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Obama says his "public option" is not "government run" health care

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WASHINGTON -- Some of the biggest questions in President Obama's push for health care reform are over the creation of a "public option" to compete with private companies in the health insurance marketplace.

Whatever the phrase "public option" suggests to you when you hear it, Obama told the American Medical Association in Chicago on Monday that it is not "about socialized medicine and government takeovers, long lines and rationed care, decisions made by bureaucrats and not doctors."

Obama twice talked of socialized medicine in order to inoculate the public against one of the first lines of attack critics of a "public option" will use -- that it's socialism on U.S. soil.

No matter that Medicare -- a government-run subsidized health insurance program covering the nation's elderly and some disabled people -- is socialized medicine.

Now I can't tell you in this column exactly what the public option is going to be, because the main committees drafting health care legislation in the House and the Senate are still at work. Over in the House, a "discussion draft" with some details should be out, maybe, by next week. What I'll try to do here is give you some of the big picture.

Obama made the quick trip home Monday to make an expansive case before the AMA for changing the health care system. His arguments relied as much on macro economics -- escalating health costs are a "ticking time-bomb for the federal budget" -- as on improving individual medical care.

"Too many doctors and patients," Obama said, "are making decisions without the benefit of the latest research."

So we are learning a bit what the "public option" is not. It is not socialism and it is not universal coverage.

A "public option" form of heath insurance would be another offering in Obama's proposed Health Insurance Exchange. Explained Obama: "This exchange will allow you to one-stop shop for a health care plan, compare benefits and prices, and choose a plan that's best for you and your family -- the same way, by the way, that federal employees can do, from a postal worker to a member of Congress."

In discussing a "public option," Obama's message team is telling Democrats on Capitol Hill to avoid using the phrase "universal coverage" because that phrase is often associated with a single-payer system, which is often associated with "socialism," which the Obama administration does not support. The Obama team-approved language is instead to talk about "guaranteed health care," a phrase that is less polarizing.

"It is important for our reform efforts to build on our traditions here in the United States. So when you hear the naysayers claim that I'm trying to bring about government-run health care, know this: They're not telling the truth," Obama said.

That guarantee can come in many, many forms and will be the subject of much debate in the weeks ahead, as Obama is pressing for some preliminary votes on health care legislation this summer.

What Obama has always argued was that if you bring down costs and provide government subsidies, millions of uninsured people will buy policies -- motivated by common sense or mandate.

The main way to get the medical marketplace to cover more people -- even folks with expensive pre-existing conditions -- is to inject more competition into the system.

So a "public option" today is a guiding principle or concept and could end up being:

• • a co-op, much like a rural utility operating with government backing -- but not direct government management.

• • an expansion of the existing government-run Medicare program, a "Peoplecare" plan.

• • some government-sponsored nonprofit entity bankrolled by the federal government but run independently.

Or a player to be named later.

13 Comments

President Obama spoke before a somewhat less supportive crowd than he is accustomed to Monday at the annual meeting of the American Medical Association, where he referred to our healthcare system as a “ticking time bomb”. A description that I believe can also be used to describe his presidency.

He did little to win over the medical establishment when he asserted his opposition to the limitation of malpractice suit awards. He suggested that other measures could help avoid "excessive defensive medicine". He failed to specify what measures. This earned him some booing from the crowd. Something he is not used to (because he can’t hear me when I watch him on T.V.).

After the speech, Les Weisbrod, president of the American Association for Justice (formerly the Association of Trial Lawyers of America), said, "The notion that 'defensive medicine' is leading to higher health care costs is not supported by empirical data or academic literature". Les should be believed as everybody knows lawyers are far more honest than doctors.

Obama said those who oppose his plan should not use "fear tactics to paint any effort to achieve reform as an attempt to socialize medicine."

He expressed a willingness to consider including in his plan a requirement that all Americans have healthcare coverage. He expressed a willingness to consider including in his plan a requirement that all Americans have healthcare coverage (I just thought that needed repeating). He proclaimed that his plan would include assistance for those who cannot afford coverage. Lets see… a government mandate requiring citizens to have health coverage even if they don’t want it, and a plan to use tax dollars to pay for coverage for those who cannot afford it… nope, no socialism here!

I see nothing in the Obama healthcare plan that will effectively reduce healthcare costs. So far it just looks like a plan to spread the costs around to more people.

If you would like to help pressure Congress to pass single payer health care please join our voting bloc at:
http://www.votingbloc.org/Health_Bloc.php

AMERICA’S NATIONAL HEALTHCARE EMERGENCY!

It’s official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.

STAND READY AMERICA TO SEIZE CONTROL OF YOUR NATIONAL HEALTHCARE SYSTEM.

We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.

And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.

Progressive democrats and others should stand firm in their demand for a robust public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and demand that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).

Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.

In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don’t even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!

Contact congress and your representatives NOW! AND SPREAD THE WORD!

God Bless You

Jacksmith – WORKING CLASS

First of all, I've heard nothing that indicates a realistic way to drive down or hold down the costs associated with health care other than arbitrary price controls.

Secondly, the "public" option, if cheaper than regular health indsurance, may very well drive employers and the insured away from insurance and into the "public" option.

My fear is that all these result some intended effects: 1) a less financially attractive medical profession with too few doctors, hospitals, and options; and 2) further strain on the middle class. The rich will manage. The poor will benefit a great deal. But I and my shrinking middle class will lose. Again.

What am I missing? I think the administration is either lying or is extremely short-sighted.

"one stop shop health care plan....the same way, by the way, that federal employees [use]" Call it what it is "public option" is government run health care----it's socialism. "Spread the wealth around"=socialism, "Bailing out the Auto Industry" is socialism. Quit playing with words Mr. President, we can see the wolf in the lamb's clothing.

quack, quack, duck, duck.

Any government-run plan, particularly ones that do not self-finance or set reimbursement rates solely out of member premiums, or that compel participation by providers or the public = SOCIALIZED MEDICINE.

The Axelrod marketing of this as an "option" where folks can keep their existing coverage if they like is a cynical fraud on the public, like much of axelrod's finest work. Estimates are that initially in excess of 20 million people covered by employer plans will lose their cherished private coverage as employers drop their expensive plans, pay employees an additional sum and tell them to buy the government plan. As was the case with medicare, the private plans will disappear in short order.

Another marketing lie. When are you so-called "reporters" going to start doing some reporting?

46 MILLION AMERICANS WITH NO HEALTHCARE, AT LEAST THE PRESIDENT IS FIGHTING FOR THEM, BECAUSE THE GOP SURE ISN'T, HANNITY ISN'T, BUSH DIDN'T, AND CHENEY FINALLY CAN PUT SENTENCES TOGETHER, MICHAEL STEELE DOESN'T CARE, PALIN HAS A PERSONAL CRUSADE AGAINST LETTEMAN, SHE DOESN'T CARE, THAT'S WHY NO MATTER WHO YOU THROW AT PRESIDENT OBAMA IN 2012, HE CAN'T LOSE, BECAUSE HE DOES CARE ABOUT 46 MILLION PEOPLE WHO DON'T HAVE HEALTH CARE, THE TRUTH HURTS DOESN'T IT, AND YOU CAN TELL RUSH THE COLLEGE DROPOUT I SAID SO!
AMERICA THERE IS A NEW PRESIDENT IN THE WHITE HOUSE AND HE ACTUALLY WORKS, HE DOESN'T OWN A RANCH TO HIDEOUT ON, ON THE WEEKENDS, IN FACT THIS PRESIDENT RARELY TAKES WEEKENDS OFF!

No matter what he decides to call it, there is no denying that it's a socialist plan. Just because he's playing with words doesn't mean he's actually changing the plan itself. This is a socialist plan and all it will do is drive out private insurers and force everyone to go with the "public option."

wow. so many people affected by the fear mongering of the conservative right. Are you kidding me? nothing obama is doing is socialist. If you have an option for private healthcare, THAT IS NOT SOCIALIST. again, check other countries with TRULY socialist healthcare, ie. canada, australia, europe and his new plan is nothing like theirs. It is disgusting how people cannot think for themselves and just believe something because they are scared. we finally have a president who is intelligent, eloquent and cares about America. And all we can do is try to bring him down? He has more on his plate than any other president, with the recession and financial crisis, north korea and the medical issue. If this was bush, he would take a 3 week vacation on his ranch and let cheney deal with it. GROW UP AMERICA AND START THINKING FOR YOURSELVES. STOP WHINING LIKE BABIES because someone told you too. it makes me sick that people are complaining when HELP has finally arrived. Read a little! or how about going out and experiencing some things for yourselves and learn the TRUE MEANING OF SOCIALISM. dear god.

I doubt 46 million people are truly without health care. In my estimation, the biggest problem we face as a nation is the welfare recipients who waste our bugetary dollars by not being compliant with therapy, and using the ER for primary care. This is a real issue, and with record deficits, this is the time to truly examine the freebies that the working folks are paying for which are being misused & mis-managed.

There is no reason that welfare recipients should be able to choose their practioner - a clinic should be set up in different regions of each state to accomodate welfare recipients & they should have to adhere to normal channels of getting care, like those who have commerical or medicare insurance. The ER is for emergencies, not primary care. If you violate that, you should be fined & have to pay the difference back to the state.

I don't trust Obama's plan. This is once again socialism & we don't need working people paying more so that those who are not productive in society or illegal immigrants, can have quality care. To those who say Obama isn't a Socialist, take the case of GM. The entire board is made up of men who have NO EXPERIENCE in the auto industry and it is being government run. Now they want to limit what executives make? Give me a break! This is America, where capitalism should be protected. However, if you believe what the Obama machine is spinning, you won't realize the socialist takeover until it is too late. If you embrace obama's policies, get ready to embrace your comrades!

38% of those uninsured have >$50,000 household incomes. It is estimated that 1/4th of those uninsured are eligible for Medicare and Medicaid...and don't know it. 9.7 million uninsured are illegal immigrants.

Subtract those groups and you get roughly 20 million who are uninsured and can't afford the $2500 a year for basic coverage.

The United States should focus its attention on preventative care and wellness programs (i.e. keep people from visiting hospitals in the first place). This can be done by taxing the sugarfoods/fast food industries just like we do with cigarettes companies. Tack on a 3% sales tax to every coca-cola and pepsi you buy, and dump all that money to diabetes education, and you're on your way to a healthier America and a health care system that can act on things that really matter, like cancer and trauma.

Pigovian taxes work people, not government-subsidized "public options" like AirTran, Amtrak, corn industry (high fructose corn syrup!), and social security (the ponzi scheme).

Eventually the cheapest option becomes the only option.

Rule #1 of economics: People respond to incentives.

The critics of the "public option" say that it will lead to complete takeover of health insurance by the government. We have an example that contradicts these naysayers: state workers compensation insurance funds. When government mandated employers to pay for the health care and disability compensation for workers injured on the job, some states starting in 1911 set up state insurance funds that compete with private insurance companies providing workers compensation insurance. Currently, 21 states have such government-backed insurance in direct competition with private insurers, and the private companies have not gone out of business. Employers have a choice. State funds keep administrative costs low and don't have stockholders to pay, so they can pay dividends to policy holders. Why can't health insurance follow the same model -- private and government-backed insurers in honest competition to keep costs as low as possible and to provide insurance when no private company will? The public option will not put private health insurance companies out of business -- it will make them compete and will give the public a chance to have quality care at lower cost. Maybe we would see better effort at keeping people healthy rather than treating them when they are sick, just as state funds provide ongoing, aggressive safety and loss prevention programs staffed by local safety professionals that reduce accident frequency, severity, and ultimate costs. I'm in favor of the public option, not fearful of it.

I believe that it is a right for all Americans to have health coverage. Too many people without health coverage wait until they get very sick and when they go to a hospital to receive services the cost is too high and we the tax payers pay the higher cost.If the unisured had coverage preventive care would be of great benefit. When you loose your job you are eligible for cobra insurance however Cobra insurance will cost a family 900.00 a month for coverage, I know because my family was confronted with this situation. One cannot afford 900.00 a month if you are no longer employed. Public Option will provide companies with with more opportunity to shop for lower cost and more coverage. Companies will have a greater competition edge. I work for an agency that is very generous regarding health coverage however I am aware that the cost is very high and the agency has had to cut back as a reslt. I remember when there was only one telephone company and cost was high. Isn't it wonderful now that we have choices on what tel. carrier would best fit our needs and hasn't the price gone down as a result. We have the competive edge.

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Lynn Sweet

Lynn Sweet is a columnist and the Washington Bureau Chief for the Chicago Sun-Times.

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This page contains a single entry by Lynn Sweet published on June 16, 2009 9:38 AM.

President Obama official schedule and guidance, June 16, 2009. Meets with Korean President Lee Myung-bak was the previous entry in this blog.

Obama White House putting muscle behind Chicago 2016 Olympic bid is the next entry in this blog.

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