Sebelius Pressing Lawmakers On Health Care

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DAVID ESPO and PHILIP ELLIOTT | June 24, 2009 10:19 PM EST | AP

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President Barack Obama, meets with five of the governors in the Roosevelt Room of the White House in Washington, Wednesday, June 24, 2009. From left are, Wisconsin Gov. Jim Doyle, Michigan Gov. Jennifer Granholm, Vice President Joe Biden, the president, Vermont Gov. Jim Douglas, Washington Gov. Christine Gregoire, South Dakota Gov. Mike Rounds. (AP Photo/Pablo Martinez Monsivais)

WASHINGTON — President Barack Obama left the door open to a new tax on health care benefits Wednesday, and officials said top lawmakers and the White House were seeking $150 billion in concessions from the nation's hospitals as they sought support for legislation struggling to emerge in Congress.

"I don't want to prejudge what they're doing," the president said, referring to proposals in the Senate to tax workers who get expensive insurance policies. Obama, who campaigned against the tax when he ran for president, drew a quick rebuff from organized labor.

Obama also fielded a pointed personal question during an ABC News town hall at the White House on Wednesday. The prime-time program was the latest in a string of events designed to build public support for his plan to slow the rise in health care costs and expand coverage to the nearly 50 million uninsured.

Dr. Orrin Devinsky, a neurologist at the New York University Langone Medical Center, challenged Obama: What if the president's wife and daughters got sick? Would Obama promise that they would get only the services allowed under a new government insurance plan he's proposing. Obama wouldn't bite.

If "it's my family member, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care," Obama said.

Earlier in the day, the administration and its allies pushed for a prominent display of progress in the Senate before Congress begins a weeklong vacation on Friday.

Senate Finance Committee Chairman Max Baucus, D-Mont., labored in a series of meetings to produce at least an outline of legislation that could command bipartisan support. Of the five House and Senate committees working on health care, Finance is the only one that appears to have a chance at such an agreement.

For their part, key Republicans pressed the White House for assurances that any concessions made now would not merely lead to additional demands at a later date. "We want to know the president is working in good faith along the way as we are," said Sen. Olympia Snowe, R-Maine, after meeting with Nancy-Ann DeParle, the top White House official on the issue.

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Baucus appeared especially eager to show progress before the exodus from the Capitol began.

To that end, several officials said he was negotiating with representatives of the nation's hospitals, hoping to conclude an agreement that would build on an $80 billion weekend deal with the pharmaceutical industry.

Hospitals were being asked to accept a reduction of roughly $155 billion over the next decade in fees they are promised under government programs such as Medicare and Medicaid, according to numerous officials.

Officials at the American Hospital Association and the Federation of American Hospitals said they could not comment on any discussions.

Baucus is seeking similar concessions from nursing homes, insurance companies, medical device makers and possibly others, noting that any legislation would create a huge new pool of customers for industry providers.

At its heart, any legislation is expected to require insurance companies to offer coverage to any applicant, without exclusions or higher premiums for pre-existing medical conditions.

Overall, Baucus has said he hopes to hold the size of any legislation to $1 trillion or less, and in private negotiations, there were discussions about further scaling back eligibility for insurance subsidies from the government.

Additionally, Baucus was still searching for ways to cover the cost of his emerging legislation, and numerous officials said he appeared roughly $200 billion shy of achieving that goal. They added that a proposal to make it harder for taxpayers to itemize their medical expenses was drawing renewed interest among key senators as one way to raise revenue.

Current law allows those expenses to be itemized when they exceed 7.5 percent of adjusted gross income. The proposal under review would raise that to 10 percent, officials said.

At the White House, Obama sidestepped when asked if he was open to taxing health care benefits _ a proposal he opposed vigorously in the campaign for the White House.

"I have identified the ways that I think we should finance this. I think Congress should adopt them. I'm going to wait and see what ideas ultimately they come up with," he said on ABC's "Good Morning America."

"I don't want to prejudge what they're doing. We've put forward what we think is best."

Organized labor weighed in quickly.

Gerald W. McEntee, president of the 1.6 million-member American Federation of State, County and Municipal Employees, said in an interview that union leaders believe Obama is "a person of his word." He was referring to Obama's opposition to taxing those benefits during last year's campaign.

"They're not going to tolerate that," McEntee said of workers' views of that proposal.

It was the latest in a series of signs of presidential flexibility. He has said he could accept a requirement for individuals to buy insurance, a position he opposed in the campaign.

Baucus and many Republicans support taxing health care benefits, and officials have said discussions center on imposing the tax in cases in which premium costs exceed $17,000 combined in payments by the employer and worker. Democrats want to exempt union members covered by contracts, but Republicans are resisting.

The officials who provided specifics on the negotiations in the Senate did so on condition of anonymity, saying they were not authorized to disclose private talks.

ABC News was the lone network broadcasting Obama's town hall _ drawing criticism from Republicans who wanted equal time.

___

Associated Press writers Erica Werner, Ricardo Alonso-Zaldivar, Charles Babington and Alan Fram contributed to this report.

WASHINGTON — President Barack Obama left the door open to a new tax on health care benefits Wednesday, and officials said top lawmakers and the White House were seeking $150 billion in concessio...
WASHINGTON — President Barack Obama left the door open to a new tax on health care benefits Wednesday, and officials said top lawmakers and the White House were seeking $150 billion in concessio...
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The so-called public option will drive out private sector insurers and is the first step toward a single payer system. Anyone who denies this is disingenuous, economically ignorant, or devious. Unless the government wants to set up the public option in such a way that it is (a) self-sufficient with no claim on government support, (b) charged a cost of capital, and (c) expected to earn a return, ie. a profit, it will be unfairly advantaged in competing with private sector insurers. This unfair competitive advantage will be used to charge lower than break even premiums which will attract customers and, in short order, leave the government as the only insurer. Think Florida and its insurance against hurricanes which is now provided only by the State ofFlorida.

For those of you who think single payer is desirable, think "monopsonist'. A monopsony is the opposite of monopoly. A monopoly is when one supplier has the market power to dictate to buyers what they must pay. A monopsonist has the market power to dictate to all suppliers what they will be paid. The auto companies are close to being monopsonists with respect to their supplier bases and they pushed many of their suppliers into bankruptcy. A single payer medical system will do the same to the entire US health care industry.

    Favorite    Flag as abusive Posted 10:24 PM on 06/24/2009

Because in most states the few insurance companies to offer policies are de facto monopolies who collude with their opposites to make high prices the rule, gouging patients and abusing providers with roundabout billing, claim denials, and hidden gotchas like lifetime coverage caps, annual prescription payout caps, and ultimately recission.
The government must step in where markets have failed and protect the citizenry or it is not doing its job and must be replaced. Provide for the common defense, promote the general welfare and secure the blessings of liberty-all three are covered in health care, which should be a public utility and regulated as such and not an excuse to extort money from Americans in some kind of white collar Mafia scam. 37 countries do it better than we do-that is an embarrassment that we can fix. 37 examples of measurable success without a lot of Austrian school nitwits raising their bogus apocalyptic economic fantasy nightmares.

    Favorite    Flag as abusive Posted 11:25 PM on 06/24/2009

The often repeated sound bite that the US spends more and gets less for its money than many other developed countries is simplistic at best. Have you ever seen this data adjusted for demography? Do you know that medical researchers estimate that the US Hispanic population has a 50% lifetime chance of becoming diabetic? Are you aware that the Black population has much lower life expectancy than the US white population because of black on black crime and a much higher pre-disposition than whites to heart problems? Before you think this is just some racist rant, talk to your doctor.

If you want to pull some data on Minnesota and show me that it compares unfavorably with Germany or France or Sweden or Norway, I'll cede my point.

    Favorite    Flag as abusive Posted 01:53 PM on 06/25/2009
- chaifreak I'm a Fan of chaifreak 10 fans permalink

Why hasn't that happened in all of the other countries where there is a single payer system? And in actuality, it only has the potential to bankrupt the health INSURANCE industry. Again, a naysayer is confusing health CARE with health INSURANCE.

    Favorite    Flag as abusive Posted 10:53 AM on 06/25/2009

It has happened in other countries. Over half of the doctors practicing in the UK now are non-European. Why? The prices paid for medical services are below the market clearing price for anyone but immigrants accustomed to a lower standard of living.

Why do you think most of the innovations in medical care originate here and most of the major health care companies are based here? It's because we pay more for our care.

What has happened ever so subtly over time is that health insurance has come to be confused with prepaid medical care. Do you know of anyone writing insurance on burning buildings? Do you know a life insurance company who won't test you for AIDS before issuing a policy? Did you know that even our Federal government will not provide flood insurance within 30 days before or after a flood? That's because insuring "pre-existing conditions" isn't insurance.

If we want a more efficient insurance market, open it up to national competition, free from the state level regulators who create local and regional monopolies.

    Favorite    Flag as abusive Posted 01:41 PM on 06/25/2009

Just so you can stay abreast of this issue, Google "Canada doctor shortage" and read a few of the articles. You will see that Canada's system has (a) led to fewer doctors going into the profession, (b) forced many to emigrate to other countries, and (c) created such a shortage that they are grumbling while scouring the world to find potential immigrant doctors to fill open spots paying less than market rates.

This is as good a preview of where we're going as you will find.

    Favorite    Flag as abusive Posted 02:10 PM on 06/25/2009
- cecebo I'm a Fan of cecebo 8 fans permalink

Fine. Tax our benefits. But not unless you ALL of the income of millionaires/billionaires at the same or higher rate. We cannot rebuild this country solely on the backs of people like me who make $46k per year with 3 kids who have only major medical coverage and lost my 4101k, paultry as it was. The money that has apparently amassed at the top in the name of theft, fraud and wage disparity must be taxed.

    Favorite    Flag as abusive Posted 03:16 PM on 06/24/2009
- Buffyboy I'm a Fan of Buffyboy 13 fans permalink

Why did Obama appoint this d**che HSS Secretary?

    Favorite    Flag as abusive Posted 11:30 AM on 06/24/2009
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