Wednesday, September 9, 2009

Obama's Health Care Reform Speech 9 Sept. 2009

This was more of the usual smooth-talking fluff.

The Good:

Obama: What this plan will do is to make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance 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. That makes sense, it saves money, and it saves lives.

That's what Americans who have health insurance can expect from this plan - more security and stability.

Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange - a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. It's how everyone in this Congress gets affordable insurance. And it's time to give every American the same opportunity that we've given ourselves.

For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need. And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned. This exchange will take effect in four years, which will give us time to do it right. In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. This was a good idea when Senator John McCain proposed it in the campaign, it's a good idea now, and we should embrace it.

The Bad:

Obama: 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. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements. But we cannot have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees. Improving our health care system only works if everybody does their part.

The "lie" part:

Obama: 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.

A little later he also said this:

Obama: My health care proposal has also been attacked by some who oppose reform as a "government takeover" of the entire health care system. As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government just like Medicaid or Medicare.

So let me set the record straight. 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. And it makes it easier for insurance companies to treat their customers badly - by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.


Obama: Add it all up, and the plan I'm proposing will cost around $900 billion over ten years - less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the beginning of the previous administration. Most of these costs will be paid for with money already being spent - but spent badly - in the existing health care system. The plan will not add to our deficit. The middle-class will realize greater security, not higher taxes. And if we are able to slow the growth of health care costs by just one-tenth of one percent each year, it will actually reduce the deficit by $4 trillion over the long term.

My thoughts:

The obvious intent is for the public offering to be floated as if it were meant to take over as a similar plan did in Canada. But, now the details...

One of the problems is the timing of it all. If this all happens 4 years from now, who's to say it won't be a political football for all of the time intervening between now and then? Might it be rescinded by a new president and a new congress four years hence? What's with the four years anyway - is Obama trying to get himself and his congress re-elected with this stuff?

And 5%? WTF? That will not be enough to have this thing take over. It will be too small and too weak.

We won't save on administrative overhead (i.e. paper pushing bullshit) because we will still have a kabillion private insurers biting back for every dollar. So the possible 30% savings that could be realized there is now gone.

I am very concerned about mandates. I am also concerned about penalties connected to a mandate. It's all too ambiguous. Too flimsy.

The last thing I want is to have to buy insurance from the same private insurance companies whose numerous acts of criminality are what necessitated a movement for health care reform in the first place. And what's the option again? Buy or pay a fine. Fuck that noise.

Matt Taibbi has neatly laid out how true reform was torpedoed from the first (see previous posts for links). David Sirota doesn't seem too impressed either, as is summed up at the end of a recent HuffPo piece:


David Sirota on "Reviewing President Rahm Emanuel's Health Care Speech"

I mean, I seem to remember an election just a few months ago that resulted in a Democratic president, and huge Democratic majorities in Congress - and I seem to remember there was a Barack Obama who only a short while ago said geting those electoral results was the only obstacle to a full-on single payer health care system, much less a weakened public option. But again, I guess it's just too bad that after that election, President Emanuel now rules America.


To echo Sirota's and Taibbi's many excellent points along the same lines: who are the Democrats attempting to appease? They own congress and the oval office. They could just ram through whatever the fuck they like. But no, first it has to be watered down into meaningless pap.

Okay, so maybe Obama's now only 95% Cheney as per Greg Palast's equation.