Health Care Forum: So Let's Get to Work

President Obama opened the health care discussion at the White House on Thursday with these words (excerpted):

"In the last eight years, premiums have grown four times faster than wages. An additional 9 million Americans have joined the ranks of the uninsured. The cost of health care now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes. Even for folks who are weathering this economic storm, and have health care right now, all it takes is one stroke of bad luck -- an accident or an illness, a divorce, a lost job -- to become one of the nearly 46 million uninsured or the millions who have health care, but really can't afford what they've got.

We didn't get here by accident. The problems we face today are a direct consequence of actions that we failed to take yesterday..."

"The same soaring costs that are straining families' budgets are sinking our businesses and eating up our government's budget, too. Too many small businesses can't insure their employees. Major American corporations are struggling to compete with their foreign counterparts. And companies of all sizes are shipping their jobs overseas or shutting their doors for good."

At the fiscal summit that we held here last week, the one thing on which everyone agreed was that the greatest threat to America's fiscal health is not Social Security, though that's a significant challenge; it's not the investments that we've made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation's balance sheet is the skyrocketing cost of health care. It's not even close.

That's why we cannot delay this discussion any longer. That's why today's forum is so important -- because health care reform is no longer just a moral imperative, it's a fiscal imperative. If we want to create jobs and rebuild our economy and get our federal budget under control, then we have to address the crushing cost of health care this year, in this administration. Making investments in reform now, investments that will dramatically lower costs, won't add to our budget deficits in the long term -- rather, it is one of the best ways -- in fact maybe the only way -- to reduce those long-term costs."

"But I am here today and I believe you are here today because this time is different. This time, the call for reform is coming from the bottom up and from all across the spectrum -- from doctors, from nurses, from patients; from unions, from businesses; from hospitals, health care providers, community groups. It's coming from mayors and governors and legislatures, Democrats, Republicans -- all who are racing ahead of Washington to pass bold health care initiatives on their own. This time, there is no debate about whether all Americans should have quality, affordable health care -- the only question is, how?"

And the purpose of this forum is to start answering that question -- to determine how we lower costs for everyone, improve quality for everyone, and expand coverage to all Americans. And our goal will be to enact comprehensive health care reform by the end of this year. That is our commitment. That is our goal."

But there are a lot of people out there who are desperate. There's a lot of desperation out there. Today I want them, and people like them across this country, to know that I have not forgotten them. We have not forgotten them."

So let's get to work."

The President indicated his openness to ideas that work. He said that about the stimulus and got nothing but grief and obstruction. What makes health care different? He talked about some of the differences--the fact that the failure of the system that pretty much came into existence after the last debate on health care legislation in 1994 has convinced almost everybody--businesses, doctors and even some insurers included--that the system is fatally broken.

But what about Republicans? The first signs--the participation of many in the forum today and some of the language they used--indicates there's reason for some hope. Not necessarily from the hard right heart of the party, but from some important moderates, particularly talking about universal coverage.

It's a difficult issue to have any optimism about. The Clinton initiative was so popular at first that President Clinton could actually wave a pen at his State of the Union and threaten to veto it if it didn't meet his standards. But in the course of a few weeks it was dead, killed mostly by lobbyists and a well financed disinformation campaign.

It's particularly tempting for me to be cynical about it, because I've been uninsured for years and I've known for years that my most likely cause of death is being refused treatment, or simply being unable to pay for it, and unwilling to burden others because of the outrageous costs. So I will believe this when I see it. But it does seem that the time is right for something to happen to improve what has been the most tragic result of a system that refuses all responsibility as long as the rich keep getting richer.