A Preview of the Obama Health Care Plan

Although we’ve been talking for more than a year about the “Obama health plan,” the fact is, there hasn’t been one–until now. The NYT got a preview of at least part of the proposal that the White House has promised to post on the internet tomorrow.

Where most of the discussion in recent months has been about the question of how to cover the uninsured, one new provision appears to be an effort to refocus the debate back on the question of controlling medical costs–something that Americans say is their top concern about the current health care system.:

President Obama will propose on Monday giving the federal government new power to block excessive rate increases by health insurance companies, as he rolls out comprehensive legislation to revamp the nation’s health care system, White House officials said.

The president’s legislation aims to bridge differences between the bills adopted by the House and Senate late last year, and to frame his debate with Republicans over health policy at a televised “summit” meeting on Thursday.

By focusing on the effort to tighten regulation of insurance costs, a new element not included in either the House or Senate bills, Mr. Obama is seizing on outrage over recent premium increases of up to 39 percent announced by Anthem Blue Cross of California and moving to portray the Democrats’ health overhaul as a way to protect Americans from predatory insurers.

Congressional Republicans have long denounced the Democrats’ legislation as a “government takeover” of health care. And while they will likely resist any expansion of federal authority over existing state regulators, they will face a tough balancing act at the meeting with the president to avoid appearing as if they are willing to allow steep premium hikes like those by Anthem.

Related Topics: Barack Obama, Congress, Health Care, White House
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  • afguy

    So… we’re talking insurance rather than health care reform…. AFTER the companies raise the sh!t out of their rates??
    .
    Why do I have a queasy feeling about the outcome of all of this?

  • kbanginmotown

    K-Tum: The significance of this action cannot be overstated. After months of labeling anything that moved, “Obamacare”, we finally are seeing the real deal. This in itself should be newsworthy and a finger in the eye of all the naysayers (who don’t believe that there is a right in the (Judeo-Christian?) US to some form of basic health care.
    .
    And the idea that the fundamental issue of “controlling medical costs” has bubbled to the surface is wonderfully good news (esp. to those lone voices such as Stuart’s, who have been beating the drum for months).
    .
    Sadly, I think that the House and Senate are going to react negatively to Obama’s plan and announce that their turf has been trod upon, and that it the legislature’s duty to legislate…or not.
    .
    Fingers crossed.

  • afguy

    Hope you’re right, kbang, and something really good comes out of all of this.
    .
    Ain’t gonna be pretty if it doesn’t, for party or country.

  • kbanginmotown

    Speaker-to-Furniture: You’re here!
    Caught your previous reply – thanks.
    .
    Re: Wooden Objects. Rep. Barney Franks claims it wuz Dining Room Tables that gotcha. From my vantage point on the sofa, it sounded more like the hardwood credenza in our dining room…ouch!
    .
    Re: Insurance Increases. Queasy is right. A 25% decrease in rates sounds good…unless it comes after a 39% increase..!

  • afguy

    Hey, businesses do it every day… the ol’ “two-step” makes VERY GOOD marketing copy… as long as you, the consumer, don’t sit down and do the ACTUAL math.

  • dwilde1

    Sounds like “rent control” in LA, and bound to be just as poisonous. Remove the limitations on interstate competition in insurance and there may be some downward pressure here. California is an extreme example here because the state has already added some very high-risk populations by fiat.

  • dwilde1

    right to basic health care?
    .
    where? why? and who stepped up to pay for it?
    .
    I’ll agree to that only if there’s a consequent responsibility to commit seppuku if you don’t deserve it.

  • apr2563

    dwilde: Interstate competition will not help contain premiums. Remember insurance companies still do not have to abide by anti-trust laws. Companies will simply find states that have the least regulations, headquarter there and go about business as usual.
    As far as high risk populations, how do you suppose those people get health care when they have no coverage. They use emergency rooms, the least cost effective care. Do not get preventive care. Then they are right back in crisis mode.
    When are the people against HCR going to understand that years of experience has shown us that universal coverage is the only way to obtain quality and saving in health care?

  • kbanginmotown

    Matthew 15:30
    Then great multitudes came to Him, having with them the lame, blind, mute, maimed, and many others; and they laid them down at Jesus’ feet, and He healed them.
    .
    …after they provided proof of insurance, I suppose…

  • kbanginmotown

    Or a 3-card Monty…25% off of 39% at 0% and no money down!
    .
    I do wish that the Dems would get some professional marketing help. The Dems remind me of the guy who finally won the 20-year battle against Ford Motor Company to get royalties for the intermittent windshield wiper:

    “It destroyed his marriage, brought on a mental breakdown and may have cost him millions.”(link)

    Yeah, truth is on your side. But, does if *have* to be so painful?

  • carotexas1

    Now I know why Dianne Feinstein signed on for the Public Option. California representatives and Senators must be getting a lot of calls. I do not recall her committing to the Public Option before.

    Thank you for this post Karen, I am looking forward to a lot of heath care blogs tomorrow.

  • dwilde1

    @apr, I fully admit that I don’t understand much about this issue, but when you mention one government minefield (anti-trust) as a response to another (interstate commerce) you’ll pardon me if I decide that there’s a fox in the henhouse. :)

  • apr2563

    Liberal blogs, Kos, Firedog, TPM, Atrios, etc in conjunction with liberal groups have been on fire for a couple of weeks. They have generated 10s of thousands of calls to Senators to support the Public Option and reconciliation. They have been asking for real filabusters since the Reps began using them on every piece of legislation.
    Emanual may find the liberal folks who helped get Obama elected annoying, but they are the base and they will push whether their help is wanted or not.
    It was Howard Dean and the 50 state push and the millions that Act Blue brought to the table that were a tremendous part of the Democratic resurgence.
    They are not as recognized as the tea baggers by the media, but their organizational power is quietly powerful. They are disparaged by the traditional media as fringe. No special interest, corporate money, or people like Dick Army or Grover Norquest supporting them. It is a real movement with real populism.

  • apr2563

    Please, tell me what you don’t understand. I am not being facetious.

  • stuartzechman

    Thanks for the hat tip.
    .
    You know it’s hard out here for a wonk.

  • stuartzechman

    Yikes:

    by focusing on the effort to tighten regulation of insurance costs, a new element not included in either the House or Senate bills, Mr. Obama is seizing on outrage

    So…
    .
    …they think they’ve got the right policy in the Senate bill, they just needed a little something extra to sell it…
    .
    …and counting on the Senate to pass it…
    .
    …unamended to water it down to meaningless symbolism after the sales pitch isn’t needed any more…
    .
    …and everybody forgets to ask if the HHS regulations/”Health Insurance Rate Authority” that actually get passed start to take effect in 2016 or 2025…
    .
    I guess we’ll have to really squint hard at the fine print, won’t we, commenters?
    .
    Well, I read HR 3200 and the Finance markup, and the Senate bill in their entireties, so I guess I’m going to have a busy week…
    .
    It is interesting that they’re finally broaching the subject of Federal price control authority (maybe? we’ll see?), but it’s disturbing that they seem to be focusing on the third-party payers, instead of setting prices for what insurers pay for.
    .
    If they don’t set the price of prescription drugs at Canadian levels, won’t they just have to allow rate increases to pay for the 6% increased price of drugs next year? …And the year after that? And so on…?
    .
    Doesn’t California already have an “authority” that authorizes rate increases for insurers, for example?
    .
    Doesn’t the current increase fall into the “justified under current regulations” black hole?
    .
    Can’t I ever be delighted to be completely, absolutely wrong about the way things are going? God, I would love to be wrong…
    .
    Christ, this is exhausting. Stay tuned…

  • the committee

    Blocking excessive rate increases? Finally, socialism has come to America, and my populist outrage has been assuaged!

    Kidding. Really it sounds like some very weak tea. I’m willing to be persuaded though!

  • mxyzptlk1953

    So much blah blah blah blah blather. Aren’t we, as a country, embarrassed to have 50 million uninsured and 40,000 unnecessary deaths per year? Any of the talkheads who piddle about “the greatest health care system in the world” have not actually had to use it the same way as we common mortals… except for Glenn Beck who is just lying now given his experience two years ago. Maybe Pharma stuffed a big check up his injured ass****.

  • slapsgiving

    We do have Socialism. We pay taxes and recieve services for those taxes. That is the definition of Socialism. I quite enjoy driving on my Socialist roads, being protected by my Socialist Police and Military and I really like all the food I buy that is halfway Socialist through subsidies.

  • artraveler

    Limbaugh seemed to have survived his brush with a “socialist” healthcare system in Hawaii. And it was the greatest system in the world until he learned that it was “socialist”.

    Take away their anti-trust exemption immediately. It ought to be in a stand-alone bill and make everyone take a position. Are you with the companies or with the American people? Would make a great 10-second sound bite.

  • Matt

    Obama needs to make Republicans an offer they shouldn’t refuse, but will. The GOP is going to walk away from anything for the simple reason that it is Obama and the Dems proposing it.

    Say that tort reform and some other centrist measures will be in a final bill and publicize it, then let the GOP deal with the consequences.

    http://www.political-buzz.com/

  • rustyreturns

    “When are the people against HCR going to understand that years of experience has shown us that universal coverage is the only way to obtain quality and saving in health care?”

    .
    Want to prove that? Show figures and studies which show that “universal coverage is the only way to obtain quality and savings”?
    .
    Oh, you can’t.
    .
    Next!!

  • rustyreturns

    The people, the majority of the people of this country have already spoken. We do NOT want this bill to be our health care reform.
    .
    The Democrats in Washington are proving yet again how out of touch they are with the American People. They only way they will “get it” is when we go to the polls in November and vote them out of office.
    .
    Now there is “change YOU can believe in”.

  • diecash1

    Ezra Klein and Paul Krugman recently wrote about the problems with selling insurance across state lines.
    ..
    Link to Ezra Klein Article
    ..
    Link to Paul Krugman’s California Death Spiral Article

  • carotexas1

    Stuart, looking forward to your posts.

    My bet is they will have something to close donut hole with drugs but no other change.

  • http://2thirdsrocks.wordpress.com 2thirdsrocks

    Walking away from anything Obama and the dems propose is the smartest thing the repubs hav done in a long time. Going along with them lost us the presidency.

  • greenlyfe

    I really think, with the addition of this new insurance regulator, and the popularity of the individual proposals the president has put forth there is a good chance at this reform passing.

    The President will have six hours on television to present his plan: afterward the substantive policy discusion will be the story. Couple this with the fact that Republicans are apparently refusing to put a plan on the table; I think the optics of this aren’t going to look good for the Republicans. This has the potential to be a bigger shot in the arm to the administration and democrats than the Republican house retreat Q&A was for the President.

    JMHO

  • http://2thirdsrocks.wordpress.com 2thirdsrocks

    PFfffft! Is there any thing in there that will help put millions of unemployed back to work? Hell No!
    .
    Kill the Bill! Give us jobs!

  • http://theblindspotsofgod.wordpress.com lawyermommy

    Here we go again. The dance and posturing begin.

    A well intentioned President surrounded by folks who cannot see past their noses.
    The Democrats have been no help to his agenda either.
    The Republicans will, as usual, find a way to make his proposed cost savings look like some “evil plot” which has a “hidden” intent to divest people of their hard earned moneys. Bleh!

    Cynical, me???? NO KIDDING! Palin and the rest of the Party of NO, got most of the folks in our country to believe that the reform of a broken system by a sitting President would make things worse for them. Freaking A CRAK.

    These Anti Obama folks cried “death panels”, “had parties and drank tea” :) AND have continued to wage and unending campaign of calumny and VILE misinformation on everything in this Reform plan.

    Will this work better? Sorry, I doubt that it will.

    The Democrats are a fractured and sad crop of self serving re-election focused politicians.

    The president’s intention and efforts to change a broken system will be supported by them ONLY if they think it enhances their prospects for reelection. The American people be damned– to them at least.

    I am getting tired of reading this intractable and unnecessarily dramatic and problematic efforts to launch a needed and key change to a horribly broken system.

    The entire effort to overhaul the system has been eclipsed by high stakes politicking and the same old “business as usual in Washington nonsense”!

    Will this work? The President has been trying hard for a long time to get this key initiative to gather real “traction”, and he has failed.

    Failed, not because of the contents of the plan but because of the desperate selfish politicians he has to deal with even in his own party.

    I hope he can set the Democrats straight and maybe do a Cheney—do exactly what I say move– on them. :)

    Until then, I have to believe this is once again news fodder. Just “news” for discourse.

    Different plan, same players, same posturing. The same old “results” can be reasonably foreseen and EXPECTED unless he has some hidden “card” which he will play this time.

    We can only hope! “Sigh*

    LM

    http://theblindspotsofgod.wordpress.com/2010/02/15/stalking-criminality-the-law-and-women/

  • pafro

    What annoys me about the current situation is a public option appears to me to be a way less intrusive of stopping rate increases than a national super-regulator like Obama proposes.
    Leave it to Democrats to go for the convoluted fix rather than the simple and popular one.
    I mean if some insurance company wants to raise their rates 40%, wouldn’t it be nice to tell them that is their right, while telling their customers there is a government provider they can switch to instead if they are sick of the vampires sucking their life away?

  • diecash1

    Nonsensical, idiotic policies that resulted in 9/11, two unfunded wars, perverting of the Justice Dept., multiple tax cuts for the wealthiest Americans during said wars, a massive, unfunded expansion of Medicare, etc. resulted in Republicans losing the House, Senate and the Presidency. Also, millions of Americans lost their jobs due to the utter incompetence of said Republicans when their failed policies drove the economy into the ditch. Funny how you forget that and then blame the Obama administration for not fixing it fast enough.
    ..
    Hypocrisy, much?

  • pafro

    Actually when people hear what is in the bill, instead of what Republicans think is in the bill, they support it.
    And you said you wanted Democrats to pass it because it would be good for you wingers, why are you so cranky about it? I thought you would be encouraging Democrats to go full bore here and signing up for the million calls on the 24th and 25th?
    The fact you aren’t tells me you are scared this will pass and people will like it and then your McCain/Palin 2012 fantasies will evaporate.

  • pafro

    Get your own job 2/3. Why do you always expect government to always hold your hand and pamper you like David Vitter on a prostitute date?

  • diecash1

    Sans diaper?

  • cigarcamel

    kbang – it didn’t COST anything when Jesus healed, no one took my property and gave it to someone else.

  • kbanginmotown

    You got me there…it didn’t COST anything when Jesus healed.
    .
    Say…what’s this Lent and Easter thing all about, anyway?

  • cigarcamel

    I wouldn’t know, I’m not Christian.

  • meanjoegreen59

    NO where in any of these “Health Insurance” plans did I see the word “Tort Reform”. Get the lawyers out of health care and lower malpractice insurance for doctors and hospitals. Doctors would not have to be running so many un-needed tests just to protect themselves.
    Allow insurance companies to compete across state lines. Than customers could have a better choice. Let everyone buy there own insurance and not be required to take what policy an employer offers.If employers want to pay for employees insurance they can pay the employee directly. Expand health care savings plans.
    We need a few health care reforms. We don’t need the federal government taking over 1/6 or 1/7 of our GNP.

  • diecash1

    Way to trumpet a variety of Republican talking points, all of them false.
    ..
    Tort reform was passed years ago in Texas to no avail. This defensive medicine you claim is a result of tort litigation has shown to be false in Texas as demonstrated by recent studies of Medicare spending. It has also failed to lower premiums for health insurance.
    ..
    There are numerous problems with selling health insurance across State lines and I have posted two articles describing such problems up thread at 3.1.
    ..
    Expanding health care savings account will do wonders for all of those that either can’t afford decent insurance or any insurance at all! Yeah, right. Next you’ll probably tell us that a few more tax cuts would fix everything!

  • http://2thirdsrocks.wordpress.com 2thirdsrocks

    Wwwwowww Paffy, @#ckin’ brilliant response! And you’re little adendum dumcash, was simply over the top!
    .
    All I had to do was read the part about penalties for those who refuse to buy insurance, and for employers who don’t provide a plan for their workers, and I say to myself, how is this good for America? I’m an average joe, not a super-intelligent Inesteen swamper like yourself, so I’m having trouble seeing what you’re seeing in this bill. I see more hardship and penalties for a major portion of this country (small business) which is already barely hanging on. Explain to this average dummy, in dummy terms, how the hell this bill can be good for working class America. And keep in mind that small business working class people make up about 80% of the country. We’re the driving force that keeps this country humming, and a @#itload of us vote, as you will see come November.

  • diecash1

    Way to go for the insults and ignore the substance. How about addressing 10.2 with some actual substance?

  • http://2thirdsrocks.wordpress.com 2thirdsrocks

    I just love how you libs keep citing the same “Texas, tort reform doesn’t work” line, while at the same time you accuse us of spouting “republican talking points”. You conveniently always leave out the fact that Texas has been hit the least by this recession or depression or whatever you want to call it, with still the lowest unemployment rate in the country. Something obviously must be working there. Again just another observation by the average joe. I must really be a dummy.

  • diecash1

    Feel free to explain how tort reform has led to lower unemployment in Texas. I would love to hear this explanation.
    ..
    BTW, Texas is 19th among the States in unemployment with 8.3%, hardly best in the Nation.
    ..
    http://www.bls.gov/web/laumstrk.htm

  • dwilde1

    @apr: The two articles posted otherwhere added light to my understanding of the concerns you raise about risk pools and interstate sales. I can see the risk pool argument and the “buy a legislature” argument. Unfortunately, from what I see the PhRMA payment cap Mr. Obama negotiated seems to be in this bill too, so “buy a legislature” seems to apply to such negotiations on the national scale as well.
    .
    What I don’t see in the current discussion is anything that addresses the fundamental difference between health insurance and any other insurance. You buy your own gas and broken mirrors, and insurance covers the major accidents and liabilities, but with health care there’s no incentive to be cost conscious on either the patients’ or the doctors’ side because all the costs are hidden. Likewise, there is no disincentive on pills in the current insurance situation.
    .
    AFA emergency rooms, that’s a great place for the INS to hang out. California politicians seem to have a very difficult time dealing with that simple idea. Setting that third rail aside, I agree that that’s a pivotal problem but that would qualify if we shifted to catastrophic insurance as I suggest in the previous paragraph.
    .
    As for how this all plays out WRT preventative care and lifestyle choices, I can’t see paying for everything for everybody unless there’s a new level of cost competition introduced that also doesn’t penalize non-AMA health care choices. In the present system, providers over-prescribe and users have no incentive to say no. Who needs a brand new $100 plastic ping-pong-ball breath tester on every visit to a hospital? Insurance companies are made out to be the bad guys in this situation (“refusing care”) but doctors are as much at fault for running up the normal bills.

  • http://2thirdsrocks.wordpress.com 2thirdsrocks

    So let me get this straight deadbrain, less than a year into Bush’s presidency, we got attacked, and it’s all a result of his nonsensical idiotic policies, but more than a year into B.o’s presidency, with everything getting worse, (yes worse, not better) it’s all (here we go again) Bush’s fault? Is that right DIE? And you left out the part where unemployment hovered below 5% during Bush’s term, that is until, oh roughly, ’07, when the dems took control of congress and senate. I know in my state, the jobs seemed to start downhill right about the time our new democrat Governor started slapping us with higher taxes. But again I’m just your average dummy, going by what I see personally,with my 2 eyes……please enlighten me, I’m lost in this here wilderness called swampland……

  • stuartzechman

    diecash1:
    .
    Thanks for backing up your claims with links to verifiable facts.

  • diecash1

    Your self-admittedly lowbrow analysis falls short of the mark, as usual. I’m sure it’s comforting to believe that the ruinous policies of W and the Repubs have no effects going forward as everything happens instantaneously in your world but that’s just not how things work.
    ..
    It’s obvious that no amount of logic, facts and reasoning can convince you that you’re wrong, so why are you here? It appears that you aren’t here for an exchange of ideas, you prefer to name-call and revert your vicarious impressions of what happens — anecdotal evidence does not an argument make.
    ..
    Feel free to peruse these economic charts
    Link to economic charts

  • pafro

    I personally think that deadbeat employers that refuse to provide benefits for employees should be fined out of existence. Long term, this is the best thing that could happen to America. I say:
    DEADBEATS, TAKE YOUR ANN RAND BOOKS TO SOMALIA SINCE IT IS YOUR PERFECT SOCIETY OF NO TAXES AND ZERO GOVERNMENT OVERSIGHT.
    Economic theory, especially that sort most thrown around by the pamper-ed conservative party, says that there will then be a free market productivity gap that will be filled by new and responsible entrants into business.

  • apr2563

    dwilde1: good morning. You have some good points. The pharma deal was unconscionable. If they thought that pharma could be bought off to help in passing the HCR, it was the first big mistake of the administration. The action was caving to a special interest,
    Catastrophic care would be helpful but preventative care must come first. For instance, if someone is diabetic, they need continual care. Children need vaccines, checkups, etc. Pregnant women need prenatal care. Everyone should have certain standard tests for breast cancer, colon cancer, etc.
    Where it stands now I don’t know. You are absolutely right about out of control medical costs. I haven’t had a chance to read the Presidents proposal yet. But at different times the HCR plans had means to drive down health care costs through control of Medicare costs and other means. Of course, a Public Option could have been a good means of negotiating with providers to keep costs down.

  • dwilde1

    @pafro: where is it written that employers should provide health insurance? That was a kluge that came up after regular compensation incentives were blocked by government fiat, and now it seems to be a good part of the reason there are no jobs. Punishing corps for basic economics will soon lead to no corps either.
    .
    You can’t have it both ways. If a job costs more than it creates value, there is no job (government-subsidized ones excepted).
    .
    Are you willing to accept a radical increase in the price of everything from toilet paper to traffic lights to pay for this brainstorm? Are you willing to have even more manufacturing and services coming from India and China and Eastern Europe? Or Somalia, for that matter?
    .
    The Internet and global shipping have radically altered the job landscape forever. There is no going back.

  • apr2563

    rusty, people on this site have linked many times to documentation about the advantages of universal health care. The data was clear.
    Now if you chose not to read that information, I see no need to keep posting it just for your effication.
    If you don’t read the facts, rusty, it allows you to keep repeating the same nonsense. Have at it.

  • pafro

    Ah, but that is where the “Fair Trade” aspect comes in. Any country that jerks around its workers gets hit with a fair- trade penalty, and that stops the Chinese from mowing my lawn or building my deck.

  • dwilde1

    @pafro: Penalties, penalties, penalties. I haven’t seen anything that is a positive incentive to anything, and the toothless threat of WTO penalties haven’t stopped the Chinese from supercharging their economy by stealing software and keeping their currency artificially low. It’s actually quite a risk that the US will get slapped by the WTO for various protectionist initiatives.
    .
    I hear lots of calls that the GOP is the party of “No”, but the Dems are becoming the nasty nanny with a broom: “DON’T or I’ll WHACK you!” Never mind that your brother doesn’t ever give YOU a cookie, you give him one. WHACK! Give him another! WHACK! That was your last cookie and you didn’t get to eat any? Too bad, but I’ll “help” you by whacking someone else! No thanks! I used to live in New Mexico which is #49 on a lot of lists for good reason.
    .

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