President Barack Obama’s town hall meeting on health care reform
Obama in Green Bay
Obama in Green Bay
President Barack Obama is a very
dynamic and demonstrative public
speaker.
dynamic and demonstrative public
speaker.
By Jonathan Gramling
Part 2 of 2
While it might be below many American’s radars as the most pressing issue facing America, President
Barack Obama has targeted health care reform as one of his highest priorities for the current legislative
session in Washington, D.C. He has repeatedly said that he wants meaningful health care reform legislation
passed by the U.S. Congress and on his desk for his signature by October.
In March 2009, Obama kicked off his health care reform initiative with a White House Forum on Health care
where industry and political leaders along with a sampling of “everyday people” in attendance. Recently,
Obama has held a series of health care reform town hall meetings to highlight the urgency of the need to
institute reform and to garner public support for his initiative. On June 11, Obama held his first town hall
meeting in Green Bay, Wisconsin. Subsequent town hall meetings have been held on ABC and on the Internet.
After Obama finished his prepared remarks, he fielded questions from the audience. The first questioner
asked Obama about the single-payer option where the federal government would essential become the sole
health insurer — raising insurance premiums through taxes and fees and reimbursing private health
practitioners for their services. Single payer is one of the thorniest issues in health care reform.
Obama emphasized that he did not want the federal government operating the healthcare system and
wanted to build upon the central part of the health care system — an employer-paid system. But he wants to
modify that system to eliminate some of its flaws. “Let's have insurance reform so that you can't eliminate
people for preexisting conditions so that there's none of the cherry picking that's going on to try to just get the
healthiest people insured and get rid of the sick people,” Obama said. “So you've got to set up some rules for
how insurance companies operate.”
In Obama’s view, the escalating cost of health care is fed by a health care financing structure that doesn’t
Part 2 of 2
While it might be below many American’s radars as the most pressing issue facing America, President
Barack Obama has targeted health care reform as one of his highest priorities for the current legislative
session in Washington, D.C. He has repeatedly said that he wants meaningful health care reform legislation
passed by the U.S. Congress and on his desk for his signature by October.
In March 2009, Obama kicked off his health care reform initiative with a White House Forum on Health care
where industry and political leaders along with a sampling of “everyday people” in attendance. Recently,
Obama has held a series of health care reform town hall meetings to highlight the urgency of the need to
institute reform and to garner public support for his initiative. On June 11, Obama held his first town hall
meeting in Green Bay, Wisconsin. Subsequent town hall meetings have been held on ABC and on the Internet.
After Obama finished his prepared remarks, he fielded questions from the audience. The first questioner
asked Obama about the single-payer option where the federal government would essential become the sole
health insurer — raising insurance premiums through taxes and fees and reimbursing private health
practitioners for their services. Single payer is one of the thorniest issues in health care reform.
Obama emphasized that he did not want the federal government operating the healthcare system and
wanted to build upon the central part of the health care system — an employer-paid system. But he wants to
modify that system to eliminate some of its flaws. “Let's have insurance reform so that you can't eliminate
people for preexisting conditions so that there's none of the cherry picking that's going on to try to just get the
healthiest people insured and get rid of the sick people,” Obama said. “So you've got to set up some rules for
how insurance companies operate.”
In Obama’s view, the escalating cost of health care is fed by a health care financing structure that doesn’t
promote behaviors that will drive down health care costs. “For the 46 million people who don't have health insurance, or for people who've got
health insurance who are self-employed but the premiums and the deductibles are so high that you almost never get prevention services — you've
put off going to a doctor until you're really sick because of the out-of-pocket expenses — let's change some of those incentives so that we get more
people getting prevention, more people getting health care to keep them healthy, as opposed to just treating them when they get sick.”
Efficiencies of scale where risk is spread over a large number of insured so that health care premiums can be kept lower are not available to
many Americans. This is an area where a public option may play a role. “Part of what we have to do —- and that's where a public plan potentially
comes in, or at least some mechanism to allow you to join a big pool,” Obama said. “That will help drive down your costs immediately: your out-of-
pocket costs for premiums and lower your deductibles. And what I'd like to see, as I said, is that every plan includes not only prohibitions against
discriminating against people with pre-existing conditions, but also every plan should have incentives for people to use preventive services and
wellness programs so that they can stay healthier.”
The next questioner asked Obama how long it was going to take to implement health care reform. Obama noted that health care reform was not
going to happen overnight. The health care system is a complex one that Obama estimates will take 4-5 years to change. He noted that things like
physician collaboration and an emphasis on primary and preventative care take time to implement because they require changing human behavior.
Then Obama emphasized that health care reform needed to happen now. “If we wait — if we said, well, you know, since we're not going to get it
right, right away, let's put this off until two or four or five years from now — it's never going to happen,” Obama emphasized. “That's what's been
going on for the last 50 years now — people have said, we can't do it right now. And as a consequence, it never gets done. Now is the time to do it.”
The next questioner wanted to know how health care reform would engage patients in managing risk and promoting health to lower costs. Obama
noted that 80 percent of the health care costs are incurred by 20 percent of those who receive health care. Part of the high costs is due to the
economic incentives that steer people away from primary and preventative medicine. “If we can get somebody first of all who is overweight to lose
weight so that they don't become diabetic, we save tons of money,” Obama said. “Even after they've become diabetic, if we are working with them
to manage their regiment of treatments in a steady way, then it might cost us $150 when you prorate the costs for a counselor to call the diabetic on
a regular basis to make sure they're taking their meds, and as a consequence, we don't pay $30,000 for a foot amputation. So there are all sorts of
ways that I think that we want to improve care, and that helps us manage risk.”
And part of the solution is making sure that everyone is engaged in the health care system so they can avail themselves of preventative and
primary care services and avoid getting their medical care at expensive emergency rooms. A public option is something that Obama feels needs to
be considered in spite of arguments that it is the beginning of the road to “socialized medicine.” “All we're trying to make sure of is that there is an
option out there for people where the where the free market fails,” Obama explained. “And we've got to admit that the free market has not worked
perfectly when it comes to health care, because you've got a lot of people who are really getting hurt: 46 million uninsured, a whole bunch of more
people who are underinsured who are seeing their premiums and deductibles rise.”
After answering one more question on how health care reform would address personal responsibility for health, Obama concluded the town
hall meeting by addressing the economics of health care reform. “What you'll hear during this debate over the next several weeks is people will
also say ‘The deficit and the debt are skyrocketing, and that's the reason why we can't afford to do health reform,’" Obama said. “So I just want to
repeat the single biggest problem we have in terms of the debt and the deficit is health care, it's Medicare and Medicaid. That is — when you hear
all these projections about all these trillions of dollars and red ink going out as far as the eye can see — almost all of that is because of the increase
in Medicare and Medicaid costs that are going up much, much faster than inflation.”
While many people are looking for a ‘silver bullet of reform’ that can be implemented quickly, Obama emphasized that it was going to take the
entire nation to implement reform. “We're all going to have to do our part; families are going to have to do their part by being healthier; employers do
their parts by encouraging their employees to be healthier; government doing its part by making sure that those people who are working very hard
but still don't have health insurance or their premiums are getting too sky-high, that they're getting a hand up; insurance companies, drug companies
doing their parts by not price gouging or trying to cut people out of the system; hospitals adopting best practices,” Obama said. “If we're doing all
those pieces, then we can start bending this cost curve down.”
Obama hopes to pass health care reform legislation by October because he feels that the window of opportunity for reform is open now. But the
debate is just beginning to heat up as those affected by this $2.5 trillion industry begin to defend their turf. We shall see if reform remains on track or
is derailed by endless debate.
health insurance who are self-employed but the premiums and the deductibles are so high that you almost never get prevention services — you've
put off going to a doctor until you're really sick because of the out-of-pocket expenses — let's change some of those incentives so that we get more
people getting prevention, more people getting health care to keep them healthy, as opposed to just treating them when they get sick.”
Efficiencies of scale where risk is spread over a large number of insured so that health care premiums can be kept lower are not available to
many Americans. This is an area where a public option may play a role. “Part of what we have to do —- and that's where a public plan potentially
comes in, or at least some mechanism to allow you to join a big pool,” Obama said. “That will help drive down your costs immediately: your out-of-
pocket costs for premiums and lower your deductibles. And what I'd like to see, as I said, is that every plan includes not only prohibitions against
discriminating against people with pre-existing conditions, but also every plan should have incentives for people to use preventive services and
wellness programs so that they can stay healthier.”
The next questioner asked Obama how long it was going to take to implement health care reform. Obama noted that health care reform was not
going to happen overnight. The health care system is a complex one that Obama estimates will take 4-5 years to change. He noted that things like
physician collaboration and an emphasis on primary and preventative care take time to implement because they require changing human behavior.
Then Obama emphasized that health care reform needed to happen now. “If we wait — if we said, well, you know, since we're not going to get it
right, right away, let's put this off until two or four or five years from now — it's never going to happen,” Obama emphasized. “That's what's been
going on for the last 50 years now — people have said, we can't do it right now. And as a consequence, it never gets done. Now is the time to do it.”
The next questioner wanted to know how health care reform would engage patients in managing risk and promoting health to lower costs. Obama
noted that 80 percent of the health care costs are incurred by 20 percent of those who receive health care. Part of the high costs is due to the
economic incentives that steer people away from primary and preventative medicine. “If we can get somebody first of all who is overweight to lose
weight so that they don't become diabetic, we save tons of money,” Obama said. “Even after they've become diabetic, if we are working with them
to manage their regiment of treatments in a steady way, then it might cost us $150 when you prorate the costs for a counselor to call the diabetic on
a regular basis to make sure they're taking their meds, and as a consequence, we don't pay $30,000 for a foot amputation. So there are all sorts of
ways that I think that we want to improve care, and that helps us manage risk.”
And part of the solution is making sure that everyone is engaged in the health care system so they can avail themselves of preventative and
primary care services and avoid getting their medical care at expensive emergency rooms. A public option is something that Obama feels needs to
be considered in spite of arguments that it is the beginning of the road to “socialized medicine.” “All we're trying to make sure of is that there is an
option out there for people where the where the free market fails,” Obama explained. “And we've got to admit that the free market has not worked
perfectly when it comes to health care, because you've got a lot of people who are really getting hurt: 46 million uninsured, a whole bunch of more
people who are underinsured who are seeing their premiums and deductibles rise.”
After answering one more question on how health care reform would address personal responsibility for health, Obama concluded the town
hall meeting by addressing the economics of health care reform. “What you'll hear during this debate over the next several weeks is people will
also say ‘The deficit and the debt are skyrocketing, and that's the reason why we can't afford to do health reform,’" Obama said. “So I just want to
repeat the single biggest problem we have in terms of the debt and the deficit is health care, it's Medicare and Medicaid. That is — when you hear
all these projections about all these trillions of dollars and red ink going out as far as the eye can see — almost all of that is because of the increase
in Medicare and Medicaid costs that are going up much, much faster than inflation.”
While many people are looking for a ‘silver bullet of reform’ that can be implemented quickly, Obama emphasized that it was going to take the
entire nation to implement reform. “We're all going to have to do our part; families are going to have to do their part by being healthier; employers do
their parts by encouraging their employees to be healthier; government doing its part by making sure that those people who are working very hard
but still don't have health insurance or their premiums are getting too sky-high, that they're getting a hand up; insurance companies, drug companies
doing their parts by not price gouging or trying to cut people out of the system; hospitals adopting best practices,” Obama said. “If we're doing all
those pieces, then we can start bending this cost curve down.”
Obama hopes to pass health care reform legislation by October because he feels that the window of opportunity for reform is open now. But the
debate is just beginning to heat up as those affected by this $2.5 trillion industry begin to defend their turf. We shall see if reform remains on track or
is derailed by endless debate.
