AARP notes on Obama's remarks

Obama Vows No Cuts to Medicare Benefits President talks about his own experiences with the health care system By: Patricia Barry | Source: AARP Bulletin Today | July 29, 2009 Thank you for submitting your comment or question to AARP Bulletin Today. Your post is now on its way to the appropriate Bulletin writer. Due to the large volume of communications we receive, we regret that we cannot answer or acknowledge all correspondence. Disclaimer: AARP.org does not share this information or keep it permanently, as it is for the sole purpose of sending this one time e-mail. RELATED * Health Care Reform * July a Banner Month for Health Care Reform: Three Bills, Big Debates Loom * Congress Hopes to Fast-Track Health Care Reform * Congressional Debate on Health Care Heats Up * The Trillion-Dollar Question: How to Pay for Health Care Reform? President Barack Obama addresses AARP members' questions about health care reform. Watch full-length video or highlights.>> • Transcript: Obama, AARP Hold Health Care Town Hall HEALTH CARE REFORM NEWS • AARP Telephone Town Hall Meetings on Health Care Reform Draw 400,000 • Obama Turns Up Volume on Health Care See AARP Bulletin Today’s full coverage on health care reform. More>> WANT TO TAKE ACTION? Join the HealthActionNow.org movement! SEE ALSO • President Lyndon Johnson signs the Medicare and Medicaid Bill BREAKING NEWS • Follow us on Twitter • Follow us on Facebook WHERE DOES AARP STAND? • AARP Responds to Health Reform Scare Tactics • AARP Endorsed Health Care Reform Legislation Flanked by AARP's CEO, A. Barry Rand, and president, Jennie Chin Hansen, President Obama takes part in AARP tele-town hall on health care reform. Photo by Paul Morse for AARP Bulletin President Obama again took his appeal for health care reform directly to the American people Tuesday, this time at a telephone town hall meeting at AARP’s Washington headquarters where he answered questions from older men and women concerned about how proposed changes to the current health system would affect them. “Nobody’s trying to change what does work in the system,” Obama told the estimated 180,000 listeners. “We are trying to change what doesn’t work in the system.” In the face of growing public skepticism and congressional delay, the president used his 75-minute town hall to address the concerns of callers from across the country and to answer recurring questions—including the bizarre charge that every five years government bureaucrats would visit all older Americans to counsel them on ending their lives early. Will care be rationed? Is America heading toward socialized medicine and a system like Canada’s? Will Medicare benefits be cut? “Nobody is talking about cutting Medicare benefits. I just want to make that absolutely clear,” he said emphatically. Seated on a stool in front of the small studio audience, Obama appeared relaxed and confident, sometimes using kitchen table analogies to explain knotty health care proposals and to untangle some of the myths now widely circulating on the Internet. Introducing Obama, AARP CEO A. Barry Rand said: “There’s a lot of misinformation about health care reform—even on what AARP stands for, and what AARP supports. This town hall is part of our ongoing effort to debunk myths and provide accurate information.” He added: “I want to make it clear that AARP has not endorsed any particular bill or any of the bills being debated in Congress today. We continue to work with members of Congress on both sides of the aisle and with the administration to achieve what is right for health care reform.” AARP president Jennie Chin Hansen also cited confusion expressed in questions that have come from thousands of members who have participated in previous AARP town halls. “Like, will the government tell my doctor how to practice medicine?” Obama said he understands that overhauling the health care system is not easy. “I know there are folks who will oppose any kind of reform because they profit from the way the system is right now. They’ll run all sorts of ads that will make people scared.” But, he added, this has all happened before. “Back when President Kennedy and then President Johnson were trying to pass Medicare, opponents claimed it was socialized medicine,” he said. “When you look at the Medicare debate, it is almost exactly the same as the debate we’re having right now. Everybody who was in favor of the status quo was trying to scare the American people saying that government is going to take over your health care, you won’t be able to choose your own doctor, they’re going to ration care.” Obama added: “You know what? Medicare has been extraordinarily popular. It has worked. It has made people a lot healthier, given them security. And we can do the same this time.” Here’s how he answered tough questions on a range of topics at the town hall session: Will Medicare benefits be cut? “Nobody is talking about reducing Medicare benefits,” Obama said. “Medicare benefits are there because people contributed into a system. It works. We don’t want to change it.” However, he added, “we do want to eliminate some of the waste that is being paid for out of the Medicare trust fund that could be used more effectively to cover more people and strengthen the system.” For example, he said, “right now we’re paying about $177 billion over 10 years to insurance companies to subsidize them for participating in Medicare Advantage [private health plans, such as HMOs, offered as an alternative to the traditional Medicare program]. “Now, insurance companies are already really profitable. So what we said is, let’s at least have some sort of competitive bidding process where these insurance companies who are participating [in Medicare] are not being subsidized on the taxpayer dime,” he added. “That’s the kind of change we want to see.” End-of-life care One caller, Mary from North Carolina, said she’d heard rumors that all Medicare beneficiaries would be visited and “told to decide how they wish to die.” Obama seemed amused by the idea, pointing out that the government didn’t have enough employees to make millions of personal visits. “Nobody is going to be knocking on your door,” he promised. The president said the rumor could be linked to a measure in one of the proposed bills that would allow Medicare coverage, once every five years, for consultations between doctors and patients about hospice care, living wills and other discussions about people’s wishes on the kind of care they want at the end of their lives. “The intent here is to simply make sure that you’ve got more information, and that Medicare will pay for it,” he said. He referred to the recent death of his grandmother and the living will that gave her some control toward the end of her life. “The problem right now is that most of us don’t give direction to our family members, so when we get really badly sick … the [doctors] are making decisions in consultation with your kids or your grandkids and nobody knows what you would have preferred,” he said, emphasizing that the provision is only one of many proposals in one bill and that Congress could revisit it. Both he and his wife, Michelle, had already made living wills, Obama added. What will happen if nothing is done to reform the system? Ollie, from Texas, noted the “many negative advertisements and articles about the tremendous cost for health care reform.” He asked the president: “What would it cost if we do nothing?” Obama responded: “Health care costs are going up much faster than inflation,” more than twice the rate of wage increases every year, “and your premiums will probably double again over the next 10 years.” Plus: “We’re already seeing 14,000 people lose their health insurance every day. So the costs of doing nothing are trillions of dollars over the next couple of decades—trillions, not billions … without anybody getting any better care.” If health care inflation can be controlled, he added, “then not only can we stabilize the Medicare trust fund, not only can we help save families money on their premiums, but we can actually afford to provide coverage to the people who currently don’t have health care.” Noting that the United States spends $6,000 more per person on health care—50 percent more—than any other industrialized country, he observed: “That’s money out of your pocket. If you’re already retired, that money could have been going into your retirement fund instead of going to pay for your health care. If you’re working right now, some of that money could be going into your paycheck. … It’s money that’s being given away and we need to save it. That’s why health reform is so important.” Will I be able to get health care if I have a preexisting medical condition? Responding to a caller who said her 56-year-old brother was “uninsurable” because of his health, the president said that under reform proposals, “If you’ve got a preexisting condition, insurance companies will still have to insure you.” Referring to his mother, who died of cancer, he said: “She had to spend weeks fighting with insurance companies while she’s in the hospital bed, writing letters back and forth just to get coverage for insurance she’d already paid premiums on. And that happens all across the country. We’re going to put a stop to that.” Also, he said, “We’re going to reform the insurance system so that they can’t just drop you if you get too sick. They won’t be able to drop you if you change jobs or lose your job. … We want clear, easy-to-understand, straightforward insurance that people can purchase. “The idea behind reform is: Number one, we reform the insurance companies so they can’t take advantage of you. Number two, we provide you a place to go to purchase insurance that is secure, that isn’t full of fine print, that is actually going to deliver on what you pay for. Number three, we want to make sure that you’re getting a good bargain for your health care by reducing some of the unnecessary tests and costs that have raised rates.” Will I be able to keep the insurance I’ve got now? Answering a question from Margaret of Greeley, Colo., who said she wants to keep the good coverage she already has, Obama said, “Here’s a guarantee that I’ve made: If you have insurance that you like, then you’ll be able to keep that insurance. If you’ve got a doctor that you like, you’ll be able to keep your doctor. Nobody is going to say you’ve got to change your health care plan. “This is not like Canada where suddenly we are dismantling the system and everybody’s signed up under some government program. If you’ve already got health care, the only thing we’re going to do for you is, we’re going to reform the insurance companies so that they can’t cheat you. … If you don’t have health insurance, we’re going to make it a little bit easier for you to be able to obtain health care.” What if I haven’t got insurance or don’t like the coverage I have now? People without good coverage—those currently uninsured, underinsured or purchasing expensive individual insurance for themselves and their families without benefit of the group negotiating power that employer-sponsored plans wield—will be able to choose from a menu of private health plans (plus maybe one government-run plan) through a national health insurance exchange. The way this would work, Obama said, is that “anybody who wants insurance but can’t get it on their job right now can go to this exchange. They can select a plan that works for them or their families … but whatever you select, you will get high-quality care for a reasonable cost, the same way members of Congress are able to select from a menu of plans. And if the plan you select is still too expensive for your income then we would provide you a little bit of help so that you could actually afford the coverage.” In response to Jeanine of Fairmont, Neb.—who said that she and her husband, both self-employed, currently pay $900 a month for insurance with an $8,000 deductible—Obama said that the exchange would offer people in their situation not only more choices but the protection of being in a large bargaining pool. “The exchange will provide that same market power [as large employers have] to help negotiate with the insurers to drive prices down.” Will care be rationed? Carolyn, from Joliet, Ill., asked: “Even if I decide when I’m 80 that I want a hip replacement, am I going to be able to get that?” Obama responded: “My interest is not in getting between you and your doctor—although keep in mind that right now insurance companies are often getting between you and your doctor. [Decisions] are being made by private insurance companies without any guidance as to whether [they] are good decisions to make people healthier or not. “So we just want to provide some guidelines to Medicare, and by extension the private sector, about what [treatments] work and what doesn’t.” That guidance, under current health care reform proposals, would come from a new medical advisory committee that, Obama said, would recommend “what treatments work best and what gives you the best value for your health care dollar,” independent of political considerations. “We don’t want to ration by dictating to somebody [that] we don’t think this senior should get a hip replacement,” he said. “We do want to provide information to [you and your doctor about what] is going to be most helpful to you in dealing with your condition.” Later, to illustrate the point, Obama used a family budget analogy: “If you figure out a way to reduce your heating bill by insulating your windows … you’re still warm inside. [But] you’re not wasting all that energy and sending it in the form of higher bills to the electric or gas company. And that’s then money you can use to save for your retirement or help your kid go to college. Well, it’s the same principle within the health system.” Does reform mean socialized medicine? Addressing the widespread concern that reforms would move the country toward socialized medicine, Obama assured the audience that they would not. “A lot of people have heard this phrase ‘socialized medicine,’ ” he said. “And they say, ‘We don’t want government-run health care. We don’t want a Canadian-style plan.’ Nobody is talking about that. We’re saying, let’s give you a choice.” Smiling, he continued, “I got a letter from a woman the other day. She said, ‘I don’t want government-run health care. I don’t want socialized medicine. And don’t touch my Medicare.’ ” As the audience laughed, he added: “I wanted to say, ‘That’s what Medicare is. It’s a government-run health care plan that people are very happy with.’ ” Winding up his remarks, Obama said he didn’t expect to achieve a perfect health care system. “But we could be doing a lot better than we’re doing right now. … We shouldn’t have people who are working really hard every day without health care or with $8,000 deductibles—which means basically they don’t have health insurance unless they get in an accident or they get really sick. That just doesn’t make sense. So we’ve got to have the courage to be willing to change things.” After the phone-in town hall ended, Bonnie M. Cramer, AARP’s board chairman, said that she thought the president “really made it very clear that Medicare beneficiaries will not see cuts in Medicare services.” In speaking directly to older Americans, she said, “He put to rest a lot of their concerns.” Patricia Barry is a senior editor of the AARP Bulletin.