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. sue

    After reading Scotts comments, I did a little research and 40% of health care costs go to the termanally ill. Use that money to help those that will get better. I had a similar experience like he did , and my mother was also mad that she was being kept alive and terrified.
    She kept telling me to take her home, so she could look out the window at the garden. Like Scott, I put her through hell and regret it. She too died an awful death. We need to think about the dying person not ouselves, and money can go to those who have hope. If so many people believe in god then why are we afraid to let them go in peace.
    Or have the terminal turned into a money making machine for hospitals and doctors, or are they afraid of the lawyers.

    July 19, 2009 01:58 pm at 1:58 pm |
  2. LST

    To Amanda: As I said in a previous note, just get catastrophic insurance. Save your money monthly *(whatever you would have spent on monthly or regular insurance), make your doctor's visits matter (make a list of all the complaints you have), insist on having refills for your regular medications. Ask your doctor to prescribe you generic drugs, see if she/he has samples or coupons, etc. If you are essentially healthy, your monthly insurance payment enriches the insurance company that you pay. Just take a look at the ads "health care is booming", or such and such insurnace company records billions of dollars in profits for 2008 or whatever. Everybody just needs to smarten up.

    July 19, 2009 02:01 pm at 2:01 pm |
  3. Eric Schnitzer

    Why is everyone so afraid of socialized medicine? We are one of the only remaining industrialized nations without it. I am not sayng our whole country should be communist, far from it, however i do believe health care should join education as a right every american should enjoy. Half of the health care cost goes to insurance companies, we should eliminate them and give everyone health care. Republicans like john behnear say we have the best health care in the world with our free market system, well he is very wrong just look at the statistics, we are probably in the thirties.

    July 19, 2009 02:02 pm at 2:02 pm |
  4. Dan

    I challenge all the liberals and Obama supporters here; if you insist that you can run a health insurance company with no profits on 2% overhead and provide cheap coverage to everyone with no denials of care, why haven't you tapped the multimillionaires and billionaires like Kerry, Kennedy, Pelosi, Obama, Soros, and Buffett who fund the Obama Party to set up a private company that does exactly that?

    Think about it. It would be funded by the rich, it would not impose any additional taxpayer burden, and it would be completely deficit neutral. So why haven't you done it?

    July 19, 2009 02:04 pm at 2:04 pm |
  5. Mark Jacobs

    Just because the government sets up a program does NOT mean a doctor will accept it. Listen up. Pay attention. Doctors do NOT have to take your health care plan. They don't have to take Medicare. They can partner with whatever insurance company they want to. They don't have to participate so just because you think you'll be on easy street paying $50/month with the Obama option, think again. I know many doctor friends who won't be accepting this plan because the reimbursement will likely be lousy. Same with Medicaid. No guns to their heads to force them to take it and they won't be taking this one as well. So have fun paying up for NOTHING because your doc ain't gonna take it.

    July 19, 2009 02:06 pm at 2:06 pm |
  6. David

    The common denominator is the insurance companies. They are the ones charging ridiculous prices, denying coverage, dropping people when they are sick, and reimbursing unfairly. We need to regulate the insurance companies. They are basically the white mob.

    People are living longer. Its going to keep getting more and more expensive with more older people. So we better get this fixed.

    July 19, 2009 02:07 pm at 2:07 pm |
  7. eric

    What part of increasing taxes during a recession makes any remote economic sense? Obama's been in office over six months and G.W. started stimulus spending over three months before that. The stimulus is not working as promised. GDP is shrinking and unemployment continues to increase. The end is nowhere in sight right now and the stimulus has thus far failed (looking at the leading indicators in the economy demonstrates this).

    We simply can't afford universal health care right now. Maybe if our government spent responsibly and let the people make their own choices as to how they use their money, we would see some recovery and then this debate would be appropriate. As it stands, the debate about how to afford health care is erroneous, b/c our country can't really afford anything, let alone health care.

    July 19, 2009 02:08 pm at 2:08 pm |
  8. Clark

    Amanda, you are one of many. But please if you need my help ... come ask me for my help .... don't use the government to take my money from me and my children so they can give it to you while they also use part of my money to pay some government employee to shuffle paperwork.

    July 19, 2009 02:10 pm at 2:10 pm |
  9. Manny

    Is anyone really naive enough to believe that only the "rich" will pay higher taxes? I can tell you exactly how this will play out - nationalized healthcare will be enacted, initially with only taxes on the so-called wealthly. After 2 years : "Oh, sorry our cost estimates were understated...we'll have to extend tax increases to everyone except the poorest of the poor." By then, though, this country will be well on the way to socialism and there won't be any "wealthy" left anyway.

    July 19, 2009 02:12 pm at 2:12 pm |
  10. Clark

    Matt, the main reason for the cost of health care is that the quality is great.

    The second reason ... the patient covered by insurance and government programs never truly sees of feels the cost of the care and therefor has no incentive to limit use to what is truly needed ... as long as there are deep pockets out there ... the cost will continue to rise.

    July 19, 2009 02:12 pm at 2:12 pm |
  11. Tammy

    I live in Canada, in a western province. My taxes are high. But with the number of major surgeries in our family over the past few years, we would be homeless right now if I were in the U.S. with selective HMO insurance. They would have told me it was my fault because it was a inherent flaw (or whatever the terminology is) – the cancer started before we got insurance, or the aneurism was there waiting to happen, etc. etc. One person had to wait a few months for knee and hip surgery, but WE DID NOT PAY ANYTHING. Other than taxes. Thank God.

    July 19, 2009 02:14 pm at 2:14 pm |
  12. Clark

    As a medical care worker I have served/treated many Medi-Cal patients over the years .... that flaunt an excessive amount of jewelry and drive brand new luxury cars ... while I pay for their health care and my families ... and drive older model economy cars ....

    I don't mind helping on a personal basis those that truly need help ... but to have the government take my money and give it to people like I just mentioned is wrong.

    July 19, 2009 02:16 pm at 2:16 pm |
  13. Dr J

    I guess I shouldn't have paid $150,000 for medical school and worked my butt off for the last five years in training to get where I am. If you are proposing cutting my pay, I guess I'll head to Wall Street, where there is no need to worry about pay caps.

    For all you people who think doctors make a lot of money – think again. Coupled with medical school debt, overhead, and ridiculous malpratice rates, why would any one want to go into medicine.

    BEVERLY – writes that we shouldn't have profit – that healthcare is a right. Why is it that I drive a Volkswagen and my plumber and electrician drive Mercedes? No one complains about their fees – $300 for an hour of work. And BEVERLY, isn't education, food, shelter, etc fundamental rights? I don't hear of anyone calling for college costs to decrease, or milk prices to go down.

    Give me a break. If we head down the road of reform the way we are going, don't expect high quality doctors – the best and brightest will seek other industries.

    The way to pay for this is to put in credible tort reform (which Mr. Obama refuses to deal with – because he is a lawyer), tax sugar drinks, tax McDonalds, and maybe a 0.5% sales tax nationally.

    July 19, 2009 02:16 pm at 2:16 pm |
  14. Tammy

    How about not-for-profit hospitals? The ones here, north of the USA, give excellent care, are research hospitals with amazing medical innovations, and still cover expenses. Of course, there is fundraising for special projects, but other than showing your health card, you are not asked for a credit card as you are admitted. Every resident of every province has a health card for medical care. We chose our doctors.

    July 19, 2009 02:17 pm at 2:17 pm |
  15. Liz

    Hey Ron
    I've been applying for gov jobs for over 4 years and have been fortunate enough to be accepted for one. You have to be a member of the good old boys club to be in one.

    July 19, 2009 02:18 pm at 2:18 pm |
  16. Maybe

    Amanda, I feel for your condition, but is it fair that other people have to pay for your health care? I have three different auto immune diseases, and degenerative disc disease. I budget every penny I make to be able to afford the insurance that I have.
    Budget.... Budget..... Budget.

    July 19, 2009 02:18 pm at 2:18 pm |
  17. John

    Under any of these plans, the wealthy will still pay less tax than they did 20 or 25 years ago. And they get a much bigger share of the income today than they did then. So they will be just fine.

    The real cost control will come from having a public option, which will create competitive pressure on the insurance companies to end wasteful practices like paying their executives tens or in some cases over $100 million a year. Profit is fine but when extreme profit comes at the expense of people dying due to costly insurance, lack of insurance, etc., a line has to be drawn.

    From what I can see the Republicans are just trying to kill the plan by stalling it. We've been following their approach of "creating incentives" for individuals and businesses to get insurance for most of the last 25 years, and look where it has gotten us! 45 million uninsured, health-care spending that is double per-capita what other industrialized countries pay, and a shorter life expectancy than virtually any other industrialized country. It is time for REAL change!

    July 19, 2009 02:18 pm at 2:18 pm |
  18. Russ

    Docanaon? so you can't even spell an abrev? Sorry doc, I can't agree with you 100%, why are malpractice premiums so high? Because there is so much malpractice maybe? I'm sure many (some?) MDs are altruistic and totally concerned with patient care, but in my personal experience, LOTS of Docs are concerned with the bottom line, fancy offices, expensive cars, and prestige.

    And please don't throw your personal hardships at us, how many millions of americans have trudged through thankless jobs, at low pay and risked life and limb on a daily basis. Doctors are no different than the rest of americans, and they DO get very well compensated. And btw, if you did a better job of policing your profession instead of protecting each other with the "good old boy" club syndrome, maybe YOUR premiums wouldn't be so high.

    July 19, 2009 02:19 pm at 2:19 pm |
  19. Tammy

    "Murder-by-numbers" would be Canada, where you literally have to win a lottery to get a doctor. " Lance is so wrong. And those ads on US tv from a "Canadian" decrying our medical system are so hypocritical and alarming. If it is an emergency, you do get treated. If you wait a bit for something, so what.

    July 19, 2009 02:20 pm at 2:20 pm |
  20. Ancientrivr

    Article in NY Times Mag section today by an Australian who describes the perfect solution for the US. The Australians have a Medicaid For All type system, which provides a basic plan with cheap drugs and access to care for EVERYONE, although it necessarily rations some care and treatment to keep the costs in line. But they also have private insurance system that allows people to buy more coverage for fancier care and treatment. It's a very thoughtful piece on rationing and it makes some very excellent points on trade offs. Do read it!

    July 19, 2009 02:23 pm at 2:23 pm |
  21. G

    Tax high-income Americans. If they're "Patriotic" we shouldnt hear a lick from them. That's what being an American is about. Sacrifice for the betterment of this country. This is just plain ridiculous. Call your congressmen and women. Demand reform for every American. We dont need Republicans who just dont want President Obama to be the man to lead this change that is so desperately needed. Conservative Dems.....get your heads on straight. Do you hear us, WE WANT HEALTH CARE REFORM NOW!! WE WANT HEALTH CARE REFORM NOW!!

    July 19, 2009 02:24 pm at 2:24 pm |
  22. La Fawn

    Mimi, that's where you have it wrong. The stimulus could make thousands of jobs and there would still be people without adequate health care. Small businesses and their employees can't afford the premiums. The subscribers (employees) used to call me every day and say the premiums were too high, they couldn't afford them; and if they dared to have a chronic ailment like diabetes or if their kid sought mental health counseling, they were declaired "Unhealthy Virginians" and the premium was hiked 3 or 4 times the original cost. You don't get it. Many of the people without insurance or acceptable insurance ARE WORKING!

    July 19, 2009 02:25 pm at 2:25 pm |
  23. Dave W

    This article conveniently leaves out the facy that on Friday night the CBO released a new, REVISED estimate of HB 3200 and found that, in fact, it IS REVENUE NEUTRAL, and produces a SURPLUS of up to $6 BILLION over the 10 year estimate window.

    July 19, 2009 02:27 pm at 2:27 pm |
  24. American raised In Canada

    @ Lance "Murder-by-numbers" would be Canada, where you literally have to win a lottery to get a doctor."

    ARE YOU SERIOUS??? I can't even express how WRONG YOU ARE!

    You should be ASHAMED for spreading such inflamatory mis-information!! Almost as bad as shouting "Fire" in a crowded theatre!

    America's Healthcare system is 37th and you ned to inform yourself & STOP being part of the problem!

    July 19, 2009 02:28 pm at 2:28 pm |
  25. LMR

    Health care reform cannot wait. We have waited for 30 years as the health care industry has turned into a profit center that does business as the mafia. I have always had healthcare and over the last 30 years my services has eroded. My doctor no longer designates treatment, at this time AETNA officials dictate what it will and will not pay for. I feel more comfortable having an government official, who will not be rewarded for denying procedures, stipulate what care I will be provided with. It goes without saying I think single payor or a private option is mandatory. We have given the industry enough time to do the RIGHT thing and they haven't, it is time to level the playing field for the public. I will also say that it is VERY evident to me and my 50 something crowd that those who oppose health care reform, including pundits, are being rewarded by the healthcare industry. The American public is not dumb!!

    July 19, 2009 02:31 pm at 2:31 pm |
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