The President’s Speech On Health Care Reform

On September 9, President Obama gave a speech to the joint houses of Congress laying out his plan for health care reform. No matter what your personal politics, the outcome of such reform regulation is going to affect us all. With that in mind, we thought it would be helpful to lay out some of the basic tenets of the President’s plan, at least as it was outlined in the speech. A full transcript of the speech can be found here.

According to the President, his proposed changes will:

Photo: Whig.com

Photo: Whig.com

  • Not require the Americans who already have health insurance through their job, Medicare, Medicaid, or the VA to change the coverage or the doctor you have.
  • Make it against the law for insurance companies to deny you coverage because of a preexisting condition.
  • Make it against the law for insurance companies to drop your coverage when you get sick or “water it down when you need it the most.”
  • Prevent insurance companies from placing an arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime.
  • Place  a limit on how much you can be charged for out-of-pocket expenses
  • Require insurance companies to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies.
  • Creating a new insurance exchange, “a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices.”
  • Provide tax credits, the size of which will be based on need for those individuals and small businesses who can’t afford the lower-priced insurance available in the exchange.
  • Immediately offer low-cost coverage to Americans who can’t get insurance today because they have preexisting medical conditions, in order to protect them against financial ruin if they become seriously ill.
  • Require individuals to carry basic health insurance.
  • Require businesses to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still can’t afford coverage, and 95 percent of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.
  • Not insure illegal immigrants.
  • Have no “panels of bureaucrats with the power to kill off senior citizens.”
  • Use no federal dollars to fund abortions, and federal conscience laws will remain in place.
  • Create a not-for-profit public option available in the insurance exchange that is only an option for those who don’t have insurance.
  • Have a public insurance option that is not funded by the tax-payers, but is instead self-sufficient and rely on the premiums it collects.
  • Not add anything to the national deficit. There will be a provision in this plan that requires Congress to come forward with more spending cuts if the savings they promised don’t materialize.
  • Cost around $900 billion over 10 years, that will be paid for by finding savings within the existing health care system, and using revenues from drug and insurance companies.
  • Charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money.
  • Protect Medicare. The Medicare trust fund will be used to pay for this plan.
  • Create an independent commission of doctors and medical experts charged with identifying more in the health care system.
  • Reform current medical malpractice regulations.

So what did you think of the speech? Do you think all these goals are realistic or realizable. What would your ideal health care system entail. All comments are welcome

37 Comments

  1. Michelle
    Posted September 11, 2009 at 12:42 pm | Permalink

    I appreciate our President’s valiant effort at this crucial time. I believe that many of these changes are necessary to ensure Americans have health coverage. But, with all due respect to the President and members of Congress, this seems more like health insurance reform, not health care reform. Under this plan, the structure of medical billing and health care administration will not be altered.

    As healthy 26-year old who was denied health insurance due to a pre-existing condition which poses no immediate threat to my health, I am pleased to see that this will no longer be an obstacle for those who wish to obtain health insurance. However, if the structure of our health care system is not altered, I believe medical costs will continue to rise as our country strives to stay at the forefront of technology in medicine.

    Overall I thought President Obama’s speech was well-delivered, respectful, and adequately addressed the concerns of many Americans.

  2. Kiran Sreenivas
    Posted September 12, 2009 at 12:22 am | Permalink

    As for Obama’s recent speech, I felt that nothing novel was stated. I felt like it was more about clearing up some misunderstandings (e.g. the death panels), calming fears (e.g. people’s current insurance won’t change), and creating momentum for a final push. With that said, I think those three things needed to be articulated and that Obama did a good job of accomplishing this.

    As for the actual reform ideas, I approve of Obama’s approach to reform as much as I condone the actual proposals. One of the biggest challenges with making health care form in the U.S. is coming up with a plan that appeases all of the stakeholders. Insurance companies, pharmaceutical companies, hospitals, doctors, and patients have competing interests. No reform can be a ‘complete win’ for any of these stakeholders. There has to be compromise. Obama did a good job of bringing these stakeholders to the table early on to have their voices in the reform process. One of the downfalls of Hillary Clinton’s health care reform proposal, when she was the First Lady, was that she came up with a plan without limited to little input from various stakeholders. Therefore, once her plan was revealed there was too much opposition to be overcome.

    Another aspect of health care reform that I think needs to be understood by everybody is that real health reform is a continuous process that takes time. A perfect example of this is French health care reform. In the beginning, workers and employers would contribute to health insurance funds. This only guaranteed health insurance to workers. Eventually, self-employed workers were allowed to contribute and take part in a health insurance fund. In 2000 every citizen, regardless of whether or not they could contribute to a fund or had a job, was guaranteed health insurance. In addition to universal health coverage, the French system was ranked number one in the world by the World Health Organization in 2000 showing that gradual reform can be effective. Overall, I feel like Obama understands this notion of gradual reform. He has used semantics to rephrase ‘health care reform’ as ‘health insurance reform’ to assure people that change will not be drastic. He also continues to mention the idea of creating an independent commission of doctors and medical experts. This is based off the idea of health boards that former Senator Tom Daschel discusses in his book (Critical: What We Can Do About the Health-Care Crisis), which is something I support. This independent commission can continually work to improve health care by gathering data on effective medical practices and giving recommendations that can have some weight if various stakeholders are part of the commission. One thing Obama said that rubbed me the wrong way was his remark that he hopes to be the last President to take on the cause of health reform. Even though I believe health reform should be continuous, I understand Obama not wanting to give the people the notion that this current debate will be never-ending. Politicians and the public might lose the sense of urgency and their interest in the matter if they thought no end was in sight.

    Determining how much change would be tolerable at this point in time is difficult. It is fairly obvious that jumping to a single payer system would be too drastic. Passing reform that prevents insurance companies from dropping individuals or denying individuals for pre-existing conditions is a good start. As for guaranteeing more individuals health insurance, a public option should help accomplish this. While I have no qualms with a public option, I can respect the worries others have that it would kill competition and be the beginning of complete government control of health care. This is why I think the idea of having a ‘trigger’ for the creation of a public option may not be that bad. We can try to use subsidies and other tax benefits to help people afford a health plan with a private not-for-profit insurance company. If this does not help insure a certain number of people, a public option could be created.

    I am optimistic that in the end reform will be passed that will be a step in the right direction. I just don’t know how big a step it will be.

  3. Posted September 12, 2009 at 10:31 am | Permalink

    I think these six ideas are crucial for the ordinary man.

    # Not require the Americans who already have health insurance through their job, Medicare, Medicaid, or the VA to change the coverage or the doctor you have.
    # Make it against the law for insurance companies to deny you coverage because of a preexisting condition.
    # Make it against the law for insurance companies to drop your coverage when you get sick or “water it down when you need it the most.”
    # Prevent insurance companies from placing an arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime.
    # Place a limit on how much you can be charged for out-of-pocket expenses
    # Require insurance companies to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies.

  4. SBG
    Posted September 17, 2009 at 10:48 am | Permalink

    Hi Mark, your 6 ideas are great; however, you seem to only fault the insurance companies. Health insurance is heavily regulated at the state level. Some states require insurance plans to cover certain types of health care providers or provide certain types of health benefits. Other state regula­tions affect the rating rules for insurance or the ability of insurance plans to exclude people from coverage. The impact varies from state to state depending on the specific regulations. In some states, regulations make it impossible for individu­als to purchase a low-cost plan that would provide only catastrophic coverage. In other cases, the ben­efit mandates and insurance rules might raise pre­miums to the point that insurance is prohibitively costly for many people.

    The economic impact of state-level health insur­ance regulations has generally received little ana­lytic attention from both the academy and the broader health policy community. A more detailed analysis of this topic might provide insights into how to lower insurance costs and provide bet­ter health care coverage for more Americans.

  5. sharon
    Posted September 17, 2009 at 4:28 pm | Permalink

    Overall, most of President Obama’s ideas are sound and well overdue. My biggest concern is that he is trying to move too quickly, with too many changes. People who are currently happy with their health plans may feel threatened and are vulnerable to misinformation. Politicians, unfortunately, have to worry about appeasing their electorate for the next election.

    Let hope we all remember the bottom line: as a nation, we have the most expensive health care system in the world, but our health status is only 17th among the industrial countries. Something is terribly wrong with this picture.

  6. Candace Tingen
    Posted September 21, 2009 at 2:22 pm | Permalink

    I agree with Kiran that everyone can’t be appeased by any one plan. Honestly, as long as I’m allowed my honest opinion, I wish the president would stop trying to be bipartisan and just push the plan through with his democratic majority. The longer this debate continues (and let’s be honest, they could keep arguing for a decade), the more bills will languish without being voted on, and the more we’ll end up paying our politicians to accomplish nothing. The legislative year ends just before Christmas, I’d really like to see *something* passed by then.

  7. Posted November 29, 2009 at 8:42 am | Permalink

    This would be all well and good if we were looking at a move towards genuine reform of the health insurance system but the reality is that this is simply another example of politics at its very worst.

    None of us know what the final bill is going to look like or even if a bill will be passed at all. What is certain however is that it will not be in the best interests of the American citizen but in the best interest of a group of politicians.

  8. Posted December 8, 2009 at 11:32 pm | Permalink

    Politics aside, I do believe that there is a need for reform, but I believe the best start to reform is to take care of the fraud and waste issues inside of Medicare, Medicaid, SS. I believe by doing that all of our rates would go down, and believe it would make SS, Medicare, Medicaid viable again.

  9. Posted December 15, 2009 at 3:43 pm | Permalink

    I am from Europe so maybe I dont know situation in USA very well, but I think that something must be changed.

  10. Posted January 3, 2010 at 8:32 am | Permalink

    I,m Italian and i think that USA must choose a public Health insurance solution.

  11. Posted January 16, 2010 at 5:23 pm | Permalink

    I would like to know where the money is going to come from to pay for Obama’s ambitions. Because the dollar sure as heck isn’t worth a dollar anymore.

  12. Nell
    Posted July 11, 2010 at 1:11 pm | Permalink

    Deciding how much change would be doable at this time would be difficult. It is obvious that changing to a single payer system might be overly drastic. Passing changes that prevent insurers from dropping individuals or denying individuals for pre-existing conditions is a great start. And guaranteeing more individuals health insurance, in public options would help make this happen. While I have no issues with a public option, I can respect the problems others have that it would hurt competition and be the beginning of total government control of health care. That is why I think the idea of having a factor for the creation of a public option wouldn’t be that bad. We can use subsidies and other tax benefits to help people afford a health plan with a private not-for-profit insurance company. If this does not help insure a certain number of people, a public option could be created.

  13. Brian Willie, Orange County Estate Planning Lawyer
    Posted August 3, 2010 at 10:24 pm | Permalink

    I think it’s a great start towards healthcare reform, I just think that we are focused on the wrong issues. Healthcare insurance is not a fundamental right. Access to healthcare is already provided, many times free of charge at certain emergency rooms.

  14. David Forbes Medicare Advisor
    Posted August 5, 2010 at 11:30 pm | Permalink

    Reform is badly needed. Costs are out of control and too many citizens are going without coverage. My concern will be that insurance companies will try to find loop holes. As an example, several major companies announced that they would not sell “child only policies”, this is designed to avoid the guaranteed issue of children. They will accept them if they are part of a family unit, but not by themselves.

  15. Todd Hutcheson
    Posted August 28, 2010 at 3:27 pm | Permalink

    Most of the reform platform sounds great. Unfortunately, I have two major problems with it.
    1. You are penalized on your taxes if you elect not to have insurance.
    2. All the major unfunded mandates that will be caused by this legislation.
    President Obama wants us to trust him on this issue and I do not.

  16. Elaine
    Posted September 21, 2010 at 8:46 am | Permalink

    The reform is needed but not sure this is the right answer. Many families do not have the funds to obtain a policy. To penalize them on their taxes for not having insurance will probably create other problems and not solve anything.

  17. Pamela, Tyler Real Estate
    Posted October 18, 2010 at 12:37 pm | Permalink

    The reforms Obama referred to are terrific, except I don’t think insurance can be forced on people. And, I am concerned about costs.

  18. Roy Innella
    Posted November 1, 2010 at 12:41 pm | Permalink

    I agree with Todd above:
    “Most of the reform platform sounds great. Unfortunately, I have two major problems with it.
    1. You are penalized on your taxes if you elect not to have insurance.
    2. All the major unfunded mandates that will be caused by this legislation.
    President Obama wants us to trust him on this issue and I do not.”

    How can you trust what you don’t know about.

  19. Curtis Johnson Realty
    Posted December 27, 2010 at 8:01 am | Permalink

    Informative blog! I enjoyed reading all response. I would also agree with Todd.

  20. Medical Billing and Coding Salary
    Posted February 5, 2011 at 11:01 am | Permalink

    I’m with Elaine. I fail to see how the federal government has any right to force its citizens to purchase anything! The commerce clause dodge is spurious, in my opinion.

  21. Homes For Sale in Deltona FL
    Posted February 11, 2011 at 8:43 am | Permalink

    Right on Todd. I’ve been doing some research on the health care policies for my company and am seriously hoping these laws are repealed. I want to offer health benefits but am afraid I either can’t afford them OR will be taxed if I don’t.

  22. Orange County Defense Attorney
    Posted February 23, 2011 at 6:56 pm | Permalink

    Fact is, if you’re tax penalized because you “don’t have insurance”, it’s only because inevitably, the public health system is going to have to absorb the costs of care for you. Makes sense to me. Are we freeloaders here, or what?

  23. medical malpractice
    Posted March 4, 2011 at 12:10 am | Permalink

    i agree with max! USA must choose a public Health insurance solution.

  24. Travel Agents in Austin
    Posted March 12, 2011 at 1:05 am | Permalink

    Debate is a wonderful thing and after all America is a democracy, but procrastinating too long about something means it will inevitably take longer to be done. The President needs to push this through.

  25. Liz
    Posted April 26, 2011 at 1:33 pm | Permalink

    I think most legislature has consequences that we can not even imagine at the begining. Of course, Pelosi’s comments indicating that the bill had to be approved to know what is inside are not very promising.

    Also, sometimes the consequences are not direct consequences but indirect consequences that we could not imagine at first.

    In England, many of the procedures needed for the elderly have a long waiting list. This can never be called death panels, but doesn’t it mean that the lives of elderly will be impacted by those huge lines?

  26. Corona Homes Craig
    Posted July 4, 2011 at 10:06 am | Permalink

    I think we need a different kind of healthcare reform. The best thing the government can do, imo, is to concentrate on the systems we already have in place. Make them better, more efficient! Let private health care continue and just get better at the medical/medicade side of things. They need to stay out of real estate and banking too…. we’ve had down markets before (about every 10 years) and we recover because they are allowed to “do what they do”/.

    If our government would stop meddling and focus on what they do best, we’d be out of this, mess already.

  27. Medical Billing Fort Lauderdale
    Posted August 7, 2011 at 8:56 pm | Permalink

    I agree. I think we need to revisit the hastily passed healthcare law. I believe that something needed to be done, but the whole thing just seemed rushed. It appears with the recent credit downgrade of the USA that we are now beginning to pay the price.

  28. Mathias
    Posted August 31, 2011 at 4:25 am | Permalink

    Im from EU (Denmark) and our health-care is totally different than the USA. Looking forward to see what way it will move in USA.

  29. Serene
    Posted September 17, 2011 at 6:41 am | Permalink

    Strange to see now 3 years later, the tone of O’s healthcare reform bill.

  30. Bill
    Posted September 27, 2011 at 8:18 am | Permalink

    I would like to know where the money will come from to pay for this. Our country is so far in debt that raising taxes on anyone may have a disastrous effect on us all.

  31. Ed Davis
    Posted October 18, 2011 at 1:01 am | Permalink

    People who say that health care insurance is socialism, I wonder if they have ever heard of social security or unemployment insurance?

  32. Chuck Sells Albany Oregon Real Estate
    Posted November 29, 2011 at 7:18 pm | Permalink

    Ed Davis wrote:
    “People who say that health care insurance is socialism, I wonder if they have ever heard of social security or unemployment insurance?”

    An excellent point! How do you draw a line between socialism and government programs designed to help people? I don’t like the idea of socialism, but there are places where the government can make improvements in people’s quality of life.

  33. Fred Myers
    Posted November 12, 2012 at 7:58 am | Permalink

    This is indeed a good news to the Americans! Hope that other President in other country will also proposed a health care reform especially for the poor who cannot afford to have life insurance, because it is really an important to our lives…

  34. jual rumah
    Posted April 3, 2013 at 1:13 am | Permalink

    change is sometimes necessary for a person

  35. Luke Gray
    Posted April 17, 2013 at 5:52 am | Permalink

    It is hard for all these conditions to exist simultaneously in the current system. I wonder if how he thinks he’ll implement them.

  36. Max
    Posted April 29, 2013 at 12:04 pm | Permalink

    I appreciate the effort taken by our President in this crucial time.
    And I feel that this changes will make sure that we Americans have proper helath coverage.
    But, I must mention this that somehow I really feel it like some health insurance rather than a helath reform.
    But, again, let me clarify this is going to be great if we are actually moving towards a real reform.

    Regars
    M

  37. gastritis diet
    Posted July 4, 2013 at 3:20 pm | Permalink

    I personally believe that every American should be covered by health insurance.

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