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Three Things About Obama's Health Care Speech
He spoke relatively frankly of the national embarrassment of the US being the highest per-capita health care-spending nation in the world, with results that don't match the cost, and of being the only wealthy nation with millions without health insurance and many others with insurance that's not all that great anyhow. The speech has proven to be something of a national Rorschach test - the Obama plan's lovers, haters, and the lukewarm generally found it inspiring, appalling, and blah, respectively, treating it as confirmation of what they already thought. Yet at least three of the president's remarks may deserve a closer look, certainly for those who think health care is a right. In one instance, the President's probably right, when his supporters may hope he isn't; in the second, we can only hope he's wrong; and in the third, he's so wrong that it's hard not to call to mind what that Congressman from South Carolina said about a different part of his speech.
Where Obama is right on the money is on just how important the "public option" probably isn't. "We believe that less than five percent of Americans would sign up," he said and "its impact shouldn't be exaggerated - by the left, the right, or the media." Now 10-11 million people purchasing a public policy, as the Congressional Budget Office (CBO) estimates, "administered by the government just like Medicaid or Medicare," as the President describes it, is a lot of people and certainly better than nothing, but his caution about making too much of it gets to the ambiguity at the heart of the plan.
"The insurance companies and their allies ... argue that these private companies can't fairly compete with the government," he said. And, apart from their judgement that it is somehow unfair for the government to provide a service more efficiently than the private sector does - or even can, they are largely right, for reasons Obama went on to explain: a government plan can avoid "some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries."
Certainly the Heritage Foundation, which describes its purpose as formulating and promoting "conservative public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values, and a strong national defense," seems to agree. They funded a study that put the number of people who would ultimately sign on for a public plan at 103 million. So, in other words, each side is claiming that the public option will ultimately play out the way the other side would prefer. If the program were good, the Heritage Foundation's numbers ought to be right; if the President is right, then there's probably something wrong with the program.
Why do I suspect that it is Obama who is right? Ultimately because it is his proposal - although arguing details of a program that doesn't yet have any is admittedly a pretty speculative proposition. And because Obama, Rahm Emmanuel, etc. are prodigious fundraisers among the insurance industry precisely because they've made it clear that they don't intend to harm its bottom line. (The announcement subsequent to Obama's speech that a lobbyist for UnitedHealth, the nation's largest health insurer, would be hosting a fundraising party at his home for House Speaker Nancy Pelosi serves as a useful reminder of the realities of the situation.)
The reason that many on the left may be making more of the program than it merits is that, having been told from the get-go that the Administration has no stomach for a fight with the insurance industry, they hope it might be possible to still achieve their goal of universal coverage by some type of technical solution - in other words, "back door single payer," as the opposition claims. But outsmarting the industry seems a pretty unlikely outcome and, at this point, the CBO estimate itself seems quite optimistic.
Which brings us to the second point, Obama's statement that "I am not the first President to take up this cause, but I am determined to be the last." Whether or not he really thinks that, let's hope no one else supporting universal health insurance does. For even if the President should accomplish everything he said he wants in his speech, there are going to be people who are not covered - a lot of them. And regardless of what any Senator might say, single payer will be on the table until they are covered.
And so, to the third point. The President said: "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," but he claimed that this "would represent a radical shift that would disrupt the health care most people currently have." Now, there are many things he might legitimately have said about the fight for a single payer system and the difficulty of achieving it. First off, there's nothing inherently shameful about compromise - it's a part of politics, just as it is a part of everyday life. What gives political compromise a bad name, however, is politicians claiming that a compromise between competing interests is not really a compromise at all, but a wonderful and better idea that they don't know why they hadn't thought of in the first place.
So Obama might legitimately have raised the point that there are powerful forces lined up against a single payer system, (and mentioned, if he wanted to be blunt, that the health insurance industry would go apoplectic - before going defunct.) And he could have spoken of how, if he were to seriously promote such a system, a lot of powerful people would turn their efforts to defeating him next time around and that they might even succeed, thereby jeopardizing other goals of his Administration. And it certainly would have been accurate to note that many people currently employed in the duplicative and wasteful private health insurance industry would no longer be needed and might have to be retrained for work in other fields, so their lives would be disrupted. (Provision for such retraining was actually written into the unsuccessful 1994 California single payer referendum.)
Unfortunately, Obama, who has in the past demonstrated a good understanding of what a single payer system would actually do, chose instead to make a statement he knows not to be true. Such a system would not change "the health care most people currently have," but only the address where the health care provider would send the bill afterwards - just as many people whose bills are now sent to Medicare once had them paid by UnitedHealth or Aetna.
After Obama's speech, George McGovern, probably the last Democratic presidential candidate to actually hold many of the views currently imputed to Obama - by supporters and detractors alike - succinctly summed the actual situation up in the title of an editorial he wrote for the Washington Post: "It's Simple: Medicare for All."
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34 Comments so far
Show AllThis is the point the Rep. Anthony Weiner has been bringing out at every possible opportunity he can:
"Unfortunately, Obama, who has in the past demonstrated a good understanding of what a single payer system would actually do, chose instead to make a statement he knows not to be true. Such a system would not change "the health care most people currently have," but only the address where the health care provider would send the bill afterwards - just as many people whose bills are now sent to Medicare once had them paid by UnitedHealth or Aetna."
I don't know what could move Obama back to a position of honesty. If he honestly believes that single payer is the better route, then how can he live with himself as he sells out the American people to the private insurance cabal?
Anybody listening to the substance of the speech (rather than the eloquence; Obama always gets A+ in my book for eloquence) could not miss the emphasis on preserving (more like enhancing) corporate profits...insurance, pharma...
"...he could have spoken of how, if he were to seriously promote such a system, a lot of powerful people would turn their efforts to defeating him next time around and that they might even succeed, thereby jeopardizing other goals of his Administration."
A contradction. If "goals" require change that may threaten the status quo that is the problem, what is the point of winning? Loss is assured if the perception is incompetence or lack of capability and confidence.
Funny how they are always talking about lost jobs in the insurance companies...It is the only case where they seem concerned about job loss when we are hemorraging jobs daily. No one cared about the autoworkers, no one cares about off-shored jobs or jobs replaced with immigrant labor willing to work for less to beef up the bottom line.
"A contradiction. If "goals" require change that may threaten the status quo that is the problem, what is the point of winning? Loss is assured if the perception is incompetence or lack of capability and confidence."
Exactly, and why is defeating single payer not considered his goal?
He might have spoken about having some political principles, but he didn't... It simply is better to fight for real change than hem and haw and fake everything. Obama shows himself totally as being unprincipled about supposedly being against war, unprincipled about supposedly being for bailing the American people out of the economic crisis, and unprincipled about supposedly ever really moving to reform this rotten Health Care mess Big Business as usual has made for us.
All three of Gallagher's "things" about the health care speech are well taken; I'd like to focus my comments on his third point, on which I partly agree and partly disagree with Mr. Gallagher.
He is right on in his observation of a legitimate concern about single payer that must be addressed forthrightly and fairly: the "disruption" of the lives of those currently employed in the insurance industry. Single payer advocates seem to gloss over the right of people to satisfactory employment in their zeal for the right to health care. It bodes poorly for populist support of a reformed health care system if people will be put out of work so it can be accomplished; and we have seen the potent political effect of support for policies ranging from war to environmental devastation if these projects provide jobs for people. Whatever was in the California referendum on this subject must be adapted to a different scope and time and given full public support; and this must be an integral part of the "plan" and not a reaction to an unwelcome by-product of a welcome and vital reform.
I have to wince a bit, however, when Mr. Gallagher says, in opposition to the public fear that their health care will be "disrupted," that people's health care won't change under single payer, only the address to which their bills are sent.I fervently pray he is wrong on this. Every critic of our current health care system notes that we pay more and get less in the way of health care than any other industrialized nation. To say that our health care "won't change" seems about as impotent a statement in its defense as the one, mentioned in Gallagher's first "thing," that the public option shouldn't be seen as threatening to the status quo because so few people will take that option. If we don't get
better health care from single payer (as well as the more equitable distribution of that care) I for one would not support it. So please, Mr. Gallagher, as an obvious supporter of single payer, don't shoot yourself and your fellow supporters in the foot by the soothing assurance that things "won't really" change under a single payer system. That assurance will come as cold comfort to all those people suffering from the miserable health care system as it currently exists.
sierra7
Would you have preferred that we still employ horses and donkeys as beasts of burden as opposed to having adopted the "machinery of production and movement of goods" because it would have, "....unemployed many people"???????????
Whatever happened to "creative destruction" in our system?
What's good for the unemployed should be good for those whose time has come to give up the fight to preserve antiquated systems, in this case the "for profit" usery system of corrupt privatized healthcare.
Absurd!
Have I stopped beating my wife?????????
I thought I made it clear from my last paragraph that I advocate the "creative destruction" of our current health care system. But that doesn't mean the instant destruction of the "horses and donkeys" currently employed in the private insurance industry. Actually, if you haven't noticed those are actually people and not animals, and if you advocate their "creative destruction" for a higher good you're fiddling around the edges of authoritarianism.
The California Nurses Association has done a study of having a national single payer program instituted and they concluded that it would actually create millions of jobs. I don't have the numbers in front of me and can't recall the actual numbers, but it was significant.
Obviously, Medicare for All would require hiring MANY employees to overhaul and administer that system.
I'm sure you can go to PNHP (Physicians for a National Health Insurance Program) and find some statistics.
Insurance companies would still exist even under single payer. They could provide coverage for the boob jobs, the facelifts, the abdominoplasties, and any other procedures that would not be considered medically necessary. Obviously, insurance companies should also become nonprofits like they are in Switzerland, and be highly regulated.
HR676 includes a provision to provide unemployment benefits for people who lose jobs as a result of the legislation for two years.
blair and zmann: Thank you for your comments about the issue of loss of jobs under a single payer, Medicare-for-all health care system. I never doubted that SP would be a net CREATOR not destroyer of jobs, only pointing out that any legislation for a new system should contain provision for those displaced, however briefly, from the changeover of systems. HR 676's provision in that direction is what I had in mind. I was only following from Gallagher's point that there were legitimate questions like this which Obama might have and did not cover in his description of the problem of instituting single payer. When (not if) single payer finally does go back on "the table" when the currently-proposed program implodes of its own weight and complexity, this will be the kind of humane issue that should be addressed in a real and not a fantasy program for universal health care.
All I seek at this point is "field of dreams" health care reform. Build it and they will come. By downplaying the effect of a public option, he might be trying to slip it past the insurance industry. Reality is, the day I can sign up for public option Medicare is the day I am standing in the HR office at work dropping my private insurance and signing up. The day the feds allow the states to do single payer is the day a handful of states implement single payer. Then the remaining states can try and figure how to explain this failed system to their citizens.
I am truly glad that this issue has hit front and center early in his term. We'll find out what hope and change truly mean. If it ends up that health care reform amounts to government mandated private insurance, any doubt about the total control the corporate fascists hold on this country will be gone. Status quo, ditto.
"Give President Obama credit for a little truth-telling..."
No, thanks. He is doing what he has always done, talking left and delivering right. His plan is worse than no plan, despite his clever line about not being the first but determined to be the last. Since this president has no courage to do anything involving actual change, he should stay home in the White House and play with whatever video games the former occupant left.
Banking used to be a public utility, regulated so it could serve a societal purpose. It was taken over by gangsters, in no small part because a revolving door existed between regulator and industry. Our government itself used to be a public good before representation of citizens was replaced with corporate auctions. Defense was originally for the purpose of defending our nation and not for enabling endless ambition - again privatized (corporatized) into a league of contractors all shoveling cash and reelections to committee members. Healthcare, as a functioning public good has an interest to society and a private profit interest. The two interests conflict, but only one gets heard.
The media, all three branches of government, and our elections are broken. We need a leader who would fight to restore the power of citizens to control our own affairs. The problems are connected. The fight in healthcare doesn't work for the same reason the financial system is worse than ever and war contractors like CACI are above the law.
"Since this president has no courage to do anything involving actual change"
It's not that he doesn't have courage, it's that he doesn't believe in actual change. Obama is a completely status quo politician whose job is to front for the big money.
I'm so sick of the "no cojones, no courage, no spine" meme. These Dem bloggers don't realize the cognitive dissonance merry-go-round they are riding. Supposedly Ob runs a "brilliant and strategically genius" political campaign. Then he gets into the White House and "loses his way." He's "lost his touch." He is "in a flail." He's "backing down" to Republicans.
The man is doing what he intended to do all along!! Why is that so hard to understand? Instead, the pwoggies "can't believe he is selling out." He's still playing "93rd dimensional chess." He's "turning right before going left."
How much more tap dancing can these clowns do before they dance themselves into a fucking fainting spell?
Over on Amerikaslog, the blog owner was bragging as recently as a month or so ago that he had helped raise $50,000 for Obama's campaign. That's not something you want to brag about, people. You raised 50 grand for a CORPORATE candidate? A guy who was raking in hundreds of millions of dollars from his corporate bundlers? I read one estimate that Obama's campaign haul was around half a BILLION. $500 million in his campaign war chest. Sorry, but that didn't come from the "little people." Your $50,000 was never on his radar. And I'd keep that information to myself, frankly. Talk about getting hung out to dry.
"He spoke relatively frankly of the national embarrassment of the US being the highest per-capita health care-spending nation in the world, with results that don't match the cost, and of being the only wealthy nation with millions without health insurance and many others with insurance that's not all that great anyhow."
He could have said this without bothering to run for president.
Probably, he will be able to say the same thing after he retires to the rubber chicken circuit.
I love it! Insurance companies whining that it wouldn't be fair if government delivered the service better and cheaper. Competition is wonderful - unless you'd lose, I guess, and then you whine about Level playing fields.
So - the insurance companies admit, albeit indirectly, that the government-adminstered universal single-payer coverage would be better, especially for the clients/patients.
Also - has anyone noticed that the insurance companies and the banks are different claws on the same lobster?
I view them as the same claw, one being the top pincher, the other the bottom. The other claw we need to be concerned with is the energy industry. Electric and natural gas are heavily regulated today but look for serious erosion of that regulation dressed up as "green reform". Watch your electric and home gas bills spike like our gasoline bills when profits aren't up to par with shareholder expectations.
Next up after energy would be water.
Privatization of water resources, coming to a community near you.
Even better yet, do you guys know that under the TARP charade, Obama also allocated money to the insurance companies? No foolin'! Somehow he rationalized that the insurance companies were yaddah yaddah yaddah and, therefore, qualified for bailouts.
http://www.usatoday.com/money/industries/insurance/2009-04-08-insurers-tarp_N.htm
This author has a weird email address.
Since you mention it, I've noticed that e-mail address too.
It just screams, "You don't REALLY want to e-mail me, do you?"
ยท Yr Obd't Servant
Just copy/paste it.
I suspect it went something like this:
tg@aol.com
Sorry that name is taken.
tgtg@aol.com
Sorry that name is taken.
so on and so forth. The beauty of creating nicks on the internet.
Well colleagues, let's quit obsessing over irrelevancies like health care reform, environmental destruction, abuse of presidential powers and the continued "war" in Afghanistan and get down to the nitty-gritty of a REAL issue of investigating how Tom Gallagher got his e-mail name: call us the TG Debating Society; oh, we can have some dandy exchanges on that burning issue!
But we will probably be more successful at making a change since the other ones ain't going all that well for us anyway so, at the end, we can at least have the satisfaction of having made a dude change his weird e-mail address. Hey, it's better than nothing!
LOL. There's something kind of passive-aggressive about posting an address like that. If you don't want people emailing you, just don't post your address.
Shit, I didn't think aol was still in business, either. He must be one of those customers caught in that aol hell where they never drop you.
I have repeatedly stated before that REAL healthcare reform would have entailed us going to a single payer or Medicare For All mode. Instead Obama and our Congress have moved towards a guaranteed profit for the HMOs. To add insult to injury they are also talking of fines for those who do not buy an insurance plan!
Health insurance reform is NOT healthcare reform! When our political leaders quit accepting bribes from the health insurance industry, maybe we will get REAL healthcare reform. Until then it's business as usual.
I think we're starting to see Obama hit the gas on the bus that is his administration to get over that roadbump known as the progressives. Killing the pubic option at the same time making it illegal NOT to have health insurance is going to be the true reform bill. Just like the financial "reform bill" was to bail out and make bigger the "too big to fail" firms while not bailing out their competitors. AND then we get the re-appointment of Bernanke. At what point as progressives do we once again support ideals and not "cult of personalities" who promise change but deliver the same-ole-same ole? Even if I personally vote again for Obama - do you really think that all the 1st time voters that actually belived something might be different this time will bother to vote again? Obama can either get incredibly rich after leaving the WH or he can be a true hero and be known as one of the greatest presidents ever - like FDR. So far it's turning out to be the 1st option.
Dennis Kucinich sent out an email today, predicting the demise of this already watered down "healthcare" scheme. The industry has battered away at all those trying to make any sort of change and, as a result, we get a turd wrapped in a bow and told we're saved.
What was all that "change" stuff about again?
http://www.mindwafers.com/3/post/2009/09/hmohhhshit-part-ii-the-return-of-the-coop.html
I really love Anthony Weiner, he's smart and tells it like it is succinctly. He seems like a good bet to maybe be a national candidate for us someday.
The most amazing thing Obama said last week in his big speech was that "we have a system that works..." I had to do a double take on that and still thought I misheard till I heard it replayed. That one inane comment by itself is enough to cast doubt on anything he said.
In the end his plan is basically a big fat French kiss to the insurance leeches who have drained us of our money as they killed so many of us. He's going to mandate us to throw even more money to them.
So I'm not buying, he's already thrown us under the bus on drugs, and seems to be headed toward selling us out on care.
>>Give President Obama credit for a little truth-telling..."
There is always a little truth in even the biggest lie.
Yeah, three things about Obama's healthcare speech: bullshit, bullshit and more bullshit.