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Obama offers little detail during town-hall meeting on health care
AP Photo
A volunteer for President Obama's political operation talked about her fight with kidney cancer and inability to get coverage.
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Published: July 2, 2009
ANNANDALE, Va.
President Obama wanted to put a human face on his plans to overhaul health care, and a Virginia supporter did just that yesterday.
Fighting back tears, Debby Smith, 53, told Obama of her kidney cancer and her inability to get health insurance or hold a job. The president hugged her -- she's a volunteer for his political operation -- and called her "exhibit A" in an unsustainable system that is too expensive and complex for millions of Americans.
"We are going to try to find ways to help you immediately," he told Smith as hundreds listened at a community college forum -- and countless others watched on television. But the nation's long-term needs require a greater emphasis on preventive care and "cost-effective care," he said.
Smith, of Appalachia, Va., is a volunteer for Organizing for America, Obama's political operation within the Democratic National Committee. She got her ticket through the White House.
The health-care changes that Obama called for yesterday would reshape the nation's medical landscape. He said he wants to cover nearly 50 million uninsured Americans, to persuade doctors to stress quality over quantity of care, to squeeze billions of dollars out of spending.
But details on exactly how to do those things were generally lacking in his hourlong town-hall forum before a friendly, hand-picked audience in a Washington suburb. The lingering questions underscore the tough negotiations awaiting Congress, the administration and dozens of special-interest groups in the coming months. Legislators will return to debating the issue when they return from a one-week recess on Monday.
Some of Obama's questioners yesterday were from friendly sources, including a member of the Service Employees International Union and a member of Health Care for America Now, which organized a Capitol Hill rally last week calling for an overhaul. White House aides selected other questions submitted by people on YouTube, Facebook and Twitter.
Republicans said that the event was a political sham designed to help Obama, not to inform the public.
"Americans are already skeptical about the cost and adverse impact of the president's health care plans," spokesman Trevor Francis of the Republican National Committee said. "Stacking the audience and preselecting questions may make for good TV, but it's the wrong way to engage in a meaningful discussion about reforming health care."
Obama made no new proposals at the sometimes emotional event. But he vigorously defended his plans while fielding seven questions from the live audience at the forum and on the Internet.
The president would bar insurance companies from turning down applicants because of their "pre-existing conditions." He would establish health-care exchanges that would spread the costs of treating such patients as Smith over a large number of people.
Obama called for shifting huge sums of money from current health-care spending to new goals. About two-thirds of the overall new costs "will come from reallocating money that is already being spent in the health-care system but isn't being spent wisely," he said.
He restated his pledge to cut $177 billion over the next 10 years from Medicare Advantage insurance plans. And he noted that doctors, hospitals, corporations and others have promised to decrease the annual rate of spending growth by 1.5 percent, or $2 trillion over 10 years.
Such savings are not guaranteed, however, and many Republican legislators said that Obama's plans will prove too costly.
"The biggest thing we can do to hold down costs is to change the incentives of a health-care system that automatically equates expensive care with better care," the president said. He said that the formula system drives up costs "but doesn't make you better."
Obama did not make specific recommendations for changing the incentive formulas.
One questioner said that limits on awards from medical malpractice lawsuits would bring down health-care costs.
Obama replied, "I don't like the idea of an artificial cap" on such awards for a patient's injuries. He also said that there was little evidence that various states' efforts to limit such awards have uniformly brought down costs.
Obama said, however, that he is working with the American Medical Association to explore ways to reduce liability for doctors and hospitals "when they've done nothing wrong." He offered no specifics for a problem that has vexed the medical and legal industries for many years.
The president repeatedly said that the current health-care system is not acceptable and must be overhauled this year. He urged the audience, which included people following on Facebook and YouTube, to reject critics who say that his plans are too costly or a step toward socialized medicine.
Obama said that a government-run "single-payer" health-care system works well in some countries. But it is not appropriate in the United States, he said, because so many people get insurance through their employers working with private companies.
Still, he again called for a government-run "public option" to compete with private insurers, a plan that many Republicans oppose.
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