オバマ大統領 議会に対し医療制度改革への最後通告

 オバマ大統領は水曜日、数週以内という野心的ではあるが非現実的な日程の呈示をして、医療制度改革のための最終的な督促を議会にした。共和党の言うような最初からのやり直しは意味がないとし、ためらう民主党員に対しては協力を求めた。1週間弱前にテレビ放送された医療フォーラムの開催されたが、この演説が最後のキャンペーンになるだろうという。
 保健福祉省長官は支持率低下を取り戻すために保険業者首脳との会談を木曜日に予定している。来週大統領はミズーリとペンシルベニアに法案のための遊説に回る。改革案は既に下院を通過し、上院も60票の圧倒的多数で通過している、と言う。
 共和党リーダーは、激怒して非難している。議会では、ナンシー・ペロシやハリーリード院内総務が大統領からの最終法案への強力な圧力を受けてはいるが、その日程表には同意していない。両院案のギャップを埋め、議会予算局での評価に時間がかかるため、多くの面で未解決のままである。人工妊娠中絶に対する保険適応についても不確定のままである。
 大統領がホワイトハウスで医療制度改革プランのフォーラムを開催して以来、金曜日で丸1年となる。大統領は国民と自らの党に対して政策の最大のプライオリティとの立場を保持してきており、この問題に全ての力を注ぎ込みたいと誓約した。
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「医療制度改革」
http://kurie.at.webry.info/theme/64293b0b07.html
医療制度改革法案が上院通過/米国医療事情
http://kurie.at.webry.info/200912/article_33.html
医療制度改革法案が下院を通過/米国医療事情 オバマ政権
http://kurie.at.webry.info/200911/article_11.html
上院財務委員会で医療制度改革法案が可決/米国医療事情 オバマ政権
http://kurie.at.webry.info/200910/article_18.html
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医療改革「決断の時」 オバマ大統領演説、上下院の採決求める
http://www.nikkei.co.jp/news/main/20100304ATGM0401504032010.html
 オバマ米大統領は3日、医療制度改革法案について演説して「今が決断の時だ」と述べ、数週間以内に上下両院で採決するよう求めた。自身が2月下旬に打ち出した新たな改革案をたたき台に、両院で可決可能な修正条項を追加し、法案の成立にこぎつけたい考えで、議会の調整加速を促した。
 法案の修正協議を巡っては「(野党の)共和党とあと1年交渉しても妥結の助けにならない」と指摘。部分的には共和党の提案を生かすものの、民主党主導で決着を目指す立場を明示した。大統領が2月下旬に打ち出した新たな改革案は上院が昨年末に可決した案を基礎にしており、総費用は10年間で9500億ドル(約84兆円)。3100万人の無保険者の解消を目指す内容。(ワシントン=大隅隆) (16:56)
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In Final Push, Obama Urges ‘Up or Down’ Vote on Health
Shawn Thew/European Pressphoto Agency
http://www.nytimes.com/2010/03/04/health/policy/04health.html

画像President Obama called on Wednesday for an “up or down vote” on health care overhaul.
By SHERYL GAY STOLBERG and ROBERT PEAR
Published: March 3, 2010


WASHINGTON ― President Obama, beginning his final push for a health care overhaul, called Wednesday for Congress to allow an “up or down vote” on the measure, and sketched out an ambitious ― and, some Democrats said, unrealistic ― timetable for his party to pass a bill on its own within weeks.

“I believe the United States Congress owes the American people a final vote on health care reform,” Mr. Obama said during a 20-minute speech in the East Room of the White House. He said there was no point in starting over, as Republicans are demanding, and called on nervous Democrats to stick with him, declaring there was no reason “for those of us who were sent here to lead to just walk away.”

The speech, less than a week after Mr. Obama held a high-profile televised health care forum, will usher in what White House officials say will be their last campaign to bring Washington’s long and contentious health care debate to a close ― with a bill-signing ceremony at the end.

On Thursday, Health and Human Services Secretary Kathleen Sebelius will meet at the White House with insurance industry executives to spotlight unpopular rate increases; next week, Mr. Obama will travel to Missouri and Pennsylvania to stump for the health care bill.

In his remarks, the president refrained from using the word “reconciliation,” the parliamentary tactic that Democrats are expected to employ to avoid a Republican filibuster and win passage with a simple majority. But he made clear that was his intent, and reminded Americans that despite current Republican objections, other major bills had been passed using the same tactic.

“Reform has already passed the House with a majority. It has already passed the Senate with a supermajority of 60 votes,” Mr. Obama said. “And now it deserves the same kind of up or down vote that was cast on welfare reform, that was cast on the Children’s Health Insurance Program, that was used for Cobra health coverage for the unemployed and, by the way, for both Bush tax cuts ― all of which had to pass Congress with nothing more than a simple majority.”

Republicans were furious.

“They’re making a vigorous effort to try to jam this down the throats of the American people, who don’t want it,” the Senate Republican leader, Mitch McConnell of Kentucky, told reporters after Mr. Obama’s remarks. “We think that’s a policy mistake, and we think resorting to these kind of tactics, to thumb your noses at the American people, is something that ought to be resisted.”

On Capitol Hill, the strategy could prove a heavy lift for the House speaker, Nancy Pelosi, and the Senate majority leader, Harry Reid, who are now under intense pressure from the White House to translate Mr. Obama’s wishes for a final bill into legislative language. Both leaders issued statements Wednesday praising Mr. Obama and vowing to press ahead. But, noticeably, neither publicly committed to Mr. Obama’s timetable.

Privately, Senate leadership aides said Mr. Obama’s deadline could be difficult to meet. The tentative plan is for the House to adopt the bill passed by the Senate, and for both chambers to use reconciliation to pass a package of changes that would bridge gaps between the initial House and Senate versions.

But the final language must still be sent to the nonpartisan Congressional Budget Office for evaluation, a process that takes time. Many aspects of the legislation remain unresolved, and rank-and-file Democrats in the House remain deeply uneasy over both the substance of the bill and the process by which it would be adopted.

Ms. Pelosi does not yet have the votes she needs to pass the legislation. She faces complex negotiations with both the moderate and liberal wings of her party to come up with a package that can pass the House without deviating so much from the existing Senate version that Mr. Reid would have trouble assembling a majority for the final vote in the Senate.

“I am not inclined to support the Senate version,” said Representative Shelley Berkley, Democrat of Nevada, who voted for the House bill in November. “I would like something more concrete than a promise. The Senate cannot promise its way out of a brown paper bag.”

As Democrats prepared for a final showdown with Republicans, other potential stumbling blocks emerged. House Democrats from New York met Wednesday with Ms. Pelosi to discuss their concern that the emerging bill would shortchange their state on Medicaid and other issues.

“I am very, very disappointed and unhappy,” said Representative Eliot L. Engel, Democrat of New York. “The White House is taking us for granted, and they shouldn’t.”

Supporters of abortion rights, in and out of Congress, said Wednesday that they were alarmed at the prospect that lawmakers might impose new restrictions on insurance coverage of abortion in the push to enact sweeping health legislation. Representative Jan Schakowsky, Democrat of Illinois, said language restricting insurers’ ability to cover abortions “remains in the president’s proposal, and we are very concerned about that.”

Friday will mark one year since Mr. Obama laid out his plans for a health care overhaul with a high-profile forum at the White House, where he engaged in a lively debate with lawmakers of both parties and executives from the insurance, hospital and pharmaceutical industries. On Wednesday, the scene at the White House was far different.

Mr. Obama spoke, without taking questions, to a group of sympathetic medical professionals, many of them clad in white lab coats to provide a TV-friendly image. After 12 months of legislative hearings, town hall meetings, speeches, polls and debates, Mr. Obama was in the position of selling not only the public, but his own party, on his top domestic priority.

“The American people want to know if it’s still possible for Washington to look out for their interests and their future,” Mr. Obama said. “They are waiting for us to act. They are waiting for us to lead. And as long as I hold this office, I intend to provide that leadership. I don’t know how this plays politically, but I know it’s right.”

Seeking to reassure wavering Democrats that he would back them up, he pledged to do “everything in my power to make the case for reform.”

Moments after he finished speaking, the White House announced plans for him to visit Pennsylvania and Missouri ― states that are home to vulnerable Democrats like Representative Jason Altmire of Pennsylvania and Representative Ike Skelton of Missouri, who were among 39 Democrats to vote against the health measure when it passed the House last year. If Mr. Obama is to sign his legislation into law, he is going to have to convert some of those no votes into yeses; traveling to a lawmaker’s home state could be one way to do that.

Senior advisers to Mr. Obama are betting that the politics of health care will eventually turn in the party’s favor, if the president can actually sign a bill into law. The legislation includes popular restrictions on the insurance industry; some, like a provision barring insurers from discriminating against children on the basis of pre-existing conditions, would take effect quickly ― a point noted by Mr. Obama’s press secretary, Robert Gibbs.

“The president has always subscribed to the notion that the politics will catch up,” Mr. Gibbs said.

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