NPR logo Obama's Health Care Speech Got It Right And Wrong


Obama's Health Care Speech Got It Right And Wrong

President Obama delivers a speech on health care to a joint session of Congress on Wednesday. Martinez Monsivais/AP hide caption

toggle caption
Martinez Monsivais/AP

President Obama delivers a speech on health care to a joint session of Congress on Wednesday.

Martinez Monsivais/AP

This much is clear about President Obama's health care address: He didn't leave much on the table. He was so specific, firm and passionate that it's easy to forget he's only been in office eight months and in Washington just four years.

He was right on the mark in saying that Congress could easily reach consensus in major ways. But, boy, was he wrong on other important points.

To summarize Obama's on-target points:

President Obama's remarks on health care Wednesday were expected to be viewed by more than half the U.S. population. Two of those viewers were commentators Frank Newport and William McKenzie. Here, they discuss what Obama will need to adjust if his plan is going to win over American skeptics.

Congress tomorrow could adopt consumer-friendly insurance reforms, including giving all individuals access to coverage no matter their pre-existing conditions. Even many Republicans are aboard that train. In addition, both sides could back an insurance exchange that lets consumers select among competing plans. There's enough consensus to offer subsidies to help struggling Americans purchase insurance. We could control costs through better practices in medicine, such as insurers and providers better coordinating a patient's care. That could bend the cost curve, which Obama should have discussed more.

Now, where he was off target:

There's no guarantee you can keep your health plan. If your company stops offering coverage and you end up on a public plan, you could lose your doctor. Look at Medicare. Washington has been tightening up Medicare payments to doctors, so fewer providers are picking up seniors. The same phenomenon could happen under a public plan. If you end up on it, and your doctor chooses not to participate, you're out of luck.

The president wants a public option so consumers can have more insurance choices. Well, they could get more options if he supported letting insurers and consumers connect across state lines. That way, we all could get plenty of choices and wouldn't have to worry about the headaches of creating a federal plan.

William McKenzie is an editorial columnist for The Dallas Morning News . Courtesy of William McKenzie hide caption

toggle caption
Courtesy of William McKenzie

There is no guarantee a public plan would be self-financing through premiums, as the president claims. Consider again Medicare. It has grown beyond what anyone could have imagined. The expansion has benefited seniors, but it also has created a financial crisis. In 2017, Medicare's hospital trust fund runs dry. Who's to say this public option wouldn't grow beyond the ability of premiums to finance it, especially if it becomes the place where companies dump their employees?

The president says his plan's $900 billion price tag could be financed largely through future savings. Look, we all have a lot riding on lower health costs. But to bet the farm on them is ridiculous. Those future savings may not materialize for a decade. And if they do, there's no guarantee they will be sufficient to foot that $900 billion price tag.

Now that the president has gotten it all off his chest, my suggestion is he should focus hard on those four areas of agreement, go further with insurance reforms and bending the cost curve, show ample flexibility on the public plan, and let the deficit hawks take over how to pay for a final plan.

Then, we could get a bill that helps today's consumers while not adding to the public debt future generations must pay.