Revisiting Obama's 2009 speech on healthcare

IronWing

No Lifer
Jul 20, 2001
69,007
26,887
136
A worthy read, IMHO.

THE IMMEDIATE NEEDS

As a nation, we are doing less than now lies within our power to reduce the impact of disease. Many of our fellow Americans cannot afford to pay the costs of medical care when it is needed, and they are not protected by adequate health insurance. Too frequently the local hospitals, clinics, or nursing homes required for the prevention, diagnosis and treatment of disease either do not exist or are badly out of date. Finally, there are critical shortages of the trained personnel required to study, prevent, treat and control disease.

The specific recommendations that follow are designed to meet this three-fold deficiency.

MEETING THE COSTS OF MEDICAL CARE

For most Americans, insurance--private, voluntary insurance-provides a sound and effective method of meeting unexpected hazards which may be beyond the capacity of the individual to bear. Risk sharing through group action is in the best tradition of vigorous and imaginative American enterprise.

The Government should cooperate with, and encourage, private carriers in the improvement of health insurance. Moreover, a great many people who are not now covered can be given its protection, particularly in rural areas where group enrollment is at present difficult.

Existing health insurance can also be improved by expanding the scope of the benefits provided. Not all private expenditures for medical care can or should be covered by insurance; nevertheless, many policies offered today are too limited in scope. They are principally for hospitalized illness and for relatively short periods of time.

I recommend, consequently, the establishment of a Federal health reinsurance service to encourage private health insurance organizations in offering broader benefits to insured individuals and families and coverage to more people.

In addition, to improve medical care for the aged, the blind, dependent children, and the permanently and totally disabled who are public assistance recipients, I recommend the authorization of limited Federal grants to match State and local expenditures.

Reinsurance.--The purpose of the reinsurance proposal is to furnish a system for broad sharing among health insurance organizations of the risks of experimentation. A system of this sort will give an incentive to the improvement of existing health insurance plans. It will encourage private, voluntary health insurance organizations to provide better protection--particularly against expensive illness--for those who now are insured against some of the financial hazards of illness. Reinsurance will also help to stimulate extension of private voluntary health insurance plans to millions of additional people who do not now have, but who could afford to purchase, health insurance.

The Department of Health, Education, and Welfare has been working with specialists from the insurance industry, with experts from the health professions, and with many other interested citizens, in its effort to perfect a sound reinsurance program--a program which involves no Government subsidy and no Government competition with private insurance carriers. The time has come to put such a program to work for the American people.

I urge the Congress to launch the reinsurance service this year by authorizing a reasonable capital fund and by providing for its use as necessary to reinsure three broad areas for expansion in private voluntary health insurance:

1. health insurance plans providing protection against the high costs of severe or prolonged illness,

2. health insurance plans providing coverage for individuals and families in predominantly rural areas,

3. health insurance plans designed primarily for coverage of individuals and families of average or lower income against medical care costs in the home and physician's office as well as in the hospital.

Medical care [or public assistance recipients.--Nearly 5 million persons in the United States are now receiving public assistance under State programs aided by Federal grants. Present arrangements for their medical care, however, are far from adequate. Special provision for improving health services for these needy persons must be made.

I recommend to the Congress, therefore, that it authorize separate Federal matching of State and local expenditures for the medical care needed by public assistance recipients. The separate matching should apply to each of the four Federally-aided categories--the aged, the permanently and totally disabled, the blind and children deprived of parental care.

STIMULATING THE CONSTRUCTION OF HEALTH FACILITIES

Many communities in the United States today lack the hospitals, clinics, nursing homes, and other modern technical facilities required for the protection of the people's health. In other communities, structures are antiquated or otherwise deficient in construction or equipment.

Present methods of financing are not always satisfactory in meeting this problem. Many sponsors and operators are unable to qualify for grants under the recently extended Hospital Survey and Construction Act. Sponsors of health facilities often find it difficult to obtain private capital for construction.

In other fields, Government insured loans have consistently helped produce the new construction required in the urgent national interests. The tested procedures developed by such successful Government guaranty programs as these should now be used to stimulate construction of additional health facilities.

I recommend, therefore, that the Congress authorize the Secretary of Health, Education, and Welfare to insure, for a small premium, mortgage loans made by private lending institutions for the construction of health facilities.

The continuing responsibility of the mortgagor and of the lending institution should be preserved by limiting the insurance to less than the face amount of the loan and by requiring that a mortgage loan, to be eligible for insurance, must be for less than the full value of the property. The authorizing legislation should, of course, include any needed safeguards against the encouragement of substandard or unsound projects.

HEALTH PERSONNEL NEEDS

Whether we look at health problems in terms of services for the community or for the individual--at problems of research, prevention or treatment of disease--we find that supplies of trained personnel are critically short.

The Administration's legislative program for this year therefore contains proposals addressed to crucial areas of personnel shortages. These particular areas, moreover, hold the key to other possible advances and improvements in health programs.

Two proposals are aimed at shortages in nurse personnel: First, I recommend a 5-year program of grants to State vocational education agencies for training practical nurses. Second, I recommend an expansion of Public Health Service operations to establish traineeships for graduate nurses in specialties such as nursing service administration, teaching and research.

In addition, my recommendations for the revision of the present public health grant programs include authority for the establishment of traineeships in all public health specialties, including mental health.

PUBLIC HEALTH PROGRAMS

The Public Health Service, the Children's Bureau of the Social Security Administration, and the Food and Drug Administration are skilled and vigilant guardians of our nation's health. All three of these agencies should be strengthened, and the programs of the Public Health Service and the Children's Bureau for aiding State health activities made more responsive to changes in State and local health needs. To this end, I urge the Congress to take the following steps:

1. Improve present grant-in-aid programs providing services . for mothers, for crippled children and for children requiring special health services. Separate funds should be provided for extension and improvement of these activities and for special projects designed to develop improved medical care techniques both for mothers and for children.

2. Permit greater flexibility in the use by the States of Federal grant funds for public health services. The States could adapt their programs more effectively to their own needs if the separate Public Health Service grants were combined into a single, unified grant-in-aid structure. In addition, separate funds should be provided for extension and improvement of existing public health programs and for special projects looking to the development of improved techniques.

3. Step up research on air pollution. As a result of industrial growth and urban development, the atmosphere over some population centers may be approaching the limit of its ability to absorb air pollutants with safety to health. I am recommending an increased appropriation to the Public Health Service for studies seeking necessary scientific data and more effective methods of control.

4. Provide greater assistance to the States for water pollution control programs. As our population grows and demands for water increase, and as the use of chemicals expands, our water supply problems become more acute. Intensified research in water pollution problems is needed as well as continuing authority for the Public Health Service to deal with these matters. The present Water Pollution Control Act expires on June 30, 1956. This termination date should be removed and the Act should be strengthened.

5. Authorize the Public Health Service to establish traineeships for both graduate and specialized training in public health in order to increase the numbers of trained personnel.

6. Strengthen the Public Health Service Commissioned Corps by improving its status and its survivor benefits.

MENTAL HEALTH

Care for the mentally ill presents a special set of problems. Only in the past few decades have we, as a people, begun to regard mental and emotional disorders as capable of specific diagnosis, alleviation, cure, and rehabilitation. We now know that effective preventive and control programs are possible in the field of mental health.

I recommend, therefore, new and intensified measures in our attack on mental illness. These are:

1. Strengthening of present aid to State and community programs for the early detection, control and alleviation of mental and emotional derangements;

2. Increased budgetary support for training activities which are now authorized, so as to increase the number of qualified personnel available for care of mental patients; and

3. Authorization of a new program of mental health project grants. Such projects would aim at improving the quality of care in mental institutions and the administration of the institutions themselves. They would also search out ways of reducing the length of stay and the necessity for institutional care in as many cases as possible.



Just kidding, this was Eisenhower's address from January 31, 1955.
 

UNCjigga

Lifer
Dec 12, 2000
24,810
9,015
136
Spot on, but unfortunately since that was written, we have fewer long-term resources for mental health, fewer rural hospitals and clinics, and several states have delayed our outright refused Medicare expansion.

It is nice we're getting 988 and medical debt no longer counts against your credit score though.
 

thilanliyan

Lifer
Jun 21, 2005
11,864
2,066
126
Nothing will get done until all (but maybe 2 or 3) GOP and a whack of Dems are kicked to the curb. And until "political donations" are severely limited, nothing will get done that is primarily for the benefit of ordinary people.
 

Homerboy

Lifer
Mar 1, 2000
30,856
4,974
126
Nothing will get done until all (but maybe 2 or 3) GOP and a whack of Dems are kicked to the curb. And until "political donations" are severely limited, nothing will get done that is primarily for the benefit of ordinary people.

Yeap - and healthcare expenses are just killing this country and it's people (literally and figuratively) .
 
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GodisanAtheist

Diamond Member
Nov 16, 2006
6,783
7,115
136
The older I get the more disillusioned I get seeing how long our societal problems have been outstanding. Same fucking problems 10 years ago, 20 years ago, 40 years ago, 80 years ago...

Anytime someone tries to do something to fix it, no matter how imperfect the solution may be, there are bunch of knuckle dragging apes ready to dogpile the idea under "does too much!" and "doesn't do enough!"

IMO I'm in a place where I just want someone to do something, anything, and I'll count it as progress.
 

dank69

Lifer
Oct 6, 2009
35,296
28,497
136
The older I get the more disillusioned I get seeing how long our societal problems have been outstanding. Same fucking problems 10 years ago, 20 years ago, 40 years ago, 80 years ago...

Anytime someone tries to do something to fix it, no matter how imperfect the solution may be, there are bunch of knuckle dragging apes ready to dogpile the idea under "does too much!" and "doesn't do enough!"

IMO I'm in a place where I just want someone to do something, anything, and I'll count it as progress.
Dems needed 60 Senators to get baby step ACA passed. That means the number we need is more like 62-65 to actually fix shit. Until then, it is the American voters' fault.
 

Moonbeam

Elite Member
Nov 24, 1999
72,400
6,077
126
The older I get the more disillusioned I get seeing how long our societal problems have been outstanding. Same fucking problems 10 years ago, 20 years ago, 40 years ago, 80 years ago...

Anytime someone tries to do something to fix it, no matter how imperfect the solution may be, there are bunch of knuckle dragging apes ready to dogpile the idea under "does too much!" and "doesn't do enough!"

IMO I'm in a place where I just want someone to do something, anything, and I'll count it as progress.
See Joe Manchin.
 

PlanetJosh

Golden Member
May 6, 2013
1,815
143
106
Sounds like mostly moderates in the thread or at least some. That's good. I hope it's the moderates who some day construct a workable national health plan, not by extremist conservatives or extremist progressives. I realize some compromises will be needed. The devil's in the details as usual.
 

[DHT]Osiris

Lifer
Dec 15, 2015
14,075
12,168
146
The older I get the more disillusioned I get seeing how long our societal problems have been outstanding. Same fucking problems 10 years ago, 20 years ago, 40 years ago, 80 years ago...

Anytime someone tries to do something to fix it, no matter how imperfect the solution may be, there are bunch of knuckle dragging apes ready to dogpile the idea under "does too much!" and "doesn't do enough!"

IMO I'm in a place where I just want someone to do something, anything, and I'll count it as progress.
Planet is making pretty solid progress on shaking us off like fleas.
 
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nickqt

Diamond Member
Jan 15, 2015
7,538
7,672
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Dems needed 60 Senators to get baby step ACA passed. That means the number we need is more like 62-65 to actually fix shit. Until then, it is the American voters' fault.
Agreed, although as I've promised, I'ma drop this link of right here as it is continually relevant.

 
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MrSquished

Lifer
Jan 14, 2013
21,168
19,644
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Sounds like mostly moderates in the thread or at least some. That's good. I hope it's the moderates who some day construct a workable national health plan, not by extremist conservatives or extremist progressives. I realize some compromises will be needed. The devil's in the details as usual.
It's pretty amusing that you think ANY conservative, moderate or not, can help come up with a 'national health plan'

Thanks for the laugh. They're whole national health plan is to not have one. Ever.


Oh boy.
 

PlanetJosh

Golden Member
May 6, 2013
1,815
143
106
It's pretty amusing that you think ANY conservative, moderate or not, can help come up with a 'national health plan'

Thanks for the laugh. They're whole national health plan is to not have one. Ever.


Oh boy.
Well then left leaning moderates to help work out compromises. But there may not be enough of them or they may not have enough power. So your points probably still stand.
 

PlanetJosh

Golden Member
May 6, 2013
1,815
143
106
The ACA is covering costs fairly well for the poor who sign up for it? I think it is. But it's way too expensive for the middle class. I'm a little over 65 so with Medicare my costs went way down from the $600 per month I was paying for the Kaiser in the ACA. There weren't any much cheaper plans in ACA for the same type coverage plan when I was 64 in 2018.

But now under Medicare it's just less than $200 a month deducted from my Social Security. But the system still needs to be fixed of course as mentioned in the thread. And the posters here don't want to wait be old and shriveled 65 year old like me even though I pay much less for healthcare. I'm for a method that includes singe payer.

Interesting some doctors oppose single payer and give their fiscal reasons and whatever other reasons they have for opposing it. Sounds like their mindset is conservative redneck underneath their neat white coats. I bet they hunt animals on the weekends.
 

DaaQ

Golden Member
Dec 8, 2018
1,310
944
136
The ACA is covering costs fairly well for the poor who sign up for it? I think it is. But it's way too expensive for the middle class. I'm a little over 65 so with Medicare my costs went way down from the $600 per month I was paying for the Kaiser in the ACA. There weren't any much cheaper plans in ACA for the same type coverage plan when I was 64 in 2018.

But now under Medicare it's just less than $200 a month deducted from my Social Security. But the system still needs to be fixed of course as mentioned in the thread. And the posters here don't want to wait be old and shriveled 65 year old like me even though I pay much less for healthcare. I'm for a method that includes singe payer.

Interesting some doctors oppose single payer and give their fiscal reasons and whatever other reasons they have for opposing it. Sounds like their mindset is conservative redneck underneath their neat white coats. I bet they hunt animals on the weekends.
I pay about 350 and change for my wife and I, a month.

It's not the monthly premium that is the killer, it is the OUTRAGEOUS DEDUCTIBLES.

EDIT: And the kicker is, I can pay the cash price, which is cheaper, but it does NOT go towards the deductible, AT ALL.

2ND EDIT: Not kicker, KICK IN THE NUTS. FTFM
 

Lezunto

Golden Member
Oct 24, 2020
1,070
968
106
I pray that everyone has good health and those who don't have the means and the opportunity to given the opportunity to avail themselves of healthcare to improve their lives.

No one should be left behind or left out.
 

Amol S.

Platinum Member
Mar 14, 2015
2,390
709
136
Spot on, but unfortunately since that was written, we have fewer long-term resources for mental health, fewer rural hospitals and clinics, and several states have delayed our outright refused Medicare expansion.

It is nice we're getting 988 and medical debt no longer counts against your credit score though.
The only valid argument Republicans have against Obama when it came to his Obama Care, was that Obama lied to 2% of Americans when he said you will be able to keep your plan. Only later changes helped fix the problem.
 
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sdifox

No Lifer
Sep 30, 2005
94,952
15,089
126
The older I get the more disillusioned I get seeing how long our societal problems have been outstanding. Same fucking problems 10 years ago, 20 years ago, 40 years ago, 80 years ago...

Anytime someone tries to do something to fix it, no matter how imperfect the solution may be, there are bunch of knuckle dragging apes ready to dogpile the idea under "does too much!" and "doesn't do enough!"

IMO I'm in a place where I just want someone to do something, anything, and I'll count it as progress.


They just struck down Roe V Wade, happy now? :colbert:
 

Gardener

Senior member
Nov 22, 1999
758
540
136
Healthcare reform was undermined by the failure to pass a public option. That failure poisoned the ACA, perpetuating the control of the insurance industry.

At this point we'd be better off cloning or buying into the Canadian system.

Forty-nine republican senators will never support meaningful reform. It is impossible to maintain a functional democracy when an entire political party is dedicated to obstruction, and insanity.
 
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Amol S.

Platinum Member
Mar 14, 2015
2,390
709
136
Healthcare reform was undermined by the failure to pass a public option. That failure poisoned the ACA, perpetuating the control of the insurance industry.

At this point we'd be better off cloning or buying into the Canadian system.

Forty-nine republican senators will never support meaningful reform. It is impossible to maintain a functional democracy when an entire political party is dedicated to obstruction, and insanity.
The interesting thing to point out is that ACA is starting to be talked about less and less as time goes on, only to be brought up in debates.

Recently the talk is now only about abortion and immigration.
 
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[DHT]Osiris

Lifer
Dec 15, 2015
14,075
12,168
146
I think the US should create a free health care system.
I realized at some point recently that basically everyone in America (likely the world, but I'll stick to my own house for now) needs pretty seriously mental health care. Decades of abuse from one thing or another, generational trauma, inappropriate concepts of emotions, compete lack of self care... It's no wonder we're so f'd up as a country
 
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