BY ROBERT PEAR
New York Times

WASHINGTON — President Barack Obama showed great fluency in the intricate details of health policy at his news conference on Wednesday night, but experts said some of his points were debatable.

Obama said doctors, nurses, hospitals, drug companies and AARP had supported efforts to overhaul health care.

While it is true the American Medical Association has endorsed a bill drafted by House Democratic leaders, a half-dozen state medical societies have sharply criticized provisions that would establish a new government-run health insurance plan.

Likewise, Obama said Medicare could save large amounts of money by creating “an independent group of doctors and medical experts who are empowered to eliminate waste and inefficiency” and hold down the annual increases in payments to health care providers.

Far from supporting this proposal, the American Hospital Association is urging hospital executives to lobby against it.

Of the proposed new cost-control agency, Obama said: “It’s not going to reduce Medicare benefits. What it’s going to do is to change how those benefits are delivered so that they’re more efficient.”

Hospitals say the cuts could indeed cut services in some rural areas and from teaching hospitals, which receive extra payments because of higher costs.

In seeking to portray health legislation as bipartisan, Obama said that 160 Republican amendments were adopted in a bill approved last week by the Senate health committee. Republicans said many of the amendments involved technical provisions and did not alter the fundamental features of the bill.

The president said that health insurance companies were making “record profits.”

America’s Health Insurance Plans, the main lobby for insurers, contends that “for every $1 spent on health care in America, approximately one penny goes to health plans’ profits.”

Obama said he was not proposing to ration care, but just wanted to coordinate it better. For example, he said, he wants to eliminate repetitious tests ordered by different doctors for the same patient.

Electronic medical records and health information technology, championed by Obama, could reduce such duplication. But, under his plan, it is not clear who would take responsibility for patients and coordinate care in traditional fee-for-service medicine.

The president continued to take credit for deficit reduction by making a claim that has been challenged by many experts.

“If we had done nothing, if you had the same old budget as opposed to the changes we made,” the deficit over the next 10 years would be $2.2 trillion greater, the president said.

In fact, $1.5 trillion of those “savings” are mainly based on an assumption that the United States would have had as many troops in Iraq in 10 years as it did when Obama took office. But before leaving office, President George W. Bush signed an agreement with Baghdad mandating the withdrawal of all American forces within three years.

So Obama is claiming credit for not spending money that, under the policy he inherited from Bush, would never have been spent in the first place.

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BY CALVIN WOODWARD AND JIM KUHNHENN
Associated Press Writers

WASHINGTON — President Barack Obama’s assertion Wednesday that government will stay out of health care decisions in an overhauled system is hard to square with the proposals coming out of Congress and with his own rhetoric.

Even now, nearly half the costs of health care in the U.S. are paid for by government at all levels. Federal authority would only grow under any proposal in play.

A look at some of Obama’s claims in his prime-time news conference:

OBAMA: “We already have rough agreement” on some aspects of what a health care overhaul should involve, and one is: “It will keep government out of health care decisions, giving you the option to keep your insurance if you’re happy with it.”

THE FACTS: In House legislation, a commission appointed by the government would determine what is and isn’t covered by insurance plans offered in a new purchasing pool, including a plan sponsored by the government. The bill also holds out the possibility that, over time, those standards could be imposed on all private insurance plans, not just the ones in the pool.

Indeed, Obama went on to lay out other principles of reform that plainly show the government making key decisions in health care. He said insurance companies would be barred from dropping coverage when someone gets too sick, limits would be set on out-of-pocket expenses, and preventive care such as checkups and mammograms would be covered.

It’s true that people would not be forced to give up a private plan and go with a public one. The question is whether all of those private plans would still be in place if the government entered the marketplace in a bigger way.

He addressed some of the nuances under questioning. “Can I guarantee that there are going to be no changes in the health care delivery system?” he said. “No. The whole point of this is to try to encourage changes that work for the American people and make them healthier.”

He acknowledged then that the “government already is making some of these decisions.”

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OBAMA: “I have also pledged that health insurance reform will not add to our deficit over the next decade, and I mean it.”

THE FACTS: The president has said repeatedly that he wants “deficit-neutral” health care legislation, meaning that every dollar increase in cost is met with a dollar of new revenue or a dollar of savings. But some things are more neutral than others. White House Budget Director Peter Orszag told reporters this week that the promise does not apply to proposed spending of about $245 billion over the next decade to increase fees for doctors serving Medicare patients. Democrats and the Obama administration argue that the extra payment, designed to prevent a scheduled cut of about 21 percent in doctor fees, already was part of the administration’s policy, with or without a health care overhaul.

Beyond that, budget experts have warned about various accounting gimmicks that can mask true burdens on the deficit. The bipartisan Committee for a Responsible Federal Budget lists a variety of them, including back-loading the heaviest costs at the end of the 10-year period and beyond.

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OBAMA: “You haven’t seen me out there blaming the Republicans.”

THE FACTS: Obama did so in his opening statement, saying, “I’ve heard that one Republican strategist told his party that even though they may want to compromise, it’s better politics to ‘go for the kill.’ Another Republican senator said that defeating health reform is about ‘breaking’ me.”

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OBAMA: “I don’t know, not having been there and not seeing all the facts, what role race played in that. But I think it’s fair to say, number one, any of us would be pretty angry; number two, that the Cambridge police acted stupidly in arresting somebody when there was already proof that they were in their own home, and, number three, what I think we know separate and apart from this incident is that there’s a long history in this country of African-Americans and Latinos being stopped by law enforcement disproportionately.”

THE FACTS: The facts are in dispute between black scholar Henry Louis Gates Jr. and the white police sergeant who arrested him at his Cambridge, Mass., home when officers went there to investigate a reported break-in. But this much is clear: Gates wasn’t arrested for being in his own home, as Obama implies, but for allegedly being belligerent when the sergeant demanded his identification. The president did mention that the professor was charged with disorderly conduct. Charges were dropped.

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OBAMA: “If we had done nothing, if you had the same old budget as opposed to the changes we made in our budget, you’d have a $9.3 trillion deficit over the next 10 years. Because of the changes we’ve made, it’s going to be $7.1 trillion.”

THE FACTS: Obama’s numbers are based on figures compiled by his own budget office. But they rely on assumptions about economic growth that some economists find too optimistic. The nonpartisan Congressional Budget Office, in its own analysis of the president’s budget numbers, concluded that the cumulative deficit over the next decade would be $9.1 trillion.

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Associated Press writer Ricardo Alonso-Zaldivar contributed to this report.