Thursday, February 25, 2010; 5:27 PM
OBAMA: Let's go to Henry.
WAXMAN: Mr. President, I just wonder if some of our Republican friends would like to have seniors on Medicare have catastrophic coverage only.
I'd say that seniors in this country -- and we've heard mention of them being the people who are worried about this Medicare -- this health care bill -- they ought to worry if we don't do something. Because not only will we hear ideas of putting on catastrophic coverage only because that'll save a lot of money, Paul Ryan has a proposal right now to say that Medicare recipients in the future ought to have just a little voucher, and then they can shop for their own insurance. They can be prudent shoppers.
Well, yesterday I had a hearing with some people who were supposed to be prudent shoppers. They're people from California who were told by Anthem WellPoint that their insurance was going to go up 30 percent -- 39 percent. And could you imagine seniors, if you have to go shopping with your voucher, and then you're told, "Oh, by the way, this private policy that you're going to have to buy just went up 39 percent"?
And the way to save the federal government money is to shift it onto the seniors. That's where we're going if we don't do anything.
Now, what do we do that makes sense? We've got to hold down health care costs. You can't -- we had some ideas that we seem to agree about to hold down health care costs. One idea I did find peculiar, and that's to have the medical malpractice issue at the federal level. And the Republican proposal was to adopt the California law. Well, the California law is in effect. It's been in effect since the 1970s. And Californians are faced with a 39 percent increase, so it isn't holding down their health care costs.
We've got to really look at holding down health care costs. That's hard to do unless we have insurance reform so we could get more people buying health care.
I thought Tom Harkin just summed it up so well, all these issues go together. If you don't bring more people in to be covered, you segment the groups that are covered in high-risk pools, they pay more money, everybody -- everybody else is going to get a break.
Well, under the Republican proposal the people who get a break for insurance are the people who are healthy. The people who have to pay more are the people who are sick. Is that what we want in this country?
Now, I hear people all day say, "Mr. President, the public doesn't want your plan." Well, if I heard the kind of rhetoric over and over again that I've heard from some of the Republicans, I wouldn't want your plan either. A federal takeover of health care? That's not what's being proposed.
Somebody said that people ought to be able to buy a policy that suits their needs. Well, how many people are going to come forward and say, "I don't want certain things covered," and then find out that they're sick and they need that coverage?
We need to have a market like the federal government employees, like members of Congress. We know what we can choose. If somebody wants to choose a health savings account, that means because they want to put some of their money away because it's tax free and it's a -- it's a really great deal if you got a lot of money, but most people want to know they're going to have necessary medical coverage, with the doctors and the hospitals, when they need it, and you have something that's basic to everybody.
Well, they ought to have that for people who are buying private insurance as well.
We had three witnesses yesterday. A woman told us that in her family she had a child with a hole in his heart, and that because -- that became a preexisting condition. So she has health insurance coverage through this individual market. She says, "I barely use it because I'm afraid to use my health insurance." She's now told she's going to have this 39 percent increase. She said her health insurance is going to cost her about as much as her mortgage payment each month. She's afraid to drop it because she doesn't know where she could ever get health coverage again.
Another woman had asthma, and that was considered a preexisting condition. She was going to face a 39 percent increase as well.
Now, if they were pooled with everybody else in that small business and individual market, which is what our bill does, then there are more people buying insurance and there's more -- there's more leverage, it's spreading the cost, not making people have to pay more of these costs.
The people who we're talking about are people in small businesses where the small business can't get insurance because, well, they got one employee with a real serious medical problem, so nobody in that group's going to get coverage, the employee can't afford it.
Or women cost more for small businesses if they're in that workforce, especially if they're older. They don't want to get coverage -- they don't want to give them coverage either.
We have single adults, a lot of them not very healthy, dealing with chronic conditions, parents and families living on low incomes, they need help from Medicaid. We have to hold down the cost by bringing everybody into the system.
Now, in Medicare, what does our bill do? It protects the solvency of the program for an additional seven to nine years. For Medicare we close the donut hole, which means that when seniors have to pay for those prescription drugs they don't have to do it all on their own. We keep them with a Medicare policy, and we provide preventive services and they don't have to pay for them because we know preventive services will keep us from having to pay for more costly care.
This bill is good for people on Medicare, and if we don't get this bill passed they're going to get squeezed like crazy.
This bill is good for the American working people. This bill is good for our (inaudible) care system. And for us to take the Republican proposal, we'd cover instead of 30 million people, 3 million. We wouldn't hold down the deficit a bit. We would still have -- we would still have all those preexisting conditions that would keep people from getting their insurance coverage. Maybe if people go and pretend to be patients we could stop some of those false claims, but I'm sure those false claims happen in the private insurance market, not just the public insurance market.
But not only are we covering more people, we're doing innovative ways to deliver the care that will make it less costly. And as we develop innovative ways to deliver care, especially with chronic care, that will hold down the costs of care, and those ideas will be picked up by the private sector. They always follow what Medicare does and then they adopt it, because they want to hold down costs.
So you can't solve any problem -- insurance reform, holding down costs, protecting Medicare, dealing with the deficit -- unless you deal with it all.
And, Mr. President, you're not going to be able to do this piecemeal, and I have doubts about whether the Republicans are going to help you because I haven't heard a lot of willingness to come and work with you now or did I hear it a year ago.
WAXMAN: I hope I'm wrong.
OBAMA: Well, the -- I'm going to be equal opportunity here and (inaudible) you know, we're not making campaign speeches right now. And I think your points I agree with, but (inaudible) still think that there's a lot of areas of agreement that we've discussed so far.
This is an area, though, that -- in which we do have some philosophical disagreements.
(UNKNOWN): Mr. President?
OBAMA: And so what I -- I think it's -- I want to go to a Republican. The question I would ask to my colleagues, my friends on the Republican side, would be are there areas of coverage for people who don't have health care that you would embrace and agree with beyond what has been presented in Republican Leader Boehner's bill?
There may not be. I mean, that may be sort of the threshold at which all of you think we can afford to provide help to people who don't have coverage, but there may be some other ideas that haven't already been presented or aren't embodied in our legislation, John, that I'd be happy to hear about.