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Obama Backs Public Option, Exchanges, Cap on Out-of-pocket Costs
For the past month, Washington pundits have speculated about the specifics of healthcare reform legislation—and who will support it. With Congress coming back from its summer recess today, the answers are expected to emerge quickly on the presidential and congressional fronts.
President Obama will give a nationally televised speech on healthcare reform on Wednesday night. But on Monday afternoon, speaking to about 5,000 union members and their families at a Labor Day picnic in Cincinnati, Obama pulled the curtains back slightly on what he might be saying on Wednesday about healthcare reform.
"The debate has been good, and that’s important because we’ve got to get this right. But every debate at some point comes to an end. At some point, it’s time to decide. At some point, it’s time to act," Obama told the audience.
In particular, he saw reforms "where Americans and small businesses that are shut out of health insurance today will be able to purchase coverage at a price they can afford." This would mean the inclusion of a new health insurance exchange, which would use "competition and choice" of insurance plans "to hold down costs and help deliver them a better deal."
And it would include a public insurance option—an issue that has had a rousing effect at many congressional town hall meetings during August. "I continue to believe that a public option within that basket of insurance choices will help improve quality and bring down costs," Obama said.
But Obama reminded the crowd that lawmakers should not overlook other healthcare reform measures. This includes placing a cap on out of pocket expenses, he said, "so you don’t have to worry that a serious illness will break you and your family even if you have health insurance" and outlawing denial of coverage for those with preexisting conditions.
The Senate Finance Committee is not expected to include a public option or any government plan in its healthcare reform bill that is anticipated this week. The "gang" of six senators—three Democrats and three Republicans and led by Chairman Max Baucus (D-MT)—had been ironing out details via teleconferencing on Friday.
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John W (9/8/2009 at 3:13 PM)
While I agree with Commonfolk that meaningful tort reform should be part of the cost control effort, that issue tends to get oversimplified. 36 states, including my state of CA, already have caps on pain and suffering awards. Hasn't done much to limit malpractice insurance costs, defensive medicine or docs abandoning certain litigation-prone specialties. Also, I'd strongly disagree that reform, as proposed, wouldn't do much for "the commonfolk." It would do a world of good. The focus is on reorganizing the individual and small business health insurance marketplace into one or more exchanges, where private insurers would compete against each other (and perhaps against a non-commercial option), where individuals and small business would have the advantage of large risk pool leverage and enjoy guaranteed issue/community rating similar to large group plans. In the past three years, 73% of people who sought to purchase insurance in the individual market ended up not getting it due to denial of coverage, exorbitant premiums due to individualized underwriting or just plain non-affordability. And tens of thousands who had individual policies had them yanked just when they needed the coverage most, based on highly dubious grounds. In the individual market, one or two insurers dominate the market in 94% of 314 metro areas surveyed. The various proposals, in my opionion, represent a huge step forward in fixing what I consider to be a horrendously disreputable individual insurance industry.
Common Folk (9/8/2009 at 9:43 AM)
Healthcare reform as proposed, absent tort reform, does not afford the Common Folk any more reasonable healthcare availability or coverage than we have available today. Healthcare costs are driven by those things somewhat manageable such as lifestyle choices, and others that are less, if at all, manageable. Unfortunately lawsuits fall under the latter being predictable only to the extent that they will occur, and will do so at great expense to the Common Folk. The Administrations healthcare reform does nothing to address this, the most costly part of healthcare in America. The plan will cost much, do little, and leave us with yet another government mess to deal with in the future. Healthcare reform starts with the consumer, with our lifestyle choices and with how with choose to deal with each other. Greed and entitlement are often the key elements to driving lawsuits. Most patients, while in the pursuit of being made whole, do not seek the ridiculously high payouts demanded of insurers and providers - their attorneys do so with their sites on 30-50% and more of the take. These unjustifiably high awards do nothing to curb the incidence of malpractice and likely fuel the issue further. Humility and modesty with healthcare professionals and facilities, the patient and their families, and attorneys - that will help to usher in appropriate healthcare reform.