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.