine Waters, D-Calif., on ABC.
Howard Dean, former Democratic National Party chair said compromise on the public option is unacceptable.
“If, for whatever reason, he chooses to go in a different direction [than the public option], then I'd scale back the bill. I wouldn't spend 5 cents on it,” Dean said on Fox. “I'm very hopeful that he will stick to his guns and that we'll have the reform we were promised in the campaign.”
Despite the White House toning down insistence on the public option in recent weeks, Gibbs said the president would continue to support a public option in his speech Wednesday.
“He will talk about the public option and why he believes and continues to believe that it is a valuable component of providing choice and competition, it helps individuals and small businesses, at the same time provides a check on insurance companies so they don't dominate the market,” Gibbs said.
Critics Says Public Option Alternatives Won’t Work
Lawmakers have floated compromise alternatives to the public-option, such as an insurance co-op – a group of private insurers that would be set up by the government, but controlled by its members. But Gov. Tim Pawlenty, republican governor from Minnesota and oft-speculated 2012 presidential candidate, said a co-op was not a viable solution.
“To say that that is the solution, I think, defies what we know about the experience with co-ops already. It hasn't substantially altered the trajectory of health care costs,” Pawlenty said on CNN’s “State of the Union.”
Another alternative to the public option, recommended by a bipartisan group of former lawmakers including former republican Sen. Bob Dole, is the idea of a public-option trigger that would give private insurers time to reform the industry and lower costs, but trigger the public-option if they failed to do so by a deadline.
Sen. Ben Nelson, R-Neb., said he supported the idea.
“If there's going to be a public option, it has to be subject to a trigger, Nelson said on CNN. “In other words, if somehow the private market doesn't respond the way that it's supposed to, then it would trigger a public option or a government-run option, but only as a fail-safe backstop to the process.”
However, Dean rejected the notion of postponing the public-option.
“The problem is it won't work. It doesn't add anything. If you're going to do that, just do the insurance reform," Dean said on FOX. "Don't pretend you're doing reform.”
And Pawlenty rejected the idea of any type of public-option, now or in the future.
“The trigger option simply kicks the can down the road,” Pawlenty said. “All it does is delays the inevitable, and for a lot of reasons, it's a bad idea. I think, if the Democrats embrace the public option, even in the form of the trigger, they're going to shoot themselves in the foot."
Republicans Warn Against Using the Reconciliation Process
Despite these battles awaiting Congress when it returns from recess Monday, the president is determined to achieve health care reform this year, fueling speculation that with a large Democratic majority in the House, and a Democratic majority in the Senate, democrat lawmakers would resort to the budget reconciliation process, by which a bill could pass the House and Senate on an up-or-down vote, avoid a Senate filibuster, and require only a simple majority of 51 senators in order to pass.
Former democratic senate majority leader Tom Daschle said Congress should not rule out invoking the reconciliation process.
“If we can't do it any other way, we shouldn't be bound by this process. I think both parties have used it. We used it to pass a single most important health bill ever in the last 20 years, the Children's Health Insurance Plan. We used reconciliation to do that,” Daschle said on ABC.
“The Republicans tried to use it to pass the Alaskan National Wildlife Refuge,” Daschle continued. “And they've used it for every tax cut so far. There's no question both Republicans and Democrats have used it in the past.”
But Sen. Alexander warned democrats of the consequences.
“One, it would create a bad health care bill because under the provisions in the rules, the parliamentarian would write the bill, so all the senators would be voting on are tax increases or Medicare cuts, and you wouldn't get to put in the bill things like pre-existing conditions or buying insurance across party lines. So it would be a bad bill,” said Alexander.
“Second, it would be thumbing your nose at the American people who have been trying to say to Washington for the last several months, ‘Slow down. I mean, too many Washington takeovers, too much debt. You're meddling with my health care,’” Alexander sad. “So thumbing their nose at the American people by ramming through a partisan bill would be the same thing as going to war without asking Congress' permission. You might technically be able to do it, but you'd pay a terrible price in the next election."
Failed Health Care Reform Could Hurt Democrats
Some analysts are predicting democrats could lose up to 25 seats in the House if health care reform fails.
“Democrats are on a dangerous slide. And when we see this kind of sea change in public option take place, it should be a flashing warning sign,” David Wasserman, House editor of the Cook Political Report, said in an interview with ABC.
Indeed, since the beginning of the president’s push for health care reform, his popularity has dipped according to the daily Gallup polls, from a high of 68 percent early this year, to 50 percent last week.
Stuart Rothenberg, editor of the Rothenberg Political report, said health care reform was now critical for the president’s credibility.
“If he is perceived to fail on health care, it is going to raise significant questions about leadership, his leadership and really when you get down to it, that’s what the presidency is about,” Rothenberg said in an interview with ABC.
Still, democrats remain hopeful the president can recapture a largely-runaway debate over health care reform, and improve his standings by taking a strong lead over health care reform.
“I think he's got to stand up and lead and be strong,” said Dean. “What people value more in a president than anything else is strength, and that's what we've got to see on this week.”
ABC News’ David Kerley contributed to this report.
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“Liberal supporters who want it all”? No, honey. What we WANTED was single payer. The public option is the compromise.
And this is Obama’s fault, for starting the negotiations from the middle. How do you compromise the compromise and still call it a victory?
Posted by: Susie Madrak | September 6, 2009, 5:57 pm 5:57 pm
It is painfully obvious that the private insurance companies have no reason to reduce their 20% overhead and thus reduce the premiums they charge us. (Medicare only has a 4% overhead for administrative costs.) Like most other big companies, their leaders are after this quarters’ or this years’ profits, not thinking of the affordablity of their product until a competitor charges far less.
That is where the public insurance option comes in. The only way to get them to see the light is to give them true competition with a public insurance option.
Susie Madrak, I agree with you that many liberals wanted a single payer sytem and the public insurance option is the compromise.
Do you like the idea put forward by the N.Y. state representative, which proposes Medicare for all, that would gradually lower the age of eligibility until all Americans can buy Medicare if they want. It seems like such a workable idea, as Medicare already has its infrastructure and workers up and running.
Posted by: Lydia | September 6, 2009, 9:10 pm 9:10 pm
The reason we need health care reform is because the current system is bankrupting us- that is the bottom line. I have been to a couple town halls on health care and the thing I walked away with is that something must be done and there are a lot of nuts out there trying to stop that from happening. We have to do something that will, first and foremost lead to lower costs. That is the challenge our representatives face. Frankly, it is time we stop using this issue as a political football and start talking sense because it is important to all of us. The extreme hate, lies and exagerations being peddled by the right wing media is sickening. And what is more sickening is the number of people who goose step behind them without a clue. The other extreme is the far left who seem to not have a clue that we have to lower costs by changes to the present system and not by creating a whole new system. I give Obama credit for even tackling this mess. He is taking a big political hit by not turning his back on this issue like past presidents have done. What ever comes out of this, I just hope that it is a better plan than the plan the hateful response of people deserves.
Posted by: gretchenmom | September 6, 2009, 10:54 pm 10:54 pm
Bob Dole, what a gentleman. I don’t agree with his position but he is fair and honest. I totally agree with Ms Waters, we need a public option. The insurance industry is eating us alive, 24 Mil for the CEO of a large Ins. co. I thought they started out to be not for profit?? Contain that and put the money back into the companies and maybe the premiums would not be so high. How could you possibly think they would go out of business. Jeeze, I don’t know but DO Something!
Posted by: Marshall | September 7, 2009, 2:36 am 2:36 am
What people want is publicly funded health care on a Canadian model. The compromises that have been made are what’s putting this bill in jeopardy. People would get behind a system in which health care would cost them nothing.
Posted by: Dred Dog | September 7, 2009, 11:26 am 11:26 am
I don’t agree with Obama’s plan because it is not addressing the subject of cost. Rather it is focusing on availability. One of the major cost drivers over the years has been prescription drugs. With doctors focusing on drugs rather than prevention this is going to continue to go higher, just for more people.
Posted by: World Vitamins Online | September 7, 2009, 11:38 am 11:38 am
A Better Way ….
Improvement In Medical Costs We Can All Believe In (or THE CASH IS KING MEDICAL PAYMENTS ACT)
It occurred to me while paying my bill at the reception window at the doctor’s office that I, as cash paying customer, was being charge considerably more that other patients receiving the same care. These other patients had health insurance plans accepted by the doctor and included pre-negotiated rates.
It struck me as unfair that the simplest and quickest way of getting the doctor paid for his/her services (i.e. my cash payment as the time services were rendered) resulted in the highest bill to the patient. I would think the easiest, and most timely, method of payment should result in the largest discount to the patient. Unfortunately the cash customer gets stuck with the largest bill not the smallest.
That has to change. We need a better way. How is the cash customer going to know what the lowest rate the medical provider is currently selling his/her services for? Patients have a right to know.
Instead of a completely unworkable, unaffordable plan, let’s go for the simple plan. Doctors already know what the lowest payment they will accept. It is dependent on which insurance plans they participate in. All that the cash customer lacks is access to this pricing information. If Gas Stations all across America must publish their gasoline prices so that everyone driving by can see them, then why can’t patients and potential patients see doctor’s pricing. This has to change – change we can believe in.
CASH PATIENT’S BILL OF RIGHTS:
1. Every medical provider shall provide a single 8.5 by 11 inch of paper listing the 200 most common procedures with columns for procedure code, procedure description, and cost to the cash customer when paid at the time services are rendered. This single sheet of paper shall also list every health insurance carrier accepted by the medical provider. The sheet shall also identify the medical provider by name, address, phone number, and Medical ID number(s). Print no smaller than 10 font must be used. Printing on both sides of the paper is authorized. This document shall be called the Medical Provider Pricing Sheet (MPPS).
2. Multiple copies of this Medical Provider Pricing Sheet shall be stored and available to all patients and all potential patients in the waiting area of the Medical provider at all times the waiting area is open to patients and potential patients. New paper copy MPPSs with new pricing must be available to patients 10 calendar days prior to the new pricing going into affect. During the 10 day period both current and future MPPSs must be available.
3. Information contained on the Medical Provider Pricing Sheet shall also be provided on-line. Earlier editions of the Medical Provider Pricing Sheets shall be provided on-line until at least 365 days after the pricing on the sheet became invalid. Earlier editions of the MPPS shall be clearly marked indicating the time period the pricing was valid. The valid time period shall appear on each page and in the file name. New MPPS information must be available on-line 10 calendar days prior to going into affect.
4. All health insurance providers shall, via an on-line presence, list the 500 most common procedures payable to each medical provider covered by the health insurance policy. The on-line listing shall be customized by medical provider type and medical provider zip code. The on-line listing shall include the provider type (medical specialty or other identifier), zip code, and the 500 most common procedure codes, procedure description, and pricing per service provider zip code. Pricing information must be available for the previous 365 day period by entering a date into the appropriate field on the health insurance web page.
5. Government, non-government organizations, and individuals will be allowed to audit health insurance information to ensure medical providers always provide cash paying patients with the lowest price currently accepted by the medical provider. Health insurance carriers must offer unrestricted access to on-line medical procedure pricing (include dated pricing up to 365 days old), even to people or organizations not covered under the health insurance plan in question.
6. In situations where the medical provider does not produce an itemized bill with diagnose codes, procedure codes, and procedure prices at the time services were rendered, then the patient must be offered the Cash discounted pricing if the bill is paid in cash within 10 days of receipt the medical provider’s bill.
7. All cash paying patients shall be charged the lowest price for any medical procedure.
8. In all cases “cash” defined as: currency, checks, debit cards, credit cards, and any other form of payment agreed to by the medical provider and the patient.
Given the Federal government is a health insurance provider, the Federal government shall be required to augment their health insurance web sites. It is estimated that the legislative cost, in dollars, to pass the CASH IS KING MEDICAL PAYMENTS ACT will be greater that the cost to augment the federal health insurance web sites. Given the database driving this pricing information already exists and is used for claims processing, and database updates are required for future claims processing, therefore out-year federal costs will be near zero for the continued implementation of the CASH IS KING MEDICAL PAYMENTS ACT. It’s not a federal budget issue. It’s not a Federal tax and spend issue. It is a fairness issue.
Now that’s a change we can believe in. Unfortunately no special interest group gains by supporting the CASH IS KING MEDICAL PAYMENTS ACT, even though Americans paying their medical bills in cash could see a drop of 65% in the cost of health care. It appears no one cares about the typical American anymore.
****** WHAT YOU NEED TO DO *******: Contact your elected representative and tell him/her to support, even champion, the CASH IS KING MEDICAL PAYMENTS ACT. Remember no one else is looking out for you. Fairness dictates that cash paying patients should pay the lowest price.
If high deductible health plans are going to be in everyone’s future. Both insured and cash patients need to support the CASH IS KING MEDICAL PAYMENTS ACT in order to have available the information necessary to make sound medical decisions and for comparison pricing.
I am not saying the CASH IS KING MEDICAL PAYMENTS ACT will create more competition within the medical industry, reduce the rate of medical care inflation, result in more health insurance carriers, result in lower-cost health insurance alternatives, assist small businesses with the health care needs of their employees, or improve the medical profession cash-flow crisis caused by slow pay health insurers. but, these may become secondary benefits.
The Administration could make universal pricing information the first milestone in the Electronic Health Records initiative. If Health Insurance carriers won’t release their pricing data, then I’m not ready to have my private health records available electronically either. Fair is fair ….. let’s have the information (i.e. pricing) that should be commonly available, actually available.
Posted by: PlanoTX | September 7, 2009, 4:57 pm 4:57 pm
9/14/09
I’m radical enough that I don’t want the so-called Public Option, but I’d settle for it.
We hear a lot about the Trigger situation these days. But IMO, the for-profit HMO’s don’t deserve this compromise. They’ve already abused the public long enough!
Dan O’Connell
Rio Rancho, NM (9/14/09)
Posted by: Dan O'Connell | September 7, 2009, 10:42 pm 10:42 pm