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. Grrr-awful-o

    Then why are the Dims pushing so hard to get it passed through Congress while no one's paying attention? Can someone change the channel I'm tired of watching the Sotomayor fan club?

    July 19, 2009 01:20 pm at 1:20 pm |
  2. eddieblue


    Im' woth you.

    If and when Congress and all Fed employees get the same healthcare we,the working middle class, are supposed to embrace, I might consider this change a change for the better and a change I can believe in.

    Until then, I say: Throw the Bums out.

    They'r bleeding us to death economically while rewarding economic criminals.

    July 19, 2009 01:21 pm at 1:21 pm |
  3. Docanaon

    Amanda– and anyone with similar situations–
    I would encourage you to visit several primary care physicians in your area and explain your situation. More than most people realize, doctors are increasingly aware of situations like yours and willing to provide care for a fixed amount of money and waive certain charges and fees. Another great option are local free clinics, where many medical students, residents, and attending physicians work together to provide care to the un-insured. They also often provide free or low-cost meds to the patients they see. In regard to medications, there are programs which offer assistance to people without prescription coverage, such as the "Bridge to Access" program.

    In some states, there are programs which offer insurance limited to costs related to emergent care– if you have a health emergency, you would be covered. Also, if you ever do incur a huge doctor's bill, as long as you are paying something on time every month (even $10 will do) you can't be placed under collections as long as the costs are health-care related. While it is still a huge burden, you are at least afforded some shelter from financial jeopardy.
    Best of luck.

    July 19, 2009 01:21 pm at 1:21 pm |
  4. Lance

    Golly Annie, thanks for insulting someone that you don't know. If it is selfish of me to recognize the value of my health care, then why is it not selfish of you to be concerned with yours? Employers insure more than 2/3 of all americans through private insurance- it is not some system that only applies to the rich. Private insurance covers most of us, as it has all our lives. My point is that insurance compaines help millions of Americans every day- far more than our government has, does, or will under the currently proposed plans. I am for health care reform, I am for universal coverage. My point simply is that it is absurd to villify insurance companies who do a great job for millions. Blue Cross has saved my family and me many times, i will not throw them under the bus- they are heros, not villans. If there is to be reform, let's at least look at the REAL problems, and not scapegoat good people who are doing their jobs.

    July 19, 2009 01:23 pm at 1:23 pm |
  5. katiec

    About to lose big,

    This is in reference to my comment about many in the house of representatives being unavilable for comments and responses
    from the American people.
    Of course they are elected to represent their districts and states first, but when they make crucial decisions involving all of us, when they brag about bringing a policy down, when they strut in front of
    the cameras trying to show their importance and power in
    destroying a much needed reform, than they need to answer to
    all of us.
    Every senator is listed and you can contact them on the web, by calling, writing etc. Why is it that the house of representatives does
    not provide that availability, allowing e mails, comments be sent
    to them on the web? Making them accountable most certainly does
    not take anything away from our constitution!

    July 19, 2009 01:24 pm at 1:24 pm |
  6. honestly

    HERE I AM:

    A disabled person willing to pay for health care.


    July 19, 2009 01:26 pm at 1:26 pm |
  7. moby49

    There is little doubt that health care is broken and broken badly. The question is what to do about it. The posts here are doing little more than repeating the talking points of the politicians and the various special interest groups. I suggest that if you don't have a solution to propose, don't post. I suspect that if everyone followed that rule, I would be the last person to post.

    Bottom line I don't have the answer and it appears neither do you! It is time to tell the politiciians to kick out the special interests, lock themselves in a room and define a solution. If they can't, we need to get rid of them and start over. I feel certain that if we put our best and brightest in a room for thirty days, they could easily come out with a solution. It just wouldn't make the special interests happy and would cost us all something as it should. Let's get this done folks!!!

    July 19, 2009 01:26 pm at 1:26 pm |
  8. democrat no mas

    My concerns for the average person without medical insurance keep coming back to the fact that a public plan will eventually cost everyone a premium each month. There will be no free health-care for anyone, and I doubt that the premiums will be reduced as much as some people think. If the public plan simply becomes an extension of existing programs, such as Medicare, then very few primary care doctors will be able to accept it because reimbursements are less than the expenses incurred in treating those patients.

    It's very interesting to me to see the opinions of what doctor's lives are like. Our hospital threw a dinner party and dance for our young doctors, but none of them knew how to dance. Why? Because they had been bookworms and nerds all through high school and college, just to meet medical school entry requirements. Ask a young doctor about what movies they saw for the 11 or 12 years prior to becoming a doctor. Most saw none. All this to work long hours, be sued, and then be told to work for multiple government "overseers"? Health-care is on sad times indeed.

    July 19, 2009 01:26 pm at 1:26 pm |
  9. Neutralizer

    Fix MEDICARE and MEDICAID first, it is riddled with FRAUD. It is the wealthy who put people to work NOT people ON WELFARE, get it?

    July 19, 2009 01:28 pm at 1:28 pm |
  10. mmm

    i dont want to pay for health ins for other people. I am sick of this welfare system.

    July 19, 2009 01:30 pm at 1:30 pm |
  11. Fair is Fair

    @ NJ Mom –

    Legalization is NOT the answer, from strictly a healthcare viewpoint. I believe it would worsen matters. It would probably help in the violent crime arena, though.

    So much disease and accident is completely preventable. Diet, exercise, smoking, drug/alcohol abuse, risky behaviors...

    While a lot of health issues are unavoidable, a lot comes down to personal responsibility, NJ Mom. Expanding the nanny state discourages personal responsibility.

    July 19, 2009 01:30 pm at 1:30 pm |
  12. Greg Hovey at www.greghovey.com

    I am a licensed health insurance agent. There are private options available that anyone can afford. My wife and I are 41 and 38. We have a high deductible major medical ppo plan that we pay $120 a month for. What Americans can't afford $2 a day for their health insurance?

    If you want to know what private health insurance should really be costing you and your family, call me toll free at 866.625.1117. I work nationally. Or visit my website at http://www.greghovey.com.

    July 19, 2009 01:30 pm at 1:30 pm |
  13. Canadave

    JD wrote "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."

    JD- That is true the wealthy do come to the United States for treatment in some cases. Of course your system is designed for the wealthy so it is perfect for them. I don't pretend that our system is perfect and there are waits for non-emergency procedures. The statistics however speak for themselves as Canadians live longer and beat the US in nearly every major measure of health care as do most of the other countries with "socialized" systems. If you don't believe the numbers then ask a Canadian citizen if they want to get rid of their health care system. I'd say 90 percent at least would say no.
    Your for profit system is a complete disaster. Knowing the garbage I have to go through with them to collect a car insurance claim, I can't imagine having them in charge of my health.

    July 19, 2009 01:32 pm at 1:32 pm |
  14. Dan

    Go to any large city in America and you may notice that the biggest skyscrapers all belong to banks and insurance companies. Does this mean that they are struggling to make a profit? I don't think so. As long as the big money from insurance companies is going into political circles, we are going to see a huge battle against and resistance to change the system. We need to get out of the for profit medical mindset or we will never resolve this Issue with high cost medical insurance. Want to know who runs things? Just follow the money.

    July 19, 2009 01:33 pm at 1:33 pm |
  15. Mary

    The biggest scam I see, on CSPAN friday night, I watched the democrats all vote themselves out of the 'great new plan' they have for everyone else. I say create a health care plan, that you in congress and the president are willing to sign up for.....if you're not willing to sign up for it, why would it be ok for the uninsured? It's just like the AIG bonuses, Obama determined my hard earned taxpayer money would go to AIG bonuses? Why haven't I been paid back? I need the money? No, it went to the AIG execs, even though the taxpayers own the company. This is the corruption I'm seeing in Washington, and now you want me to believe they can be responsible for Health Care? If they won't sign up for the plan they want to pass, it's just more corruption! WAKE UP TAXPAYERS!

    July 19, 2009 01:36 pm at 1:36 pm |
  16. Melissa

    Then bloody well work on it but just do the bloody job instead of doing nothing but complaining.

    July 19, 2009 01:36 pm at 1:36 pm |
  17. Olaf

    Reality Alert!

    Here yet again is the false statement "46 million Americans are uninsured". 20% of this number are NOT Americans. They are non-citizens, most of whom are in the country illegally. In 2003, a BlueCross BlueShield Association study estimated that about 14 million of the uninsured were eligible for Medicaid and SCHIP. These people would be signed up for government insurance if they went to an emergency room. In 2007, 17.6 million of the uninsured had annual incomes of more than $50,000 and 9.1 million earned more than $75,000. Most of these could likely afford insurance if they chose to have it. 18.3 million of the uninsured were under 34, and some in this age group may have decided they are young and healthy enough to do without coverage.

    The 2003 BlueCross BlueShield study determined that 8.2 million Americans are actually without coverage for the long haul, because they are too poor to purchase health care but earn too much to qualify for government assistance. Then there are a number like me, who have to rely on a state risk pool because individual private coverage was refused because of a pre-existing condition. That is the actual size of the problem. Yes, it is a real problem and should be dealt with. But let's stop with the hype and hysteria and deal with reality.

    July 19, 2009 01:36 pm at 1:36 pm |
  18. JD

    So let's recap...medicare and medicaid are government-run health care programs that cover only a fraction of the population...and their annual budget is over 500 BILLION dollars.

    And we're supposed to believe that government-run universal health care is affordable?

    Wake up, people. This whole notion that government can do better than the private sector is nothing short of madness. More government is NOT the solution. If anything, it's the problem!

    July 19, 2009 01:39 pm at 1:39 pm |
  19. DumpTheGOP


    July 19, 2009 01:39 pm at 1:39 pm |
  20. Trylon

    I hope that before healthcare refrom legislation is passed, as many Americans as possible can view the documentary film by the late Walter Cronkite called "Borderline Medicine". This film is now "dated" – but I challenge Ken Burns or other PBS documentarian to reproduce the 1990 study. That means following six families, 3 from the USA and 3 from Canada, dealing with a) pregnancy and childbirth, b) coronary disease with surgery, 3) cancer treatment.

    Of my 66 years, 33 were lived in the USA and 33 in Canada.

    I had the wisdom to videotape the original broadcast and have played it many times since then. Does anybody want to venture why a copy of "Borderline Medicine" is not upon the shelf of every American public library? Could it be that the medical-industrial complex remembers what happened when Walter Cronkite told Americans it was time to give up expecting victory in Vietnam and get out with as many lives as we could then save? Well, ask Mr. Wendell Potter.

    July 19, 2009 01:40 pm at 1:40 pm |
  21. Chris

    Regardless of what Obama wants, the American taxpayer wants relief from those who refuse to work and yet get more benefits than those who work their entire lives. The American taxpayer says give us a plan where everyone pays and everyone gets coverage who pays. There has to be limits to the benefits that people who do not want to work get. Also, no non-American citizens should be in this plan.

    July 19, 2009 01:50 pm at 1:50 pm |
  22. Lilarose in Bandon, Oregon

    My children live with "family Medicare" in Australia. They love it. They don't have to live with sick kids like we do in the US.

    There is no reason all of America can't live with Medicare. I have it as a senior and I have no complaints.

    Those ads coming in from so-called Canadians are full of bull. All they have to say is lies. I have never had problems with Medicare, nothing the ads claim. Canadians: mind your own business!

    We need to get this thing fixed, even if it isn't perfect to begin with.

    July 19, 2009 01:51 pm at 1:51 pm |
  23. Chris

    "Medicare and Medicaid are bleeding us to death. Change is needed!" Do not confuse Medicare with Medicaid. One is for those people who have worked all their lives, the other is used by the welfare system to cover many people who won't work to their potential. Yes, there is a difference in those who work or have worked and those who won't work isn't there? Let's have a system that required everyone who is not retired to pay something into the system. Those people who are actually retired deserve our help as they are the ones who have carried the countries debts for years.

    July 19, 2009 01:55 pm at 1:55 pm |
  24. Steve in Las Vegas,NV

    Why not regulate the insurance companies? And tax them enough to get them to lower costs.

    The higher the cost the higher the tax, and the lower the cost the lower the tax.

    Insurance companies have almost no regulation now, and it's time to do so. But the lobbyists will flood DC to prevent anything like that!

    July 19, 2009 01:55 pm at 1:55 pm |
  25. LMC

    First, for Amanda–check and see if your university has health coverage for students.

    Second, if is ridiculous that our country has such poor coverage for ALL people. Medical costs should not put people out on the streets, yet that has happened in many cases. I really don't see that we have much choice other than a single payer insurance program. I don't see that having that would mean poor quality and quantity of health care. One problem is that insurance companies pay hospitals and doctors per procedure, so that means extra procedures are done. The payment should be per diagnosis. That's the system used and promoted by companies like Kaiser Permanente, and it seems to be working.

    I don't know how the systems in Canada and the UK are working. I have been told that Germany has a very good system that is a combination of private insurers and a government insurance. Do we ever look to other countries for advice and ideas? We might learn something!

    July 19, 2009 01:56 pm at 1:56 pm |
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