Obama's Health Care News Conference

Summary
President Obama tried to sell his health care overhaul in prime time, mangling some facts in the process. He also strained to make the job sound easier to pay for than experts predict.

• Obama promised once again that a health care overhaul "will be paid for." But congressional budget experts say the bills they've seen so far would add hundreds of billions of dollars to the deficit over the next decade.
• He said the plan "that I put forward" would cover at least 97 percent of all Americans. Actually, the plan he campaigned on would cover far less than that, and only one of the bills now being considered in Congress would do that.
• He said the "average American family is paying thousands" as part of their premiums to cover uncompensated care for the uninsured, implying that expanded coverage will slash insurance costs. But the nonpartisan Kaiser Family Foundation puts the cost per family figure at $200.
• Obama claimed his budget "reduced federal spending over the next 10 years by $2.2 trillion" compared with where it was headed before. Not true. Even figures from his own budget experts don't support that. The Congressional Budget Office projects a $2.7 trillion increase, not a $2.2 trillion cut.
• The president said that the United States spends $6,000 more on average than other countries on health care. Actually, U.S. per capita spending is about $2,500 more than the next highest-spending country. Obama's figure was a White House-calculated per-family estimate.

Analysis
With the health care debate on Capitol Hill raging on, President Barack Obama held a prime-time news conference July 22 to make his pitch for a health care bill once again to the American public. Among his facts and figures, we found some false and questionable statements.

Paying For It
Obama promised that a health care overhaul "will be paid for." Thus far, that's been a tall order.

The House bill doesn't pay for itself, adding a net $239 billion over 10 years to the federal deficit, according to an analysis by the Congressional Budget Office and Joint Committee on Taxation. The Senate Health, Education, Labor and Pensions Committee bill is much further away from covering its costs. The CBO estimated that legislation would bring a net deficit increase of $597 billion over 10 years. The Senate bill, CBO said, only produced net savings of $48 billion (compared to current law), while the House came up with more money, saving $219 billion and bringing in $583 billion in federal revenue over that 2010-2019 period.

As the Committee for a Responsible Federal Budget, a bipartisan group, said in a report released this month, it's tough to save money while greatly expanding health care coverage at the same time:

CRFB: More access and broader coverage do not save money, however. Greater coverage will increase health spending. Unless major changes are successfully implemented in health care delivery and payment systems, costs will continue to rise from a larger base at a rapid pace. Moreover, potential savings are speculative, while costs are far more certain. That imbalance suggests that unless there is broad popular support for the measures that will be required to achieve savings, the nation's health care bill could become that much more unaffordable.

Obama went on to say that "the entire cost of that has to be paid for and it has got to be deficit-neutral. And we identified two-thirds of those costs to be paid for by tax dollars that are already being spent right now."

"Identified" is the key word—the White House may have pinpointed ways it says can save that much, but whether the president can make these happen is an open question. Obama has spoken before about saving around $650 billion (about two-thirds of a cost of $1 trillion over 10 years) by cutting spending, largely in Medicare. But proposed cuts in payments to insurers and hospitals are likely to draw strong opposition from lobbyists and lawmakers. And Obama admitted last night that legislators hadn't adopted his proposals: "Not all of the cost-saving measures I just mentioned were contained in Congress' draft legislation," he said—but he remained optimistic, adding that "even though we still have a few issues to work out, what's remarkable at this point is not how far we have left to go, it's how far we've already come."

Obama detailed a few of his Medicare savings proposals last night and went into greater detail in a speech June 15 at the American Medical Association conference. Some of the ideas are backed up by independent studies, at least in theory: Obama proposes introducing a competitive bidding process for Medicare Advantage, a program through which private insurers offer Medicare coverage and get higher payments from the government than standard Medicare reimbursements. Last night, he said it would save "over $100 billion of unwarranted subsidies that go to insurance companies"; he's said before that it would save $177 billion over 10 years. And the CBO has estimated such a proposal could save nearly that much, $159 billion over 10 years.

Other proposals are more vague: Obama has called for adjusting Medicare payments to "reflect new advances and productivity gains in our economy," which, he told the AMA, would "create incentives for providers to deliver care more efficiently," saving about $109 billion over 10 years.

As CBS News anchor Katie Couric recently asked Obama, "[A]ren't a lot of these cost savings, Mr. President, theoretical?. … [T]here are no guarantees these projected savings will really happen."