Thursday, February 25, 2010

livecaresummitbloghealth10 : hey, let's not let those uninsured people dominate this discussion...

Dropped back in on the summit and found another Democratic nonwhite guy. Rep. Xavier Becerra squabbled a bit with Paul Ryan, and makes the point that if you throw out CBO numbers, we can’t discuss this.
(CBO tells us the Dems health care reform bills reduce the deficit by 100 billion in the first ten years. Ryan may disagree with those numbers, but they’re the best we have, and the best we’re going to have.)

Boehner is up:
Thank you for having us. A useful conversation. Don’t disagree with premise of meeting.
Our job is to listen. I’ve heard an awful lot. What I’ve heard more than anything ist hat the American people want us to scrap this bill.
Let’s talk about why
Fiscal condition. We’re going broke. This new entitlement program will bankrupt our country. I think this is a dangerous experiment. We may have problems, but we have the best health care system in the world. A government takeover of health care, and I believe that’s what that is, is risky.
The last thing we need to do is raise taxes. $500 billion in cuts to Medicare. It’s going to drive up unemployment. Employers will dump employees into the exchange. Federal government is going to design every single health care plan in America within five years. For thirty years we've had a federal law that says we’re not going to have federal taxpayer funding for abortions. This bill allows for taxpayer funding for abortions
So let’s scrap the bill. Let’s start with a clean sheet of paper we can agree on.
I’ve been patient, I’ve listened. Why can’t we come to an agreement on selling across state lines, malpractice, etc.

(A thoroughly dishonest and distasteful performance.)

Obama: every so often we go back to the standard talking points. And that doesn’t drive us to agreement. There’s so many things you said, that people here disagree with and based on my analysis, just aren’t true. We were trying to focus on the deficit. The CBO says this will reduce the deficit. Paul may disagree. I’ll get back to you on some of these.


Rep. Jim Cooper. Medical expenses driving us off the cliff. Tough talk is not good enough, we need to take tough votes.


Dick Durbin
Orin Hatch asked CBO about tort reform. It saves $54 billion over ten years.
5.4 billion a year is a lot of money except when compared to the 2 trillion we spend each year on health care.
And if we do have tort reform, more people will die. Thousands more.
There are other ways to reduce medical errors and lawsuits that should not be filed.
The number of paid malpractice claims have been cut in half in the last ten years.
Money paid has been going down, cut in half in last ten years.
This is an important issue but to make it the overriding issue is [wrong]
The best health care system in the world for the wealthy. We should give everyone the same plan congress has. If you think it’s a socialist plot for goodness sake drop out of the federal health benefit plan.

(One of the more powerful, and shortest, speeches today.)

Obama: looking at access now. Republican plan would cover an additional 3 million, Dem plan would cover an additional 30 million.
This may be most contentious part: it does cost money. But let’s not pretend that we’re going to cover another $30 million for free. If we think its important as a society to not leave people out then we’re going to have to figure out a way to pay for it.

John Barrasso
This is about all Americans, not just those who don’t have insurance (???).
He says *everyone* believes that passing the bill will increase costs. Will make care worse. Will hurt seniors.
They all believe that because you keep lying to them.
Gotta take another break.

sumbloghealthliveit9care

Ok, gotta take a break for awhile. Hopefully will come back late in the day with some kind of summary.

For the record, a nonmale Republican has been sighted.

livehealtblogcaresummit8

McCain

Wants to talk about process. Taking a pretty critical tone; talking about lack of transparency, “unsavory deal making,” asking rhetorical questions, just being his usual grumpy old man self.

Boy, he’s really making us regret electing Obama.

Obama tries to cut in, McCain steamrolls on, says Americans want us to go back to the beginning. He really reminds me of the debates. I don’t know who this is good for. He’s certainly throwing mud at Obama. Will it stick?

Obama: let’s get back to the issues.

Is Saturday Night Live on this weekend? ‘Cause if it’s a new episode the opening skit should be awesome.

Nancy Sibelius is talking to a roomful of people who probably are counting the minutes to lunch. OK, just an observation. So far this has been going on all morning. Lots of people have been talking. A total of two, I believe, were female. A total of one was not white. The nonmale nonwhite contingent were all Democrats. Just making an observation about how inclusive and diverse our government is these days.

Eric Cantor has a huge stack of paper in front of him, comes about up to his collar. Obama asks about it. I guess Eric wants to be able to look stuff up if he needs to.

“There is a reason why we all voted no.” (Yep, it’s called November).

He says it’s ‘cause the sec. of HHS will define benefits. What these guys are arguing is again, that government can’t work. I guess that’s an argument. Sure isn’t a constructive one, though.

Taking on oversight of insurance premium increases. Government regulation will force premiums to go up, says EC.

Obama ripping apart his talking points. Making the point that regulations are necessary to protect consumers. Explaining the concept of risk pools. Man, it’s sad that we’re at this point.

“We just can’t afford this.” Cantor.

We could afford two wars, massive tax cuts, and the Medicare drug benefit you voted for. Right.

Cantor is dogged, I’ll give him that.

Oh, hey another nonmale. Hello, Rep. Slaughter. Hey, she's pretty good. But she used the phrase "eating my lunch" and I could hear people shifting in their seats.

Livehealthcaresummitblog7

Best new catchphrase (and movie pitch) from summit:

Undercover Patient.


Schumer notes that we can’t health care costs without cutting waste in Medicare, hits R’s for saying you can’t cut Medicare.

Sen John Kyl
We do not agree with the question on who should be in charge.
Do you trust your doc or do you trust Washington.

Oh, he’s going back to the premiums. Quotes a letter from CBO; premiums will go up because it’s a richer benefit, because the government would mandate it. Getting into acturarial tables. Govt will mandate that insurance will cover more things, so premiums will go up. Taxes.

Kyl has a big pile of papers in front of him, and danged if I don’t take him more seriously. Best use of props.

Taxes, fees, will increase the cost to the consumer. That’s why R’s would rather start by not having to raise a lot of money to pay for bill, instead take it piece by piece.

(my question: how many years til we get reform that addresses the real problems that way? 5? 10? 25?)

Obama responds:
Premium argument. If I’m self-employed, can’t get coverage. High deductible plan: it’s not health insurance, it’s house insurance. (good phrase) What CBO is saying: if I have an opportunity to buy good insurance, costs more but is real insurance. So yes I’m paying more because instead of buying an apple I’m getting an orange.

The federal benefit has a minimum benefit that all in congress enjoy. We’re saying we’re going to do the same thing for others that we do for ourselves. Saying there’s a baseline of coverage is not some radical idea. A lot of states do it.

I just want to point out the issue of gvot regulation is very different than the way this has been framed. This is not a government takeover of insurance. (He’s hammering home that point, I guess it needs to be said)

James Clyborn is talking up community health centers as a way to address cost and access issues. No matter what we do, there should be sig. expansion of those centers.

HCSummitLiveBlog6

Coburn called for undercover patients. I love that song.
“Undercover patient, midnight fantasy…”

After Coburn, Obama points out again, that many of the cost containment ideas and prevention ideas are already in the bill. This is going to be common theme of today: you guys say you want xyz reforms, hey, they’re already in the bill.

Here’s Steny Hoyer, telling Coburn the bill does exactly what he suggests in working on Fraud in Medicare & Medicaid (hereafter known as M&M)

Steny seems more focused and articulate than Reid/Pelosi. Not necessarily more exciting, but I don’t find myself saying, wait, what? …as much.

Obama: what are your objections to health insurance exchanges? I know some of you have agreed to this concept in the past. (ooo, nice passive aggressive move.)

JOHN KLINE, from MINNESOTA!!

Kline: we’re looking at thousands of pages of legisatlion, better to go step by step. We have proposed that small biz be able to band together.

I love that tie. I mean it, it’s outstanding.

Let small biz band together to get the same advantages that bigger co’s have. Obama, nodding. Kline: we think that’s a better idea than exchanges.

Obama asked Max Baucaus to respond.

Baucus: this is what strikes me. We all know what the problems are. We are actually quite close. The gaps are not that great.
Going back to Lamar. We’ve got most of what R’s want. Across state lines. Tort reform (HHS working on) . Baucus seems nervous and a little tongue tied.
HSAs work pretty well for middle and high income people.
Small business: we’re not that far apart. Association health plans (Kline’s thing) That’s fine, what we provide is the SHIP Act. Bipartisan, allows small business participation in exchanges. Major provisions on fraud and waste in the bill. We basically agree. Looks like he's ready to start hugging people.

(I sense a real advantage here for the Dems. They keep hammering home that they have made reasonable attempts to address the R concerns. They show how the bill incorporates R ideas. They get a chance to explain how the bill works and what it does. The R’s can’t come back with the outright falsehoods, because Obama has made it clear he won’t let them pull that stuff. Obviously, I’m pro-reform so my take on this may reflect that. But this seems effective to me.)

McConnell yields to Boehner, Boehner yields to … who is that? Camp? Rep. Dave Camp. He says if you care about costs, why are you spending a trillion dollars? (because it reduces the deficit?) He says someone (medicare?) says the plan does not bend the cost curve the right way. He wants malpractice reform. Quotes CBO that says med malpractice reform would reduce deficit.

Remember he quotes CBO.

Lots of details with this guy, he’s definitely a policy guy, seems more prepared than some of these guys. Talks about an unelected board to make Medicare cuts (death panels!)

Obama cuts him off: doesn’t want to get off on tangents, then lets him finish.

Obama and Camp getting into premium increases. When all this is structured around a government centered exchange: that kind of approach raises cost. Mandates.

Rob somebody. Robert Andrews.
He says difference between association and exchanges is semantic mostly, one substantive difference. Different consumer protections in diff. states. Shouldn’t be 51 different sets of rules, one reasonable federal standard.

Republican guy just said he doesn’t hear people complaining about their health insurance companies. “We do” says Andrews.
“We don’t agree with the idea that the insurance company gets to make (medical decisions.)

McConnell has been keeping a stopwatch. Sheesh.

Paul Ryan from Wisconsin. Washington shouldn’t mandate things. Let the industries set up their associations for their members. We want to decentralize the system, give more power to small businesses.

Andrews: asks Ryan about setting consumer protections.

Should people in Washington decide for everyone?

Obama says its an important point.

Obama: Focus in on this philosophical debate. Legitimate points. When I was young I had to buy auto insurance. It was a joke. Health insurance is different. We should set up minimum standards in the exchange. It is true you can always get cheaper insurance if it has high deductibles or doesn’t cover things. The principle of pooling is at the center of the bills. A lot of talk about government takeover. That’s not the issue. The issue is how much should govt set a baseline?

When we start talking about how much government involvement – it’s not that it’s a takeover, it is that govt is setting up regulation, baseline requirements.

MST3K5

Obama doesn’t respond much to R criticism, but notes that some areas of agreement,
Says let’s not dwell on process and stick to substance

Everyboy agrees on cost

Talking about costs, costs to businesses,
Talks about exchanges –not a Democratic idea but a Republican one! (dig it!)

CBO cost estimates: plan would lower costs for individual markets, calling Lamar out on this, Lamar cuts in--CBO says premiums will rise Obama-no no no
We have to get our facts straight, what you said, Lamar, was not factually accurate
Costs for families would go down 14 to 20 percent
Because they now have a better deal, they may chose to buy better coverage, which might be more expenseive

(So we have our first tussle. Decision, Obama.)

Obama still going over cost containment in the proposals.
Additional ideas that R’s have suggested, that we have included
Buying across state lines: that’s in the proposal
What we’ve tried to do is take every single cost containment idea and put it in bill

What ideas you have that you don’t think are in the bill to contain costs?

10:00

Not letting LA cut back in.

We’ve adopted a lot of your ideas

LA: I punt on this other stuff.

I think your wrong on increasing premiums, I’ll put my facts down and send them to you.

Obama: I’d like to get this issue on premiums increases settled before the day’s out.
(Yes!)

McConnell: Can I get a Pepsi?
(he did not say that)

McConnell: The American people hate this bill. Hate reconciliation.
Calling Dr. Tom Coburn. Stat!

Coburn (whoa, lookat that hair!)

We’re performing bad medicine.
Govt health care doesn’t work

Cost is the problem.
We could solve this problem if we just address costs! There are lots of ways to fix this!
Tort reform! Change the school lunch program!
(I smell a Nobel prize)

LVHCS4

9:35

Alexander:

this has to be bipartisan. (I think this is a good argument, if we have a bipartisan, goodwill effort on both sides. We clearly don't. But let's see where this argument goes and how Obama's team responds)

Re-earn the trust of the American people.

Obama:
kicking it to Nancy and Harry. I loved that movie.

Nancy opens with some lovely hand gestures. Bipartisan passage of House bill to lift anti trust exemption for health insurance cos.

Talking about Sen. Kennedy. (Now you are just bumming me out.)

Character of country, kitchen table,
People don't have time for us to start over

I've seen grown men cry
(I bet she has! I bet she has! Know wot I mean?)

(very sorry)

What it means for economy. People locked to jobs.
some discussion of early legislation health technology, children's insurance
innovation, prevention, wellness

Most people haven't heard about that
they don't want to hear about process they want to hear about results
lower cost, accessibility,

NP kind of rambles at times. Teleprompters aren't always bad, you know.

But making OK points.

Here comes the REIDINATOR!

Babies with prexisting conditions,


Lamar A is entitled to opinions but not facts (that is getting so old)

Make sure we talk about facts

Kaiser Foundation poll found poeple would be angry if we did not do hcr this year

(we are going to hear a lot of dueling polls today)

What is Reid's point on opinion and facts?

No one has talked about reconciliation (what?)

Now he's talking about how Reconciliation has been used for major things, often by R's. Finally a good point but not delivered well.

Bill reported out of committe has more than 150 Repub. amendments

Ok, taking abreak...

LBHCS3

McConnell kicks it to Alexandar! Alexander has the ball and is pulling the Governor end run. OH, the tea party gambit! Not even three sentences into it! Town Halls proved we should start over!

Good they're not going to talking points.

We want you to succeed, but would like you to change direction.

Detroit auto show (what the-- trying to tie this to the unpopular auto bailout??? Yeah, they've done that before)

Should start with a clean sheet of paper. ( --I am very interested in hearing Obama's response to this talking point--)

New taxes, premiums will go up, unfunded mandates, just maybe a few scare tactics here, dumps millions of americans into a Medicaid program (yeah, they're going to HATE having health insurance--ok, legit concerns about reimbursments but come on)

This is car that can't be recalled and fixed

Is he going to throw in a Toyota reference? Come on Lamarr, go for it!

We don't do comprehensive well. Our country is too big and complicated (to govern, I guess)(why are these guys senators. I mean, really why are you in government if you think it's a waste of time?)

going over points of R plan. Cost control, selling across state lines, medical malpractice, Health savings accounts, Hey, we have SIX ideas! Oh, and maybe we need to rein in insurance companies. But maybe not.

Renounce your plan! Give up on reconciliation! Surrender Dorothy!!!

All yr bases R Mine!

LIve Blogging the Health Care Summit 2

Outlining the problem: families suffering, drain on economy, things are getting worse, hurting businesses, effect on the federal budget (bad), exploding cost of medicare and medicaid...

Personal stories--his kids going to the hospital when they were young, what would've happened if he didn't have reliable health care, his mom's cancer. I think this personal, low key approach is good for setting the tone as not intimidating or confrontational. I guess since his real audience is the country it also is a way to connect with normal folks.

"This became a very partisan battle" um hmmm.

That plant by his head is distracting

Overlap of ideas, areas of agreement

9:20

Hope as we discuss each section today, hope to bridge some gaps, don't know if we *can* bridge gaps, but I'd like to make sure this discussion is actually a discussion and not just us trading talking points.

Well, good luck with that

...(it could happen)...

Live blog the health care summit? Sure, why not?

I'm keeping one eye on the health care summit in washington today. So I figure it might be fun to drop a few comments here. Or not. We'll see how it turns out.

9:05, POTUS in the HOUSE!

Sorry, just trying to spice it up. Mostly the diff. lawmakers were sitting around looking nervous,now Obama is making the rounds shaking hands. Some of these guys are introducing themselves to the Prez,so I'm guessing they're aides or -- wait, Paul Ryan just introduced himself. What? Those two have never met?

Obama has a nice tie... oh, had to wait a sec for Biden to sit down. Get it together, Joe!!