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Liveblogging Obama HCR Speech

President Obama has just taken the podium and is thanking various dignitaries and medical professionals for joining him today. Consider this a thread for the speech.

Notes that he began the push for health care reform last March in the same room. And now he’s bringing this journey to a close.

“Everything there is to say about health care has been said, and just about everybody has said it. So now’s the time to make a decision.” Gets some chuckles.

Reiterates that the status quo isn’t working for anyone. And that the problem will only get worse if we do nothing. “Nobody disputes that.”

Jon Cohn is in the audience.

Obama doing his “on the one hand, on the other hand” shtick. Feels the need to reject single payer for absolutely no reason. “Not practical or realistic.” Then rejects Republican approaches to loosen regulations on insurers. Positions himself in the middle.

“I believe that doctors and nurses and physician’s assistants should be free to decide what’s best for their patients.” Actually, medical professionals maximizing profits is one of the contributions to the rising costs of health care.

Talking about his proposal as “building on what works.” Says it would change three things about the current system: 1) it would end the worst practices of insurance companies (pre-existing conditions, annual limits, rate hikes, rescissions); 2) give uninsured Americans and small business owners the same choice of private health insurance than members of Congress have for themselves (note the word “private”), basically the pooling of risk through an insurance exchange, where those who can’t afford it will get “tax credits” (subsidies) to do so; 3) start spending money in health care system more wisely, lowering unnecessary costs.

Talking about “eliminating tax breaks” for insurance companies… that’s a fairly new way of that argument.

Says his proposal would bring down the cost of health care, says he’s incorporated most of the serious ideas across the political spectrum to lower costs of health care… except drug reimportation and the public option, but who’s counting?

“Approach has been debated and changed and I believe improved over the last year.” Says he’s taken the best ideas from Republicans and Democrats. He eliminated some special deals as well.

“Despite all we agree on” there’s a fundamental disagreement on how to best provide health care. Says Republicans should vote against the proposal if they don’t like it. Rejects the piecemeal approach. Notes that the Republican proposal only covers 3 million uninsured Americans. Makes the case for getting everyone in the risk pool. “Insurance reforms rest on having everybody access to coverage.” And you don’t get the savings from uncompensated care. You have to take care of all of the problems at once.

Some in the crowd say “No” when Obama says Republicans want to start over. “I don’t see how another year of negotiations would help.” And the insurance companies aren’t starting over, they’re raising premiums. We can’t wait. “No matter which approach you favor, I believe the United States Congress owes the people a final vote on health reform.”

Reform passed the House with a majority, already passed the Senate with a supermajority. It demands an up or down vote with a simple majority like Republicans did with reconciliation. Wants a vote “in the next few weeks.” And says “from now until then I will do everything in my power to make the case for reform.”

Finally asks the American people to “make their voice heard” in the process.

HCR is a difficult and complicated issue, easily lends itself to demagoguery and political gamesmanship. “But that’s not an excuse for us who were sent here to lead.”

“I will leave it to others to sift through the politics, because that’s not what this is about.” Says it’s about individuals getting health care.

Full transcript, if you’re interested.

This debate is about “what country we want to be.” Connects it to our ability to solve any problem, this was part of the excerpts released earlier. “They are waiting for us to act, they are waiting for us to lead…” Closes with “let’s get it done.”

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David Dayen

David Dayen