Obama's Labor Day Speech to AFL-CIO

President Barack Obama today spoke about health care to the AFL-CIO in Ohio:

In Monday's speech, at the AFL-CIO's annual Labor Day picnic at Ohio's Coney Island amusement park, the president drew wild applause when he spoke of his support for a government-run insurance plan, one of the most contentious health reform issues.

"I see reform where Americans and small businesses that are shut out of health insurance today will be able to purchase coverage at a price they can afford," he said. "Where they'll be able to shop and compare in a new health insurance exchange. And I continue to believe that a public option within the basket of insurance choices would help improve quality and bring down costs."

But, what does that mean? [More...]

White House officials have previously indicated, however, that while Obama will continue to push the public option, he will not make it a condition for signing a bill.

Do people just hear what they want to hear?

Richard Trumka, the incoming president of the AFL-CIO, said that Obama's support for a public option helped make his speech "the best Labor Day speech I've ever heard from a president."

"You have to take the president at face value," he said. "He said the public option is necessary, he's going to fight for it, and we're going to fight with him."

We know Obama is committed to passing health care reform legislation. But it still sounds like he's going to work some kind of compromise on the public option. Will it be in the basket of options from the get-go -- or only come into play if the insurance companies don't pony up?

Here's Reuter's latest list of possible outcomes. This one doesn't sound too good:

Obama may also have to compromise on how to pay for the package, which could cost $1 trillion over 10 years. He has called for limiting tax deductions for the very wealthy. The House bill includes a 5.4 percent tax on millionaires, while the Senate Finance Committee is considering taxing high-end health insurance policies.

Democrats may also have to reduce the bill's cost by scaling back plans to cover all Americans and settle on expanding access to health coverage without requiring individuals and businesses to purchase insurance.

< What Does Snowe Bring To The Table? | A Helpful , Glossry of Health Care Terms >
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    I want to hear more like this (5.00 / 3) (#1)
    by nycstray on Mon Sep 07, 2009 at 05:04:27 PM EST
    . . settle on expanding access to health coverage without requiring individuals and businesses to purchase insurance.

    That would at least ease the pain of a bad/less than we need bill passing. So far though, the mandates aren't mentioned often/at all when discussing Exchanges/Co-Ops/No PO.

    The public option and mandates (5.00 / 5) (#2)
    by andgarden on Mon Sep 07, 2009 at 05:07:41 PM EST
    absolutely have to be linked. The insurances companies have to give something up in order to justify getting such a massive subsidy (in the form of what I consider to be a tax collected on their behalf).

    And if the PO isn't open to all (5.00 / 4) (#4)
    by nycstray on Mon Sep 07, 2009 at 05:15:04 PM EST
    No mandates. I can't even imagine what insurance will cost in 2013 as a self employed person, but the PO darn well better be affordable to those that just miss the cut off for subsidies if we're eligible.

    What they give up (5.00 / 9) (#5)
    by gyrfalcon on Mon Sep 07, 2009 at 05:17:25 PM EST
    in return for the mandate is being able to reject  people for preexisting conditions, rescission practices and those appalling "lifetime" benefit caps.  As long as we're going to have profit-making middlemen in the health care equation, they have to be able to make a profit.  The mandate is the trade-off for accepting regulations that will take a bite out of their profits.  As I understand it, you really can't have one without the other.

    Which is why, IMO, the public option is an absolutely essential third leg of the stool to keep us from getting totally screwed.

    Eventually, it's got to start occurring to people that this whole idiotic pretzel that has to be constructed to keep the profit-making enterprise while not screwing people and simultaneously bringing down the cost of health care to the overall economy makes no sense whatsoever.  At some point, some sort of Occam's razor of policy has to start to become apparent.


    From your lips to God's ears (5.00 / 2) (#8)
    by cawaltz on Mon Sep 07, 2009 at 05:21:13 PM EST
    I haven't completely gotten the impression though that the electorate is always rational. Granted we went from the guy everyone wanted to drink a beer with to the guy everyone wanted to watch a football game with but this election was still less about ooky policy then it was a big ol' American Idol President addition(who had the better storyline, was the most transformational etc, etc).

    GW Bush wasn't just (5.00 / 2) (#29)
    by FoxholeAtheist on Mon Sep 07, 2009 at 11:44:17 PM EST
    the guy everyone wanted to drink a beer with

    It was a lot more twisted than that. To his credit, GW Bush was the recovering alcoholic everyone wanted to drink a beer with. Did any pundit EVER mention that bit of cognitive dissonance.


    IIRC the insurance industry agreed (5.00 / 7) (#9)
    by MO Blue on Mon Sep 07, 2009 at 05:35:07 PM EST
    to provide coverage for people with preexisting conditions, and end the annual and lifetime benefit caps in return for mandates that everyone purchase insurance. What they refuse to do is promise to end their rescission practices.

    On June 16, despite Ignagni pledges of commitment, insurance executives from UnitedHealth Group, Assurant, and WellPoint specifically refused to "commit" to ending the controversial practice of rescinding coverage after an applicant files a medical claim. link

    So they can still take your money (5.00 / 5) (#12)
    by Fabian on Mon Sep 07, 2009 at 05:59:26 PM EST
    and dump you onto the street the instant you file a claim.

    Then you buy a new policy and the exact same thing happens - "Thanks for the premium payment, so sorry.", SLAM! goes the door in your face.

    That scenario goes for people who have paid for decades or just once.  Coupled with a mandate, it means that the insurance companies can play hot potato with consumers.


    I'm sure (5.00 / 3) (#14)
    by cawaltz on Mon Sep 07, 2009 at 06:16:25 PM EST
    it's great fun to go shopping for health care when you're sick. In some cases having to jump through hoops you already jumped through simply because the insurance company has policies that state in order to get B through us you must first do A. Nothing like making someone sick waste that precious time commodity.

    Does anyone else imagine these are the exact folks anxious to buy into the life insurance pools that are basically wagering on people's life span?


    You can't go shopping (5.00 / 1) (#23)
    by gyrfalcon on Mon Sep 07, 2009 at 11:30:47 PM EST
    for health insurance when you're sick.  They won't take you.

    That would change (5.00 / 1) (#27)
    by cawaltz on Mon Sep 07, 2009 at 11:40:07 PM EST
    according to this but what wouldn't change is the fact that each insurance company is going to require you to start from square one after you end up at a new insurance company due to a recission(which they want to continue to allow).

    I don't think (5.00 / 1) (#22)
    by gyrfalcon on Mon Sep 07, 2009 at 11:29:41 PM EST
    they will get to choose whether to end them, under any plan that emerges.  And I think they know that.  Most likely all they're doing here is following BTD's negotiating advice. :-)

    I have not heard a single Republican talk about any form of health care or insurance reform who hasn't included outlawing rescission as one of the primary points.  There's not a chance in hell they're going to get an individual mandate without having to give up rescission.


    The problem is (5.00 / 5) (#13)
    by andgarden on Mon Sep 07, 2009 at 05:59:35 PM EST
    that it's very easy to say that you'll cover everything if you're able to charge anything.

    Heh (5.00 / 1) (#15)
    by Dan the Man on Mon Sep 07, 2009 at 06:22:50 PM EST
    The argument that the insurance companies aren't willing to cover everyone is equally bogus because right now they are willing to "cover anyone" - just as long as you give them enough money.  The problem has never been "they don't cover everyone" or "they don't cover everything".  The problem is that the only way they will cover certain medical procedures or certain people is if you give them a lot of money.  So the problem is cost containment - which none of the bills coming out of Congress addresses.

    With subsidies (5.00 / 1) (#16)
    by cawaltz on Mon Sep 07, 2009 at 06:55:48 PM EST
    We'd probably be looking at a paradoxical response. Prices would go up as the demand for insurance rose. The government pretty much would provide them a floor by covering the cost of the people on the lowest rung of the ladder, rather than a ceiling which said the most that can be charged is such and such for the rest of us.

    Higher taxes for the poor and middle-class (5.00 / 1) (#18)
    by kidneystones on Mon Sep 07, 2009 at 07:37:11 PM EST
    And tax shelters for the rich and well-connected who pay to sit and write the regulations.

    Like it or not, Feingold may be right. I don't see any meaningful improvement for those most in need with a national plan. Get some sort of emergency short-term low-income aid package, send some cash to hospitals in poorer communities, and get more nutritionists and health-care professionals onto the front-line.

    If TARP and cap and trade are any indication of the sort of 'solution' this administration will put in place, folks in need might be better off with no bill. If the big pharma and the insurance companies are backing Obama on this, the final product can't be good for anyone but the rich.

    But, wait...maybe the insurance companies have had a change of heart...that could happen...right?


    Of course not (none / 0) (#26)
    by gyrfalcon on Mon Sep 07, 2009 at 11:39:36 PM EST
    but there's no question they see the writing on the wall and are very, very eager to cooperate enough to get a decent deal out of this.

    Actually not true (5.00 / 2) (#24)
    by gyrfalcon on Mon Sep 07, 2009 at 11:33:52 PM EST
    They don't cover the people they drop through rescission, and they won't cover at all people with really expensive preexisting conditions.

    I haven't read the bill (none / 0) (#25)
    by gyrfalcon on Mon Sep 07, 2009 at 11:37:54 PM EST
    but again, every Republican I've heard talk about this at all includes a caveat that the price for coverage for people with preexisting conditions would be capped at something like 1.5 times "regular" coverage.

    That's not good enough, obviously, but I think it's not right to say that there's no intention of putting some kind of ceiling on what they'd be allowed to charge-- if they get the mandate.  If the GOPers are all for capping fees, I have a hard time imaginging the Dems. and the White House opposing the idea.


    The cap shouldn't read (none / 0) (#30)
    by cawaltz on Mon Sep 07, 2009 at 11:47:11 PM EST
    1.5 times the "regular coverage". There should be very clear parameters about what percentage of income is acceptable for any family to have to pay of their income on health care.

    I thought I had heard something about 16% without copays from somewhere I just don't remember where.


    They do if two things are true (5.00 / 2) (#34)
    by lambert on Tue Sep 08, 2009 at 12:03:10 AM EST
    1. New regulations work well enough to force the insurance companies to comply;

    2. When the government contracts out the health insurance exchanges and the public option policies to the private insurance companies, they "play fair" and don't wreck the programs, even if it doing that helps their bottom line.

    Neither seems likely to me.

    Jeralyn (5.00 / 8) (#3)
    by kmblue on Mon Sep 07, 2009 at 05:10:33 PM EST
    you ask "but what does that mean?" about a graf in Obama's speech.
    That's the point--you're supposed to  guess at what he means, and eventually he'll tell you you guessed wrong.

    but but but (5.00 / 3) (#6)
    by cawaltz on Mon Sep 07, 2009 at 05:17:35 PM EST
    if he took a position or made a judgement it might be construed as bad by Glenn Beck or at least some of the electorate....../snark

    There is going to be a point where he needs to take a stand.....apparently that time isn't now.


    Jeralyn's Best Comment Evah! (none / 0) (#17)
    by kidneystones on Mon Sep 07, 2009 at 07:26:30 PM EST
    I especially appreciate the devastating pith of '...eventually..'.

    Framed in amber. Well done!


    The comment wasn't made by Jeralyn (none / 0) (#31)
    by FoxholeAtheist on Mon Sep 07, 2009 at 11:49:14 PM EST
    it was made to Jeralyn by kmblue. I had to look twice as well.

    if it's in "the basket" at all (5.00 / 5) (#7)
    by kempis on Mon Sep 07, 2009 at 05:19:12 PM EST
    it'll be on the bottom--squashed beyond recognition.

    "You have to take the president at face value," [Trumka] said. "He said the public option is necessary, he's going to fight for it, and we're going to fight with him."

    At first I rolled my eyes at the above, but then I realized that Trumka made a smart move. If Obama was merely trying to soothe frayed nerves by mentioning the PO, this puts him on notice: his credibility is on the line. He has to show that he means what he says.

    If Obama is not mainly interested in winning friends in the insurance industry to help out Dems in 2010 and beyond--and to rebrand the Dems as the new, more moderate GOP--then Obama needs to fight his butt off for the public option. It has the public's support, it is our best option, and it counters his increasing image as a politician who says whatever he thinks people want to hear but lacks the courage to follow through. He's going to have a serious image problem if this "reform" ends up being a gift to insurers at the public's cost. It's time for him to stand and deliver.

    Yeah, I saw a puff-piece on Trumka in WaPo... (none / 0) (#35)
    by lambert on Tue Sep 08, 2009 at 12:04:16 AM EST
    today or yesterday, and I wondered what it was about.

    Now I know.


    My guess, and I tend to be negative on (5.00 / 2) (#10)
    by tigercourse on Mon Sep 07, 2009 at 05:48:08 PM EST
    the President, is that when he says "And I continue to believe that a public option within the basket of insurance choices would help improve quality and bring down costs." he means,
    "I guess I believe that a public option would help (though I've never really thought too much about the issue), but I never bothered to fight for it, you ain't gonna get it, and I'm going to throw my hands up and say 'I tried, people, I tried' when it doesn't happen."

    That's a litle too negative (5.00 / 1) (#28)
    by gyrfalcon on Mon Sep 07, 2009 at 11:43:27 PM EST
    for me anyway.  Obama has pushed the public option idea from the get-go on this, and continues to push it.  To me, from everything I've read, it's clear he believes it's the best way to go.

    The problem isn't that he doesn't support it and believe in it, the problem is that he believes mini-incrementalism is better than nothing and probably won't risk putting his foot down for it.

    That said, there are increasing noises coming out of the White House that Obama will "draw lines in the sand" in his Wednesday address.  Whether one of those lines will be the PO, I have no idea.


    Now there's a change I can believe in... (5.00 / 11) (#11)
    by lentinel on Mon Sep 07, 2009 at 05:52:47 PM EST
    Obama in 2003 - addressing the AFL-CIO:

    "I happen to be a proponent of a single payer universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody... everybody in, nobody out.

    ...A single payer health care plan, a universal health care plan. And that's what I'd like to see."

    Obama in 2009 - addressing the AFL-CIO:

    "I continue to believe that a public option within the basket of insurance choices would help improve quality and bring down costs."

    Moving from coherence to fudge.

    The single-payer system has morphed into the public option which he wants to place in a basket.

    One Stoly please.

    "The basket of insurance choices"... (5.00 / 3) (#36)
    by lambert on Tue Sep 08, 2009 at 12:05:50 AM EST
    Man, that's something to take to the streets for, isn't it!

    Hold me back, people!


    God lambert (none / 0) (#39)
    by Militarytracy on Tue Sep 08, 2009 at 07:10:10 AM EST
    You're always so suspicious and nontrusting.  Can't you just find a way to spin this positive?

    That WAS positive (none / 0) (#41)
    by lambert on Tue Sep 08, 2009 at 10:50:54 AM EST
    When I get irritated, I've been known to get shrill. And watching the Dems --except for  a few stars, like Anthony Weiner and John Conyers -- flush health care reform down the toilet has provided me with plenty of opportunities for irritation.

    better make it a double (n/t) (5.00 / 1) (#37)
    by Jeralyn on Tue Sep 08, 2009 at 12:46:53 AM EST
    I'm tired of waiting for him to say (5.00 / 3) (#19)
    by Militarytracy on Mon Sep 07, 2009 at 07:41:51 PM EST
    something of substance. How was this a great speech in anyone's opinion given the actions that go with this President's great speeches?

    Speeches, Bush v Obama (5.00 / 3) (#20)
    by KeysDan on Mon Sep 07, 2009 at 08:13:34 PM EST
    Bush's speeches were bad and incoherent; Obama's are good and ambiguous.  In both cases, we walk away wondering just what they said, or meant.

    Hillary the Movie (none / 0) (#38)
    by weltec2 on Tue Sep 08, 2009 at 05:06:25 AM EST
    And now we have "Hillary the Movie" by some brainless twit...

    It Means About As Much As Dem Promises (5.00 / 1) (#21)
    by BDB on Mon Sep 07, 2009 at 10:24:52 PM EST
    on card check.  Which is to say, they love to tell labor all the things it wants to hear and then screw them in the legislative process and claim that they had no choice in the matter.  And so far, every two years labor unions show up and provide a lot of money and people to democrats.  One of these days, however, they aren't going to.  At the rate the Dems are selling us out to their corporate overlords, it may be sooner than they think.  If for no other reason than with the way things are going, there may not be much "labor" left in this country.

    It totally floors me (none / 0) (#32)
    by cawaltz on Mon Sep 07, 2009 at 11:51:08 PM EST
    that people don't see the inherant value of collective bargaining. I understand that unions aren't perfect vehicles but it really does surprise me how effective the GOP has been at demonizing the labor movement and painting them as a bunch of hucksters extorting money.

    It means the Medicare Part D except bigger (5.00 / 1) (#33)
    by lambert on Tue Sep 08, 2009 at 12:00:13 AM EST
    Why on earth would anybody believe that the market for health insurance and/or health care is a market where comparison shopping will work?  Is there any evidence at all that it will?

    Well, yes, in fact, there is evidence. You can look at Medicare and Medicare Part D as a controlled experiment between single payer and a health exchange model. Guess which one wins?

    I read your link (5.00 / 1) (#40)
    by jimakaPPJ on Tue Sep 08, 2009 at 08:35:49 AM EST
    and frankly it appears that the author doesn't know the difference between Medicare Advantage and Medicare Part D.

    You need a new "expert."

    (In case you don't, Part D is Rx drug insurance.)


    Thanks very much (none / 0) (#42)
    by lambert on Tue Sep 08, 2009 at 10:54:02 AM EST
    I'll straighten it out. Gawd, the complexity makes me crazy.