Obama urges action on health reform

President Barack Obama speaks alongside health care professionals about his final strategy for moving forward with health insurance reform in the East Room of the White House in Washington, D.C.


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.


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.

About the author

Gregory Warner is a senior reporter covering the economics and business of healthcare for the entire Marketplace portfolio.
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If Corporate America is truly committed to bringing down the cost of healthcare its time they faced up to their own contribution to the problem. Every important study published in the last ten years on health problems in our nation has identified excessive stress as the cause of eighty percent of all health issues. What is the source of majority of that stress? The workplace! That’s right, incompetent managers driving workers to produce more within the confines of a dysfunctional workplace contributes more to the health & lifestyle issues we face as a nation than any other cause. If we as a society attacked the root of stress in our nation, in short order we would reduce the demand on our healthcare system by eighty percent. That’s right; four fifths of our healthcare costs would melt away as people became more skilled at working together, living together and getting along with each other better. Why is no one talking about this? It’s not like we are all masters at dealing effectively with our neighbors and co-workers. We all need to work together to learn how to better work with each other to weed out this unhealthy source of stress. We’ll become a healthier nation for it.

It infuriates me beyond anything else that we are trying to "reform" health care without actually doing anything. The current plan just puts more burden on small business. If this stuff goes through my guess is we will see a drop to the rate of social security transactions or under the table wages.

We really, really have to stop the system of incentive based tests. And in fact that's all we have to do. Redefine the system by rewarding doctors for primarily for fixing and helping patients rather than ordering tests. Cut the costs of prescription drugs by allowing selected international competition and giving patients more flexibility in drug choices. Change diets in public school cafeterias. Let employers still provide health insurance but shift "health care" to individuals.

Like what if the IRS enabled FSA flex cards for tax returns? All you have to do is a w2 and you can decide how much money you put away for health care.

Bottom line, the solution to health care will not come from micromanaging politicians.

Why do Gregory Warner and other pundits assume that all “Uninsured” people are deadbeats? (I think I heard him on another public radio program today, 3-Mar, making the same assertion.) Or do only fools who get treated without insurance pay the resulting bills?

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