Well the time for bickering is over. The time for games has passed. Now is the season for action.Why? This is just a raw pronouncement, and he's tried to call time before, including back when the hot debate was only beginning. What I hear is: Shut up. It irks me. It makes me want to make trouble for him. He never encouraged debate. But the debate grew in spite of that. He keeps looking back on what he didn't want at all and says now, that's enough of that.
[I]f you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.I get it. Nothing will require anything of me if I have what I like (and I do). But if you change the structure of the insurance market, my insurance company may not survive or it may be forced to change. Then how do I keep what I have? What I have now may not exist in the future. This is why I do not feel secure.
What this plan will do is to make the insurance you have work better for you.But I like my plan now. You admit you're going to change it.
Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition.Not just me, but anybody. The health insurance business will have to change. I understand the good of helping people with medical conditions, but I wonder what it will do to the private business to suddenly change this.
As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most.And that will change the economics of insurance. Why will that work? What if companies go out of business when you deprive them of the ways they've come up with to be profitable? I'm afraid making the insurance business unprofitable is completely acceptable to you, because you don't mind if in the end government takes over everything. It's what you would do now if you could, isn't it?
They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.It will cost less? I just don't believe that prevention and early detection will perform the necessary magic. And who will provide all this extra care?
That's what Americans who have health insurance can expect from this plan – more security and stability.Security and stability? That sounds nice, but I don't feel... secure about it.
Obama goes on to describe the insurance exchange that will improve the market for people who don't now have health insurance and the tax credits that will help "individuals and small businesses who still cannot afford" insurance. I don't know who qualifies for these credits, but that is a loss of tax revenue, and the burden must fall on the rest of us, some of whom are going to be forced to buy something we haven't been buying yet. There is some kind of a squeeze on people in the middle. But presumably, we are already paying for these people when they do go to emergency rooms, and getting everyone covered, even if some don't pay, will spread the costs more widely.
[The] exchange will take effect in four years, which will give us time to do it right.And him time to get re-elected.
Next, Obama explains why everyone will be required to buy health insurance. It's "irresponsible" not to. So all-encompassing care is recast as personal responsibility. But the real point is economic: The new system — requiring insurance companies to cover pre-existing conditions and not to charge different rates even for those who begin with very expensive medical needs — won't work unless all the healthy people are forced to join and pay in much more than they are taking out. They can't be allowed to game the system, keep all their money, and then opt in to cheap insurance when they start needing reimbursements.
Where will all these people get the money to buy insurance? We're told that some people and businesses will get "a hardship waiver," but we aren't told where the cut-off point is.
While there remain some significant details to be ironed out...This got a huge laugh at the time. It was the biggest laugh of the night, I think.
... I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses to purchase affordable coverage, and a requirement that people who can afford insurance get insurance.At this point, last night, I felt some hope, but not knowing what the details are going to be, I was also pretty suspicious. The next part of the speech, however, attacked his critics and felt like nasty attack on ordinary people who have legitimate doubts and whose criticisms were what pushed him into the more moderate position that was giving me hope.
And I have no doubt that these reforms would greatly benefit Americans from all walks of life, as well as the economy as a whole.
Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Such a charge would be laughable if it weren't so cynical and irresponsible. It is a lie, plain and simple.Ugh. He says nothing more about the genuine concern that there will need to be rationing, that lines will be drawn, and that he himself has said things that suggest that someone will be deciding when older and disabled persons will get "the blue pill" instead of vigorous treatment.
There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false – the reforms I'm proposing would not apply to those who are here illegally.An important promise.
And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.But insurers will have cover abortions, and people will have to do business with insurers.
My health care proposal has also been attacked by some who oppose reform as a "government takeover" of the entire health care system.... Now, I have no interest in putting insurance companies out of business... But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange.Why is something more needed to keep them "honest"? You're imposing new regulations on them. Enforce those regulations. Why is more competition needed to make them "honest"? I'm saying "more competition," because Obama is clear that the public option will be a separate entity that must operate solely on the premiums it collects and free of any taxpayer subsidy. Won't that coverage be expensive too, then? He claims that "by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers." But private companies try to control costs to compete, and government entities tend to get bloated too. It's hard to see what this is for.
... I will not sign a plan that adds one dime to our deficits – either now or in the future. Period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.How will this promise be enforced?
This is the plan I'm proposing. It's a plan that incorporates ideas from many of the people in this room tonight – Democrats and Republicans. And I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open.Am I allowed to shout "You lie" at the TV?
Now comes the sentimental, inspirational stuff that I don't need to spend time on.
... Ted Kennedy....Zzzzz.... Then my ears perk up:
One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government. And figuring out the appropriate size and role of government has always been a source of rigorous and sometimes angry debate.Words for conservatives. Obama then concedes that Teddy seemed to be the opposite off all of that to conservatives. But somehow he really wasn't. Why? I scan the text for a reason. He had conservative allies in some of his political ventures? There's a list of friends — John McCain, etc. Eh. Not enough. Obama goes on about problems Teddy saw, kids with cancer, and it seems as if the idea is just to make us forget about the questions he'd just raised.
You see, our predecessors understood that government could not, and should not, solve every problem. They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom. But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.That's the kind of moderation I like, so that worked on me, but I'm sure it's a disappointment to those who got really excited by those words for conservatives.
Finally, he bemoans the lack of civil conversation again. I hear echoes of the "shut up" I heard at the beginning of the speech. He says we need to act now, not be timid. We need to do "great things" and "meet history's test." We need to do it because it's "our calling." He's entitled to end his speech with a call to action.
I'd say he did pretty well with what he had, but some of us still have questions and don't appreciate being called louts and liars.