July 19th, 2009
01:42 PM ET
9 years ago

Health care proposals need more work, health secretary says

HHS Secretary Kathleen Sebelius said Sunday that the Obama administration wants a deficit-neutral health care reform bill.

HHS Secretary Kathleen Sebelius said Sunday that the Obama administration wants a deficit-neutral health care reform bill.

WASHINGTON (CNN) - More work is needed on proposed health care reform legislation to ensure that whatever bill eventually gets passed by Congress is budget neutral, Health and Human Services Secretary Kathleen Sebelius said Sunday.

Appearing on the NBC program "Meet the Press," Sebelius said an additional tax on wealthy Americans is "a legitimate way to go forward."

She noted the tax surcharge provision in a House proposal was one of several options under discussion to help pay for overhauling the nation's ailing health system.

A final bill "will be paid for - it will not add to the deficit," Sebelius said of health care reform, which is currently President Barack Obama's top domestic priority.

Obama seeks an overhaul to ensure that health insurance is available to the 46 million Americans currently uninsured while preventing costs to both the government and individuals from continuing to climb.

The House and Senate are working on Democratic proposals that would create a government-funded public health insurance option intended to drive down costs of private coverage.

However, the non-partisan Congressional Budget Office reported last week that the measures currently under consideration in both chambers would fail to pay for themselves, increasing the budget deficit.

Republican opponents seized on the CBO report as ammunition against Obama's push to have a bill from each chamber approved by the time Congress begins recess on Aug. 7.

Senate Minority Leader Mitch McConnell of Kentucky, also appearing on "Meet the Press," said the government is over-reaching by seeking to reform the whole system.

He called for expanding the tax deduction on health care costs for employers to include individual taxpayers - what the Republicans call equalized tax treatment - and limiting medical malpractice lawsuits that he said drive up the cost of medical care.

"I'm not in favor of doing nothing," McConnell said. "It's important to reduce the number of uninsured. The question is how to do that."

However, White House Budget Director Peter Orszag said the real purpose of Republican criticism is to slow momentum in hopes of eventually killing health care reform.

"The typical Washington bureaucratic game of 'if you don't have a better alternative, just delay in the hope that that kills something' is partly what is playing out here," Orszag said on the CNN program "State of the Union."

Democrats pushing the health care bills argue the CBO analysis does not take into account the financial impact of cost-cutting measures under discussion, nor how stronger preventive care programs will reduce demand and costs.

Sebelius noted that all proposals include various provisions to decrease fraud and improve efficiency of the current system.

"In all the plans, more than half the money to pay for the proposal is already in the system," Sebelius said, referring to what she called "misdirected" money for ineffective programs and other instances of waste and inefficiency.

Orszag also called for creating an independent commission of doctors that would set reimbursement levels and other health care policy issues under congressional oversight, calling it "the single most important thing that's missing from the legislation at this point."

However, Sen. Orrin Hatch, R-Utah, told the CBS program "Face the Nation" that such a panel would end up limiting care available to people, like in the government-run system of England. He said he would propose a plan next week modeled on the 1997 Children's Health Insurance Program he sponsored with Democratic Sen. Ten Kennedy of Massachusetts to provide states with money to set up programs based on need.

Both the House and Senate proposals so far include mechanisms to raise revenue through increased or new taxes.

The Senate Finance Committee wants to create a new tax on medical benefits provided by employers, a plan that Obama opposes.

Sebelius said the new tax could cause employers who provide coverage for 180 million Americans to change or drop their programs, which could "dismantle the private market."

"He's reluctant to move in that direction," she said of the president.

Obama continues to favor reducing the limit on income tax exemptions for high-income Americans, Sebelius said.

Both Sebelius and Orszag emphasized that the progress was occurring in Congress, and that Obama's goal of legislation coming from both chambers by Aug. 7 remained possible.

"This hasn't happened in 50 years for a reason - it's complicated," Orszag said. "(The) legislative process is working. I think people are sort of reaching judgment about who's going to win the marathon based on who's ahead at, like, mile 19."

Updated: 1:42 p.m.

soundoff (190 Responses)
  1. pt

    One way to "save" money, provide all American children with a set amount for schooling per fiscal year – with a few strings to ensure the public gets what it pays for. Also, no litigation to increase/decrease the amount. This will cut out some of the abuses in the system. Have some really good real life system-abuse examples.
    Another instant money saving would be to cut out these do-nothing "czars." To save millions, if not billions, pass law that only Americans may legally received money from any American gov. programs. What do I know? This and other ideas have been said for years with no one in government listening, and I do not expect it to change now.

    July 19, 2009 11:42 am at 11:42 am |
  2. molly

    I would rather have the government in charge of my care than the gangster, murder-by- spreadsheet insurance industry. Biggest racket ever inflicted on this country.

    July 19, 2009 11:42 am at 11:42 am |
  3. Lynda/Minnesota


    Are YOU prepared to make the terminally ill "comfortable". I have done that with both my parent's. First with my mother who had cancer and alzhemiers. It took her 10 years to die. My father and I nursed her at home during the entire time. My father died of cancer. My brothers and I nursed him at home for the year it took him to die. Both died at home. I assure you, neither were "comfortable".

    It was without a doubt the single most difficult thing I have ever had to do. They both had 100% medical insurance coverage, so their medicals needs WEREN'T and issue.

    I haven't a clue how the un-insured or under-insured cope under such circumstances.

    July 19, 2009 11:44 am at 11:44 am |

    I'll say and you d...! well better not dip in to Social Cecurity anymore for all your illegal's programs.

    July 19, 2009 11:45 am at 11:45 am |
  5. Anonymous

    Beverly Schuler said:

    "I am in favor of removing the profit in the health care industry as a whole."

    Okay, Beverly. People need food and clothing too, right? So should the government force grocery and clothing stores to function as non-profit entities as well?

    July 19, 2009 11:47 am at 11:47 am |
  6. NJ Mom

    Can't we come up with any other plans than "tax the wealthy"? They already pay a seriously disproportionate share of taxes!

    Why don't we raise the amount of co-pays, on a sliding scale? Surely "the wealthy" could pay $50 each time they see a doctor? Surely those earning $100-$250K could pay $25...

    Why don't we charge a co-pay for EACH prenatal visit, not just the first one? $10 during an entire pregnancy is ridiculous! If you can't afford a $10 co-pay for each prenatal visit, how can you afford diapers?

    The bulk of our medical costs go to the care of those in their final days of life and to obesity-related conditions.

    Let's fix the pathology, not raise money to continue to treat the symptoms! Isn't that what healthcare should be about?

    July 19, 2009 11:48 am at 11:48 am |
  7. Fair is Fair

    Beverly Schuler said:

    "I am in favor of removing the profit in the health care industry as a whole."

    Okay Beverly. Food and clothing are necessities as well, right? So should the government make grocery and clothing stores function as non-profit entities as well?

    July 19, 2009 11:49 am at 11:49 am |
  8. Linda

    Susie dear I work and pay my bills on time and guess what.? I'm all for the President's health card plan.

    July 19, 2009 11:49 am at 11:49 am |
  9. Lynda/Minnesota


    Next time you're at Wal-Mart get the heavy duty tin foil. What you use now isn't working too well.

    And turn off FOX News.

    Or both.

    July 19, 2009 11:50 am at 11:50 am |
  10. Al, CA

    We need universal single payer health insurance.

    My advice to Obama: please, do not look back on GOP extremists, they are hosts of the past.

    July 19, 2009 11:54 am at 11:54 am |
  11. reeba

    TO WOW!: you wrote that you were [' willing to bet that most people wailing about "socialism", "no choice of doctor", "caps on treatment", "waiting lists for basic care" and all the other scare tactic buzzwords and phrases have no real understanding or concept of what is actually happening in Canada, the UK and those other Western countries other than what is fed to them by one side of the other of this debate or what little blurb they happen to see or read out of context somewhere.]'

    I can probably BET that you have not lived in either country (e.g. Canada or Britain) under their government controlled health care. I did for 20 years, and now am under my CHOSEN health care as a US citizen. I know the difference – – I am not being "fed by scare tactic buzzwords......", etc. Personal experience is a great teacher and I understand the concept of socialized medicine.

    July 19, 2009 11:55 am at 11:55 am |
  12. Jasmine in Germany

    The U. S. health system has been behind the modern times for more 100 years. It is wonderful that the USA has contibuted to medicine over the years, but it is a tragedy that human/citizen rights within the US have not advanced over the years. Wake up, America! Grow up and allow your citizens to be part of the "Land of the Free, and the Home of the Brave". Every citizen and resident in the USA should have the right to health; a health care package. Unfortunately, 40,000, 000 don't. What a pitiful "democratic" country.

    July 19, 2009 11:56 am at 11:56 am |
  13. JS

    If we are having to pay for this then why can't we have the same insurance and retirement that the Senate and Congress has. Can we vote ourself a raise too and only have to serve one day to get retirement checks for the rest of our lives in prison or not. How did we let the Senate and Congress get this way we let them just like they will vote on the Health Care it dosen't cost then a cent.

    Vote all the bums out and let the people govern not the goverment. They seem to make it easy for our wonderful Senate and Congress to get what they want at our expense and the tax payers continue to foot the bill.


    July 19, 2009 11:57 am at 11:57 am |
  14. susie

    To bad Congress doesn't take the time to read the health bill first before voting on it! AND Why do we have to provide health care for people who aren't U.S. citizens?

    July 19, 2009 11:58 am at 11:58 am |
  15. Pfft

    To those who think taxing the wealthy is so wonderful – did you know that if the Obamanation's taxes go through, the "wealthy" will be paying 57% of their gross income to taxes? That's over half! I find that repulsive. I have to ask, what's wrong with working hard? Apparently everything, since so many people think that more taxes are fine.

    July 19, 2009 11:59 am at 11:59 am |
  16. chris

    I quote "a surcharge on wealthy people who are already disproportionately taxed and penalized for being successful, hard working Americans is not a legitimate way forward for paying for poor, non-hardworking, undeserving American's health problems." you people disgust me i cannot wait for republicans to return in 2012, what a disgrace

    July 19, 2009 11:59 am at 11:59 am |
  17. Lance

    "Murder-by-numbers" would be Canada, where you literally have to win a lottery to get a doctor. Like almost everyone on this post, I have had private health insurance my whole life. I have ALWAYS had a doctor, I have ALWAYS had quality care. Private insurance saved my cousin's life- the $1 million bill would have ruined her family were it not paid by Blue Cross. When my son was hit by a car, I had the luxury of worrying about him without worrying about how we would pay the bill. U.S. private insurance pays billions of claims a year, much of which would have been unaffordable without insurance. There are flaws in the system, yes, but I am really tired of people who have grown up with one of the undoubtedly best health care systems in the world doing nothing but griping. Insurance profit represents less than half a % of health care costs- it is not the cause of the problem. In fact, about 1 in 3 insurance companies are not-for-profit. Stop taking pot-shots at an industry that employs hundreds of thousands of people and helps millions pay their doctor bills every single day.

    July 19, 2009 12:04 pm at 12:04 pm |
  18. Jane

    When Congress removes the clause that exempts them from a public health care system–I may listen. They are elected officials and not elite...Congress should be FORCED to participate in the "gov health care plan–I mean public heath care". Then we will see how "good" the system is. Elected congressional members have the best health care system there is and get a nice pension even if they only serve one term. We can cut money by limiting elected terms to two and NO pension (they are public servants you know and most are millionaires)

    July 19, 2009 12:05 pm at 12:05 pm |
  19. Jake

    Everyone seems to miss the first three things that should be done for reform.

    1 Limit malpracticee suits and awards. This will reducr the unnecessary tests and prolonged hospital stays that exist to protect MDs from lawsuits

    2 Lower drug costs. Why do we have to pay the hight\est costs for medicines?

    3 Change insurance practices. it is redicules for an insurance company to pay for 6 days when the patient is in only one. Abnd this is just one example of areas that have to be corrected.

    When these things are done, then lets tackle insuring everyone. Congress is not on the right track now.

    July 19, 2009 12:07 pm at 12:07 pm |
  20. Fair is Fair

    NJ Mom said:

    "The bulk of our medical costs go to the care of those in their final days of life and to obesity-related conditions."

    NJ mom, you're only partially correct.

    I'm an ER physician – graveyard shift. I will be the first to tell you that the lion's share of what comes in falls into 2 categories –

    Drug/Alcohol related, including overdoses and automobile accidents.

    Violent crime related including domestic assaults – again fuled by drugs/alcohol

    Maybe we can so something about that?

    July 19, 2009 12:07 pm at 12:07 pm |
  21. "you people disgust me i cannot wait for republicans to return in 2012"

    thats the way to convince people and sway them to your thinking, tell them that they disgust you

    Republicans are sooooooooo smooth

    July 19, 2009 12:08 pm at 12:08 pm |
  22. Ron Nath, MD

    Here's an idea to revamp the broken healthcare system. Just utilize the existing govt healthcare dollars being spent more efficiently; no need for additional taxes. We already spend billions on Medicare and Medicaid. Instead of just paying it out to whomever for whatever, the govt should expand the National Health Service Corps to cover the elderly and poor and then expand it to cover the uninsured. Over time, it could even be opened up to the general public.

    People fear "socialized" medicine – wake up people. We already have it, just half-baked. It's called Medicare and Medicaid. What they should be fearing are the robber-barons of the for-profit insurance industry. I deal with them daily so I know firsthand. They limit access to tests and treatments far worse than the govt which is a breath of fresh air compared to them. And for those who criticize the govt for doing nothing right, remember the govt is us. We elect these people so you may as well criticize yourself. If you think you can do better, then run for office or apply for a govt job. No more excuses!

    July 19, 2009 12:10 pm at 12:10 pm |
  23. GI Joe

    How is Sen. Hatch's sports ruling coming along? He started it a few weeks ago -- more important than health care (obviously).

    Our representatives write these bills – NOT THE PRESIDENT.

    Blame the correct person/people. Write your representatives and tell them what you want.

    The don't read these blogs.

    July 19, 2009 12:10 pm at 12:10 pm |
  24. NJ Mom


    What "tax deductions" for high earners?

    Deductions for paying interest on student loans is 100% phased out for high earners (middle class earners to be honest)... deductions for contributing to IRAs/Roth IRAs are 100% phased out for high earners... high earners are limited to contributing the same amount to 401(k)s as all earners, which is a significanly lower percentage of their overall income, and the Alternative Minimum Tax triggered by "high earners" significantly limits the few deductions (charitable donations, real estate taxes and mortgage interest) they actually are still entitled to.

    Believe me, paying a lesser tax on capital gains (especially in this economy LOL) doesn't begin to make up for the inequitable tax consequences of being a "high earner."

    Bring on the flaming!

    July 19, 2009 12:11 pm at 12:11 pm |
  25. scott

    @linda , In your case homecare was probably not the best thing. But in most cases people who are termanally ill, should not have the resources put into them, except for pain. My fathers last six months cost over 200,000 and he was mad that we kept trying to keep him alive. He died an aweful hospital death, with zero dignity. We were selfish trying everything to keep him going, now I feel guity that I put him throught the system. I should of made him comfortable and let him die peacefull @ home. We need to all think about the person dying instead of ourselves. If I sound cold i'm not that way, but experiences have taught me to be realistic. I loved my father and talked to him every day of my life, but I know he hated the end.

    July 19, 2009 12:11 pm at 12:11 pm |
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