Following healthcare summit on Twitter

by Kay B. Day

Sen. Max Baucus speaks at the Healthcare Summit.

10 a.m.-11 a.m.

I'm following the healthcare summit and will do an analysis. I am commenting via Twitter as the alleged summit takes place. We're one hour into the so-called summit. Three Democrats have spoken; one Republican has spoken. Democrats have trotted out straw men. Sen. Harry Reid (D-Nev.) made serious attempts to look like a human being instead of a robot. Nancy Pelosi (D-Calif.) went on and on in an attempt to look compassionate. Obama opened the summit and after listening to Sen. Lamar Alexander (R-Tenn.), Pelosi and Reid, the president is talking again.

I've put my commentary in brackets. Some of this is off the cuff.

[What no one admits: the government has manipulated the healthcare market since starting Medicaid and Medicare. Entitlements have raised the cost for those of us in the private market. No one talks about that.]

[Hoyer's straw woman has a tumor. Maladies galore.][Democrats definitely control the floor and the time in this 'summit.']

Now Alexander talks about the CBO saying premiums will rise as a result of this.

President says CBO doesn't say that. Says CBO says if passes, and policies are cheaper, families may choose to buy better coverage and that may cost more. Double and triple talk.

[Alexander still can't get a word in edgewise, to respond to Reid, Pelosi or Obama.]

Obama is still talking. He says buying insurance across state lines "shows some promise." He says that's where there's "some overlap."

 11 a.m.

Obama is still talking.

11:02 a.m. Alexander gets a word in.

Now Obama wants to settle whether premiums will be reduced; there's disagreement on that.

Sen. Mitch McConnell (R-Ky.) now talks, noting Americans are opposed to this bill according to polls. And opposed to reconciliation. [**See followup after this article.**]

Dr. Tom Coburn (GOP senator from Oklahoma) wants to get past "treating the symptom as opposed to treating the disease."

Said one out of every three dollars spent doesn't help anyone get well.

Government now directs over 60 percent of healthcare in this country. [FINALLY somebody points to the real issue.]

Coburn said 33 percent of healthcare costs shouldn't be there. Notes Harvard prof that said 20 percent of government run healthcare is fraud.

[That's a fact--just look at the FBI field office news releases.]

Coburn said we can cut costs by eliminating fraud. Said should go back and concentrate on areas with the biggest pot of gold. Mentions lawsuits not productive for the country. Conflicts of interest within the medical field. We do not incentivize prevention--"I'm not talking about creating walking paths."

Coburn talkiing about changing school lunch and food stamp programs so people will eat right. Coburn notes fraud costs are shifted to private pay.

Coburn is a doctor. So far he's really the only person who knows anything about front line medical care.

Now Rep. Steny Hoyer's (D-Md.) talking.

Talks about a transparent market where people can compare prices and know what they're going to get. "An open transparent market will bring down costs we believe." Agrees with Coburn on 1-in-3 dollars not being spent as they should be.

 Hoyer agrees on wringing fraud and waste from system. Says agreement on conflict of interest on delivery of medicine.

Says have put in incentives on prevention [translate: the government will tell you what you can do with your body. I recall one study that said prevention did little to save money--I'll dig that study up.]

 Hoyer still talking at 11:19 a.m. Brings up public option and says that would open up competition.

Now another Democrat will speak. Sen. Max Baucus (D-Mont.)

Oops. Obama's talking again. Asking whether Coburn or other members might be interested in--veers off to undercover patients and prevention such as how our kids are eating and getting exercise and First Lady's obese child program. Issue of defensive medicine Secretary Sebelius (HHS) is working on.

He wants to hear from GOP on driving down costs. Obama still talking at 11:22 a.m.

 Rep. John Boehner (R-Ohio) turns his time over to Rep. John Kline (R-Minn.). Kline wants to allow small businesses to bind together as group to buy insurance to lower costs. Small businesses have wanted this for years.

Now Sen. Baucus will talk. "We are actually quite close." [God help us all.]

Baucus said including buying insurance across state lines "not exactly the way some would."

Baucus said secretary trying to find ways states can settle before lawsuits.

Baucus said states can opt out--"lot of flexibility in that regard."

"Expand HSAs--work pretty well if you have middle or high income."

Baucus said, "We're not that far apart."

Rep. Dave Camp (R-Mich.) is talking.

Both bills feature restrictions on HSAs and FSAs--they ban the use of over-the-counter meds [being covered]; a new cap on FSA contributions of $2,500.

 Under HSAs premiums decreased a little more than 1 percent for individuals. When people switch to HSA premiums decline.

Another concern Camp has--"unelected board charged with recommending even more Medicare reductions." Gives too much authority to unelected bureaucrats.

Obama interrupts. Said trying to focus on costs related to lowering families. [That's exactly what Camp is talking about.] Says doesn't want to cut him off but cuts him off.

Camp said CBO does say the estimated average premium for non group policies will increase and value of benefit is  higher but reason is becasue of the mandates contained in the legislation. "One of our big concerns."

That kind of approach raises costs--states have to have a waiver from secretary.

Obama not comfortable with Camp citing sections of legislation.

Now Obama turns it over to Rep. Rob Andrews (D-N.J.) Now he brings up a woman having a C-section. Says should not be 51 different rules for each state. Said if they can find a way to agree--if insurance company doesn't get between that baby and her doctor--

Kline said he doesn't hear from people complaining about insurance policies from big companies.

Says put association health plans in same position big companies have today.

Camp doesn't agree.

 McConnell points out difference in times each party has had. McConnell is right.

Rep. Paul Ryan (R-Wisc.) talks about small business groups not being restricted--if feds mandate how it works--wants to de-centralize system. If you federalize it you do not achieve that.

Classic conflict: centralized power vs. non-central power typical of Dems and GOP ideology.

 Obama said time differences because "I'm the president." [We hear that a lot.]

11:45 Obama talking again. Talking about beat-up cars, sick kids and breast cancer.

"We should set up some minimum standards within the exchange."

[I am going to shoot my phone. It really hurts to be a one-person office. Can the feds help me out on that?]

 Obama said bills put in place minimum requirements for insurance companies--not a takeover.

Now Sen. Chuck Schumer (D-N.Y.) talking about "rein that waste out" without affecting care.

He's talking about what Obama said they should wait to talk about.

11:51 Sen. Jon Kyl (R-Ariz.) says they don't agree on who should be in charge.

 Kyl quotes CBO on non-group policies rising in 2016; also quotes a 3rd party. Rising costs because it's a richer benefit mandated by federal government. Requirement of 60 percent actuarial value but average today between 55 and 60 percent. Mandate

 [I hate my phone.]

Kyl says taxes will be raised on average income $65k and will hurt people we want to help.

Obama talking again.

Said if self-employed can't get coverage or have high deductible plan, I'm buying that to help me with catastrophe. "If I get hit by a truck I don't go bankrupt." [You'd probably sue the truck driver, actually.]

11:57 a.m. Obama still talking.

Mentions "generous package" they have in Congress. "There'd be a riot in Congress" if they had to have a high deductible plan. [Taxpayers cover that, by the way.]

Obama agrees if you get more regional and national markets instead of state-by-state you get more competition. "That's something we find attractive." But notes GOP not supporting because Dems want a minimum baseline benefit, protections for the "woman who's got breast cancer."

[A lot of this comes to pre-existing conditions--a pool that's sicker and older will see premiums go up.]

12 noon

Obama still talking. "Issue of government regulation is very different than the way this debate has been framed...not a government takeover of insurance."

Rep. Jim Clyburn (D-S.C.) talking now, about Dillon, SC [That's where South of the Border is--'Everybody's a wiener at Pedro's!] 

Clyburn talks about emergency room care for normal sickness. Wants "significant expansion of community health centers." Said both House and Senate plans have that.

Clyburn says other thing is people who cannot navigate the system. People who "work very hard." Mentions "restaurant owners who design plans for their members." Says keep in mind the employees of the small businesses are not negotiating the plans--they're at the mercy of the small business owners, compared to larger employers.

Clyburn talks about doing a call in show this morning on CSPAN, and mentions a caller who was getting ready for transplant surgery. Patient was told because he's on Medicare his post-operative treatment is limited to 3 years. After that, he'll have to find some way to pay. "This man was very emotional today." Clyburn said we should be honest with the American people, trying to make sure Medicare is there for that man.

 Now Obama's talking again (12:07 p.m.) He said any insurance we have would be grandfathered. I would not be required to get the better one.

Kyl said there's a time limit on that and employers would drop you because it's cheaper to pay the fine. Kyl said, "With all due respect, I disagree."

Kyl points out 'Does Washington know better?'

Obama said "That's tipping the scale because everyone's angry at Washington right now." [Glad to know he gets that.] Now he brings up family in trouble over sick kid.

Obama wants to bring up where they agree: can't just drop somebody; agree on idea of extending dependent coverage for people at a certain age; agree on no annual or lifetime limits; agree philosophically we want to end prohibition on pre-existing conditions; other insurance reforms proposed by House and Senate where we should explore.

Now Obama goes to Mitch who yields to Rep. Dr. Charles Boustany (R-La.) Boustany talks about streamlining process/paperwork. Also says, "How do you promote choice and competition." He talked about CBO saying one GOP bill that brings premiums down by about 10 percent. Savings could even be higher. Boustany said ran small medical practice and when insurance premiums going up in double digits each year, "We had very limited costs." Said small business health plans would allow for pooling.

 [Breaking now; will return in a bit.]

 Now Sen. John McCain's (R-Ariz.) talking (12:28 pm.) about Big Pharma bill and lobbyists at the White House.

Obama tries to stop but McCain keeps going.

Talks about people treated differently in states, says Americans overwhelmingly reject this proposal and want us to go back to the beginning to do what's best for all Americans. Not just people who happen to live in favored states. Says should go through 2,000+ page document and remove special interests so "geography does not dictate what kind of healthcare they receive."

Obama says "Election's over." [But Obama set tone of a campaign from the start, as did Reid and Pelosi. Those Dems love their double standard.]

 Obviously Obama does not want to start over.

"My hope would be that we can just focus on the issues of how we actually get a bill done."

McCain said, "American people care about what we did and how we did it."

Now Obama turns it over to HHS secretary Kathleen Sebelius. Cites GOP concerns about rate review, benchmark standards. Cites her experience as governor and insurance commissioner.

Sebelius says a lot of agreement insurance market fails "way too many people."

 [Must break again.]

Update on Thursday, February 25, 2010 at 1:33PM by Kay B. Day, Editor

Feb. 25, 2010 1:35 p.m.

Some thoughts on the Health Care Summit:

I agree with a pundit at CNN who said there is "honest disagreement" between members of both the Democrat Party and the GOP.

I believe that disagreement goes to the traditional difference between the Parties--the Democrat Party traditionally has turned to government for solutions, centralizing power. The Republican Party has traditionally focused on more limited centralized power.

Having watched the morning session of the Summit--admittedly with a few interruptions from my famous phone--I came to the conclusion the whole situation may end up where it started. That is to say with the Democrats having an option of either scaling back both bills significantly to create a hybrid bill and then possibly using reconciliation to pass a healthcare bill Of course Sen. Reid denied that but everyone knows the Democrats have considered it.

One rather underreported development: the Democrats finally admitted the GOP has come forth with specific legislation. The president and Dems in Congress, up until now, had denied seeing any such proposals. Yet today both the president and several Dems admitted, even praised, suggestions contained in GOP plans. That type of hypocrisy will not be lost on voters.

CNN and Fox News polled viewers about the Summit. CNN found only 25 percent favored the existing legislation; Fox found only 23 percent favored it. The remainder in each poll either wanted no reform or a start over.

I also agree with Fox News correspondent Mike Wallace's assessment of the outcome so far: "I don't see a single inch of progress today."