Obama Urges Realistic Expectations on Health-Care Reform

By Michael D. Shear
Washington Post Staff Writer
Sunday, August 16, 2009

GRAND JUNCTION, Colo., Aug. 15 -- President Obama held his third and final health-care town hall gathering Saturday, telling a friendly crowd that reform would require insurance companies to abide by caps on out-of-pocket expenses and accusing some of the effort's detractors of being "simply dishonest."

About halfway through the questioning, Obama sought to encourage people to have realistic expectations about what could come of health-care reform, his largest domestic initiative.

"The truth is -- I want to be completely honest here -- there is no perfect, painless silver bullet out there that solves every problem, gives everyone perfect health care, for free," he said. "There isn't. I wish there was."

The president has said that before. But he went further Saturday, taking the opportunity to urge people to have what he called an "honest" debate about the proposals that he has been pushing.

"What you can't do -- or you can, but you shouldn't do -- is start saying things like we want to set up death panels to pull the plug on Grandma," he said. Growing more serious, he added: "I just lost my grandma last year. I know what it's like to watch someone you love, who's aging, deteriorating."

He said the allegation that he and members of Congress are pursuing reform "so that they can go around pulling the plug on Grandma -- that's simply dishonest, especially when I hear the arguments coming from members of Congress in the other party, who, turns out, sponsored similar provisions."

He went on: "We've got enough stuff to deal with without having these kinds of arguments."

One of the most inflammatory charges has been that Obama and Democrats were seeking to implement "death panels," with bureaucrats making decisions about whether elderly or seriously ill patients live or die. The allegation stems in part from a provision in a bill passed by three House committees that would provide Medicare reimbursement to patients seeking end-of-life counseling. On Thursday, lawmakers working on the Senate version said that provision had been dropped from their proposal.

The president, who visited Yellowstone National Park with his family earlier Saturday and who heads to the Grand Canyon on Sunday, responded to questions with detailed answers meant to address criticism that has been aimed at health-care reform.

That effort has been hampered in the past several weeks. The audiences and questions at the town halls organized by his administration have been overwhelmingly supportive, giving him little opportunity to engage critics of health reform.

On Saturday, Obama continued to direct his ire at insurance companies, accusing them of unfairly capping benefits and raising premiums on people who have insurance.

The president was introduced by Nathan Wilkes, a local electrical engineer. He described annual expenses of $750,000 a year for his ill son, and his scramble to find insurance companies that would cover the expenses.

"If you think this can't happen to you or your family, think again," Obama told the crowd, which applauded effusively throughout the meeting. "No one is holding the insurance companies accountable for these practices. We're going to ban arbitrary caps on benefits."

Obama repeated his assertion that "special interests" are using misinformation to try to scare people into opposing reform.

"These struggles have always boiled down to a contest between hope and fear," Obama said. "That was true when Social Security was born. That was true when Medicare was created. It is true in today's debate."

The questions for Obama -- seven in all -- were largely supportive. He praised one of his questioners, a college student named Zach, who challenged the president on whether insurance companies can compete against a government insurance business that doesn't have the same costs that private companies do.

"It's good to see a young person who's very engaged and confident, challenging the president," he said. "Gotta have a little chutzpa."

Obama called Zach's questions very legitimate but said, "I think we can craft a system in which we have a public option that has to operate independently, not subsidized by the government."

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