Finished watching and liveblogging President Obama’s address to a joint session of Congress.  It was his 29th speech on health care, and I don’t think he’s going to sway many people.  You can read the transcript here.  The White House outlines his plan here.  You can read the Republican response given by Congressman Charles Boustany, MD (R-LA) here.

Initial thoughts – way too long.  Highly partisan, kept up the same mantra of blaming Bush, but somehow forgets we also had a Democratic Congress involved in spending prior to his administration.  I also don’t think he was nearly specific enough about how he would cut spending, and frankly, saying he wouldn’t add to the deficit was just plan laughable.  Threatening to call out people “if they misrepresent what is in the plan” (point out problems he glosses over) makes me wonder, exactly how will he go about that?  Also, isn’t that what they are doing to him?  Pointing out problems?

He brings up an individual mandate and said that everyone must have some type of medical insurance.  He likened it to how we are required to carry auto insurance.  Here’s the problem with making that correlation – the standard is carrying at least a certain amount of liability insurance incase you hit somebody else.  When you lack medical insurance and become ill, you aren’t liable to anyone.  You either pay up or suffer with the symptoms.  Personal responsibility.  I highly doubt it will found constitutional to force someone to have to pay for medical insurance.

He’s keeping the public option (no surprise there).  I will say I think the tax credit idea is a good one (a Republican idea), and that should be part of the health care reform bill.  I do like that he mentions waste and fraud in Medicare.  That is a huge problem.  I’m not going to hold my breath though.  He also brought up medical malpractice reform, but I will believe it when I see it.  It would be a great start in cutting costs, but it won’t pay for the whole thing.  What he does is far more important than what he says.

If he is serious about abortion not being paid for within the bill, or that rationing would not exist (nobody is saying the government will go in “and pull the plug”) then I expect him to be in favor of language in the bill that states clearly, specifically just that.  He also didn’t say he wouldn’t raise taxes, I’d like to see that promise.  Also one obvious way to address the problem of only being able to choose between a handful of health insurance companies in different states is to allow people to shop across state lines.  That would just make sense right?

Also, I can understand a nod to the late Senator Kennedy, but I thought how he went on and on and with Vice President Biden tearing up in the background (I’m not questioning the authenticity of his tears, I know they were friends) just struck me as manipulative.  Way over done.

The Center for Health Transformation gives a 10-point checklist by which you can grade the President.  What grade would you give him?  You can also grade him here.

Reactions: (HT: Memeorandum)

The good:

The bad:

The ugly:

21 comments
  1. Lying is pointing out problems? IS Obama advocating we have a Universal Healthcare System like Canada? Is that what you heard him say tonight? Rush, Beck & Hannity are saying he is! That is lying!
    I liked the part that I heard. I like that he confronts misrepresentations head on….I like people that “tell it like it is!” There WAS NOT a Death Panel in that bill. The words were twisted to make it appear that is what it was talking about! Hospice doesn’t do anything different when they talk to people coming into their system that have a short time to live. Telling them the options available to them!

    1. @Don, Don, you’ve drunk the kool aid. No the bill doesn’t make any mention of “death panel,” but there is rationing. There already is with medicare, there is in the VA system, there is in the Canadian system, and with the British. It’s happening in Oregon. To think there’s not going to be is foolish. Who will decide what gets paid for?

      Hospice doing it is fine, I have no problem with that my grandmother was in hospice before she passed. I have a problem with the government involvement with the process – which the Senate Finance Committee said the language in Section 1233 in HR 3200 was going to be cleaned up. Why do that if there wasn’t a problem? Was this some nefarious plot? No, but I think it was a collective think tank idiocy as a result of rushing to fix a problem that took us years to get into. Call in unintended consequences if you like.

      Palin (and she wasn’t the first to point that out) did plenty of research into this and it wasn’t what Beck or Hannity said. That this bill will pay for abortion – no abortion isn’t mentioned, but there isn’t language in the bill either. His comment about illegals not being covered, well I’ll believe it when I see it. At least he didn’t include their number in the figure he used for those who are uninsured. He did before to inflate the number.

      I guess you neglected to see what I was glad to see in the speech. Now we’ll see what the House Democrats actually do. Frankly he’s in a corner on this so he has to make concessions, otherwise I think he’d ramrod what he wants through.

      I just reread my post and I didn’t say anything about Canada in the post did I? No. If you read his plan he’s still in for a government option, and I don’t want health care like Massachusetts either. A Government option with crippling regulations on private insurers could end up ruining the system, ergo we have a problem. It may not end up like Canada, but it won’t be good.

  2. One has to wonder how many people really believe what Obama is saying. I have seen several staunch dems who simply can’t defend the assertion that any of this reform can be paid for by making Medicare and other programs more efficient. It’s a laughable concept, especially considering that these are ALREADY government run programs. Who in the world really thinks that they are suddenly going to become efficient and begin saving us hundreds of millions of dollars? How this guy even gets away with saying something like that without getting laughed off the podium is beyond me.

  3. IF you don’t think there is fraud and inefficiency in our present “perfect” American System…..maybe you’ve been drinking some kind of “kool aid” too! 🙂 A woman called in on Limbaugh’s program yesterday saying insurance was going to pay $259 for an x-ray on her toe….she called around and was able to pay $20 (more than her copay) to get it done! I have had prescriptions where it was cheaper to pay for it myself than use the present “perfect” American System. btw, I’m not using that term because you used but because it seems most everyone on the right thinks our present system is perfect. Except for the ones run by the Government. After all the present American System IS the one managed by Insurance Companies & the Healthcare Industry & Drug Companies. Seems everyone can get drugs cheaper anywhere except the U.S…….still we want to believe that everything is perfect the way it is? I believe that IF we could eliminate all this bloated system….costs could be lowered dramatically. It is no wonder these 3 entities are fighting against this tooth and nail. They no doubt see Universal Healthcare as the next step on this process. Lets not forget that “The love of money is the root of all evil.”

    1. @Don, I don’t think you’ll ever read any of my posts and see that I think our system is perfect. I even say we do need reform. Let’s make sure the solution doesn’t end up being worse than the problem.

      I say… scrap current bills, at least the one we’ve seen – HR 3200, and do over.

      I think the Center for Health Transformation has some excellent ideas. I am encouraged that tort reform, tax credits, and addressing waste & fraud in medicaid. All good. Would he have been open to any of this prior to August? I doubt it. I would also like to see details on those items as well, but I know it is something that conservatives can work with him on.

      You know you put on your Facebook profile that you are “mostly conservative and libertarian,” his plan is neither conservative or libertarian, nor do I think it’s necessarily taking the moral high ground as those on the religious left seem to imply.

      There were areas where he flat out lied.

      1. Abortion – unless the bill specifically bans it, it will be provided for.
      2. Illegal immigration – the voters of California passed a referendum trying to ban social services for illegals. It was struck down in federal court and the U.S. Supreme Court refused to hear the case. Ergo, social services provided for citizens have to be available for everybody.
      3. Not raising the deficit – CBO disagrees
      4. We can argue about health care rationing… he in his speech talks of the council who will decide on costs, waste, etc. (don’t remember his exact words), what do you think that will lead to?

  4. The most ridiculous thing that I heard in the speech yesterday was that the program wouldn’t increase the deficit by a dime ( I laughed – because of course it will increase it by billions) and that Government would generate savings by reducing waste and increasing efficiency! Pffft! WHEN has it EVER done that?!? Our Govt. has run on a “Fat-Cat/Pork Barrel” mentality for decades! The only way I have seen them cut costs is by CUTTING SERVICES which equals lower quality of care!

    Someone in Govt. has to rethink the whole Health care delivery system and get a new idea that is really based more on the old “doctor visits the patient and patient pays out of pocket idea”- there has to be a current , healthy version of this. When I lived in a small town in New Hampshire, my doctor was like this, and I can honestlysay that was the best care I have had!

    1. @laraffinee, They really need to be looking at implementing measures that would lower health care costs. Preventative medicine, tort reform, etc.

      Health Savings Accounts would be an excellent idea for out-of-pocket expenses. There are a lot of ideas out there that need to be explored before we jump to the government option.

  5. Shane, I think you are pointing out what I fear about this plan: there has been nothing said about how it will be paid for except the mention of controlling costs–that must bring in the option of refusing to care for some patients, yet there doesn’t seem to be any written provisions protecting a person’s right to be treated through a program that they will be paying for. There is no language that guarantees that fines or other punishments will not be implemented that would drive private insurers out of business. (Remember when the Federal speed limit was 55? States were told that they didn’t have to change their interstate limits, but if they didn’t they would forfeit Federal aid for infrastructure repair.)
    I am concerned that there is no language (please correct me if I’m wrong) that would guarantee that I, as a 60-something, or my mother-in-law at 80-something, would not be denied treatment because we’re too old to contribute the cost back to society by our existence. There is just too much not said in this already megabill about guaranteeing quality and cost, without implementing punishing taxes and fines.
    I do think we need to fix some things in this country’s medical system. My husband and I, until last month, were paying over $1,000/month for coverage and it was increasing at least twice a year. (Uninsured people are not always uncovered by choice.) But, our president’s plan is just too unclear at this point for me to support. I think anyone who blindly wants this thing passed “so we can adjust it later” is living in la la land. We need to get it right before passage.
    Personally I think that three simple actions would pretty much fix the problems in the current system–one: require insurance companies to cover everyone regardless of current health; two: limit the premiums companies could charge to something affordable, and provide vouchers for the poor to help pay premiums; three: get the litigation-happy lawyers under control when it comes to malpractice suits.
    To me, these solutions make a lot more sense than destroying the best system in the world just to try to copy what we know doesn’t work.

    1. @sue, actually ‘action one’ is part of what Obama outlined. Everyone needs to be ‘in the pool’. ‘Action two’ cannot be accomplished without substantial reform, competition and changes in the way health care is delivered but it is related to the public option and insurance exchange ideas Obama outlined. Obama is also pushing, in a separate bill, for the transition to online medical recordkeeping (another cost-saving & efficiency measure), and that is being funded. ‘Action three’ was mentioned by Obama. Many have doubts about how far the last will go but Democrats will not always control the legislative and executive branches. If not fixed now, that could be addressed in the future.

  6. Shane, thanks for your reply. My only addition would be that I doubt that my idea of “in the pool” would be accomplished in the same way by our president. Also, I’m afraid that I sense from this president that everything he wants, or the Democrats want, will be accomplished by a huge government stick rather than a carrot (positive incentives) approach which I would far prefer. I reject, as do most, a total government takeover of our way of life.
    Last night, President Obama seemed to lack any sense of the public outrage that exists. It’s like he is blind to any view but his own. I think that his attitude is really starting to sink in around the country, even to those who voted for him. I’m 61 and I don’t ever remember a president with such arrogance. It’s a little scary.

    1. @sue, good points.

      One question: I don’t know what you have in mind when you mention ‘pools’. For example, what is the ideal compostion of a pool?

      Ideally, the pool for the insurance would cover everyone. Currently companies try to be selective about who they cover and how they group people by expense and pre-existing conditions. Consequently, the expensive clients get booted from the company’s coverage and somebody else (like taxpayers after the patient files for personal bankruptcy) pick up the tab. Still, it doesn’t have to be this way. Instead, insurance companies would compete on the basis of how well they manage costs across the entire demographic — No splitting, no rescission and no cherry-picking: One big pool.

      If you’d like to know more about the plan, the one that passed in the House is online. Given the rhetoric on all sides, I think it’s probably best to examine the source document. Mind you, the House version is not the final bill, and there is probably going to be many revisions. The Senate will likely pass a separate version in a few months and then the two versions have to be reconciled before voting on the final version. I can provide a link the current House document if you’d like.

  7. Shane, in a perfect world (or perfect Congress) every bill would start out perfect. All the rest need a starting point so everything can be discussed. I believe Obama is open to a discussion but it has to be about Insurance.
    Sue, you said, “Last night, President Obama seemed to lack any sense of the public outrage that exists. It’s like he is blind to any view but his own.” The reason is that the “public outrage” is based on the lie that Congress is considering Universal Healthcare. While that may be what Obama & the Dems will propose next…..it hasn’t been talked about yet. Comparing Bill 3200 to what Canada has is a smokecreen….red herring being put out there by all the right wing talking heads.

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