And at last, Obama commits to something. My bet is that he wouldn’t be saying this if he didn’t think that there’s an excellent chance the Democrats can pass health care reform soon. The big hurdle is getting enough Democrats ((I say “Democrats” because it’s clear that not one Republican will vote for the bill.)) in the House to vote for the bill the Senate already voted for; after that, all that’s left is to make some small fixes through reconciliation.<\/p>\n
I’ve put the entire speech after the break (it’s not long). So what do folks think?<\/p>\n
My view is that this is a long, long way from what I’d really like, which is a French-style health care system<\/a>. But that wasn’t an option on the table. Neither was “Medicare for all,” aka single-payer health care, which is what most of the lefties I know want.<\/p>\n But even though it’s not what we want, it’s a large <\/em>improvement over the status quo. It would set up systems that could “bend the cost curve” down; it would get a hell of a lot more people covered; and it would make it possible for nearly all Americans, including those with pre-existing conditions, to get health insurance coverage.<\/p>\n So if the Democrats do pass this plan, that will do a lot to make them seem other than worthless. On the other hand, if the Democrats don’t manage to pass health care reform, then I barely see any point in supporting them at all. It’ll be time to rejoin the Green Party, I guess.<\/p>\n <\/p>\n President Obama’s speech:<\/p>\n Good afternoon. We began our push to reform health insurance last March with the doctors and nurses who know the system best, and so it is fitting to be joined by all of you as we bring this journey to a close.<\/p>\n Last Thursday, I spent seven hours at a summit where Democrats and Republicans engaged in a public and substantive discussion about health care. This meeting capped off a debate that began with a similar summit nearly one year ago. Since then, every idea has been put on the table. Every argument has been made. Everything there is to say about health care has been said and just about everyone has said it. So now is the time to make a decision about how to finally reform health care so that it works, not just for the insurance companies, but for America\u2019s families and businesses.<\/p>\n Where both sides say they agree is that the status quo is not working for the American people. Health insurance is becoming more expensive by the day. Families can\u2019t afford it. Businesses can\u2019t afford it. The federal government can\u2019t afford it. Smaller businesses and individuals who don\u2019t get coverage at work are squeezed especially hard. And insurance companies freely ration health care based on who\u2019s sick and who\u2019s healthy; who can pay and who can\u2019t.<\/p>\n Democrats and Republicans agree that this is a serious problem for America. And we agree that if we do nothing \u2013 if we throw up our hands and walk away \u2013 it\u2019s a problem that will only grow worse. More Americans will lose their family\u2019s health insurance if they switch jobs or lose their job. More small businesses will be forced to choose between health care and hiring. More insurance companies will deny people coverage who have preexisting conditions, or drop people\u2019s coverage when they get sick and need it most. And the rising cost of Medicare and Medicaid will sink our government deeper and deeper into debt. On all of this we agree.<\/p>\n So the question is, what do we do about it?<\/p>\n On one end of the spectrum, there are some who have suggested scrapping our system of private insurance and replacing it with government-run health care. Though many other countries have such a system, in America it would be neither practical nor realistic.<\/p>\n On the other end of the spectrum, there are those, including most Republicans in Congress, who believe the answer is to loosen regulations on the insurance industry \u2013 whether it\u2019s state consumer protections or minimum standards for the kind of insurance they can sell. I disagree with that approach. I\u2019m concerned that this would only give the insurance industry even freer rein to raise premiums and deny care.<\/p>\n I don\u2019t believe we should give government bureaucrats or insurance company bureaucrats more control over health care in America. I believe it\u2019s time to give the American people more control over their own health insurance. I don\u2019t believe we can afford to leave life-and-death decisions about health care to the discretion of insurance company executives alone. I believe that doctors and nurses like the ones in this room should be free to decide what\u2019s best for their patients.<\/p>\n The proposal I\u2019ve put forward gives Americans more control over their health care by holding insurance companies more accountable. It builds on the current system where most Americans get their health insurance from their employer. If you like your plan, you can keep your plan. If you like your doctor, you can keep your doctor. Because I can tell you that as the father of two young girls, I wouldn\u2019t want any plan that interferes with the relationship between a family and their doctor.<\/p>\n Essentially, my proposal would change three things about the current health care system:<\/p>\n First, it would end the worst practices of insurance companies. No longer would they be able to deny your coverage because of a pre-existing condition. No longer would they be able to drop your coverage because you got sick. No longer would they be able to force you to pay unlimited amounts of money out of your own pocket. No longer would they be able to arbitrarily and massively raise premiums like Anthem Blue Cross recently tried to do in California. Those practices would end.<\/p>\n Second, my proposal would give uninsured individuals and small business owners the same kind of choice of private health insurance that Members of Congress get for themselves. Because if it\u2019s good enough for Members of Congress, it\u2019s good enough for the people who pay their salaries. The reason federal employees get a good deal on health insurance is that we all participate in an insurance marketplace where insurance companies give better rates and coverage because we give them more customers. This is an idea that many Republicans have embraced in the past. And my proposal says that if you still can\u2019t afford the insurance in this new marketplace, we will offer you tax credits to do so \u2013 tax credits that add up to the largest middle class tax cut for health care in history. After all, the wealthiest among us can already buy the best insurance there is, and the least well-off are able to get coverage through Medicaid. But it\u2019s the middle-class that gets squeezed, and that\u2019s who we have to help.<\/p>\n Now, it\u2019s true that all of this will cost money \u2013 about $100 billion per year. But most of this comes from the nearly $2 trillion a year that America already spends on health care. It\u2019s just that right now, a lot of that money is being wasted or spent badly. With this plan, we\u2019re going to make sure the dollars we spend go toward making insurance more affordable and more secure. We\u2019re also going to eliminate wasteful taxpayer subsidies that currently go to insurance and pharmaceutical companies, set a new fee on insurance companies that stand to gain as millions of Americans are able to buy insurance, and make sure the wealthiest Americans pay their fair share of Medicare.<\/p>\n The bottom line is, our proposal is paid for. And all new money generated in this plan would go back to small businesses and middle-class families who can\u2019t afford health insurance. It would lower prescription drug prices for seniors. And it would help train new doctors and nurses to provide care for American families.<\/p>\n Finally, my proposal would bring down the cost of health care for millions \u2013 families, businesses, and the federal government. We have now incorporated most of the serious ideas from across the political spectrum about how to contain the rising cost of health care \u2013 ideas that go after the waste and abuse in our system, especially in programs like Medicare. But we do this while protecting Medicare benefits, and extending the financial stability of the program by nearly a decade.<\/p>\n Our cost-cutting measures mirror most of the proposals in the current Senate bill, which reduces most people\u2019s premiums and brings down our deficit by up to $1 trillion over the next two decades. And those aren\u2019t my numbers \u2013 they are the savings determined by the CBO, which is the Washington acronym for the nonpartisan, independent referee of Congress.<\/p>\n So this is our proposal. This is where we\u2019ve ended up. It\u2019s an approach that has been debated and changed and I believe improved over the last year. It incorporates the best ideas from Democrats and Republicans \u2013 including some of the ideas that Republicans offered during the health care summit, like funding state grants on medical malpractice reform and curbing waste, fraud, and abuse in the health care system. My proposal also gets rid of many of the provisions that had no place in health care reform \u2013 provisions that were more about winning individual votes in Congress than improving health care for all Americans.<\/p>\n Now, despite all that we agree on and all the Republican ideas we\u2019ve incorporated, many Republicans in Congress just have a fundamental disagreement over whether we should have more or less oversight of insurance companies. And if they truly believe that less regulation would lead to higher quality, more affordable health insurance, then they should vote against the proposal I\u2019ve put forward.<\/p>\n Some also believe that we should instead pursue a piecemeal approach to health insurance reform, where we just tinker around the edges of this challenge for the next few years. Even those who acknowledge the problem of the uninsured say that we can\u2019t afford to help them \u2013 which is why the Republican proposal only covers three million uninsured Americans while we cover over 31 million. But the problem with that approach is that unless everyone has access to affordable coverage, you can\u2019t prevent insurance companies from denying coverage based on pre-existing conditions; you can\u2019t limit the amount families are forced to pay out of their own pockets; and you don\u2019t do anything about the fact that taxpayers end up subsidizing the uninsured when they\u2019re forced to go to the Emergency Room for care. The fact is, health reform only works if you take care of all these problems at once.<\/p>\n Both during and after last week\u2019s summit, Republicans in Congress insisted that the only acceptable course on health care reform is to start over. But given these honest and substantial differences between the parties about the need to regulate the insurance industry and the need to help millions of middle-class families get insurance, I do not see how another year of negotiations would help. Moreover, the insurance companies aren\u2019t starting over. They are continuing to raise premiums and deny coverage as we speak. For us to start over now could simply lead to delay that could last for another decade or even more. The American people, and the U.S. economy, just can\u2019t wait that long.<\/p>\n So, no matter which approach you favor, I believe the United States Congress owes the American people a final vote on health care reform. We have debated this issue thoroughly, not just for a year, but for decades. Reform has already passed the House with a majority. It has already passed the Senate with a supermajority of sixty votes. And now it deserves the same kind of up-or-down vote that was cast on welfare reform, the Children\u2019s Health Insurance Program, COBRA health coverage for the unemployed, and both Bush tax cuts \u2013 all of which had to pass Congress with nothing more than a simple majority.<\/p>\n I have therefore asked leaders in both of Houses of Congress to finish their work and schedule a vote in the next few weeks. From now until then, I will do everything in my power to make the case for reform. And I urge every American who wants this reform to make their voice heard as well \u2013 every family, every business owner, every patient, every doctor, every nurse.<\/p>\n This has been a long and wrenching debate. It has stoked great passions among the American people and their representatives. And that is because health care is a difficult issue. It is a complicated issue. As all of you know from experience, health care can literally be an issue of life or death. As a result, it easily lends itself to demagoguery and political gamesmanship; misrepresentation and misunderstanding.<\/p>\n But that\u2019s not an excuse for those of us who were sent here to lead to just walk away. We can\u2019t just give up because the politics are hard. I know there\u2019s a fascination, bordering on obsession, in the media and in this town about what passing health insurance reform would mean for the next election and the one after that. Well, I\u2019ll leave others to sift through the politics. Because that\u2019s not what this is about. That\u2019s not why we\u2019re here.<\/p>\n This is about what reform would mean for the mother with breast cancer whose insurance company will finally have to pay for her chemotherapy. This is about what reform would mean for the small business owner who will no longer have to choose between hiring more workers or offering coverage to the employees she has. This is about what reform would mean for the middle-class family who will be able to afford health insurance for the very first time in their lives.<\/p>\n And this is about what reform would mean for all those men and women I\u2019ve met over the last few years who\u2019ve been brave enough to share their stories. When we started our push for reform last year, I talked about a young mother in Wisconsin named Laura Klitzka [KLITZ kah]. She has two young children. She thought she had beaten her breast cancer but then later discovered it spread to her bones. She and her husband were working \u2013 and had insurance \u2013 but their medical bills still landed them in debt. And now she spends time worrying about that debt when all she wants to do is spend time with her children and focus on getting well.<\/p>\n This should not happen in the United States of America. And it doesn\u2019t have to. In the end, that\u2019s what this debate is about \u2013 it\u2019s about the kind of country we want to be. It\u2019s about the millions of lives that would be touched and in some cases saved by making private health insurance more secure and more affordable.<\/p>\n At stake right now is not just our ability to solve this problem, but our ability to solve any problem. The American people want to know if it\u2019s still possible for Washington to look out for their interests and their future. They are waiting for us to act. They are waiting for us to lead. And as long as I hold this office, I intend to provide that leadership. I don\u2019t know how this plays politically, but I know it\u2019s right. And so I ask Congress to finish its work, and I look forward to signing this reform into law. Thank you. <\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":" And at last, Obama commits to something. My bet is that he wouldn’t be saying this if he didn’t think that there’s an excellent chance the Democrats can pass health care reform soon. The big hurdle is getting enough Democrats … Continue reading