Health care reform: 'Time for bickering is over,' Obama says

Washington » The government's inability to rein in health care costs or ease the plight of the uninsured has pushed the nation to a "breaking point," President Barack Obama argued Wednesday in a pivotal address to Congress meant to reassure the public and rally lawmakers to back his vision for sweeping reform.

"The time for bickering is over. The time for games has passed. Now is the season for action," Obama said. "Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do."

But the reaction he received from Congress showed that on this issue, emotions still run exceedingly high. One House

Republican -- Joe Wilson of South Carolina -- heckled the president, screaming, "You lie" when Obama said his bill would not provide insurance for undocumented immigrants.

And shortly after his 45-minute address, Utah's Republican members of Congress said they were far from persuaded.

"I don't think he swayed one person in the hall. It's the same thing, just trying to put on a different shade of lipstick," Utah Rep. Jason Chaffetz said.

The president took the rare step of giving a policy speech before a joint session of Congress in a bid to reclaim the offensive on his signature issue, which has faced withering attacks throughout August. He also sought to place his effort in historical context, referencing

unsuccessful attempts of the past century. The last came in the early 1990s when President Bill Clinton similarly tried to spur Congress into action, only to see his plan collapse a few months later.

"I am not the first president to take up this cause, but I am determined to be the last," Obama said. "Our collective failure to meet this challenge -- year after year, decade after decade -- has led us to a breaking point."

The president said his proposal has three aims -- to lower costs, bring a sense of security to those who have insurance, and provide affordable coverage to those who are now going without. He vowed to do this without increasing the deficit or replacing employer-based insurance.

Obama also said he is not attempting to put insurance companies out of business. "They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable," he said.

His proposal would ban insurance companies from dropping customers who get sick or rejecting people due to pre-existing conditions. It would eliminate co-payments for preventive care, place a cap on out-of-pocket expenses and reduce the coverage gap in the Medicare prescription drug benefit.

Every big company would have to offer employees coverage or pay a fine. Everyone would be required to have insurance or pay a fine. Those who can't afford it would receive a subsidy.

For small businesses and those who buy insurance on the individual market, the plan would create an online exchange where private insurers and some sort of government-sponsored alternative would compete.

Obama didn't shy away from his support for a "public option," which would essentially be a government-created and run insurance plan. Republicans, such as Utah Sen. Orrin Hatch, decry this idea as a stepping stone to a total government takeover of the insurance industry. And even some conservative Democrats are uneasy about the option.

The president did not say a public option was a must, but he did say that if Americans can't find affordable coverage, the government should provide them a choice.

And he welcomed serious proposals from either side of the aisle while warning, "I will not waste time with those who have made the calculation that it's better politics to kill this plan than improve it."

The president railed against opponents' use of what he called "scare tactics," telling his audience: "What we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government."

The president vowed to call out those who misrepresent his ideas. The most persistent myth has been that the plan gives bureaucrats the ability to cut off care to the elderly through so-called death panels. Obama said: "It is a lie, plain and simple."

But Rep. Rob Bishop, R-Utah, argued Obama just repeated past talking points, losing an opportunity to broaden the discussion.

"It was disappointing that he did not reach across the aisle to include any new or creative ideas," he said.

The president did offer an olive branch to the more conservative elements in Congress by saying he would support state experiments in reducing medical malpractice claims.

Utah's lone House Democrat -- Rep. Jim Matheson -- said that was important "because it's been cast in such partisan terms in the past."

Matheson, a supporter of malpractice reform, voted against his own party's proposal in committee, but said he was encouraged by the president's promise to tamp down costs without adding to the deficit.

Obama placed the cost of his plan at $900 billion over the next decade, paid for by a combination of savings from eliminating waste in the system and fees on health industry groups, such as drug and insurance companies. He also wants to charge insurers a fee on their most expensive plans.

Whether Obama's speech proved to be the game-changer he needs to garner broad support remained to be seem.

Most lawmakers agree that some reform must take place, but opinions vary widely on what role the government should play and on how best to control costs. Hatch sent the president a letter Wednesday saying that Democrats should tone down their reform proposals and seek some common ground, largely on insurance reforms.

"We must be more responsible and realistic in our health care reform initiatives to craft legislation that we all can be proud of," Hatch said.

Senate Majority Leader Harry Reid, D-Nev., said that's exactly what Obama did Wednesday, outlining a "clear and concise vision" of what health insurance reform will mean for America and how to get there. He said the address will help lawmakers craft a bill to lower costs and boost care.

Republican Party officials disagreed. Said Republican National Committee Chairman Michael Steele: "The president has proven his ability again to speak very well and say very little."

mcanham@sltrib.com

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