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Obama Tells Town Hall Crowd He Won't Relent on Comprehensive Health Care Overhaul

By Jane Norman, CQ HealthBeat Associate Editor

February 3, 2010 -- President Obama delivered a lengthy defense of the need for a wide-ranging, comprehensive health care overhaul in his remarks at a New Hampshire town hall meeting on Tuesday, and took responsibility for not living up to his campaign pledge that negotiations would be televised on C-SPAN.

He said he made that commitment to transparency, though it's hard to know if lawmakers will negotiate in good faith or posture for the cameras if negotiations are televised. "But I think it is a legitimate criticism to say, if you say that all of it is going to be on C-SPAN, all of it is going to be on C-SPAN," he added.

Obama also said because of the many pieces of health care that need to fit together in comprehensive legislation, it became a "big, complicated bill and it's very easy to scare the daylights out of people."

Obama has devoted most of his focus to jobs and the economy since the Jan. 19 Massachusetts special election in which Republicans gained a 41st seat in the Senate and the ability to mount filibusters, throwing congressional Democrats into disarray as to how to move ahead. Republican Scott P. Brown won the seat held by the late Sen. Edward M. Kennedy, a Democrat.

But in the Nashua, N.H., event Obama — prodded by questions — reverted to the detailed explanations of the overhaul that marked his campaign for it last August and argued why change in the health care system should matter to Americans.

He was emphatic that an overhaul will be signed into law. "I do not quit. We are going to get that done," Obama told the crowd at Nashua High School North.

Obama made the case for comprehensive legislation, which Democrats say they are still trying to achieve through the budget reconciliation process while also attempting to move approval of smaller initiatives such as an end to anti-trust exemptions for the health insurance industry.

The president said that one of the most basic principles of the overhaul is that people should not be denied health insurance because of a pre-existing medical condition, but that requirement affects the rest of the health insurance structure and demands other shifts in policy, such as an individual mandate.

"Now, (a ban on denials) is something that's very popular if you just say it in isolation, but when you start explaining what is required to make that happen, then sometimes some people get a little nervous," he said. "You can't have insurance companies have to take somebody who's sick, who's got a pre-existing condition, if you don't have everybody covered, or at least almost everybody covered.

"And the reason, if you think about it, is simple. If you had a situation where not everybody was covered but an insurance company had to take you because you were sick, what everybody would do is they'd just wait till they got sick and then they'd go buy insurance. Right? And so the potential would be there to game the system."

That's important to understand because "a lot of the reforms that we've proposed fit together," he said. "Here's the problem, though, is when you've got all those things fitting together it ends up being a big, complicated bill and it's very easy to scare the daylights out of people. And that's basically what happened during the course of this year's debate."

Members of the House and Senate who approved separate measures (HR 3962, HR 3590) disagreed on about 10 percent of what was in each bill, he said. "So we were just about to clean those up, and then Massachusetts' election happened," said Obama. "Suddenly everybody says, 'Oh, oh, it's over.' Well, no, it's not over. We just have to make sure that we move methodically and that the American people understand exactly what's in the bill."

In answer to a question from a high school student as to "how you would grade yourself on your transparent government?" Obama said his administration has been praised as "the most transparent ever" by outside watchdogs. Hours of congressional hearings and his own town hall meetings last summer were televised, he noted.

"So when people say, well, the negotiations weren't on C-SPAN, what they're frustrated about — and I take responsibility for this — is that after Congress had finally gone through its processes, the House had voted on a bill, the Senate had voted on a bill, it is true that I then met with the leaders and chairmen of the House and the Senate to see what differences needed to be resolved in order to get a final package done," he said. "And that wasn't on C-SPAN."

Brian Lamb, chairman and CEO of C-SPAN, has written Obama asking that important meetings on health care be open to media coverage.

Obama said that when Republicans present him with proposals for a health care overhaul, "and we put forward what we want to do on health care, I very much want that on C-SPAN, and I want everybody here to watch . . . because I think it will be a good educational process for people to weigh the arguments about the relative merits of the bill instead of listening to millions of dollars' worth of insurance industry ads that have been put out there or whatever pundit on the left or the right is saying about these different issues."

He insisted that his administration may not have "gotten it perfect" on transparency but is doing better than any in recent history. "And we'll keep on trying to improve on it," he said.

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