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I actually found a pretty good segment on TV: Kathleen Sebelius, the Secretary of Health and Human Services was excellent today on CNN's State of the Union. She spoke clearly and effectively of the importance that there be a public option available for health care to all Americans. No Luntz talking points, just straight talk about how the public option will benefit Americans.

SEBELIUS: Well, I think that competition is a good thing, that most Americans understand that choice and competition is what we want. So, if you look at a health exchange, a marketplace, where people can have some options -- in many parts of the country, private insurers have no competitor, in -- in a state like my own home state of Kansas. There is a dominant insurance company in a lot of the states.

So, we created a public option for state employees, so they could choose side by side benefits and prices. Competition is good. You can write the rules for a level playing field.

The president does not want to dismantle privately-owned plans. He doesn't want the 180 million people who have employer coverage to lose that coverage. He wants to strengthen the marketplace.

But, you know, I -- I don't think it's a big surprise that a lot of insurers say, you know, what we would really like is, everybody who doesn't have insurance to be told they must buy it, and buy it only from us.

The president feels that having a public option side by side, same playing field, same rules, will give Americans choice and will help lower costs for everybody. And that's a good thing

.
Wow, who would have thought that Insurance companies would be against a public option. She beat back the "trigger" that many HICers want to try and put in place. She said that we can't afford to wait for some trigger to go off. The time is now to attack this problem.

KING: ...So, how about a trigger? How about you enact reforms that give the private insurance industry, maybe it's three years; maybe it's five years, and if, by then, they haven't lowered costs, they haven't brought the uninsured into the thing, then the government option would trigger and kick in then"? What's wrong with that?

SEBELIUS: Well, there are a lot of, now, specific ideas being discussed on Capitol Hill. And, certainly, the trigger is one of them.

But what Massachusetts found when they moved to insuring all citizens of the commonwealth is that, unless you address costs from the very first day, unless you have a system where cost control and cost lowering is one of the goals, you don't do so well. You -- you can bring everybody into the system, but the costs may rise.

So, I think having a public option from the outset, having the design, being competitive, and making sure there is some choice, making sure that consumers have a choice of plan, and, for the first time ever in the United States, making sure that insurers don't decide who gets covered -- if you got a preexisting condition, we want you in the marketplace, we want you and your family to be covered, and we want you to be able to go to a doctor of your choice and have preventive care and wellness care. That's part of reforming the system.

Goodbye to the "trigger effect." It won't work and it gives the health care industry a license to fleece us. And I loved what she said here.

SEBELIUS: Actually, the comparative effectiveness research says, as part of the rules, that Medicare cannot use the research for payment decision. It prohibits, you know, the kind of rationing that people talk about.

What we're doing right now is rationing quality, not cost. Higher cost does not translate to higher quality. We want better health outcomes for every patient. If you come through the doors of a hospital, if you see your doctor, you should be getting the best possible information, the best possible strategies.

And that's happening some places. It's not happening every place. And we think that part of reforming the system is that every American should getting the best bang for their buck. And they're not doing it right now.

She's breaking past the idea that since we're paying more for health care then that means the quality is better.

CNN full transcript:

PRESIDENT BARACK OBAMA: Let there be no doubt, health care reform cannot wait, it must not wait, and it will not wait another year.

(CHEERING AND APPLAUSE) (END VIDEO CLIP)

KING: Many people will say, we have been down this road. And some, Secretary Sebelius, make the argument that President Clinton made the very same argument: Our businesses cannot survive. Our economy cannot survive. We must have health insurance.

And, yet, after the Clinton plan was derailed, we had the biggest period of growth in this country in the last 25 years. The unemployment rate was low. The government actually ran a surplus at the end of the Clinton administration, without health care reform.

So, there are many out there who will say this is, you know, boy crying wolf. SEBELIUS: Well, I think that the situation has changed. The good news, is a lot of the people who opposed, not only the plan that Harry Truman put forward -- and he did relentlessly during his administration -- and what Bill Clinton put on the table, they were back as opponents, they're now they're at the table.

Doctors understand the current system doesn't work. They're spending way too much time on paperwork and overhead, and not enough time with patients. Hospitals can't sustain it. The Medicare system is going to be broke down the road in the not-too-distant future, a system that millions of seniors rely upon.

Insurance companies are saying they are willing to change, they're willing to talk about this. That's a very different dynamic than even in the Clinton era, when those same folks were pushed away, saying the status quo is acceptable.

Everybody recognizes the status quo is the enemy. It's unacceptable, unsustainable. We can't continue down this path.

KING: Let's look at some of the policy options. You mentioned doctors.

The president tomorrow will speak to the American Medical Association. Doctors are skeptical about this public option. And let's look at -- we will show our viewers what our means. It's a government-owned health insurance plan, similar to Medicare and Medicaid. And it essentially would increase competition. And the goal is to lower prices by having competition with private insurers.

Those who argue against it say the subsidies from the government would be unfair competition, hurt private insurers, and perhaps drain the federal treasury, because, once you have a government option in place, you need to pay for it.

How will the president make the case to the skeptics, even in his own party, that this is too much government?

SEBELIUS: Well, I think that competition is a good thing, that most Americans understand that choice and competition is what we want. So, if you look at a health exchange, a marketplace, where people can have some options -- in many parts of the country, private insurers have no competitor, in -- in a state like my own home state of Kansas. There is a dominant insurance company in a lot of the states.

So, we created a public option for state employees, so they could choose side by side benefits and prices. Competition is good. You can write the rules for a level playing field.

The president does not want to dismantle privately-owned plans. He doesn't want the 180 million people who have employer coverage to lose that coverage. He wants to strengthen the marketplace.

But, you know, I -- I don't think it's a big surprise that a lot of insurers say, you know, what we would really like is, everybody who doesn't have insurance to be told they must buy it, and buy it only from us.

The president feels that having a public option side by side, same playing field, same rules, will give Americans choice and will help lower costs for everybody. And that's a good thing.

KING: And how do you answer those who would say: "We're not sure. We're not sure. Maybe we will be in that position of a public option, but we're not sure. So, how about a trigger? How about you enact reforms that give the private insurance industry, maybe it's three years; maybe it's five years, and if, by then, they haven't lowered costs, they haven't brought the uninsured into the thing, then the government option would trigger and kick in then"?

What's wrong with that?

SEBELIUS: Well, there are a lot of, now, specific ideas being discussed on Capitol Hill. And, certainly, the trigger is one of them.

But what Massachusetts found when they moved to insuring all citizens of the commonwealth is that, unless you address costs from the very first day, unless you have a system where cost control and cost lowering is one of the goals, you don't do so well. You -- you can bring everybody into the system, but the costs may rise.

So, I think having a public option from the outset, having the design, being competitive, and making sure there is some choice, making sure that consumers have a choice of plan, and, for the first time ever in the United States, making sure that insurers don't decide who gets covered -- if you got a preexisting condition, we want you in the marketplace, we want you and your family to be covered, and we want you to be able to go to a doctor of your choice and have preventive care and wellness care.

That's part of reforming the system.

KING: Another option put forward by those, including in your party -- Senator Kent Conrad, the chairman of the Budget Committee, will be with us later.

He says he's a little skeptical of having a national government- run plan. How about do something like they do in rural areas with electric co-ops? And, so, have a co-op plan. They're privately owned, nonprofit health insurance cooperatives. And he says that would get you your goal. You would increase competition and lower prices.

The argument against it is, it's hard to scope out how much that would cost the taxpayers. But is that worth trying as an alternative, if you have so many centrist Democrats and maybe even some Republicans who would join you if you did that way, not a government option?

SEBELIUS: Well, again, I think that having these ideas on the table is exactly where we need to be right now. The Senate is actively engaged in looking at strategies. There is no one-size-fits-all idea. The president has said: These are the kinds of goals I'm after, lowering costs, covering all Americans, higher-quality care. And around those goals, there are lots of ways to get there. So, we're going to look at idea by idea. I -- I think the good news is, the Senate and House are rolling up their sleeves. They're ready to go to work, and they're ready to work with the president to get this done this year.

KING: Another -- I'm going to use a term that might cause some eye-glaze-over at home, but it could become very important in this debate.

And it's comparative effectiveness research. And this is where you collect and compare data on everything that is done out in the health care. And you want to see essentially what therapies, what tests, what surgeries have a high effective rate and -- and what don't.

SEBELIUS: Right.

KING: The argument for is, you improve the quality of care and you eliminate unnecessary tests, unnecessary procedures, which saves money. The argument against is that, well, that will be used for rationing of some kind.

Will that be used in an Obama administration plan? And is there someone out there who might not get an MRI, might not get a CAT scan, might not get a certain test or a certain procedure because it only works in 50 percent of cases or it only works in 20 percent of cases, and, so, they will be told, no, sorry?

SEBELIUS: Well, John, I think the great news is, is there is fabulous medical care being delivered at lower costs all across America.

I was just in Omaha, Nebraska, and went to Lakeside Hospital, where it's a fully digital hospital. And the doctors have come up with protocol to deal with everything from heart attacks to trauma care.

And they are trying to drive quality, so that every patient who comes through the doors of Lakeside gets the same high-quality care. And they find, not only is it very effective in reducing costs, but it's very effective in terms of outcome. That's what we want to have happen across the country.

So, comparative effectiveness research says, you know, does paying twice as much in McAllen, Texas, as some other part of the country deliver better care? And the answer is no. What are the strategies that work?

Every patient, if you could choose not to be operated on, and have a -- you know, a medication that works just as well, I think, would opt for that. If three tests don't produce a better result than one test produces, I would rather have the one test, thank you very much. So, we want to empower doctors and empower consumers to know what works, how often it works, what is the most effective, and try to help with that care.

KING: You say empower doctors. But if you -- once you have that data, you will be telling doctors, won't you, especially if you have a government-run plan that is setting the tone of the marketplace and the rules of the marketplace? You will be telling them what's in and what's out, won't you?

SEBELIUS: Actually, the comparative effectiveness research says, as part of the rules, that Medicare cannot use the research for payment decision. It prohibits, you know, the kind of rationing that people talk about.

What we're doing right now is rationing quality, not cost. Higher cost does not translate to higher quality. We want better health outcomes for every patient. If you come through the doors of a hospital, if you see your doctor, you should be getting the best possible information, the best possible strategies.

And that's happening some places. It's not happening every place. And we think that part of reforming the system is that every American should getting the best bang for their buck. And they're not doing it right now.



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31 comments

in this interview.

Ms. Sebelius is 100% on target with her comments. She is calm, knowledgeable, bright, sincere and with every excellent answer John King kept coming back with a negative comment: "But would you believe THIS different way (private)? Would you believe THIS kind of way (profits)? Well, would you believe it if I mentioned x,y and z plan (a different code for keeping profits)???"

It sure seems to me that somebody handed him his talking points before this interview...somebody like...would you believe, the CEO of Blue Cross/Blue Shield??

The public option is not single payer. It is a ruse.

Remove the profit motive from health insurance, period.

It would be refreshing to hear exactly what kind of health "insurance" one would be getting with the so-called "public option". How much would the premiums be? How would they be calculated? What would be covered? What hospitals/doctors would you be able to choose?

Somebody from the Obama Administration needs to spell out exactly what the "Public Option" would be.

BTW, I recall seeing here on C&L a few days ago a comment by Sen. Baucus?? that a study was done at a "think tank" and that he felt the problem was that too many with private insurance said they would opt out and go for the public plan!!

We need some solid information here!

They are just throwing things out to see what sticks, which is understandable if you realize the only thing that is definite is that SINGLE-PAYER IS OUT! The republicans are stalling in case they get back in power and kill the whole thing.

As reluctant as I am to watch the corporatocracy's shills spewing disinformation to keep the citizenry confused and self-doubting on Sunday morning, I did catch the interview with this lady and it was a pleasure to listen to an intelligent, articulate argument re health care. However, Ms. Sebelius is just another "care-us interuptus" advocate who, for some reason, can't understand, given the evidence that is publicly available, that universal health care is both the ethically right program to implement and cheaper overall than private health care. Here in Canada, that debate is over even though our version of mean-spirited, bloated, old white men have been trying for 3 decades to put a two-tiered (read "for profit") version in place. The Canadian teeming unwashed have to date resisted.

Oh, and by the way . . . . Fuck you, Dick Cheney.

REMOVE THE PROFIT!!! Nobody should profit from a person's illness. No doctor should be movitivated to order a test or perform a surgery to earn more money. No drug company should be able to profit from drug sales other than to fund more research.

Another thing driving up costs is law suits. Doctors have to practice defensive medicine. They are so afraid of being sued they order more tests than necessary just to cover their butts.

Then there are also the professional patients - the worried well who over-use the system. There are so many problems with our inefficient healthcare system.

And one more thing - It's not right or fair that one person pays $20 for something that somebody else has to pay $200 for and somebody else gets for free. I wish it were all based on income. There should always be a copay to discourage the over-users. And I'm not talking about actual ill people in terms of the over-users.

My husband and I have pre-existing conditions. The state - high risk pool is more expensive than the spousal premium through work. Still a whopping $400/month.

The insurance companies should be sued for not allowing people the health care they need. The malpractice/law suit issue is a red herring. The insurance companies want tort reform so the only people who get even with them now, lawyers, can't do it any longer. Tort reform. The next big project for the insurance industry. After this one, of course.

Here is a list of elected people taking payoffs to cheat the American people and the amounts of bribes being taken. This is just from health care and insurance.
It is mind boggling to think how much these people are taking from others!
Arlen Specter (R-D- PA- $4,026,933)
Max Baucus (DLC- MT- $2,833,731)
Mitch McConnell (R-KY- $2,758,468)

And when you just go right to Big Insurance, the non-presidential candidates who got the biggest legalized bribes were the 7 senators who have been tasked with the job of killing single-payer:

Ben Nelson (DLC-NE- $1,196,799)
Max Baucus (DLC- MT- $1,184,113)
Joe Lieberman (DLC- CT- $1,036,302)
Arlen Specter (R-D- PA- $1,035,530)
Chuck Schumer (D-NY- $981,400)
Mitch McConnell (R-KY- $929,207)
Chuck Grassley (R-IA- $884,724)

We need to investigate and prosecute these criminals now. Severe jail terms are in order for these criminals!

There oughta be a law....

Too bad it's the shysters making them.

of were you get these figures. Also how do they get these contributions, they are vey well hidden.

Not sure what source "project" pulled those money figures from, but a good site for that type of information is
opensecrets.org

Approximately 99% of those taking bribes in the Congress are lawyers. Being lawyers, they decided to not call them bribes -- instead they are freedom of speech contributions. Hey, who can be against freedom of speech. Simply, there is only one answer to our health disaster. Single payer. But, we aren't going to get that. We will get screwed as always. Welcome to insurance/HMO/big pharma slavery, past, present, and future.

!

it should not be long before the shysters working for
the health insurance companies and the pharm corps will
be saying it's the medical test that are responsible for
all the high cost and that ALL tests for patients should
be eliminated. meanwhile, these same bastards have used
the "get a second opinion" to not pay or refuse needed
medical care.

I'd easily vote for Kathleen Sebelius!!!!!!!!
Take that, Right wing scum.

8 years? Obama may have earned my vote in the last election, but supporters of Obama must continue to pressure him and his administration to push for the platform he ran on.

remember that he's dealing with a politically unsophisticated citizenry. They'll flow whichever way the Tv tells them to. It's going to take great skill to finesse the change that is needed in the US@a. If we don't reform the election process we're all Fucked. This country is run by the rich and for the rich. It took a long time for them to pull it off and they're not going to go quietly. I think a great way ,to teach the electorate how much power they wield is to have everyone cancel their cable TV subscriptions on the same day (fourth of July?) and watch the mad scramble that ensues until they lower their rates. After that a national strike until we get universal health care. Ah, well......

Elections should only be funded by the few dollars people can donate on their tax returns.

what's going on in Iran is putting this nations citizens to shame. This is what should have happened in 2000.

think they have the same pharmaceutical leakage in the drinking water we have?

If we had a choice between the over-priced, under-served health plan our employers offer and a universal health plan. The great sucking sound would be the employers dropping insurance companies. Since the realization of the global economy employers cannot compete while straddled with the health care of their employees. Why can't we have the same choices as our congressmen and senators? Why cannot they share? If the President does not get this done during this term of office it may take decades for it to come to the front again.

in the next election. This is critical.

Maybe it is just "over my head", but I don't hear what she's saying as being helpful for what this country needs. We DON'T need to be stalling on single payer health care.

Nice that she wants to talk about all these things. Nice that she wants to have them all on the table. Nice, nice, nice...but doesn't really get us down the road to where this country is really RETARDED!!

I WANT SINGLE PAYER HEALTH CARE. I WANT a government run program. I DON'T want subsidized "private health insurance". THE INSURANCE COMPANIES ARE CROOKS, and I'm tired of taking it in the ass!! We've done that...been there...and you can see how well it works. 46-50 million with NO HEALTH CARE, cause they simply can't afford the terrifically high premiums or they can't get coverage for "pre-existing conditions", etc. So they neglect or can't get preventitive care, and then they either die early or go bankrupt paying for what could have been a minor procedure earlier.

WE ARE THE LAST of the major world powers to cover our citizens. HOW LONG must we be raped by insurance companies? They make BILLIONS off our suffering every year.

I'm sorry...but I'm getting only more frustrated and pissed off listening to this woman and listening to ALL of these talking heads. They sound like they are playing a f*cking game of "gotcha"!!

Get Senator Bernie Sanders, Howard Dean, President Obama, Hillary Clinton, Representative Kucinich....the voices that can cut this bull crap and deliver the straight, unadulterated bull shit.

GOD...I'm one frustrated American!! Pay me now, or pay me later after the insurance company has vacuumed out my savings. BULL SHIT!!

P.S. You'd think this dumb shit would know that President Clinton had NO CHANCE with the newt and his gang of trickle down, f*ck taxes for the wealthy REPUKES in Congress!! That, and the lobbyist crooks polluting the airwaves. IDIOT!!

This whole issue is monopoly capitalism in action.

The ultimate goal of corporations, including health care corps, is to DRIVE OUT competition, not embrace it.

The healthcare lobby claims a "public option" would constitute "unfair competition." This is total, 100% unadulterated horseshit.

Most right-wingers claim that the government screws up everything it touches and is incompetent. OK, well, if that's true, private health insurance companies don't have anything to worry about, do they? "Government run" health care would be so bad that no one will sign up for it.

On the other hand, if it turns out to be popular and it actually works, insurance companies will no longer be able to treat clients like garbage whenever they get sick. People will have a public option to resort to if they're not happy with their insurance.

But they are there to feed.

I'm sorry, John, but you keep overstating the positive. You completely misunderstood Senator Snowe's comments the other day, miraculously turning her support for a trigger into support for a strong public plan.

In this case, I listened to Sebelius and found no reason for your optimism about her comments. She's arguing the Obama line -- which is an absolute mess. It's taking a totally dysfunction system that can't work and smearing some make-up on it and pretending that we'll have a responsive, comprehensive system. Nonsense.

I don't see any way an adequate public option is going to survive. Based on the comments of Obama, Sebelius, Conrad, Nelson, et al., any public plan is going to be so saddled with conditions that it will almost certainly fail.

Every few years, as the situation deteriorates further, people start arguing that the system is finally so broken and Americans are so fed up that now is the time to reform the system. But our system doesn't need to be reformed -- it needs to be razed and rebuilt from the foundation up. We need to eliminate private, for-profit insurers. We need to have everyone in the system regardless of their age, income, or health status. And affordable has to mean affordable. That means if someone has no income, they pay no premiums, no copays, and no deductibles. Somehow, the US is the only developed country that can't figure out a way to do that.

John King -- who sounds like he's being fed his questions in a direct feed from Karl Rove -- shows just why we keep failing. If one person feels that he or she might be denied coverage or have to wait for service, then we can't change the status quo. All insurance is based on numbers. Right now we are rationing care to tens of millions of Americans. I wouldn't be surprised if the true number approaches (or even greatly exceeds)100 million, if you count everyone who is uninsured or underinsured. One problem is that there are no reliable, honest statistics anymore. Presidents (of both parties) have redefined all manner of statistics to serve their own narrow political interests. The only use most statistics have now is as comparative measures that relate today to an earlier time -- but only if the definitions haven't been changed in the meanwhile.

Sebelius' blanket approval of competition is just more mindless capitalist boilerplate. Surely, competition can be good, but it depends on the rules. If we get a public plan that has to be run the same way private insurers are, then the competition will be meaningless.

John, I think you really need to look at the health care debate with a great deal more skepticism than you've shown to date.

Just ask the retirees at General Motors and Chrysler what happened when the new Medicare D pharmacy plan kicked in - both companies ended their plans for retirees.

I can bet most companies with sizable populations would drop their plans if a govt version was available.

This is a good thing and not something the private insurance business wants.

is what the Insurance Companies want.

This is what I want:

I want health care instead of bloated military budgets.
I want health care instead of NO-BID federal contracts.
I want health care instead of bridges to nowhere.
I want helath care instead of four-dollar-gasoline.
I want helath care instead of billion-dollar payments to dictators.
I want health care instead of bail-outs for failing banks.

Every OTHER civilized country on earth GETS THIS better than the US. It's time to nationalize health care.

KING: "President Clinton made the very same argument... And, yet, after the Clinton plan was derailed, we had the biggest period of growth in this country in the last 25 years. The unemployment rate was low. The government actually ran a surplus ... without health care reform."

And MILLIONS STILL WENT WITHOUT HEALTHCARE, John!!!

Just because the economy gets better doesn't mean the healthcare gets better. In fact, more people lost their healthcare, WHILE WALL STREET WAS SETTING RECORD PROFITS.

And the economy STILL CRASHED. Stuff the economy. I'd rather have my health.

KING: "You say empower doctors. But... you will be telling doctors, won't you, especially if you have a government-run plan...what's in and what's out, won't you?"

SO WHAT? The government also sets the price of stamps, but sending a letter is affordable for everyone, not just those who can afford FedEx.

I'd prefer the government dictate the marketplace than the greedy profit-driven insurance companies.

Notice how he doesn't even bother exploring the possible positive outcomes of a non-profit-driven healthcare system. He just wants to piss all over it. Imagine if it were King instead of Walter Conkrite questioning the Kennedy administration on the space program:

"You can't possibly believe you can put a man on the moon, can you?"

"Do you really want the GOVERNMENT involved in making decisions about ASTRONAUTS' LIVES?"

"Don't you think the AEROSPACE ECONOMY will suffer from LACK OF COMPETITION?"

The USSR would have been the sole world power, with today's media.

ANYBODY in the media asking a Bush official, "But if we go into Iraq, won't we be spreading our military too thin and risk losing the mission in Afghanistan?"

Crickets.

I'm tired of the corporate media.

Uninformed. Uninformative. And worst of all, MISinformative.

The media is a joke, and definitely being controlled by the insurance industry and the rich.

We can't possibly get a break with the absolute traitorous reporting being done on almost every issue, but especially now with a democrat in control across the political board. These people are paid to portray progressive issues in a negative light, as progressive issues help the poor and middle class, and the rich doesn't like that at all.

Whatever happens and whatever form of healthcare reform we end up with will be constructed in such a way as to accomplish two things. One, give as little help as possible to the poor and middle class, and two, frame the whole thing in such a way as to cast a negative light on democrats.

Obama's actions since his election are beginning to show us that he too is being controlled, and given the hope we all had for him being different, this is perhaps to me the cruelest blow.

The United States is number one in spending money for healthcare and 37th in life expectancy, behind Costa Rica and Columbia. What is wrong with this picture? Oh ya, that's right, it's republiKKKons who seem to think this is okay. I doubt we rank first in anything to do with healthcare except paying the most for the least.

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