A President Up to the Challenge: Reforming Health Care

Tuesday afternoon was a fascinating display of the Obama touch as I joined other Ways and Means Democrats in meeting President Barack Obama at the White House to discuss health care reform. The president was clear and forceful in his commitment to not just add more money to health care spending. The president made clear he wants a change in the culture of health care delivery and a system that cannot simply reward more tests and procedures, but needs to deal with how we provide the best health care and the best value for the American taxpayer dollars. As an example, he referred to a high priority of mine: doing a better job helping families cope with medical decisions at the end of life for family members. Citing the example of his own grandmother, he made clear he thought we could do a better job.

There was agreement with the president around the table that the program needs to be clearly paid for over the next ten years, that it needs to improve not just the coverage but the quality of health care, and that it be sustainable over time. He has made clear that he doesn't want taxes raised for 95% of the American public. Overall, the president once again demonstrated his active listening skills as virtually everybody around the table had an opportunity to share their concerns, raise questions, and be a part of the process. I continue to marvel at his commitment to inclusivity, ability to keep discussions moving, and clearly draw out interests and concerns from policy makers.

Clear outlines have been developed that ought to make it possible to reform health care: We will preserve the American people's choice, that if they happen to want to keep their current health care, that we need to provide an alternative for people who currently don't have health care or they don't have meaningful choices -- the public health insurance plan can and should be part of that mix. Finally, we should be placing the health care that the government already ensures through Medicare on a more sustainable basis, reducing costs and improving the quality of care.

I have no doubt that if more Americans could have the experience we had with our president Tuesday afternoon that health care reform is a goal that we would in fact easily achieve. We may not be able to have everybody in a small group discussing it with the president, but Congress and the president ought to be able to provide meaningful opportunities for this conversation that will get them the information they need and America the healthcare that they deserve.

Comments

[nyprogressive34]

It fires my optimism that people like Earl are seated at the White House table, working to provide everyone with good choices under a new system -- and I am encouraged knowing we have a president who is so attentive a listener.

Go Earl! Thanks for your nuanced treatment of the issues, as usual. Would that there were more people like you in the halls of power -- only then you couldn't be so wonderfully authentic! Keep up the good work.

[andrico]

Watching this "debate" on heathcare unfold, the complete dysfunction of our political process is on display. It is a stunning omission not to include serious discussion of a real single-payer option with no trigger. Even though a majority of Americans want this, even though we voted for change in November, even though Dems couldn't have a clearer mandate for change, we watch Republican branding of this issue dominate and Democrats failing to define the message. Again.

It's pretty simple. Until we have a not-for-profit healthcare system, costs will continue to skyrocket and families will lose. Calling anything else real healthcare change is a joke.

So be bold and change the tide.

I live in your district. Off-topic, but great work on sustainability issues.

[zest]

Single payer is the only answer.

[jmpurser]

Yes, it's the "only answer" but in DC it's "none of the above"

[Manx]

You say, "We will preserve the American people's choice..."

According to national polls, the American people are not looking for "preservation" of the current system, which is the problem, but looking for a single-payer system. How can you ignore this so blithely??? A single-payer system, where the risks are spread among everyone, is the only viable solution, whether it's politically realistic or not. And the polls show that is what the majority of Americans want. At present, the politicians aren't negotiating on the basis of providing the best health care for Americans but on what the insurance companies will or will not tolerate. The basic questions is why do insurance companies have more clout than the electorate?

[cclowe]

Congressman Blumenauer, On April 16 in Portland you said you would not support HR 676 because you did not want to waste "political capital" on an idea that had no realistic prospects of passing. I would like to know what political capital it would cost to co-sponsor HR 676 along with Rep. Stark's bill of which you are a cosponsor, if the only objection is the political prospects?

If your actual objection is substantive, I urge you to emulate what you praise in President Obama -- make your position forthrightly, listen actively, and engage the substance. Not to do so is deeply disrespectful of many, many of your constituents and generates disrespect back.

I don't expect your position on HR 676.

However, if you genuinely are interested in active listening and inclusiveness, then you should use your position on the Ways & Means Committee to influence Chairman Rangel to include the single payer option fully in the Committee's hearings. Your own ally, Dr. Howard Dean, said at the June 5 "town hall" event that your preferred public option approach benefited from single payer activists voicing our position.

Ideally you your commitment to full, open, honest debate in public.

Single payer suffers from an unjustified symbiotic blackout of consideration by elected officials and by the media. This is both undemocratic and immoral. Please stand up for what is right in the form of debate, even if we disagree about what is right in health care reform or its politics.

[cclowe]

Congressman Blumenauer, I am glad that you value the president's "active listening" and commitment to "inclusivity." Speaking as one of your constituents (Portland, 97202) it would be good if you emulated them in your approach to your constituents who disagree with your approach to health care reform.

I am told by someone I know to be in a position to have heard this from your staffers, in a conversation where this person was criticizing the demonstrations at your closed "town hall" with Howard Dean, that you feel angry at and perhaps hurt and bewildered by the protests directed against you by single payer supporters, to the point where you are considering disengaging from the health care issue.

Your post here suggests that the disengagement claim was exaggerated. The anger, perhaps not. If indeed that is part of your response, I ask you to consider how advocates of a serious idea whose seriousness is shown by its superior results around the world to our fragmented non-system, and in cost control compared to the European system most like ours (Germany), at preemptive dismissal that fails to engage with the substance of its claims.

If you want to be an active listener, and understand the sources of the protests, think about that, and consider engaging your constituents in a more respectful manner.

[whitebird46]

Is the President up to the challenge of a town hall style televised event on the topic of healthcare?
It's time to let the people hear more details of the plans being floated. People in the audience could ask questions and get some answers. Most people I know have no clue what the public plan option is. Yesterday I had lunch with a friend (63 yrs.old) who, with her husband will soon lose their ins.coverage with Cobra. They have been paying $800 a monthand of course are a few years away from Medicare. I explained what I knew about the public option and she is ready to sign Dr. Howard Dean's petition. (Standwith­Dr.Dean.co­m) Obama is great at explaining complex issues to people and it needs to happen soon so that more of us can weigh in with some knowledge of the proposed options.

[WinterParkMom]

Good idea,
A town hall in all 50 states with mandatory tv coverage from every station in the prime time hour.

Here's my plan...ultimately single payer is the most preferable. Next would be the public insurance option. To be paid into by everyone if they want to. Premiums based on income. Deductibles based on income and capped out at maybe $1500-2000. Allow an option to pay an additional minor premium for long term/end of life care, which can be transfered from family member to family member or even friend to friend.
1 penny sin tax on every fast food item, high fructose corn syrup beverage and food, and every bottle and glass of alchohol.

Small wellness clinics need to be established with extended hours, especially in rural and low income areas to accommodate folks who cannot travel far (Appalachia comes to mind) and accomodate folks with the potential to get fired or docked pay for taking off for doctor's appointments for them and their kids. Each clinic must have a midwife or pediatric nurse to make home visits to new mothers at least 3-4 days after release. I have more ideas than this post will allow me. Congressman, I hope you read these responses.

[Merlin7]

Baloney. If Obama were serious about overhauling health care, he would have backed single-payer and twisted arms until he got it passed. As it is, what we're seeing is an elaborate con game designed to perpetuate the status quo while mollifying an increasingly restive public. Obama is looking more and more like a one-term president.

[jmpurser]

Agreed on all counts.

[mcantwell]

Single Payer! Stand up and Fight for Us!

[Openeyes]

Congressman Blumenauer: It's very simple: either you provide single payer health care or its still just a private insurance system which is the root of the entire problem.

Don't go gushing about how well the meeting went when the policy is still to provide "insurance alternatives."

The objective is to provide health CARE not health INSURANCE.

As for all the naysayers screaming about "burearcats" running health care, why is it prefearable that insurance company employees run health care as they do now?

Overhead for medicare is 22 cents per dollar. Overhead for the average health insurance provider is 60 cents per dollar, because of paying out dividends to shareholders, bonuses to CEOs and sales people, advertising, etc. - a much more expensive system just in administration costs than the government, which is why private insurance is terrified single payer will actually go thru.

If you sincerely want to provide health care, and not just lip service, you need to get beyond the current private insurance system and implement single payer insurance - otherwise, you're just blowing smoke and fronting for private insurers.

It really is just that simple.

[marijam]

I'm not going to support health care reform that means a give-away to the insurance companies. If I had wanted health care ala Romney or McCain, then I would have voted for them.

[NotBrainwashedByMedia]

Source: http://news.yahoo.com/s/ap/us_social_security

WASHINGTON – Social Security and Medicare are fading even faster under the weight of the recession, heading for insolvency years sooner than previously expected, the government warned Tuesday. Social Security will start paying out more in benefits than it collects in taxes in 2016, a year sooner than projected last year, and the giant trust fund will be depleted by 2037, four years sooner, trustees reported.

Medicare is in even worse shape. The trustees said the program for hospital expenses will pay out more in benefits than it collects this year, just as it did for the first time in 2008. The trustees project that the Medicare fund will be depleted by 2017, two years earlier than the date projected in last year’s report.

The trust funds — which exist in paper form in a filing cabinet in Parkersburg, W.Va. — are bonds that are backed by the government’s “full faith and credit” but not by any actual assets. That money has been spent over the years to fund other parts of government. To redeem the trust fund bonds, the government would have to borrow in public debt markets or raise taxes.

[wrobbins]

That's what happens when you create mandatory federal Ponzi schemes.

[Openeyes]

No, that's what happens when Congress continually borrows from the fund, rather than leaving it intact. Social Security has worked just fine for decades. Bush borrowed heavily from it to help hide his massive deficits (along with keeping the Iraq war "off budget"). If Social Security isn't sabotaged any further it can certainly be saved. Conservatives have been trying to kill it for years.

[jhNY]

In which the denizens of the Beltway labor mightily and deliver a gnat, which by skillful lighting and a magnifying glass will appear to be a monstrous winged thing to its enemies and an angel of mercy to its supporters, but will be, nonetheless, a gnat, unless the plan is single-payer and no more obliged to pay for itself than is our Defense Department.

At some point, folks are going to need real health care when they have real health problems. Is the plan touted to date really liable to deliver such care? Or is it, like so much of what we are going to get for the time being, much symbolism with a dollop of 'compared to the old system this is better in some ways' sprinkled on top?

[tompoe]

Blumenauer, stop patting yourself on the back, and pass single payer. Until then, you can bet you won't be returning to office.

[dianhow]

Good point. Single payer- like Mediare- which works well for millions- and is lots cheaper to administrate thn ' private ' CO's . who msu pay 10-20 mil- stock options- golden parachutes- as well as make their stock holders happy. None of that is involved in SINGLE PAYER.
Most of the lies / horror stories about public health care - is funded by the right and huge Co's
who care little about health care. GOP says ' Gov't should NOT come between you and your MD
" but insurance CO's already do that .If your job is lost - 18 months of COBRA is too expensive for most folks- so you have NO insurance at all .Ins Co make money by denying care and is some cases hoping the very sick die before they have to pay the huge bills. Many HMO 's work well only when you are healthy - and they limit which MD 's you can see.
Profit motive in Health care - makes no sense.

[RoloTomassi]

"I have no doubt that if more Americans could have the experience we had with our President Tuesday afternoon that health care reform is a goal that we would in fact easily achieve."

Well congressman, you should have a doubt, because if we don't see AT LEAST a viable public option [without a trigger, thank you] in a final bill that gets passed into law, then your glowingly great experience will be a nice memory for you, and a big fat ZERO gain for the rest of us.