Is quasi-Blue Dog Obama barking down the wrong political street on health care reform? Yes, obviously. His present mushy non-position satisfies almost no one, either politically or personally.
I believe President Obama must take a firm stance for a Medicare-like public-plan option, or his health care reform agenda is dead... and possibly his 2012 reelection chances, as well.
My friend Robert Longley, About.com's Guide to Gov't Info, emailed me today, "Do you think Obama does or does not support the public health insurance option?"
My answer is that logically, President Obama must find a way to sign a bill that includes major progress in tamping down medical costs and in covering a big chunk of uninsured Americans. The only viable option to accomplish those goals is a Medicare-like public option, as candidate Obama repeatedly explained during the campaign.
Follow my logic:
Republicans will oppose Obama's health care reform with or without a public option. Per Rasmussen polling today, "Minus the government insurance option, 68% of Republicans remain opposed to the plan, down from 79%."
And without a public plan option, Democrats have little enthusiasm for the President's agenda, either. Per startling Rasmussen Reports polling:
"Without the public option, just 50% of Democrats support the legislation. That's down from 69% support measured a week ago. But here the enthusiasm gap is especially strong.
"A week ago, polling found that 44% of Democrats strongly favored the reform plan. Without the public option, just 12% of Democrats strongly support it."
To summarize, Obama's dreams of bipartisan health care reform are fantasy. Not based in reality.
And yet Obama, ever anxious to please white, middle-aged, predominantly southern legislators and voters, continues to compromise and pander and futilely attempt to placate... at the expense of his irritated, dispirited Democratic base.
"Just 34% of voters nationwide support the health care reform plan proposed by President Obama and congressional Democrats if the so-called public option is removed...
"Last week [before Obama distanced himself from a public-plan option], Rasmussen Reports tracking found that support for the Congressional plan was at 42%."
Logically, to pass health reform legislation, President Obama must include a provision that he can credibly label as a public-plan option to plans offered by private insurers.
Otherwise, he will fail, as Congressional Republicans have no plans to support him in any endeavors. And white, older, largely Republican town hallers didn't support Obama in the presidential election, and have only grown more enraged in 2009 by his "change" agenda. I fully agree with the New York Times conclusion today:
"We are frankly skeptical that any compromise will be enough to satisfy Republican opponents of health care reform. If the White House and Democratic leaders decide to go it alone, and they may well have to, they should restore a robust public plan. It is the best way to give Americans real choice."
Will Obama Throw Progressives Under the Bus?
Robert also asked, "If a health care reform bill that DOES contain the public option fails, is Obama going to throw
progressives under the bus by blaming them for not backing off on the public option?
Obama could blame progressives, of course, for his failure to take a firm, principled stand behind his campaign promises, and for his abject failure to craft a coherent message... but that would be self-defeating if he plans to run for reelection in 2012.
After all, most Republicans apparently have no plans to support him again for the White House. If he also consistently offends and defies the Democratic party base, who's left to vigorously support his candidacy?
His fellow Blue Dog Democrats, who are predominantly white, conservative, middle-aged and southern? President Obama is indulging in more political flights of fantasy if he believes Blue Dog centrists alone are sufficient support for a successful term in office, and assured reelection. Most Blue Dog constituents intensely dislike Mr. Obama. And Blue Dogs notoriously care about their constituents.
The question I find myself asking lately: Does President Obama even want a second term in office? Judging by his illogical, puzzlingly muddled non-leadership on key issues, I'm honestly not sure anymore...
Comments
No More Health Catrina !
Let’s set up the Equation !
1. All across the spectrum share the urgent need for the reform as the course today is financially unsustainable. By the way, how do we pay for it ?
Let’s make it affordable while improving quality.
2. Of all choices on the table, savings via efficiency is the best, and Removing Wastes alone is Enough to Meet the Goal.
As one instance, please visit http://www.npr.org/templates/story/story.php?storyId=111967435, you will be stunned !
No one knows just how much medical fraud there is, and estimates range from $600 to $6000 billion over the next decade lost to it.
And, in May 2009, the Obama administration announced a new task force made up of officials from the Department of Justice and the Department of Health
and Human Services to work on health care fraud.
3. Enough Room For Savings !
Many reformers recognized roughly 30 percent of all health-care spending in the U.S. -some $700 billion a year- might be wasted on medical abuse, unnecessary procedures, unnecessary visits to the doctor, overpriced pharmaceuticals, bloated insurance companies, and the most inefficient paper billing systems imaginable, and payment reform could solve this problem.
Provided the American people pay around twice the amount of the efficient systems, the result is still well below them, the ratio of waste might be estimated to far more than 50% in the U.S.
Let’s be conservative regarding the ratio. Even If as little as 10% of savings apply to the combined Medicare and Medicaid cost of $923.5bn per year, as of July, the savings of $923.5bn over the next decade are possible.
And when these savings add to the already allocated $583 billion, the savings of wastes involving so called “doughnut hole” , the unnecessary subsidies for insurers, medical abuse, exorbitant costs by the tragic ER visits etc, the concern over revenue might be a thing of the past.
As a matter of fact, with the promising redesign in the pipeline, some patient-focused clinics in 10 regions have already achieved 16% of savings in Medicare while their quality scores are well above average.
Please be ’sure’ to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp for credible evidences !
Thankfully, the provisions in the reform include more expansive, systematic policies such as ‘a patient’s outcome-based payment system’ than they have. I for one firmly believe this American innovation, ‘a patient’s outcome-based payment system’ , is capable of turning profit-oriented practices into patient-focused system / value.
Dr. Armadio at Mayo clinic says, “If we got rid of that stuff (waste), we save a third of all that we spend and that is 2.5 trillion dollars on health care. A third of that and that is 700 billion dollars a year. That covers a lot of uninsured people.”
Please visit http://www.kare11.com/news/news_article.aspx?storyid=820455&catid=391 for detailed infos
– Americans’ Best Friends Are The Envy Of The Planet ! –
– Except For The Underinsured, The Uninsured Alone Outnumber The Entire Population In Canada –
4. Some say, if the reform package is affordable and improve quality, then the inflation/bankruptcy-oriented market can not last, thereby competition should begin with our unfair, unsustainable market value, or let’s make another insurer-friendly scheme, even though the inflation/bankruptcy-oriented market share the need for change.
5. CONCLUSION = THE WILL OF REFORM, NOT COST.
The runaway premium similar to the peak fuel price last year and left so many folks in despair insists on staying the course with the attitude ‘unchanged’, clearly this trend could bankrupt individual, business, and government. Now the government subsequently is tasked with these two main assignments, first, to address premium inflation, second, to expand coverage to all in urgent need.
In order to cover all and not to add to the deficit, the public option can not set the same rates of private market, rather, it needs to have BALANCING function to keep it in check in terms of INFLATION, too. Unfortunately, this ‘unavoidable’ direction is aggressively being accused by the runaway premium, citing government ‘take-over’ .
Under the circumstances the energy bill to determine human future and the other major issues are presently piled up, who wants to waste time making enemies ?, which also does not benefit the forthcoming election.
with the heartbreaking tears in mind (Nearly 11 Million Cancer Patients Without Health Insurance), private market also needs changes and should join together to complete this reform , as promised, otherwise, the runaway premium only has itself to blame while new firms are filling the void with competitive deals.
And It can be said that fair competition starts with a fair, sustainable market value.
However, the plan in the House is designed to keep people in an employer-based health insurance system, and the public option would be offered to those for whom employer-provided insurance is not available. And job-based coverage (indirect payment) mandate code, and ample capital, reduced ER costs, IT base to streamline the administrative processes and trim the costs might be favorable to the private market. Over time, supposedly, the public plan will concentrate more on basic, primary cares, and the private insurers will provide their clients with differentiated services.
Let me repeat; No More Health Catrina, No More Bankruptcy Of Middle Class !
– Americans’ Best Friends Are The Envy Of The Planet ! –
– Except For The Underinsured, The Uninsured Alone Outnumber The Entire Population In Canada –
Thank You !
Deborah, I’m looking past the reform discussion to a more serious problem. We have talked about this in the past but forgot in the celebratory mood of Obama’s big win, but an increasingly savage undercurrent of rage is not going away. As the numbers become smaller, the anger intensity grows, as seen in the guy with a loaded gun at the president’s New Hampshire appearance, holding a provocative sign. News sources even gave him air time. Since then I have heard reports of copy cats doing the same thing. At one event the police, when questioned, replied that the protester was in a designated public area.
I saw a picture of an old woman actually crying as she held the microphone at one of these meetings. The level of fear and mistrust is swelling faster than the Barney Franks who know better can turn divert attention. And often when informed elected officials try to reassure their constituents they are shouted down anyway.
If and when insurance and health care reform comes to pass, the resentment and mistrust will only get worse. And as the number of crazies shrinks the potential for violence increases.
At some point the president will have to decide that enough is enough and confront these people head on. Like bullies everywhere, their power lies in their ability to plant fear and dread in others. I’m a card carrying peace-monger, but sometimes an unapologetic confrontation is in order. There is no need to postpone the moment. The time for action is now, before the fear-mongers taste more blood.
We need reform not destruction of the finest health care system in the world. Why not start with something such as tort reform and if the government can figure out how to get out of the pocket of the lobbyists then move onto something else?
John, I’ll likely surprise you when I say that I agree that healthcare reform must include some modicum of tort reform.
As far as the U.S. having the “finest health care system in the world,” indeed, it does in terms of medical services for the wealthiest Americans. For tens of millions of Americans, though, the U.S. health care system ranks with undeveloped third-world nations.