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Our previous coverage of President Obama’s opening remarks: President Obama: health care reform – blogger conference call

….Question…Now we have these, uh, we’ll call them, uh, conservative Democrats joining with some Republicans [garbled] wanting to delay the bill, saying they need more time to, to go over and actually read it. But my question to you is will you ask Congress to forego the August recess and work this bill out? Because while they’re taking a vacation millions of Americans are either losing their health care or about to go bankrupt because of health care issues. So if they are going to whine about not having enough time they should act like real Americans and work during August.

President Obama: Well, here, here’s, here’s what I’ve said. Uh, we cannot delay any longer. Uh, if people keep on saying, “What’s the rush?” We’ve been debating this for fifty years. Uh, we’ve been talking about health care reform throughout the campaign. The day after, uh, I was elected, uh, we started contacting key leaders in Congress about the fact that this was gonna be our number one domestic priority. Uh, all these committees have been meeting. Experts, uh, have been talking. And now’s the time to make tough decisions. And I understand people wanting to put off tough decisions, but, uh, ul…ultimately, uh, we can move a process forward in which all the options have been dec…considered and we go ahead and make smart choices that provide the American people more security, uh, greater options, as well as, uh, bending the cost curve over the long term. And I, I’m confident that we can achieve that on the time line, uh, that I’ve put forward. I, I think it was telling, some of you may have seen, uh, uh, a Republican senator this weekend saying “That we’re just gonna delay and delay because if we can stop Obama,” uh, “on this one this is gonna be his Waterloo.” Uh, “We’ll break him.” Uh, that, that, that was a quote. And I think it indicates the degree to which, uh, a lot of folks may sincerely think that the more time we take, uh, the better off we’re, we’re gonna be, but I also think that there are some who deliberately want to delay this process because they know that the longer the special interests have to run negative ads or lobby members of Congress, uh, the more difficult it becomes, uh, to get this done. And, uh, you know, I think that, uh, the time for talk is, is through. Uh, now’s the time for us to go ahead and act.

Question I agree. Will you then make them give us a bill before the August recess?

President Obama: Uh, we, we are working, uh, as hard as we can and I, I’ve told, uh, uh, Harry Reid and and Nancy Pelosi that, uh, you know, it is critical, uh, that we see serious forward motion, uh, before people leave. All right?…

….Question …Given the time line and the fact that it seems like, uh, bills may not be through both the House and the Senate by the August recess, is there a point at which you would say to the Senate your, uh, sixty votes is, doesn’t seem like it’s gonna happen, use the reconciliation process, uh, lower the threshold so the Republicans cannot delay the process? Is there, I know it’s not optimal, but is there a point at which you would say that to the Senate?

President Obama: Uh, keep in mind that, uh, the way we had structured the reconciliation issue, uh, several months ago. Uh, we, we moved forward on, on the basis of the assumption that we can get a bill through the regular order and the regular process by October. If I think that that is not possible then, uh, we are going to look at all of our options, including reconciliation. Uh, not because that’s my preferred option but because what I, what I think will be unacceptable for the American people is inaction, uh, at a time when, uh, we have been, uh, seeing families bankrupted, businesses, uh, straining under the costs of health care, uh, and in the absence of action, uh, a continuation of a Medicare and Medicaid, uh, trajectory that is unsustainable. Uh, now in, in fairness I do think that, uh, what you’re seeing right now is really serious hard work on the part of, uh, members of the Senate, uh, and those on the Finance Committee. And although, uh, I may not, uh, agree with every single decision that may be made in, in any of the committees I think that folks really are working overtime. Uh, and t..and I appreciate the work that they’ve done and I remain confident that we can pass a bill, uh, in the absence of reconciliation. But I do think that, uh, the bottom line for me is give the American people a, uh, a serious reform package that lowers costs, increases choices, covers Americans, improves quality, changes our delivery system in, in a way that’s rational and, and, uh, makes our health care system, uh, a lot smarter and more efficient than it is right now. And I think that’s achievable and I, I continue to believe there are enough people of good faith, uh, who want to see that happen that we’re gonna get it done, uh, through the regular process….

….Question …Robert Reich, uh, put out an article today talking about the tension between, uh, some of the deals that have been made with, uh, stakeholders…

President Obama: Um hmm.

Question …in the debate, pharmaceutical deals, hospitals and things. And the need to, uh, bring more costs out of the current system. Is there a tension there and, and considering that the debate seems to be moving towards costs, uh, is there a tension with holding up to these deals with, sort of keep these stakeholders at bay and on the same side And also trying to, you know, get as much costs, uh, internally, uh, recycled back into the system?

President Obama: Right.

Question Which, you know, are, obviously at some point the rubber hits the road and it hurts the stakeholder

President Obama: Right. Well look, uh, obviously, uh, I, I can’t expect, uh, the hospital association to sign up for something that they don’t think is gonna be good for hospitals. Uh, and so I think there’s nothing wrong with them saying in the context of serious reform, knowing that reform’s happening and, uh, that we, uh, are gonna have to change how we do business, can we negotiate and find a way of doing it that, uh, works for our membership, uh, but also, uh, moves the reform process forward? Uh, it, you know, it’s conceivable, obviously, that in any of these cir…circumstances we might be able to cram down, in theory, additional savings. Uh, but for us to have the American Medical Association, the nurses association, hospital association, uh, and even pharma, as well as large employers like Wal-Mart, uh, saying this is important to do, uh, I wouldn’t underestimate the degree to which that helps us get, uh, a final package done that, that works. Uh, as I said, one, one of the difficult things, uh, about health care reform is we all know that theoretically there are enormous savings to be had in the existing system. So on paper we should be able to design, uh, a system that, uh, covers everybody and reduces costs compared, uh, what we’re spending right now, with no additional revenue. But capturing those savings, uh, changing delivery systems, uh, changing reimbursement systems, uh, that’s a lot harder to do in practice because you’ve got these legacy systems that are put in, in to place. And so if we can at least get a framework in which reform begins, we get people covered, we set up an exchange, that we have a public option, we have, uh, concrete reductions that can be applied, uh, and that the Congressional Budget Office can point to and say, you know, this is helping to pay for health care reform. Uh, if we can put more money into prevention and wellness and health IT and, uh, [garbled] do systems like comparative, uh, effectiveness, uh, research in order to move the system in a more efficient direction, then it’s co
nceivable that once the first ten years is completed we are seeing a even more efficient system and greater savings, uh, than we had anticipated or were memorialized, uh, in, in some of the agreements that have been made so far….

….Question …I actually have a question that was asked more than once by our readers. Uh, and they wanted to know, will self employed individuals and small businesses be able to enroll in the public option and what will their, uh, benefit for this new health care reform be?

President Obama: Well, that, they are some of the primary beneficiaries of the potential public option. The, they way we want to set it up is they can sign up into the exchange. The exchange would be specifically for folks, uh, or especially for folks like that who may not have any other recourse, they’re not part of a, uh, big self funded employer health care plan, the, they don’t get health care, uh, through, uh, a big pool that drives down their costs. They can then come into the exchange, they can shop for the best possible benefit, uh, in some cases they may be eligible for tax credits or, uh, other subsidies to make it more affordable for them. Uh, and that exchange would allow them to look at not just, uh, a public option but potentially if they preferred it, uh, other options, uh, through, uh, the private insurance market that, uh, they think, uh, serve their family’s needs, uh, the best. So, uh, it is precisely for those folks who have so much difficulty pooling, uh, and getting a decent bargain through the private marketplace, uh, that the exchange can end up being, uh, a very powerful tool, uh, for them to get high quality affordable health care.

….Question …We invite you back to visit Maine in the summer.

President Obama: …You know, Maine is gorgeous all the time, but, uh, I gotta admit that when it’s warm I like it better. I grew up in Hawaii, what can I tell you?

Question Exactly. Um, I’ve been running into the same, the same quote from, uh, from an opinion piece from Investors, Investors Business Daily, uh, where they’re saying that, uh, HR 3200 will make individual private medical insurance illegal. And they actually quote from Section 102 of the bill which is grandfathering, um, existing policies. Is this true, will, will people be able to keep their insurance and will insurers be able to, um, write new policies even though, uh, HR 3200 is passed?

President Obama: You know, I, I have to say that I am not familiar with the provision you’re talking about. I’ll, let me just speak for, uh, the Obama administration. Uh, I have committed myself consistently to a very simple proposition. If you have health insurance and you like it and you have a doctor that you like than you can keep it. Period. And I won’t, uh, sign a bill that somehow would make it tougher for people, uh, to keep their health insurance. Uh, I want to make it more affordable and easier for them to keep their health insurance. And that’s exactly why reform’s so necessary right now because if current trends continue more and more people are gonna lose their health care. At minimum more and more people are gonna be paying more money for their health care. And so, uh, we certainly would not be, uh, signing a bill that, uh, somehow prevented somebody from, uh, from getting, from keeping, uh, insurance that they’ve already got or, uh, allow, uh, private insurers to sign up new folks if, uh, if they’re providing good service.

Okay, I, I’ve got time for one more question….

….Question Thank you Mr. President for, for doing this. We really appreciate it.

President Obama: I enjoy it, thanks.

Question Um, I was reading in Roll Call today that the Senate Finance Committee is still working on Conrad’s co-op proposal and I’m wondering if there’s any kind of co-op plan you can envision that will fulfill what you see as a good public option.

President Obama: Well, you know, I’m still looking at the details of, uh, a co-op approach. Um, I will tell you that, uh, there are some, uh, instances of co-ops being set up and just having a very difficult time getting off the ground, uh, because they don’t have the scale, uh, and the resources to be able to, to compete effectively. Uh, what I’ve asked my health care team to do is to get what, uh, um, uh, what evidence we have that this could provide a, the kind of competition that drives or helps to promote insurance reform, uh, and helps improve quality and drive down costs. Uh, if I can see some evidence that that could work then I’d be happy to consider it. Uh, but I will tell you that, uh, as I’ve been very clear about before, uh, I continue to believe that a robust public option, uh, would be, uh, the best way to go.

Uh, the, the one thing I, I do want to, uh, say, um, uh, to all of you as, as I sign off and, and, uh, David Axelrod and  Nancy-Ann DeParle should, should still be on after I hang up, is that, you know, the House bill and the Senate bills are not gonna be identical. Uh, we know this. Uh, the, the politics are different because the makeup of the Senate and the House are different and they operate under different rules. Uh, [garbled]  I am not interested in making, uh, the best the enemy of the good. And there is gonna be a conference committee in which the House and the Senate bills are reconciled that is gonna be a very tough, lengthy and serious negotiation process. Uh, I think that, you know, I, I’m less interested in making sure that there’s a litmus test of perfection on every bill that comes out of every committee than I am in going ahead and getting a bill off the floor in the House, a bill of the floor in the Senate. Eighty percent, uh, of, uh, those two bills will overlap. There’s gonna be twenty percent that’s gonna be different in terms of how it’s funded, it’s approach to the public plan, it’s approach to, uh, the pay or play provisions. And, you know, I think that, you know, we shouldn’t automatically just assume that if any one of the plans that come out of the committees, uh, don’t, uh, meet our tests that somehow, um, there’s a betrayal or there’s a failure. I think it’s an honest process of trying to reconcile a, a lot of different interests in a very big bill. Uh, the conference then is gonna be the place where these differences get ironed out and that’s where, you know, my bottom line, uh, will remain.

Does this, uh, cover all Americans? Does it drive down costs both in the public sector and the private sector over the long term so that it’s sustainable?  Does it improve quality? Does it emphasize prevention and wellness? Does it have a serious package of insurance reforms that insure that people aren’t losing health care because of pre-existing conditions, or changing jobs, or losing their jobs? Uh, are we giving relief to small businesses? Uh, do we have, uh, serious, uh, options, uh, a, a serious public option in place? You know, tho..those are the kinds of, uh, benchmarks that I’m gonna be using, but I, I’m not anticipating that, you know, uh, either the House or the Senate bills will match up exactly with where, uh, I want them to end up. Uh, that’s part of the democratic process, but, uh, I am gonna be insisting that we get something done. All right?

Thank you everybody. And, uh, I look forward to talking to you again in the future. Bye bye….