Obama's speech: So long, public option
President Barack Obama's health-care speech to the Congress Wednesday night was delivered effectively and the watching national audience likely will likely give Obama, and his handling of health care, a short-term jump in public approval. Within the Congress, where the substantive issue will be decided, greater polarization will take place. Obama took several rhetorical swipes at Republicans which will have the net effect of hardening their opposition to bamaCare.
Moderate, Blue Dog Democrats in the House, principally concerned with the costs of the prospective health package, may have been heartened by his apparent toss overboard of the "public option" — a government entity to compete with private health insurers — but will remain worried by his promise that the package's estimated $900 billlion cost will be met largely through undefined savings in Medicare. The latter also will alarm senior citizens dependent on Medicare. Obama's suggestion of pilot experiments in tort reform will not be sufficient to attract tort-reform proponents to ObamaCare.
Liberal House Democrats were reinforced by Obama's forcefulness and swipes at the opposition. But they, labor unions, and other proponents of a public option will be less enthusiastic about the overall legislation because of Obama's willingness to abandon the option. Liberals have nowhere else to go, however, and in the end will vote overwhelmingly for final legislation.
Practical Senate Democrats will be heartened by Obama's message on the public option because, it had become apparent, no legislation could pass the Senate containing such a provision. Legislation expected from the Finance Committee later this month will no doubt omit the provision. Insurance and drug companies are now more likely to resist legislation because of being singled out by Obama for reproof and targeted as revenue sources for ObamaCare.
Surveys have consistently shown citizens to be more greatly concerned with rising federal deficits than with designing a health-sector remake. Obama promised Wednesday night that he would sign no plan increasing federal deficits. At the same time he proposed major expansions of health-care coverage, involving major increases in health-care costs, not consistent with a zero effect on the federal budget.
The large and central question in debate from this point forward: How, specifically will $900 billlion be found to pay for the plan? How much from removing "waste and abuse" from Medicare and Medicaid and how much from higher taxes and fees on whom?








Comments:
Posted Thu, Sep 10, 8:38 a.m. inappropriate
Tax the hell out of the obese! I've been in Seattle 15 years and the populace I would guesstimate has increased it's average weight by a pound a year, not this forever bantam however. For every pound overweight, you pay one per cent extra on your income tax!
Posted Thu, Sep 10, 1:52 p.m. inappropriate
Prez Barry 'Joe Camel' Obama mentioned a 30,000,000 number of uninsured American citizens in the speech. That is 17,000,000 fewer than the bantered about nebulous number 47,000,000. So; do the 17,000,000 illegal aliens face fines, penalties, and 8% of payroll to be taxed for not being insured? Or, will one federal judge rule that they are to be included and covered by any new health insurance reform? Obama has made so many factual errors so as to render his credibility on the issue at ZERO. He has failed.
Posted Thu, Sep 10, 2:59 p.m. inappropriate
I'm having a hard time grasping why "incentives" are the unmentionable third rail when we are trying to save money, i. e., encourage responsible decision-making and the cat's meow when we are all to happy to give away the store to assure amenities such as affordable housing and working farms.
Posted Thu, Sep 10, 4:11 p.m. inappropriate
The large and central question is, where were all these fiscal hawks when we decided to spend godzillion dollars on invading Iraq, Star Wars and other useless, bottomless-pit weapons systems and other boondoggles to prop up our weapons industry. the country isn't broke because we spend too much on health care; it's broke because we spend more on military weapons and adventures than the rest of the planet combined.
Posted Thu, Sep 10, 4:13 p.m. inappropriate
I think Mr. Van Dyk's assessment of health reform is offbase once again, driven by his repeatedly stated position that President Obama should have have attempted health reform at this time. Very briefly:
1) Obama's "rhetorical swipes" were simply statements that Republicans have been lying about the Democratic legislation, which they provably have been, and that he will strike back if they continue to do so. Mr. Van Dyk ignores Obama's numerous efforts during the speech to reach out to Republicans and incorporate their ideas. The GOP opposition hardened long ago and leading Republicans have repeatedly signaled they have no interest in working seriously with the Democrats on this issue.
2) The real action on the public plan option is "tossing it overboard" but designing an Olympia Snowe-type trigger mechanism to put it in place ahead of time in states where there isn't sufficient private plan competition and affordable premiums.
3) Actually, Obama and the Democrats have pretty clearly defined where the Medicare savings would come from (subsidies for private plans and elimination of reimbursement for preventable hospital readmissions). Mr. Van Dyk also fails to note the enhancements in drug and primary care benefits that Obama and the Dems propose.
4) Time Magazine reported in May that Obama offered tort reform to top Republicans as part of a reform deal, and they rejected it at that time. So again, Mr. Van Dyk's presumption that there is a deal to be had with Republicans is disproven by actual events.
5) There's no evidence that the insurance and drug industries are moving toward a posture of resistance. Just the opposite. They have stayed at the table and continued to finance pro-reform advertising.
6) Most polls I've seen show deficit reduction to be a pretty low priority for the American public, and most Americans still say the health care system needs a major overhaul.
7) I agree with Mr. Van Dyk's skepticism about Obama's statement that health reform and covering more Americans won't increase the deficit one dime. This will cost money, as Obama has acknowledged in the past, and he should be frank about it. But there's good reason to believe reform will curb overall health costs and Medicare costs over time. Health care cost control is a very complex subject, not one that can be addressed in a minute or two in a speech like this. The Democratic legislation would launch a wide range of cost control initiatives, such as better primary care, accountable health organizations, comparative effectiveness research, changing payment incentives for doctors and hospitals, etc. Mr. Van Dyk should understand that there are no easy answers.
Posted Thu, Sep 10, 4:14 p.m. inappropriate
Sorry, typo, I meant to say Mr. Van Dyk's repeatedly stated position that Obama should NOT attempt health reform at this time.
Posted Thu, Sep 10, 5:54 p.m. inappropriate
Thanks for your various comments.
I agreee with my friend Floyd McKay that prior expenditures on foreign wars, weapons systems, etc. have often been questionable. I would add to the list "earmark" pork-barrel spending sponsored by legislators of both political parties...much of the non-stimulating 2009 stimulus package...a good share of financial- and auto-industry bailout monies...and much else that has contributed to looming federal deficits that are unsustainable.
The health-care initiative comes at a time when we are burdened by this other spending and the coming deficits which will set off inflation unless somehow reduced over the next several years. CBO estimates the cost of present pending health proposals to be about an additional $1 trillion over the next decade; President Obama last night suggested the cost would be slightly less. He further suggested that Medicare savings and selective
new taxes and fees would pay for it and that he would not sign any health bill that increased deficits. All "health" spending is not necessarily good and "military" spending necessarily bad. We need to make
spending in all sectors wise and appropriate.
I won't attempt to answer Harris Meyer's free-ranging broadsides. My blog was a straightforward attempt to tell readers what likcly lay in store, in the Congress and among interest groups, in the wake of the President's Wednesday night speech. I suspect you would find few experienced D.C. or health-policy hands who would disagree greatly with my morning-after analysis.
Posted Fri, Sep 11, 9:32 a.m. inappropriate
Mr. Van Dyk, my criticisms of your piece were not "free-ranging broadsides," they were very specific and supported by evidence. Sorry you choose not to engage them. In terms of reaction by experienced political and health policy observers, quite a few very smart people had very different reactions and thought Obama's speech significantly advanced the likelihood of legislation passing. Such people include Mara Liasson and Julie Rovner of NPR, E.J. Dionne of the Washington Post, Jonathan Cohn of New Republic, and even, in his own contrarian way, David Brooks of the New York Times. Mr. Van Dyk seems to have made up his mind quite a while back about health reform, but for the rest of you Crosscut readers, Dionne's column is worth checking out:
http://www.washingtonpost.com/wp-dyn/content/article/2009/09/09/AR2009090902218.html?sub=AR
Posted Fri, Sep 11, 10:16 a.m. inappropriate
Harris: I have said in the past that some legislation will pass---but not necessarily the legislation passed by the three House committees. My summary was intended to provide insight into what now will happen in the legislative process. Suggest you and others check back a month from now to see whether I was right or wrong.
I respect the judgements of some of those you characterize as "very smart people" and have little regard for those of some others. I actually know some of them and have a basis for judgement. If you are looking for cogent commentary on the issue in the Washington Post, you wouild better served to turn to columnist Bob Samuelson or the unsigned lead editorials on the subject. Dionne seldom strays from the Democratic National Committee message of the day.
I "made up my mind" a long time ago that the health initiative was unfortunately pressed forward before the country had emerged from financial/economic distress---thus making its passage more difficult. I still believe that was a correct assessment. Nonetheless, the process continues and, in the end, some legislation is likely to pass (although with more difficulty and with less comprehensiveness than otherwise might have been the case).
I enjoy your copy on Yakima Valley wines.
Posted Sun, Sep 13, 10:14 p.m. inappropriate
Actually, Mr. Van Dyk, the CBO projected that the cost of HR 3200, the House Democratic health reform bill, would be $239 billion over 10 years, not $1 trillion as you claimed. Here's the link. Let's try to be more accurate in the future.
http://www.cbo.gov/ftpdocs/104xx/doc10464/hr3200.pdf
Posted Tue, Sep 15, 8:41 p.m. inappropriate
How surprising to hear that Ted "I haven't been a liberal since HHH" VanDyke is against yet another progressive idea.
Ted is obviously taken care of when it comes to his health care. Aren't you Ted?
This column can be summarized as follows: "I, Ted VanDyke HATE the idea of health care for all citizens and it's not worth spending one dime on this. Plus, I think we should just leave the insurance companies alone. And I WANT the Public Option to die, so I'm predicting it has "no chance", in an effort to sway public opinion against it."
Why is this old hack still given a column anyway?
Posted Tue, Sep 15, 8:43 p.m. inappropriate
LOL. So predictable that VanDyke would cite Robert Samuelson, who hates the very idea of the public sector, as an objective source. Give it up, Ted.