Obama's Health Care Speech- WHAT OBAMA ACTUALLY SAID ABOUT HEALTH REFORM

It's not pretty ...



1965 - President Lyndon Johnson signs Medicare bill while President Harry Truman looks on. Truman signed up for Medicare right away. Image

Address to Congress

Michael Collins
http://electionfraudnews.com/MichaelCollins.htm
(With links: http://smirkingchimp.com/thread/23731 )


President Obama closed his address to the joint session of Congress by scolding those who have raised the absurd charges regarding his health care initiative. It was well timed and diverted attention from fundamental flaws in his proposal.

This article examines the Obama plan as outlined in his speech. His goals were clear and the speech was well structured. The heart of the address provides the type of information necessary to judge the merits of the plan as presented.

Obama got serious when he said, "The plan I'm announcing tonight would meet three basic goals:

"It will provide more security and stability to those who have health insurance.

"It will provide insurance to those who don't.

"And it will slow the growth of health care costs for our families, our businesses, and our government." Pres. Barack Obama, Sept. 9

Cost and availability are the core issues in health care today. They subsume all others. What's missing here? Instead of universal coverage, the uninsured get "insurance," most likely private insurance, if they can afford it. Instead of beating back prices or bold initiatives to reduce them, we're hearing "slow the growth." Health care costs are unaffordable to many already. The promise here seems to be that they'll still be unaffordable, just less so.

"Bending the curve" may happen but it fails to address the key problem -- people can't afford insurance rates and medical bills. As a result they get sick more, suffer more, and die before their time.

"Here are the details that every American needs to know about this plan"

Obama detailed the impact of his plan on two distinct groups, those currently with insurance and those without. This is a key distinction since the public option, for example, is available to only those without insurance.

Those with Insurance

Those with insurance were promised that "nothing in our plan requires you to change what you have." That's assuring to some. But to others who lave plans that are too expensive, plans purchased directly from insurance carriers, there may be a desire or need to change to a more affordable plan. You're out of luck. Let's say that you own a small business and pay $1200 an employee a month for health insurance. The plan offers no apparent benefit other than slowing "the growth of health care costs."

The plan will offer four ways "to make the insurance you have work better for you." It will: get rid of preexisting conditions as a reason to deny coverage; bar insurance companies from dropping coverage due to a major illness; limit "out of pocket" expenses; and require coverage for preventative care. These are all positive steps.

That's it for "security and stability." You can stay in your current plan. You can go elsewhere with certain long overdue guarantees of coverage but for those insured, there's no freedom to choose a Medicare-like public option or use the insurance "exchange" There's no security that you will ever see affordable health care.

Health insurance and pharmaceutical companies who have jacked up prices at record setting rates will be unimpeded.

The health care "exchange" that was part of Obama's campaign proposal is not available to those with insurance:

"But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don't have insurance." Sept. 9

We're left to assume that "keeping the "insurance companies honest" is only a benefit saved for those citizens who are uninsured.

Those without Insurance

Those without insurance will be offered membership in "one big group" that will leverage their numbers to drive competition from insurance companies on a public "insurance exchange." The exchange aims to fulfill a huge promise:

"If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices." Sept. 9

What if you don't have a job? What if you have a job but can't afford the prices on the "exchange?" This was not addressed.

The president elaborated his argument for the "exchange:"

"Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers." Sept. 9

Who are the members of this group that the insurance companies will so desire? They're the uninsured, the people who get sicker more frequently and have great medical needs because they're uninsured. Is that an appealing market for companies who are in the business of excluding sick people? Is there some major group of very healthy uninsured ready to balance out the generally poor, low income uninsured?

To further bolster the insurance "exchange," Obama offered this argument:

"As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance." Sept. 9

No it isn't. The largest companies have "self funded" health insurance plans. They don't buy insurance coverage from the Blue Crosses of the world. They set up a fund for benefits that pays for employee health care. They hire out the administration of benefits to private insurance companies who issue checks and reimbursements but that money is from large companies. The entire "exchange" argument is based on a factual error. Since the assumption of competition underlies the "exchange," the plan crumbles for those without insurance.

Percent of workers in self-insured companies

From Exhibit 10.1 Kaiser Family Foundation 2008 (p. 162)

Why would companies do this? Because self funded plans save money by cutting out insurance company profits as an operating cost. Self funded plans also provide more control of expenditures. There are no $800,000 a day salaries for plan employees as we've seen at insurance companies.

The underlying premise for the insurance exchange for the uninsured is flawed operationally and factually. So how will people pay for this coverage?

Tax credits! We're told that, "For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need."

Who will be in the exchange and what can they afford with or without tax credits?

The Distribution of the Uninsured and Total U.S. Population by Income

72% of the uninsured are below the income level required to afford
employer health insurance. Based on U.S. Census Bureau data, 2005 Link

This augmented chart shows an estimate of the income level required for the uninsured to afford a "company insurance plan." Self funded plans covered 54% of those insured (p. 162) at the time this data was collected. According to the study, an individual needs income of 300% of the federal poverty level, $27,000 to afford "employer insurance." A family of four needs an income of 300% of the federal poverty level for families or $57,000 for "employer" insurance. This study didn't presume an insurance "exchange" but the analysis is applicable as a model for answers we need to determine the ability of people to purchase insurance under the president's proposal.

Even if everything worked perfectly for the uninsured, the president said, "This exchange will take effect in four years, which will give us time to do it right." If that's the criterion, do it right, it will take a lot longer than four more years before the uninsured benefit.

With a flawed basis for the exchange, no mandatory participation by insurance companies, no price controls, and a poorer, less healthy "big group," what chance is there that the very limited public option proposed will be "be self-sufficient and rely on the premiums it collects" as Obama requires? What chance is there that private insurance companies will be more inclined than they are today to insure those that they don't want to insure?

What about Medicare?

Medicare is a well liked plan with lower administrative costs, and no requirements for shareholder returns. It's also much less intrusive in care decisions than private insurance plans. But that's not in the cards. The president said:

"Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch." Sept. 9

Medicare is a national program in operation since 1965. It provides universal health care for those 65 and older. It faces challenges from the bulge in beneficiaries that don't negate its lower unit costs, lower administrative fees, and high satisfaction rate. Medicare would be even more effective in delivering improved health if seniors were it able to negotiate discounted drug rates with the major drug companies. But Congress outlawed that in 2004. That wasn't mentioned as part of the plan. Why?

In his apparent attempt to preserve the private health insurance industry and to appease the major pharmaceutical companies, the president missed a key lesson from the market place.

When large companies want to save money on employee health costs, they get rid of the private insurance companies. As a result, they save money and often offer more coverage. They save even more money bypassing the built in cost of insurance company profits and excessive CEO compensation.

Medicare is the big company self funded plans writ large. In fact, you could argue that the Medicare approach of direct funding for "the big group" of seniors was the model for self funded big company health plans.

Isn't it time to stand back and reevaluate the entire process?

Isn't it time to say no to more corporate welfare?

How many more bailouts can we take?

END

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Let's say that you own a small business and pay $1200 an employee a month for health insurance. The plan offers no apparent benefit other than slowing "the growth of health care costs."

See Robert Reich discussing the "public option"--http://www.youtube.com/watch?v=ZXFHXqrrJ6g

It would NOT be taxpayer funded and would compete against for-profit insurance and drive prices down.

"But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don't have insurance." Sept. 9

I don't understand why you think this would compete against anyone.

:shrug:

Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. (Applause.) And the insurance reforms that I've already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. (Applause.) Now, let me be clear. Let me be clear. It would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5 percent of Americans would sign up.

Despite all this, the insurance companies and their allies don't like this idea. They argue that these private companies can't fairly compete with the government. And they'd be right if taxpayers were subsidizing this public insurance option. But they won't be. I've insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits and excessive administrative costs and executive salaries, it could provide a good deal for consumers, and would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities. (Applause.)

Now, it is -- it's worth noting that a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight. But its impact shouldn't be exaggerated -- by the left or the right or the media. It is only one part of my plan, and shouldn't be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage available for those without it. (Applause.) The public option -- the public option is only a means to that end -- and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have. (Applause.)

******

I believe that if the gov't run health care can prove itself better than the private health care insurers, they will be forced to improve. Otherwise, more and more of us will demand to have access to the gov't plan.

Also, it's a way to implement the public option without an immediate upheaval of the existing system.

I still don't know how you come those conclusions. It'll be like a tiny little medicare program that only a few will be able to join. We already have something like that. I don't see what you think will be accomplished here. Are you saying that if we don't get universal care now it's ok because that means we will get it sometime in the future when it won't cause any upheaval or any other discomfort for the insurance industry? That sounds like what you said.

except you added a whole lot more -- and very welcome -- data to back it up.

I was flamed in various threads on DU, and I'm sure you will be too.

that, of course, doesn't change the fundamental truth: there will be nothing here that truly benefits the millions of uninsured and underinsured (including those who are insured but will have benefits denied for one cockamamie reason or another) either now or in four years, but the insurance companies -- meaning their stockholders and bloated executives -- will begin raking in the dough immediately.

Obama's place in history is secure. Regardless what he does or doesn't do in office, he's the first African-American president and no one can take that away from him. Unfortunately, it's beginning to look more and more to me like he made a whole lot of promises in order to achieve that, and didn't really care about keeping any of those promises.

We aren't out of Iraq and we're deeper than ever into Afghanistan.

Taxes haven't changed.

DADT and DOMA are still securely in place.

US companies are still shutting their US plants, ditching their US workers, and going merrily on their way to reap higher profits for their stockholders.

Wall Street is still happily rolling in barrels of taxpayer dough. The bankers are still making billions while the people who used to have jobs are watching as their homes and cars and dreams are repossessed.

Pelosi is raising funds from the health care lobbyists, Baucus hasn't stopped taking money from them, the 20% fringe nutcases are dictating the media agenda, and the whole fucking country is going to hell in a hand basket.


Tansy Gold

"that, of course, doesn't change the fundamental truth: there will be nothing here that truly benefits the millions of uninsured and underinsured (including those who are insured but will have benefits denied for one cockamamie reason or another) either now or in four years, but the insurance companies -- meaning their stockholders and bloated executives -- will begin raking in the dough immediately."


Why do you think this? Do you really think Obama will be able to pass a bill that will do nothing but give insurance companies profits?


"Obama's place in history is secure. Regardless what he does or doesn't do in office, he's the first African-American president and no one can take that away from him. Unfortunately, it's beginning to look more and more to me like he made a whole lot of promises in order to achieve that, and didn't really care about keeping any of those promises."


Obama has definitely gone back on a lot of promises, but name me a politician who kept all of his campaign promises. That is politics, and while it sucks that is what anyone who wants to be an elected official in this country has to do. You are also ignoring all of the cool stuff he has done, and the few promises he has actually stuck to. It is his first year as president and he is trying to create a public health care option. If he did not care about the American people and was only concerned with himself why would he attempt to tackle one of the most controversial issues in our society in his first year. He has also made himself a target to some of the craziest motherfuckers in this country. If he were just another politician there is no reason why he would subject himself to so much personal risk.

Exactly. Ironically, given the way he's being attacked by the crazies, he could be practicing some truly progressive policies, instead of center-right, corporatist policies that he's practicing now - while still being called a socialist/marxist, etc.
It's like these people live in some sort of a parallel universe. :shrug:

Scream socialism, when it's just the slightly improved status quo ,

Good post. :thumbsup:

As I've said many times in many previous posts, I do not and did not expect Obama to right all the wrongs in his first 60 days or even first six months. it's not that he hasn't done ANYTHING. It's that too much of what he has done has gone counter to many of his promises.

As I wrote -- Don't Ask, Don't Tell is still in place. No change there.

The tax structure hasn't changed. The rich are still getting huge breaks and the vast majority of the rest of America -- the very people who made Barack Obama the first African-American president -- are getting poorer and poorer and poorer.

Wall Street hasn't changed, not one bit. As I posted back on 11/25/09, Obama installed an economic team with strong, strong, almost unbreakable ties to Wall Street. Geithner and Summers and Rubin, oh my! The voices of dissent were kept quiet.

The former administration has not been held accountable for one single thing. There's this whole looking forward bullshit while the KBR and the Blackwater contracts get renewed and the wiretaps go on and the torture and the killing and the bombing and none of it undoes 9/11/01.

So what HAS he done? A few mortgages have been restructured allowing a few thousand -- maybe -- families to work out deals to keep their homes. But the banks are still charging usurious interest rates on credit cards and gouging people with horrendous late fees and overdraft fees and everything else they can think of because they were given a long lead time on the implementation of curbs to that kind of predation. The global gag order was lifted, allowing federal funds to go to organizations overseas that might offer family planning information and birth control devices and medications and even abortion counseling. And there's some kind of dialogue beginning with Iran and North Korea, and there's a new tariff on tires from China. Cubans can get more visits from their family members in the US and the families can send more money to the Cubans.

We haven't seen a national energy policy.

Health care is just now getting an airing and it doesn't look good.

Looks like we'll get a speech on the banking situation, but I haven't heard any proposals to actually DO anything.

There's an old joke called The Two Envelopes --

A guy gets hired for a new job and his new boss shows him to his office and his desk. He sits down and as soon as he's alone he opens the top drawer. He's not surprised to see the usual pencils and pens and paper clips, but he's intrigued by the two white envelopes sitting side by side in the middle of the draw. One is marked in bold black marker "#1" and the other likewise is "#2."

He takes out the envelop labeled #1 and opens it. Inside he finds a sheet of paper on which is written a short note:

To my replacement:

I know you're going to have a rough time; I left things kind of in a mess. That's why they got rid of me and hired you. So if you have problems getting things straightened out, feel free to put the blame on me. I'm not here to defend myself.

But if after a few months that doesn't work, well, open the other envelope.

Well, as it turns out the new job is harder than the guy expected, because his predecessor really had screwed things up, but he found that it was very easy to blame the other guy when he made his own mistakes. In fact, it was too easy. More and more often he found himself saying, "I didn't do it; the guy who was here before me messed it up," regardless what "it" was.

But after a while, people he worked with, especially his boss, stopped buying that excuse. The problem was, he hadn't taken the time to really learn the job, and now that he was six months into it, the problems seemed insurmountable. Finally one afternoon he sneaked into his office and shut the door. Quietly, afraid someone would come in and find out what he was doing, he opened the middle drawer and looked at that second envelop.

"It's been six months," he said to the spirit of his departed predecessor. "I sure hope you left me the solution to this mess."

He opened the envelope and found, as with the first, just a single piece of paper. This time, however, the message was shorter. Just three words were written:

"Prepare two envelopes."

We survived, barely, eight years of a president who thought he could learn the job on the job. We thought Obama was going to be different. Maybe if he'd actually start DOING the job and not just talking about it, we could find out.



Tansy Gold

K&R for the truth in the OP, too.

number 5 (or one any way!) thanks for posting this!

"Isn't it time to stand back and reevaluate the entire process?

Isn't it time to say no to more corporate welfare?

How many more bailouts can we take?" hear, hear.

bernie.

True believers choose to ignore reality. News goo at 11.