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Obama’s Health Care Speech: Delayed Reaction

September 12th, 2009 Leave a comment Go to comments

I wanted to write my reaction to Obama’s big speech Wednesday night before reading any blogs or watching my cable news programs, just to report my gut opinion before bombarding it with other perspectives that had the potential to change my mind. But as I’m currently living with company, I didn’t want to say, “Why don’t you twiddle your thumbs for awhile why I rant about politics for my blog?” and as such I put it off until now, Saturday morning, while my guest remains asleep and I’m ready to state my opinion. As it turns out, in spite of everything I’ve read and seen between the time I watched the speech and now, my opinion remains fundamentally unchanged.

My first reaction was that the man can give a good speech, as I expected he would, but that in terms of substance absolutely nothing has changed. We now just have a clearer view of what Obama wants in the plan, where he will put his foot down, and most importantly where he won’t draw lines in the sand, specifically with regard to the public option. In spite of all the brilliant, emotionally-satisfying rhetoric, the president seems just as poised as ever to flush the only meaningful part of health care reform down the drain.

But before I get to the substance, it would not be fair of me to dismiss the rhetoric. We heard things from this president that touched on issues going far beyond the narrow confines of the health care debate and strike at the core of America’s “national character”. When Reagan took office he put forward a philosophy that government is not the answer to our problems, but that it is the problem. Ever since then this has been the predominant view, the underlying sentiment in American politics, even throughout the Clinton years. A liberal may have felt in their heart of hearts that government can be the solution to some of our problems but they could never say so directly, as Reagan’s anti-government philosophy was the generally accepted common wisdom and you would be a fool to suggest otherwise.

Obama finally decided to grab hold of the pendulum that Reagan had thrust towards the right and with these words, which if he backs them up have the potential to become the most historic words of the speech, gave it a gentle nudge back in the direction of the left:

You see, our predecessors understood that government could not, and should not, solve every problem. They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom. But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, the vulnerable can be exploited. And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes for wisdom, and we can no longer even engage in a civil conversation with each other over the things that truly matter — that at that point we don’t merely lose our capacity to solve big challenges. We lose something essential about ourselves.

The importance of such words finally coming from the American president can hardly be understated. For once, we have a leader willing to challenge the accepted doctrine that government is always the problem and make the suggestion that should have been trumpeted by liberals all these years, that the government can be the solution. He could have gone farther and completed this thought by asking his audience to consider what government actually is. Government, in the form of a representative democracy, is supposed to represent the people. Ideally, this would mean that the government, working on behalf of the people, would create laws and implement policies that would serve the best interests of the people. In reality, the only “people” the current U.S. government represents are the corporations, which are legally “persons” under federal law. And in service of those “people” the government has systematically weakened itself over the last three decades to the detriment of the actual people, the flesh-and-blood citizens of the United States. The current struggle over health care reform is emblematic of this problem, as half of the government, beholden more to the insurance companies than the population, is trying (quite successfully) to undermine reform and to transfer more wealth from the bank accounts of average Americans to the coffers of the health insurance corporations. This is the heart of the matter when it comes to health care reform, and I am pleased that Obama, at the very least, alluded to it.

And indeed, Obama laid out the case for health care reform in a far more strong and persuasive way than he has done so far, and it was gratifying to finally see the case—such an obvious and easy case to make—finally be made. All he really needed to do was shift the debate from numbers and figures and abstract projections to the moral level, the human level, the level on which the effects of this legislation will actually be felt, at which reform is most desperately needed:

One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn’t reported gallstones that he didn’t even know about. They delayed his treatment, and he died because of it. Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne. By the time she had her insurance reinstated, her breast cancer had more than doubled in size. That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America.

Seriously, republicans, why don’t you argue with that? Why don’t you explain to these people exactly why it’s not the government’s responsibility to make sure your health and well-being, your very life, which through the military it protects from foreign enemies, is protected from the domestic threat of profit-driven medicine? Profit-driven medicine kills people—more people than died on September 11, 2001—so why shouldn’t the government do something about it? This is plain and obvious, and it’s high time the president started framing this debate in this way.

So, with all that said, and with all the hope I had that the president really would come out swinging and look like the leader he seemed to have the potential to be during the campaign, I simply can’t and won’t delude myself into believing that this speech will make any real and substantive difference in the shape of the legislation that will finally be made law. To be fair, I think it went a long way in increasing support for reform over all, but what kind of reform will we get?

At the very least, it will be illegal for insurance companies to exclude people for pre-existing conditions and to deny necessary treatments to those already insured. These kinds of laws are long since overdue, and I would be happy if congress merely voted to pass these measures without any of the other legislation being proposed, as I expect about 99% of Americans would as well (the remaining 1% being those with a vested financial interest in health insurance industry profits). Making it illegal for companies to let their clients die for the sake of profit is the very least that the government can do for its people in this area.

But what of the remaining issues? How do we keep costs down and the health insurance companies honest? Well, the only real way to do this (since we’ve already given up on a single-payer system) is with a public option, a government-run insurance program that can compete with the private industries and offer an alternative both for those who can’t afford private insurance and those who, like me, would rather die than let these evil companies have a nickel of our hard-earned money. The public option is more than a great way to inject real competition into the insurance market—it is an option of conscience for those who are unwilling to subsidize the private insurance industry, which we see as morally equivalent to the mafia. So what does the president have to say about the public option?

Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. And the insurance reforms that I’ve already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Now, let me be clear. Let me be clear. It would only be an option for those who don’t have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5 percent of Americans would sign up.

Right off the bat he affirms his fidelity to the insurance mafia by declaring that “they provide a legitimate service” and that he has no intention of putting them out of business. While I and many of my progressive friends feel that they provide no service whatsoever other than imposing the obstacle of a profit-motive between people and their health care, and while we would be more than happy to see these giants crumble to the ground and be replaced by one completely not-for-profit single-payer system, the president abandoned this idea long ago. And while my progressive friends and I felt that at the very least, the public option could be a step towards the single-payer system we desire in that the insurance companies wouldn’t be able to compete with a non-profit-driven entity, the president assures everyone that the option would be so weak and contain so many limitations as to constitute less than 5% of the insurance market. Hardly reassuring. But then he goes even further, and says in what I may one day look back on and regard as the moment I completely gave up on Obama:

Now, it is — it’s worth noting that a strong majority of Americans still favor a public insurance option of the sort I’ve proposed tonight. But its impact shouldn’t be exaggerated — by the left or the right or the media. It is only one part of my plan, and shouldn’t be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage available for those without it. The public option — the public option is only a means to that end — and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have.

There are two elements here, the first being that he warns his “progressive friends” (who probably won’t be his friends much longer) that the public option is merely one element of his plan and that it is, essentially, expendable. It is only a means to an end, he says, and if there are other ways to achieve this end he is open to them. Well, without strong competition from a not-for-profit entity, I just don’t see how the end of preventing the abuses of private for-profit insurance companies can possibly be achieved. As long as every player in the health care system is motivated by profit, there will be abuse. Whatever other laws and restrictions you might make, these companies will find a way around them, just as the Wall Street banks continue to find their way around whatever regulations they allow their bought-and-paid-for congressmen to impose on them.

The second element to this section is his message to his “Republican friends” (who have never been his friends at any point) that he still wants to work together. Now, perhaps this is good politics and it certainly appeals to all the moderates and centrists in his audience, but anyone who is paying any kind of attention knows that not one single Republican really wants to make a good-faith effort to work with the president to bring about meaningful reform that will help the American people. Obama has already compromised so heavily with those whose only objective has been to kill the bill and destroy his presidency that any willingness on his part, perceived or otherwise, to make any further compromise would be insane.

Finally, we come to the element of the plan mentioned even before the bit about the public option, the part of the plan that makes it far worse than even the fucked up non-system we have now, worse than what we’d get if there were no reform at all. Regarding the rising cost of health care he says:

It’s why those of us with health insurance are also paying a hidden and growing tax for those without it — about $1,000 per year that pays for somebody else’s emergency room and charitable care. And 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.

Individual mandates. If you don’t have health insurance, you will be breaking the law, and you will have to pay a fine. Coupled with an obvious willingness to drop the public option, these two elements are the nightmare scenario for progressives, for those of us unwilling to subsidize the private health insurance mafia. If this is the shape of the plan that passes, it will force every American citizen to fork over a chunk of their hard-earned money to this evil mafia thus making them even stronger, and without competition from a public option to deal with the premium hikes, the denials of coverage, and every other nasty element that the profit-motive introduces into health care. It would be like Obama and the rest of our government forced every citizen to bend over and take it up the ass by Big Insurance. All in the name of “reform”, in the name of making life “better” for the American people.

It is the antithesis of the ideals and principles on which Obama ran, on which his supporters threw their weight behind him. We were excited to see an outsider candidate beat the odds and win the game, someone who really seemed like he might be on our side, someone at the helm of government who really believed in what government ought to be—not “so small you can drown it in a bathtub” but strong enough to serve as the people’s voice in this country dominated by corporate power. A government that took some of the wealth and power back from those corporations and kept the promise of America alive: that if you work hard, follow the rules, stay honest, and apply yourself to your goals that you could achieve a comfortable life in which you could spend most of your money as you choose and live free from the fear that you might lose everything just because of a downward turn in the stock market or a sudden injury or illness that could drive you bankrupt. The corporations have undermined America’s promise and representative government is the only way, short of full-blown torch-and-pitchfork revolution, that has any potential to restore it.

Obama talks a great game, and his rhetoric is exactly the kind of rhetoric I would want from an American president—it’s the reason I supported his candidacy in the first place. But if it turns out that this rhetoric is pure political calculation, that it’s only purpose was to strengthen support among the American people for a bill that will actually serve to their own detriment, than we ought to throw Obama to the wolves and start to once again think seriously about revolution.

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