President Obama Wednesday night began to lay out details of a health care proposal he said incorporates ideas from Democrats and Republicans and planned to warn opponents against opposing his plan purely for political gain.
In an offering to Republicans concerned about the issue, Mr. Obama announced a new pilot program that would be created by administrative action to curb medical malpractice lawsuits that have been making it more difficult for doctors to practice.
The initiative would “create alternatives” to lawsuits and is similar to programs done in Maine and Indiana.
“I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine,” Mr. Obama was to say, according to the White House. “I know that the Bush administration considered authorizing demonstration projects in individual states to test these issues. Its a good idea, and I am directing my Secretary of Health and Human Services to move forward on this initiative today.”
Senior administration officials, speaking on a condition of anonymity Wednesday afternoon to freely discuss the upcoming speech, said the medical malpractice idea indicated “movement” on Mr. Obama’s part, but was not going to be used as a bargaining chip for the overall health care plan.
“Let’s see how this works and if it works well, then we’re going to have a much greater opportunity to get this passed through the Congress,” the official said, adding if it were part of the bill, it “could become an impediment to finally getting done what we need to get done.”
Mr. Obama also planned to single out Sen. John McCain, his Republican opponent in the 2008 presidential race, for an idea the Arizona senator pushed on the campaign trail last year.
Embracing the creation of a high-risk pool to help people with pre-existing conditions be able to afford catastrophic expenses, Mr. Obama would credit it as Mr. McCain’s “good idea.”
That pool would work until the insurance exchange goes online in 2013.
The officials said Mr. Obama still opposes Mr. McCain’s other campaign proposal — taxing employer- based health benefits, even though Senate Finance Committee Chairman Max Baucus has said he’d consider the idea.
According to excerpts provided in advance by the White House, Mr. Obama was to say while some good progress has been made among lawmakers as the plan moves through five separate committees on Capitol Hill, but that there there also has been “the same partisan spectacle that only hardens the disdain many Americans have toward their own government.”
“The time for bickering is over. The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do,” according to the advance text of Mr. Obama’s much-anticipated remarks. “Now is the time to deliver on health care.”
Aides stressed the address would lay out in clear terms what Mr. Obama wants to see in a bill and offer a stark definition of what he sees as the “breaking point” in health care as millions of middle-class Americans are struggling.
“I will not waste time with those who have made the calculation that its better politics to kill this plan than improve it,” according to Mr. Obama’s text.
Mr. Obama promises anyone who mischaracterizes his plan will hear from him: “We will call you out.”
As Mr. Obama began speaking, the White House posted what it described as a “concise, printable version” of the plan.
The PDF file was one page, and was headlined with “The Obama plan: Stability and security for all Americans.”
Earlier Wednesday, a senior administration official alluded to the problems President Clinton had in 1993 when his White House presented Congress with a more than 1,300-page bill to consider.
“We could stand up there and read a 1,300 page bill but I don’t think that’s what the American people are looking for … [they] aren’t asking about subsection 13b of a bill. They want to know how is this going to work and how is it going to affect them,” the official said.
“I know there is an obsession with the Clinton experience. You can learn things from the past but every time is different,” the official said.
As the president said “significant” details of the plan must still be ironed out, laughter erupted in the chamber. As he detailed some of the myths about the health care plan he said “some politicians” had been pushing, the chamber grew rowdy. Mr. Obama insisted the plan does not cover illegal immigrants and someone from the Republican side of the chamber shouted, “It’s a lie!”
The president planned to lay out his three goals for health care, which most Americans have heard in the dozens of speeches he’s given on the topic this summer.
The goals are providing “more security and stability” for the insured; coverage for the uninsured; and keeping costs down generally.
Mr. Obama will say he’s determined to be the president who achieves universal health care, after failed efforts by past chief executives.
“I am not the first president to take up this cause, but I am determined to be the last,” according to Mr. Obama’s advance text.
The president also will highlight the medical and insurance difficulties of people he’s met at town hall meetings and those who have sent letters to the White House. Some of them will join first lady Michelle Obama in the House gallery. Also to be seated with Mrs. Obama will be Sen. Edward Kennedy’s widow, Vicki.
Mr. Obama will outline Republican ideas that have been incorporated into the plan and stress that Americans who like their coverage will not be required to change it — a contention critics have sharply challenged.
He said he aims to “make the insurance you have work better for you” since it makes it illegal for insurers to deny coverage due to pre-existing conditions and can be portable if Americans lose their jobs or move to another job.
It also would put a limit on out-of-pocket expenses and cover routine care and preventive care such as mammograms and colonoscopies.
The president will outline the creation of a new insurance exchange where small businesses and those without insurance can get health insurance, a plan similar to what Congress enjoys.
Aides said much of the focus while lawmakers were on summer break was on the “trees, and not the forest.”
“Tonight’s the night when he can describe the forest in terms that people can understand and bring some clarity to this process,” a senior administration official said. “We felt we would let the Congress do its work and then bring those strands together.”
The official said the White House is pleased with the president’s strategy he started in May to outline his broad principles for a bill and “encourage the Congress to do its work.”
“It’s been, in our view, an effective strategy because it’s flushed out a lot of ideas that speak to our overarching goals. They are now on the table,” the official said on a condition of anonymity to allow for a free discussion about the upcoming address Mr. Obama was still laboring over just hours before the joint congressional session.
But Mr. Obama himself conceded in an interview on “Good Morning America” on Wednesday morning that his strategy of leaving the specifics for lawmakers to work out had not always proved effective.
“I, out of an effort to let Congress do their thing and not step on their toes, probably left too much ambiguity out there, which allowed opponents of reform to come in and fill up the airwaves with a lot of nonsense,” Mr. Obama said.
On the most intensely debated issue — the creation of a taxpayer-funded “public” insurance option — the official said Mr. Obama still believes the public option is “the best way to bring choice and competition to this insurance exchange for the unemployed and for small businesses.”
But Mr. Obama also will stress that the public option is a small piece of the overall plan since it would help “tens of millions” of people, while the overall reform package will aid “hundreds of millions of Americans.”
For Mr. Obama, the public option is a “means to an end, it’s not an end in and of itself,” according to the aide.
The administration official noted that despite the furor that erupted during town halls across the country during the August congressional recess, polls haven’t shown support for health care reform dropping recently. The official said the downward trend happened during June and July.
The official said Mr. Obama deserves credit because Republicans are acknowledging there is a health care crisis and that the debate has made clear that if something doesn’t get done, “it would be a political failure, not just for the president but for the Congress.”
During the address to a joint session of the House and Senate, Mr. Obama hopes “to bring some clarity to the debate,” the official said, adding the president will “be clear about what he favors, what the parameters are.”
“He’s proposing a plan that will bring security and stability to people who have health insurance in the form of health insurance reforms that have been long overdue and will help those who don’t have insurance get coverage at a price they can afford,” while bringing costs down, the official said.
The official said Mr. Obama will detail how he thinks that should be approached — the new insurance exchange, tax credits for those who still can’t afford insurance premiums, and “a variety of measures to reduce costs.”
• Christina Bellantoni can be reached at 125725@example.com.
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