Thursday, September 10, 2009

Obama's Big Health Care Speech

Before I get a chance to listen to my favorite radio pundits on the matter, I wanted to jot down my thoughts on the president's big speech last night to a joint session of Congress. I watched it with my wife, who is an insurance actuary, then got to hear it two more times while I was driving to and from a meeting with an old friend (more on that in a minute).

Overall it was a well-delivered speech, but then we've come to expect that from him, haven't we. One thing I liked about it was that he really has gone out on a limb with this issue. He was very aggressive in his speech; very demanding that Congress get this reform accomplished this year. He was forceful to the point that I remember thinking that if Congress does not get something big done, Obama is going to look impotent. To me, that's leadership. I don't agree with most of what he is saying, but I have to give the guy credit for standing on his principles and fighting hard for them.

One thing I did not like was his partisan tone and outright dismissal of those who have argued against the proposals now being created in the House of Representatives. Over and over again, while trying to come off sounding bi-partisan, Obama claimed that opponents of "his" plan were liars and driven only by political expediency. He gave no credence at all to the points they have been making for months, now. He also pointed the finger at Republicans as the source of these supposedly "wild" arguments, not acknowledging that his real fight is with conservative "blue dog" Democrats, not the Republicans. This is something some in Congress have been trying to do, blame Republicans for their problems even though they have the votes to do whatever they want.

On three separate occasions, Obama took a shot at the Bush administration, which I also didn't like. Presidents are supposed to be above that. Reagan never whined about Carter's screw-ups, and Bush 43 never complained about the deep recession he inherited from Clinton (you never hear about that anymore, do you?). Presidents should take ownership of their office and not look back. Play the hand you are dealt. Instead, Obama and many in his administration are still taking potshots, 7 months after arriving in office, at the outgoing administration. Give it a rest.

A Little Overheated

The speech was not boring, at least not until Obama started doing a eulogy of Ted Kennedy. At one point he did something that Bush 43 rarely did: Stood up to his critics directly. He got to this point where he had laid out all his big improvements to the system, then he paused and started acknowledging that people were arguing about them. At least he's seeing what's been happening at town halls around the country, I suppose. Anyway he started listing several of the major arguments against his proposals, calling each one of them "a lie." That's very aggressive for a president. He also disparaged those who have been pushing these arguments. The first one he attacked was the idea of "death panels," first propagated by Sarah Palin. I found his attack to be unbecoming of a president because, while he didn't name her (everyone knew exactly who he meant), he disparaged her as a person and her motives, neither of which he has any place to be doing. He should have mentioned it, disagreed with it, and let it go.

His next attack as "false" was the idea that illegal immigrants would be covered under this plan. He was very dismissive of the very idea, and conservative pundits have pointed out that in H.R. 3200, illegals WOULD be covered; further, that they had asked that liberals put in a specific statement saying that they would NOT be covered and they were denied. So when Obama attacked Sarah Palin, conservatives started making noise, aware that they were being targeted. When he called this illegal immigrant claim "false" and dismissed it, one congressman actually yelled "that's a LIE!" from off to the president's left. Obama, Speaker Pelosi, and V.P. Biden all turned toward the shout. Pelosi looked as though she would have throttled the congressman with her bare hands; she was VERY angry. I thought she reacted childishly, like the bully she is. Obama, for his part, recovered quickly and continued on, which I thought was good and proper. This is the major leagues, and this is an important and emotional issue.

Something for Conservatives?

Later, the president appeared to throw a bone to conservatives when he acknowledged that they wanted litigation reform in the package. His wording, though, was murky and he never said he supported it. The democrats complain constantly about "special interests" but they only mean "Republican special interests," never Democrat special interests, one of the most prominent being trial lawyers. It doesn't seem credible that he or any other Democrat would get behind reducing malpractice lawsuits; but we'll see. Obama also, I think, stunned everyone when he said outright that no federal dollars would be used to pay for abortions, and all "conscience" laws would be upheld and respected. There was stunned silence for a couple of seconds, then applause, I assume from conservatives. No liberal, and few Democrats, would applaud such an idea. Again, let's see if he means it.

Smoke & Mirrors

Obama talked a good game defending "his" plan, but as even Democrats involved in the process (Kent Conrad, for one) have stated, the president has no plan. What he has is an idea, a concept, a framework in his head. The real plans are being hammered out in Congress. It's these congressional plans that conservatives have been attacking and critiquing. So it seems really easy for the president to defend "his" plan by saying it will do everything and cost little; because when he defends it in a speech, it IS whatever he SAYS it is. It seems intellectually dishonest to me, sort of a "bait and switch" tactic. Obama sells this nice, shiny plan that people go "ooh" and "ah" for, knowing that what's actually being built in the factory isn't nearly as pretty.

Several of the things conservatives have opined on, which Obama attacked, were things that, as he rightly pointed out, are not actually in the bills being proposed. But he didn't acknowledge that they were things that could conceivably, even likely, come to pass should this legislation become law. "Death panels" are one example, but another is the idea that it's fair for the government to run a competitive enterprise against private insurers because the government's company will be self-sustaining, based only on premiums, never drawing money from taxpayers. Yes, this is in the bill (I assume). However, it seems highly unlikely that the company he describes could possibly stay solvent. If it doesn't, then what? Will they just let it go bankrupt? Or will we hear the "too big to fail" bit again, just like with FNMA, and pull taxpayer money to prop it up? The answer seems obvious. And if we can reasonably expect such a thing to happen one day, why is it not fair or correct to argue about it now, before this thing gets passed into law? Maybe there's a good argument that it WON'T happen. So make that argument. Just don't sit there and say "it's not in the bill so we shouldn't be debating it."

Parting Shots

My wife is a career actuary. She doesn't like the demonization of insurance companies and she doesn't see how Obama's proposed system will work, financially. She wonders why no one is attacking doctors or hospitals, who create the charges in the first place. Why all the fuss at insurance companies?

My old friend who I had a meeting with last night at the local hotel where he's staying, it turns out, is a management consultant specializing in health care. We had a long conversation about the whole plan and I learned a few things. One concrete thing he left me with was, "I GUARANTEE you there will not be a single-payer" system in place, which is what many conservatives fear and what Obama has said he wants. Also, my friend disagreed with something I told him I thought Newt Gingrich made a good point with, which was that instead of going for one gigantic bill, why not do it in small steps each year? Jeff said that has been tried and doesn't do anything. He pointed to HIPPA, a piece of legislation I'd never heard of but that he said passed 15 years ago, putting all kinds of rules in place for healthcare providers, and yet today there still is little compliance and no real change.

My best friend got bitten by a monkey during a vacation in Indonesia, and had to start rabies shots this past week. He went to the E.R. to get the first one, and a) his insurance company said they won't pay for it; and b) the hospital hit him with a bill for almost $9,000 for a single injection! My friend immediately got online and declared that he wanted socialized medicine.

This is one of the most contentious debates I've ever seen, rivaled only by the illegal immigration / amnesty fight from a few years ago. George W. Bush eventually backed away from that fight, but Obama seems to be pressing forward with this one. It will be interesting, if nothing else, to see how it all plays out in the next few months.