If you have "no place to go," come here!

Obama: "Got the little single-payer advocates up here."

[Transcript] Nice attitude, huh?

"Got the little torturers up here"? Nope.

"Got the little banksters up here"? Nope.

But just do what any citizen should be able to do and applaud for single payer, and the President who ought to be on your side -- and would be, if his policies were science-based -- diminishes you. Here's the whole thing:

Q Oh, thank you. Thank you, Mr. President. I work for one of the large corporations here. But I talk to a lot of people about health care. My question is, so many people go bankrupt using their credit cards to pay for health care. Why have they taken single-payer off the plate? (Applause.) And why is Senator Baucus on the Finance Committee discussing health care when he has received so much money from the pharmaceutical companies? Isn't it a conflict of interest? (Applause. THE PRESIDENT: Well, as you know, I campaigned vigorously on health care reform, and I think that we have a better chance of getting it done this year than we've had in decades. I am optimistic about us getting health care reform done. Now, health care is one-sixth of our economy, so it is a complicated, difficult task. And Congress is going to have to work hard. And everybody is going to have to come at this with a practical perspective, as opposed to trying to be ideologically pure in getting it done. Here are my principles in terms of health care: Number one, we've got to control costs across the system, because if we simply insured everybody under the current system, we couldn't afford it -- we'd go broke. The fact of the matter is, is that families are seeing their premiums go up -- skyrocket each and every year. Businesses are getting crushed by the rising costs of their employees' health care. And the federal government -- Medicare and Medicaid -- is going broke. That's the single biggest driver, by the way, of our deficits. I want everybody to be clear about this, because driving in I saw some folks who were saying, what are you going to do about debt, et cetera. Listen, by far the biggest contributor to our national debt and our annual deficit is the costs of Medicare and Medicaid -- as well as the other entitlement, Social Security -- defense, and interest on the national debt. That's the lion's share of the federal budget.

The things you read about in the newspapers and you see on TV about earmarks -- I want to get rid of earmarks, but the truth of the matter, they're only 1 percent of the entire budget. Most of what's driving us into debt is health care. And so we've got to drive down costs. Now, here is some good news. There are ways that we can drive down costs, because we just have an inefficient system. If we emphasize prevention and wellness programs; if we help -- (applause) -- if we -- so that we're reimbursing doctors and providers not just for treating people after they get sick but for helping people stay well if we use medical technology to reduce error rates and ensure electronic medical billing so when you go to the hospital, you don't have 15, 20 forms that you have to fill out over and over and over again.

There are simple things that we can do that will save us money, so we need to focus on cost, that's number one.

Number two, I think that it is very important that we provide coverage for all people, because if everybody's got coverage then they're not going to the emergency room for treatment. (Applause.) And right now, if you've got health insurance, the average family is paying about $900 a year in additional hidden costs because you're subsidizing the folks who are going to the emergency room.

And so you'd be better off with a system that might cost the federal government overall a little bit more -- and we do have to pay for that -- but that would lower your premiums so that you don't have these hidden costs, because it's cheaper to treat a child for asthma with an inhaler than it is to have them go to the emergency room and take up a hospital bed. So that's the second principle.

Now, this brings to the last principle, and so this touches on your point, and that is, why not do a single-payer system. (Applause.) Got the little single-payer advocates up here. (Applause.) All right. For those of you who don't know, a single-payer system is like -- Medicare is sort of a single-payer system, but it's only for people over 65, and the way it works is, the idea is that you don't have insurance companies as middlemen. The government goes directly -- (applause) -- and pays doctors or nurses.

If I* were starting a system from scratch, then I think that the idea of moving towards a single-payer system could very well make sense. That's the kind of system that you have in most industrialized countries around the world.

The only problem is that we're not starting from scratch. We have historically a tradition of employer-based health care. And although there are a lot of people who are not satisfied with their health care, the truth is, is that the vast majority of people currently get health care from their employers and you've got this system that's already in place. We don't want a huge disruption as we go into health care reform where suddenly we're trying to completely reinvent one-sixth of the economy.

So what I've said is, let's set up a system where if you already have health care through your employer and you're happy with it, you don't have to change doctors, you don't have to change plans -- nothing changes. If you don't have health care or you're highly unsatisfied with your health care, then let's give you choices, let's give you options, includinyou could enroll in and sign up for. That's been my proposal. (Applause.)

The good news: Obama mentions that he's for the public option. [How wrong, or trusting, I was on that!] Whether he'll renege (FISA; torture photos) is a question, but it's a positive this is out there.

For the rest of it... It's the same canned speech. Turn the "start from scratch" argument over: The rest of the world has a proven system that works. Obama's the one who's "reinventing," by experimenting with ideas that not only haven't been proven to work, we don't even know what they are because they haven't been embodied in legislation -- and he's left all the details to Congress!

NOTE * It's not all about you!

NOTE Oh, and did you notice that Obama never answered the question? The question is "Why have they taken single-payer off the plate?" The other thing Obama said -- flat out right said it -- is that the process doesn't bring single payer to the table, and isn't transparent. Oh, well.

UPDATE Helen Thomas puts the case for single payer eloquently.

UPDATE The White House transcript; "the little" people...

UPDATE Digby noticed too.

UPDATE See here on White House censorship of a single payer advocate's question in a live blog.

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Submitted by Anne on

pretty much everything Obama says about health care (and more than a few other things - and now Social Security, God help us) triggers from me a near-reflexive uttering of, "oh, fuck you."

Next thing I expect is to see him "brush" the "little" single-payer advocates off his shoulder.


MsExPat's picture
Submitted by MsExPat on

I'll get back to you later on that little single payer stuff....

a little night musing's picture
Submitted by a little night ... on

Formerly Known as Compassionate?

They no longer feel our pain?

Submitted by jawbone on

The letters are increasingly getting rubbed off my keyboard. Not that old either.

I need some white pain (keys are black). And I'm lousy typist.

But, hey, FKC fits, too! Just loses a little something....

Submitted by hipparchia on

yeah, that was my first reaction too -- this sounds just like his calling women sweetie.

Submitted by lambert on

Anytime you want to start helping out with the headlines...

Sarah's picture
Submitted by Sarah on

Same horseshit, different shoveler.

caseyOR's picture
Submitted by caseyOR on

Those oh so concerned people from the health care industry who met with Obama and got him all excited about how they were finally ready to help with health care are now calling foul on the president.

It seems they were just talking in generalities and cliches, and have no intention of agreeing to anything that can be measured or quantified.

It was all just for show.

Submitted by jawbone on

tell him about this exciting new development, which came in the form of a letter.

Now, just how did the two parties interpret it so differently??

But on Saturday, excited administration officials called me to say that this time the medical-industrial complex (their term, not mine) is offering to be helpful.

Six major industry players — including America’s Health Insurance Plans (AHIP), a descendant of the lobbying group that spawned Harry and Louise — have sent a letter to President Obama sketching out a plan to control health care costs. What’s more, the letter implicitly endorses much of what administration officials have been saying about health economics.

Are there reasons to be suspicious about this gift? You bet — and I’ll get to that in a bit. But first things first: on the face of it, this is tremendously good news.

The signatories of the letter say that they’re developing proposals to help the administration achieve its goal of shaving 1.5 percentage points off the growth rate of health care spending. That may not sound like much, but it’s actually huge: achieving that goal would save $2 trillion over the next decade.

So the WH called Krugman on Saturday with this that he could get out a column for Monday's NYTimes. The WH called loads of other reporters on Sunday, Mother's Day for a conference call, also on Mother's Day, so they could be ready to amplify Obama's pronouncement on Monday.

Big, big, big catapulting of the propaganda. Was it a rush job, so they didn't ask questions, pin things down?

Submitted by lambert on

That would be that Obana's trying to corner the insurance industry by claiming they said what they didn't say (or "even say." I mean, you'd think that if Obama was going to outright fabricate, he'd do a better job than a 1.5% reduction in the rate of increase). So, they can either knuckle under or fight, and lose.

One problem with that would be that they would have made everyone they called while catapulting the propaganda into a liar. Stenographers don't take kindly to being turned into liars by others, as I understand it.

a. Obama is telling the truth, and the insurance companies are lying.

b. Obama is lying, and the insurance companies are telling the truth.

c. Obama is lying, and the insurance companies are lying.

I'd say (c) is the most likely. The "two trillion" number (which Obama made a great point of repeating) is suspiciously round, and sounds like PR out of Nancy DeParle's shop. And the insurance companies just lie about everything anyhow.

Submitted by hipparchia on

looks to me like the administration is trying to push the medical-industrial complex into a corner they can't back out of. or that they want it to look like they're cornering the medical-industrial complex, so as to gain the trust of the little people. gotta keep the little single payer advocates squished, yanno.

i won't swear to it, but i'm pretty sure i saw a copy of the letter in question, with those exact numbers that are now in dispute, up on the ahip website this morning, but it's gone now. the link that says it goes to the letter [under 'latest information'], now goes to a copy of obama's remarks instead.

what with obama's tireless work on the illinois health justice act, and regulating the nuclear power industry too, i'm convinced it's all theater, on everybody's part.

Submitted by hipparchia on


The good news: Obama mentions that he's for the public option.
no, this is not good news.

we're not starting from scratch
medicare [and medicaid too] has been around for nearly 45 years now. it has a well-defined structure, and requires about 4100 employees for a program that covers about 30% of our population [about 44 million in medicare and about another 50 million or so in medicaid/schip].

the vast majority of people currently get health care from their employers
add in a few more million people covered by the va, the military, the indian health service and we're easily up to 1/3 of the population getting their health care from the govt.

compare the approximately 100 million people covered directly by the govt to the approximately 160 million people covered by employer-sponsored insurance. that looks like a clear majority maybe, but the 160 million who have employer insurance? that's about 52% of the population, leaving the remaining 48% of us either uninsured or insured by the govt.

52-48 might be a landslide in elections, but i wouldn't call it a vast majority, especially for someone who has a fetish about getting 60 votes in the senate.

as for the [non]generosity of employers:

At the aggregate level in 2007, businesses (25 percent), households (31 percent), other private sponsors (4 percent), and governments (40 percent) paid for about the same share of health services and supplies as they did in 2006.

suddenly we're trying to completely reinvent one-sixth [about 16.8% -ed] of the economy
um, no. private health insurance pays about 36% of total healthcare spending, which means that their healthcare spending only makes up about 6% of the economy, though if you add their insane price gouging they do make up about 7.5% of our economy. the expected $350 billion savings we would get from medicare for all is only about 2.5% of the economy [probably slightly more than that this year, and possibly into the near future after that, given how much the economy is expected to shrink for a little while longer].

Submitted by lambert on

I'd rather have Obama vagely mentioning public option in a good way, then not.

Yes, my baseline is low.

Submitted by hipparchia on

Yes, my baseline is low.

they're all, including obama, sooooooo concerned about the public option competing unfairly with the insurance companies that i expect the public option they do all agree on to be as useless for people like me as even the cheapest of private policies in massachusetts have turned out to be for about 3% of their population.

enough obama surrogates have been talking about the many ways that we can cover everybody with totally private plans that i think obama's talking favorably about the public option is pure window dressing. he can tap into the populist feelings on this and come out smelling like a rose when the public option fails to materialize in the final plan.

Submitted by hipparchia on

steal this comment!

i've taken at stab at

  • 1/6 of the economy,
  • vast majority covered by employers, and
  • starting from scratch.

i could probably take it on tomorrow night, if you want me to.

i didn't know that about diparle being the dealbroker for that 'historic' coalition, interesting. i can well believe that she has indeed seen the real industry numbers.

i've been wanting to do something on the we have to rein in medicare and medicaid spending thingy. it's only sorta true. basically if we had enacted medicare for all in the mid-70s [after giving medicare for old folks a 10-year trial run], we'd have spent about 12% of gdp on health care last year, rather than the 16+% we did spend. i've been spending most of my recent online time either hunting down data to support my thesis, or arguing [politely, mostly] with public option supporters elsewhere in the blogosphere.

i'm convinced the thing we need to do though, if we're going to get single payer, is to set aside the analysis for now and fire up the rabble rousing. we need to get waaaaay more than 13 people arrested, just for starters, so now i want to do the next installment here.

a little night musing's picture
Submitted by a little night ... on

- of the "most people are happy with their doctor and health care plan and don't want to switch" meme. (My emphasis)

There's less to this than meets the eye.

But I won't get to it until Saturday or Sunday.

I leave the rest in h. and j.'s very capable hands! (And anyone else who wants to dig into the data!)

Submitted by hipparchia on

please do!

There's less to this than meets the eye.
good one.

Submitted by lambert on

Let me guess. It's bullshit. Really complicated, obfuscatory bullshit.

Easily Distracted In Texas's picture
Submitted by Easily Distract... on

healthcare that it will readily admit. TriCare, Medicare, Medicaid, and health care for government employees are the obvious cases of government sponsored healthcare. The not so obvious cases are government contractors who are mandated to provide their employees with health care as part of a service contract with the goverment. Such health care costs of these contractors are passed through to and reimbursed by the government. So while contractors' employees may technically receive insurance benefits from their "employers," in the end it is the taypayers that are funding such benefits; which is essentially government-sponsored isn't it?