Thursday, February 25, 2010; 12:14 PM
OBAMA: Before you go, Max, I just want to ask, whether it's you, Tom, or anybody else on the Republican side, and maybe some of the House members might be interested, you know, Senator Coburn mentioned some cost containment issues where it sounds like we agree.
Fraud and abuse, we agree. It sounds like you have, maybe, one other idea that you don't think is in our proposal, but -- the idea of undercover patients -- but that's something that I'd be very interested in exploring. I don't think, conceptually, that would be a problem. The issue of prevention -- and that includes, by the way, things like the -- how our kids are eating and getting exercise. And I'm proud of the first lady for working to see what she can do on that front.
And that's -- there are some provisions in the legislation that's already been passed through the Senate and the House that directly relate to this that I think you'd be supportive of.
The issue of defensive medicine, as I indicated, Secretary Sebelius is working on this. But I think that there are things that we could do at the state level to help foster innovation and eliminate some of -- some of the concerns that you've got.
I would be interested in hearing from any of our Republican colleagues what objections they have to what we consider one of the biggest ways of driving down costs, and that's what Steny just referred to, which is allowing individuals and small businesses who are currently trapped in a very expensive market -- essentially they're having to be out there fending for themselves -- to be able to buy into, essentially, a large group, to become part of a large group, just like all of us as government employees are part of a large group, so that they have more negotiating power with the insurance companies, which I think we all agree would drive down costs.
If you've got bigger purchasing power, insurance companies want more customers; they would drive down those costs. I know some of you have agreed to this as a concept in the past, and so my question is, is there something, in terms of the way the House and Senate bills have been structured, that leads you to be concerned or want to not move forward on that approach?
BOEHNER: Well, Mr. President, I'd like to yield to Mr. Kline from Minnesota, who will talk about the small-business health plans, in terms of how we would propose to do this.
KLINE: Thank you, Leader.
Thank you, Mr. President.
I think that Senator Alexander framed our overall position very well when he said that we're looking at thousands of pages of legislation, and we believe a better approach is to go step by step to address these issues of cost.
We certainly agree that you get better economies of scale if you can come together. We have proposed, in both the House and the Senate -- in fact, for a number of years -- that small businesses be able to band together in small-business health plans or association health plans.
We all know, and I've heard everybody say here, that small businesses are the engine that drives our economy. We also know that about half of the uninsured either work for small businesses or depend upon somebody who does.
And so we believe that we ought to address that issue by allowing these small businesses to band together in the same way that I think, Mr. President, you mentioned large companies do. And I mean really the same way, so that they get all the advantages of, if they self- insure, being able to avoid the 50-state mandates; being able to lower their administrative costs because they're not having to deal with that.
And it will lower the cost of premiums for these small businesses and allow them to insure more people and to keep people that are already insured on the books, because we all know -- we all know stories like we've heard here of small businesses that are saying "I can no longer provide insurance for my employees."
Small businesses have been asking for this for years. It's not a new idea. They've been asking for it for years. And we think it's a far better way to get these economies of scale than the exchange thing that's in the huge -- that's in the huge bill, that this will actually allow businesses to be able to lower their costs exactly the same way that large businesses do.