Speaking to a joint session of Congress and the American people, President Barack Obama laid out his latest vision for health care reform.
The President said that he doesn’t want a radical shift. Instead, he wants to build on what works, and fix what doesn’t. He criticized those who use scare tactics that split people into unyielding idealogical camps.
The time for bickering is over, he said. Now is the season for action.
President Obama outlined three goals. The first is security and stability for those who have insurance, the second is to provide insurance for those who don’t have it, and the third is to slow the growth of costs.
First, for those with insurance, including Medicare, Medicaid, and VA, nothing in this plan will require a change of coverage or doctors. Nothing, he repeated, requires you to change what you have.
Also, insurance companies can’t deny coverage for pre-existing conditions, or drop coverage when people get sick. There will be no caps on coverage for a year or lifetime. There will be a limit on out-of-pocket expenses. At no extra charge, companies must cover exams like mammograms and colonoscopies.
Second, for those without health insurance, he proposes to offer quality, affordable, choices. “You’ll be able to get coverage.” An insurance exchange, established and run by government, will let consumers shop for insurance at competitive rates. Insurance companies get to compete for millions of customers, which will cut prices.
Tax credits will provide subsidy for those who still can’t afford insurance premiums. This will take effect in four years. Meantime, the government will immediately offer low-cost coverage.
What about those who still don’t want coverage? Some companies may refuse to give coverage to their workers. This costs the rest of us money. So, individuals will be required to carry basic coverage. Also, businesses will be required to provide health care coverage, or to help their employees pay for it. Most small companies will be exempt, but large companies that can afford this will have to pay.
The President said that misinformation has been spread, and this has made Americans nervous. He debunked the bogus claims spread by those want to kill reform, such as panels with power to kill off senior citizens. This charge is a lie, plain and simple, he said, to a standing ovation from Democrats.
He said this plan will not insure illegal immigrants. No federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
What about those who criticize what they term a government takeover of health care? The President said his guiding principle is that consumers do better when there is choice and competition. He doesn’t want to put insurance companies out of business, he just wants to hold them accountable. A not-for-profit public option in the insurance exchange would provide this accountability. No one would be forced to choose it, as it would be available only for those who don’t have insurance.
This public insurance option would have to be self-sufficient, but by avoiding costs, it could provide a good deal for consumers.
The President insisted that this won’t result in a government takeover of health care, and that he won’t back down from providing a choice to those who can’t find insurance.
He added that no bureaucrat, government or otherwise, will get between you and the care you need.
Finally, he asked how to pay for this plan. He said that he will not sign a plan that adds to the deficit, now or in the future. To show he is serious, he said that spending cuts will be forced if savings don’t materialize.
The source of payment for this plan is savings.
The President gave a slight nod to tort reform, and directed Secretary of Health and Human Services Kathleen Sebelius to look into demonstration projects on this matter.
The biggest criticism of the President’s plan is that coverage can be increased — in terms of the number of insured, the generosity of benefits, and ability to get insurance — without increasing costs. This goal of rooting out waste and inefficiency is elusive. Politicians at all levels claim to want to get rid of it, but little progress is ever made.
The President refuses to recognize that employer-provided health insurance is a problem. He wants to create a co-op so that there will be a vigorous market for insurance. This market could be created very quickly, without government oversight, by simply ending the present system of employer-provided insurance.
The President’s claim that illegal immigrants will not be covered can’t be believed. Illegals are not supposed to be able to work in America, and we don’t have the national will to vigorously enforce that law.
His claim that he doesn’t want a government takeover of health care isn’t believable, either. Aspects of the plan such as the public option are the first step to the end of a private market in health insurance.
The idea that there will be a mandate for everyone to be insured is a characteristic of the Swiss system, and it seems to work for them.
I believe the President is mistaken in his belief that tort reform would provide only modest savings, saying that “defensive medicine may be contributing to unnecessary costs.” Directing Secretary of Health and Human Services Kathleen Sebelius to look into seeing if malpractice reform could help is not likely to produce results. She is, after all, the former lobbyist for the Kansas Trial Lawyers Association.
Related on this site: Fact-checking the president on health insurance and In health care debate, can we trust the president?
The complete text of the President’s speech is at Obama’s Health Care Speech to Congress.