Obama: ‘We Are Going After The Waste, Fraud, and Abuse’
By Stephanie Woodrow | March 15, 2010 2:10 pm

During a Monday speech in Ohio, President Barack Obama vowed to go after health care fraud in government programs. The speech was Obama’s third in a week discussing the health insurance overhaul currently before Congress. Last week during a trip to  St. Charles, Mo., Obama discussed efforts to use so-called bounty hunters to retrieve money spent on improper and fraudulent payments.

In Monday’s Ohio speech, Obama said, “By now, we have incorporated most of the serious ideas from across the political spectrum about how to contain the rising cost of health care – ideas that go after the waste and abuse in our system, especially in programs like Medicare.”

The president cited Congressional Budget Office data that such efforts would decrease health insurance premiums and help reduce the deficit by up to $1 trillion over the next 20 years. “Yes, we are going after the waste, fraud, and abuse in Medicare.  But that’s because these are dollars that should be spent on care for seniors, not the care and feeding of insurance companies through subsidies and sweetheart deals,” Obama said.

The full text of the president’s speech:

Hello, Ohio!  It’s great to be here in the Buckeye State.  And it’s even better to be out of Washington for a little while.

I want to thank Connie and her family for being here on behalf of Natoma.  It’s not easy to share such a personal story.  I appreciate your willingness to do so.  I want you to know that she is the reason that I am here today.  I know that she felt it was important that her story be told.

Last month, I read a letter from Natoma.  She’s self-employed, trying to make ends meet, and has for years done the responsible thing: buying health insurance through the individual market.

The thing is, sixteen years ago, she was diagnosed with a form of treatable cancer.  And even though she had been cancer free for more than a decade, the insurance company kept jacking up her rates anyway, year after year.  So she increased her out-of-pocket expenses.  She raised her deductible.  She was doing everything she could to maintain health insurance that would be there for her in case she got sick.

But even as she upped her deductible to the maximum, last year Natoma’s insurance company raised her premiums by more than 25 percent.  Over the past year, she paid more than $6,000 in monthly premiums.  She paid more than $4,000 out-of-pocket for co-pays, medical care, and prescriptions.  So she ponied up more than $10,000 dollars.  But because she never hit her deductible, her insurer only spent $900 on her care.  And yet what comes in the mail at the end of last year?  A letter telling Natoma that her premiums would go up again by more than 40 percent.

She just could not afford it.  She didn’t have the money.  And despite her desire to keep her coverage – despite her fears that she would get sick and lose the home her parents built – she finally surrendered and gave up her health insurance.  January was her last month of being insured.  Like so many responsible Americans – folks who work hard every day, who try to do the right thing – she was forced to hang her fortunes on chance.  She hoped against hope she would stay healthy.  She feared terribly she would not.

That was the letter.  And I understand Natoma was pretty surprised when she found out that I read it – word for word – to the CEOs of America’s largest insurance companies – including the company that hiked up her rates by more than 40 percent.

This was less than two weeks ago.  But then Natoma’s worst fears were realized.  Just last week, she was working on a nearby farm, walking outside – apparently, chasing after a cow – when she collapsed.  She was rushed to the hospital.  She was very sick.  She needed two blood transfusions.  Doctors performed a battery of tests.  And on Saturday, Natoma was diagnosed with leukemia – a serious form of cancer.

The reason Natoma is not here today is that she’s lying in a hospital bed, suddenly faced with this emergency – suddenly thrust into a fight for her life.  She expects to face a month or more of aggressive chemotherapy.  And she is racked with worry not only about her illness but about the cost of the tests and treatments she will surely need to beat it.

I’m here because of Natoma.

I’m here because of countless others who have been forced to face the hardest and most terrifying challenges in their lives with the added burden of medical bills they cannot pay.

I’m here because I remember my own mother, in the last six months of her life, on the phone in her hospital room arguing with insurance companies when she should have been spending time with her family.

I’m here because of the millions denied coverage because of pre-existing conditions – or dropped from coverage when they get sick.

I’m here because of the small businesses forced to choose between health care and hiring.

I’m here because of the seniors unable to afford the prescriptions they need.

I’m here because of the folks seeing premiums going up by thirty, forty, fifty percent in a year.

I am here because this is not the America I believe in – and it’s not the America you believe in.

And so when you hear people say “start over” – I want you to think of Natoma.  When you hear people saying that this isn’t the “right time” – think of what she’s going through.  When you hear people talk about who’s up and who’s down in the polls – instead of what’s right or what’s wrong for the country – think of her and the millions of responsible people – working people – being hurt by today’s system of health insurance.  And I want you to remember: There but for the grace of God go I.

This status quo on health care is simply unsustainable.  We cannot have a system that works better for the insurance companies than it does for the American people.  We know what will happen if we fail to act.  We know our government will be plunged deeper into debt.  We know millions more people will lose coverage.  And we know that rising costs will saddle millions more families with unaffordable expenses – and will force many small businesses to drop coverage altogether.  A study just came out yesterday – a non-partisan study – which found that without reform, premiums could more than double for individuals and families over the next decade.  Family policies could pass $25,000.  Can you afford that?

We have debated health care in Washington for more than a year.  Every proposal has been put on the table.  Every argument has been made.  I know many people view this as a partisan issue, but both parties have found plenty of areas where we agree.  And what we’ve ended up with is a proposal that’s somewhere in the middle – one that incorporates the best ideas from Democrats and Republicans.

On one side of the spectrum, there were those who wanted to scrap our system of private insurance and replace it with government-run health care.  But I didn’t think that was practical or realistic.

On the other side of the spectrum, there are those who believe the answer is to simply unleash the insurance industry, by providing less oversight and fewer rules.  I call this the “putting the foxes in charge of the hen house” approach.  It would only give insurance companies more leeway to raise premiums and deny care.

I don’t believe we should give the government or the insurance companies more control over health care in America.  I believe it’s time to give you – the American people – more control over your own health insurance.

That’s why my proposal builds on the current system where most Americans get their health insurance from their employer.  If you like your plan, you can keep your plan.  If you like your doctor, you can keep your doctor.  I wouldn’t want any plan that interferes with the relationship between a family and their doctor.

Essentially, my proposal would change three things about the current health care system.  First, it would end the worst practices of insurance companies.  Within the first year of signing health care reform, thousands of uninsured Americans with pre-existing conditions will be able to purchase health insurance for the first time in their lives.  This year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.  This year, they will be banned from dropping your coverage when you get sick.  Those practices will end.

If this reform becomes law, all new insurance plans will be required to offer free preventive care to their customers starting this year – free check-ups so we can start catching preventable illnesses on the front end.  Starting this year, if you buy a new plan, there will be no more lifetime or restrictive annual limits on the amount of care you receive from your insurance companies.  And if you’re an uninsured young adult, you’ll be able to stay on your parents’ policy until you’re 26 years old.

The second thing that would change about the current system is this: for the first time, uninsured individuals and small businesses will have the same kind of choice of private health insurance that Members of Congress get for themselves.  If this reform becomes law, Members of Congress will be getting their insurance from the same place the uninsured get theirs.  Because if it’s good enough for the American people, it ought to be good enough for the people you send to Washington.

My proposal also says that if you still can’t afford the insurance in this new marketplace, we will offer you tax credits to do so – tax credits that add up to the largest middle class tax cut for health care in history.  After all, the wealthiest among us can already buy the best insurance there is, and the least well-off are able to get coverage through Medicaid.  But it’s the middle-class that gets squeezed, and that’s who we have to help.

Now, it’s true that all of this will cost money – about $100 billion per year.  But most of this comes from the nearly $2.5 trillion a year that America already spends on health care.  It’s just that right now, a lot of that money is being spent badly.  With this plan, we’re going to make sure the dollars we spend go toward making insurance more affordable and more secure.  We’re also going to eliminate wasteful taxpayer subsidies that currently go to insurance companies.  And we will set a new fee on insurance companies that stand to gain as millions of Americans are able to buy insurance.  Here’s the point: our proposal is paid for.

Finally, my proposal would bring down the cost of health care for families, businesses, and the federal government.  Americans buying comparable coverage to what they have today in the individual market would see premiums fall by 14 to 20 percent.  For Americans who get their insurance through the workplace, costs could fall by as much as $3,000 a person.

By now, we have incorporated most of the serious ideas from across the political spectrum about how to contain the rising cost of health care – ideas that go after the waste and abuse in our system, especially in programs like Medicare.  Our cost-cutting measures would reduce most people’s premiums and bring down our deficit by up to $1 trillion over the next two decades.  And those aren’t my numbers; they are the savings determined by the Congressional Budget Office, the nonpartisan, independent referee of Congress.

Now, the opponents of reform have tried a lot of different arguments to stop these changes.  But maybe the most insidious is the idea that somehow this would hurt Medicare.  And I know we’ve got some seniors with us today.  So let me just tell you directly: this proposal adds almost a decade of solvency to Medicare.  This proposal would close that gap in prescription drug coverage – called the doughnut hole – that sticks seniors with thousands of dollars in drug costs.  This proposal will over time help to reduce the costs of Medicare that you pay every month.  And this proposal would make preventive care free so you don’t have to pay out-of-pocket for tests that keep you healthy.

Yes, we are going after the waste, fraud, and abuse in Medicare.  But that’s because these are dollars that should be spent on care for seniors, not the care and feeding of insurance companies through subsidies and sweetheart deals.  Every senior should know: there is no cutting of your guaranteed Medicare benefits.  Period.  This proposal makes Medicare stronger, makes the coverage better, and makes its finances more secure.  Anyone who says otherwise is misinformed – or is trying to misinform you.

So that’s the proposal.  And I believe Congress owes the American people a final up-or-down vote.  Of course, now that we’re approaching this vote, we’re hearing a lot of people in Washington talking about the politics.  Talking about what this means for November.  Talking about the poll numbers for the Democrats and the Republicans.  But that’s why I wanted to come here today.

Because in the end, this debate is about far more than the politics.  It’s about what kind of country we want to be.  It’s about the millions of lives that would be touched and, in some cases, saved by making private health insurance more secure and more affordable.  It’s about a woman, lying in a hospital bed, who wants nothing more than to be able to pay for the care she needs.

And the truth is, what is at stake in this debate is not just our ability to solve this problem, but our ability to solve any problem.  The American people want to know if it’s still possible for Washington to look out for their interests and their future.  They are waiting for us to act.  They are waiting for us to lead.  And as long as I hold this office, I intend to provide that leadership.  I don’t know about the politics.  But I know what’s right.  So I am calling on Congress to pass these reforms – and I look forward to signing them into law.

Thank you, God bless you, and God bless the United States of America.

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