What Do We Know About Health Reform?

In this Aug. 11, 2009 file photo, a woman, who opposes health care reform, points to her wrist watch while listening to panelists during a health care town hall meeting in Alhambra, Calif.
AP Photo/Jae C. Hong
President Barack Obama continues his campaign-style effort to win the hearts and minds of Americans over health care reform. The latest stop - a town hall meeting in Grand Junction, Colorado.

"These struggles have always boiled down to a contest between hope and fear," the president said Saturday.

That was true when social security was born. That was true when Medicare was created. And it' s true in this debate today, reports CBS News correspondent Martha Teichner.

For the third time in five days, Mr. Obama used the presidential bully pulpit on behalf of what he's now calling health insurance reform in an effort to seize back control of the agenda from an angry opposition.

Here's a question: Do they even know what's in the bills currently being considered by Congress?

Do you?

"For all the chatter and yelling and shouting and the noise, what you need to know is this: If you don't have health insurance, you will finally have quality affordable options once we pass reform," Mr. Obama said last week at a town hall in Portsmouth, New Hampshire.

Right now, though, reform is a moving target, still changing. There is no such thing as an Obama bill.

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The president presented a wish list to Congress, where five different committees - three in the House and two in the Senate - are in various stages of drafting bills, with some big differences but a lot of similarities.

"All agree that all Americans should be covered. They all agree that you cannot be denied coverage because of a pre-existing condition," said Ralph Neas, CEO of the National Coalition on Health Care, a non-partisan alliance of groups working for health care reform.

"The all agree that if you leave a job, you don't lose health care coverage. They all agree if you have health care coverage, you can't be denied it once you get sick."

"And they would mandate that all but the smallest employers would have to provide insurance for their workers," adds Jonathan Oberlander, a professor of health policy and management at the University of North Carolina at Chapel Hill.

"The second thing that they would do is create a new marketplace, where the uninsured and small businesses could go to get insurance. It would be called a health insurance exchange and if you didn't have insurance from your employer, you would get subsidies from the government and you go to this exchange and you could choose what insurance plan you would have." Oberlander said.

And each of the proposals would expand Medicaid. Where there's disagreement is over how all of this will be paid … and over the so-called "public option," a government-run health care plan that would be available alongside private plans.

The public option is by no means a done deal, but tell that to the people doing all the yelling at town hall meetings last week.

"I don't want this country turning into Russia, turning into a socialist country," a woman said at a town hall organized by Pennsylvania Sen. Arlen Specter, a Democrat. Specter denied that's where the country was heading.

"The reason they oppose the public option is they think it's a stalking horse. They think the real plan of President Obama, or those who want health care reform, is to have single-payer, totally government-run health care reform," Neas said. "It will fail if people think it is tilted to kill the private insurance industry."

And now to address some of the health care reform's hottest hot-button issues, such as the reference to a "death panel" on Sarah Palin's Facebook page.

"The America I know and love is not one in which my parents or my baby with downs syndrome will have to stand in front of Obama's death panel so his bureaucrats can decide whether they are worthy of health care. Such a system is downright evil," the message read.

The reality?

"You would have a greater chance of being killed by a Death Star in one of the Star Wars movies than you would being killed by a government-run death panel, which is to say they don't exist," Oberlander said.

Another hot-button issue - taxpayer-funded abortions.

"On the contrary, there is language in the House Energy and Commerce bill that says federal monies cannot be used for abortion," Neas said.

And what about those television ads aimed at the elderly, claiming that seniors may lose their own doctors?

"That is absolutely false," Oberlander said. "In fact, the opposite is true. This legislation is absolutely good for seniors."

"There is now, every year, $2.5 trillion spent on health care. The United States spends twice as much as the average of all the industrialized nations in the world. One half of all the foreclosures, one half of all the bankruptcies [in the country] are because people can't pay their medical bills and it's because of the broken system we have," Neas said.

The American public agrees.

"Our most recent poll found that more than eight out of 10 Americans think the U.S. health care system either needs fundamental change or needs to be completely rebuilt," said Sarah Dutton, the head of surveys at CBS News. "Even 70 percent of Republicans feel that way."

A poll at the end of July showed nearly two-thirds of Americans supporting some sort of public option - 66 percent exactly, although fewer Republicans, 49 percent, than Democrats, 85 percent.

Where Americans are most ambivalent is over the cost of health care reform.

"We can't spend any more money. We gotta stop," one angry opponent said in Mississippi.

That's the third hot-button issue.

"You can't tell us how you're going to pay for this," one person questioned Mr. Obama in Montana.

"Look, you're absolutely right that I can't cover another 46 million people for free," the president replied. "Two-thirds of the money we can obtain just from eliminating waste and inefficiencies."

But the Congressional Budget Office has put a trillion-dollar price tag on health care reform over the next 10 years and calculates it will add $239 billion to the federal deficit.

And what happens if health care reform fails?

"The Urban Institute estimates that as many as 66 million Americans could be without health insurance in 2019," Oberlander said.

"There is now, every year, $2.5 trillion spent on health care. This $2.5 trillion will soon be $3.5 trillion, $5 trillion. Our economy cannot sustain it now," Neas said.

In the face of these estimates, President Obama has often repeated the message that "for all the scare tactics out there, what is truly scary is if we do nothing."

A contest between hope and fear is what Mr. Obama has called the fight for health care reform. At week's end, with the decibel level still rising, President Obama's battle cry had the unmistakable sound of his presidential campaign.

"I need your help," the president said in Colorado. "I need you to stand against the politics of fear and division. I need you to knock on doors and spread the word."