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. annie s

    @Lance, the attitude you have is selfish and naive – and that's the problem across the board. You have great private insurance – I assume paid for by an employer – so to hell with those that are self employed, minimally employed, over 50 or with pre-existing conditions? And don't be so sure your wonderful Blue Cross plan will really cover all your future needs – my experience as a health care administrator says otherwise. I've seen far too many hard working families financially destroyed when a catastrophic illness hits and their benefits don't go far enough. Health care for ALL Americans should be a right. No one is asking for free care adn no one is asking you to give up what you currently have. We're asking for a public option so that all Americans can have access to health care. How can you justify wanting to deny them that?

    July 19, 2009 12:13 pm at 12:13 pm |
  2. Alicia

    Must be the Repub moderator on Sunday now.

    Great article considering it is now being reported that this is like any contract to be negotiated. The Republickans have been stalling with absoolutley no intention of getting anything through. Just like they did for Social Security and Medicare.

    My tax dollars pay for these politicians health care and social security, while they do not pay into social security. Not fair! Yet they fight for average Americans to not have health care?

    July 19, 2009 12:15 pm at 12:15 pm |
  3. Larry S

    We hear so much talk about different type of taxes . . . why not propose a tax just for politicans . . . now that would that be a great idea. Then the next step would be to tax those in lazy government jobs . . . it could be amazing what the politicans would 'spin' about this. The final tax would be, for ever lie the politicans tell us there would be a surcharge.

    July 19, 2009 12:17 pm at 12:17 pm |
  4. JD

    The last thing this nation needs is socialized medicine. Just look at every nation where they have it. Those who can afford to flee their nation's abomination of health care ALWAYS come to the United States for real quality care. That in itself speaks volumes.

    And let us not forget that socialized medicine ALWAYS ultimately entails health care rationing. Anyone who says different is either lying or hasn't been paying attention. And if you want to see a sterling example of government run health care, just look at the VA and Walter Reed.

    If there's any reform that health care needs, it's tort reform and abolition of frivolous lawsuits and capricious jury awards that are wholly divorced from reality. It's these two things that have jacked up malpractice premiums to the point that health care is unaffordable. Remove those two abominations and health care will once again be affordable to all...and without the ridiculous bureaucracy that Obama and crew demand.

    July 19, 2009 12:20 pm at 12:20 pm |
  5. NJ Mom

    @Fair is Fair

    Absolutely! I have recently come to believe that we MUST consider legalizing drugs and legislating and taxing their consumption. I never thought I'd even think that, but this country needs another revenue stream (besides taxing the wealthy) and a better way to minimize the violence and way of life that results from illegal drug trafficking.

    July 19, 2009 12:21 pm at 12:21 pm |
  6. Docanaon

    Health care without profit... now there's a cute idea. Let's get thousands of America's best and brightest to pay $150,000 or more for a four year medical education, pay them a residency salary that usually works out to $3/hr, and then give them NO MONEY for working long hours the rest of their lives! I love it. Sounds perfect.
    The reality and the public perception of doctors' lives are very different. People see that physicians make "lots of money" and assume that they are charging exorbitant amounts of money that ends up in the doc's pocket. They forget about the overwhelming amount of student loans that we have to pay back, the fact that we ALL give up 7-14 years of our lives so that we can get the best possible training, the huge overhead costs of running a practice, and the long and stressful hours. You want to reduce the amount doctors get paid? Good luck getting ANYBODY to go to medical school. As it is, there is a physician shortage that stems from the increasing shift to higher-paying specialty care rather than primary care. Most of us going into medicine do it because we love medicine, we love people, and we want to help heal. But it comes at a great personal cost to us: huge divorce rates, emotional duress, great financial strains as students and residents, and a loss of personal time with people we love that we will never get back. Decreasing the few tangible benefits of becoming a physician will only hurt, not help. You want the best people to stay in the field? Forgive student loans with service obligations for all fields of medicine, decrease the malpractice insurance, and make sure primary care is given its due. Doing those things will allow some reductions to cost of care without affecting the net income of a group of people who work hard enough to deserve every penny. Think about all the times you have come to your own doctor with fear in your heart, only to have it relieved by the kindness, knowledge, and skills your physician has worked hard to be able to give you. What is that feeling of relief worth to you?

    July 19, 2009 12:24 pm at 12:24 pm |
  7. Maureen

    SO !!!!! Will the members of congress drop their current cadillac coverage and use Universal Health Care, I seriously doubt it. Oh no!, they want to rush through a bill that more than likely has not even been read all the way through, or do they even have a bill to be read. They have not even figured out how to pay for this, but because Obama says he wants this before the session closes they will do his bidding. Wake up America!!!!

    July 19, 2009 12:24 pm at 12:24 pm |
  8. mimi

    If people had jobs they would be able to pay for their own health care how about working on that problem first...

    July 19, 2009 12:31 pm at 12:31 pm |
  9. Lynda/Minnesota


    I am TRULY sorry for the pain your father suffered and your loss!

    July 19, 2009 12:32 pm at 12:32 pm |
  10. albert

    the senator occupying the white house was duely elected by all of you.... you beleived in his hope and change logo..... please be quiet everyone and take it like adults up you know where : i hope he gets elected agian to keep you in your misery

    July 19, 2009 12:34 pm at 12:34 pm |
  11. JK

    How exactly is arbitrarily taxing a small percentage of the population to prop up a large portion a "legitimate way to go forward.? How is this anything other than wealth distribution, in a massive way? I know they CAN pay for it by doing so, but it doesn't mean they SHOULD.

    July 19, 2009 12:35 pm at 12:35 pm |
  12. TheWizard

    Medicare and Medicaid are bleeding us to death. Change is needed!

    July 19, 2009 12:41 pm at 12:41 pm |
  13. Kate in SW Fla

    mi mi, sorry, but you are very wrong. Millions of people who currently have jobs can NOT pay for their health care now. From 2000 to 2007, the profits of health insurers rose 458%, from less than 3 billion to more than 12 billion. During that same time period, the number of Americans who have insurance has continued to drop. So, these companies, who do not contribute one single thing of value to making people healthier, have gobbled up more and more health care dollars, while insuring fewer people. I also don't understand why people can not put 2 and 2 together. If the only area of our economy that is growing is Health Care, actually continuing to ADD jobs, why can you not understand the huge number of jobs that will be created when all the millions of people who do not now get any care, show up for services. It is ridiculous to put this off any longer. It is PART of the solution, not th enemy of it. Couple this with the Prez's plan to increase number of kids who go to school and get the needed skills, you have a long term winner. Please do not insist again on immediate results, but try and look at the long term results – strategic planning vs short term tactics.

    July 19, 2009 12:45 pm at 12:45 pm |
  14. matt

    ALL insurance companies and prescription drug companies are for-profit. There the main reasons we have sky rocketing health costs in this country. People that think there not the problem need to research the terrible health system in this country.

    July 19, 2009 12:46 pm at 12:46 pm |
  15. Amanda

    There's one thing that I feel like I need to point out:

    Government Insurance / Public Health Plan is not Socialized medicine. It is not a National Health Program. All the doctors are still the doctors, still doing their own thing. They don't get paychecks from the government. Hospital employees don't suddenly join the US payroll.

    Everything in regards to the individuals who provide care STAYS THE SAME. HMOs can limit care, you can have a wait, you need referrals and waiting periods to see specialists. Why is that different?

    I just turned 25, so I lost my dad's insurance. Because I have allergies, asthma and the occasional weather related migraine, I was quoted 637$/mo in order to get insurance. 637. I'm in -college-. I'm terrified to go without insurance in case something bad happens. What am I supposed to do, then, people who are against what the administration is trying to do?

    I'm a good student – I'm working full time plus going to school, in my last year of a BFA in Graphic Design. I work as a Marketing assistant. I consistantly make the dean's list, but I only make $17,000 a year. I'm not a dead-beat – am current with all my bills and have a credit rating of 710. I've called around – both the state and 10 different insurers, trying to find any cheaper way. With my 'medical conditions' They tell me to take COBRA, but it's still 331$ a month, and is only for a limited time. I have rent to pay and I need to eat – 331$ is impossible. The other option is Open Enrollement – which, in Ohio, starts plans at $1200 a month.

    But because cat hair makes me wheeze, and when huge storms roll in I get migraines, I'm expected to pay almost half my income to keep health insurance. How is that fair? My work is in a small commercial real estate company, so they don't offer insurance. What am I supposed to do?

    July 19, 2009 12:46 pm at 12:46 pm |
  16. MD

    The great American dream- work hard, play fair, become successful by following the rules and then, for all of your hard work...PAY for EVERYTHING...for all of the dead beats that would rather sit around doing their drugs and drinking their beer. Oh, and I forgot, producing more children for my taxes to support! 2012 cannot come soon enough. And, I used to be a Democrat. I am DISGUSTED.

    July 19, 2009 12:57 pm at 12:57 pm |
  17. matt

    The best solution for universal health coverage is Medicare for everyone who wants it, or stay with your for-profit insurance company and pay high premiums. The big losers of universal health care will be for-profit insurance companies and the prescription drug companies, because they'll be regulated by the government. Regulation of health care is the only solution to an out of control system run by corporate crooks.

    July 19, 2009 12:58 pm at 12:58 pm |
  18. Kelly

    Don't ya just love all the scare tactics the right is constantly throwing about "government take over", endless waiting, no choices, etc. etc.
    I have private insurance and have the endless waiting and no choice already. At least with a public option I wouldn't have to worry about recision, or being denied care because of a "pre-existing condition".

    How can you have an effective health care system based on denying care as much as possible to fatten a company's bottom line?!?

    July 19, 2009 01:03 pm at 1:03 pm |
  19. MD

    Amanda- you clearly have not read the proposals. Everything does not stay the same for providers. The government reimbursements rates for physicians is far lower than the cost of providing medicine, which will effectively drive the best and the brightest out of business. Obviously, at 25, you cannot possibly understand the toll becoming a physician takes on one...both financially and otherwise. DO you honestly think it is fair for physicians to graduate with 200k in loans and earn less than enough money to repay those and live comfortably for giving up all of their 20s and earning the equivalent of 3$ / hr for that decade? Under this national health care proposal, perhaps we should go to school for free and become government employees and collect a federal pension. That will be the only way to afford practicing medicine.

    July 19, 2009 01:04 pm at 1:04 pm |
  20. Aunt Bea and Opie

    I see all the paid street teamers are all out for the healthcare companies that are robbing us.Long lying posts and made up names.They make money trying to change our minds,and its not going to make us change our mind.hahaha

    July 19, 2009 01:05 pm at 1:05 pm |
  21. Tin


    The reason your insurance bill is so high is because you are not pasrt of a collective network.

    The solution to this problem is to allow, by law, for insurance company to sell to all the individuals as a collectiive netword of purchasers, and even further, to allow insurance purchase to sell across the state line.

    This is an idea behind the arguement for 'insurance portability'.

    Its like buying car insurance. We don't need to be in a collective network to but auto insurance. We can buy all as an individial, and pick the insurance company with the lowest premium.

    July 19, 2009 01:11 pm at 1:11 pm |
  22. southerncousin

    Gee do you think? So glad that the idiotic thug you all voted for, hired the best, brightest and most perceptive. You had to be stupid or stoned, or both to vote for him in the first place. Looking so forward to 2010, when we can get some competence back in the system.

    July 19, 2009 01:11 pm at 1:11 pm |
  23. eddieblue

    Yeah, the obama-care proposal needs work.

    flush it down the toilet and throw the bums out!

    July 19, 2009 01:17 pm at 1:17 pm |
  24. Susie

    Kathleen can pay MY SHARING – she has the money – I don't!!!!

    July 19, 2009 01:19 pm at 1:19 pm |
  25. Rick

    We do have a shortage of primary health care providers. We have Nurse Practitioners and Physicians Assistants who would love to take Medicaid patients who can not because their collaborating Doctor will NOT take Medicaid. Why? Because rates are too low. In my opinion Medicare and Medicaid rates should at very least be the same. NOT lowered. ALL Doctors should have to take Medicaid and Medicare and be a percentage of their practice. A small fix would be to change the rules and Nurse Practitioners and PA'S take Medicaid patients.
    Because of the low Medicaid rates Medicaid patients do NOT have ACCESS to ALL Doctors and DO NOT get the quality of care they should have. Are they not entitled to quality health care because they have no other choice than Medicaid?
    Doctor's, you take the Hippocratic Oath to heal the sick to the best of your ability. Your forefathers did so regardless of that persons ability to pay. That should be so today, as well. Please do what is right and treat all patients whether they can pay , are on Medicaid or any other LOW paying plan. Thank you

    July 19, 2009 01:19 pm at 1:19 pm |
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