My Reactions
I didn't see it live, Steve. Thanks for the link to the transcript. I've selected a few of the President's quotes, and my reactions. It was a long speech and my response is also quite long.
The cost of our health care is a threat to our economy. It's an escalating burden on our families and businesses. It's a ticking time bomb for the federal budget. And it is unsustainable for the United States of America. Absolutely true. Congress has skirted this issue for years. By the President placing the issue on the Congressional table is not only a campaign promise, but something that calls out for legislative action.
...health care system is unsustainable for doctors like Michael Kahn in New Hampshire, who, as he puts it, spends 20 percent of each day supervising a staff explaining insurance problems to patients, completing authorization forms, writing appeal letters -- a routine that he calls disruptive and distracting, giving him less time to do what he became a doctor to do and actually care for his patients. Correct. Can't legislation require a simple "one size fits all" claim form that would apply to all insurers/payors?
...if we fail to act, federal spending on Medicaid and Medicare will grow over the coming decades by an amount almost equal to the amount our government currently spends on our nation's defense. Kind of a scary thought. This defines why Congress must address the issue now, and not forego it again, as it has so many times in the past.
... if we're honest, another part of the reason has been the fierce opposition fueled by some interest groups and lobbyists -- opposition that has used fear tactics to paint any effort to achieve reform as an attempt to, yes, socialize medicine. Sound familiar? It's happening again right now.
...we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period. (Applause.) If you like your health care plan, you'll be able to keep your health care plan, period. Well, the guy has been pretty consistent so far in meeting his campaign promises. I think we have to believe him on this one.
...we need to upgrade our medical records by switching from a paper to an electronic system of record keeping. The AMA itself says that this alone will not only reduce office operating costs, but will also provide a data base resulting in vastly improved diagnoses.
...The second step that we can all agree on is to invest more in preventive care. There are endless examples of how preventive care has worked when sponsored and funded by employers. In fact, maybe that's a way to improve healthcare at no cost to the government...incent employers with tax deductions or credits for them to sponsor a well-specified program of prevention.
...what accounts for the bulk of our costs is the nature of our health care delivery system itself -- a system where we spend vast amounts of money on things that aren't necessarily making our people any healthier... Whether it be for unnecessary tests and procedures to provide a defense for malpractice suits, or huge and unneeded expenditures at the end of life, there seems to be plenty of opportunity to cut costs in those areas alone.
... We need to create incentives for physicians to team up, because we know that when that happens, it results in a healthier patient. We need to give doctors bonuses for good health outcomes... An attractive-sounding idea...but how do you do it?
...identifying what works is not about dictating what kind of care should be provided. Based on his track record so far, I'm willing to believe him on this one.
...I'm not advocating caps on malpractice awards... He's a lawyer. I understand why not. But I wish this would definitely be included.
...as we seek to contain the cost of health care, we also have to ensure that every American can get coverage they can afford. Absolutely. Key point.
We are not a nation that accepts nearly 46 million uninsured men, women and children. Agreed. It's not only expensive, but borders on being immoral.
...under what we've proposed, to take part in what we're calling a Health Insurance Exchange... Sounds like a good idea. Standardize benefits, deductibles and co-pays so people can make an informed choice of selecting an insurer. Kind of like Medicare Advantage Plans, which work pretty well and is understood by almost everyone.
... I believe one of these options needs to be a public option that will give people a broader range of choices -- (applause) -- and inject competition into the health care market so that force -- so that we can force waste out of the system and keep the insurance companies honest. I'm not totally comfortable with this. I agree with the objective, but is there another way to accomplish it without a "government insurance company"?
...when you hear the naysayers claim that I'm trying to bring about government-run health care, know this: They're not telling the truth. Again, based on his track record, I'm willing to believe him on this one.
... Insurance companies have expressed support for the idea of covering the uninsured and they certainly are in favor of a mandate. If they're so enthusiatic, why didn't it get done under the free market, without the "mandate" prescribed by the government?
... I've set down a rule for my staff, for my team -- and I've said this to Congress -- health care reform must be, and will be, deficit-neutral in the next decade. Obama's political opponents are cherry-picking the costs in their criticisms. I'm willing to wait to see the totality of his numbers and underlying assumptions that will make this "deficit neutral".
...for those who are always talking about free market principles. That's why we need to introduce competitive bidding into the Medicare Advantage program, a program under which private insurance companies are offering Medicare coverage. It'll be interesting to see if anyone opposes this. Those that do are clearly in the pockets of the insurance company lobbyists.
We can also save about $75 billion through more efficient purchasing of prescription drugs. This will be a hot button debate. The pharma lobbyists will fight tooth and nail to prevent the government from getting into competitive bidding, or any other kind of price manipulation. Again, we'll see who's on the take from the pharma lobbyists.
.. I look forward to working with Congress to make up the difference so that health care reform is fully paid for -- in a real, accountable way. He's setting a tough objective for himself and the Congress. I think we need to resist the political naysayers who will nitpick parts of the plan instead of considering it in its totality.
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