Friday, September 11, 2009

The president has a plan (at last)

A little over a month ago, I pointed out that President Obama hadn't actually presented a health care plan of his own, and if he wanted to counter all the "misinformation" being spread by Republicans, then he should give another of his famous (or infamous) television addresses. Well, it looks like someone in the White House reads my blog, because just two nights ago, the president presented his own plan on television before a rare joint session of Congress.

It wasn't a very spectacular speech, though some apparently tried to make it a spectacle. Most notably was Congressman Joe Wilson, a Republican from South Carolina. When the president said that none of his reforms would benefit people here illegally, Congressman Wilson shouted, "You lie!" Tempers were a bit high that evening, of course, and he had just returned from a month filled with townhall meetings with angry constituents saying pretty much the same thing; but that still doesn't give a congressman the right to interrupt a national address with a petty attack. He later apologized.

The president committed a certain amount of partisan warfare himself during the course of his speech, making veiled and some not-so-veiled attacks on the GOP. Without mentioning anyone directly, he took shots at former President George W. Bush, former Alaska Governor Sarah Palin, and other critics of some Democrats' reform proposals. He accused them of not wanting reform of any kind, and of using fear and misinformation to turn public opinion against him. Anyone who's visited, though, can tell you that the Republicans have just as many ideas as Democrats do, and not all of them are that different from what any moderate would propose.

But let's get to some of those proposals, specifically. The president began by saying that, if you already have health insurance, Medicare, Medicaid, or veterans' benefits, then nothing will require you to change what you have. He promised to work to make your current insurance work better for you. He said that insurance companies will not be allowed to deny coverage based on preexisting conditions; to place caps on your coverage in a given year, or in your lifetime; to drop or "water down" your coverage when you get sick; or to charge extra for routine checkups. And he promised to limit out of pocket expenses during hospital visits.

If you do not already have some form of insurance, the president has promised to help you find quality, affordable choices; that, if you lose your job or change jobs or strike out on your own, then you will have choices. He proposes a market exchange where insurance companies can compete for your business. And, if you or your small business still cannot afford the market prices, then he will offer tax breaks and tax credits to help you afford it. His proposal would take up to four years to implement, so that they can "get it right".

So far, so good, right? Perhaps. I don't much care for the idea of the government telling insurance companies, which are basically giant investment firms, how to do business; but as the president pointed out, it is sometimes the government's job to step in and regulate commerce. But what about the next proposal on the president's list? He'll work hard to make sure anyone who wants to purchase health care can afford to do so; but what about those who do not want to purchase it? The president, and certain members of Congress, want to make purchasing insurance a requirement.

He likens it to the requirement to buy automobile insurance. Personally, I've never cared for that analogy. Driving a car places lives in danger, which is why we are required to hold licenses and insurance to drive. Simply living, though, is a constitutionally-protected right; and just as we don't license people to live, we should not require people to purchase insurance. Some say that it places a financial burden on the rest of us to provide health care for the uninsured; I've made that argument myself, in fact, and it is true. However, that is no justification for the government violating our right to privacy by dictating how we should care for ourselves and our families. In some cases, it is the government's role to intervene when an injustice has taken place; but to make short-sightedness illegal?

The president then addressed some issues that have been major sources of contention in recent weeks. He has pledged that health care reform will not include any provisions for "death panels", committees that would take end-of-life decisions out of patients' and their families' hands. He has also pledged that tax dollars would not go to cover abortions, and that federal conscience clauses would remain in effect. Obviously, these are sensitive issues for conservatives, moderates, and liberals alike. At the least, it's important that we all be clear on the president's position.

And, as I wrote earlier, the president has pledged that no tax dollars would be spent on health care for illegal immigrants. Can we trust it? I've never been to an emergency room, personally, but I can't imagine that they spend a lot of time investigating the status of patients. Can the president actually guarantee that no federal money will benefit illegal immigrants? Some have suggested that the actual language of HR 3200, which is just one proposal before Congress, is not so concrete, and that we need firmer commitments.

According to the president, there are some states where one insurance company or another may be "cornering the market", as it were, leading to unfair practices and prices in these markets. To keep these businesses "accountable", he wants to start a not-for-profit, self-sustainable insurance option. This form of public option, he says, would not be supported by tax dollars, and that it would only be there to keep insurance companies honest. He addressed the progressives in his party, saying that the entire point of a public option is to keep insurance companies honest, and if that goal can be accomplished without a public option, then they should be open to it.

There has been plenty of speculation on both sides of the aisle about what that means for the future of the public option. Bill O'Reilly of Fox News took it to mean that President Obama is merely a step away from dropping the public option entirely, and that his statement was intended to give himself cover when he does. Other pundits insist that he still supports a public plan and may just be trying to lull conservatives. In my opinion, only time will tell on this particular issue. But you can be sure I'll keep on my congressman and senators to not support a government-run plan, whether it's taxpayer-supported or not.

President Obama then gets into some details about the cost of health care reform. He has pledged not to sign a bill "that adds one dime to our deficit, either now or in the future". *sighs* That pledge alone has the potential to kill health care reform. I mean, forget taxpayer-funded abortion or single-payer systems; if you want to kill health care reform, just tell the president it'll increase the deficit by more than nine cents and he'll veto it himself.

Okay, sarcasm aside, he does have some ideas for reducing the deficit. First of all, he wants a bill that will require more spending cuts if savings cannot keep up. He says that cutting fraud and waste in the current plan will produce hundreds of billions in savings, and that not a dollar of the Medicare trust fund will be used to pay for the plan. The savings would fill the gaps in coverage, especially as regards prescription drug costs, and that seniors will get the benefits they were promised. As drug companies gain new customers under this plan, more revenue will be generated to help pay for the overall plan. It's sort of a "trickle down plan", Obama-style.

Up to this point, the president had thrown only a few bones to the Republicans and conservative Democrats in Congress. He did have a piece of meat for them, though. Tort reform, which deals with medical malpractice suits, has been touted by conservatives as a way to arrest the costs of health care. The more nuisance suits are brought, the higher the price of health care rises. Many feel that trial lawyers hold too much influence in the House of Representatives for any tort reform to be enacted; but with the president now supporting it, conservatives and moderates from each party can work on serious changes.

Overall, President Obama has estimated that his plan would cost around $900 billion. He expects that most of it can be paid with money that is already being spent (badly) and by slowing the growth of health care costs (which would reduce the deficit by itself). He claims that he will not stand by for the special interests, for misrepresentation, or for the status quo as a solution; and that anyone with a serious proposal is welcome.

I certainly hope he intends to follow through on that statement, at least. Many have suggested recently that Democrats, since they control the White House and both houses of Congress, should simply go ahead with their agenda, overruling and even overrunning the GOP if they cannot get their support. That would be a serious mistake, though. As I've said before, this is not a country that is content with one-party rule, no matter which party that may be. The president billed himself as a consensus-builder during last year's campaign. If his only interest is bringing the left together with the far left, then let them pass health care reform that will allow illegal aliens to get abortions from a government-run, single-payer system. Republicans will just come in and tear it all down in a few years when they regain power.

But if the president's goal is to pass lasting, quality health care reform, then he'd do well to keep his mind, his ears, and his options wide open during the next few weeks, months, and years.


  1. I recently came accross your blog and have been reading along. I thought I would leave my first comment. I dont know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.


  2. Thank you, Patricia. *smiles* I appreciate that.