Wednesday, July 22, 2009

Obama Presser : Instant reaction rant :

"In addition to making sure that this plan doesn't add to the deficit in the short-term, the bill I sign must also slow the growth of health care costs in the long run .  ... [snip]

I won't sign a bill that doesn't reduce health-care inflation so that families as well as government are saving money. I'm not going to sign a bill that I don't think will work.

And my measure of whether things work or not are listening to the American people, but also listening to health-care experts who have shown that in some communities health care is cheaper and delivers a better result. [E.A.]

He's still in the thrall of Orszagism! Here we're dramatically changing insurance (no more "preexisting conditions") and insuring the uninsured and creating a health care exchange and promoting a public option and generally telling everyone they can stop worrying about whether they will have coverage. It's all going to be deficit neutral over a ten year period . Why do we have to also dramatically change the "health care delivery system" at the same time (in order to save even more money after ten years)?  Doesn't that undermine the reassuring message that if you like your health coverage, nothing will change? Sure. Nothing will change except the entire health care delivery system! Which is going to be redesigned! By experts! Maybe get rid of fee for service--Obama hinted at change along those line. All seemingly on the basis of a single article in the New Yorker that isn't nearly as convincing as it's made out to be. (I would like to see Dems apply Orszag's logic--that all Medicare expenses can obviously, without sacrifice be cut to the level of the cheapest provider--to the school system.) ...

I know I'd like universal health coverage. That's been debated ad nauseam. What hasn't been debated--what have been blessed mainly by pronouncements from on high couched in euphemisms and deception--are Orszag's "delivery system" changes. I'm worried that they will result in denial of treatments that may be useful at saving and prolonging lives. Obama's refusal at his press conference to declare that all covered treatments would still be covered is an example of what people worry about. And Obama knows--or even scarier, maybe he doesn't--that the difficult decisions don't involve cheap blue pills that are as good as red pills, but treatments that are the "best" but also the "most expensive"--including cancer drugs like Herceptin and Sutent . ...

P.S.: Obama got more mired in explaining (or, rather, santizing) curve-bending and therefore became less effective during the question period. Why was a press conference--as opposed to a speech--the best way to rally support? ....

P.P.S.: On tax increases, Obama said

I don't want that final one-third of the cost of health care to be   completely shouldered on the backs of middle-class families who are already struggling in a difficult economy. And so if I see a proposal that is primarily funded through taxing middle-class families, I'm going to be opposed to that ... [E.A.]

In standard Washspeak, this means Obama is open to a health reform that taxes middle class families as long as it isn't "primarily" or "completely" funded by taxes on middle class families. But 49% funded by taxes on middle class families? ... However you interpret these sentences, it's hard to see how Obama hasn't given a flashing green light to non-trivial tax increases on middle class families. ... 6:10 P.M.

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