President Obama's Ohio town hall: Liveblog

By GottaLaff

Already I can see a higher energy than last night. The punditiots can now stop saying he is too low key. Maybe he just responds better to a crowd of people who don't couch their questions with Republican talking points.

He started right out with the word "change"... and job loss, collapsed financial system. He just said the Depression word.

Immediate danger has passed, but people are questioning his policies.

Passed a 2 year Recovery Act with an immediate tax cut for 95%. Extended unemployment, health coverage for those who lost jobs, emergency assistance.... Kept banking system from collapsing, helped homeowners...

Now is the second phase: Repairs, clean energy... projects. Staving off a deeper disaster. But, for the unemployed, recovery can't come soon enough. I read your letters. You are the focus of my attention.

It took us years to get into this mess, it'll take more than a few months to dig out. I will promise you this: WE WILL GET THERE.

He's listing his goals, his plans... education, rebuilding, etc. Pursuing health insurance reform, so everyone has access.

HEALTH CARE: Reform isn't just about the 46 million w/o insurance. With all the charges and criticisms, Americans may wonder what's in it for me? If you have health insurance, you'll have more security. It will KEEP THE GOVT. OUT OF HEALTH CARE DECISIONS, we will not be forcing govt. run health care, and keep the INSURANCE COMPANIES OUT OF YOUR DECISIONS TOO. You won't have to worry about pre-existing conditions. Or losing coverage if you lose your job. EVERYONE will have access to affordable plans via a marketplace.

If you run a small business, you'll also be able to choose a plan from this exchange as well.

If you're a taxpayer concerned about deficits, I am too. In the past 8 years, there were 2 large tax cuts for wealthy, funded two wars, and more WITHOUT PAYING FOR THEM. National debt doubled. We had to add to deficit in short term to deal with financial crisis.

I have to say, folks have a lot of nerve WHO GOT US INTO THIS FISCAL HOLE, TALKING ABOUT "FISCAL RESPONSIBILITY." I'm always a little surprised that people don't have a little shame, creating this mess....

The truth is, I am now president and I am responsible, and together we have to restore a sense of responsibility in Washington. Cut out what we don't need to pay for what we do.

I pledge not to sign reform if it adds one dime of deficit in next decade, and I mean what I say.

About 2/3 of health care reform by taking $ not spent wisely moved to things that will keep you healthy.

I still insist that health care reform not be paid for by middle class families.

Short term, plan must slow growth of health care costs by improving care in the long run.

Better care = lower expenses. Preventive care, mammograms, physicals end up lowering costs. Saves money, improves care.

Proposals change incentives, doctors can give best care, not just expensive care.

Eliminate waste in Medicare. Quality of care for srs. improved, AARP approves our methods as well.

Lowering costs is essential for families/businesses.

We spend one in six dollars on health care in America.

Our reform has forged an unprecedented consensus.

Quoting R "go for the kill" and "breaking me" lines. It's the American people who are being broken by declining coverage, high costs.

Happening too soon? If there's not a deadline in Wash. nothing happens. We may not be able to get bill out of Senate by end of August? That's ok, I just want them to keep working. I want the bill to be reconciled between House and Senate and DONE BY THE FALL, by the end of this year.

Too soon? That's odd. We've been talking about this since Truman. Too soon for families who see cost rise, coverage drop? Too soon? Maybe for some in Wash. but not America.

Others say this is too hard, why take it on? Americans don't shirk from a challenge! Mentions going to the moon, Kennedy.

Questions: None are preprogrammed.

Q: Plan has health care industry funding reform. Concerned. I own a Medicare certified home care agency. Budget has drastic cuts to reimbursement.

A: I don't think so. Homecare industry has endorsed reform effort.

Q: Okay, but budget has cuts for years that amounts to 13 billion?

A: The Medpac idea is to have health experts and drs. to make Medicare more cost efficient. Not just cutting, in some cases must be higher. Home care is more efficient than insitutional. In rural communities, drs aren't reimbursed enough, so they leave. We want to incentivize smart things. [Make things more efficient] Efficient smart care is good for providers and patients, and can provide higher remibursements for some.

Q: Willing to urge Reid/Pelosi to stay at work?

A: Reid said we can get this bill out of Finance Comm. by recess, then vote in fall. I want to get it right, but get it done promptly. Haven't talked to him today. As long as they work diligently, moving forward that builds consensus... No delay for sake of delay, due to worry about casting tough votes. If they're really working out tough problems, no prob. But no delay just because of politics... because they might be controversial. Medicare, Soc. Security were controversial. Roosevelt was called a socialist. But we can't be afraid to change a broken system.

Q: Medicare... doughnut hole. 1/4 seniors... so, meds v. food. Will you support House legis. to close the doughnut hole.

A: Even more, we extracted concessions from Pharma that closes it. That's why AARP endorsed the bill. Doughnut hole = you hit a ceiling where subsidies go away. You pay out of pocket, more thousands of $, and then help kicks in again. Costs srs. thousands. Reform will make sure we move to close the hole, a commitment.

Q: High school student asks how to help.

A: Plan extends insurance of parents, keep kids on until they're 25. So persuade your parents, get active. Call representatives. Everyone can do that, and should. It makes members of Congress nervous. But when you do this, make it PERSONAL. Tell your story. Sometimes the debates get abstract.

If your employer pays high premiums, that affects your salary, no raises. UNIONS MOST AFFECTED. Negotiations? Employers say they can't afford to raise hourly wage. Health care rates too high for that. So you carry the burden. That's why reform is so important, even to those who have insurance.

Q: Taxing health care benefits...? She lists the payments, from 24-50, rising into thousands. Tax credit can only benefit those who make enough $ to use a tax credit. Most don't need one. How will tax be equitable to older and female workers?

A: First, taxing: I oppose taxing of benefits of those receiving. Discussed: An expensive, fancier plan than Congress gets, cap tax deduction, so we discourage costly plans. It's legit debate to have, but I've said no to eliminating tax deduction for employers.

Q: Extend age of going on to parents' plan is fine. But large % still stuck. How can we be guaranteed?

A: Anybody would be eligible to get insurance through the exchange with subsidies for help from govt. if you can't afford it, as long as you're eligible financially. Assuming you qualify, a working person w/o a lot of money, you'd be eligible to buy through the exchange. That's the whole idea. The exchange offers private plans too. We help you purchase insurance. Any insurer w/in the exchange has to abide by rules (pre-existing, changing jobs, etc.).

Q: Provisions for prevention, and mental health services?

A: I'm a supporter of that... but in addition... issues of prevention and wellness. Ex: Nutritionist to help get wt. down before diabetes... or a counselor for a diabetes patient to help with regimen to keep disease under control. There will be reimbursements, incentives for prevention and wellness, that do not require costs from patient.

Q: Too much, too fast?

A: Great question. Get done by Aug. meant bills voted out of House/Senate by Aug., but still have to come back in fall, reconcile the two, get a new bill, back to Senate/House, and to my desk. Fall is the bottom line, but even by then, most changes phased in over several years.... in an intelligent, deliberate way. But some we need fast: Reduce prescrip. drugs for srs, or pre-existing conditions, and other things that need to get done.

Too much? No. Only by standards of Wash. politics today... anything becomes this big tangle of who's up, down, special interests, lobbyists scurrying around.... But we're not talking about scrapping existing system. If you have it, you can keep it, if you don't, we'll help. If you have it, we'll reform the industry so it can still profit... but can't engage in rules that collect premiums but don't pay out when you get sick.

What is complicated: Changing delivery systems to get more quality for less $. Won't happen over night. Cleveland Clinic and Mayo Clinic drove down costs, maintained quality. How? They started in 1921. Drs. get salary instead of fee for service. That may not be what all drs. want to do, but there are other ways. Important is what is needed for patient, not worrying about what is the govt. saying... a million forms...