Wednesday, September 09, 2009

Obama's health care speech

I didn't hear Obama's health care address live, for better or worse. So I first got acquainted with it from the text as published at Salon.

The bottom line on this speech for me is that meaningful health care reform with a robust public option is still possible this year. But Obama is still unwilling to straight-out fight for the public option, which is currently the key issue on which the difference between constructive reform and grossly inadequate reform hangs. His insistence on false equivalence between left and right, and his appeals to bipartisanship, don't make any rational sense to me in this situation.

I'm hopeful that this speech will push solid reform over the top. But after the past few weeks, I'm cautious about here Obama stands on this and, especially, on how much he will fight for meaningful reform. His speech should also help to discredit some of the Republican lies over health care reform.

The speech is tinged by tragedy in my mind. Despite his elegance, this speech should have come months ago. And it's painful to see things like this: "We spend one-and-a-half times more per person on healthcare than any other country, but we aren't any healthier for it." Not because it's wrong. It's an important point. But instead of insisting on getting out the message that other countries like Canada, Britain, Germany, France, Spain and Switzerland along with others get comparable or better results at a lower cost per person while covering all their citizens.


Instead, there's been incomprehensible talk about "bending the curve downward", which I gather means reducing the rate of inflation in health-care costs. I'm just a finance guy, so I've never heard the phrase "bend the curve downward" before this year. And, of course, I'm referring here to the realm of sane arguments over health care. Unless the Dems pound on their key points consistently, our pitiful national media certainly are not going to inform people about things like, "We spend one-and-a-half times more per person on healthcare than any other country, but we aren't any healthier for it."

I'm burned out on the "bipartisan" nonsense. The Republicans have been making it clear for months they have no intention of allowing a meaningful health care reform to pass if they have anything to say about it. Yet Obama was still offering up fluff like this to give the priests of High Broderism who worship "bipartisanship" (for Democrats):

There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone. On the right, there are those who argue that we should end the employer-based system and leave individuals to buy health insurance on their own.
Of course those on "the left" in Congress who would have preferred single-payer are trying their damnest to get a solid health-care reform passed of the non-single-payer type that Obama favors passed. While those "on the right" are trying to kill it. What's the point of saying such things in this situation other than to please the David Broders of the world?

And this struck me in the same vein:

But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government. Instead of honest debate, we have seen scare tactics. Some have dug into unyielding ideological camps that offer no hope of compromise. Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge. And out of this blizzard of charges and counter-charges, confusion has reigned. [my emphasis]
No, Mr. President, that's not what we've seen. We've seen Republican Party media stars, political operatives and Members of Congress gin up hysteria and lies against the plan you say you want. Do you think you're going to please Republican fanatics who hate your guts and, as Party leader Rush Limbaugh has ordered them, want you to fail? The abstract and phony pretense that there are somehow equal extremes on both sides is useless. Useless, that is, if you're serious about getting your own Democratic agenda enacted.

What kind of seriousness does it show when Obama says, "Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do." The Republican Party has one idea on health care reform: block it at all costs. Things like this make me think that David Sirota has a point when he writes, "Barack Obama has ties to the progressive movement, but he is an inherently cautious - and, at times, frightened - politician."

It was good that Obama made a strong point on one of the aspects of the bill that some people will find unpleasant, the individual mandate to buy health insurance. But the robust public option is one of the main aspects of health care reform that makes that requirement palatable. Obama's reference to the public plan was tepid. As Scarecrow at FireDogLake writes:

President Obama kept the public option alive tonight, but probably only enough to pretend it has some negotiating value with those who oppose it. He said nothing he hasn't said before, and the fact that he still won't nail this down will only feed the impression by progressives that they're being played.
Obama did manage to say straightforwardly that the accusations of Sarah Palin and the Republicans that reform would include "death panels" is "a lie, plain and simple." But instead of making a positive defense of a public option, he was more apologizing for it:

But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear -- it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.

Despite all this, the insurance companies and their allies don't like this idea. They argue that these private companies can't fairly compete with the government. And they'd be right if taxpayers were subsidizing this public insurance option. But they won't be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. [my emphasis]
This wouldn't be bad if he were clearly defending the public option as a necessity and insisting it be a part of the package. But he's not. The public option is far from dead. But if it gets through, it will only be because the Congressional Progressive Caucus and their supporters force it on him. And that is sad. And in telling us how little he cares about getting it, he managed to make another false equivalence between "left" and "right":

It's worth noting that a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight. But its impact shouldn't be exaggerated -- by the left, the right, or the media. It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it. The public option is only a means to that end -- and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of healthcare, we should work together to address any legitimate concerns you may have.

For example, some have suggested that that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others propose a co-op or another non-profit entity to administer the plan. These are all constructive ideas worth exploring. [my emphasis]
And he gave a nod to the fiscal scolds who are also only out to sink his whole domestic program. And to the advocates of "tort reform", who pretend that unjustified lawsuits are creating some significant part of the excessive US health care costs. (They aren't.)

I just heard David Dayen (dday) on the radio noting that Obama's theatrical invocation of Ted Kennedy's memory was a good plug for liberalism in general. But as David also pointed out, he tried to spin Kennedy's legacy into a mushy bipartisanship. This is not the approach to be taking when your faced with a fanatical opposition Party determined to sink your most important pending legislation and your whole administration.

He even managed to toss in a compliment for the great Maverick McCain, a determined opponent of health care reform. At least he didn't praise Rush Limbaugh and Glenn Beck, too.

Bottom line for me: I'm still hopeful on health care reform, but doubtful about the strength of Obama's leadership on distinctively progressive reforms.

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