In a prime time press conference Wednesday night, President Obama said he cannot guarantee that health care reform will not bring about any changes in how patients receive insurance or care. The changes that occur, though, should be for the better, he said.
"Can I guarantee there are going to be no changes in the health care delivery system? No," Mr. Obama said. "The whole point is to try to encourage changes that work for the American people and make them healthier."
Mr. Obama said decisions about what treatments deserve to be insured should be made by doctors and medical professionals.
"That's not how it's working right now," the president said, adding that insurance companies often make those decisions now.
The president also touted the proposal for a government-sponsored insurance plan, or "public option," as a way to bring about positive changes and keep costs down.
"There had been reports just over the last couple of days of insurance companies making record profits... and premiums are going up," Mr. Obama said. "What's the constraint on that? ...Well, part of the way is to make sure that there's some competition out there."
The president's press conference followed days of aggressive promotion of his health care agenda in television interviews and online. In tonight's address, Mr. Obama tied the country's economic future to health care reform.
(Read Mr. Obama's full prepared remarks here.)
"Let me be clear," Mr. Obama said tonight. "If we do not control these costs, we will not be able to control our deficit. If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket."
The president acknowledged, though, that Congress is held up figuring out how to pay for reform.
"Before we talk about how to pay for it, let's talk about what needs to get done," Mr. Obama said.
The president said many Americans have concerns about how the proposed changes will affect their lives. In fact, the public has grown increasingly doubtful Mr. Obama can accomplish his goals, including health care reform, a recent Associated Press poll found.
However, Mr. Obama promised Congress has already agreed to some key points: Those with health insurance already will have more more security and more stability, he said. Furthermore, he said, the government will stay out of people's health care decisions, out-of-pocket costs will be limited and preventive measures like check-ups and mammograms will be covered.
Congress has also already agreed to establish an insurance exchange for individuals and small businesses, the president pointed out, and insurance companies will not be allowed to deny coverage for people with pre-existing conditions.
The president pointed out that he expects two-thirds of the bill to be paid for by re-allocating money already in the health care system more efficiently.
He said he is open to ideas from Congress on how to cover the rest of the cost, but he added, "I don't want that final one third of the cost of health care to be completely shouldered on the backs of the middle class."
Mr. Obama said House Speaker Nancy Pelosi's proposal to tax families making more than $1 million a year meets his principle of keeping that burden off the middle class. He also said it is potentially possible to fund even more than two-thirds of reform by identifying more waste in the system.
CBS News Chief White House Correspondent Chip Reid asked the president what sacrifices beneficiaries will have to make in order to cut costs in Medicare. The president has proposed leaving Medicare payment rates up to an independent body of experts.
"It's not going to reduce Medicare benefits," Mr. Obama said, referring to the cuts that the commission would likely propose. "What it's going to do is to change how those benefits are delivered so that they're more efficient."
He related how the the pharmaceutical industry agreed to find $80 billion in cost savings "because there's probably even more waste than $80 billion in terms of how the drug plan in Medicare is administered."
On a day when bipartisan negotiations for health care reform continued to unravel, Mr. Obama stepped up his rhetoric against Republicans.
"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,'" the president said. "Another Republican senator said that defeating health reform is about 'breaking' me."
The president repeated his earlier message that "this isn't about me."
"This debate is about the letters I read when I sit in the Oval Office every day, and the stories I hear at town hall meetings," he said. "This debate is not a game for these Americans, and they cannot afford to wait for reform any longer."
The president said he has been "frustrated by some of the misinformation" coming from Republicans, though he appreciates efforts to cooperate from Senators like Chuck Grassley and Olympia Snowe. He also acknowleged that not all Democrats are happy with the legislation so far, but their concerns are being considered.
"This is part of the normal give and take of the legislative process," he said.
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