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Kai Ryssdal: I know I have said this before, but this time I think I really mean it. The end of the health care debate may finally be upon us. The president is certainly ready for it to be over with. To that end he put on the full bully-pulpit press in the East Room of the White House today. The formal unveiling of his overhaul proposal. We've got our health desk reporter Gregory Warner on the line from WHYY in Philadelphia with us. Hi, Gregory.
GREGORY WARNER: Hello, Kai.
RYSSDAL: I was watching the president today, as I know you were, it seemed like a lot of familiar ground that he covered.
WARNER: This is pretty much what we saw in the Senate bill. We have coverage of 31 million people, a system of government-run exchanges where people could buy insurance. There are some new things in the president's plan that he didn't mention in this speech, but he talked about in a letter to Congress last night. One is he's going to do more to go after Medicare fraud. Also, he's looking at increasing Medicaid payments to doctors. Thirdly, he's going to make health savings accounts more accessible. And these are these tax-sheltered accounts for people to put money away to pay for their own health care.
And finally, he's going to get more aggressive around malpractice reform. And I should just mention that this is not what the Republicans have been calling for, with capping rewards the juries can give in malpractice cases, but rather setting up specialized courts to just take the whole thing out of the legal system.
RYSSDAL: Can't talk the economics of health care policy without talking the politics of health care policy, so anything in there that's going to change votes on either side?
WARNER: Well look, the president has gone after health insurance executives and skyrocketing costs of premiums. That's certainly popular on both sides of the aisle. And to hold down premiums, it's pretty much agreed by economists that you've got to get more healthy people into the pool of people being covered. That's just the way insurance works. And right now the opposite is happening where people are getting priced out of the system. So the president's plan has this mandate that every American buy insurance, and it gives them subsidies. This is this middle-class tax credit he's talking about to do so. What Republicans say, and have been saying, is that this just brings more people into a broken system, and it does not address the problem of the cost of care.
RYSSDAL: But the president said specifically today my plan is paid for. How is he going to take care of the costs?
WARNER: Well right. Because when we talk about costs, we're really talking about two things. One is the cost that is wrapped up with access. If someone walks into an emergency room, and they don't have insurance, the cost of treating them goes somewhere. Hospitals are going to shift that cost to private insurers or increasingly the government, which now pays for half of all health care costs in this country. So what the president is going to argue is well, we're paying either way. But there's another cost, which is the complexity of the system. And this incentive-based system that rewards more tests, more treatments and not much is being done about that at all.
RYSSDAL: Briefly, Gregory, what happens now? Where do we go in Congress?
WARNER: Well, since Republicans are firmly against the plan, and Democrats don't have a 60-vote majority they'd need, the only plan in place is a parliamentary procedure called reconciliation. And that's basically you can filibuster a bill, but you can't filibuster a bill if it affects the federal budget, and so congressional Democrats would make that argument about health care that they can use this parliamentary procedure.
RYSSDAL: Gregory Warner, at the Marketplace Health Desk at WHYY in Philadelphia. Thanks a lot.
WARNER: Thanks, Kai.