Obama to Congress: The 'time for bickering is over'

Wednesday, September 9, 2009 | 9:17 p.m. CDT; updated 10:09 p.m. CDT, Wednesday, September 9, 2009

WASHINGTON — Shaking off a summer of setbacks, President Barack Obama summoned Congress to enact sweeping health care legislation Wednesday night, declaring the "time for bickering is over" and that the moment has arrived to protect millions who have unreliable insurance or no coverage at all.

Obama said the changes he wants would cost about $900 billion over a decade, "less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans" passed during the Bush administration.

In a televised speech to a joint session of Congress, Obama spoke in favor of a provision for the federal government to sell insurance in competition with private industry. But in a remark certain to displease liberals, he did not insist on it, and said he was open to other alternatives that create choices for consumers.

Obama said he remains ready to listen to all ideas but added in a clear reference to Republicans, "I will not waste time with those who have made the calculation that it's better politics to kill this plan than to improve it."

In an unusual outburst from the Republican side of the House chamber, Rep. Joe Wilson, R-S.C., shouted out "You lie!" when the president said illegal immigrants would not benefit from his proposals. The president paused briefly and smiled, but from her seat in the visitor's gallery, first lady Michelle Obama shook her head from side to side in disapproval of the interruption.

In general, the president shied away from providing lawmakers with a list of particulars he wants to see included in the legislation, and there was nothing in the speech to invite comparisons with Bill Clinton's pen-waving veto threat more than a decade ago on health care.

Obama's speech came as the president and his allies in Congress readied an autumn campaign to enact his top domestic priority. Republican opposition, contentious town hall meetings and drooping polls have contributed to their woes. An AP-GfK survey released hours before the speech showed public disapproval of Obama's handling of health care has jumped to 52 percent, an increase of 9 percentage points since July.

While Democrats command strong majorities in both the House and Senate, neither chamber has acted on Obama's proposal, missing numerous deadlines leaders had set for themselves.

With a fresh sign of urgency, Sen. Max Baucus, D-Mont., announced that his Senate Finance Committee would meet in two weeks to begin drafting legislation, whether or not a handful of Democrats and Republicans have come to an agreement. The panel is the last of five to act in Congress, and while the outcome is uncertain, it is the only one where bipartisanship has been given a chance to flourish.

Obama said there is widespread agreement on about 80 percent of what must be included in legislation. And yet, criticizing Republicans without saying so, he added: "Instead of honest debate, we have seen scare tactics" and ideological warfare that offers no hope for compromise.

"Well, the time for bickering is over," he said. "The time for games has passed. Now is the season for action."

"I am not the first president to take up this cause, but I am determined to be the last," he added.

The president was alternately bipartisan and tough on his Republican critics. He singled out Sen. John McCain, R-Ariz., for praise at one point. Yet, moments later, in a line apparently aimed at McCain's former running mate, former Alaska Gov. Sarah Palin, Obama accused Republicans of spreading the "cynical and irresponsible" charge that the legislation would include "death panels" with the power to hasten the death of senior citizens.

In one gesture to Republicans, Obama said his administration would authorize a series of test programs in some states to check the impact of medical malpractice changes on health insurance costs.

Responding on behalf of Republicans, Rep. Charles Boustany, R-La., said the country wants Obama to instruct Democratic congressional leaders that "it's time to start over on a common-sense, bipartisan plan focused on lowering the cost of health care while improving quality."

"Replacing your family's current health care with government-run health care is not the answer," said Boustany, a heart surgeon.

In a reflection of the stakes, White House aides mustered all the traditional pomp they could for a president who took office vowing to change Washington. The setting was a State of the Union-like joint session of Congress, attended by lawmakers, members of the Cabinet and diplomats.

The House was packed, and loud applause greeted the president when he walked down the center aisle of the House chamber.

Additionally, the White House invited as guests men and women who have suffered from high costs and insurance practices, seating them near first lady Michelle Obama. Vicki Kennedy, the widow of Sen. Edward M. Kennedy, D-Mass., was also on the guest list. Kennedy, who died last month, had made health care a career-long cause, and Obama spoke movingly of his efforts.

Obama intends to follow up the speech with an appearance Saturday in Minneapolis, the White House announced.

Despite deep-seated differences among lawmakers, Obama drew a standing ovation when he recounted stories of Americans whose coverage was denied or delayed by their insurers with catastrophic results.

"That is heartbreaking, it is wrong, and no one should be treated that way in the United States of America."

The president sought to cast his own plan as being in the comfortable political middle, rejecting both the government-run system that some liberals favor and the Republican-backed approach under which all consumers buy health insurance on their own.

Obama said the legislation he seeks would guarantee insurance to consumers, regardless of pre-existing medical conditions, as well as other protections. "As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most," he added.

The president assured those with insurance that "nothing in this plan will require you or your employer to change the coverage or the doctor you have."

Obama also said the legislation he seeks would help those who lack insurance to afford it. "These are not primarily people on welfare," he said in a line that appeared aimed at easing concerns among working-class voters. "These are middle-class Americans."

The president also said he wants legislation that "will slow the growth of health care costs for our families."

Obama said a collective failure to meet the challenge of overhauling health care for decades has "led us to a breaking point."

The so-called government option that Obama mentioned has emerged as one of the most contentious issues in the months-long debate over health care, with liberal Democrats supporting it and many moderates inside the party opposed. An early draft of Baucus' plan calls for an alternative consisting of nonprofit co-ops. Sen. Olympia Snowe of Maine, the Republican who seems most inclined to cross party lines on the issue, favors a different approach, consisting of a standby in which the government could sell insurance if competition fails to emerge in individual states.

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Charles Dudley Jr September 10, 2009 | 4:15 a.m.

It was a good speech.

(Report Comment)
Ray Shapiro September 10, 2009 | 4:43 a.m.

I didn't hear Obama announce to all those civil servants present in that great hall that they will be enrolled in this new and vague United States of America Public Health Insurance Policy.
Maybe he didn't want them to stop clapping.....

(Report Comment)
Connie H September 10, 2009 | 8:20 a.m.

"New and Vague" is better than nothing, isn't it?

(Report Comment)
Jim Dog September 10, 2009 | 8:49 a.m.

Connie - I'll trade you my car for your car. I won't tell you what year, model or mileage it is - lets just trade. I realize that my description is rather vague - but what the heck - you'll have a new car. Let me know when we can meet up and do the swap. I'll bring my title and keys.

(Report Comment)
King Diamond September 10, 2009 | 9:03 a.m.

Jim, you are still going to give her the car if she doesn't have a car, right?

(Report Comment)
Charles Dudley Jr September 10, 2009 | 11:33 a.m.

King Diamond ya he will be included into that 5% figure of those who will not want it anyway so why not go ahead with the deal.

(Report Comment)
Connie H September 11, 2009 | 9:53 a.m.

Jim Dog, What you don't get is that this isn't about a trade. I have a car that I like very much. I also have excellent health insurance. I know how valuable health insurance is. I can imagine that you do as well. People without health insurance need an option. Why do you suggest that this is about a trade. Are you missing something?

(Report Comment)
Ray Shapiro September 11, 2009 | 11:12 a.m.

@Connie H:
("People without health insurance need an option.")
People without health insurance have options.

(Report Comment)
Connie H September 12, 2009 | 10:30 a.m.

People without health insurance need "affordable options" for coverage.

(Report Comment)
John Schultz September 12, 2009 | 2:47 p.m.

And I don't think a single thing in Obama's speech (or rather HR 3200, which he has STILL to say if it is the bill he supports or not) will reduce costs for insurance. He says the public option will not be subsidized and people will have to pay their way, although tax credits may be involved to some degree to offset costs. He has made no indication of supporting reforms that could reduce costs, such as association health plans or allowing people to purchase insurance across state lines (the more services a state mandates, the higher the insurance in that state will be). Some other ideas President Obama should consider:

(Report Comment)
Ray Shapiro September 12, 2009 | 2:54 p.m.

Granted any health care provider or clinic has its limitations, just as any insurance instrument will. My concern with Obamacare is that it does not acknowledge or build on the health realms we have today. It seems to be focused on government issued health care and/or some kind of government "insurance policy.".
Affordable options exist.
For instance, I entered the search words, "services provided by free clinic," and these guys were the first, of many, listed for reference...

("Services Provided

The Free Clinic in Lorain County provides a wide range of services to fit the needs of its residents. Primary Care services, referral services, vision and some dental referalls, and plenty of prescription drug programs allow residents who normally cannot receive medical care to receive some of the best in Lorain County.

The LCFC maintains a Dental Program, a decentralized model where qualified patients are referred to the LCCC School of Dental Hygiene for screening. Patients requiring more comprehensive or acute care are referred into a network of volunteer dentists throughout the community. The Vision Program also helps with screenings and optometry exams.")

Now I ask you, other then "Obamacare," what kind of across the board cooperative effort would you suggest health care professionals use to provide local, neighborhood accessibility for these diagnostic testing?
My guess is that if University Hospital or someone else here in town can't help you, Kansas City or St. Louis institutions might.
Information and referral from the Heart Association, Cancer Care, Lung Association, etc might help. (And for those who want every health care service in their backyard, let me just say that health, as is life, is a journey.)

The point I'm trying to make is that insurance is not the only answer. Access and affordability is. That's up to the medical community, not the federal government and not the private insurance companies.

(Report Comment)
Ray Shapiro September 12, 2009 | 2:55 p.m.

Here's how a municipality, not the Feds, do it...
("While continuing to redefine public health care to become the first choice health care system for all New Yorkers, HHC never deviates from its key mission: to provide the health care safety net for the city's poorest, least enfranchised residents.
HHC is a model system run by a diverse team of health professionals who are committed to delivering quality, affordable health care to 1.3 million city residents, including nearly 400,000 patients without health insurance, to patients with limited English proficiency and the most frail and needy New Yorkers who present multiple, complex health conditions. Click on the links below to learn more.")

We are trying to bring you the most recent information about Free Medical Clinics and Free Dental Clinics that are available in all the States and Cities in the United States. We started recently and are making progress. As you know this not an easy task, and is not error free. Please help us in bringing the most accurate and recent information together.")
Examples of United Way Agencies

("Vision of a Hospital Based on Fun and Friendship

by Patch Adams

I entered medical school in 1967 to use medicine as a vehicle for social change. I used my free time to study the history of health care delivery around the world and to look at contemporary models with the idea of creating a medical model that would address all the problems of the way care is delivered. I didn't intend to create a model that would be the answer to the problems; but to model creative problem solving, and to spark each medical facility to design their own ideal rather than succumb to the garbage of managed care, or a resignation to the impossibility of humanistic care. Beginning in the climate of the political "war on poverty," I felt confident that a free hospital to serve the poorest state, West Virginia, would find easy funding and that we would be built in four years.")

In 1992 the Free Clinic Foundation of America was founded, publishing a How-To Manual on starting a free clinic, and a National Directory of Free Clinics.

(Report Comment)

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