I’ll be live blogging the health care summit off and on today. Less than two minutes into President Obama’s opening remarks, he told the story he has told everytime he talks about health care: I take about 10 letters home with me every night (now fill in the blanks – the letter writers need his health care).
At 4:45 PM EST: Charlie Rangel says “We are so close to National Health Care.!”
I’ll be paraphrasing some of the time. I will have some comments in brackets 
The summit is on lunch break. Waste and fraud is a big discussion. It’s obvious that Democrats do not agree with suggestions such as thought from Dr. Tom Coburn, who spoke to how to cut out the waste and fraud.
Obama did not like McCain bringing up the “gifts” given to some states, like Nebraska, Louisiana and Florida. He told McCain “the campaign is over.” As I watch FOX, listeners are blogging and saying Democrats are considering nothing of substance from Republicans.
Lamar Alexander said a health care bill is not a car that can be recalled.
Carl Cameron speaking at 2:40 PM EST: Don’t buy Harry Reid’s hype that no one is talking about reconciliation. He says “facts” prove differently.
From Politico – Just before Jim Clyburn begins speaking: Democrats have about 74 minutes of talk time and Republicans about 37 minutes.
Pelosi denies that abortion is in the bills. Pelosi denies that benefits to Seniors will be cut.
SUMMIT BEGINS AT 10:03 AM EDT:
Obama: We all know this is urgent. Politics trumped practical sense. I didn’t take this on because I thought it was good politics. What I’m hoping to accomplish today is for everybody to focus on not just where we differ, but where we agree, because there are some places where we agree. He mentions Boehners plan, taken into consideration what Tom Coburn and Ryan has said. He says there is some overlap.
The plan he posted this week was the best blend of the House and Senate Bills.
About his plan exchange for an exchange, a place where individuals and small business could go and get choice and competiotion for health care plans – just like Congress does. There would be pooling power.
Prohibit banning people with pre-existing conditions.
Obama’s Closing before the discussion begins: My hope in the hours we will be here, that in each section
lower cost, insurance market works for people, make sure we are dealing with the long term deficits. Then let’s talk about areas we do agree and see if we can bridge the gap. I don’t know if we can bridge those gaps at the end of the day.
I’d like to make sure this is actually a discussion, rather than trading talking points. He says people still want to see change.
McConnell: Boehner and I have selected Lamar Alexander for the opening.
Alexander: As a former governor I want to represent governors [Obama would not allow governors at the meeting].
Alexander says “we” have a better idea, and the people in his state do not want this health care plan.
Alexander says: we need to start over. This is not a car that can be recalled.
Alexander says we want you to succeed, because if you succeed, we succeed. But we think we have a better idea.
Alexander talks about the President talking about his “letters” he takes home and reads every night. Alexander says we get letters too, but to fix it and make our people happy, we must start over.
Alexander says more taxes, more subsidies – 2700 pages more or less will cut medicare by half a trillion dollars – there will be half a billion dollars in new taxes, premiums will go up, and they will go up because of the government mandates. The Mother of Unfunded Mandates!
Dumps millions of Americans into Medicaid, and doctors will not see those people.
[I SEE OBAMA’S CHIN IN THE AIR]
You’ve given a sweetheart deal to Louisiana. Why should the people in California and Arizona suffer when Louisian does not.
When people ask where our comprehensive bill is, I say this:
McConnell is not going to roll a wheel barrow in here, it’s not going to happen. We’ve watched the comprehensive bills, and they don’t work. We are too big and too complicated. He gives 6 ideas.
Let us buy across state lines.
Most governors want to put a end to junk lawsuits to stop big city lawyers.
Take all the profits of insurance companies away – every penny of it, we can pay for 2 days of your health care plan.
The best way to increase access is to reduce cost.
My suggestion for a bipartisian and productive session:
Don’t do reconciliation. You say it has been used before and you’re right, but this is not appropriate for 17% of the economy. Senator Byrd has said it is inappropriate to use reconciliation.
The tyranny of the majority is the biggest threat to our country (deTocqueville)
He quotes Democrats, one Moynihan said he could not imagine a major piece of legislation that did not happen with a bipartisian sponsorship.
[NOW, OBAMA IS LEANING HIS HEAD AGAINST HIS HAND]
[NOW OBAMA’S CHIN IS IN HIS HAND]
Alexander has done a great job in his intro.
Obama is now saying both I and Lamar went over our allotted time. Nancy and Harry will split time and make some quick remarks.
Pelosi – thanks Obama. On the path to lower cost and provide access for all Americans. Obama said there was a glimmer of partisanship with passing the jobs bill. The repealing of insurance exemption and anti trust laws.
Pelosi speaking of Ted Kennedy saying he was a “foot soldier” for health care and it is about the character of our country. We should be mindful as we set around the table, we should be mindful what America feels when they set around their table. ‘WE DO NOT HAVE TIME TO START OVER.” “THE PEOPLE OF AMERICA DO NOT HAVE TIME FOR US TO START OVER.” When people talk to her, they cry. People have to deduct their deductible from their food budget.
9:40 a.m. CST – Pelosi still speaking.
We have a moral obligation to reduce the budget, but I want to talk about how health care can effect the economy. They have a child that is bi-polar, and now they can get insurance. Bring dynamism to the economy. Without it we lock them down and business has an anvil around their neck
It will create 400,000 jobs immediately. [Remember, that every facility will have to foreign language workers in them – several languages – just to interpret – federally mandated.]
Those people sitting at that table want to hear that there is affordability and accessibility, and accountability for the insurance companies. Now she talks about Medicare fraud – with nothing about stopping it. Quotes Kennedy: health care is a right, not a privilege.
Many of our initiatives put forward by Republicans.
Nevada, our country and not what is going on here in Washington. Jesus Guiterrez – he works hard, has a restaurant in Reno, Nevada. He had everything he needed but a baby. The baby was born. The baby had a cleft palate. They did surgery and took care of it. Baby had a pre-existing condition. Got a bill for $90,000 uncovered. He had health insurance. He paid his premiums.
REID CALLS ALEXANDER A LIAR:
Reid to Alexander: You are entitled to your opinion, but not your own set of facts.
Last Monday, all over America. A Kaiser foundation poll said 58% of Americans would be angry if we did not do health care this year.
He talks about the doughnut hole. Again he calls Alexander a liar!
He says no one is talking about reconciliation but no one on his side has talked about it. He says Republicans are the only ones talking about reconciliation. He says reconciliation has been used for the Contract for America, for Medicare and….
The bill put forward this morning has significant input from Republicans.
A Harvard study:45,000 Americans die every year because they do no have health care.
75% of bankruptcies are due to health care.
Shows his story about Jesus Guitererrez is not an rarity.
It is your right to oppose our legislation, but it is your responsibility to hear your plan. Let’s hear it. Let’s work on it. [LOL]
He wants to do everything he can to work on both sides of the aisle to get this done [TO GET IT DONE THE WAY HE WANTS TO DO IT]
Everyone is going overtime. Now we need to be more disciplined about the time we use.
As I listened to your description of the house senate bill and the proposal I put on our website, I disagree with your characterization, but the steps you mentioned that you would be acceptable to are things we can agree on. In fact, some of then are already in the bill.
I don’t know yet whether we can bridge the differences.
Rather than talk about legislative process, let’s talk about substance. How we can help the people deal with costs. That will help to dictate legislative process. I’d like to start first with something I heard everyone agree on – the issue of cost. It is true, if all we are doing is adding people to a broken system, costs will escalate, and the government will be broke.
I’ve already indicated some stats. More than a 1/4 of small business premium increase of 20% or more. Many have dropped coverate. Fewer than half of businesses with less than 10 employees have dropped coverage.
MORE STORIES: I hear stories of people all the time of how cost impacts their lives. HE TELLS ANOTHER STORY ABOUT LAYING OFF THEIR EMPLOYEES.
How do we control costs. We have tried to take an idea that is a Republican idea – which is to set up exchanges – pools – where people can come in and get competitive products – choice and competitition. A menu of private insurance options, with the discounts that comes from a larger pool. If you still can’t afford it, we will subsidize. The plan will lower the individual cost of premiums by 14%-20%. He says the CBO backs this up.
Lamar Alexander says the CBO says the costs will go up.
Obama says that is not factually accurate. Now he states his fact again. The CBO says they may choose to buy better coverage, and in that case, it may be more expensive if they choose to buy into a pool of better insurance.
Alexander tries to respond. Not allowed to.
Obama says we have taken every proposal “out there” and adopted them. There are some additional ideas that Repubs have presented and we have included them.
Obama put buying across state lines in his proposal – it shows promise.
Obama wants a concrete discussion. Wants to know what ideas Repubs want, that they think is not in the Democrat proposal.
He strikes out that Alexander all spoke about what he doesn’t like about the bill.
Alexander says your bill will raise premiums.
Alexander wants other Republicans to be given a chance to talk.
Obama says the issue of whether premiums will rise or not will be SETTLED TODAY.
McConnell says Dr. Tom Coburn will speak next. McConnell says polls show that America is against this health care bill.
TOM COBURN – 10 a.m. CST:
Caution: what I see Congress doing is performing bad medicine. We are trying to treat the symptoms, rather than treating the disease. One our of every $3 we spend doesn’t make any well. The gov’t directs over 60% of health care in this country – and that 60% hasn’t worked.
He wants to talk about why it costs so much. 33% of cost in health care should not be there. We should be talking about how to handle that 33%. Harvard says 20% of federal health care is fraud. Someone else says 15% of government run health care is fraud. If we fix fraud, we could cut health care 7-1/2% tomorrow. We need to go to where the money is.
The other thing: a large portion of the tests aren’t for patients. They are for doctors, and we do it to protect ourselves from the extortion of lawsuits.
Thompson Reuters Study: $625 billion of health care dollars are wasted. Coburn wants patient-centered, market oriented solution.
If tomorrow, if everyone’s health care went down 15% percent, more people would have health care. Let’s go to the pot of gold. We should not encourage lawsuits that cause the cost to go through the roof.
We do not incentize prevention. I’m not talking about creating walking paths. I’m talking about changing the school lunch program. We create diabetes through food stamps and school lunch.
The goal is where are the costs excesses? How do we come together to solve the extortion in malpractice. How do we eliminate fraud. The private sector fraud is 1% compared to Medicare of at least 15% and probably 33%. We should fix this by going after the $1 in $3 that is fraud. Have undercover patients. A Doctor doesn’t know who is an undercover patient.
REID ACCUSES COBURN OF FILIBUSTERING.
Obama says every good idea they have heard about fraud – they have adopted. There are a whole host of provisions to do this in the bill. Does it help the average family – cost shifted with every penny of waste. You shift it to the private sector.
STENY HOYER 10:13 CST:
We should have health care for every family (quotes John McCain in his debate with Obama in 2008). We should be talking about them, and not about us. We believe we are addressing them by telling their stories. Everyone of us has a story AND NOW STENY IS TELLING ABOUT THE MESSAGE ON HIS ANSWERING MACHINE. Another story.
We need to deal with cost containment. Many in my caucus wants to increase competition – an open free market that is transparent – where people can compare prices. That’s what we tried to do in these bills. Sen. Coburn, we agree with you. $1 in $3 is not being spent as it should be spent. You speak correctly about wringing waste, fraud and abuse out of the system. I know you’ve seen that we are trying to do that. We’ve dealt with that in our bill and previously. We have put incentives in this bill to do all that. Maybe you have a better way to do that. We want wellness as a focus. We have worked very hard on that. We agree with the premise about school lunches. We’ll find a way to get there. Wants everyone to have access to a large group (pool). People with pre-existing condition not be prohibited. We want better coordination of care. Incentivize the coordination of care. Incentives to provide care based on best practices, rather than procedures being reimbursed.
My caucus thought that a public option would open up the marketplace. We need to fix the doughnut hole. We deal with that in the House bill. Seniors are faced with a large payment. The House fixes that. We need to meet the objective of Coburn.
Ask Repubs: Coburn mentioned some cost containment – waste and abuse. Undercover patients, I’d be interested in exploring. Prevention: how our kids are eating. Mentions MO’s program. Issue of defensive medicine: Sebelius is working on this. Things we can do at State level. I want to hear your objections to allowing individuals and small business to be able to buy into a large group to become part of a large group, so that they have more negotiating power with insurance companies (IS HE TALKING ABOUT A PUBLIC OPTION?) Is there something about the House and Senate bills that leads you not to want to do what we have put forth.
Alexander said we have 1,000’s of pages of legislation. We want to go step by step rather than the big legislation. We want small business to band together to get the same advantages big Business does. It will lower the cost of premiums. Small bs. has been asking for this for years. This is what we should be doing, rather than the “exchanges” you propose.
Obama asks Max Baucus to address small businesses doing what was just suggested.
We are the verge to bridge a lot of gaps because our differences are not great. We are allowing for selling insurance over state lines – NOT EXACTLY THE WAY YOU SUGGEST.
Lawsuits – SEBELIUS IS WORKING ON WAYS TO SETTLE BEFORE THEY BECOME BIG LAWSUITS.
Expanding Health Savings Account. They work pretty well.
Small business: Some suggest Small Health Plans. That’s fine. We provide for something similar SHOP ACT. Basically allows small businesses to exchange, and get the advantage of all the pooling. They can shop and compare. We are providing tax credits to small businesses 35% for first few years.
We agree on how we reimburse doctors. We re close – another example of how close we are.
The exchanges are a Republican idea. They are like Orbitz or Expedia. Shop around and get the best price. Hospitals should publish the cost of their procedures – like colonoscopy. The disinfectant of sunshine.
We have MAJOR PROVISIONS to combat fraud and waste.
Baucus says we basically agree. Let’s take this opportunity to work it out.
If you are interested in controlling costs, we should not be spending a trillion dollars. The non partisan actuaries say it will bend the cost curve by 1.25 billion dollars. A key way to fix costs is missing: Lawsuit reform. CBO on page 4 says this will reduce cost by _____________. Price Waterhouse says tort reform yields a savings of $239 billion.
Page 1,959 of your bill, language hinders the savings, and the buyer’s ability to compare costs.
Another on page 982 creates an unelected board charged with more medicare reductions. If congress doesn’t accept the charges, they must find other ways to cut. Too much power to this board.
OBAMA STOPS HIM. He doesn’t like his gazillion of pages being called out. He tells him to finish but…
CBO on page 4 says the estimated premium would increase 10-13%…because of the mandates contained in the legislation. Buyers will buy a better plan, BECAUSE THEY ARE MANDATED TO DO SO.
What ideas do we share. Fraud database. Wellness. Junk lawsuits. Sebelius is fixing that. Pooling the purchasing power of small business and individuals. To John Klein – a woman has a baby by C-section. You can’t be kicked out of the hospital until the doctor says it is time for you to go home. Under your Repub plan, the woman is not protected. How can we fix that. How can her doctor protect her.
There are large companies today who operate this way. They don’t need mandates from each state. Many fall into what we call cadillac plans. Your suggestion is a red herring. We put the association health plans in the same category.
Democrats have had 52 minutes. Repubs 25 minutes.
The diff is this. All the answers do not lie in Washington. All your answers sit in Washington. You are defining exactly what kind of health insurance everyone has. We think association health plans can set up their own offers of insurance. By mandating you are making it more expensive and restricting people by federalizing it.
We distrust all the governors, all the insurance companies. Should Washsington decide what people can and cannot buy?
OBAMA SAYS MCCONNELL IS RIGHT – THERE WAS AN IMBALANCE OF TIME GIVEN TO DEMOCRATS – BECAUSE HE IS PRESIDENT AND HE DIDN’T COUNT HIS TIME.
Obama: this is a legitimate debate. What is happening in the exchanges. When I just got out of college. I had to buy auto insurance. I was paying my premiums. I got rearended and when I was asked about getting my car fixed, they laughed at me. The policy was designed not to fix my car.
We should set up minimum standards that a plan that people are buying into should be solid enough that you get treated if you get sick. You can always get cheaper ins. if it has a higher deductible. The principle of pooling is at the center of our bill.
The implication that everyone has to sign up for a government health care plan. That is not true. How should government set a baseline, rather than letting people make their own choices. How much gov’t involvement is at issue, is not fair. We want a baseline of minimum requirements.
Agree with most of Coburn’s remarks. A third of all spending in Medicaid and Medicare is waste. How do we wring that waste out, and give the patient good care.
He likes the undercover patient who scopes out waste, fraud and abuse. OBAMA IS NODDING WISELY.
Cantwell has a provision: we ought to reward doctors for the quality and not the quantity. He doesn’t say how that can be done. If we are going to eliminate waste, fraud and abuse, the only way to do it is cut Medicare. [In otherwords, he suggests that this is part of the billions already planned to be cut.]
We cannot paper over some differences. We do not agree about who should be incharge. Trust Washington or Doctors. This is a huge difference. You have put control in Washington. It is not enough to say we agree about eliminating waste, fraud and abuse, but we can’t do it your way.
CBO est. that the average group policy will be 10% -13% higher in 2016. Reason – 1, a richer benefit – because the federal govt’ mandates it – so a higher cost. You will mandate that ins covers more than it does today so cost goes up.
Medicare payroll tax gets raised under your plan. It will kill small business. You are raising taxes on medical devices and pharmaceuticals. He quotes the CBO statement of large increases in premiums.
Republicans do not want to have to raise money by raising taxes in order to fund your bill.
Average age of 45 and average income of $69,000 bill will be penalized.
OBAMA ADMONISHES THAT HE DOESN’T WANT CRITICISIMS. Kyl hit a sore spot.
If I can only buy a high deductible plan that doesns’t pay for anything – what good is it to me. I don’t go to the doctor, I don’t get preventative care.
Yes, I’m paying 10-15% more because I get more under my mandated plan. You still have an option. The way that this bill is written uses a catastrophic pool if you cannot afford to buy the better insurance (which you already did not have). We are going to do the same thing we do for Congress for everyone else…on the taxpayer’s dime. Baseline of coverage in pool is not radical. A lot of states already do it. We agree that if you get more regional and national markets you might get more choice and competition.
ALL OF A SUDDEN – BUYING OVER STATE LINES IS ATTRACTIVE
But he wants a baseline benefit in every state.
This issue of gov’t regulation, is very different than the way Republicans have framed the debate. This is not a government take-over of insurance.
Two cost containment issues not vetted: McCloud Health Care Center in North or South Carolina. Looking for assistance to expand emergency room. Why have ER costs doubled. 31% of people are not there for emergencies. They are there for primary care. Some do not have health insurance, but many do have it but can’t afford $1500-$2500 deductible. I think that no matter what plan we develop, there will be many people left uncovered and we need a safety net. Suggests significant expansion of community health centers. All Democrat plans have a provision for this.
People who really cannot navigate the system. People who work very hard. They know what they need for themselves. Reminded of that when we talked about restaurant owners designing plans for their industry. The employees of those business should be a part of the negotiating. They are at the mercy of the small business owners.
ANOTHER STORY FROM A CALLER TO CLYBURN ON CSPAN:
Because he is on Medicare that his post operative treatment is limited to three years. What we are doing in our Dem bill fixes that. We want Medicare to be there for this man.
TO JOHN KYL: Obama tells Kyle that your insurance is grandfathered in. Kyl says that is for a very limited time and then ends.
Obama does not like the statement: DOES WASHINGTON KNOW BETTER. Obama says it is only a talking point.
CHUCK (CHARLES) UNKNOWN REPUB SPEAKER SITTING NEXT TO MARSHA BLACKBURN’S RIGHT. He is a doctor. People want the same perks unions get. Health Savings accounts are good. Small business will jump on this.
In our proposals we give small business owners to compare apples to apples, we eliminate lifetime caps. Your bill does not allow a comparison of apples to apples.
America wants a step-by-step approach.
OBAMA WANTS MORE DISCIPLINE IN THE AMOUNT OF TIME TAKEN BY SPEAKERS. Boehner says we have not been told what our time restraints are.
GEORGE MILLER D-CA:
Preventative care should not have a co-pay.
You haven’t done what you promised during the campaign. You have given big perks to Nebraska and Louisiana. You exempted seniors in Florida. You did not allow cameras as you promised. He quotes Obama saying that giving perks to some states and not to some, is “compromise.” McCain says that is NOT COMPROMISE. Obama tries to stop him. McCain keeps going. He wants all citizens treated the same in all geographies.
OBAMA tells McCain we are not campaigning anymore. We are supposed to be talking about insurance (which McCain was doing).
My hope is that we focus on how we can get this done (translation: don’t point out my corruption).
McCain reminds him that the American people care about this.
He wants her to talk about government requirements on insurance companies.
There is no question that the current insurance program has failed. There is no choice and no competitition. 99% of the market in metro areas, 75% of markets across the country are monopolies.
She mentions knowing how much insurance executives make.
There needs to be a pool to pool the risk. Obama nods wisely.
Cantor has pages stacked in front of him. Obama is pi**ed. Obama says let me guess, that’s the 2400 page health care bill…right?
Cantor says we don’t care for this bill. The American people don’t care for the bill. There is a reason we all voted no and it has to do with the philosophical differences.
Oops! I was interrupted by a phone call.
She must be a Republican. She says we need to hear more about the economic benefits of doing this. She quoted Lee Iocacca. She says we will be abandoning our mentally ill and elders. Think about the people who do not have health care.
NOW SHE IS TELLING HER STORY ABOUT A WOMAN WHO HAD NOT TEETH AND HAD TO WEAR HER DEAD SISTER’S TEETH.
We don’t export, we’re not technologically up-to-date.
We have 4 remaining speakers. We will break so that the House can take a break. Then we will resume. We are scheduled to be back at 12:45 PM CST (1:45 PM EST)
BRETT BAIR has a panel on.
JUAN WILLIAMS is praising both sides. He quotes Obama saying this is not a government takeover. Juan drank the Kool-Air and said he was shocked at the areas of agreement.
CHRIS WALLACE says Juan and I saw a different summit. He basically says it is ridiculous to think there are not huge philosophical, fundamental differences. How do you square the circle. No wonder nothing gets done. He quotes Paul Ryan: do you want to leave it to Washington or the Doctor. He quotes Lamar Alexander: we don’t do comprehensive well.
CHRIS WALLACE says nothing was accomplished. Not a single inch was accomplished.
BRETT BAIR says there was a different tone between the two parties.
A female Dem strategist is on saying Republicans brought their A game and talked about substance. She says it was very shrewd of Democrats to keep saying that there was a lot of commonalities. She said that is how Dems will walk this back. She said something to the effect that Republicans came off very well.
STEVE HAYS from Weekly Standard:
The debate of letting Washington or the Doctor solve the problem was excellent, and the President denigrated it and called it a talking point.
JUAN WILLIAMS: Talked about premiums and the President saying you don’t have to take the mandated plan which raises premiums. He doesn’t mention that Republicans pointed out that that expires in a very short time.
BRETT BAIR points out that Obama said the truth about the cost of premiums will be fleshed out today.
JIM ANGLE the president corrects himself about the CBO analysis of premium cost. Bottom line rates will increase 10%-13%. After being handed a piece of paper, Obama says you will pay more because you are getting more. BUT LAMAR ALEXANDER was right.
PETER JOHNSON, JR – FOX ANALYSIS; Obama is trying to convince American that this is a moderate proposal. Disingenuous. Testyness on Prez part and inability to listen to McCain and Cantor. He clearly did not want to hear things that went against his plan.
That ends the panel.
MEGYN KELLY on America Live is continuing the analyzation of the summit. Kelly gives the polls to LINDA DOUGLASS, Director of Communications for White House. DOUGLASS dismisses the polls and says THE AMERICAN PEOPLE DO NOT UNDERSTAND.
KELLY says so, you are saying Americans just don’t understand? That was basically here answer, but she goes on to point out there will be tax cuts to help most afford the President’s plan. I have bridge for sale in the Everglades.
KELLY asks if the President has, as has been reported this morning, a scaled down version of health care ready to go – a Plan B. DOUGLASS says a Plan B is overhyped.
ALEXANDER: gives Obama comments against Reconciliation in 2005. Alexander asks the president about this.
KELLY asks DOUGLASS if the President is prepared to use reconciliation. DOUGLASS says we should not be talking about reconciliation today. KELLY say I know you don’t want to talk about it, but everyone else does.
KELLY tell DOUGLASS to answer her question. DOUGLASS says talking in hypotheticals doesn’t make sense because they have found many areas of agreement.
[In fact, there have been no areas of agreement on exactly what is appropriate to do – NO AGREEMENT – NOT ONE.]
KELLY: Is reconciliation on the table.
DOUGLASS: he is focused on areas of agreement. [NO ANSWER]
Democrat strategist Mary Ann Marsh was just on with Megyn Kelly. She said Democrats brought everything to the table. Republicans brought nothing.
1:03 PM CST (2:03 PM EST) – Summit pick up again.
Obama is asked when the summit will end. He says “not too late – by 4:15 EST.”
Tone of earlier discussion was helpful. Will finish up on insurance reform
MIKE ENZI (R-WY)
Medicare – seniors are really nervous. They see 1/2 Trillion dollars coming out of Medicare. We should have had this 9 months or a year ago. When we got it in committee, the bill was half written. Barbara Mukowsky was adding provisions everywhere for Native Americans.
Insurance reform – one problem is mandates. Slams Olympia Snowe – said if 26 states accepted an issue, it would become a mandate. Health Savings accounts will cover the deductible in three years time, and it is tax free. I like the exchanges, they are more transparent. Exchanges can be good, but they should list anyone’s insurance that wants to add their plan. Make a list of those meeting the minimums, but do not keep others off the list because they do not meet YOUR STANDARDS. Let the people make their own decisions.
2:08 PM EST
TOM HARKIN (D_IA) – [he begins with WHAT ELSE – A LETTER WITH ANOTHER STORY! These people could stay within their time constraints if they cut to the chase and dropped the stories and letters. How about getting down to detail.]
We spent 1 year considering a range of ideas from experts throughout the political spectrum. We don’t have time to start over. We had over 100 bi-partisian meetings. Of 10 key elements of the house bill, we have 9 out of 10. The only one missing is health savings accounts.
We don’t allow segregation in our country on the basis of color, creed, orientation. Yet we still allow segregation today on the basis of your health. Why should we allow that happen. It is time to stop. Whenever I think of the word “pool,” I think of segregation. The more people in the pool, the cheaper for everyone. [Evidentally what Harkin wants is one big pool, and not smaller pools within industries].
DAVE CAMP (R)
You can raise premiums after this gets started. After 2014 when the bill fully comes into play, you establish preexisting conditions and link it to the mandate. People don’t want that. Americans do not want to face a fine for not having health care.
Pre-existing conditions: the way I understand the bill works, is to essentially set up a high risk pool. What you are saying is, if you are sick, older or have a hip replacement, you can buy into a high risk pool. Undisputable: a high risk pool without healthy and younger people in the same pool, will be higher. We looked at the Boehner bill to see what you did with this. Given the amount of money that you have allocated for that pool, it will not be a useful pool for people with pre-existing conditions. That is why other states have high-risk pools, but out of the 21 states, about 20,000 use the high-risk pool. By just dealing with older, less healthy people with pre-existing conditions there is not enough money. If everybody is in the pool, it drives prices down for everyone. The goal has to be to get everyone in a place where those risks are spread more broadly.
DAVE CAMP (R):
(sorry didn’t get this response)
2:27 PM EST:
This appears to be the end. Even CSPAN is not following. Megyn Kelly is on FOX, Wolf Blitzer is on CNN. I really wish they would air this whole thing. Grrrrrrrrrrr.
2:55 PM EST:
The American people are engaged, and if you think they want a government take over of health care you are mistaken. We have a difference and it is that America does not want to government to control their health care.
Does your side think Medicare Advantage works well?
Say Medicare costs $1. We said we could give private insurers a bonus for Medicare. We find we are getting nothing for that bonus. What if we take that bonus and give it to Medicare to pay for the doughnut hole? That’s about $300 billion a year. Let’s make changes 80% of Seniors not on Medicare Advantage getting a better deal. I haven’t seen that patients are better for there Medicare Advantage.
Do we have agreement that Medicare Advantage is not a good deal. Regular Medicare costs seniors about $90 to pay for others to have Medicare Advantage.
Why are we carving out the people of Florida still keeping their Medicare Advantage if it is not a good deal.
OBAMA TO MCCAIN:
You make a good point.
Medicare Part D. We are talking about filling the doughnut hole. It’s a trade off – where are we giving the benefits. What we need to say is, we can’t afford what we have today, so let’s not add more. Let’s fix what we have.
That’s valid, but let’s talk about the Medicare that pays for those having Medicare Advantage. The problem is not that we gave people Prescription Drug benefits. The problem is we didn’t pay for them. We should take Medicare Advantage funds and pay for it.
XAVIER BECERRA (D-CA):
Addresses to Paul Ryan. If there is no referee on the field, we will never agree. Do we believe in the CBO or not. You and I have sat on the same committees and you have expressed doubt in the CBO.
I doubt the reality.
XAVIER BECERRA: (This the Congressman who laughed at the idea of reciting the Pledge of Allegiance at an Immgration/Union meeting.
The CBO says the bill reduces the deficit. These bills reduce the deficit. We are trying to figure out a way to reduce costs without reducing benefits. We are able to do that and extract over $100 billion in savings, according to the CBO. We have provisions that deal with the issue of fraud – $60 billion. We are going after the waste and fraud. That’s how we extract the savings. We can do a better job of coordinating care for people (I guess he means the government). We need to follow them into the hospital, the nursing home – if we coordinate care was get reductions.
CHARLES GRASSLEY (R-IA)
You can’t count a dollar twice. The CBO says there is double accounting when you figure the savings.
We’re not going to reduce health care. We’re going to close hospitals. 14-18 million people will go on Medicaid. Doctor’s don’t take Medicaid. How do you promise people will be covered. Isn’t that intellecturlly dishonest? These cuts will not materialize. Hundreds of hours of meetings with Max Baucus. I’m glad I spent that time there. I learned things I would not have know, even though we didn’t get a bill.
If the notion is that we can’t make hard decisions, because no one is willing to make hard cuts, then we are going nowhere.
[so there’s Grassley’s question: If we make the cuts people will be without providers, and that is intellectually dishonest.]
Argument that savings should go to fill the doughnut hole. Insurance companies are making a lot of money but seniors in the programs are not better of and are paying $90 a year to subsidize those on Medicare Advantage.
If you are going to have program cuts, you have to have a system left to serve the people.
The money is going to insurance companies.
Biggest unfunded mandate is Medicare. Will go broke in 8 years. It is disconnected from reality to say that we don’t have to find savings in Medicare. We can do this together, or we can have it imposed on us.
Coburn made one of the most important statements. The chronically ill. 5% of Medicare beneficiaries use 50% of their benefits. 5% – the chronically ill – use 50% of the benefits. A study – a care coordinator of chronically ill. Sit down at their kitchen table. Look at their drugs. Found they can eliminate 8 drugs. Save lots of money. [bet you can’t wait for that “coordinator to come to your table]
[just a note here: as I manage my mother’s health care, her primary doctor, and then every other doctor she goes to, gets a list of her current meds EVERYTIME A DOCTOR SEES HERE.]
This has been a useful conversation. I don’t disagree with anything you said at the beginning – your premise of why we’re here.]
[Boehner is sitting with a huge stack of papers in front of him]
I’ve heard more than anything – the American people want us to scrap this bill. Our fiscal condition not good. Medicare is going broke, social security is going broke, medicaid is breaking states and federal government, and here we are creating more entitlements.
I think this 2400 hundred pages is a dangerous experiment. We have the best health care in the world. This is a government take over. We have 500 billion in new taxes. This is the last thing we need to do. We have $500 billion of medicare cuts. Why will we spend $500 billion to create more entitlements. We have a mandate – unwise, an employer mandate – unwise or be fined. It will drive up costs. Employers are going to look at this and pay the fine and dump employees into the exchange. Within 5 years everyone has to go to the exchange anyway.
I could go on and on and on. For 30 years we have had a federal law that says we are not going to have taxpayers paying for abortion. This bill begins for the first time in 30 years for taxpayers to paye for abortions. Obama is bowing his head, rubbing his eyes.
Why can’t we come to agreement about buying across state lines. Obama is shaking his head.
The problem we have is the standard talking points doesn’t drive us to an agreement on issues. There are so many things you have said that Democrats profoundly disagree with and things that are not true. We would get bogged down.
I will come back to you at the end of the session to address your questions [can wait to hear that!].
JIM COOPER (D-TN)
We’re all here, we’re dressed up, we’re on good behavior. Health care cost inflations are driving us off the cliff. I like McCain’s suggestion. Let’s get rid of special deals. Coburn is right – let’s get rid rid of waste and fraud. It means that we cannot leave this to our successor. He says the Conrad-Gregg bipartisan measure sounded good, but those who supported it, didn’t show up to vote. [that’s legislation to form a financial board that would give congress issues that they had to give an up-or-down vote to].
We have Medicare Advantage passed during a Republican Congress, and we didn’t fund it. If we offered them, we should pay for them. Let’s have a new day and a new beginning, with this bill a good beginning.
None of want to do nothing. We want to start over. We have the 800,000 people carved out of this bill. We need to start over. The point is, we don’t have to go very far. Medical malpractice in California and Texas – and both are working. Texas has caps (didn’t get them). Lawsuit filings are down. Physician recruitment is up. Rural physician recruitment is up. It’s already there. Let’s just enact this in legislation and it’s done. You can enact medical malpractice reform and it works.
Issue overhanging: whether the majority leader will impose reconciliation. I understand the frustration that the majority feels. It’s real and I understand it, but I remember the last time when there was a proposal that we Republicans would adopt reconciliation to judicial nominees. We wanted to do that, but we found another way. Reconciliation of 1/6th of our economy will harm our country and our institution.
Reconciliation – American people are not interested in procedures inside the Senate. They want a vote. Most Americans think a majority vote makes sense. This is an issue, though that can bridged. [THE PRESIDENT JUST SAID AMERICANS DO NOT CARE – AND WE WILL HAVE RECONCILIATION].
Coburn talked about incentivizing and allowing states to experiment to reduce frivolous lawsuits. HE IGNORES THE SUGGESTION THAT CALIFORNIA AND TEXAS HAVE ALREADY WORKED IT OUT. I would work at arriving at a package.
I’ve been biting my tongue throughout this meeting. I’ve worked in a courtroom and been at both sides of the issue of Doctors and Patients. They say that medical malpractice is the first thing we should do $5.4 billion is all that will be saved in the first 10 years. As you lose accountability for what doctors and hsopitals do, another 4800 people die, additionally, if we institute medical malpractice. We should focus on reducing medical errors, which reduces lawsuits. HE TELLS HIS STORY OF ONE CASE IN AN OPERATING ROOM.
According to Kaiser Foundation, malpractice has been cut in half. From $8 billion to $4 billion. It should not be the overriding issue. When Boehner says we have the best health care, I agree, but the Federal Employee Health Care program is all we are asking for for the people. [SO THE QUESTION IS – WHY HAVEN’T YOU JUST GIVEN US YOUR INSURANCE. WHY 2700 PAGES OF NEW LEGISLATION?]
Extends time to 4:30 PM EST:
Issue of coverage: Can we make sure that every person here can get covered? [SO WHY NOT JUST GIVE US THE PLAN CONGRESS HAS?]
Points at Paul Ryan, criticizes his “poll tested language” – it is not government run health care. Is there a way to arrive at an agreement that will meet this goal.
John Boehner, I’ve looked at your bill. Three million people in your bill are covered. In the House and Senate bill, we will cover 30 million people, and premiums will go up. Do you feel it is important to leave people out. We should not pretend that there is a magic wand to get it done.
Barrasso is an orthopedic doctor in Wyoming. His wife is a breast cancer survivor. Any community in America – ask – do you believe you will pay more for your health care. Every hand goes up. Do you believe if this bill passes your health care will be better. No one’s hand goes up.
Put all medicare doctors under the Torts Claim Act. Then their insurance is covered under that and they will see more patients. Coverage does not equal care. Listen to what people tell you. People around this table are not listening to the American people. Only 1 in 3 supports your plan.
Asks if every member of Congress should have only catastrophic health care. Barrosso says yes. Would you feel the same way if you were making $40,000.00? They are not a Sultan flying in. They are folks who are left out. This notion that for them the system is working, if they just ate a little better, and were better health care consumers, are not the case. Some work two jobs. If they work for a small business, they cannot get health care. If they are self-employed, they cannot get health care. HE GETS TOO MANY LETTERS.
Members of Congress can choose only catastrophic care.
Should Seniors have only catastrophic health care? That will save a lot of money. Paul Ryan has a proposal for seniors to have a voucher to shop for health care. Anthem told seniors that premiums were going up 39%.
We have made sense by holding down health care costs. Have malpractice be handled by the feds. McCain’s suggestion to follow California will not work. We need to get more people buying health care.
If I heard your rhetoric over and over again – you call it government health care – but that’s not what it is. We need a market like Congress [SO WHY ARE THEY NOT JUST GIVING THE SAME AS CONGRESS!!!!]
He talks again about the pool that will spread the cost. He ignores what will not be available in that pool. We have to hold down costs by bringing everyone in the system. We need to close the doughnut hole for seniors. We provide preventative services that they don’t have to pay for. This bill is good for people on medicare, and for the working people.
The Republican proposal covers $3 million, and pre-existing conditions. We have innovative ways to deliver care, and that will hold down costs.
You can’t accept that the responsibility lies with the person to do away with bad habits. 14,000 Americans will lose their health care TODAY. Six-8 people lose their life today because they lack health insurance.
An incremental approach will not work with health care. Coverage is the critical issue. NOW HE TELLS HIS STORY OF ONE OF HIS CONSTITUTIENTS.
We are so close to National Health Insurance. [THE TRUTH OUTS]. I don’t think that Republicans are the Party of No. He says Americans don’t understand by we need 60 votes to pass the bill. We should not start over.
Says this is affordable and budget neutral.
Speaks to Boehner, and says there is absolutely no public funding of abortion.
She says it is a fact that benefits to Seniors are not cut in the legislation.
We agree that we need some insurance market reforms. We agree on some of those. Those that we do not agree on, the ones that are not in Republican plans right now, but are in the Democrat plans are very popular.
He ended by saying that Republicans may not be able to cooperate because of “political” factors. And he said after a time, maybe a month, maybe 6 weeks, Democrats will have to make a decision (meaning reconciliation)
Related and Background:
Linked by Chicago Ray’s Conservative Chronicles – Obama scolds Rep. Cantor at Summit for Paper Prop. Thank you Ray!
Linked by Talk Wisdom – Health Care Summit [Update 1] – Thank You!