Skip to comments.Seniors Across America to Host Local Meetings, Participate in Health Care Tele-Town Hall Meeting...
Posted on 06/07/2010 10:38:51 PM PDT by Cindy
Note: The following text is a quote:
Home Briefing Room Statements & Releases
The White House
Office of the Press Secretary
For Immediate Release June 07, 2010
Seniors Across America to Host Local Meetings, Participate in Health Care Tele-Town Hall Meeting with President Obama
Senior Obama Administration Officials to Attend Local Meetings
WASHINGTONOn Tuesday morning, senior citizens across the country will gather at a series of local meetings to participate via phone in a national tele-town hall meeting on the Affordable Care Act with President Barack Obama. Additionally, more than a dozen senior Obama Administration officials will join seniors at selected meetings to discuss the new health care law and answer questions. The Presidents tele-town hall meeting will be broadcast live on C-SPAN.
During the tele-town hall meeting, the President will take questions from seniors across the country. The President will also discuss the new health care law and efforts to combat senior scams and fraud in advance of the first mailing of the $250 rebate checks for seniors on Medicare who fall into the prescription drug coverage gap known as the donut hole. An estimated 4 million seniors nationwide will receive rebate checks.
A partial list of meetings that are open to members of the media is included below. The tele-town hall begins at 11:40 AM EDT:
National Council on Aging Housing Opportunities 600 E. 43rd Street Texarkana, AR
National Council on Aging Life Program of Jewish Family Service 7377 Santa Monica Boulevard Santa Monica, CA
National Council on Aging St. Thomas of Canterbury 5306 East Arbor Road Long Beach, CA
National Council on Aging Frank Bergon Senior Center 238 South D Street Madera, CA
National Council on Aging John XXIII Multi-Service Center 195 East Fernando Street San Jose, CA
National Council on Aging Canoga Park Senior Citizens Center 7326 Jordan Avenue Canoga Park, CA
National Council on Aging Aurora Center for Active Adults 30 Del Mar Circle Aurora, CO
National Council on Aging City of Lafayette Senior Services 103 South IA Ave Lafayette, CO
National Council on Aging Routt County Council on Aging 1255 Lincoln Ave Steamboat Springs, CO
American Association of Homes and Services for the Aging Total Long-Term Care 8405 West Alameda Lakewood, CO
National Council on Aging New London Senior Center 120 Broad Street New London, CT
National Council on Aging Madison Senior Center 330 West Miffin Street Madison, CT
National Council on Aging Woodbury Senior Center 265 Main Street Woodbury, CT
Center for Medical Advocacy Windham Memorial Community Hospital 112 Mansfield Avenue Willmantic, CT
National Association of Area Agencies on Aging Alliance for the Aging 760 N.W. 107th Avenue, Ste. 201 Miami, FL
National Council on Aging Neptune Beah Senior Activity Center 2004 Forest Avenue Neptune Beach, FL
Alliance for Retired Americans Double Tree Hotel (entrance to Universal Orlando) 5780 Major Boulevard Orlando, FL
National Association of Area Agencies on Aging Area Agency of Aging 729 34th Avenue Rock Island, IL
National Council on Aging North Shore Senior Center 161 Northfield Road Northfield, IL
American Association of Homes and Services for the Aging Provena St. Anne's Center 4405 Highcrest Road Rockford, IL
National Council on Aging Omega Healthcare Community Organization 7177 North Lincoln Avenue Lincolnwood, IL
National Council on Aging Office of Congresswoman Schakowsky 5533 North Broadway Chicago, IL
American Association of Homes and Services for the Aging Provenia Senior Services 19065 Hickory Creek Drive Mokena, IL
National Association of Area Agencies on Aging Administrative Offices 2927 Lake Avenue Ft. Wayne, IN
National Council on Aging Iowa City Johnson County Senior Center 28 South Linn Street Iowa City, IA
Alliance for Retired Americans Machinists Hall 2000 Walker Des Moines, IA
Alliance for Retired Americans Black Hawk Labor Temple 1695 Burton Ave Waterloo, IA
Alliance for Retired Americans IBEW 405 1211 Wiley Blvd. SW Cedar Rapids, IA
Cedar Falls Senior Center 528 Main Street Cedar Falls, IA
Buchanan County Senior Center 400-5th Avenue Independence, IA
Marshall County Senior Center 20 ½ E. State Street Marshalltown, IA
Kimball Ridge Senior Center 2101 Kimball Avenue Waterloo, IA
National Council on Aging Johnson County Area Agency on Aging 11811 South Sunset Drive Olathe, KS
National Council on Aging Amherst 70 Boltwood Walk Amherst, MA
National Council on Aging Wareham Council on Aging 48 Marion Road Wareham, MA
National Council on Aging Brandeis Student Health Center 415 South Street Waltham, MA
American Association of Homes and Services for the Aging Carroll Lutheran Village 9078 Chevrolet Drive Elicot City, MD
National Council on Aging Grantsville Senior Center 125 Durst Court Grantsville, MD
National Council on Aging Mary Browning Senior Center 104 East Center Street Grantsville, MD
National Council on Aging MetLife Bank 9571 Whiskey Bottom Rd. Laurel, MD
Alliance for Retired Americans Council House 3940 Bexley Place Suitland, MD
Alliance for Retired Americans Southwinds Adult Community 4210 Southwinds Adult Community White Plains, MD
National Council on Aging Lakeside Towers 32980 Birchwood Chesterfield, MI
National Council on Aging Winona Friendship Center 251 Main Street Winona, MN
National Council on Aging/National Association of Areas on Aging The Gables of Boutwells Landing 13575 58th Street, North Oak Park Heights, MN
National Council on Aging Maple Grove 2365 McKnight Rd N Ste 4 North St. Paul, MN
Alliance for Retired Americans St. Louis Labor Council Office 3301 Hollenberg Drive Bridgeton, MO
American Association of Homes and Services for the Aging St. Andrews Resources for Seniors System 6633 Delmar Blvd St. Louis MO
Alliance for Retired Americans Nashua Crossing Assisted Living Facility 674 West Hollis Street Nashua, NH
Alliance for Retired Americans Cashin Senior Center 151 Douglas Street Manchester, NH
American Association of Homes and Services for the Aging Christian Health Care Center 301 Sicomac Avenue Wyckoff, NJ
National Council on Aging Keyport Senior Center 110 2nd Street Keyport, NJ
Alliance for Retired Americans Highland Senior Center 131 Monroe Street, NE Albuquerque, NM
National Council on Aging Garland Senior Center Hwy 701 Corner of Third and Church St. Garland, NC
National Association of Area Agencies on Aging Ellen Fitzgerald Senior Center 327 South Hayne Street Monroe, NC
Alliance for Retired Americans NC State AFL-CIO 1408 Hillsborough Street Raleigh, NC
National Council on Aging The Brunswick Center at Southport 450 Main Street Shallotte, NC
National Association of Area Agencies on Aging Iredell Senior Center 344 East Front Street Statesville, NC
National Council on Aging Northern Wake Senior Center 235 East Holding Avenue Wake Forest, NC
International Union of Painters and Allied Trades Las Vegas Painters Union Hall 1701 Whitney Mesa Drive #105 Henderson, NV
National Council on Aging L.H. Pink Senior Center 2702 Linden Blvd Brooklyn, NY
National Council on Aging Council Center for Senior Citizens 1001 Quentin Road Brooklyn, NY
National Association of Area Agencies on Aging Chemung County Department of Aging and Long Term Care 425 Pennsylvania Avenue Elmira, NY
National Council on Aging Eddy Senior Care 504 State Street Schenectady, NY
American Association of Homes and Services for the Aging Glen Eddy 1 Glen Eddy Drive Niskayuna, NY
American Federation of Teachers Retirees NYSUT Headquarters 800 Troy Schenectady Road Latham, NY
American Association of Homes and Services for the Aging Menorah Park Center for Senior Living 27200 Cedar Road Cleveland, OH
National Council on Aging Senior Citizens Inc. of Delaware County 800 Cheshire Road, Ste B Delaware, OH
National Council on Aging 741 Senior Center 205 East North Street Mason, OH
National Council on Aging Jewish Family Service Cincinnati 11223 Cornell Park Drive Cincinnati, OH
National Council on Aging Village of Evendale Adult Services 10500 Reading Road Evendale, OH
National Council on Aging Hyde Park Center for Older Adults 2800 Erie Ave Cincinnati, OH
National Association of Area Agencies on Aging West Chester Area Senior Center 530 East Union Street West Chester, PA
Alliance for Retired Americans Center City Philadelphia 1606 Walnut St Philadelphia, PA
National Council on Aging Philadelphia Senior Centers Main Branch 509 South Broad Street Philadelphia, PA
National Council on Aging American Association of Homes and Services for the Aging NewCourtland 1845 Walnut Street, 12th Floor Philadelphia, PA
National Council on Aging Mercy Center on Aging, Inc. 444 East Grandview Blvd. Erie, PA
National Council on Aging Earl Simons Senior Center 323 Tenth Street Honesdale, PA
National Council on Aging Philadelphia Senior Center Tioga Branch 1531 West Tioga Street Philadelphia, PA
National Council on Aging Pittsburgh OASIS 400 Fifth Ave (10th Floor) Pittsburgh, PA
National Council on Aging St. John Vianney Center 151 Woodbine Road Downington, PA
National Council on Aging Connellsville Senior Center 100 East Fayette Street Connellsville, PA
National Association of Area Agencies on Aging White Rose Senior Center 27 South Broad Street York, PA
National Council on Aging Smithfield Senior Center 1 William J. Hawkins Jr., Trail Greenville, RI
Alliance for Retired Americans Progressive Network 100 North Church Street Lexington, SC
National Council on Aging TN SHIP 8th Floor AJB, 500 Deaderick Nashville, TN
National Council on Aging Dyer County RSVP Dyersburg, TN
National Council on Aging Platteville Senior Center 55 South Court Street Platteville, WI
At the tele-town hall meeting, the President will be joined by Health and Human Services Secretary Kathleen Sebelius and representatives of the following organizations that have worked to organize local meetings across the country:
AARP AFL-CIO AFSCME Retirees Alliance for Retired Americans American Association of Homes and Services for the Aging American Federation of Teachers Program on Retirement and Retirees American Postal Workers Union Retirees Department Bnai Brith International Center for Medicare Advocacy, Inc. Communications Workers of American Retiree Division Easter Seals Families USA International Union of Painters & Allied Trades IUPAT Medicare Rights Center National Academy of Elder Law Attorneys National Association of Area Agencies on Aging National Association of State Units on Aging National Association of Nutrition and Aging Services Programs National Association of State Long Term Care Ombudsman Programs The National Caucus and Center on Black Aged National Committee to Preserve Social Security and Medicare National Council on Aging NCCNHR The National Consumer Voice for Quality Long-Term Care National Gay and Lesbian Task Force OWL- The Voice of Midlife and Older Women SEIU Service and Advocacy for GLBT Elders Workers United
Seniors Must Scrutinize Medicare Mailer
IBD Editorials ^ | June 8, 2010 | NEWT GINGRICH AND NANCY DESMOND
Posted on June 8, 2010 4:09:53 PM PDT by Kaslin
As weeks turned to months during the Great Debate over what to do about health care this past year, President Obama made one solemn pledge to the nation and its seniors:
He said health care would not add one dime to the deficit. And if all of us liked our doctor, we would get to keep our doctor.
Fast-forward almost 90 days after the passage of ObamaCare and the attitude of most Americans to that pledge is: “Prove it.”
In the past two weeks, the Obama administration has been trying to stem the tide of skepticism toward its health care law with a new mailer sent directly to the nation’s seniors, titled “Medicare and the New Health Care Law What it Means for You.”
Problem is, for anyone who has paid attention during the past 12 months, the message about the biggest government expansion into health care in our lifetime just doesn’t add up.
Let’s contrast fact from fiction and the language used in the new flier:
“The Affordable Care Act passed by Congress and signed by President Obama this year will provide you and your family greater savings and increased quality of care.”
Fact: Most Americans will pay higher insurance premiums, according to the Congressional Budget Office. And more than 10 million seniors will see reduced benefits under their private Medicare Advantage plans. Overall quality will decline as fewer doctors take on Medicare patients.
“Your guaranteed Medicare benefits won’t change whether you get them through Original Medicare or a Medicare Advantage plan.”
(Excerpt) Read more at investors.com ...
It’s sad to say, but I don’t see as long a life as it could of been because of the “new” healthcare program.
Death and taxes...100% guaranteed.
Thank God there is a heaven.
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FOR IMMEDIATE RELEASE
Tuesday, June 8, 2010
Attorney General Holder, Secretary Sebelius Send Letter to State Attorneys General on New Outreach and Education Efforts to Combat Medicare Fraud
Attorney General Eric Holder and Secretary of Health and Human Services (HHS) Kathleen Sebelius today sent a letter to state attorneys general urging them to work with HHS and federal, state and local law enforcement officials to mount a substantial outreach campaign , beginning this summer, to educate seniors and other Medicare beneficiaries about how to prevent scams and fraud. The outreach campaign is another step in the ongoing work of the Health Care Fraud Prevention Enforcement Action Team (HEAT), a cabinet-level initiative launch by the Justice Department and HHS in May 2009.
“We are heading into the week when our first tax-free $250 donut hole rebate checks will be mailed out to Medicare beneficiaries who have fallen into the coverage gap. Accordingly, we are especially concerned about fraud and increased activity by criminals seeking to defraud seniors and we are seeking your help to stop it,” said Attorney General Holder and Secretary Sebelius in the letter. “Building on our record of aggressive action, we will use the new tools and resources provided by the Affordable Care Act to further crack down on fraud.”
In the letter, the Attorney General and Secretary outline education and outreach efforts where state attorneys general could make a big difference. These include efforts to cut the improper payment rate, which tracks fraud, waste and abuse in the Medicare Fee for Service program, in half by 2012; a series of regional fraud prevention summits around the country over the next few months; regular health care fraud task force meetings to facilitate the exchange of information with partners in the public and private sector, and to help coordinate anti-fraud effort; HHSs plans to double the size of the Senior Medicare Patrol and to put more boots on the ground in the fight against Medicare fraud; and a new educational media campaign this summer to educate Medicare beneficiaries about how to protect themselves against fraud.
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Home Briefing Room Speeches & Remarks
The White House
Office of the Press Secretary
For Immediate Release June 08, 2010
Remarks by the President at a Tele-Town Hall with Seniors
Holiday Park Multipurpose Senior Center, Wheaton, Maryland
11:41 A.M. EDT
THE PRESIDENT: Thank you, everybody. Thank you. Thank you so much. Everybody, please have a seat. Well, it is wonderful to see all of you. I want to thank Fran for that wonderful introduction. And I want to make a few acknowledgements before I make some opening remarks.
First of all, weve got one of the best secretaries of Health and Human Services that weve ever had in Kathleen Sebelius. Please give her a big round of applause. (Applause.) I want to thank Governor OMalley for joining us here today, for his terrific efforts. (Applause.) I want to acknowledge our wonderful senior senator from the great state of Maryland — Barbara Mikulski is here. (Applause.) Ben Cardin couldnt be here, but hes wonderful too, so give him a round of applause. (Laughter and applause.) We got U.S. Representative Chris Van Hollen here. (Applause.) And U.S. Representative Donna Edwards. (Applause.) And I wanted to just let you know, they fought hard on behalf of seniors and on behalf of this health care bill, and I could not be prouder to be joined by them.
I really want to thank Fran for sharing her story with us. I want to thank everybody whos joined us here at the Holiday Park Senior Center. And there are a lot of people who are listening and watching all across America, so I appreciate all of you as well.
Im looking forward to taking some of your questions, but first, what I want to do is say a few brief words about the Affordable Care Act that we passed a couple months back, and what it means for Americas seniors.
Its hard to imagine today, but just two generations ago, millions of our seniors went without basic health care coverage. Millions. It wasnt right. It wasnt reflective of our values and who we are. So rather than allow that reality to continue, we made a promise to Americas seniors that you can live out your golden years with some basic peace of mind and health coverage that you can count on. That was the promise of Medicare.
The Affordable Care Act renews and strengthens that promise. This new law recognizes that Medicare isnt just something that youre entitled to when you reach 65; its something that youve earned. Its something that youve worked a lifetime for, having the security of knowing that Medicare will be there when you need it. Its a sacred and inviolable trust between you and your country. And those of us in elected office have a commitment to uphold that trust - and as long as Im President, I will.
And thats why this new law gives seniors and their families greater savings, better benefits and higher-quality health care. Thats why it ensures accountability throughout the system so that seniors have greater control over the care that they receive. And thats why it keeps Medicare strong and solvent - today and tomorrow.
Now, youve just heard Frans story. When Fran was diagnosed with breast cancer, the cost of her medication surpassed the Medicare Part D coverage limit - but it didnt reach the catastrophic coverage threshold. So she found herself in this coverage gap called the doughnut hole, where she was forced to pay the entire cost of the medicine she needed out of pocket. That came to thousands of dollars, forcing her and her husband to cut back everywhere else.
And I think everybody here understands Frans story is not uncommon. Ive heard others like it all across this country, and I read them — read about it when I read letters from so many of you at night. Those stories - your stories - are why we passed this law in the first place - to ensure that we dont have to keep on telling this same story.
Now, this debate got pretty contentious at times last year. I think you remember. (Laughter.) And just when you were looking for accurate information about what this reform would mean for you, there were a lot of opponents of health care reform generally that sought to deny you that information. And they ran some pretty nasty rumors in hopes that it would scare folks. I know thats hard to imagine in politics — (laughter) — but thats what happened.
And we had seen it before. In the 1930s, when more than half of our seniors couldnt support themselves and millions saw their savings vanish, there were a number of opponents who argued that Social Security was going to be socialism. In 1965, plenty of folks warned that Medicare was going to lead to a government takeover of the health care system. Same argument that was made earlier this year and last year. We found out that those warnings had no anchor in reality, and neither do the hysterical claims about this law.
So heres the truth: First and foremost, what you need to know is that the guaranteed Medicare benefits that youve earned will not change, regardless of whether you receive them through Medicare or Medicare Advantage. Your guaranteed benefits will not change. Eligibility wont change. Medicare will continue to cover your costs the way it always has. If you like your doctor, you can keep your doctor. In fact, were taking steps to increase the number of primary care physicians so that seniors get the care that they need. And Im committed to reforming the way in which we compensate doctors under Medicare, because right now it doesnt make any sense. I dont think — some of you may be aware of the fact that weve got this patchwork system where Medicare doctors each year have to see if theyre going to get reimbursed properly or not. And weve got to change that, and thats something that Im committed to doing. And Im going to keep fighting for doctor pay that is more cost-effective and efficient, and I urge Congress to pass a short-term fix today and then we need to fix this thing over the long term tomorrow.
So those are the facts. What youll see through this new law are new benefits, new cost savings, and an increased focus on quality to ensure that you get the care that you need. And were moving quickly and carefully to implement this law so that you begin to see some of these savings immediately.
Case in point: Beginning this week, tens of thousands of seniors who fall into the doughnut hole, like Fran, will receive a $250 rebate check to help you cover the cost of your prescriptions. That will happen immediately — thats starting now. (Applause.) Each month — and whats going to happen is, each month, as more seniors hit the doughnut hole, more and more checks will hit the mail - helping more than 4 million seniors by the end of this year. Now, beginning next year, if you fall into the coverage gap, youll get a 50 percent discount on the brand-name medicine that you need — 50 percent. (Applause.) And by 2020 — its being phased in, but by 2020 this law will close the doughnut hole completely. The doughnut hole will be gone. It will be gone. (Applause.)
Now, thats not all. Beginning next year, preventive care - including annual wellness visits for Medicare beneficiaries, certain screening services like mammograms - will be free, because the best way to prevent a serious illness is to diagnose it early.
This law also gives us the power to see to it that insurance companies dont raise your rates just to pad their profits. (Applause.) Last week, Secretary Sebelius reminded insurance companies that weve got the authority to review and reject unreasonable rate increases for Medicare Advantage plans, and she put them on notice that we will exercise that authority.
Finally, because seniors are more frequently targeted by scam artists, we made sure the new law gives us stronger tools to target criminals. And I want to send a notice to all who would swindle and steal from seniors and the Medicare system: We are going to find you, we will prosecute you, and we will ultimately prevent those crimes from happening ever again. (Applause.)
Part of the reason this is so important is because weve been receiving some outrageous reports from around the country of people trying to scam seniors out of Medicare. Theyll call asking for a Medicare number or a Social Security number or bank account information, claiming its necessary to re-enroll in Medicare or to sign up for new Medicare cards. Some even go door to door, claiming theyre selling new government policies. Its appalling and its infuriating, and were going to put a stop to it. And thats why today, I want to announce a couple of tough new efforts to protect seniors.
At my direction, Secretary Sebelius and Attorney General Holder have expanded efforts across the country to vigorously crack down on criminals who seek to take advantage of seniors and of taxpayer dollars. Weve established a joint Health Care Fraud Prevention and Enforcement Action Team, also known as HEAT. (Laughter.) Yeah, you like that — HEAT. (Applause.) This task force is already focusing on certain cities with high rates of questionable Medicare expenses, and charged several individuals with fraudulent billing. In addition, theyll continue a series of summits in cities across America with high rates of Medicare fraud, beginning next month in Miami. At these summits, theyll work with state and local officials, health care providers, and others that seniors rely on most, to increase awareness of fraud and share information and expertise in identifying fraud.
And finally, were going to reduce by half the amount of waste, fraud and abuse in the Medicare system, protecting your Medicare and the American taxpayers money. In fact, were looking to eliminate waste everywhere we can. Earlier this morning, my budget director Peter Orszag laid out our effort to cut wasteful spending across government - including asking all agencies to identify their worst-performing programs as we put together the next federal budget.
So thats what this law does. Now, having said that, there — some of the folks who were against health reform in Congress, they still think that none of this should have happened. They dont think you should be getting these rebates, dont think we should be closing this doughnut hole. In fact, you have an entire party out there thats running on a platform of repeal.
They want to roll back all these reform efforts. They say they have their own plan, but over the last 14 months of debate, they never seriously advanced it. And when you look at it, you can see why. Theyd roll back the rebate to help you pay for your medicine if you fall in the doughnut hole. Theyd roll back the free preventive care for Medicare recipients. And then away from seniors, theyd roll back all the insurance provisions that make sure that insurance companies arent cheating folks who are paying their premiums.
Their plan would let insurance companies continue to deny folks coverage when they get sick. Theyd do little to make insurance more affordable. Theyd gut the existing consumer protections. Theyd put insurance companies back in charge. Some have even filed legislation that would end Medicare as we know it, giving every senior a voucher for health care instead.
Now, I refuse to let that happen. Were not going back. We are going to move forward. Thats why I was elected. (Applause.)
So, all told, the Affordable Care Act is a law that keeps Americas promise to our seniors. And it extends that promise to your children and your grandchildren and your great-grandchildren, because in recent years, weve arrived at one of those moments where we needed to make right a longstanding wrong. Millions of middle-class Americans watched our employer-based health care system fray along the edges, leave a lot of people out. A lot of people didnt have Medicare or qualify for Medicaid. They fell into terrible situations. And we decided we were going to stand up, as weve done so many times before, to make sure that everybody got a fair shot. And were a better nation for it.
Once this reform is fully in effect, middle-class families are going to pay less for their health care. Taxpayers wont have to pay higher premiums for trips to the ER by uninsured Americans. Businesses are going to get help with their health care costs — in fact, small businesses are already learning theyre eligible for tax credits to cover their workers this year. And the worst practices of the insurance company will end, so that they cant deny you coverage because you got a preexisting condition, or because you happen to get sick and suddenly they decide its not convenient to cover you. So this law looks out for future generations by doing more to bring down our long-term deficits than just about anything that we could do.
And in the end, this debate was about whether were still a nation that keeps its promises to our seniors, and gives all of our citizens — not just some of them, but all of them — a chance to reach their dreams. It was about whether were still a people that are able to meet big challenges. And Im proud to say that the answer to each of those questions was yes. And as long as Im President and Ive got great allies like the members of Congress who are here, then this is going to be a promise that America continues to keep.
So thank you very much, everybody. And now I want to take some of your questions. (Applause.) Let me make sure my mic is working. (Laughter.) Okay. Secretary Sebelius is going to be like Oprah — shes going to run the show here. (Laughter.)
SECRETARY SEBELIUS: But I cant give away cars, Im afraid. (Laughter.) So as I told you before, we have lots of people listening from around the country, and a number in here I know who want to ask questions. So well take the first question from the audience.
Yes, maam. And if you would say your name and then ask your question to the President.
Q Good morning, Mr. President.
THE PRESIDENT: Good morning.
Q I just joined —
SECRETARY SEBELIUS: Can you tell us your name?
Q Yes, I can do that. (Laughter.) Mary Kay Crangel, (phonetic) and I live in Arlington, Virginia. I just became eligible for Medicaid four weeks ago, and Ive joined the program. My question is about —
THE PRESIDENT: For Medicare or Medicaid? I want to make sure — Medicare?
Q Medicare. Did I say Medicaid? Oh, sorry.
THE PRESIDENT: Thats okay. (Laughter.)
Q Medicare. My question is about the doughnut hole. I think all of us appreciate the $250, and I think that will help a lot of folks. But my concern is that its taking so long — why 10 years to close the hole completely?
THE PRESIDENT: Well, heres what happening. Essentially, were going to be phasing this down. And Ill be honest with you, its just a matter of money. Its very expensive to close this doughnut hole. When the prescription drug plan was originally passed — frankly, we shouldnt have had a doughnut hole in the first place, but once that hole was created, then each year the budget was assuming that doughnut hole was there. For us to close that right away would have blown a hole through the budget.
So essentially what we said is, how do we provide some immediate assistance to seniors who are falling into the doughnut hole, and then how do we ratchet down the cost to seniors each year so that by the time we get to 2020, the doughnut hole is completely eliminated?
In the meantime, though, as I said — I want everybody to be clear here — you will immediately benefit first from the $250 check that you receive. Next year we then phase in 50 percent discount on the prescription drugs that youre paying. And each subsequent year what youre going to be seeing is, is that the costs are going to be continually reduced.
Now, part of what we still have to do is we still have to work with the drug companies to reduce just the cost of prescription drugs generally. And this is something that Secretary Sebelius takes very seriously. Are there ways that, for example, we can get generics on the market quicker? Are there ways that we can make sure that the patent laws dont prevent new products from getting to the market the way they should? Are there ways that we can do a better job negotiating for better prices? So there are going to be a whole host of things that were going to be doing. Its not like were going to be standing still during this 10 years. But what this law does is it guarantees that help and makes sure that a decade from now its going to be completely eliminated.
SECRETARY SEBELIUS: Thank you, Mr. President. My understanding is we have folks standing by around the country. So the next question will come from the audience.
OPERATOR: Thank you. Your first call is from Barbara Franklin from Rantoul, Illinois. Barbara, please ask your question.
THE PRESIDENT: Its like magic. (Laughter.)
Q Mr. President, my name is Barbara Franklin. Im President of the Illinois Alliance for Retired Americans. My question is, will the reduction and subsidies to Medicare Advantage plans cause these companies to reduce coverage to senior plans?
THE PRESIDENT: Well, its a great question. Where are you calling from in Illinois?
Q Rantoul, Illinois.
THE PRESIDENT: Rantoul is a great town. (Laughter.)
Q Yes. (Laughter.)
THE PRESIDENT: Tell everybody back home I said hi.
Q I sure will.
THE PRESIDENT: This has been an area where probably theres been the most misinformation and concern, after the death panels. Remember those?
For those who are not familiar with it — and I want to make sure that I explain this as clearly as possible — Medicare provides a guaranteed benefit. And then a while back a law was passed saying were going to have a program called Medicare Advantage in which we pay insurance companies to provide Medicare benefits. So the insurance companies are supposed to manage these Medicare benefits.
There are examples of where Medicare Advantage has been a good deal for some seniors. But, overall, what happened to the program is, is that insurance companies were getting paid on average $1,000 more — $1,000 more — than the costs of regular Medicare. Okay?
Now, by law these insurance companies were supposed to be providing additional benefits and better services for this $1,000. But a lot of it ended up going to their profits and CEO bonuses and their bottom lines. Whats more was you — if you werent signed up for Medicare Advantage — were still paying higher premiums for somebody elses Medicare Advantage. If youre in regular Medicare, which is about 77 percent — so three out of four of you who are in Medicare are signed up for regular Medicare, and one out of four of you are signed for Medicare Advantage — those of you who arent in Medicare Advantage, youre actually paying a higher premium for that extra $1,000 going to the insurance companies.
Well, that doesnt seem like a good deal. That doesnt seem fair. So heres what we did under the law. What we said was, you can maintain Medicare Advantage, but we are going to say to the insurance companies that you cant use this just to pad your profits or to pay higher CEO bonuses. Eighty-five percent of what you spend has to actually be for health services. Were going to review the rates that are applied. Were going to set a rate that is fair and appropriate so that Medicare Advantage isnt costing people who arent in Medicare Advantage.
So those are the changes that weve made. Now, that is, by the way, where we are obtaining a number of the savings in Medicare. Its by eliminating some of these insurance subsidies that were unnecessary for the program. But we have not eliminated Medicare Advantage, and insurance companies can still make money operating a well-managed Medicare Advantage program that helps to manage and coordinate the prescription drugs and the dental and all that stuff. So for administrative convenience, Medicare Advantage may still end up being a useful program for some people. We just want to make sure that that money is not just a big giveaway to the insurance companies.
And this was costing Medicare overall I think around $17 billion to $18 billion every year. Thats billion with a B — right? So part of the way that we pay for the improved benefits and doughnut hole is to say were going to take some of that money from the insurance companies — and theyll still be able to make money. And theyre — so seniors who are under a Medicare Advantage plan that is doing a good job have nothing to worry about. If youre signed up for a Medicare Advantage program that is wasting money, then were going to be just telling those insurance companies you got to stop wasting the money. And that I think is something that everybody expects us to do as overseeing a program so that it lasts over the long term.
Anything you want to add there, Kathleen?
SECRETARY SEBELIUS: I think the President did a great job answering that question. Is there — lets take the next one from the audience. Sir, in the back.
Q My name is Pat Connover (phonetic), Im 69 years old, and I have heart disease, high blood pressure, and incurable fast-growing prostate cancer. I have a couple of other chronic conditions and special concerns as a transgender person. And in addition, Im allergic to some of the drugs that would most be used to treat my conditions. Im actually doing the wise things for myself and Im still productive in several ways. One of the big reasons for my sustained good health is my primary care physician, Dr. Gail Povard (phonetic). In addition to being a good doctor, she is an outstanding advocate in coordinating for my sometimes complex care. I believe significantly more money can be saved in Medicare by directing more resources to primary physicians for coordination and patient advocacy, and less to the complex organizational programs that have the same purpose. Instead of buying expensive football teams, what we need is more archers. (Laughter.)
THE PRESIDENT: Well, let me — Im not going to comment on football because — (laughter) — are most people around here Ravens fans or Redskins?
AUDIENCE MEMBER: Redskins!
AUDIENCE MEMBER: Ravens! (Laughter.)
THE PRESIDENT: I mean, Im just not — I just want to make sure. (Laughter.) You know, I dont know. See, this is why I didnt want to talk about football. (Laughter.) And we got a Navy person here, right here. (Laughter.)
This issue of primary care physicians is absolutely critical. And it has the promise of making such a big difference in the overall health of everybody, from children to seniors. It used to be that most of us had a family doctor; you would consult with that family doctor; they knew your history, they knew your family, they knew your children, they helped deliver babies. And as a consequence, what happened was, is that everybody got regular checkups and could anticipate a lot of the problems that are out there.
Now, in these big medical systems, so often what happens is, is that youre shuttled around from specialist to specialist; oftentimes people dont have a primary care physician that theyre comfortable with so they dont get regular checkups, they dont get regular consultations, preventable diseases end up being missed; and you dont have the kind of coordination thats necessary between all these different specialists, right?
So you go to one doctor; they take a test. Then you go to the hospital; they have you take the same test. A lot of errors occur because theres not communications between these various specialists, and it adds a lot of cost because each time that test is being taken, theyre charging Medicare if youre on Medicare, and if youre not on Medicare theyre charging the insurance company. And that is part of what is adding to all these costs.
So what weve been trying to do — and this was a major focus of the health reform bill — is, how do we get more primary physicians, number one; and number two, how do we give them more power so that they are the hub around which a patient-centered medical system exists, right?
And the first step is getting more primary care physicians. I mean, sadly, a lot of young medical students, theyd love to go into primary care, but primary care physicians dont get paid as well as specialists. So they say to themselves, you know what, I dont want to — Ive got all these medical school bills that Ive got to pay, Ive got to become a plastic surgeon or something. And so part of the bill was to, through loan forgiveness programs and other mechanisms, make it more enticing for young medical students to go into primary care, build up the pool of primary care physicians.
Number two is increasing the reimbursements for primary care. Right now youve got a situation where if a primary care physician says to a patient, you know what, you need to lose some weight because youre at risk of diabetes, and Ive got a good exercise program that makes sense and heres a dietician that you should talk to, sometimes Medicare may not reimburse that consultation. But theyll reimburse the $30,000 foot amputation because — after somebody gets the disease.
Well, that doesnt make sense. So changing our reimbursement system to encourage preventive care and encourage what primary care physicians do is probably going to be the single most important thing that we can do to assure that you and those of you who have good primary care physicians continue to get that kind of care.
Last point Ill make, and I just want to go back to this point that I made during my remarks, about a decade ago I guess — and Barbara, correct me if Im getting the timing wrong — but about a decade ago, Congress — not our Congress but a previous Congress — (laughter) — made the decision that the way we were going to actually cut Medicare — or cut the rising costs of Medicare was to say to doctors and providers, were going to cap you at a certain level, and if you dont, tough luck.
And in theory it sounded good, but it wasnt very well thought through. And so what happened was, each year, costs for doctors went up and the reimbursements didnt. And eventually it got so bad that Congress then started saying, you know what, this isnt realistic, so each year theyd kind of do a patchwork fix on this thing. And the formula for reimbursing Medicare doctors would be adjusted, but it would only be adjusted for a year or adjusted for two years. But it wouldnt get adjusted permanently.
And whats happened is, over time, its built up so that now each year you end up having this emergency where unless Congress passes a bill right away, suddenly Medicare doctors are going to get a 21 percent cut in their reimbursements because all that health care inflation had built up over time. Well, were now in this situation again. And weve got to fix this permanently.
Now, in the meantime, temporarily, we got to make sure that your doctor is getting reimbursed so that they can stay in business and keep their doors open. And my administration has worked very closely with doctors to try to see if we can get this fixed short term, but ultimately were going to have to get it fixed long term.
What we want is a system where doctors are reimbursed for the right things — we want them reimbursed for quality, we want them reimbursed for how good care youre giving patients. We dont want doctors just to be reimbursed for how many tests they do or how many procedures they do because sometimes that may mean that theyre not giving the best care. We want quality, not quantity.
So there are adjustments we need to make over the long term in how we reimburse doctors. But what we shouldnt do is have this guillotine hanging over their heads every year where theyre having to figure out, am I am going to get reimbursed or is suddenly my income going to drop by 20 percent? Because what will happen is, more and more people will say, I dont want to be a Medicare doctor, I dont want to be a primary care physician for somebody on Medicare, because its going to make my income unstable. Thats something that weve got to fix.
SECRETARY SEBELIUS: Thank you, Mr. President. Before we take the next question from the operator, I just want to add one thing to that great answer, which is to tell you that the President has been focused from the beginning of the discussion about health reform on the workforce, understanding that its great to say everybody should get great medical care, well have more access. He said over and over again, what about the docs? What about the nurses? What about the nurse practitioners? What if we dont have enough people, how are we going to deal with this?
So really starting in the Recovery Act, the first or second piece of legislation that was signed, thanks to members of Congress and the President, there was the beginning of more scholarships, more incentives for a whole range of health care practitioners that really got increased in the Affordable Care Act that was just signed. Its in the budgets in the future, its going to be continued, but I want to thank you, Mr. President, because as the discussion went on in Congress, it often didnt get enough attention, but I can tell you, because I had the privilege of seeing the President on a very regular basis during this discussion, that that was constantly a focus of his. We have to make sure we have not only the doctors and nurses and nurse practitioners, but the primary care, the gerontologists, the folks who are going to take care of the entire population. And thats been a focus, and I think it will continue to be a focus.
Operator, if you are still there — its hard because we cant see, so I assume youre still there — is there another question from the audience listening in?
OPERATOR: Your next call is from Barbara Call (phonetic) from Denver, Colorado. Barbara, please ask your question.
Q Mr. President, this is Barbara Call.
THE PRESIDENT: How are you?
Q Im a participant of (inaudible). I would like to have you answer a question.
THE PRESIDENT: Im all ready.
Q Okay. For leading health care reform, I am concerned about how any health care changes will impact seniors and choice around alternatives to having to go live in a nursing home. My friends and I want to live independently.
THE PRESIDENT: Well, it is a great question, and let me just say you sound like a woman after my grandmothers heart — (laughter) — because she — some of you know my grandmother passed away a couple years ago. She helped raise me, so I was very close to her. And she lived in Hawaii, and after my grandfather passed away, she had the same little apartment she had had when I had been growing up over there. And we kept on trying to say, you know, listen, why dont you move to Chicago? And she said, what am I, an idiot — (laughter) — that I am going to trade 80 degrees and trade winds for Chicago winter?
But she was always very proud and insistent. And until the end of her life, she insisted on making sure that she could live in her apartment. And there are all kinds of different options for different people. The key is we want to give choice to seniors, whats best for them. Some people love living in a retirement facility. Some people want to stay in their own house. Some people want a mix of options and so if they can get some help that comes in, that may be the best option.
And what we try to do, not just in this law, but what were trying to do generally — and I want Secretary Sebelius to fill in some of the specifics on this — is to increase the number of options that are available for people and make sure that we are reimbursing through Medicare not just for the traditional choices of, if youre in a nursing home, then youre going to do it one way or another — but are there other ways that people can get maybe a nurse who comes in, or maybe somebody whos cleaning an apartment for — once a week. Thats what my grandmother did, for example. And it made all the difference because she couldnt always reach to some of the places — Barbara is all nodding. She can relate to that. (Laughter.)
So those are the kinds of innovations and flexibility that we want to introduce into the system. Some of this will be facilitated by the new law; some of it will be facilitated by the ongoing improvements that we want to institute over the next several years, so its not going to happen all at once.
But — go ahead.
SECRETARY SEBELIUS: Thank you, Mr. President. I think there are a couple of — let me just mention just a couple of specific things that are part of the new law. One is there is a provision called the CLASS Act, which is going to allow workers in the current workforce to begin to voluntarily decide to have a payroll check-off and put aside some money that they can draw on later to provide the kind of residential care that I think is being talked about. So if somebody needs to come to the house and help with lunch, or give a bath, or go to the grocery store, those kinds of features. So youd have your own savings account to be able to draw on that. And that will be managed as part of the law and I think allow a lot of people to have more choices.
Just yesterday or the day before, under the Department of Aging, we released grants to the communities which are going to help governors like Governor OMalley and his senior volunteer program get the word out to families about what their options are. For a lot of people, particularly if something happens quickly, somebody suddenly gets much sicker than they were and needs help, a lot of families dont know what their options are, dont know if theres anything other than a nursing home available. And so part of choice is knowing what are — what is here in Maryland, whats around the country, what are those options. So these will be counselors who will be able to meet with families, meet with family members and talk about where the options are.
There are also a whole series of medical strategies in the bill that provide for wrap-around care once a patient leaves a hospital, so a home health team, where somebody may need some follow-up. They dont really need to be in a full-time residential care, but they need somebody to follow up. You know, did you fill your medicines? Are you having any problems? Did you — are you experiencing any trouble? So the bill also has a whole lot of features that I think will make the kind of choices much easier for people.
And finally the Caregiver Act, there is a program now, which is part of the overall President and Vice Presidents move moving forward, which will provide for benefits for family members who are helping to provide for care services, because sometimes, in this tough budget time, its tough. People are running out of money, and they think, I want to help my loved one stay at home, I want to provide the care, but Im trying to raise kids and take care of an aging parent or aunt and uncle; I dont have the resources, or I need a day off, or I need some help going to the grocery store. So there is going to be some caregiver money, knowing that about 80 percent of long-term care services are really provided in communities by loved ones right now and they just need a little help.
So the system is going to get stronger to give those choices across the board. And I think all of that is good news for Americans.
THE PRESIDENT: Good.
SECRETARY SEBELIUS: Yes, sir. And, again, if you would say your name, that would be great.
Q Im Ben Williamowski (phonetic). Im a senior citizen who lives in Maryland — Silver Spring, Maryland. And I want to thank —
SECRETARY SEBELIUS: Nice to see you again, Doctor. Its lovely to have you here.
Q Nice to see you. And I want to thank Secretary Sebelius and the President for allowing me the opportunity to be here and ask this question. And Im asking it more on behalf of my children, who are in their late 50s and 60s, and my grandchildren and my great-grandchildren. But I have heard from some of my friends who are — who spread the myths, who are against the health care bill no matter what it says. Of course they were — told me about the death panel, of course, which is now dead. (Laughter.)
But the — one of the things that they bring up — and I heard this same argument in 1965 — that with providing Medicare — at this point, we may not be concerned with this at our ages but our children may be — that we will soon, with the program the way it is, that Medicare and Social Security will soon run out of money. Now, as I say, that concern is not so much for me at my age but for my children and their children.
THE PRESIDENT: Well, it is a wonderful question so let me talk just about the finances of the health care bill, Medicare, and Ill throw in Social Security in there.
We have a genuine long-term problem. And I can describe it very simply: Weve got a population thats getting older, so youre going to see a bulge in the number of people who are using Medicare and Medicaid. More recipients, fewer workers to support those programs. Weve got more money going out and less money coming in. And thats going to worsen over time.
Now, that has nothing to do with the health care bill. That has to do with the fact that weve got an aging population and health care inflation — the cost of — the additional cost of health care each year is going up much faster than overall inflation and how fast wages and taxes, et cetera are growing, right? So youve got this gap between how much were going to need for Medicare and Social Security versus how much is actually coming into the programs.
That has to be fixed. Now, one way to fix it would be to just say were just going to cut benefits. If theres going to be a gap between how much Medicare is going to cost and how much we actually have, we just say, you know what, each of you, were going to have to eliminate some benefits. You get less — fewer prescription drugs. You got to pay higher co-pays. You got to — certain procedures wont be covered, or maybe some people wont be covered. Or well raise the eligibility when you qualify for Medicare. I mean, there are a bunch of adjustments that could be made that essentially come down to cutting benefits. Thats one way of dealing with rising costs of Medicare.
Another way, which we think is the smarter way, is to say, where are we getting good value for our money; where are we not getting good value for our money; how can we design Medicare so that were reducing the costs going — that are skyrocketing, but people are actually getting better care? Are there ways that we can do that?
For example, can we have one test instead of five tests — have that one test emailed to everybody so that Medicare is not paying for five tests? Can we arrange so that because weve got a good primary care physician, you make one visit to the doctors office and all the specialists come to that one office, as opposed to you having to make five different visits? Are there ways in which we can use best practices for certain diseases so that were catching them sooner? Its cheaper to care for than when youve really gotten sick.
So what we tried to do in this health care bill is actually see how can we make the health care system as a whole smarter, more efficient for everybody, including young people — not just for seniors, because obviously health starts — the healthier you are when youre younger, odds are the healthier youre going to be as you get older. So are there ways that we can — through preventive care, better efficiencies, better management, make the health care system overall more effective? Because if we can do that, then that starts controlling the costs of Medicare and it wont go bankrupt as quick.
A lot of those changes are what we introduced in our health care bill, okay? Now, in addition, the health care bill overall, because of us eliminating some of those subsidies to insurance companies that I mentioned, actually are going to save a billion — a trillion dollars out of our deficit over the long term. A trillion — thats with a T. Thats a lot of money.
So when you hear arguments out there that, well, you know what, we couldnt afford this health care bill, folks who are saying that, they didnt read the bill, because according to the Congressional Budget Office, this will actually reduce the deficit, reduce costs by making the system smarter, making it more efficient. That in turn means that Medicare will be there longer.
Now, the one thing I want to say about both Medicare and Medicaid, though, this health care bill alone doesnt solve all our problems, and I dont want to over-advertise. The truth of the matter is its very hard to change a health care system that involves millions of patients, tens of thousands of doctors, hospitals, all those systems all across the country. Trying to manage that all from the top is just too hard.
What we try to do is create new incentives, find whos doing the best job treating what, advertise those best practices so that other people start adapting them, and over time that trickles throughout the system so that the system overall gets more efficient. Thats what were trying to do, and thats going to take some time. Its not going to happen overnight. Its going to happen over the course of a decade, maybe two decades in some cases, before were actually going to be able to solve this problem overall.
But what I want you to tell those friends of yours is that the long-term fiscal implications of Medicare — the only way to fix those are to — whats called bend the cost curve, make health care more efficient.
The other alternative, which is often the one that is presented by our Republican colleagues, is to essentially voucherize the system. I mean, thats been the main proposal that theyve got that was presented during this debate in terms of saving Medicare. And what that basically means is, you know what, were going to give you a set amount — just hypothetically, well give you $5,000 — you go buy your own health insurance on the private market instead of getting Medicare.
But think about it. What happens? You get $5,000 and it turns out the costs are $10,000. That comes out of your pocket. And then the next year the costs are $12,000, and maybe they gave you an adjustment on inflation adjustments, so now you get $5,500, but the cost for the same quality care youre getting under Medicare is $12,000.
I mean, theres an easy way to make it look like youre solving the problem — you just dump it on other people. And what were trying to do is actually solve the problem by making the health care system more efficient. Thats going to be harder but its fairer, its more just, its going to keep the commitment and the promise of Medicare for years to come.
SECRETARY SEBELIUS: Thank you, Mr. President. Operator, we have time for one more from the world out there.
OPERATOR: Your next question comes from Dennis Yurkas (phonetic) from Las Vegas, Nevada. Dennis, go ahead and ask your question.
Q Mr. President —
THE PRESIDENT: Hi, Dennis.
Q How are you, sir?
THE PRESIDENT: Good.
Q I am a retiree whos a member of the International Union of Painters and Allied Trades who is currently drawing my health insurance from COBRA since the federal subsidy for employer is in danger of being discontinued. And I have confirmed my former employer will not offer COBRA if the subsidy is discontinued. What am I supposed to do and how does the new health care law help me now to get health care, especially since my wife is dealing with some very serious health issues?
THE PRESIDENT: Dennis, can I just ask you the — so you dont yet qualify for Medicare. Youre getting COBRA because your employer is not — youre not on the job right now, is that whats going on?
THE PRESIDENT: Okay. Well, heres what happened is because of just this terrible recession that we had, we knew that a lot of folks were going to be losing their jobs. I mean, when I took office, 750,000 people per month were losing their jobs. Were now, because of the Recovery Act, the great work that Congress did, were now gaining jobs again every month, but we have that 8-million-job hole that was created because of the recession, and thats going to take some time to fill. So youve got a lot of people like Dennis out there — people in construction, people in the trades — a lot of folks who were laid off who not only are struggling to pay their bills but they were in danger of losing their health care because they got it through the job.
Now, theres been a program around for a long time called COBRA — some of you know about it. The idea is that youre, by law, allowed to keep your health insurance even if you lose your job just by paying the premiums. Heres the catch, though: If the premiums are $1,000 a month, you werent paying those, now youve lost your job so youve got even less money. A lot of people couldnt afford COBRA.
So one of the most important things we did in the Recovery Act — and a lot of people dont realize this, but this was hugely important to so many Americans, including Dennis, as you just heard — was through the Recovery Act we said that we are going to subsidize 65 percent of the costs of what your premiums were so that you can keep your health insurance even as youre looking for a job and trying to get back on your feet. So if your premium for your family was $1,000 a month, now it will only cost you $350 a month.
We have sustained that for a year and a half now, and we think its important to sustain it for at least another six months because theres still a lot of folks who are out of work. The economy is improving, but the unemployment rate is still high. This is being debated in Congress right now.
And so, Dennis, the answer is what we need is to make sure that Congress follows through on its commitment to go ahead and maintain COBRA until people are working at a higher rate again.
Now, thats not a long-term solution to Denniss question, though. The problem is that for a lot of folks like Dennis, once COBRA ran out, before this crisis and before the Recovery Act, they were just out of luck. If you didnt have a job you didnt have health insurance, because buying health insurance in the private marketplace as an individual is prohibitively expensive. If you dont — if youre not part of a big pool that can negotiate with the insurance companies, they jack up your rates; youre paying 20 percent more or 30 percent more that you would paying if you were working for a big company.
In some cases, if youve got a preexisting condition, you just cant get health insurance at all. Some of you have been through this. Some of you, if you havent yet qualified for Medicare, are going through it right now. There are a lot of early retirees who arent yet qualified for Medicare but theyve lost their job; theyve got enough savings to support themselves, but they dont have enough savings to be paying these huge medical bills.
So the whole idea behind the health reform bill was lets put you in a pool so you get the same leverage that somebody else does. Lets — even if youre on your own, or youre a small business owner, lets give you the same negotiating power that somebody who works at Google has. So — or another example, if youre a federal worker, youre part of a pool — and you get a great deal.
So the way the health care bill is structured is this: If somebody like Dennis — even after COBRA is — hes no longer eligible for COBRA, somebody like Dennis could sign up to be part of a pool where they got the best, lowest rates possible. Kathleen Sebelius, as Secretary of Health and Human Services, would be overseeing what these policies were that were offered. Youd have a choice of plans. It wouldnt be one size fits all. If you were — had — if Dennis had a bigger family and he had — he mentioned his wife, so he wanted to have a certain kind of better insurance, he could pay a little bit more. If he was young and single and feeling healthy, he could have a cheaper version. But the point is, hed get the benefit of being part of this big pool. Thats the main concept behind this health care reform bill.
If you still couldnt afford it — and theres some people who — theyre making minimum wage, theyre not making a lot of money — they still couldnt afford the premium even though its a much better deal than what they could get on their own, then were going to provide tax credits, provide subsidies, to help people pay for their insurance.
Now, all of this doesnt go into effect until 2013. And Ill anticipate the question earlier — how come its taking so long? (Laughter.) In this case, its not just a question of money, its also a question of just setting it up right. I mean, were talking about 30 million people suddenly getting insurance. That — youve got to set it up in a way that is efficient, isnt subject to fraud. So we had to phase that in to do it right over a certain number of years.
But the key is, by 2014, which is right around the corner, what youre going to see is a situation where somebody like Dennis, even if his COBRA eligibility has lapsed, hes going to know, have the confidence, have the security, that he can look after himself and his wife when it comes to their health care needs.
And that is something that has existed in every other industrialized country in the world except the United States — up until this year. Think about that. Were the wealthiest nation of Earth. Every other country had that basic security except us.
And what we did was, we didnt do anything radical. We didnt — contrary to our critics, this wasnt socialized medicine. We built off the private employer-based system that we already had. But we said, you know what, were going to fill these gaps so that everybody has some security; so that you have no parent out there whos thinking, Im not sure I can afford to take my child to a doctor even though shes not feeling well; theres nobody out there who they lose their job at 55 and suddenly are thinking, you know what, for 10 years Ive got to go without health insurance; theres nobody out there who, because they had a preexisting condition — if somebody like Fran, who had been stricken with breast cancer, who right now, if Fran was working rather than retired and tried to get insurance right now, she might be prohibited. She might not be able to get health insurance.
Well, thats just not — thats not right. Its not reflective of the values of our country. Thats why we changed it. And thats why we are going to fight any effort to go back to a system that doesnt work for the American people and doesnt work for our seniors.
Thank you so much, everybody. God bless you. (Applause.)
SECRETARY SEBELIUS: Thank you, Mr. President.
12:39 P.M. EDT