President Obama’s speech Wednesday night clarified what he will, and won’t, accept from Congress. It also was politically artful, mollifying the liberal Democrats while borrowing from Republican positions in an effort to give just enough to each to keep the process moving.
My main takeaway was this – for the first time, substantial attention was paid to cost, with a good chunk of the speech focused on reducing spending due to unnecessary care, excessive Medicare Advantage subsidies, and squeezing out administrative cost.
This is the speech that should have started the health reform campaign.
Instead we’re far into the legislative process, and many, if not most, Americans are uneducated about and unaware of the key issues reform should address. Example – I had dinner Friday night with several well-educated people in Chicago, one of whom is a nurse anesthetist married to an anesthesiologist. She railed against the reform bills’ negative impact on physicians, but could not point to any specific issues or clauses or reimbursement changes in any of the bills currently before Congress. She complained vociferously about the cost of medical malpractice insurance, stating that this is not a problem in any country but ours. The others listened, as to them, she is deeply involved in the industry and therefore an ‘expert’.
This is why the chances for health reform are dim and fading. The Democrats ceded the field of public debate to opponents of reform who successfully focused the public’s attention on secondary issues such as tort reform while avoiding any discussion of cost (which would mean lower revenues for reform opponents). Now the President is paying catch-up, trying to educate the American people about the problems, cost drivers, and inefficiencies in health care. This education will not happen overnight. Wednesday night he set the stage, raised a number of good points, and was generally accurate in describing the health care system’s cost drivers.
It would have been the perfect speech except it wasn’t in May.
I’ll temper my comments with the observation that then-Senator Obama was counted out last August, appearing to stumble while his opponents soared, only to soundly trounce Senator McCain three months later, winning several states that had historically been solidly Republican. He also defeated the Clintons to win the Democratic candidacy, an accomplishment that cannot be overstated.
Can the President get reform done? Possibly. But not probably.
Sep
12
“Politically artful”…? “Generally accurate”..? Not according to the fact check websites. It is just me, or do political opponents of Obama get no respect from you Joe, no matter how rational their arguments?
Obama always says, “I inherited a 1.3 trillion dollar deficit.” Yes, but is turning it into a 13 trillion dollar deficit. Can we afford health care reform? Recall, the main concern for Americans was actually health care cost, not reform or universal heath care.
Joe,
The problem with the President’s speech, as with all of the plans out there is too much, too fast.
For example; the move to take underwriting out of the equation so that your prior conditions cannot be a factor in getting insurance (a great idea in my opinion) will by itself cause a short term spike in the cost of health insurance because companies will not know how to charge out a persons coverage. This will be worked through with time and experience, but not right at first.
Then, combine that with taking off the lifetime maximums on plans and you add another cost driver to these policies.
These two alone – done at the same time – would upset the insurance world. But combining those two with the “Exchange” concept, with a public plan option and you create the “perfect storm” of events that will cripple the insurance community.
There are “intelligent” arguments against what he is proposing and I applaude the outcry against it. The President’s speech came across as though he were our monarch, dictating to the Congress what they will do. He presumes too much and I believe he may be in for rude awakening on this issue.
I think that you are too focused and need to step back. You are giving the Republicans more influence than they have, it appears to me, the bulk of the battle has happened within the Democratic wing. Look at how many Democrats are being attacked by the liberal faction of their own party. The Democrats are going to implode. Secondly, people are concerned about all of the issues that are happening concurrently with the healthcare debate and that concern is showing up across the spectrum of political views. If this was merely a Republican issue, there would be no problem. This issue has been mishandled and all of the education in the world isn’t going to make it happened. If there is going to be additional costs, and there will be, people are going to fight it.