Health Care Reform # 8

I watched Barrack Obama’s speech to the joint session of congress while eating dinner last night. I purposely haven’t read any commentary yet. I wasn’t optimistic about the speech, but I had hope. Here are my thoughts:

He is starting from a position where he has already compromised on critical issues. He’s proposing a regulated private system with public funding for the poorest. He is being accused of communism. Since he is already demonized, he may as well take the step to a government funded capitalist system like the rest of the world.

I think I heard him say that a single-payer system is a government controlled health care system. If that’s what he said, he’s wrong. It is a taxpayer funded capitalist system. He says that we must support the health insurance and the pharmaceutical industries which have served us so poorly. If we want savings and improved outcomes, we have to make a difficult transition. We may as well do it now.

As I listened, I didn’t hear anything about the public option until near the end. He seemed to describe it as no different from the health co-ops which have been discussed. His public option seems to be available only to those who could not otherwise afford insurance. This seems to guarantee that no one would choose it voluntarily. It also makes it impossible for the public option to become the dominant health plan. That should mollify the critics, but probably won’t. I think it makes it a failure over all.

He didn’t do anything to contradict the stories about his deals with the pharmaceutical industry or hospitals.

He teased Republicans about malpractice law. He got them excited. Then he showed that he wasn't serious. Think how betrayed the Republican’s felt after sitting there applauding his idea. Of course abuse of the legal system is not a major part of the problem, but it is part of the problem. Why not compromise here. At least establish standards of care and caps on pain and suffering.

I didn’t hear anything he said that would really decrease costs. He’s adding layers.

I don’t like the idea of punishing people for failing to buy insurance. We should have a system which provides for all instead of a system which punishes people for trying to manage without government involvement. I respect people like that. That is going to anger and mobilize many people – for good reason.

Most importantly, he had no specific plan to offer. The current hodgepodge of messy bills still exists. There is no one plan which can be explained and defended. I can’t believe he doesn’t see this.

Good things:

He made it clear that insurance companies had to be reasonable.

He did refer to some statements as lies, but he didn’t get specific. He addressed death panels, cuts to Medicare and illegal immigrants.

He made clear that Medicare, Social Security, and Medicaid were all seen as disasters for the country and they weren’t. In fact, we are dependent on them.

I’ll work for this, but he’s fighting for a small thing. We have to fight as hard as if he were trying to accomplish a big thing.