Obamacare 2.0Did Obama's speech succeed in recasting the debate over health care reform?
Posted Wednesday, Sept. 9, 2009, at 11:09 PM ET
Barack Obama must envy Steve Jobs. In a speech Wednesday afternoon, Apple's CEO unveiled several spiffy new product updates, and within hours, on millions of computer screens across the country, little windows popped up asking users if they wanted Apple's new software. If they did, it was seamlessly a part of their lives in just minutes.
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StumbleUponSeveral hours later, President Obama spoke to a joint session of Congress promising his own painless overhaul: a retrofitting of the American health care system with no changes for those who like their coverage, coverage for those who don't have any, and all of it paid for.
Unfortunately for the president, installation is a nightmare. To make his case, Obama drew from a wide palette. At times he sounded like he was on the campaign trail. Knocking down claims about "death panels," he said, "It is a lie, plain and simple." To opponents who might distort his plans, he promised, "We will call you out." He dove deep into the details of insurance coverage as if he were presenting to a policy roundtable. He ended with high speechifying that included a celebration of the life of Sen. Ted Kennedy.
As for the substance, there were some new nuggets. But mostly the president sought to reiterate what he's been saying for months. "Nothing in our plan requires you to change what you have," said Obama in the first of what he described as three main principles of his reform. For the insured, he promised, "as soon as I sign this bill," their lives would be better. It would be illegal to deny coverage because of a pre-existing condition or lose it because of illness. For those without insurance he promised quality and affordable choices.
Obama's goal was not to present some perfect plan but to support the best plan that can get the votes. "There is a path here to get this done," a senior administration adviser said before the speech. Obama tried to lay out that path both in detail but also in manner: He played the middleman.
He talked about those on the left who want a single-payer plan and those on the right who prefer to leave things pretty much as they are. (This will no doubt infuriate the left more than the right, who will not only claim false equivalence but who might remind the president that before he was using them as a foil, he was courting their support by saying he supported a single-payer plan, too.) He was reminding those independent voters who tell pollsters they disapprove of his handling of the health care issue that he's the reasonable, unradical guy they liked during the election. "I believe it makes sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch."
Twice Obama referred to Republican ideas. He praised John McCain's idea of providing catastrophic care for those who've been denied insurance because of a pre-existing condition. He also said he was looking into medical malpractice reforms considered by George Bush. He made a detailed appeal for the public option, a favorite of liberals, but then downplayed it, saying it would cover only 5 percent of the uninsured.
The president was not met with a similar considered tone. Rep. Joe Wilson, a Republican from South Carolina, shouted out "You lie" when Obama suggested illegal immigrants would not be covered. (Which still doesn't make him the most unruly South Carolina congressman in history). Wilson later apologized.
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Nothing I heard last night or over the past few months solves the problem of escalating costs beyond squeezing the insurance companies and perhaps making Medicare and Medicaid less attractive than they already are to HC providers.
While adding 30-47M people to the roles of regular patients may be the moral and ethical thing to do, how do the proposals provide for the hundreds of thousands of additional HC providers that will be needed to provide the care for these new patients? Like many gaps in this and other problems we have, the government just ignores them and by doing so I can only assume they expect providence to provide the answers.
We need reform, we do not need more debt and we need a clear, complete, well thought-out program that does not make a bad situation worse.
-- DirtyBird
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