June 11, 2009
Health Care Reform Enters Critical Phase
As Obama Promotes His Plan, CBSNews.com Examines The Status Of The Health Care Debate In Washington
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Play CBS Video Video Attacking Rising Health Costs President Obama says attacking the root causes of skyrocketing health costs is a priority. However, Americans themselves may be driving up costs. Dr. John LaPook reports.
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Video Axelrod On The Road Ahead White House Senior Advisory Davis Axelrod spoke with Harry Smith about Pres. Obama's trip abroad, Supreme Court justice nominee Sonia Sotomayor, and health care reform.
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President Obama meets with Senate Democrats to discuss health care, June 2, 2009, in the State Dinning Room at the White House in Washington. From left are, Senate Finance Committee Chairman Sen. Max Baucus, D-Mont., Obama and Senate Budget Committee Chairman Sen. Kent Conrad, D-N.D. (AP Photo/Haraz N. Ghanbari)
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Only On The Web Your Health In Focus CBS News Medical Correspondent Dr. Jon LaPook hosts a weekly show, CBS Doc Dot Com, all about health issues.
"It's time to deliver," President Obama said on Saturday. So with Washington starting to make progress on major changes to the nation's health care system, the president today heads to Wisconsin for a town hall meeting about health care -- to get the public on his side while Congress works through the sticking points of reform.
Meanwhile, Senate Democrats unveiled a draft bill on Tuesday that would require every American, except for those who cannot afford it, to obtain health insurance and that would create "health benefit gateways" through which to purchase it.
While that proposal still faces strong opposition, the 615-page document only brushes over even more contentious issues -- such as establishing a government-sponsored insurance plan (or a "public option"), and how to pay for an expansion of health care that could cost more than a trillion dollars. Senators will also have to address whether to require employers to contribute to coverage, another hot button issue, known as "pay or play," that is only mentioned the draft.
Similar legislation is in the works in the House, and a draft is expected to be available by the end of next week.
The Senate committee that issued the draft legislation is slated to hear today from no fewer than 24 health care experts -- including medical doctors, top executives from insurance companies, economists and union leaders -- in its first hearing since the text of the legislation was released.
Mr. Obama is stepping up his own involvement in the debate, with town hall meetings, speeches, and other means of promoting the principles he seeks to include in the bill: universal access to affordable and quality care, patient choice and reduced costs. The president personally appealed to grassroots mobilizers in a conference call last month hosted by Organizing for America, Mr. Obama's political arm of the Democratic National Committee. On its web site, OFA, which has its roots in Mr. Obama's presidential campaign, says the president believes health care reform "must" include a public option.
"Every American must have the freedom to choose their plan and doctor - including the choice of a public insurance option," the Web site says.
Obama Pushes Public Health Care Option At Town Hall
House Leaders Duel Over Health Care
Mr. Obama will also very soon reveal a plan to pay for a large chunk of his reform proposals through $200 to $300 billion in Medicare and Medicaid savings. The president's plan has been estimated to potentially cost more than $1 trillion over 10 years, and Mr. Obama has already allocated $634 billion in his budget for health care.
While the cost of his plan and his support for the public option will make it difficult for Mr. Obama to win over Republicans, he has made it clear he would like to sign a bipartisan bill. He does not have to, however, since the Democratic Congress has reserved itself the right to use the budget reconciliation process to pass health reform, which would only require 51 votes instead of 60 to break a filibuster. Congress is aiming to get a bill to the president's desk by October.
Democratic leaders in the House and the Senate are also emphatic the final bill should get bipartisan support. As they grapple with differences of opinion over fundamental principles of reform, the party must also resolve disagreements within its own ranks over how to shape the legislation.
The administration argues that not passing health care reform legislation that meets the president's goals would be a disservice to the nation. Currently about 46 million Americans are uninsured, and that number could rise if costs are not reined in. Health care expenditures account for 18 percent of GDP in the United States, Mr. Obama's Council of Economic Advisers reported, and could account for 34 percent by 2040 if costs continue to grow.
The Public Plan
Advocates for reform say the public option would help make health care more affordable for consumers. A well-cited study by the Lewin Group shows that if Medicare payment levels were used in the public plan, premiums would be up to 30 percent less than premiums for comparable private coverage. The study estimates more than 119 million people would switch from private to public insurance if the plan were open to everyone.
But a government-sponsored plan would ultimately lead to a government "monopoly" over health care, some conservatives argue, thereby stripping patients of choice.
In a letter to the president Monday, nine Senate Republicans from one of the committees responsible for health care characterized this shift in care as "119.1 million Americans losing their private coverage."
"Forcing free market plans to compete with these government-run programs would create an unlevel playing field and inevitably doom true competition," the letter says.
Sen. Ted Kennedy (D-Mass.), who has led health care reform in the Senate Health, Education, Labor and Pensions (HELP) Committee and introduced the bill now in play, has emphasized his support for a public option but acknowledged in a statement at the bill's release that "much work remains, and the coming days and weeks won’t be easy."
The HELP committee will begin the "mark up" process of amending the bill on Tuesday and aims to ready the bill for a full Senate vote by the second half of July.
The Cost
Democrats and Republicans will also surely fight over the cost of health care reform -- a responsibility that falls more on the Senate Finance Committee, which is working on its own bill under the leadership of Chairman Max Baucus (D-Mont.).
Baucus has told reporters the reform package may tax a portion of employer-provided benefits, though it may only cap the current tax exclusion at a high rate, rather than eliminate it all together.
"This would be set at a high enough level where it wouldn't affect very many people," Baucus said, according to the Wall Street Journal. He said legislators are aiming to raise as much as half of the $1.2 trillion needed for reform through new taxes.
Some point out that the tax exclusion is regressive, so taxing benefits would even out the economic playing field. It could anger taxpayers, however.
Moreover, it could create a sticky political sitution for Mr. Obama, who during the presidential campaign opposed Republican John McCain's proposal to tax health benefits. Senior Presidential Adviser David Axelrod told CNN on Sunday that the president is not interested in the proposal to tax benefits and would rather see Congress limit tax deductions for the rich.
"He made a very strong case for the proposal that he put on the table, which was to cap deductions for high-income Americans, and he urged them to go back and look at that," Axelrod said on CNN's "State of the Union."
The president is insisting the health care bill be budget nuetral over the next five to 10 years, and that it implement long term cost solutions like the use of health information technology and "comparative effectiveness research."
Is There A Bipartisan Solution?
Sen. Chris Dodd (D-Conn.), a senior member of the HELP Committee, said the committee left details out of the bill about the public option and cost because, “I wanted my Republican colleagues on the committee to know I wanted to their ideas. I want to hear what they have to say.” Dodd is currently leading HELP Committee efforts on the health legislation due to Kennedy's poor health, which has kept him out of Washington.
What many Republicans and Democrats have had to say so far, however, does not bode well for a compromise. While liberals in Congress have insisted reform must include a public plan, Republicans are saying just the opposite.
"A public plan is a nonstarter," Sen. Orrin Hatch (R-Utah) said Monday, according to CNN. "They're trying to come up with various ways to have a public plan without calling it that."
In fact, there is one alternative to the public plan that leaves the government out of the equation and is drawing attention on Capitol Hill. Sen. Kent Conrad (D-N.D.) has proposed setting up non-profit health care cooperatives owned by groups of residents and small businesses.
"The strength of this proposal is that it accomplishes much of what those who want a public option are calling for - that is, something to compete with private for-profit insurance companies," Conrad said, according to the New York Times.
"It's got possibilities," Sen. Chuck Grassley (R-Iowa), ranking member of the Finance Committee, said, according to the Associated Press. "There were lots of questions raised about it not outright objections in our caucus, but a lot of questions."
Liberal advocacy groups are pushing back against the idea, though. The group Health Care for America Now said Wednesday that Conrad's plan does not have the same bargaining clout to control costs or keep insurers honest that would make a public option so appealing.
Sen. Jay Rockefeller (D-W.V.), a senior member of the Finance Committee, revealed on Wednesday his own version of a public option. His legislation would enact a public option within a national health insurance exchange and set up a non-profit health insurance trust to evaluate and give ratings to all health care products in the exchange.
"Without the steady, positive influence of a public plan option in the marketplace, we will never truly solve the health care crisis in this country," he said in a statement.
In the House, some members of the Blue Dog Coalition, a group of fiscally conservative Democrats, have said that the public option should only be enacted as a last resort.
While Congress hashes out its differences, the pressure is mounting to get something done.
Pragmatically speaking, Democrats may never again have the political clout they currently have or a president with so much political capital -- making this the ideal time to push through a major overhaul of the nation's health care system. Moreover, many contend bloated health care costs have brought the nation to its breaking point on the issue.
"We know what's at stake," the president told his grassroots supporters last month. "If we don't get it done this year, we're not going to get it done."
Predict: Health Care Reform
Will a major health care reform bill pass Congress before Labor Day?
© MMIX, CBS Interactive Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.
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See all 161 Commentsfor it is us that the president is fighting for, in every state we need to stand up and be recognized, at every meeting we need to be recognized, we have been the silent minority for too long, if we want this legislation to pass and cover us then we ahve to fight for it, for there are those who are fighting unfailry trying to get this legislation killed because for years that don't want the poor and the minorities to have basic health care form vevery village and vevry hamlet let us b be heard, from every town meeting to every congressional hearing let us heard, to every congressmen lets be heard
this bill was introduced by the president and now it is our time to stand up and fight for it, over the ignorant voices who oppose it , over the racist views of those who would destroy it, over the insudrance companies who treated us terribly with higher premiums, non-coverage of presxisting conditions, opposing valid claims, if there is anyoe out there who tjinks that insurabce companies are on the side of the people, you better pray you dont lose your job or your finances, or that they don't just terminate your policy on a whim beacsue you will be just like the millions who are without health insurance, out of luck
The repubilcans have no merit to mthier claims and thier rhetoric is suspiciously opposing the president simular to what they have done since he took office, they are out opf touch with the people and are hell benmt on proving the president wrong becaue he thumped them pretty good in the election, all thier are doing is tearing this country apart and neagtivley affecting millions of people, i want to remind them of something, that i will be voting to unseat every republican who is voting no just for the sake of voting no and the netire country should do the same starting with the nearest upcoming election, send them a message work to try rto solve the problems this country faces are pack you bags a go home
Robert McCann Chesilhurst NJ
Posted by charlie345 at 4:11 AM : Jun 12, 2009
The only problem with your statement is mergers. How many different viable insurance underwriters exist? Do the words Monopoly have any meaning.
It just like big oil.
The other options include having the government underwrite health insurance and to use anti trust laws to break up the insurance giants forcing competition.
I recently was hospitalized and they charged us $ 400.00 per bag a saline solution for an I.V. That is just a bag of water with a little salt mixed in and it costs $ 400.00.
I have considered offering the provider 5 gallons of distilled water and bag of salt as repayment, but they would rather have the money.
The way they overcharge people and nobody is questioning it. If we have a government controlled system and someone was caught overcharging it fraud charges would have been brought.
When are you people going to wake up? The current healthcare management is completely broken and they are ripping us off.
How is letting business regulate itself going to solve these issues when nobody is holding them accountable?
Requiring American citizens to have health insurance is unconstitutional ! No way No how, is that legal, and will certainly be challenged in court.
The AMA is opposed to this plan ! What health care reform could possibly be successful when the health care professionals are not going along with it? Think about it people, your doctor is free not to play ! If they all went on a strike, we all would be SOL.
Posted by indivthinker
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You don't sound like much of a "thinker," posting propaganda like that. Our taxes pay for public schools, police and fire protection and health care for some unable to afford it, so I'm missing your point that these services are FREE.
We already pay more than double what other developed countries pay for health care, and for that $2.5 Trillion or 18% of GDP, we are ranked 37th in the world. Very POOR.
Currently, the for-profit insurance companies -- mostly a lawyer as a claims supervisor -- make all our medical decisions for us, denying some and cutting benefits for others, instead of physicians and patients making those important decisions.
Currently, 62% of all bankruptcies in America have and underlying health care problem, and mostly from someone that did have health insurance.
Currently, our health care debacle is one that that is entirely too costly for its poor performance, but the insurance companies and their CEO's make huge profits and great benefits.
It surely is a sickness to not see the huge need for health care reform now!
Posted by charlie345
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What do you mean by "is going to be?"
Today, we already have 100,000 Americans dying each year in hospitals due to mistakes and many more than that requiring longer stays due to hospital infections. This is what we already have with the for-profit health care system, ranking the U.S. 37th in the world in health care, but costing much more than any other country at $2.5 Trillion or 18% of GDP.
Posted by clarkssuppor at 2:09 PM : Jun 11, 2009
Socialism. Redistribution of wealth. Welfare. Big government. It's all the same to the liberals. But to them they see:
Socialism = capitalism for the poor
Redistribution of wealth = making the evil greedy rich people pay a "fair" share of their income so that hardworking lower class Americans that all finished high school and college can have a break.
Welfare = free stuff that someone else can pay for
Big government = what serves as my nanny and makes my decisions for me. I get free education, healthcare, protection, etc
Liberals (and for that matter too neocons) have lost their minds.
Pros:
1. the government does not need to make profit, thus driving down some costs
2. mailing and paperwork would be cut by 75% since there are not dozens of insurance companies
3. Medical Records would be on file for everyone on a government database as opposed to having records for every office you visit
4. everyone gets healthcare
5. Preconditions do not matter
Cons:
1. Health care is rationed by the government. If they find your treatment is too expensive or your chance of survival is too low, they might reject your case
2. The program will cost trillions
3. In a private system, everyone pretty much pays for the medical care they want. In government health systems, the 20% of the richest Americans pay for 80% of the programs cost but only receive 20% of the benefit. Such is unfair that the rich are forced to pay for the poor, and those who pay minimal to no income taxes will get healthcare for little to nothing.
4. the government will enter the market and try to control costs. They will cap physician salaries (and destroy some incentive to see as many patients as possible), control pharmaceutical company profit (and thus slow their innovation), and insist on the cheapest (and possibly less effective and more dangerous) surgeries possible.
5. Waiting lines will be long. There is already a shortage of doctors, nurses, PAs, Pharmacists, medical technicians, etc, and it is difficult to see all the patients as is. Adding 50 million new people to the appointment list will overload the system.
The COMPROMISE to make an EFFECTIVE, CHEAP, FAIR and RELIABLE system.
1. Create a free healthcare plan and additiional buy-in plans for those with more money (to provide those who pay more into the system to receive better care).
*EVERYONE starts out at the bottom bracket with the basic healthcare: annual checkup, mammograms, colonoscopies, immunizations, a set amount of money for doctor visits, basic medicines, and emergency surgery
*If you have more money and wish to move up, you can get plans with more benefits.
2. Physicians and pharmaceutical companies have the right to remain private. They cannot be forced by the government to perform a surgery, and they cannot have their profits regulated beyond reason. They can see the patients they want to see, and they can perform procedures outside of government rationing, which means that a person can still have the procedure even if the government will not pay for it.
3. Make sure that the government has barriers to how it can regulate and control costs. It should create a consistent system where it doctors are notified of price ranges covered by the government. If a doctor wishes to get patients, he will charge lower costs for his services. Otherwise, the patients will see another doctor who is cheaper.
4. Protect choice. The doctor and patient know more about the situation than the government. If a surgery is covered by a government plan, then the government should not demand the cheapest surgery over the surgery that is the most effective and safest.
5. DO NOT GIVE HEALTHCARE TO ILLEGALS. If the illegal is under eighteen, treat him/her and then ship them back. If the person is over eighteen, reject them and send them packing. No more free giveaways to law breakers.
Pros:
1. the government does not need to make profit, thus driving down some costs
2. mailing and paperwork would be cut by 75% since there are not dozens of insurance companies
3. Medical Records would be on file for everyone on a government database as opposed to having records for every office you visit
4. everyone gets healthcare
5. Preconditions do not matter
Cons:
1. Health care is rationed by the government. If they find your treatment is too expensive or your chance of survival is too low, they might reject your case
2. The program will cost trillions
3. In a private system, everyone pretty much pays for the medical care they want. In government health systems, the 20% of the richest Americans pay for 80% of the programs cost but only receive 20% of the benefit. Such is unfair that the rich are forced to pay for the poor, and those who pay minimal to no income taxes will get healthcare for little to nothing.
4. the government will enter the market and try to control costs. They will cap physician salaries (and destroy some incentive to see as many patients as possible), control pharmaceutical company profit (and thus slow their innovation), and insist on the cheapest (and possibly less effective and more dangerous) surgeries possible.
5. Waiting lines will be long. There is already a shortage of doctors, nurses, PAs, Pharmacists, medical technicians, etc, and it is difficult to see all the patients as is. Adding 50 million new people to the appointment list will overload the system.
The COMPROMISE to make an EFFECTIVE, CHEAP, FAIR and RELIABLE system.
1. Create a free healthcare plan and additiional buy-in plans for those with more money (to provide those who pay more into the system to receive better care).
*EVERYONE (universal) starts out at the bottom bracket with the basic healthcare: annual checkup, mammograms, colonoscopies, immunizations, a set amount of money for doctor visits, basic medicines, and emergency surgery
*If you have more money, you can get plans with more benefits but you will have to payer higher taxes.
2. Physicians and pharmaceutical companies have the right to remain private. They cannot be forced by the government to perform a surgery, and they cannot have their profits regulated beyond reason. They can see the patients they want to see, and they can perform procedures outside of government rationing, which means that a person can still have the procedure even if the government will not pay for it.
3. Make sure that the government has barriers to how it can regulate and control costs. It should create a consistent system where it doctors are notified of price ranges covered by the government. If a doctor wishes to get patients, he will charge lower costs for his services. Otherwise, the patients will see another doctor who is cheaper.
4.. Protect choice. The doctor and patient know more about the situation than the government. If a surgery is covered by a government plan, then the government should not demand the cheapest surgery over the surgery that is the most effective and safest.
5. DO NOT GIVE FREE HEALTHCARE TO ILLEGALS. Until they come in to America the LEGAL way, then they deserve NOTHING. If the illegal is below the age of 18, then treat the person and as soon as he/she is well, ship them back to his/her home country. If the illegal is over 18, then reject the patient and ship them back to the home country. These people should know to expect this.
I'm glad to hear that you are promoting the reform on health..
It is really important issue.
I would suggest that you primarily to ensure free psychiatric treatments.
After I read that "Obama seeks global uranium fuel bank"(Bosot.com), Revealed to me that the problems in your head are not the weird ears.
It seems you need treatment on a daily basis.
This reform will save you a lot of money in the future.
Ofer, Israel.
Posted by joeybergas at 10:59 AM : Jun 11, 2009
Calling BS on that one, and that's based on your medical response regarding Diabetes.
Secondly you have no idea of what my qualifications in the medical and insurance industry is. You've been called out by more than myself here.
Like I said "You can't fix stupid"
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SO GET REAL, THIS IS JUST ANOTHER INSURANCE COMPANY SCARE TACTIC,
WHAT AMERICANS REALLY NEED IS SINGLE PAYER, UNIVERSAL
HEALTH CARE FOR ALL AMERICANS
Posted by mcintoshlou
I'm not disagreeing with you at all. I feel that all people should have the basics far as housing, food and health coverage. Anything greater or beyond that should be taken care of by the individual or the family.
BINGO!!! The biggest driver of all Malpratice suits, on top of suits, more and more suits. Someone like we the people have to pay off those darn suit cases.
Posted by onesword at 11:50 AM : Jun 11, 2009
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??? ????????.(thank you - word of advice, y'all should learn it soon......) although it would be funny to see someone like the mcdonalds hot coffee burn lady try to sue uncle sam for her millions....lol....good luck. or actually, they would probably justify it saying the coffee was racist and she was unfairly profiled for being friggin stoopid.
You guys are so right on the money
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SO GET REAL, THIS IS JUST ANOTHER INSURANCE COMPANY SCARE TACTIC,
WHAT AMERICANS REALLY NEED IS SINGLE PAYER, UNIVERSAL
HEALTH CARE FOR ALL AMERICANS
BINGO!!! The biggest driver of all Malpratice suits, on top of suits, more and more suits. Someone like we the people have to pay off those darn suit cases.
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