Universal Health Care for America

[Guest Southern Pride]

Amen Brother,

Let's pass this message on by our next President, Sarah Palin.

 

Statement on the Current Health Care Debate

By Sarah Palin

 

As more Americans delve into the disturbing details of the nationalized health care plan that the current administration is rushing through Congress, our collective jaw is dropping, and we’re saying not just no, but hell no!

 

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

 

Health care by definition involves life and death decisions. Human rights and human dignity must be at the center of any health care discussion.

 

Rep. Michele Bachmann highlighted the Orwellian thinking of the president’s health care advisor, Dr. Ezekiel Emanuel, the brother of the White House chief of staff, in a floor speech to the House of Representatives. I commend her for being a voice for the most precious members of our society, our children and our seniors.

 

We must step up and engage in this most crucial debate. Nationalizing our health care system is a point of no return for government interference in the lives of its citizens. If we go down this path, there will be no turning back. Ronald Reagan once wrote, “Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth.” Let’s stop and think and make our voices heard before it’s too late.

 

- Sarah Palin

 

Rep. Bachmann's speech can be viewed here:

[Guest Orhan J Muren]

There is no "death panel" provision in the bill. That section refers to a voluntary discussion you and your doctor may have regarding a living will.

[Guest THE WHITE HOUSE]

There are quite a few “viral emails” floating around, making outlandish claims about health insurance reform and pretending to be careful analyses of the bills moving through Congress. Drafted to appear as if they are written by concerned citizens, more often the information comes from organizations with a strident agenda to protect the status quo. White House Health Reform Director Nancy-Ann DeParle takes on one of the most prevalent emails directly.

 

 

[Guest David]

8 common myths about health insurance reform

 

1.Reform will stop "rationing" - not increase it: It's a myth that reform will mean a "government takeover" of health care or lead to "rationing." To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies.

 

2.We can't afford reform: It's the status quo we can't afford. It's a myth that reform will bust the budget. To the contrary, the President has identified ways to pay for the vast majority of the up-front costs by cutting waste, fraud, and abuse within existing government health programs; ending big subsidies to insurance companies; and increasing efficiency with such steps as coordinating care and streamlining paperwork. In the long term, reform can help bring down costs that will otherwise lead to a fiscal crisis.

 

3.Reform would encourage "euthanasia": It does not. It's a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.

 

4.Vets' health care is safe and sound: It's a myth that health insurance reform will affect veterans' access to the care they get now. To the contrary, the President's budget significantly expands coverage under the VA, extending care to 500,000 more veterans who were previously excluded. The VA Healthcare system will continue to be available for all eligible veterans.

 

5.Reform will benefit small business - not burden it: It's a myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses, provide tax credits to help them pay for employee coverage and help level the playing field with big firms who pay much less to cover their employees on average.

 

6.Your Medicare is safe, and stronger with reform: It's myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform will improve the long-term financial health of Medicare, ensure better coordination, eliminate waste and unnecessary subsidies to insurance companies, and help to close the Medicare "doughnut" hole to make prescription drugs more affordable for seniors.

 

7.You can keep your own insurance: It's myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.

 

8.No, government will not do anything with your bank account: It is an absurd myth that government will be in charge of your bank accounts. Health insurance reform will simplify administration, making it easier and more convenient for you to pay bills in a method that you choose. Just like paying a phone bill or a utility bill, you can pay by traditional check, or by a direct electronic payment. And forms will be standardized so they will be easier to understand. The choice is up to you – and the same rules of privacy will apply as they do for all other electronic payments that people make.

 

Learn more and get details:

 

http://www.WhiteHouse.gov/realitycheck

http://www.WhiteHous...ealitycheck/faq

[Guest David]

8 ways reform provides security and stability to those with or without coverage

 

1.Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.

 

2.Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.

 

3.Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.

 

4.Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.

5.Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.

 

6.Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.

 

7.Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.

 

8.Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.

 

Learn more and get details:

 

http://www.WhiteHouse.gov/health-insurance-consumer-protections/

[Guest David]

Small Businesses Struggle to Provide Health Coverage: Nearly one-third of the uninsured – 13 million people – are employees of firms with less than 100 workers. From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%. About a third of such workers in firms with fewer than 50 employees obtain insurance through a spouse. Learn more: http://www.healthreform.gov/reports/helpbottomline

[Guest Commonwealth Fund]

The United States leads all industrialized countries in the share of national health care expenditures devoted to insurance administration. The U.S. share is over 30 percent greater than Germany’s and more than three times that of Japan. This issue brief examines the sources of administrative costs and describes how a private–public approach to health care reform—with the central feature of a national insurance exchange (largely replacing the present individual and small-group markets)—could substantially lower such costs. In three variations on that approach, estimated administrative costs would fall from 12.7 percent of claims to an average of 9.4 percent. Savings—as much as $265 billion over 2010–2020—would be realized through less marketing and underwriting, reduced costs of claims administration, less time spent negotiating provider payment rates, and fewer or standardized commissions to insurance brokers.

[Guest Lassie]

The costs of insurance administration in the U.S. health care system totaled nearly $156 billion in 2007, and that figure is expected to double—to reach $315 billion—by 2018.

[Guest Lassie]

Of the $156 billion spent on health care administration in 2007, about 60 percent, or $94.6 billion, was paid for by consumers and employers in the form of premiums to private insurance companies.

[Guest Rebecca Panoff]

An insurance premium is the actual amount of money charged by insurance companies for active coverage. An insurance premium for the same service can vary widely among insurance providers.

 

The business model can be reduced to a simple equation: Profit = earned premium + investment income - incurred loss - underwriting expenses.

 

Insurers make money in two ways:

 

1. Through underwriting, the process by which insurers select the risks to insure and decide how much in premiums to charge for accepting those risks;

 

2. By investing the premiums they collect from insured parties.

 

Costs Affecting Health Insurers

 

1. People are living longer.

 

2. A larger group of senior citizens requires more intensive medical care than a young healthier population.

 

3. Advances in medicine and medical technology can also increase the cost of medical treatment.

[Guest Amy Goodman]

Health Care Reform Needs an Action Hero

By Amy Goodman

 

Imagine the scene. America 2009. Eighteen thousand people have died in one year, an average of almost 50 a day. Who’s taking them out? What’s killing them?

 

To investigate, President Barack Obama might be tempted to call on Jack Bauer, the fictional rogue intelligence agent from the hit TV series “24,” who invariably employs torture and a host of other illegal tactics to help the president fight terrorism. But terrorism is not the culprit here:

 

It’s lack of adequate health care. So maybe the president’s solution isn’t Jack Bauer, but rather the actor who plays him.

 

The star of “24” is played by Kiefer Sutherland, whose family has very deep connections to health care reform—in Canada. Sutherland is the grandson of the late Tommy Douglas, the pioneering Canadian politician who is credited with creating the modern Canadian health care system. As a youth, Tommy Douglas almost lost his ailing leg. His family could not afford treatment, but a doctor treated him for free, provided his medical students could observe. As an adult, Douglas saw the impact of widespread poverty caused by the Great Depression. Trained as a minister, he had a popular oratorical style.

 

He moved into politics, joining the Co-operative Commonwealth Federation party. After several years in Parliament, he led the CCF’s decisive victory in the province of Saskatchewan, ushering in the first social democratic government in North America.

 

Douglas became premier of Saskatchewan, and pioneered a number of progressive policies there, including the expansion of public utilities, unionization and public auto insurance. But Douglas’ biggest battle, for which he is best remembered, is the creation of universal health insurance, called Medicare. It passed in Saskatchewan in 1962, guaranteeing hospital care for all residents. Doctors there staged a 23-day strike, supported by the U.S.-based American Medical Association. Despite industry opposition, the Saskatchewan Medicare program was so successful and popular that it was adopted throughout Canada. While Tommy Douglas was fighting for health insurance in Canada, a similar battle was raging in the U.S., resulting in the passage of Medicare and Medicaid, giving guaranteed, single-payer health care to senior citizens and the poor.

 

Rush Limbaugh, Fox News Channel’s Glenn Beck and insurance-industry-funded groups are encouraging people to disrupt town hall meetings with members of Congress. A number of the confrontations have become violent, or at least threatening. Outside President Obama’s Portsmouth, N.H., event, a protester with a pistol strapped to his thigh drew further attention with a sign that read, “It is time to water the tree of Liberty.” Thomas Jefferson’s complete quote, not included on the sign, continues, “... with the blood of tyrants and patriots.” Limbaugh says “24” is one of his favorite shows. He has even visited the set. Rush should learn from the real-life actor who plays his hero, Jack. Limbaugh and his cohorts may find truth not as satisfying as fiction.

 

In 2004, a Canadian Broadcasting Corp. poll named Tommy Douglas “The Greatest Canadian.” At a protest in 2000 against efforts to roll back the Medicare system in the province of Alberta, Kiefer Sutherland defended Canada’s public, single-payer system:

 

“Private health care does not work. America is trying to change their system. It’s too expensive to get comprehensive medical care in the U.S. Why on earth are we going to follow their system here? I consider it a humanitarian issue. This is an issue about what is right and wrong, what is decent and what is not.”

 

Maybe Jack Bauer can save the day.

 

Denis Moynihan contributed research to this column.

 

Amy Goodman is the host of “Democracy Now!” a daily international TV/radio news hour airing on more than 750 stations in North America. She is the co-author of “Standing Up to the Madness: Ordinary Heroes in Extraordinary Times,” recently released in paperback.

 

© 2009 Amy Goodman

[Guest Rust Belt]

Chuck Norris could kick Jack's ass any day. So are you saying we should follow him? What do movie stars know about working people.

 

I follow only people that talk straight about how they are going to help me and my family. I know this isssue is important but why all the hate talk and scare tactics.

 

Good intentions are just as bad in my book. From what I see all the government instutions are breaking down. Is this going to be the same way?

 

Death Panels don't scare me. Government management does.

[Luke_Wilbur]

A friend of mine mentioned something simular. He was concerned that our government would run healthcare like it runs the post office. I would agree on some points to that argument. Just seeing how the DC and Maryland governments treat my disabled friend right now with his special needs makes me worry. Local governments are not allowed to communicate with each other on medical history. So, my disabled friend has had to go through a 5 month process to get his benifits. And he still has none and cannot get his medicine. I think what they are doing is criminal.

 

On the other side of the coin, my mother and father had government health insurance and it was great. I also hate the limitations that my family insurance coverage puts on doctor and dental visits. Once I am over the limit I have to pay the entire bill. In my opinion, for the amount of money I am paying monthly insurance companies should offer more. They make way too much money. I think the profits they make is criminal.

 

I like the idea of people getting the option of joining a large pool of discounted coverage. I am not sure that I want our government to manage it. I also like putting stiffer regulations on the insurance companies. No one should be denied medical coverage at a reasonable price.

 

 

[Guest James P. Moran]

Congress is currently working on legislation to reform and improve America's health care system by lowering costs and expanding access to affordable health care. As you've probably seen in the media, the public debate over this issue has been robust. Many Americans are understandably concerned about what real reform would entail.

 

On Tuesday, August 25th, I will be holding a town hall meeting to explain what the health care reform being considered by Congress really means for Northern Virginians. We'll take questions from the audience and are also fortunate to have Howard Dean, physician, former Governor of Vermont, Democratic National Committee Chair Emeritus, author, and national grassroots leader join us for the meeting.

 

When: Tuesday, August 25, 2009

7:00PM - 9:00PM

--Doors open at 6:00PM

 

Where: South Lakes High School, Auditorium

11400 South Lakes Dr.

Reston, Virginia

 

 

I hope you will be able to come to the event on the 25th. For more information on the health care reform proposal Congress is considering, you can also visit the health care reform page on my website.

 

http://moran.house.gov/health-choices-act.shtml

[Guest Bob Adams]

Dick Morris, the Fox News analyst, has produced a new TV ad for League of American Voters. He says it can stop Obama's health care plan. Please take a moment to read the League's urgent message below and how you can help defeat the Obama plan.

 

Obama's Poll Numbers Plummet.

 

He Will Do Anything to Start Obama Care.

 

Dick Morris Has a Plan to Stop Him.

 

Read More Below.

 

Dear Fellow American:

 

Barack Obama and his radical friends in Congress are on the run. They know Americans are shifting away from supporting his so-called healthcare "reform" program.

 

As Dick Morris, the chief strategist for the League of American Voters, says, Obama's plan is nothing less than a slick attempt to nationalize all of America's healthcare.

 

Dick has prepared a powerful TV ad that exposes Obama's takeover.

 

You can see the TV ad by Going Here Now

 

Dick's ad also warns seniors that, when Obama adds 50 million new patients into the government system, it will collapse Medicare, causing massive rationing of healthcare to people who paid taxes all their lives.

 

Obama and the Democrats in Congress can't afford to lose the seniors. They are a key swing group.

 

Polling data shows our message is getting out there.

 

A new Gallup poll out this week shows that seniors overwhelmingly oppose Obama's plan.

 

For example, lower percentages of seniors expect the reform plan to benefit them personally than any other age group - and more expect their medical care to worsen than improve by a margin of 39 percent to 20 percent.

 

And only 34 percent of seniors think healthcare reform would improve medical care in this country.

 

It's no wonder that Obama's overall job approval ratings are plummeting.

 

Have no doubt: Democrats in Congress are running scared.

 

Dick Morris Issues Urgent Plea

 

Dick Morris, the famous Fox News analyst who Time magazine said was "the most influential private citizen in America," says our national advertising campaign is the best way to defeat Obama Care.

 

Dick feels so strongly that he has joined our group as chief strategist for the League of American Voters. He has developed a powerful plan to expose Obama Care in key swing states and congressional districts.

 

This week, thanks to your generous help, we are rolling out the TV ad in four states: North Dakota, Arkansas, Maine, and Montana.

 

As Dick notes, three of these states are very "red" states that have Democratic senators. We need to encourage voters in these states to let their senators know that they OPPOSE Obama Care.

 

But we need to add another eight states and 10 congressional districts to our national campaign in the next week.

 

We need your urgent help to do it - Go Here Now to Donate.

 

Remember, Congress is set to vote soon after Labor Day. We need to muster every vote we can.

 

Obama and his crew will do anything to win this. They want to force millions of Americans on the "public option."

 

We need to expose the lie that "you keep your doctor."

 

We know that his plan allows most employers to move all their employees on to the cheaper public system - even against their will!

 

Do you want your healthcare run the same way government runs the U.S. Postal Service?

 

I doubt it.

 

In fact, Obama just admitted that private companies such as FedEx and UPS work fine. In fact, they are profitable and have delivery systems that are efficient.

 

But in the same breath, Obama revealed that the Postal Service has problems!

 

If the U.S. government can't oversee the Postal Service, which delivers just packages, how can it properly handle the medical care of more than 300 million Americans?

 

You know the answer. I know the answer. The American people know the answer.

 

It can't.

[Guest Ron]

I think you need to read the latest FactCheck.org article:

 

http://factcheck.org/2009/08/seven-falsehoods-about-health-care/

 

False: Government Will Decide What Care I Get (a.k.a. they won’t give grandma a hip replacement)

 

This untrue claim has its roots in the American Recovery and Reinvestment Act of 2009 (the stimulus bill), which called for the creation of a Federal Coordinating Council for Comparative Effectiveness Research. The council is charged with supporting and coordinating research that the government has been funding for years into which treatments work best, and in some cases, are most cost-effective. Supporters of this type of research say it can provide valuable information to doctors, improving care and also lowering cost.

 

Betsy McCaughey, a former Republican lieutenant governor of New York (and now a professing Democrat), wrote in an opinion piece that the government would actually tell doctors what procedures they could and couldn’t perform. The claim took off from there, popping up in chain e-mails and Republican press conferences. It’s not true. The legislation specifically says that the council can’t issue requirements or guidelines on treatment or insurance benefits:

 

American Recovery and Reinvestment Act of 2009: Nothing in this section shall be construed to permit the Council to mandate coverage, reimbursement, or other policies for any public or private payer. … None of the reports submitted under this section or recommendations made by the Council shall be construed as mandates or clinical guidelines for payment, coverage, or treatment.

 

As for the health care bills themselves, the House’s H.R. 3200 sets up a center to conduct and gather such research within the Agency for Healthcare Research and Quality, an entity the CBO called “the most prominent federal agency supporting various types of research on the comparative effectiveness of medical treatments." Like the stimulus legislation, the bill states that: "Nothing in this section shall be construed to permit the Commission or the Center to mandate coverage, reimbursement, or other policies for any public or private payer.’’

 

The Senate Health, Education, Labor and Pensions Committee bill (not yet released in its entirety) calls for a similar center that “will promote health outcomes research and evaluation that enables patients and providers to identify which therapies work best for most people and to effectively identify where more personalized approaches to care are necessary for others,” according to the summary of the bill.

 

This claim also stems from a fear that the U.S. will institute a system like that of the U.K., where the government provides and pays for health care. But none of the bills now being debated in Congress call for such a system, and the president has said he doesn’t want nationalized or single-payer health care, as we’ve said several times.

 

For more, see: "Doctor’s Orders?" Feb. 20

 

"Government-Run Health Care?" April 30

 

False: The Bill Is Paid For

 

At least, it isn’t paid for yet.

 

President Obama has repeatedly said that a health care overhaul "will be paid for” and that he won’t sign a bill that isn’t deficit-neutral. But neither the House bill nor the Senate HELP Committee bill meets that criteria. According to the nonpartisan Congressional Budget Office and Joint Committee on Taxation, the House bill as introduced would add a net $239 billion over 10 years to the deficit, while the HELP Committee bill racks up more, $597 billion over 10 years.

 

Obama has also said he has "identified two-thirds of those costs to be paid for by tax dollars that are already being spent right now.” But "identified" is the operative word. These savings are estimates and whether around $650 billion (about two-thirds of the cost of health care over 10 years) can be saved remains to be seen. Most of the money would come from Medicare, but cuts in payments to insurers and practitioners aren’t popular measures that move easily through Congress.

 

So the big questions remain. Will the president break his promise and sign a bill that piles up hundreds of billions of additional debt? Will the legislation have to be scaled back to cost less, and perhaps cover fewer of the uninsured? Who will pay additional taxes? Can pain-free reductions in other government programs be found?

 

"Obama’s Health Care News Conference," July 23

 

False: Private Insurance Will Be Illegal

 

In July, Investor’s Business Daily published an editorial in which it claimed that H.R. 3200 would make private insurance illegal. But IBD was mistaken. It was citing the part of the bill that ensures people with individually purchased coverage don’t have to give up that coverage unless they want to.

 

Under the House bill, people who want to buy new individual, nongroup coverage will have to purchase it through a new health insurance exchange. They can still buy private insurance – the exchange, in fact, would offer a range of private plans, in addition to a new federal health insurance option. However, those who were already buying their own insurance before the bill went into effect – about 14 million Americans – will have their plans grandfathered in. The part of the bill IBD cites doesn’t forbid insurers from issuing new plans. It says that new individual plans will not be considered grandfathered, and will have to be purchased through the exchange.

 

"Private Insurance Not Outlawed" Aug. 13

 

False: The House Bill Requires Suicide Counseling

 

This claim is nonsense. In an appearance on former Sen. Fred Thompson’s radio show, McCaughey also enthusiastically pushed the bogus claim that the House bill will require seniors to have regular counseling sessions on how to end their lives:

 

McCaughey, July 16: The Congress would make it mandatory … that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner, how to decline nutrition, how to decline being hydrated, how to go into hospice care … all to do what’s in society’s best interest … and cut your life short.

 

This is a misrepresentation. What the bill actually provides for is voluntary Medicare-funded end-of-life counseling. In other words, if seniors choose to make advance decisions about the type of care and treatments they wish to receive at the end of their lives, Medicare will pay for them to sit down with their doctor and discuss their preferences. There is no requirement to attend regular sessions, and there is absolutely no provision encouraging euthanasia.

 

Of course, seniors who talk to their doctors about end-of-life care might well choose to discuss what types of life-saving treatment they wish to refuse. That choice has been federally guaranteed for almost 20 years. Euthanasia, on the other hand, is legal in only three states, making it even more unlikely to be a major part of the federal health plan.

 

"False Euthanasia Claims," July 29

 

False: Families Will Save $2,500

 

Proponents speak constantly of holding down rising medical costs. As recently as May 13, the president said legislation plus some voluntary measures by the private sector "could save families $2,500 in the coming years – $2,500 per family," echoing a claim he made countless times on the campaign trail last year.

 

Don’t start spending that $2,500 just yet.

 

For one thing, Obama isn’t actually promising to reduce health care spending below current levels, only to cut the rate of growth in spending. And even that is proving to be far tougher to accomplish than Obama led voters to believe. We’ve already mentioned that the Congressional Budget Office says "savings" in Medicare spending resulting from the House bill would fall short of what is needed to pay for two-thirds of its cost, which is Obama’s goal. And those savings come only in what the government pays, not in what families pay.

 

Squeezing more savings, even from Medicare, is proving difficult. On July 17, Obama’s lead man on the subject, Office of Management and Budget Director Peter Orszag, wrote to congressional leaders seeking legislation setting up an independent agency, the Independent Medicare Advisory Council (IMAC). It would be made up of health care experts with the power to make a package of annual changes in the amounts Medicare would pay to doctors. The president must either approve or diapprove the entire package as offered; if he approves, it goes into effect unless Congess passes a joint resolution stopping it. But when CBO took a look, it estimated that the new agency would save a total of only $2 billion over the next decade.

 

As for saving $2,500 for families, as opposed to saving money for the government, the CBO’s letter, signed by Director Douglas W. Elmendorf, said:

 

CBO: [E]xperts generally agree that changes in government policy have the potential to significantly reduce health care spending—for the nation as a whole and for the federal government in particular—without harming people’s health. However, achieving large reductions in projected spending would require fundamental changes in the financing and delivery of health care.

 

As an example of the "fundamental" changes that might do the trick: CBO suggested moving away from the current system of paying doctors and hospitals for performing medical procedures and paying them instead a fixed fee per patient or some other payment based on "value." Another CBO suggestion: "higher cost-sharing requirements." So far we don’t see those ideas in the bills being considered.

 

False: Medicare Benefits Will Be Slashed

 

The claim that Obama and Congress are cutting seniors’ Medicare benefits to pay for the health care overhaul is outright false, though that doesn’t keep it from being repeated ad infinitum.

 

The truth is that the pending House bill extracts $500 billion from projected Medicare spending over 10 years, as scored by the Congressional Budget Office, by doing such things as trimming projected increases in the program’s payments for medical services, not including physicians. Increases in other areas, such as payments to doctors, bring the net savings down to less than half that amount. But none of the predicted savings – or cuts, depending on one’s perspective – come from reducing current or future benefits for seniors.

 

The president has promised repeatedly that benefit levels won’t be reduced, reiterating the point recently in Portsmouth, N.H.:

 

Obama, Aug. 11: Another myth that we’ve been hearing about is this notion that somehow we’re going to be cutting your Medicare benefits. We are not.

 

Is he wrong? Not according to AARP, by far the nation’s largest organization representing the over-50 population. In a "Myths vs. Facts" rundown, AARP says:

 

AARP: Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.

 

To be sure, Obama hasn’t always thought that Medicare "savings" could be accomplished without actual cuts in benefits. Last fall, his campaign ran two television ads accusing Sen. John McCain of wanting “a 22 percent cut in [Medicare] benefits.” The basis for the ads was a newspaper article in which a McCain aide said the Arizona Republican would cut Medicare costs. But the aide said nothing about cutting benefits, in fact quite the contrary. We called the claim "false" when Obama made it against McCain, and it’s still false now when Obama’s critics are making the same accusation against him.

 

False: Illegal Immigrants Will Be Covered

 

One Republican congressman issued a press release claiming that "5,600,000 Illegal Aliens May Be Covered Under Obamacare," and we’ve been peppered with queries about similar claims. They’re not true. In fact, the House bill (the only bill to be formally introduced in its entirety) specifically says that no federal money would be spent on giving illegal immigrants health coverage:

 

H.R. 3200: Sec 246 — NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS

 

Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.

 

Also, under current law, those in the country illegally don’t qualify for federal health programs. Of interest: About half of illegal immigrants have health insurance now, according to the nonpartisan Pew Hispanic Center, which says those who lack insurance do so principally because their employers don’t offer it.

 

"Misleading GOP Health Care Claims" July 23

[Guest MarkMoveOn]

There is a ruthless predator out there killing Americans. And someone needs to stop them.

 

Check out the video and then share it with your friends, , because to combat this growing menace, we're going to need a bigger boat.

 

[Guest Dr. Justine McCabe]

We're witnessing a conspiracy to prevent all Americans from getting the quality health care that we all deserve and from knowing that such a plan is within our reach. We demand a televised national debate between advocates and opponents of single-payer, so Americans can hear the truth about universal health care. We demand new studies by the GAO and Congressional Budget Office on the cost of single-payer. In the 1990s, analyses by these offices showed that single-payer would save billions of dollars in health care expenses.

[Guest SeaMonkey]

Darn right. Obama would be getting a whole lot more grassroots support if he was promoting single payer healthcare.

[Guest TR]

There are several versions of this bill–

1–House version led by Nancy Pelosi.

2–Senate Health Committee version led by Chris Dodd.

3–Senate Finance Committee version led by Max Baucus.

4–White House version led by Barack Obama.

 

With that lineup of leadership, how could anyone really feel comfortable with legislation by lying partisans, that are either the most Liberal members in WashingtonDC or the most payed off by WashingtonDC healthcare lobbyists.

 

The only thing that Changed is the players.

[Guest Dixiecrat]

Republican extremist groups did cause Obama's poll numbers to go down. But, it loooks like religious groups are starting to side with Obama. That usually is a Republican strength. If the GOP starts looking like the party that cares only for the wealthy then they are doomed to fall behind the Green or Libertarian party. Healthcare is a fundamental right we all should have.

 

http://www.youtube.com/watch?v=IDLuy3h-f-Y

[Guest LAW]

Here is an excerpt of President Obama's Townhall meeting in Belgrade, Montana:

 

Now, before I take questions, I just want to talk briefly about what health insurance reform will mean for you. We still have work to do in Congress. The bills aren't finalized. But I just want you to understand about 80 percent of this has already been agreed to. And here are the basic principles that folks are talking about.

 

First, health insurance reform will mean a set of common-sense consumer protections for folks with health insurance. So those of you who have health insurance, this is what it will mean. Insurance companies will no longer be able to cancel your coverage because you get sick. (Applause.) That's what happened to Katie. It can't happen anymore.

 

If you do the responsible thing, if you pay your premiums each month so that you are covered in case of a crisis, when that crisis comes -- if you have a heart attack or your husband finds out he has cancer or your son or daughter is rushed to the hospital -- at the time when you're most vulnerable and most frightened, you can't be getting a phone call from your insurance company saying that your insurance is revoked. It turns out, once you got sick, they scoured your records looking for reasons to cancel your policy. They'd find a minor mistake on your insurance form that you submitted years ago. That can't be allowed to happen. (Applause.)

 

One report -- one report found that three insurance companies alone had canceled 20,000 policies in this way over the past few years. One man from Illinois lost his coverage in the middle of chemotherapy because his insurer discovered he hadn't reported gall stones he didn't know about. True story. Because his treatment was delayed, he died. A woman from Texas was diagnosed with an aggressive form of breast cancer, was scheduled for a double mastectomy. Three days before surgery, the insurance company canceled the policy, in part because she forgot to declare a case of acne. True story. By the time she had her insurance reinstated, the cancer had more than doubled in size.

 

And this is personal for me. I'll never forget my own mother, as she fought cancer in her final months, having to worry about whether the insurance company would refuse to pay for her treatment. The insurance company was arguing that she should have known that she had cancer when she took her new job -- even though it hadn't been diagnosed yet. If it could happen to her, it could happen to any one of us. It's wrong. And when we pass health insurance reform, we're going to put a stop to it once and for all. That is what Max Baucus is working on. (Applause.)

 

Number two: Insurance companies will be prohibited from denying coverage because of your medical history. A recent report found that in the past three years, more than 12 million Americans were discriminated against by insurance companies because of a preexisting condition. No one holds these companies accountable for these practices. But we will.

 

And insurance companies will no longer be able to place an arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. (Applause.) And that will help -- that will help 3,700 households in Montana. We'll place a limit on how much you can be charged for out-of-pocket expenses, as well, because no one in America should be broke when they get sick. (Applause.) And finally -- finally, we'll require insurance companies to cover routine checkups and preventive care, like mammograms and colonoscopies, because that saves money and that saves lives. (Applause.)

 

So that's what health care reform is all about. Right now we've got a health care system that all too often works better for the insurance companies than it does for the American people. We want to change that.

 

Now, if you are one of nearly 46 million people who don't have health insurance, you'll finally have quality affordable options. And if you do have health insurance, we'll help make sure that your insurance is more affordable and more secure. If you like your health care plan, you can keep your health care plan. This is not some government takeover. If you like your doctor, you can keep seeing your doctor. This is important. I don't want government bureaucrats meddling in your health care, but I also don't want insurance company bureaucrats meddling in your health care either. (Applause.) That's what reform is about. (Applause.)

 

But because we're getting close, the fight is getting fierce. And the history is clear: Every time we are in sight of health insurance reform, the special interests fight back with everything they've got. They use their influence, they run their ads, and their political allies try to scare the heck out of everybody. It happened in '93. It's happening now. It happened, by the way, when Lyndon Johnson tried to propose Medicare. It happened when John F. Kennedy tried to propose Medicare.

 

We can't let them do it again. Not this time. (Applause.) Because for all the scare tactics out there -- for all the scare tactics out there, what is truly scary -- what's truly risky -- is if we do nothing. If we keep the system the way it is right now, we will continue to see 14,000 Americans lose their health insurance every day. And that could be you. Premiums will continue to skyrocket, rising three times faster than wages. That will be you. The deficit will continue to grow. Medicare will go into the red in less than a decade.

 

So for all the seniors out there who understandably are worried about Medicare, understand if we don't reform the system, in about eight years Medicare goes in the red. And given the deficits that we have right now, we've got to start thinking how are we going to pay for that. Insurance companies will continue to profit by discriminating against people for being sick.

 

So if you want a different future -- a brighter future -- I need your help. Change is never easy -- and by the way, it never starts in Washington. It starts with you. So I need you to keep knocking on doors, talking to your neighbors, spread the facts. (Applause.) Fight against the fear. This is not about politics; this is about helping the American people, and if we can get it done this year, the American people are going to be better off.

 

Thank you, Montana. Thank you. (Applause.)

 

Here is an excerpt of the questions that were asked:

 

All right, everybody have a seat. So we are going to try to take as many questions as we can in the time that we've got. And we haven't pre-selected anybody, or pre-screened the questions. All we want to do is just ask you to raise your hand if you've got a question. And I'm going to go girl-boy-girl-boy so I don't get into trouble. (Laughter.)

 

There are -- there are people in the audience with microphones, as you can see. And so if you can -- once I call on you, if you can just wait until they bring the microphone, stand up so we can all see your lovely face, and introduce yourself, and then I will ask -- I will answer the question. And if you can keep your questions relatively brief, I'll try to keep my answers relatively brief.

 

All right, this young lady right here in the blue blouse. Right there.

 

Q Hi, Mr. President. Thank you so much for coming to Southwest Montana. We really appreciate you being here. (Applause.)

 

THE PRESIDENT: Thank you. It's great to be here.

 

Q I was laid off in January. I am currently uninsured. My two children have Medicaid right now. And my question is, without going into too much detail, can you tell us what you -- if you have kind of looked at Canada, England's system, and sort of -- can you pick and choose from those systems that work, that we see there's some success rate and apply that to what you're trying to push through right now?

 

THE PRESIDENT: Well, let me tell you what happens in other industrialized countries. First of all, I think it's important for everybody to understand that Americans spend $5,000 to $6,000 per person more than any other advanced nation on earth -- $5,000 or $6,000 more than any other person -- any other country on earth.

 

Now, if you think that -- how can that be? Well, you probably don't notice it, because what's happening is if you've got health insurance through your job, more and more of what would be your salary and wages is going to health insurance. But you don't notice it; you just notice that you're not getting a raise. But a bigger and bigger portion of compensation is going to health care here in the United States. Now that's point number one.

 

So clearly we've got a system that isn't as efficient as it should be because we're not healthier than these people in these other countries.

 

Having said that, most other countries have some form of single-payer system. There are differences -- Canada and England have more of what's called -- what people I guess would call a socialized system, in the sense that government owns the hospitals, directly hires doctors -- but there are a whole bunch of countries like the Netherlands where what they do is, it's a single-payer system only in the sense that government pays the bill, but it's all private folks out there -- private doctors, private facilities. So there are a bunch of different ways of doing it.

 

Now, what we need to do is come up with a uniquely American way of providing care. (Applause.) So I'm not in favor of a Canadian system, I'm not in favor of a British system, I'm not in a favor of a French system. That's not what Max is working on. Every one of us, what we've said is, let's find a uniquely American solution because historically here in the United States the majority of people get their health insurance on the job. So let's build on that system that already exists -- because for us to completely change that, it would be too disruptive. That's where suddenly people would lose what they have and they'd have to adjust to an entirely new system. And Max and I agree that's not the right way to go.

 

So all we've said is, in building a better system, what are the elements? Well, number one, for people like you, you should be able to get some help going into the private insurance marketplace and buying health insurance. So we would give you a tax credit, a subsidy of some sort, to help you obtain insurance.

 

Now, the problem is, if you're going out there on your own, then it's much more expensive than if you go in a big group. So we would allow you to buy into a health care exchange that would give you some power to negotiate for a better rate, because you're now part of a big pool. We would also make sure that if you do have health insurance that you are protected from some of the policies that we've already talked about that have not been very good for consumers. So you wouldn't be able to be banned for preexisting conditions. There would be caps on the amount of out-of-pocket expenses you would have to spend. So we would reform the insurance market for people who already have health insurance.

 

And if we do those things -- making it better for folks who already have insurance, making it easier for you to buy insurance, and helping small businesses who want to do the right thing by their employees but just can't afford it because they're charged very high rates, they can't get a good deal from the insurance companies -- if we do those things, then we can preserve the best of what our system offers -- the innovation, the dynamism -- but also make sure that people aren't as vulnerable. Now, that's essentially what we're talking about with health care reform.

 

And so when you start hearing people saying, you know, we're trying to get socialized medicine and we're trying to have government bureaucrats meddle in your decision-making between you and your doctor, that's just not true.

 

All right? Okay. It's a guy's turn. Gentleman right there in the back, with the green.

 

Q I think most of us know that Medicare is one of the best social programs this nation has ever put together. (Applause.) It works extremely well and helps the people who need it the most. But money doesn't grow on trees. How can we be assured that increasing coverage to others is not going to make Medicare more expensive or less effective?

 

THE PRESIDENT: Well, I think this is a good point, and I appreciate the question, because a lot of seniors are concerned about this. First of all, it is important to know that Medicare is a government program. So when you hear people saying, "I hate government programs, but keep your hands off my Medicare" -- (laughter) -- then there's a little bit of a contradiction there. And I have been hearing that quite a bit, all right, so I just want to -- (applause) -- I want to be clear about that.

 

Medicare is a terrific program and it gives our seniors security. And I want Medicare to be there for the next generation, not just for this generation. But if we don't make some changes in how the delivery system works, if we don't eliminate some of the waste and inefficiencies in the system, then seniors are really going to be vulnerable. So what we've proposed is not to reduce benefits -- benefits on Medicare would stay the same -- it's not to ration. What we are asking is that we eliminate some of the practices that aren't making people healthier.

 

Example number one: Subsidies to insurance companies under Medicare amount to about $177 billion over 10 years. That's how much we think we could save by eliminating subsidies to insurance companies that are offering what's called Medicare Advantage. It doesn't help seniors any more than regular Medicare does. (Applause.)

 

And so if we took that $177 billion, we're not making seniors worse off, but we've got that money now not only to strengthen the health care system overall, but potentially to cover more people. Now, the insurance companies don't like it, but it's the right thing to do.

 

Let me give you another example of changes that we should make. Right now when you go into the hospital, you get a procedure under Medicare, if you end up having to come back to that hospital a week later because something went wrong, they didn't do it right, the hospital doesn't pay any penalty for that; they just get reimbursed for a second time or a third time -- same fee, same service.

 

Now, think about that if car -- auto repair shops operated the same way. You take your car in and you get it fixed, and a week later the thing is broken again. You go in. The guy says, well, let me charge you all over again, and I'll do just the same thing. That doesn't make sense. So what we've said is, let's give hospitals an incentive. Let's say to the hospitals, we're going to charge you for overall treatment of whatever the problem is. And if you get it right the first time, you get to keep a little extra money. But if you keep on having the person coming back again and again, then there's a disincentive.

 

Those are the examples of the kinds of changes that can be made that aren't reductions in benefits, but they save the system money overall, and by the way, will actually increase the life expectancy of the Medicare Trust Fund, which is in deep trouble if we don't do something, because as you said, money doesn't grow on trees. So we're actually trying to help preserve Medicare and make people healthier in the process.

 

All right. (Applause.) Young lady in the back there, right there. No, well, actually, I was pointing -- I didn't see you. Right there. No, the young lady in the blue who stood up there.

 

Q Good afternoon, Mr. President. I'm a Bozeman resident. Sorry, I'm a little nervous.

 

THE PRESIDENT: You're doing great. (Laughter.)

 

Q Thank you. I'm a single mother of two children. I'm an MSU student. I have a son that suffers from many disabilities. He's disabled for the rest of his life. He's 11 years old. He suffers from autism. He's non-verbal. He suffers from extremely hard to control epilepsy, and he's Type I diabetic. He has been sick with these ailments ever since he was nine months old. My question to you is, I rely heavily on his Medicaid to support good health care for him. What, with this reform, would happen with his Medicaid -- Medicare coverage -- or Medicaid coverage, sorry.

 

THE PRESIDENT: First of all, thank you for sharing your story. You are a heroic mom, so we are grateful to you and your son is lucky. (Applause.)

 

If you currently qualify for Medicaid -- your son currently qualifies for Medicaid, he would continue to qualify for Medicaid. So it would not have an impact on his benefit levels and his ability to get the care that he needs.

 

Some of the reforms that we're talking about, though -- what I just referred to as delivery system reforms, where we help, for example, encourage doctors when they are seeing a patient, instead of having five tests, do one test and then e-mail all the tests to five specialists. Those kinds of changes can save money in the Medicaid and the Medicare systems overall, and that will actually help Governor Schweitzer, who has to come up with half of Medicaid in his state budget every year, it will actually help him then be able to pay for it.

 

So we're not changing the benefit levels or who qualifies for Medicaid -- we might see some expansion of Medicaid, in fact, under the reforms that have been proposed in some of the legislation -- but we do have to make the whole system overall just a little bit smarter, make sure we're getting a better bang for the buck, so that the money is there for the services that your son needs. Okay.

 

This also includes, by the way, preventive care, wellness care, because our system really is not a health care system, it's more like a disease care system, right? We wait until people get sick and then we provide them care. Now, think about it -- are we better off waiting until somebody gets diabetes and then paying a surgeon for a foot amputation, or are we better off having somebody explain to a person who's obese and at risk of diabetes to change their diet, and if they contract diabetes to stay on their medications? Obviously the second is more cost-efficient, but right now the health care system is perverse. It does not incentivize those things that actually make people better or keeps them out of hospitals in the first place, and that's what we have to change overall to make sure that the resources are there for your son. Okay? (Applause.)

 

It's a gentleman's turn, and I'm going to call on that gentleman right there -- right there.

 

Q My name is Randy --

 

THE PRESIDENT: Hold on, Randy. There you go.

 

Q Okay. My name is Randy, I'm from Ekalaka, Montana. And as you can see, I'm a proud NRA member. (Applause.) I believe in our Constitution, and it's a very important thing. I also get my news from the cable networks because I don't like the spin that comes from them other places.

 

THE PRESIDENT: Oh, you got to be -- you got to be careful about them cable networks, though. (Laughter.) But that's okay, go ahead, go on with your question.

 

Q Max Baucus, our senator, has been locked up in a dark room there for months now trying to come up with some money to pay for these programs. And we keep getting the bull. That's all we get, is bull. You can't tell us how you're going to pay for this. You're saving here, you're saving over there, you're going to take a little money here, you're going to take a little money there. But you have no money. The only way you're going to get that money is to raise our taxes. You said you wouldn't. (Applause.) Max Baucus says he doesn't want to put a bill out that will. But that's the only way you can do that.

 

THE PRESIDENT: Well, let -- I'm happy to answer the question.

 

Q Thank you.

 

THE PRESIDENT: Look, you are absolutely right that I can't cover another 46 million people for free. You're right. I can't do that. So we're going to have to find some resources. If people who don't have health insurance are going to get some help, then we're going to have to find money from somewhere.

 

Now, what I've identified, and most of the committees have identified and agreed to, including Max Baucus's committee, is that there -- overall this bill will cost -- let's say it costs $800 billion to $900 billion. That's a lot of money. That's a lot of money. That's over 10 years, though, all right? So that's about $90 billion -- $80 billion to $90 billion a year.

 

About two-thirds of it -- two-thirds -- can be obtained by doing some of the things I already mentioned, like eliminating subsidies to insurance companies. So you're right, that's real money. I just think I would rather be giving that money to the young lady here who doesn't have health insurance and giving her some help, than giving it to insurance companies that are making record profits. (Applause.) Now, you may disagree. I just think that's a good way to spend our money.

 

But your point is well taken, because even after we spend -- even after we eliminate some of the waste and we've gotten those savings from within the health care system, that's only two-thirds. That still means we've got to come up with one-third. And that's about $30 billion a year that we've got to come up with. Now, keep in mind the numbers change, partly because there are five different bills right now. This is all going to get merged in September. But let's assume it costs about $30 billion a year over 10 years. We do have to come up with that money.

 

When I was campaigning, I made a promise that I would not raise your taxes if you made $250,000 a year or less. That's what I said. But I said that for people like myself, who make more than that, there's nothing wrong with me paying a little bit more in order to help people who've got a little bit less. That was my commitment. (Applause.)

 

So what I've said is -- so what I've said is let's, for example, just -- this is the solution that I originally proposed; some members in Congress disagree, but we're still working it through -- what I've said is we could lower the itemized deductions that I can take on my income tax returns every year so that instead of me getting 36 percent, 35 percent deductions, I'll just get 28 percent, like people who make less money than me.

 

If I'm writing a check to my local church, I don't know why Uncle Sam should be giving me a bigger tax break than the person who makes less money than me, because that donation means just as much. (Applause.) If we just did that alone -- just that change alone, for people making more than $250,000, that alone would pay for the health care we're talking about. (Applause.)

 

So my point is -- my point is, number one, two-thirds of the money we can obtain just from eliminating waste and inefficiencies. And the Congressional Budget Office has agreed with that; this is not something I'm just making up; Republicans don't dispute it. And then the other third we would have to find additional revenue, but it wouldn't come on the backs of the middle class.

 

Now, let me just make one final point. I know that there are some people who say, I don't care how much money somebody makes; they shouldn't have to pay higher taxes. And I respect that opinion. I respect that view. But the truth of the matter is, is that we've got to get over this notion that somehow we can have something for nothing, because that's part of how we got into the deficits and the debt that we're in, in the first place. (Applause.)

 

When the previous administration passed the prescription drug bill, that was something that a lot of seniors needed, right? They needed prescription drug help. The price tag on that was hundreds of billions of dollars. You know how we paid for it? We didn't. It just got added on to the deficit and the debt.

 

So it amuses me sometimes when I hear some of the opponents of health care reform on the other side of the aisle or on these cable shows yelling about how we can't afford this, when Max and I are actually proposing to pay for it, and they passed something that they didn't pay for at all and left for future generations to have to pay in terms of debt. That doesn't make sense to me. (Applause.)

 

All right, can I say this, though? Randy, I appreciate your question, the respectful way you asked it, and by the way, I believe in the Constitution, too. So thank you very much. Appreciate it. (Applause.)

 

All right, right there in the green in the back there. Yes, that's you.

 

Q Okay, so when funding dried up last fall due to the economic downturn, I lost my job at a non-profit helping struggling teens. And I'd like to thank you because -- because of your stimulus funding to community health clinics, I now have a new job helping people who are -- (applause) --

 

THE PRESIDENT: That's great.

 

Q -- mostly uninsured people with mental health. I'm a therapist.

 

THE PRESIDENT: That's great.

 

Q So I wanted to thank you for that. But there was a gap in there where I lost my insurance in between losing my job at the non-profit and my current job. And I'd like to ask you how you will help people with that gap when they're unemployed.

 

THE PRESIDENT: Well, first of all, the recovery package, the stimulus helped people precisely with that gap when we said we'll cover 65 percent of the cost of COBRA. How many people here have been on COBRA or tried to get on COBRA? All right, so just for those of you who aren't familiar with it, if you lose your job, under federal law you're able to access something called COBRA which allows you to pay the premiums for the health care insurance that you had until you find your next job. Sounds like a good deal.

 

Here's the only problem, as I said before, most of us don't realize how much our insurance costs our employers because we're not seeing the actual bill that's being paid mostly by our employers. So when we lose a job, suddenly we get this bill for a thousand dollars or $1,200 or $1,500 a month, and that's absolutely the worst time for you to have to come up with that money, is when you've lost your job.

 

So what we did was, let's -- we said because this is such a extraordinary crisis, let's pick up 65 percent of that temporarily so that the huge numbers of people who've lost their jobs because of this financial downturn, they get a little bit more of a cushion.

 

Now, that was the initial help that we wanted to do to provide that bridge. When we pass health reform, you are going to be in a position where, first of all, you will be able to have selected a plan that you can carry with you whether you've lost your job or not, and depending on your income levels, you will also be qualified for a tax credit that will help you pay and continue your coverage even if you've lost your job.

 

And for a lot of people -- this is especially important for a lot of people who are self-employed because increasingly, you know, if you're a consultant, you're somebody who's opened up your own shop, a little mom and pop store somewhere, you are the people who have the toughest time getting insurance because you just don't have enough employees for the insurance companies to take you seriously.

 

That's why what we want to do is create an exchange -- it's like a marketplace -- where you can go and choose from a menu of different options, different kinds of plans that you think might be right for you. And one of the options that's being debated is, should there be a public option, all right? (Applause.) And I want to -- I want to just explain this briefly, because this is where the whole myth of a government takeover of health care comes from. And not everybody -- not even every Democrat -- agrees on the public option, but I just want at least people to be informed about what the debate is about.

 

The idea is, if you go to that marketplace and you're choosing from a bunch of different options, should one of the options be a government-run plan that still charges you premiums? You still have to pay for it just like private insurance, but government would not -- this government option would not have the same profit motive. It would be obviously like a non-for-profit. It would have potentially lower overhead, so it might be able to give you a better deal, should you be able to choose from that option among many others. That's what the debate is about. (Applause.)

 

Now, what the opponents of a public option will argue is, you can't have a level playing field; if government gets into the business of providing health insurance, they will drive private insurers out of the health insurance market. That's the argument that's made. (Applause.) And I -- that is a legitimate, it's a fair concern, especially if the public option was being subsidized by taxpayers, right? I mean, if they didn't -- if they could just keep on losing money and still stay in business, after a while they would run everybody else out. And that's why any discussion of a public option has said that it's got to pay for itself, it's not subsidized by private insurers.

 

The only point I want to make about this is whether you're for or against a public option, just understand that the public option is not a government takeover of health insurance. Everybody here who still has -- who has currently private insurance, you would more than likely still be on your private insurance plan. Employers wouldn't stop suddenly providing health insurance. So that is where this idea of government-run health care came from. It is not an accurate portrayal of the debate that's going on in Washington right now. All right?

 

It's a gentleman's turn. This gentleman right there, sitting -- right there, yes. Yes, sir.

 

Q Thank you. Given your comments regarding the public option, I would like, if you could, to comment on the following -- and also welcome, and thank you. And I believe in reform as well. I've learned that Medicare pays about 94 percent of hospital cost. And I've learned that Medicaid pays about 84 percent of hospital cost. And I've learned this from a reputable source, my brother who is a chief administrative officer at a large hospital group. He also explains to me, when I communicate with him, that private insurers -- his hospital collects about 135 percent of cost from private insurers, and that makes up the difference. So if public option is out there, will it pay for its way, or will be under-funded like Medicare and Medicaid? Thank you.

 

THE PRESIDENT: It's a great question, and I'll try to be succinct on this. This is a complicated area. Anybody who has ever gotten a bill from a hospital knows it's a complicated area. But here's the short answer. I believe that Medicare should -- Medicare and Medicaid should not be obtaining savings just by squeezing providers.

 

Now, in some cases, we should change the delivery system, so that providers have a better incentive to provide smarter care. Right? So that they're treating the illness instead of just how many tests are done, or how many MRIs are done, or what have you -- let's pay for are you curing the patient. But that's different from simply saying, you know what, we need to save some money, so let's cut payments to doctors by 10 percent and see how that works out. Because that's where you do end up having the effect that you're talking about. If they're only collecting 80 cents on the dollar, they've got to make that up somewhere, and they end up getting it from people who have private insurance.

 

This is true, also, by the way, of emergency room care. Each of us spend -- even though we don't know it; our employer pays for it so we don't notice it on our tab -- each of us spend about a thousand dollars per family, maybe $900 per family, paying for uncompensated care -- people without health insurance going in, getting fixed up. That money comes from somewhere -- well, it comes from you. You just don't see it on your bill.

 

And so if we can help provide coverage to people so that they're getting regular primary care and they're not going to the emergency room, we will obtain some savings and that's partly -- going to Randy's earlier question -- that's partly how we'll end up paying for giving people health insurance -- because we're already paying for it right now, we just don't notice it. (Applause.) We are paying for it in uncompensated care that is subsidized by the rest of us who have health insurance.

 

All right. I think this is the signal that I only have a few more questions. I'm going to take two more questions. If I'm in Montana, I got to call on somebody with a cowboy hat. (Laughter.) Absolutely. You've got a little plaque on there -- is it the --

 

Q Montana Ambassadors. We're a business advisory group appointed by the governor. We've served three Republican and two Democratic governors, and I'd like to welcome you on behalf of the Montana Ambassadors to Montana.

 

THE PRESIDENT: Thank you so much. Well, you make a great ambassador. (Applause.)

 

Q Thank you.

 

THE PRESIDENT: Absolutely.

 

Q My question -- and I'm glad you called on me -- it has to do with the COBRA question -- because I'm in the building materials business; I own a lumberyard in a beautiful little town of a thousand people about 40 miles southwest of here, Ennis. And I was -- when the economy took a nosedive, I was forced to take my workforce from 11 people to six. And I want to -- like most employers in America, I want to, you know, provide -- I think it's my responsibility to provide health insurance; you know, we like to take care of our peeps, so to speak. (Laughter.) And so I went on --

 

THE PRESIDENT: Is that a Montana phrase, "peeps"? (Laughter.)

 

Q And so I went searching for replacement coverage for the employees that have been laid off, only to find out that COBRA doesn't apply to me because I have less than 20 employees. And that conservatively affects 80 percent of all workers in Montana.

 

So they were pretty much out on their own, and I was wondering if -- what we can do to eliminate discrimination against small employers. As an example, we're a lumberyard. We're out there lifting boards and packing stuff all day long. Every one of my remaining seven employees are fit. So why are we, and I as an employer, able to provide a lesser level of benefits to my employees, and yet an employer with 30 employees who sit in cubicles on their butts instead of working them off -- (laughter) -- gets a better rate? (Applause.)

 

THE PRESIDENT: Well, that's a pretty good question. So for all of you who are all sitting on your -- what did you call them? (Laughter.) No, as I said, small business is probably as vulnerable as anybody. And one of the things that Max has been working very hard on -- and this just doesn't get advertised, so I just want to make sure everybody is paying attention here -- one of the things that we're trying to do is give a substantial subsidy to help small businesses allow their employees to get health insurance, because there are a lot of employers just like you who want to do the right thing, but they're a small shop, they're operating on small margins, they've got no leverage with the insurance companies.

 

So there are two ways we want to help. Number one, we want the small business to be able to buy into the exchange. That allows you then to use the purchasing power of everybody who is in the exchange to get the best rates from the insurance companies. That right away would drive down the premiums that you'd have to pay.

 

And the second thing we want to do is for employers who are doing the right thing and providing health insurance that is real, then we want to give you a tax break so that it's easier for you to make your bottom line.

 

Now, this is something that a lot of small businesses would benefit from. Nobody is talking about it. And since small businesses are the place where you're seeing the fastest job growth, it makes sense for us to provide this kind of protection. This, I guarantee you, will end up being an important component of whatever we pass out of Washington. All right? (Applause.)

 

I've only got time for one more question, and it's a guy's turn, and I want somebody who's got a concern or is skeptical about health care reform. Here we go, there we go. I knew we could find a couple here. So I'll call on this gentleman right here in the pale blue shirt -- and hopefully that list is not too long. All right, go ahead. Introduce yourself, though.

 

Q My name is Mark Montgomery. I'm from Helena, Montana.

 

THE PRESIDENT: Great to see you, Mark.

 

Q I appreciate you coming here. It's great to be able to do this.

 

THE PRESIDENT: Thank you.

 

Q Mr. President, I make a living selling individual health insurance. (Laughter.) Obviously I've paid very close attention to this insurance debate. As you know, the health insurance companies are in favor of health care reform and have a number of very good proposals before Congress to work with government to provide insurance for the uninsured and cover individuals with preexisting conditions. Why is it that you've changed your strategy from talking about health care reform to health insurance reform and decided to vilify the insurance companies? (Applause.)

 

THE PRESIDENT: Okay, that's a fair question, that's a fair question. First of all, you are absolutely right that the insurance companies, in some cases, have been constructive. So I'll give you a particular example. Aetna has been trying to work with us in dealing with some of this preexisting conditions stuff. And that's absolutely true. And there are other companies who have done the same.

 

Now, I want to just be honest with you, and I think Max will testify, that in some cases what we've seen is also funding in opposition by some other insurance companies to any kind of reform proposals. So my intent is not to vilify insurance companies. If I was vilifying them, what we would be doing would be to say that private insurance has no place in the health care market, and some people believe that. I don't believe that. (Applause.) What I've said is let's work with the existing system. We've got private insurers out there. But what we do have to make sure of is that certain practices that are very tough on people, that those practices change.

 

Now, one point I want to make about insurance: Some of the reforms that we want for the insurance market are very hard to achieve, unless we've got everybody covered. This is the reason the insurance companies are willing to support reform, because their attitude is if we can't exclude people for preexisting conditions, for example, if we can't cherry pick the healthy folks from the not-so-healthy folks, well, that means that we're taking on more people with more expensive care. What's in it for us? The answer is if they've got more customers, then they're willing to make sure that they are eliminating some of these practices. If they've got fewer customers, they're less willing to do it.

 

So it's important for people -- when people ask me sometimes, why don't you just do the insurance reform stuff and not expand coverage for more people, my answer is I can't do the insurance reform stuff by itself. The only way that we can change some of the insurance practices that are hurting people now is to make sure that everybody is covered and everybody has got a stake in it, and then the insurance companies are able and willing to make some of these changes that will help people who have insurance right now. But thank you for the question. I appreciate it. (Applause.)

[Luke_Wilbur]

From what President Obama stated in Montana only the households that make $250,000 per year will be taxed. Here is a guestimate of what it will cost those households.

 

Roughly one in 50 households will take in more than $250,000. President Obama stated that these household will have to pay the 30 billion dollars over 10 years to make this program happen. There is approximately 116 million households.

 

30,000,000,000 divided by 116,000,000 = $258.00 if all households payed equally into it.

 

116,000,000 diveded by 50 = 2,320,000 households will be affected by this plan.

 

The 2,320,000 can expect to pay roughly $13,000 over 10 years.

 

So, if you make a combined income of over $250,000 expect to pay roughly $1,300 per year for the new healthcare system.

 

 

[Guest Bronco]

Why should I have to pay money to lazy people that just want to take advantage of the system. I give at my church. At least I have a chance of knowing the money is going to the right people. Osama your time is over.

[Guest Sheri]

I see that Obama is caving in to the special interest groups. I want public healthcare and so do my neighbors. It looks like the President is bowing down to the polls, so he can get elected. That gets me upset. Fight it out President Obama. Fight for the working class.