Obama Wants New Cuts In Federal Health Spending

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CHARLES BABINGTON | June 13, 2009 10:04 PM EST | AP

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President Barack Obama runs back to the microphone after he was ask a question about Iran as he was leaving, after delivering remarks in the Rose Garden of the White House in Washington, Friday, June 12, 2009, about passage of the tobacco legislation (AP Photo/Ron Edmonds)

WASHINGTON — President Barack Obama said Saturday he wants to help pay for his health care overhaul by slowing Medicare and Medicaid spending, but hospitals, medical technicians and others are resisting.

The high-stakes struggle over medical care is heating up as Obama declares the status quo unacceptable.

The president suggests trimming federal payments to hospitals by about $200 billion over the next 10 years, saying greater efficiencies and broader insurance coverage will justify the change. Hospitals, especially those with many poor patients, say the proposed cuts are unfair and will harm the sick and elderly.

Congress ultimately will shape the new laws. Obama is urging lawmakers to be bold and to resist powerful lobbies trying to maintain their clout and profits.

"Americans are being priced out of the care they need," Obama said in his weekly radio and Internet address.

Obama said high health care costs hurt the entire economy and contribute to the nearly 50 million people who lack coverage. His address focused on payments to Medicare and Medicaid, which cover millions of elderly and low-income people and involve thousands of doctors, hospitals, nursing homes and other institutions.

He proposed cutting $313 billion from the programs over 10 years. That's in addition to the $635 billion "down payment" in tax increases and spending cuts in the health care system that he announced earlier.

Together, Obama's plans would provide $948 billion over a decade in savings and/or tax increases to help insure practically everyone and to slow the rate of soaring health care costs.

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The president wants to cut $106 billion over 10 years from payments that help hospitals treat uninsured people. Spending on Medicare prescription drugs would fall by $75 billion over a decade.

And slowing projected increases in Medicare payments to hospitals and other providers _ but not doctors _ would save $110 billion over 10 years, the president said.

Obama called them "commonsense changes," although he acknowledged that many details must be resolved. Some powerful industry groups called the proposals unwise and unfair.

"Payment cuts are not reform," Rich Umbdenstock, president of the American Hospital Association, said even before Obama's plan was announced. His group is urging hospitals with large proportions of low-income patients "to push back on proposed cuts."

The pharmaceutical industry is wary of Obama's plan to extract $75 billion over 10 years from Medicare prescription drug spending. The White House said "there are a variety of ways to achieve this goal." For instance, it said, drug reimbursements might be reduced for people who receive both Medicare and Medicaid.

The drug manufacturers' chief trade group issued a cautious statement Saturday, saying pharmaceutical companies support health care changes, but that much work remains to be done.

An industry group that which represents makers and users of medical imaging devices, such as MRI and CT equipment, was more hostile.

Obama wants to reduce government payments for such services. He said the devices are used so frequently and efficiently that providers can spread their costs over many patients, requiring less government reimbursement.

The Access to Medical Imaging Coalition, a trade group, disagreed. It said the president's plan would "impair access to diagnostic imaging services and result in patients' delaying or forgoing life- and cost-savings imaging procedures." The group said Obama's efficiency estimates were based on a flawed survey.

Even if Obama and Congress could hit the overall goal of $948 billion in health care savings over 10 years, it still might not be enough to cover all the nation's uninsured. Outside experts say the 10-year cost could range from $1.2 trillion to $1.8 trillion, depending on factors such as how generous federal subsidies turn out to be. One Senate proposal would subsidize families making as much as $110,000.

The administration wants to hold the cost to about $1 trillion, and Obama says the plan must not add to the federal deficit.

His budget director, Peter Orszag, told reporters that $948 billion "is in the ballpark of many of the proposals floating around," and that "there may well be some additional resources that are necessary." He said the administration will work with Congress.

But the president's earlier package of $635 billion in spending cuts and tax increases has gotten a cool reception from lawmakers. And there's no clear indication the latest proposal will fare any better.

House Republican leader John Boehner of Ohio said Medicare and Medicaid need reform, "but serious changes should not be rushed through Congress as part of a new government-run program that will raise taxes and make health care more expensive."

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Associated Press writer Ricardo Alonso-Zaldivar contributed to this report.

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On the Net:

White House: http:/ http://www.whitehouse.gov/

WASHINGTON — President Barack Obama said Saturday he wants to help pay for his health care overhaul by slowing Medicare and Medicaid spending, but hospitals, medical technicians and others are r...
WASHINGTON — President Barack Obama said Saturday he wants to help pay for his health care overhaul by slowing Medicare and Medicaid spending, but hospitals, medical technicians and others are r...
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- zanzig I'm a Fan of zanzig 41 fans permalink

There used to be a fabulous BBC TV series called Yes Minister; I don't know if it ever played in America, but there was one episode where the Minister discovers that there is a brand new hospital in his electorate which is rated as the best functioning hospital in all of Britain. On further enquiry he discovers also that there are no patients, but 500 staff; none of his public servants and advisers as well as the Union can see anything wrong with this. Here's a link: http://www.yes-minister.com/ymseas2a.htm#YM%202.1

    Favorite    Flag as abusive Posted 03:48 AM on 06/15/2009
- DRaymond I'm a Fan of DRaymond 67 fans permalink
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The US already spends a far greater share of its GDP on health care than any other country on earth. The reason is that the uninsured and underinsured put off basic care until it puts them in the emergency room.

For example doctors usually see diabetes cases in the US only after they have proceeded far along and more drastic measures are needed.

Now when we go to universal care there will be a big initial surge of deferred care but the eventual result will be lower overall health care spending in line with other countries. Otherwise what's the point?

    Favorite    Flag as abusive Posted 02:42 AM on 06/15/2009
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"Hospitals, especially those with many poor patients, say the proposed cuts are unfair and will harm the sick and elderly."
So, wait, aren't hospitals slated to NEED less money because fewer people will be getting care at emergency rooms when everyone is insured? I guess if I worked at a hospital I'd be pretty skeptical, too.
Right now, there are more INSURED people being seen at emergency rooms because they can't get in to a doctor because there aren't enough doctors. It's the biggest rise in INSURED people seen in emerg. rooms ever, and it accounts for most of the increase in Emergency room visits, because the perecentage of uninsured has remained pretty stable.

    Favorite    Flag as abusive Posted 02:15 AM on 06/15/2009

My husband and I are on TRICARE for about 8 more years, then we have to go on MEDICARE. I think we might need to look into become delicious SOYLENT GREEN.

    Favorite    Flag as abusive Posted 11:37 PM on 06/14/2009

Boy oh boy, based on information provided in this article Obama's proposals sound far from appealing and far from providing a real solution. Especially given the case that Medicare and Medicaid supposedly pay doctors less (at least according to a physician friend who bemoaned this and said with cuts he may just decide to cut out Medicare patients alltogether).

HOWEVER, I doubt that in this article we are getting the complete picture of what Obama's health care plan fully entails. Thus, before I sputter off a bunch of criticism I will keep an open mind and see if I find something that provides a more wholistic approach on this complex issue and fully reflects what the President's fully developed vision looks like.

    Favorite    Flag as abusive Posted 10:50 PM on 06/14/2009

It seems to me an appropriate reshuffling of payment protocols. Why have a fund pay emergency rooms to cover the uninsured if everyone is insured?

Presuming better preventive care could allow replacing hospital beds allocated for elders with gym memberships.

It makes sense to have everything handled by a single payer to give medicare to everyone. A basic set of medical services should be available to all people for free. People could remain free to choose private policies to supplement their needs on an open market.

It may be nearly impossible to repair the social safety net that lays before us in pieces. But health care is an important strand.

    Favorite    Flag as abusive Posted 09:31 PM on 06/15/2009
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Woo-Hoo.

Isn't it the libs and dems that scream every election to the over 60 crowd, "Don't vote for those mean, evil republicans. If you do they'll cut social security, medicare, and medicaid."?

Obama seems to be getting worried how all his spending is playing with the voters, but his attempts to come up with ways to pay for it will likely re-enforce a recurring problem with the dems:

(1) they raise your taxes, and
(2) they often do the exact thing they so stridently accuse the republicans of doing or wanting to do.

Couldn't happen to a nicer bunch ....

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/13/AR2009061302035_pf.html

    Favorite    Flag as abusive Posted 04:44 PM on 06/14/2009
- AFAN I'm a Fan of AFAN 33 fans permalink

He has to make some compromise on Health Care because if he listens too much to Pelosi then the GOP and Conservative will be hollowering that he's socializing Health Care.

    Favorite    Flag as abusive Posted 03:49 PM on 06/14/2009
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Except, during his campaign, he railed against McCain over McCain's desire to cut cutting federal funding... and increase taxes.

This is the danger in advertising yourself to people. Without good reason, it's not easy to change one's stance. Never mind today's climate where people, riddled by cynicism and distrust (of which the republicans get due credit for their constant hypocrisy; from corporate values down to fiscal values to family values and more), trusting is not an easy thing to do.

I'm taking President Obama at his word. He's already done a lot that shows his honesty while trying not to upset too many people. It's not easy, but I'll do my part. Anybody who hates the guy, well they can shut up or they can do what the people in Iran are doing because I refuse to stoop down to their level.

    Favorite    Flag as abusive Posted 07:27 PM on 06/14/2009
- starkcr31 I'm a Fan of starkcr31 14 fans permalink
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This guy just keeps getting better and better (for republicans). He spends us into oblivion but cuts spending on things that actually important, like health care and defense. I swear, if I was into conspiracies, I would say this guy is a sleeper agent. It's almost as if he's trying to ruin the country on purpose.

    Favorite    Flag as abusive Posted 03:09 PM on 06/14/2009
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Yo, take off the blindfold. Liberal president George W Bush started the corporate bailouts long before Obama was elected.

    Favorite    Flag as abusive Posted 07:28 PM on 06/14/2009
- starkcr31 I'm a Fan of starkcr31 14 fans permalink
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I actually agree with you. George W. Bush wasn't a conservative. Not even close.

    Favorite    Flag as abusive Posted 07:47 PM on 06/14/2009
- Pigeon2 I'm a Fan of Pigeon2 3 fans permalink

Agree, agree, agree......

    Favorite    Flag as abusive Posted 09:07 PM on 06/14/2009
- xryeyes I'm a Fan of xryeyes 17 fans permalink

I have worked in health care, directly working with patients, for 24 years.

Cutting payment to hospitals providing direct care to the indigent and underinsured is not the way to save the US health care system, only the way to save the $ at patients' expense. These hospitals are point of care facitlities, and when they can't afford to provide the care, the patients suffer and the hospitals have closed and will continue to close.

Obama should focus on reforms aimed at industry providers, such as the insurance, medical equipment and pharmaceutical companies. They always make a profit, and the patients' welfare is really not their concern, their shareholders' benefit is their concern. The prices of medical devices and pharmaceuticals are outrageous, justified by "research and develpment" costs, which include huge sums for lobbying and other "non-value added" (to patients) practices. Perhaps a few restrictions to those practices at least are in order.

    Favorite    Flag as abusive Posted 02:27 PM on 06/14/2009
- schatsie I'm a Fan of schatsie 87 fans permalink

I worked in Health Care and the fact is that the Reimbursements are pretty secret and nobody knows the charges....How in the sam hill can these hospitals charge so much money????

In france, they see their doctors TWICE as often as we see ours and I believe that they are in the hospitals TWICE as long....for a c-section 10 TEN days, not our pathetic 2 days....

    Favorite    Flag as abusive Posted 03:47 PM on 06/14/2009
- xryeyes I'm a Fan of xryeyes 17 fans permalink

The hospitals pay huge amounts for expensive equipment, pharmaceuticals, etc. The not-for-profit hospitals , of which I write, charge the amount calculated to recover those costs, so they can stay viable. The insurance companies rarely pay what the hospital charges, they apply concession rates (of 40% or more), which means they can pay less than 60cents on each dollar the hospital charges (did you know THAT? Do you actually know what the insurance company pays for your hospital bill, or do you only know what the initial charges were?)

If you want to know why the costs are so high, look at those who actually make a PROFIT, not just shake your head at a charge some hospitals cannot afford to reduce. Too many people are blaming the direct source of the care as the origin of the costs, not bothering to look at how those costs became so inflated.

    Favorite    Flag as abusive Posted 04:06 PM on 06/14/2009
- lysistrata I'm a Fan of lysistrata 21 fans permalink

If all patients had insurance there would not be a gap of payment. How would hospitals loose money? Health care for all in a national system would cover all, that is the whole point.

    Favorite    Flag as abusive Posted 01:54 PM on 06/14/2009
- schatsie I'm a Fan of schatsie 87 fans permalink

All the providers would eliminate the 10% that it takes to process claims thru the antiquated insurance system...Then all the providers would no longer have bad debts from people who could not pay...Then all providers could cut their malpractice in HALF.....There are savings galore!!!

    Favorite    Flag as abusive Posted 03:48 PM on 06/14/2009
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Yes, a national car for everyone would solve the public transport problem.

But, where in the constitution exactly does it give the governemnt the power to tax the rest of us to provide for these things?

Are we a nation of laws or not? Where is the effort to pass a constitutional amendment to give the government power to do these things?

We've become a nation where too many believe in the "living constituiton", where the constitution is twisted to mean whatever a majority of the Supreme Court Justices say it means, despite the clear language in which it is written.

Thus the viciuous fights over appointments to that court.....

    Favorite    Flag as abusive Posted 06:43 PM on 06/14/2009
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that's what I think, too

    Favorite    Flag as abusive Posted 02:17 AM on 06/15/2009
- Confused1 I'm a Fan of Confused1 3 fans permalink

Many people out there believe that the healthcare program being proposed is going to be free. Obama is not talking about what these costs for coverage will be either. For those who chose not to have healthcare, even thought they can afford it, it will be a very unpleasant surprise when they are forced to buy it. If there is a public 'option' the government will offer substantially lower premiums (let's face it, they have taxpayer dollars to ofset any losses), thus eventually eliminating the private sector and competition. Coverage will be reduced and in the case of the elderly, rationed, there is no other way to remotely think it could be viable without it. Why do you think that $1.5 BILLION was put into the 'stimulus' bill for studies into cost and effectivity of medical procedures vs effect on life extension? For anyone over 60, I suggest you get your financial house in order. If you need an expensive procedure, you won;t get it0--it won't be cost effective. Need a knee/hip replacement? You won't get it. Diagnosed with a cancer in an advanced stage--you won't get treatment. Need bypass surgery or dialysis? Good chance you won't get it. Essentially if you are elderly and get sick, get ready to die. Look at Great Britain and Canada for proof.

    Favorite    Flag as abusive Posted 10:41 AM on 06/14/2009
- marijam I'm a Fan of marijam 41 fans permalink
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This entire posting is not true. It will not and would not eliminate all private health insurance, nor should it. Coverage is already being rationed, or aren't you in an HMO or PPO? Coverage is already limited to whether or not you can get an appointment or not, in a timely manner.

If BHO pushes this reduction, the people are going to kill all hope of health care reform. We don't want an insurance industry give-away and would rather have status quo. Fact of the matter is, our politicians don't care one flip for what we think or what we want. It's all about campaign donations and corporations having their way. The old, usual "What's good for American companies is good for American citizens" rhetoric. That's complete and total B. S. If there were any justice in the U.S. of A. then Americans would be able to expand medicare and medicaid to cover everybody, single payer and regulate the insurance companies accordingly. People could do what they are doing now, in terms of retirement. Buy into social security and have additional investments. Same thing with a public plan that covers everybody.

    Favorite    Flag as abusive Posted 10:50 AM on 06/14/2009
- marijam I'm a Fan of marijam 41 fans permalink
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One more thing. Your guise of standing up for the elderly and sick is quite transparent, given the state of health care today.

    Favorite    Flag as abusive Posted 11:11 AM on 06/14/2009
- lysistrata I'm a Fan of lysistrata 21 fans permalink

You should look at the UK and Canada for yourself and don't just believe what you see in the ads from the industry. The industry has interests that are not your interests. The elderly do have Medicare, in effect taking them out of the private sector because they have more health problems and therefore would be cutting the profit margin.

We do have competition now, so why then does it not work? Supposedly we have the best system in the world, why can't people pay their medical bills, why are we down to #37 with infant mortality, why do we have 50 million uninsured, why no insurance for people with chronic conditions? Why do people have to go to Mexico or India to get medical treatment if our system is so great?

You know, I don't care if it is called socialism or what ever, as long as it works. And our glorious system does not work. I know European systems and I tell you, they are much much better. They pay too, but they get more for the money.

    Favorite    Flag as abusive Posted 02:13 PM on 06/14/2009
- schatsie I'm a Fan of schatsie 87 fans permalink

Same reason our educational system has gone to heck in a handbasket,.,,, The RePUGS are strangling government....Same reason they did not want BRAKES installed on TRAINS in the 1890s, same reason they were against CAR seats, Same reason they were FOR LOVE CANAL...They are all about money and profits and against a CIVIL SOCIETY...Heck they would fire all the policemen if they could.....so they could drive drunk and speed and kill and pay off the judges......

    Favorite    Flag as abusive Posted 03:53 PM on 06/14/2009
- socalgal38 I'm a Fan of socalgal38 52 fans permalink
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WE ARE NOT ASKING FOR FREE HEALTHCARE. Get it thru your head, we are asking for fairness and equality for everyone. WE the people of the United States pay for services for others already but we are kept from the most basic of neccessity, AFFORDABLE Health Care. The talking points coming from some of you says Canadian seniors are being denied care because of age and are left to die. Which is an outright lie, because statistics show Canadians have a longer life expectancy than the United States.
Yet you are not outraged by the fact that people with pre existing conditions are turned away by Insurance Companies here. Then you have the audiacity to insinuate that hospitals will treat people for free. Another huge lie. Their services run into the hundreds of dollars just for minor care. The biggest lie of all the Canadians have to wait for hrs to get immediate care. Truth is it depends on the severity of emergancy who gets treated first. Here you can have chest pains and die in their waiting area without ever seeing a Doctor. Oh wait that was an HMO establishment Kaiser where it happened. After 9/11 and 8 yrs of the previous administration's fear of doom and gloom doesn't work anymore We the people have awoken from a nightmare and learn to see the truth of the Republican Party.

    Favorite    Flag as abusive Posted 11:50 PM on 06/14/2009
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How many people over 60 can even afford insurance NOW? are you in touch with reality?
Millions of people aren't getting treatment now. Practically anything Obama does is bound to help if there's a public option. you and your friends are just so out of touch with most people. Great Britain and Canada - they are happy with it. your message is so very old and out of date. did you know we can talk to people in Canada and England by INTERNET nowadays? So we NEVER have to take your word for it any more, since it's a lie.

    Favorite    Flag as abusive Posted 02:20 AM on 06/15/2009

When the first concern of your doctor when you are critically ill is finding the cheapest way to treat you and not saving your life.................

    Favorite    Flag as abusive Posted 10:30 AM on 06/14/2009
- seted I'm a Fan of seted 25 fans permalink
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Unless you watch Fox News, I'm pretty sure you haven't heard of people dropping like flies in Canada or the other civilized countries.

    Favorite    Flag as abusive Posted 12:56 PM on 06/14/2009
- starkcr31 I'm a Fan of starkcr31 14 fans permalink
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Actually, I have relatives in the UK and they tell me socialized medicine is an abomination.

    Favorite    Flag as abusive Posted 03:11 PM on 06/14/2009
- Osusuki I'm a Fan of Osusuki 37 fans permalink

There is no health care savings until and unless you replace the insurance industry with single payer. Much of the rise in health care cost is due to the fact that medical care providers maximize their revenue by depending on insurance payments boosted by federal support. Take away the insurance payments, and the cost of medical care will be controlled by a single entity and reduced accordingly. This is a no-brainer, given that every other industrialized nation does it this way and experiences lower costs for medical care and higher quality of care than the United States.

Mr. President, I love ya'. I love the hoodoo that you do in fixing this country despite the objections of every big money fed GOP obstructionist in creation, but you need to find a way to pull that single payer rabbit out of your magician's hat and get us competitive with the rest of the world. Please.

    Favorite    Flag as abusive Posted 09:45 AM on 06/14/2009

Politician run medical care will be politicized, wasteful, inefficient, with plenty of fraud and corruption and added bonus political cronyism used as a basis for who gets treatment. There can be no worse situation then one where politicians have the power to make life or death decisions about citizens.

    Favorite    Flag as abusive Posted 10:33 AM on 06/14/2009
- marijam I'm a Fan of marijam 41 fans permalink
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Unlike private health care, huh? I trust the gubmint more than I trust American business. Period.

    Favorite    Flag as abusive Posted 10:52 AM on 06/14/2009
- seted I'm a Fan of seted 25 fans permalink
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Iraq and Afghanistan have free health care paid for by us.

    Favorite    Flag as abusive Posted 12:41 PM on 06/14/2009
- lysistrata I'm a Fan of lysistrata 21 fans permalink

Yes there can be a worse situation namely the one we now have where the insurance honcho decides based on the profit motive only sitting in some cubicle a thousand miles away from your doctor and you.

    Favorite    Flag as abusive Posted 02:35 PM on 06/14/2009
- schatsie I'm a Fan of schatsie 87 fans permalink

CORPORATE run medical care is politicized, wasteful, inefficient, with plenty of fraud and corruption and added bonus political cronyism used as a basis for who gets treatment. There can be no worse situation then one where CORPORATIONS have the power to make life or death decisions about citizens AND PROFIT OFF IT AND DENY CARE TO THE UNINSURED.....

    Favorite    Flag as abusive Posted 03:57 PM on 06/14/2009
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You want lower costs. Allow free trade in medical services. Stop subsidizing the AMA and Big Pharma
Give green cards to doctors from other countries or go to India for treatment. Its much cheaper there. Allow grey reimporting from Europe.

    Favorite    Flag as abusive Posted 09:01 AM on 06/14/2009
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"resist powerful lobbies"
Remind me how this works again ....
The people we elected can't vote in our interest because ....
These lobbies are "powerful" because ....
Just exactly how does this work? Do they have guns or dirty pictures or just exactly what is their "power" over the people we elected ....

    Favorite    Flag as abusive Posted 08:42 AM on 06/14/2009
- Chaimirija I'm a Fan of Chaimirija 56 fans permalink
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Money talks

    Favorite    Flag as abusive Posted 09:25 AM on 06/14/2009
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