His ideas sound good in theory – many say President Barack Obama made an eloquent argument for health care reform in his speech to Congress on Wednesday – but South Bay residents are still worried about changes to come.

"I believe everyone should have health care, and we should provide it for citizens of this country," said Ross Strange, a long- time Inglewood resident who watched the speech. "But what I don’t agree with is extending insurance to people who are already straining the system."

Reaction to the speech, and to the ideas on both sides of the political spectrum, varied widely among South Bay constituents. Strange, who has undergone several major medical procedures this year, worries that the government program for seniors over 65 will be scaled back or cut.

"Right now I can go to any doctor of my choice who accepts Medicare," she said. "If that is taken away, I will be very concerned."

Doctors, insurers, hospital administrators and consumer advocates varied widely in their responses to the speech, in most cases cautiously supportive of changing a system that many agree is too expensive and highly dysfunctional.

Stakeholders in the debate, however, disagree on the details of how to accomplish reform.

The president "did a really good job of framing what his expectations are," said Jim Lott, executive director of the Hospital Association of Southern California, a trade group. "I am hoping that his speech will move things forward."

Lott and others in the hospital industry support change and Obama’s overall message, but not a plan that would include a public insurance option. Medicare and Medicaid already underpay for services, and there’s no reason to believe that a government-run plan would be any different, he said.

"I was pleased to see that (President Obama) seemed to emphasize that his goals can be achieved without the public option," Lott said. "It’s not so much the method, but the result that matters."

Insurance companies, not surprisingly, are also against the public option. In a statement released Thursday, America’s Health Insurance Plans, a trade group, said it remained committed to containing costs, but that a government-run plan would introduce unfair competition in the market.

Consumer advocates, however, argue that the public option is an essential component of any reform plan. Insurance companies would have no other incentive to lower insurance premiums or to stop denying coverage to those with preexisting conditions, according to Consumer Watchdog, a national advocacy group.

South Bay consumer advocate Jerry Flanagan said lessons can be learned from the fight to require drivers to have auto insurance.

Laws didn’t work as much as the government having a strong role in regulating how much companies can charge for policies. Insurance companies in California must ask for approval before raising rates, which has saved drivers billions of dollars.

"Obama and Congress should require states to adopt similar prior approval laws for health insurance rates," he said.

Torrance physician Dr. Tom LaGrelius said he was impressed by the president’s eloquence – and that was about it.

"The speech was eloquent, and full of half-truths and untruths," said LaGrelius, who serves on a committee with the Los Angeles County Medical Association looking at health care reform.

The primary care doctor doesn’t have confidence in the president’s promise that consumers will be able to keep their current coverage. He also isn’t persuaded by Obama’s seeming support of restricting medical malpractice lawsuits – a necessity in any reform package, LaGrelius said.

"There’s just thousands and thousands of frivolous lawsuits being filed and, for a doctor, that is frightening," he said. "You’ve got to limit damages for pain and suffering, for punitive damages, and you’ve got to make people who file frivolous suits pay legal fees for the doctors."

Consumer advocates disagree, saying the president shouldn’t concede this issue to win points with Republicans. Caps on lawsuits "have locked injured patients out of court, degraded the quality of health care and denied justice to too many families," according to Consumer Watchdog.

LaGrelius, meanwhile, sided with South Carolina Rep. Joe Wilson, a Republican who took flak for yelling "You lie" during Obama’s speech on Wednesday.

"I guess he apologized, which is the thing to do these days," the doctor said. "But he was right. The president’s speech was full of lies."

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