Obama Makes His Pitch for Health Care Reform

Despite the fact that nothing that occurred in August changed the vote count in Congress on health care reform, President Obama's speech on that subject last night was cast as a make-or-break performance. By now, the world should know that when he needs a speech to succeed he's the best orator of his generation (and a few others as well). A CNN poll noted a 14% swing toward his position after the speech. He said at the opening of his address, "I am not the first President to take up this cause, but I am determined to be the last." A deft turn of phrase, but if his plan gets passed, another president 10-20 years from now will have some work to do in this area.

The bill that will be passed is going to be a Democratic Party bill. The GOP has made it clear that they are not interested in bipartisanship. When Congressman Charles Roustabout (R-LA) gave the Republican response, he called for the entire process to start over with "real bipartisanship." Throwing out the last six months of work gets the country nowhere. It is merely a ploy to ensure that the status quo remains such. The Senate bill has 160 Republican amendments, but it will get maybe 2 Republican votes at most. Seven weeks ago today, the GOP said it was putting the finishing touches on its plan. Yet the party has not released anything resembling a plan.

Unfortunately, the Democratic Party is a broad tent that has genuine divisions between its various factions. The progressives want a single-payer system, at very least a public option, another term for a voluntary government-run insurance program. The conservatives, self-named the Blue Dogs, are concerned about getting re-elected in toss-up or Republican-leaning districts. Hence, they resist the public option as the thin-end of a socialist wedge. Of course, the health insurance industry's campaign contributions affect their judgment. So, Mr. Obama's address and the negotiations on the various versions of the bill are about keeping the Democrats on board. In a parliamentary democracy, a three-line whip would solve the problem, but the US doesn't have a parliamentary system, and the Democrats are not an organized party that would response to such discipline.

In the end, the law will reflect almost everything Mr. Obama outlined last night. No more insurance problems because of pre-existing conditions, no more caps on coverage, no more going without insurance if one wants it. There won't be a public option right away, if at all. There won't be federal regulation of insurance companies, nor will people in California be able to buy insurance from a carrier in Nebraska. However, Mr. Obama made it clear that he is married only to ends, not to means. A system that covers more people, more cheaply, with greater choice is the objective. How America gets there is largely irrelevant. The real question that no one has answered is whether any of this will result in longer life expectancies with better quality of life.

In the end, no system is perfect, and what is on the table is far from it. Treating health insurance as a pure public good and having a single payer system would be better. Treating it as a public and private good best delivered by insurance companies that are regulated like public utilities would also be an improvement. Merely allowing interstate purchase of insurance under the current arrangement would meet the goals Mr. Obama outlined. When the bill is signed, America will move forward, but it will spend a decade or two finding out where the shortcomings of the legislation are. And so while Mr. Obama has a chance to make history, he won't be the last president to address this subject anymore than he could be the last to deal with national security.

For now, the status quo offers only one reasonable insurance plan. Every American can get excellent health care with minimal out-of-pocket expenses for just under $1,000 a year. That's the price of an Air France non-stop, round-trip ticket from New York to Paris, which the World Health Organization.says is home of the world's best health care system.

© Copyright 2009 by The Kensington Review, Jeff Myhre, PhD, Editor. No part of this publication may be reproduced without written consent. Produced using Fedora Linux.

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