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Obama Underscores Health Care Urgency

By Adriel Bettelheim, CQ Staff

July 23, 2009 -- Responding to worries over the $1 trillion price tag attached to health care overhaul plans and resistance from several corners of Congress, President Obama is stepping up his salesmanship.

The president pushed back Wednesday night during a nationally televised news conference that largely revolved around his ambitious plan to retool the U.S. health system. Obama underscored the importance of completing work on a plan within weeks and prodded lawmakers not to succumb to political inertia.

The press conference provided a venue for Obama to again detail shortcomings in the current health system and portray opponents of the health plan as defenders of the status quo. He'll repeat the message on Thursday, when he travels to Cleveland for a town hall meeting during which he will again promote his plan and will make a visit to the Cleveland Clinic, which has been touted as a good example of recalibrating the approach to patient care.

The question is how hard will he lean on risk-averse centrist Democrats to heed his calls for swift action.

During the news conference, Obama responded to a "why the rush?" question about the time frame of the overhaul. "I'm rushed because I get letters every day from families getting clobbered by health care costs, and they ask me can you help," he said. "In a country like ours that's not right."

He also said that "if you don't set deadlines in this town, nothing happens. The default position is inertia."

In his opening remarks, the president again stressed the perils of inaction: "So let me be clear: if we do not control these costs, we will not be able to control our deficit. If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket.

"If we do not act, 14,000 Americans will continue to lose their health insurance every single day. These are the consequences of inaction. These are the stakes of the debate we're having right now."

During the news conference Obama reiterated that at the beginning of his administration "we inherited an enormous deficit, enormous long-term debt projections" but insisted that "health care reform is not going to add to that deficit. It's designed to lower it."

Asked about his endorsement of a goverment-run plan to compete against private insurers, Obama said he believed the concept would "help keep the insurance companies honest. With regulation there already has been an improvement, but having a public plan out there...that shows maybe if you take some of the profit motive might be even better."

The president also noted that insurance companies "are making record profits and premiums are going up. Where's the constraint? How can we be sure those costs aren't being passed on to employers or their employees? The way to do that is to have some competition."

Obama also referred to the health care initiative as "health insurance reform," a departure from his standard "health care reform."

Administration aides say the goal is to keep the broadest segment of the public believing it has a stake in the outcome, by focusing on how an overhaul will tamp down health inflation and make coverage more affordable to working-class families.

"It's important that the president continues to remind the American people what's at stake, what's in it for them, why the status quo is unacceptable and unaffordable, and what must be done in terms of this issue to lay that foundation for long-term economic growth," said White House press secretary Robert Gibbs. "I don't think he can probably say that enough."

However, experts say Obama faces a formidable political challenge. Polls suggest that voters are losing confidence in Obama's ability to control federal spending, and generally are questioning whether he is taking on too much at once.

The concerns have been amplified by projections from the Congressional Budget Office concluding the overhaul bills produced to date will increase, not reduce, the government's long-term health costs.

"A key turning point was when the Congressional Budget Office acknowledged the proposals don't address the core problems in health spending," said Scott Gottlieb, a former deputy FDA commissioner and top Medicare official in the administration of George W. Bush. "The plans have a lot of vehicles to control decision-making and payment structures, but they don't change the way health care is delivered."

Senate Minority Leader Mitch McConnell of Kentucky said Republicans want to work with Democrats on solutions that can pass on a bipartisan basis. He also said that the health care debate is not about the future of Obama's presidency.

"We want to do the right thing. It's not about the president. Some people think everything is about the president. It's not. It's about the country," McConnell said. "This is too important to be rushed."

Members of Obama's own party in Congress remain concerned about being forced to walk the plank and support an expensive bill few are certain can contain health care spending.

Many of the same lawmakers supported the $787 billion economic stimulus package that Republicans contend has not done enough to stabilize the economy.

Now, some of the Democrats are demanding political inoculation.

Members of the fiscally conservative House Blue Dog Coalition reached a "verbal agreement" with Energy and Commerce Chairman Henry A. Waxman, D-Calif., and Obama on Tuesday to work on language in a House overhaul bill (HR 3200) that would create an independent board with the power to influence payment rates for Medicare and possibly other programs.

"We consider that a significant breakthrough," said Mike Ross, D-Ark., who chairs the coalition's health care task force.

Obama on Wednesday said he understood the coalition's concerns. "I have also pledged that health insurance reform will not add to our deficit over the next decade—and I mean it," he said.

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