From a policy standpoint, there was nothing new in President Obama’s speech to a joint session of Congress tonight. It can only be assessed, therefore, in political terms. I read the transcript rather than watching it, but the speech struck me as reasonably effective. I assume the delivery was standard Obama–smooth, generally flat, occasionally a bit whiny.
One striking aspect of the speech was that Obama kept talking about the “plan” that he “announced” tonight–but there is no plan; not in writing, anyway. Not unless Obama meant Nancy Pelosi’s House bill, but he didn’t seem to, since he made a point of saying that details remain to be filled in, referred to work still going on in committee, and said that “his plan” is open to alternatives to the public option. This vagueness gives him a sort of deniability: what he was describing was more his concept of the qualities health care legislation should have, rather than a specific bill. Whether that was politically smart remains to be seen. So far, vagueness hasn’t seemed to be the President’s friend on this issue.
Here are some excerpts from the speech that I thought were noteworthy:
Instead of honest debate, we have seen scare tactics.
Then, a few minutes later:
Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it most. And more will die as a result.
By far the biggest scaremonger on this issue has been Obama himself.
Well the time for bickering is over. The time for games has passed.
I’m not sure whether Obama and his handlers understand how this sort of talk grates on those of us who are not liberal Democrats (a large majority of the country). Debating public policy issues is not “bickering.” Disagreeing with a proposal to radically change one of the largest sectors of our economy is not a “game.” This kind of gratuitous insult–something we never heard from President Bush, for example–is one of the reasons why many consider Obama to be mean-spirited.
I assume most people noticed how, in tonight’s speech, Obama’s assurance that we will not lose our present insurance coverage has been scaled back. This was after thousands of critics pointed out that under the Democrats’ proposals, many people (more than 100 million according to some estimates) will in fact lose the insurance coverage they now have:
[I]f you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.
That’s true, of course. No one ever said it did. What the Democrats’ plan does do, however, is give employers the opportunity and, depending on pricing, the incentive to terminate their employees’ plans and dump them into the public system. And whether private insurance companies can compete with the public “option” depends on whether Obama keeps his pledge that the public program won’t be subsidized.
[I]nsurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there’s no reason we shouldn’t be catching diseases like breast cancer and colon cancer before they get worse.
How does that work? Better coverage for more people at less cost. Does anyone actually believe that is possible? I don’t think so.
Obama described his plan for an insurance exchange where those who are not part of a larger plan will be able to buy coverage. He then added:
This exchange will take effect in four years, which will give us time to do it right.
But wait! Aren’t people dying? The Democrats tried to ram their bill through Congress before the August recess, with essentially no debate and with virtually no one having read it. Their theory was that we are facing such a dire emergency that there is not a moment to lose. If, in fact, we have four years to spare, could we maybe stop trying to cram the bill down Americans’ throats?
Now, even if we provide these affordable options, there may be those – particularly the young and healthy – who still want to take the risk and go without coverage.
That’s true, of course. There are millions of people, mostly young and single, who choose not to buy health insurance or take a job where compensation comes largely in the form of benefits (same thing) because they have made a rational decision that for them, health insurance isn’t worth the money. As Americans, they should have that right. The problem is that, in the unlikely event they do get sick, they know they will be treated anyway.
That’s why under my plan, individuals will be required to carry basic health insurance – just as most states require you to carry auto insurance.
Traditionally, it was liability insurance that drivers were required to carry, not to protect themselves, but to protect others from their possible negligence. It is only because of no-fault laws that most states now require drivers to carry insurance that includes first-party coverage. There are some similarities, but many differences, between automobile and health insurance.
[U]nless everybody does their part, many of the insurance reforms we seek – especially requiring insurance companies to cover pre-existing conditions – just can’t be achieved.
This is a key point that many will overlook. One of the central purposes of nearly all health care “reform” proposals is to force young people into the system to help pay older peoples’ bills. Why is it that you can’t force insurance companies to cover pre-existing conditions–i.e., “insure” against something that has already happened, a logical impossibility–unless you force young people to “do their part”? Insurance companies, and, eventually, the government as single payer, need young people to pay premiums that far exceed any actual risk to subsidize the known losses that will come from being forced to “insure” people whose medical conditions are not risks but certainties.
Consider the analogy to life insurance: could a dying, 90-year-old person expect an insurance company to issue him a million dollar life insurance policy? Maybe, but it would cost close to a million dollars. Why can life insurance companies sell policies at rates that people consider reasonable? Only because they are insuring against premature death, and the insured has been paying premiums for many years, during most of which time there was little risk of his dying. The same principle applies, pretty closely, to health insurance.
Some of people’s concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Such a charge would be laughable if it weren’t so cynical and irresponsible. It is a lie, plain and simple.
No, it isn’t. The Democrats’ bill doesn’t call the agencies it sets up “death panels,” it says they will decide on “best practices.” But any socialized medicine scheme saves money by rationing care. Who gets shorted, the politically powerful? No, of course not; the elderly and those who are otherwise helpless. In the United Kingdom, the death panel goes by the Orwellian acronym “NICE.”
There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false – the reforms I’m proposing would not apply to those who are here illegally.
This is an outright lie, as Congressman Joe Wilson couldn’t resist blurting out during Obama’s speech. The Democrats defeated Republican-sponsored amendments that would have attempted, at least, to prevent illegals from being treated under the House version of Obama’s plan. I think everyone expects that if Obamacare becomes law, illegals will receive benefits on an equal basis with citizens.
And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
More oily language from the master of the half-truth. Under Obama’s plan, it won’t be necessary for federal dollars to fund abortions, at least not until socialized medicine actually arrives. Insurance dollars will fund abortions. The House bill sets up a nameless, unaccountable committee that will decide what coverages must be included in any approved private insurance policy. Those required coverages, you can be 100 percent certain, will include the costs of abortions. But Obama will take no responsibility; those are just “best practices.”
This seems to me to be the most critical moment in Obama’s speech:
My guiding principle is, and always has been, that consumers do better when there is choice and competition. Unfortunately, in 34 states, 75% of the insurance market is controlled by five or fewer companies. In Alabama, almost 90% is controlled by just one company. Without competition, the price of insurance goes up and the quality goes down.
In fact, Obama and Congressional Democrats have zero interest in increasing choice and competition. If they did, there is an easy solution. There are over 1,000 health insurance companies in the United States; why do you think it is that in Alabama, one company has 90 percent of the business? It is because there are major legal obstacles to insurance companies operating across state lines. State legislatures, and lots of the companies, like it this way. Competition is hard. But if Obama really wanted to expand “choice and competition” in health care, all he would have to do is go along with the Republican proposal to allow health insurance companies to sell on a national basis. Like, say, computer companies, beer companies, automobile companies, law firms, and pretty much everyone else. The Democrats’ refusal to allow existing health insurance companies to compete against each other nationwide, more than anything else, puts the lie to their nonsense about “choice and competition.”
Now, I have no interest in putting insurance companies out of business.
Really? We’ve all seen the YouTube video where Obama says that under his plan, private health insurance will be driven into extinction over a period of ten to twenty years. Has he changed his mind? When? Why? Does President Obama fail to understand the ubiquity of YouTube? Does he not understand that many millions of Americans consider him a liar when he says things like this?
President Obama talked about the “public option” and assured listeners that it would not be subsidized by the government:
I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.
Is it churlish to point out that profits are not overhead? It might be if this were just a slip of the tongue on the stump. But this was a speech that was carefully crafted by Obama and his top advisers. They really do not know the first thing about business or economics. So why should we put them in charge of our economy?
I want to speak directly to America’s seniors for a moment, because Medicare is another issue that’s been subjected to demagoguery and distortion during the course of this debate.
Actually, the administration has said that around half the cost of the plan, $500 billion, would be paid for by cuts in Medicare. So it isn’t exactly “demagoguery and distortion” to suggest that there might be cuts in Medicare.
[N]ot a dollar of the Medicare trust fund will be used to pay for this plan.
I should hope not, since there isn’t any Medicare trust fund, just like there isn’t any Social Security trust fund.
The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud…Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan.
But wait! If we can identify hundreds of billions of dollars in waste and fraud in Medicare and Medicaid and we know how to eliminate it, why haven’t we done so already? Why don’t we do so–right now!–regardless of the administration’s highly controversial health care bill?
There is no possible answer to these questions. The Obama plan–whatever it is, once reduced to writing–depends for most of its financing on the bare assertion that we are currently wasting hundreds of billions of dollars, and that we will stop wasting that money only if taxpayers knuckle under to Obamacare.
This was not, to put it kindly, a speech that was directed at thinking people.