Obama stumps for health care reform

Published 5:33 am Thursday, July 23, 2009

WASHINGTON — President Obama, confronted by increasing doubts about the impact of widespread changes to the nation’s health-care system, sought to assure middle-class Americans on Wednesday that the landmark legislation he envisions would improve their quality of life and is essential to curing the nation’s economic ills.

“This is not just about 47 million Americans who have no health insurance,” he said in a televised news conference, the fourth of his presidency. “Reform is about every American who has ever feared that they may lose their coverage.”

Six months after his inauguration, Obama finds his signature domestic issue stalled on Capitol Hill. Shortly before he spoke Wednesday, Democratic leaders in Congress acknowledged that they are still struggling to agree on legislation that is expected to cost at least $1 trillion over the next decade.

With his ambitious timetable for legislative action in jeopardy, Obama took to the airwaves to repeat his case that comprehensive health-care reform is critical to the nation’s overall economic well-being.

“That is why I’ve said that even as we rescue this economy from a full-blown crisis, we must rebuild it stronger than before,” he said. “And health insurance reform is central to that effort.”

Polls show unease

Polls show that most Americans believe there is a need to improve a system that is among the costliest and least effective in the world, but there is widespread unease about how the changes might affect those who are generally satisfied with their care. Obama attempted to shift the discussion Wednesday from legislative haggling to an appeal to Americans’ everyday lives.

“I realize that with all the charges and criticisms being thrown around in Washington, many Americans may be wondering, ‘What’s in this for me? How does my family stand to benefit from health insurance reform?’ “ he said in setting the theme of his speech. “Tonight I want to answer those questions.”

Specifically, he promised that almost every American would benefit from a system that provides “more security and more stability.” He pledged insurance market changes that would enable nearly all Americans to obtain coverage and suggested that everyone would be guaranteed preventive care, such as checkups and mammograms.

In an interview with The Washington Post’s editorial page editor earlier in the day, he also said that meaningful reform must tackle the twin challenges of covering the uninsured and containing skyrocketing medical costs.

“I think that it’s important to do both,” he said. “I think it’s important for us to make sure that 46 million people who don’t have health insurance get it. And I think it’s important for us to bend the cost curve, separate and apart from coverage issues.”

Obama suggested that the legislation would reduce overall health costs by eliminating expensive and unnecessary duplication and arming doctors and patients with information “about what works and what doesn’t.” As he put it: “Why would we want to pay for things that don’t work?”

As his fellow Democrats on Capitol Hill wrestled with intraparty divisions over the legislative details, Obama took up the partisan battle with Republicans who have battered the legislation’s costs and have suggested that Democrats are attempting to rush its passage.

“I understand how easy it is for this town to become consumed in the game of politics, to turn every issue into a running tally of who’s up and who’s down,” he said.

The battle, he argued, is not about politics, but the people who write him letters and show up at town-hall meetings fretting about their medical care.

“This debate is not a game for these Americans, and they cannot afford to wait for reform any longer,” he said. “They are counting on us to get this done. They are looking to us for leadership.”

Quick action

From the outset of his presidency, Obama has pressed for quick action on legislation that extends health insurance to the vast majority of Americans, raises the quality of care nationwide and clamps down on cost increases that he has described as “unsustainable.” He has demanded votes on the House and Senate floor before the August recess.

On Capitol Hill, House Speaker Nancy Pelosi, D-Calif., expressed confidence she will have the votes to pass a health bill. But she declined to commit to meeting Obama’s goal of completing floor action before the House breaks on July 31 as she attempts to tamp down a series of brush fires within her own diverse Democratic caucus that have slowed the legislation’s progress. She said House members are watching for a clear indication of what the Senate’s bill will look like.

“We are hoping that in the next day or so that we will see,” she said.

In recent days, the House has become bogged down in negotiations, with several factions inside the Democratic caucus unhappy with the 1,000-page bill drafted by three committee chairmen.

“I think the speaker was well intentioned because she was hearing optimistic things, but I don’t believe there are the votes on the floor as of right now,” said Rep. Baron P. Hill, Ind., a centrist Democrat.

Two House panels approved the legislation in little more than a day, but action in the Energy and Commerce Committee came to an abrupt halt when members of the conservative Blue Dog Coalition said they had the votes to defeat it. Uppermost on their agenda is the issue of long-term cost control in a health system that now consumes $1 out of every $6 spent in the nation.

Blue Dog pact

After a lengthy White House meeting Tuesday, the group said it had reached a verbal agreement to add a proposal aimed at clamping down on soaring Medicare spending. The idea is to empower a group of medical experts, called the Independent Medicare Advisory Council, to set Medicare reimbursement rates with an emphasis on rewarding doctors and hospitals that follow evidence-based guidelines and meet performance standards. If the president approved the council’s recommendations, Congress would have 30 days to reject the package.

The approach helps “to insulate Medicare policy decisions from undue political interference, while at the same time preserving a say for our democratically elected representatives,” White House budget director Peter Orszag said in a speech to the Council on Foreign Relations.

The president “will not sign a health-care reform bill unless it is deficit-neutral with hard, scorable savings over the next decade,” he added.

Republicans continued to hammer the Democratic proposals as expensive efforts to move the nation into a European-style single-payer system. “No matter how you slice it, or who the president tries to blame, he is forcing Americans into a government-run plan with a $1.6 trillion co-pay that results in higher taxes and greater debt,” said Rep. Dave Camp, Mich.