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Obama on single payer in online town hall

[UPDATE 64,000 views, but I'm betting that they're influencers. Numbers will increase, too. Technically, the show was fine, and Obama looked good. And the play? Well... --lambert]

[TYPING LIVE] Why? Costs. Medicare, Medicaid is the biggest driver of the deficit. If you add up the recovery package, and the various economic proposals, that amounts to a fraction of the long term deficit and debt that we're facing. Better to pay now, rather than wait. I want a "universal" health care system. Whether we do it like Europe or Canada.

A lot of peopel think "single payer"; Canada the single payer. Basically, everybody pays a lot of taxes, and you're covered. You go in you say I'm sick, somebody treats us.

Problem is legacy institutions that are not that easily transformed. Majority of Americans employer based. I don't think the best way to fix our system is to scrap what people are accusomted to. We should build on what we have and fill gaps. We can lower costs through information technologies. Invest in prevention.

Cut costs and increase coverage. My expectation is that we will have a health care bill this year.

* * *

President Underpants Gnome!

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gqmartinez's picture
Submitted by gqmartinez on

That says a lot, doesn't it?

Nevermind that single payer would save would save a ton of money. Nevermind that Bush's tax cuts and the war in Iraq are actually contributing more to the deficit.

This is one of Obama's more revealing statements. He seems to really beiev all the right wing talking points WRT "entitlement" and health care. Not even the scary Clenis--who makes all young progressives cry--was so down on single payer. Does that mean that Obama is going to make proggers cry as well?

Submitted by lambert on

And when you think about it:

"You go in, you say I'm sick, somebody treats you"

doesn't sound like a bad idea.

I view this as another example of pressure works. He'd rather not mention it at all, now he his.

Bottom line is he wants to keep the insurance companies in business. But it's single payer, so people's plans and doctors won't change. That's what people are "accustomed" to. If Obama thinks people want to stay "accustomed" to their insurance companies, he needs to think again.

Early days!

Submitted by jawbone on

Really big effective change?

What to do, what to do. Well, if you're the not-FDR, this may be it.

I was struck by the use of the word "legacy." Now we get" legacy health insurance" to go along with those toxic "legacy assets."

Oh, and those "legacy excutive powers" from the BushCo power grab....

I'm seeing a pattern here.

Submitted by jawbone on

on healthcare

The top question, by a large size based on eyeballing the dark bar, was about universal publicly provided healthcare, "like many European countries." Here are the top 10 healthcare questions (without the bars). I forgot about the marijuana questions coming in #2. Heh. But it does suggest a revenue source.

"Why can we not have a universal health care system like many European countries, where people are treated based on needs, rather than financial resources?"
richard, sd, ca

"Why is marijuana still illegal? Cigarettes and alcohol are far more harmful, and with the taxes put on the legal distribution of marijuana the US could make millions"

Ben R, Washington, DC "Are you going to make eliminating insurance companies ability to deny coverage based on "pre-existing conditions" a part of your health care reform policy? I'm afraid to go to the doctor, because what if I have a condition, but then lose my job?"
T.Kapanka, San Francisco, CA

"Insurance companies run healthcare in this country. True healthcare reform cannot happen until health insurance is revamped. The current system ties the hands of both docs and patients. What plans are there for reform in this area?"
maxfun, Hillsboro, OR

"Why has "single payer" been taken off the table as an option for health care reform? As my friend with MS says, "we don't need health insurance, we need health care.""
Hollyw25, Portland

"In the campaign you called for a public option so that anyone could have the same coverage as Congress. Unfortunately some members of Congress have said they won't vote to let us have the same coverage they have. Will you fight for a public option?"
Karl S, St Paul, MN

"Why isn't the right to good health care just as important as the right to police and fire protection?"
Shari, Eugene, OR

"Wouldn't we all be better served if health insurance was government-managed ONLY? The for-profit model we live under today works for the stock-holders first, so of course costs keep climbing. Will your plan fix this?"
PNStoneham, Oakland, CA

"As a person with Multiple Sclerosis, I have many other MS friends who use marijuana just to feel some relief from their bodies. When can pressure be placed to reclassify Cannabis from a Schedule 1 drug (no medical benefit) to Schedule 5?"
Marcia, Texas

"Why is health care so much more expensive in the United States than in other countries?"
Drew Miller, Somerville, MA

At Open for Questions-- To see questions, click on a topic on the left side column. A rather short box opens, which doesn't allow you to see all 10 questions at once (and there's plenty of space on a web page to have the full 10 shown, even more. That was kind of annoying, having to toggle up and down to compare questions. Grrrr. Who's their web wizard??)

(Two questions about Mary Jane. And what's up with the raids on legal marijuanca distribution sites in CA? I thought those were going to stop, but over at TL there was another one. No comment essentially, from the Feds.)

Submitted by jawbone on

Right here. Yessssss! (No blockquote--just all quote)

From Richard in California: "Why can we not have a universal health care system, like many European countries, where people are treated based on needs rather than financial resources?"

THE PRESIDENT: Well, first of all, I was in this room last month in what we called a health care forum. And we brought all the members of Congress, Republicans and Democrats who were interested in this issue; we brought together various constituency groups, insurance companies, drug companies, you name it. And my message to them was: Now is the time to reform the health care system -- not four years from now, not eight years from now, not 20 years from now. Now.

And the reason -- (laughter) -- the reason that I think it is so important is that the high costs of health care are a huge drag on our economy. It's a drag on our families. I can't tell you how many personal stories that I hear about people who are working, maybe have two parents working and yet still don't have health care. And the decisions that they have to make -- excruciating decisions about whether or not somebody goes to a doctor -- it makes them less productive, it makes them less mobile in terms of being able to take new jobs or start a new business because they're worried about hanging on to their health care. So it's a drag on families.

But it's a drag on businesses, as well. There's not a small business or large business out here who hasn't seen their health care costs skyrocket, and it cuts into their profits.

And it's a drag on the federal budget and the state budgets. That's the thing that is going to potentially break the bank here in the United States. Medicare and Medicaid, if we don't get control of that, that is the biggest driver of our long-term deficits.

[Anyone know if this is accurate? What about, oh, military and other "security" spending? Really, I'm not sure it's the biggest.]

So when people -- when you hear this budget debate that's taking place right now, and folks say, oh, you know, President Obama's budget, he's increasing money for veterans and he's increasing money for education, and he's doing all these things that -- that's going to bust the budget, what they don't understand is, is that if you add up the recovery package that we've already passed and you add up the various proposals I have to grow the economy through clean energy and all that stuff that we're doing, that amounts to a fraction of the long-term deficit and debt that we're facing. The lion's share of it has to do with Medicare and Medicaid and the huge, rising cost of health care. So our attitude is, better to pay now and make an investment in improving the health care system rather than waiting and finding ourselves in a situation where we can't fix it.

Now, the question is, if you're going to fix it, why not do a universal health care system like the European countries? I actually want a universal health care system; that is our goal. I think we should be able to provide health insurance to every American that they can afford and that provides them high quality.

So I think we can accomplish it. Now, whether we do it exactly the way European countries do or Canada does is a different question, because there are a variety of ways to get to universal health care coverage.

A lot of people think that in order to get universal health care, it means that you have to have what's called a single-payer system of some sort. And so Canada is the classic example: Basically, everybody pays a lot of taxes into the health care system, but if you're a Canadian, you're automatically covered. And so you go in -- England has a similar -- a variation on this same type of system. You go in and you just say, "I'm sick," and somebody treats you, and that's it.

The problem is, is that we have what's called a legacy, a set of institutions that aren't that easily transformed. Let me just see a show of hands: How many people here have health insurance through your employer? Okay, so the majority of Americans, sort of -- partly for historical accident. I won't go into -- FDR had imposed wage controls during war time in World War II. People were -- companies were trying to figure out how to attract workers. And they said, well, maybe we'll provide health care as a benefit.

And so what evolved in America was an employer-based system. It may not be the best system if we were designing it from scratch. But that's what everybody is accustomed to. That's what everybody is used to. It works for a lot of Americans. And so I don't think the best way to fix our health care system is to suddenly completely scrap what everybody is accustomed to and the vast majority of people already have. Rather, what I think we should do is to build on the system that we have and fill some of these gaps.

And I'm looking to Congress to work with me to find that optimal system. I made some proposals during the campaign about how we can lower costs through information technologies; how we can lower costs through reforms in how we reimburse doctors so that they're not getting paid just for the number of operations they're doing, but for whether they're quality outcomes; investing in prevention so that kids with asthma aren't going to the emergency room, but they're getting regular checkups.

So there are a whole host of things that we can do to cut costs, use that money that we're saving then to provide more coverage to more people. And my expectation is, is that I will have a health care bill to sign this year. That's what we're going to be fighting for. That's what we're going to be striving for.

[Mr. Incrementalism speaking here? After all those words about how necessary real change is, this?]

Can I just interrupt, Jared, before you ask the next question, just to say that we -- we took votes about which questions were going to be asked and I think 3 million people voted or --

DR. BERNSTEIN: Three point five million.

THE PRESIDENT: Three point five million people voted. I have to say that there was one question that was voted on that ranked fairly high and that was whether legalizing marijuana would improve the economy -- (laughter) -- and job creation. And I don't know what this says about the online audience -- (laughter) -- but I just want -- I don't want people to think that -- this was a fairly popular question; we want to make sure that it was answered. The answer is, no, I don't think that is a good strategy -- (laughter) -- to grow our economy. (Applause.)

So -- all right.

Submitted by lambert on

1. To anybody who actually cares about a working health care system, as opposed to keeping the insurance companies in business with forced mandates and a big honkin subsidy, and

2. To everybody who's got a friend or relative in jail -- not for stealing millions of dollars, say, or wrecking people's 401(k)s, or turning them out of their houses -- but for smoking a weed that's more harmless than the alchohol we used to prohibit, before we decided that was really, really stupid.

Plus ça "change," plus c'est la même chose...

But he speaks in complete sentences! Isn't that the most awesomely Presidential thing you've ever seen?!?!

NOTE I also thought the laughter of the courtiers in the East Room at the marijuana question was both hilarious and enraging. None of them are going to jail, or their relatives either.

oceansandmountains's picture
Submitted by oceansandmountains on

can outline the "11-dimensional-chess" explanation for me. Certainly there has to be an explanation. It just can't be that Obama is a corporate tool, a political coward. After all, he was supposed to be sooooo kewl that all the Dems and repubs in congress were going to just lay down for him. What gives?