By John Fritze and Mimi Hall, USA TODAY

WASHINGTON — The health care debate in Congress has been plagued for months by misinformation and bickering by Democrats and Republicans trying to define how the changes being proposed would affect hospitals, doctors and patients.

President Obama tried to cut through what he called "this blizzard of charges and counter-charges" in an address to a joint session of Congress on Wednesday night.

Here's a closer look at some of his statements in the context of what's happening on Capitol Hill:

The statement: "Nothing in this plan will require you or your employer to change the coverage or the doctor you have."

The context: A Gallup Poll report this month showed that 87% of people with private insurance rate the quality of their care as "good" or "excellent." Obama needs to convince those people that the health care system needs change and ease fears they could lose their coverage.

Although it is true that the bills in the House and Senate do not directly force people to change their current coverage, the non-partisan Congressional Budget Office predicts some employers may change coverage options, which means some employees would indirectly be forced out of their current plans.

"Some firms are likely to buy different coverage for their workers than they have now, or simply drop coverage and pay a penalty instead, leaving workers to buy their own private coverage or go on a new federal insurance plan," according to FactCheck.org, a website run by the Annenberg Public Policy Center.

Under the House bill, companies that self-insure would have to modify their benefit packages after five years if they don't meet minimum standards. The non-partisan Congressional Budget Office has estimated that 11 million to 12 million people would opt for a proposed government-run insurance program.

The statement: A government-run insurance plan would "keep pressure on private insurers to keep their policies affordable and treat their customers better."

The context: Democrats, including Obama, argue that a public option would provide competition. Republicans, such as Senate Minority Leader Mitchell McConnell of Kentucky, say a taxpayer-backed insurance plan would put private companies out of business.

Though Obama said Wednesday that he supports the idea he was careful not to make it an ultimatum. The White House knows it may not get the votes to create a public insurance plan, and that's why Obama has never said he'd veto legislation that didn't include it.

Support has been waning for the public option in recent weeks. Senate Finance Committee Chairman Max Baucus, D-Mont., reinforced the growing sense that even some Democrats are pulling back from the idea when, hours before Obama's speech, he said it "cannot pass the Senate."

The statement: "I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs."

The context: Republicans in Congress, including McConnell, say limiting medical malpractice lawsuits will help drive down costs. Democrats have said such a change will not have a significant impact on costs.

Along with 33 other states, Texas limits "pain and suffering" damages in malpractice suits. Although the Texas limits have been in place only since 2003, a University of Texas and University of Illinois study estimates that about 20% less would have been paid by malpractice defendants if the state caps been in place from 1988 to 2004.

"If including medical malpractice reform with overall health reform earns physicians' trust and helps change the practice of medicine, it could have a big impact on health care costs," says William Sage, a physician and law professor at The University of Texas. "Tort reforms on their own are unlikely to have much impact."

The statement: "There are those who claim that our reform effort will insure illegal immigrants. This, too, is false."

The context: Some Republicans, including Rep. Steve King of Iowa, have charged that Obama's plan would offer insurance to millions of illegal immigrants. The issue was raised repeatedly during town hall meetings on health care during the August recess. But current federal law bars illegal immigrants from getting government-funded health care and versions of the bill pending in the House and Senate also prohibit it.

The statement: "The only thing this plan would eliminate (in Medicare) is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies."

The context: Top on the list for cuts is the Medicare Advantage program, which allows seniors to purchase Medicare coverage through a private insurance company. Critics, including Obama, have said the program has been able to offer lower premiums than regular Medicare because it is subsidized by taxpayers at a rate 14% higher per patient. The Congressional Budget Office says eliminating the disparity would save $150 billion over 10 years.

The statement: "I will not sign a plan that adds one dime to our deficits — either now or in the future. Period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize."

The context: This isn't the first time Congress has considered a "trigger" to protect against cost increases. When Congress passed a plan to subsidize the cost of prescription drugs in 2003 known as Medicare Part D, lawmakers included a trigger to protect against drug companies submitting huge bills to the government. If the bills got too large, a government plan would be offered to promote competition. Despite big costs, the trigger was never pulled.

Health care: Then and now

Aside from annual State of the Union messages, presidents rarely speak to joint sessions of Congress. On Sept. 22, 1993, then-president Bill Clinton spoke on the topic of health care. Comparing Clinton's speech with President Obama's address to the joint session Wednesday:

Issue: Why fix the system?

• Clinton: "We cannot ignore what is wrong. Millions of Americans are just a pink slip away from losing their health coverage, and one serious illness away from losing their life savings. Millions more are locked into the wrong jobs, because they'd lose their coverage if they left their companies. And on any given day over 37 million of our fellow citizens, the vast majority of them children or hardworking adults, have no health insurance at all. And despite all of this, our medical bills are growing at more than twice the rate of inflation." 

• Obama: "Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it most. And more will die as a result. We know these things to be true. That is why we cannot fail. Because there are too many Americans counting on us to succeed — the ones who suffer silently, and the ones who shared their stories with us at town hall meetings, in e-mails and in letters."

Issue: Who will pay?

• Clinton: "Some will be asked to pay more. If you are an employer, and you are not insuring your workers, you will have to pay more. If you are a firm that provides only limited coverage, you may have to pay more. If you are a young, single person in your 20s and you are already insured, your rates may go up somewhat. But ... the vast majority of you watching tonight will pay the same or less for your health care coverage and, at the same time, get the same or better coverage than you have today."

• Obama: "Most of this plan can be paid for by finding savings within the existing health care system — a system that is currently full of waste and abuse. Right now, too much of the hard-earned savings and tax dollars we spend on health care doesn't make us healthier. That's not my judgment — it's the judgment of medical professionals across this country. And this is also true when it comes to Medicare and Medicaid. ... Much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers."

Issue: Who will be covered?

• Clinton: "Under our plan, every American will receive a health security card that will guarantee you a comprehensive package of benefits over the course of your lifetime that will equal benefits provided by most Fortune 500 corporations. This card will guarantee you a comprehensive package of benefits that can never be taken away. And let us pledge tonight: Before this Congress adjourns next year, you will pass, and I will sign a new law to create health security for every American."

• Obama: "First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. ... Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange — a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices."

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