Healthcare

Obama plans to reform economy, not just health insurance

Let’s go back, just for a minute, to a time before screaming teabaggers, before Republicans decided to kill health insurance reform as a means to politically destroy this country’s first African-American president.

Try and remember what it was like before discussion of health insurance reform raised voices, a time when instead it raised concern. Recollect Aug. 7, 2007, during the Democratic primaries, when then-60-year-old retired and disabled steelworker Steve Skvara stood at a microphone during a political debate and told his story with tears in his eyes and a catch in his throat.

He’d worked more than 30 years at LTV Steel in East Chicago, Ind., and assumed like many who earned pensions and retiree health coverage that those benefits were guaranteed. But then LTV went bankrupt and ditched its obligations. Skvara told the candidates:

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The truth about the Capps amendment (Rep. Lois Capps)

Enacting comprehensive health insurance reform is no easy task - if it was, we'd have done it decades ago. Making it more difficult is the blatant misinformation being spread by some opponents of reform as well as people who perhaps just don't know better. A case in point is the House health reform bill's provision continuing the policy of restricting the use of federal funds to pay for abortions. There is a lot of misinformation about this provision, some of it probably the result of honest mistakes and some of it based on outright fabrications.

In an attempt to try to find a compromise for dealing with abortion services in the legislation, I offered an amendment that would essentially continue this ban - even though I personally oppose the Hyde Amendment - that was supported by Energy and Commerce Committee Members whose records span the pro-life and pro-choice spectrum. Our hope was that we could continue the current ban on federal funding for abortion so the issue wouldn't bog down the overall health reform legislation.

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Setting high health standards for formaldehyde (Sen. Mike Crapo)

I joined with Minnesota Senator Amy Klobuchar to introduce the Formaldehyde Standards for Composite Wood Act, which will protect consumers by establishing national uniform standards for formaldehyde in composite wood products, which would apply to both domestic products and foreign imports.  The standard would provide certainty for manufacturers of composite wood products and achieve important public health benefits.  High levels of formaldehyde are a health threat, and this bill sets national standards that will eventually be the strongest in the world.

Formaldehyde is found in many common household items and furniture because it is commonly used as an adhesive, bonding agent or solvent in many household products that use composite wood such as furniture, cabinets, shelving, countertops, flooring and molding.

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The need for medical liability reform (Sen. John Cornyn)

Last week, the President embraced a part of health care reform that I have long been fighting for on a national level: medical liability reform. We know a thing or two about this subject in Texas. Ten years ago, we faced a terrible shortage of doctors in Texas. One of the main reasons was the high amount frivolous lawsuits and jackpot justice. By enacting much-needed medical liability reform,  that is starting to change and our state is now going in the right direction.

 What works in Texas can work in Washington, and the nonpartisan Congressional Budget Office agrees.  The CBO estimated that the federal government would directly save about $5.6 billion dollars from the types of reforms enacted in Texas, and that total health care spending could be reduced further if these reforms reduced the practice of defensive medicine.  Other academic studies have concluded liability reform could save between 5 and 9 percent of health care costs.  These reforms will also increase access to health care, especially to high-risk medical specialties.

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The Big Question, Sept. 11: Did Obama's speech improve the chances of passing healthcare reform?

Celinda Lake, President of Lake Research Partners, said:

Without question. He energized the base, motivated Democrats, and clarified questions.

Craig Newmark, founder of Craigslist, said:

Obama's speech was compelling for Americans looking at these issues in good conscience and honesty.

I saw a lot of independents, including myself, see the speech as representing the interests of people who want something real to happen.

The speech showed the President persistently trying to reach out to everyone, despite criticism for those who profit from the current health care failure.

Personally speaking, as a libertarian pragmatist (or "pragmatic libertarian"?) I appreciate the balance between public and private interests, and I appreciate being talked to as an adult.

This is what it takes to get reform passed.

Bernie Quigley, Pundits Blog contributor, said:

The President’s speech served only as a background for The Shout. This was a significant happening. It was a staccato moment that marked the rapidly advancing alienation between the states which support the federal bailouts and the Obama healthcare plan and those who oppose them. It was the spontaneous prelude to a set of ideas seeking form, clarity and public expression that will inevitably find them in the near future. 39 states this past six months have initiated legislation in opposition to what they see as federal overreach by the Obama administration. The Shout came from them. The Shout will help bring the mainstream press out of denial on these issues.

Chris Kofinis, Pundits Blog contributor, said:

Yes. President Obama's speech was crucual to kickstarting the political momentum in the democrats favor. However, Rep. Wilson with his idiotic and disrespectful outburst may have helped impassion democrats to fight for health care even more.

Bottom line, contrary to the naysayers, we will have health care reform pass by the fall and the speech will be seen as a turning point for two very different reasons. 

A.B. Stoddard, Associate Editor of The Hill, said:

President Obama's speech improved the chances of passing health care reform because he likely consolidated support within his party by warning the liberal left this is their last chance for reform, calming some nerves among centrists and finally explaining to the public in clear terms what reform would mean to them. The speech had partisan elements, and combined with the outburst by Rep. Joe Wilson (R-SC), which many Republicans are defending, the gulf between the two parties probably grew larger and not smaller on Wednesday night.
 
If the public option is either triggered or dropped entirely it is likely that centrist and conservative Democrats will stay on board and a bill will get signed into law. Obama's message attempted to assuage both factions in his party -- the left heard his enduring support for a public plan while conservatives heard that such a plan is clearly negotiable -- and unite them against reform opponents. The Bigger Question now, perhaps for next week, is whether the president and his party plan to seek Republicans to gain 60 votes in the Senate, or to use the politically toxic reconciliation process. 

Grover Norquist, President of Americans for Tax Reform, said:

Obama raised more questions than he answered.  He kept talking about "his" plan.  Fine.  Let's see it in writing. And the assertion that the alternative is the status quo was an insulting--what is the word--"untruth," "fib".  All the Republicans sitting in the Capitol building know well the tort reform and reforms such as the Shadegg legislation that would allow Americans to buy insurance across state lines.  These are reforms that Democrats have been opposing for decades.  The Democrats lose any ability to even pretend that they are being honest or grown up by denying the existence of legislation they have to vote against thanks to their tort lawyer masters.

Obama suggested he might think about trying tort reform out in some states. Silly. We have examples of medical malpractice reform in California dating back to the 1970s, Texas has enacted strong tort law reforms.--these reforms have done everything their supporters hoped and the left's scare tactics were exposed as such.
 
But Obama has unleashed a good idea. If one is pushing an untested idea, let's try it out in a small state.  Let's have ObamaCare in Vermont for a few years and see how it works.  We have had parts of ObamaCare in Massachusetts, Tennessee, Maine and Hawaii and they have all failed.  The target state or states for the whole thing should be chosen from volunteers.

Armstrong Williams, Pundits Blog contributor, said:

 President Obama's recent health insurance reform speech at a town hall meeting before a joint session of Congress was delivered in nearly perfect form –complete with a Republican to demonize. This speech is one that the American public have been all too familiar with during the primaries.

There is so much to interpret and understand.

Recently, President Obama’s poll numbers have been sliding across the board. Many who had been earnestly in attendance to the Obama Health Care Forums are discontented that they are not getting what they voted for. Instead of getting a powerful leader that stood for change, many who have changed their position claim he lacks a strong spine that collapses to the opposition. A man who is all too often willing to try and please all constituencies.  In the end everyone loses. Apparently, the rubber didn’t meet the road.

Was there really anything different in the Presidents speech Wednesday night? Not really. President Obama brought in the whole crew and ensemble along for this one. His essay read like many colleg e papers –almost perfect to a fault, for what he was trying to accomplish, without much regard for the complexities that arise from application.

Behind the curtain, the real facts and details  are being crafted by lobbying specialists with the arcane knowledge capable of pressing out the real costs and realities of health insurance reform. For the most part, most Americans know this, and are looking to esoteric journals for their information.

President Obama’s recent scripted speech on health insurance  reform was nothing more than rhetoric serving tradition that presented no game changers. Reform is still along the lines of what Max Baucus and his group of six have developed. However, at this point reform looks inevitable. 

Terence Kane, Pundits Blog contributor, said:

Did Obama's speech improve the chances of passing healthcare reform? Obama likely created enough political will for moderate Senate Democrats to press ahead with a plan that gets only one or two GOP votes. At the same time, he also performed well enough to recapture the hearts of the progressives in the House. The text of his speech lays out a negotiating position that is actually quite centrist, but progressive Democrats are simply unlikely to go against a President they deeply admire.

While the speech made it more likely a piece of healthcare legislation passes, the biggest question, however is whether President Obama speech improves the chances of a good healthcare reform bill passing. Members are likely to cling to arbitrary and parochial demands during the final negotiations, it is critical these demands do not hinder coverage expansion.

Brent Budowsky, Pundits Blog contributor, said:

The president's speech last night was fine. It might add a little boost in the polls. It will not significantly affect the outcome. It does not deal with the larger and more important issue about the Obama presidency in general and healthcare in particular, which is this:

This town is run by power players, power centers and power institutions. The most successful presidents have mastered the art of dealing with these power centers. This is something that President Barack Obama has not yet done.

I suggested in a column Wednesday that the president bring to the White House staff a very high-level Democrat and very high-level Republican to play the role that James Baker, Clark Clifford and others have played for Presidents Truman, Roosevelt, Kennedy, Johnson, Reagan, Bush 41 and others.

Beyond the White House staff, the president (and any president) would be well-advised to watch the C-SPAN tape recordings of Lyndon Johnson calling senior members of the House and Senate, one after another, to push through Medicare.

LBJ was a grandmaster and virtuoso. I recommend the LBJ tapes to everyone, including Obama. LBJ's managing of the Medicare battle is both a history and guide to how great achievements are accomplished in Washington.

The president's speech was fine. But words, no matter how eloquent, are no substitute for direct, aggressive, hands-on presidential leadership that engages and moves the power centers of this town. This is my advice to the president.




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Address mental health in reform legislation

Let’s talk about mental health care.

It’s part of the broader health care debate.

The National Alliance on Mental Illness agrees with President Obama that the time for health care reform is now.

Mental illness does not discriminate. It affects Democrats and Republicans alike. Men and women. The young and the old.

Too many parents are forced to confront “the sheer helplessness and terror” that comes when their children—at any age—become gravely ill.

That is the experience of individuals and families affected by serious mental illness like schizophrenia, bipolar disorder and major depression. For those who have private health insurance, reform will prohibit loss of coverage due to pre-existing conditions, arbitrary caps on annual or lifetime coverage or excessive out-of-pocket expenses.  For mental health care, four issues also are important:

*Full parity of insurance coverage for mental illness and addictive disorders in all private and public health plans.

*Full integration of mental and physical health care, including early identification and intervention for mental illness in children and adolescents

 *Elimination of the prohibition against Medicaid dollars being used for inpatient psychiatric or substance abuse treatment—which leads to dumping people from hospitals into homeless shelters.

 *Improved data collection, outcomes measurement and accountability. Good numbers are essential to measure progress, failure or success and data collection in mental health care lags far behind.. Federal action must create a framework for state mental health care systems to develop comprehensive, uniform, meaningful data in order to move into the future.

NAMI calls on Congress to move forward.

Do not retreat. Do not stand still.
 
Do not forget that mental illness can strike anyone at any time

The time for action is now.

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Moving forward with meaningful healthcare reform (Rep. Maxine Waters)

The President hit a home run last night.

President Obama said exactly what proponents of meaningful health care reform -- including myself -- needed, expected, and wanted him to say. The time for bickering, myths, and flat out lies by those who want to block reform is over. We will move forward with health care reform and get it done this year.

What most impressed me about the President was his demeanor. He came there as Barack Obama the educator, explaining clearly both the need for health care reform and the specifics of our proposal. He presented a strong case for reform, and he spoke directly to the American people, outlining the benefits of health care reform both for those who are currently covered and those who are uninsured.

He stood there -- amid cheers from most of us and unfortunately also unprecedented jeering and outright disrespect from some on the opposite side of the aisle -- to reaffirm core principles, to debunk rumors, to reclaim the debate, and to spur us to act once and for all to fix America's broken health care system.

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Healthcare should emphasize wellness (Rep. Rob Wittman)

As many citizens can attest, the U.S. is a great place to get sick, but a terrible place to stay well. This requires a shift in the way both doctors and patients approach health maintenance and disease prevention. We have a unique opportunity in healthcare reform to decrease costs through health maintenance and wellness, as opposed to when we get sick down the road and incur more costly expenditures through treatment.

Individuals will achieve healthier lifestyles when prevention and wellness programs are accessible and available in their workplace, through their health provider, and in their communities. The key is to incentivize the provision of prevention and wellness programs and consultations- our system currently pays for procedures and office calls when a person is already ill, not for preventative, preemptory activities to encourage healthy lifestyles.

Specifically, we can improve prevention and wellness by giving employers and insurers greater flexibility to financially reward individuals who make efforts to achieve or maintain a healthy weight, quit smoking, and manage chronic illnesses like diabetes. We should also take efforts to reward high-quality care, instead of encouraging health care providers to order more and unnecessary services. In addition, we must take steps to make healthcare more convenient to folks in underserved areas, both in large cities and in rural areas by expanding access to Community Health Centers and Free Clinics, for example. Finally, we must implement new and innovative treatment programs to better coordinate care between healthcare providers, ensuring that those with chronic disease receive the care they need and do not continue to fall through the cracks in the system.

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Absence of medical liability reform highlights Democrats’ empty promises (Rep. Eric Cantor)

By now it’s well known that soaring health care costs pose a grave threat to the delivery of health care services throughout the country.

This morning President Obama reiterated his promise that any health care bill he signs will not add “one dime to the deficit.” But is lowering costs truly a top priority of his as he attempts to move health care reform through Congress?

If his goal truly is to eliminate billions in waste and make the health care system more affordable, medical liability reform must be accomplished. Yet so far the President and fellow Democrats have left the issue off the table. And this despite the fact that the pervasive fear of being sued, even when a doctor or hospital follows standard and by-the-book procedures, has racked the medical community and led to hundreds of billions dollars of waste through defensive medicine. Much of the additional costs are passed on to consumers.

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The Big Question, Sept. 8: How important to Obama's presidency is the fate of healthcare reform?

Dean Baker, Co-Director of the Center for Economic and Policy Research, said:

The fate of health care is hugely important to the Obama presidency because it is hugely important to the economy and the country. First, as an economic matter, if we don't fix our health care system then it will be a rapidly growing cancer on the economy. We will have many more Chryslers and GMs if health care is not fixed. Companies that pay for health care will face unmanageable costs.

The excess cost of our health care system is like a tax on the economy. Currently the size of that tax is approximately $1.2 trillion a year ($16,000 for a family of four). That is the difference between what we pay per person and what people in other countries with comparable health outcomes pay. This is a crushing tax burden that will get much larger in the years ahead. This sort of redistribution from the Joe the Plumbers of the country to the insurance industry, the pharmaceutical industry, and the highly paid specialists is unbearable.

Also, as every expert on the budget knows (this excludes most of the whiners about budget deficits), excessive health care costs are the main factor driving the deficit. If President Obama can't contain health care costs, then the country will face devastating deficit problems in the years ahead.

Of course there is the most basic issue. It is important for people to have secure health care. It is not just the 47 million who are counted as uninsured who lack real insurance. Most of us do not enjoy insurance against serious illness because if we got sick we would lose our jobs and then we would lose our insurance.

For the sake of the economy, the budget, and the country's well-being, health care reform is absolutely essential.

A.B. Stoddard, Associate Editor of The Hill, said:

The economy will determine the legacy of President Obama, and will likely determine the outcome in the next two elections of 2010 and 2012. But it is critical to that legacy that Obama and the Democrats in Congress find a way to pass some form of health care reform in the months to come.

Obama's coalition and his governing style have been profoundly tested throughout this intense debate. He has remained cool and detached while the liberal and conservative wings of his party have fought to the draw on health care reform. As of today they are as far apart as they could be, having missed deadlines to draft and pass legislation because of those disagreements and Obama is having to step in to get more "specific," on an effort he had left largely to the Congress.

Just what he will say in his televised speech to members of the U.S. House and Senate we don't know, but what he says behind closed doors to members of his party is what matters most. He must explain to them that the lesson learned from the party's last attempt to reform health care is that nothing will cost them more than something.

Since overreach isn't possible now, with the Democratic middle nervous about a public option and costs, any reforms Democrats can pass are likely easier to defend than failure. As Obama keeps stating: failure is no longer an option.


Bill Press, Pundits Blog contributor, said:

President Obama has made health care reform the first test of his presidency, and he will therefore be judged accordingly. A strong bill will empower him in all future legislative battles. Failing to get health care reform would leave him significantly weaker in any future battles.

Brent Budowsky, Pundits Blog contributor, said:

The most important issue to Obama's legacy and his presidency will be the state of the national economy. Does the economy recover and does the unemployment rate fall in the coming months? Or does the economy suffer a double-dip recession and joblessness rises above 10% into next year? This is the issue that will determine other issues. Health care is an important part of the Obama legacy and I predict a compromise will pass this year that will be better for the Obama legacy and the Democratic Congress than most pundits currently believe.

Craig Newmark, founder of Craigslist, said:

Obama's true legacy will be motivating large numbers of people to repair government, from the inside and the outside, inventing new forms of public/private partnership.

This is already happening.

Healthcare is an important part of that, part of a moral responsibility to serve one another; we need to ease the suffering of millions. That will be part of the Obama legacy.

Grace-Marie Turner, President of the Galen Institute, said:

President Obama has made health reform a legacy issue by deciding to place it at the top of his domestic policy agenda.  But for someone who was so atuned to the voters during the 2008 presidential campaign, this is a major miscalculation.

Poll after poll shows that the American people believe that getting the economy back on track should be the president’s first priority.  Only one person in five believes that health care should be his top concern.

But by calling for a joint session of Congress to call for passage of health reform legislation, Mr. Obama guarantees that tomorrow night’s speech will be the turning point in his young presidency.  If he succeeds, then he will be seen as virtually unstoppable, able to push his agenda even in the face of clear opposition from the American people.  But if he fails, he will struggle to pass any other parts of his reform agenda.

In town hall meetings across the country in August and in virtually every opinion poll taken over the summer, the American people say they are increasingly fearful about the changes and cost of the president’s sweeping reform plan.  They are very concerned about the nation’s ballooning debt and are highly reluctant to add to it with another big health spending program.  And they are frightened about what health reform would mean for them and their access to medical care.

The biggest problem that the president has right now is the growing distrust of the American people.  They don’t see, for example, how spending another $1 trillion on health care can lower health costs.  They don’t believe his assurances that if they like the coverage they have now, that they can keep it, when independent studies show that millions of people will lose their current coverage, many involuntarily.  And they are concerned that government bureaucrats will start deciding whether they should take the blue pill or the red pill or take pain killers rather than get surgery, as Dr. Obama has suggested.

It is not at all clear that stirring oratory before cheering members of Congress and a nationally televised audience will be able to put these fears to rest, especially with more and more conservative Democrats are expressing their wariness about a big reform agenda.

Mr. Obama is making a big gamble, and the stakes for the success of his presidency could not be higher.

Peter Fenn, Pundits Blog contributor, said:

There is no question that it is still "the economy, stupid!"  But, of course, one-sixth of the economy is health care and getting larger every day.  President Obama is attempting to do what Presidents have been attempting for over 50 years.  The stakes are high.  The rewards are great.  The time is now.  By passing the beginnings of real health care reform now, it will stimulate the economy further, boost public confidence, and put the U.S. further on the road to economic recovery.

Bernie Quigley, Pundits Blog contributor, said:

What will impact is the bad timing and mismanagement of this issue. In hindsight, Obama is not unlike Bill Clinton who didn’t know how to be President until he hired Dick Morris. The political culture has moved on. Afghanistan is quickly becoming the key issue and Obama is still talking about health care. It gives opposition throughout the heartland an opening, and instead of Obama being the “Change” he personifies the old, hackneyed, out-of-date political formula; the bland background against which change is occurring: Those pesky blue-haired ladies packing Glocks in the town halls are beginning to look like the Change. Ignoring Afghanistan has also forced Democrats to oppose their own President on moral grounds. As he is down to 46% approval now it is possible to see a challenge coming in 2012 on this issue if he doesn’t change direction – Hillary and Jim Webb conceivably or Mark Warner and Joe Sestak. To early to say. He’ll be alright. But he better hire Dick Morris.

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