Think Progress

by Faiz Shakir, Amanda Terkel, Matt Corley, Benjamin Armbruster, Nate Carlile and Igor Volsky

Obama's Health Care Presser

As Congress works to pass comprehensive health reform legislation, Republicans are trying to "slow down" the effort and mischaractarize it as a costly and ineffective endeavor that would expand government health care, take away Americans' existing coverage, ration care, and contribute to run-away government spending. Yesterday, President Obama held a prime-time news conference to explain how middle-class families would benefit from health care reform. "This is not just about the 47 million Americans who have no health insurance," Obama said. "Reform is about every American who has ever feared that they may lose their coverage if they become too sick, or lose their job, or change their job. It's about every small business that has been forced to lay off employees or cut back on their coverage because it became too expensive. And it's about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid." As CAPAF Senior Fellow Elizabeth Edwards observed, "14,000 Americans every single day lose their health insurance. If you talk about the time between the first of August and Labor Day, we're talking about a half a million Americans are going to lose their health insurance coverage. ... Maybe it's not a rush for those men in suits...they all have health insurance, it's not an issue for them. But I think that people like Sen. DeMint, who's going to go back to South Carolina and find out that when he's trying to create a Waterloo for the  President, a political tactic, that he's going to find out that there are a lot of Waterloos going on in South Carolina with families who are facing real crisis because we have not addressed this health insurance issue and quickly and effectively as we could."

AFFORDABLE HEALTH REFORM: While critics have charged that health reform would add to the budget deficit and drive up long-term spending, Obama reiterated his pledge that "health insurance reform will not add to our deficit over the next decade." He insisted that health care reform "must also slow the growth of health care costs in the long term" and proposed creating an independent commission, modeled largely on Medicare Payment Advisory Commission (MedPAC) that would "eliminate waste and inefficiency in Medicare on an annual basis," begin changing incentives in the health care system, and start rewarding providers for improving patient outcomes and delivering quality care. Every year, MedPAC -- an independent agency advising Congress on issues affecting Medicare -- publishes two reports chock-full of the kind of payment reform that could transform the health care system, from incentivizing quantity to quality and value of care. Every year, however, Congress ignores them. By giving a MedPAC-like panel the power to implement the kind of payment reforms that MedPAC has always advocated, the proposal would free the panel from the constraints of congressional politics and allow it to actually influence Medicare spending patterns. The goal is to adopt reforms that slow the growth of Medicare spending and modify payment methods -- reforms that the private sector could then emulate. As Tim Foley explains, under the White House's proposal, every year the new panel would release a set of recommendations for how to best control Medicare expenditures. "The President could choose to submit all of MedPAC's recommendations as a package deal. Congress would have 30 days to intervene, but they couldn't pick and choose what proposals they like -- they could only vote up or down on the whole package." This kind of proposal provides a valuable tool to bend the cost curve.

CUTTING WASTE OUT OF THE SYSTEM: Asked if Americans "would have to give anything up in order for this [health reform] to happen," Obama replied, "They're going to have to give up paying for things that don't make them healthier...if, right now, hospitals and doctors aren't coordinating enough to have you just take one test when you come because of an illness, but instead have you take one test, then you go to another specialist, you take a second test, then you go to another specialist, you take a third test, and nobody is bothering to send the first test that you took, same test, to the next doctors, you're wasting money." Experiences at the Mayo Clinic and Geisinger health systems have shown that changing the payment system and rewarding quality care based on improved patient outcome can dramatically lower the growth of health care spending. As Obama explained, "part of what we want do is to free doctors, patients, hospitals to make decisions based on what's best for patient care. And that's the whole idea behind Mayo. That's the whole idea behind the Cleveland Clinic." The Mayo Clinic, which rewards providers for quality services and produces better outcomes at lower costs, endorsed the President's reforms after he reiterated his support for establishing a board that could develop Medicare payment reform and reward "providers who deliver quality affordable care instead of those that simply do the most procedures." "We view favorably the concept of an independent body that can move Medicare to a 'value-based payment' model.  An independent Medicare advisory commission focused on defining value, measuring it, and finding ways to pay for value could have significant, positive impact on health care for the long term," the clinic wrote on its blog.

REPUBLICANS PROPOSE DOING NOTHING: While the President and the relevant committees in the House and Senate are hard at work on health reform legislation, conservatives -- both in and out of power -- are doing everything they can to stand in the way of major reform. Last night, Congressional Republicans suggested they are not planning to fix health care through legislation. "Republicans who had promised last month to offer a healthcare reform alternative are now suggesting no such bill will be introduced," Roll Call reported. "Our bill is never going to get to the floor, so why confuse the focus?" Rep. Roy Blunt (R-MO), chair of the GOP Health Care Solutions Group, asked. "We clearly have principles; we could have language, but why start diverting attention from this really bad piece of work they've got to whatever we're offering right now?" In fact, Republicans have introduced at least four alternative proposals to allegedly expand "patient choice," "freedom," and "improve care." Generally, these alternatives claim to expand access by giving Americans a tax credit to purchase health care coverage outside of the employer based system and control health care spending by capping awards for malpractice claims, and eliminating "waste, fraud, and abuse" from the system. But a close examination of these nearly identical proposals suggests that the Republican effort would actually push Americans out of their current health insurance coverage, shift health care costs to the individual, and explode health care spending. In sum, the Republican health care alternatives fail to control costs or expand access to care for the majority of Americans.

The House might be a greater barrier to health care reform than the Senate.

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Glenn Beck likes to bring his gun to the movies.

Rep. Tim Ryan (D-OH) gets "booted" from Democrats for Life of America for advocating use of contraception.

TARP Inspector General Neil Barosky debunks his own claim that the bailout will cost taxpayers $23 trillion.  

Rep. Marsha Blackburn (R-TN) doesn't want the government "to cry 'emergency' every time we have a Katrina."

Where in the world are people watching President Obama on YouTube?

Yglesias urges time-traveling congressional Democrats from the 1970s to make a deal with Nixon.

"What [Obama] just said about the [Harvard Professor Henry Louis] Gates [Jr. arrest] case up in Cambridge, Massachusetts -- saying it was an example of profiling, basically."
-- MSNBC host Chris Matthews, 7/22/09

VERSUS

"I don't know, not having been there and not seeing all the facts, what role race played in that."
-- President Obama, 7/22/09