WASHINGTON (AP) - President Barack Obama's assertion Wednesday
that government will stay out of health care decisions in an
overhauled system is hard to square with the proposals coming out
of Congress and with his own rhetoric.
Even now, nearly half the costs of health care in the U.S. are
paid for by government at all levels. Federal authority would only
grow under any proposal in play.
A look at some of Obama's claims in his prime-time news
OBAMA: "We already have rough agreement" on some aspects of
what a health care overhaul should involve, and one is: "It will
keep government out of health care decisions, giving you the option
to keep your insurance if you're happy with it."
THE FACTS: In House legislation, a commission appointed by the
government would determine what is and isn't covered by insurance
plans offered in a new purchasing pool, including a plan sponsored
by the government. The bill also holds out the possibility that,
over time, those standards could be imposed on all private
insurance plans, not just the ones in the pool.
Indeed, Obama went on to lay out other principles of reform that
plainly show the government making key decisions in health care. He
said insurance companies would be barred from dropping coverage
when someone gets too sick, limits would be set on out-of-pocket
expenses, and preventive care such as checkups and mammograms would
It's true that people would not be forced to give up a private
plan and go with a public one. The question is whether all of those
private plans would still be in place if the government entered the
marketplace in a bigger way.
OBAMA: "I have also pledged that health insurance reform will
not add to our deficit over the next decade, and I mean it."
THE FACTS: The president has said repeatedly that he wants
"deficit-neutral" health care legislation, meaning that every
dollar increase in cost is met with a dollar of new revenue or a
dollar of savings. But some things are more neutral than others.
White House Budget Director Peter Orszag told reporters this week
that the promise does not apply to proposed spending of about $245
billion over the next decade to increase fees for doctors serving
Medicare patients. Democrats and the Obama administration argue
that the extra payment, designed to prevent a scheduled cut of
about 21 percent in doctor fees, already was part of the
administration's policy, with or without a health care overhaul.
Beyond that, budget experts have warned about various accounting
gimmicks that can mask true burdens on the deficit. The bipartisan
Committee for a Responsible Federal Budget lists a variety of them,
including back-loading the heaviest costs at the end of the 10-year
period and beyond.
OBAMA: "You haven't seen me out there blaming the
THE FACTS: Obama did so in his opening statement, saying, "I've
heard that one Republican strategist told his party that even
though they may want to compromise, it's better politics to 'go for
the kill.' Another Republican senator said that defeating health
reform is about 'breaking' me."
Associated Press writer Ricardo Alonso-Zaldivar contributed to
(Copyright 2009 by The Associated Press. All Rights Reserved.)