Obama focuses his health care vision

President Barack Obama told the nation and a joint session of Congress that he is in favor of a public health insurance option that would provide competition and coverage only for those citizens without health insurance and that the $900 billion price tag for reform would be paid for from waste and fraud in the Medicaid programs.

After months of partisan bickering between senators, representatives and citizens at town hall meetings, Obama finally came forward and took ownership of the health care reform that would affect one-sixth of the nation’s gross national product. He also called on both sides of the aisle to stop the bickering.

“Now is the season for action,” Obama said. “Now is the time to deliver on health care.”

He said health care reform is necessary to save the nation’s economy and to fulfill three, important goals: to provide security and stability to those who already have health insurance; to provide insurance to those who don’t have coverage; and to slow the growth of health care costs for American families, businesses and the government.

Obama promised that Americans with insurance will not have to change their coverage or doctors under any health care reform bill that he signs. He added that it would be against the law to deny coverage due to pre-existing conditions, to drop a patient’s coverage, to cap coverage limits  and to limit out-of-pocket expenses. His vision for reform, he said, would require insurance companies to provide coverage of routine checkups and preventative care, such as mammograms and prostate exams.

For those without insurance, Obama said an insurance exchange would be created to allow those without coverage to shop for the best competitive price. Insurance companies would win in this exchange since it would bring millions of new customers to the table, which in turn would lower premium prices.

Sen. John McCain (R-AZ) proposed a plan during the 2008 presidential campaign that would provide for immediate government low-cost coverage for those who absolutely could not afford or obtain coverage. Obama offered a bipartisan olive branch by endorsing McCain’s plan in his speech Wednesday night.

He also endorsed mandatory health insurance coverage for all Americans, similar to mandatory auto insurance in many states. Individuals and businesses that refuse to purchase coverage would be penalized. He quickly added that 95 percent of small businesses would be exempt from the mandatory purchase or could offset their costs with tax credits. But he emphasized he would not tolerate irresponsible behavior that forces those with insurance to pick up the tab.

“We cannot have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees. Improving our health care system only works if everybody does their part,” he said.

Finally, Obama called the idea of “death panels” a “lie, plain and simple.” He was called a liar by Rep. Joe Wilson (R-SC) when he promised illegal immigrants would not be allowed to apply for the public option, and he vowed that “no government bureaucrat or insurance company bureaucrat will get between you and the care that you need.”

He also insisted that federal dollars would not be used for abortions under any plan he signs, and that federal conscience laws would remain in place.

The majority of health care reform would be paid for by the elimination of waste and fraud in the current Medicaid program, according to the President. He said he would also seek to create a special watchdog panel to look for waste and fraud.

“I will not sign a plan that adds one dime to our deficits — either now or in the future. Period. And to prove that I’m serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don’t materialize.”

In addition to using money found in Medicaid waste, Obama said he would encourage the overall adoption of “best practices” that are currently saving money in hospitals and medical clinics. And, he endorsed the adoption of a fee to be charged to insurance companies that sell, and individuals who buy, “Cadillac” policies.

Another nod to the Republican side of the aisle came when Obama said he is open to reforming medical malpractice laws. “Defensive medicine costs us money,” Obama said, but he did not expand on what he would consider a major reform against a large contributor to his party.

His final remarks pulled on the heartstrings of those in the chamber, by calling upon the name of recently deceased Sen. Edward M. Kennedy. He told the legislators about a letter Kennedy sent to him to be read upon his death, in which Kennedy “expressed confidence that this would be the year that health care reform — ‘that great unfinished business of our society,’  would finally pass.  ‘What we face,’ he wrote, ‘is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.'”

Rep. Charles Boustany, Jr., a cardiologist representing Louisiana, provided the Republican response to Obama’s remarks. He said the right side of the aisle wants health care reform done right, with lower costs and improved quality. He added that the Republican party was disappointed that Obama had a chance to take the “public option” off the table, but didn’t. He concluded his remarks calling for tough medical liability reforms and the implementation of intrastate purchasing of health insurance coverage.