Last night, President Obama laid out his vision for health care reform before a special joint session of Congress. The pillars of his plan are: i) Curbing the worst abuses of private insurance, ii) Requiring everyone to have insurance, iii) Insurance exchanges, which are basically government websites where customers can order insurance off a "menu" of plans, the idea being that if tens of millions of people order the #2 Combo, everyone's lunch will be cheaper.
The president made it clear that the country can't afford to wait for reform. Last night, he took on the self-proclaimed fiscal conservatives who claim that they oppose reform because it would increase the deficit. "Put simply, our health care problem is our deficit problem. Nothing else even comes close," Obama said. The president reminded the audience that each of us pays a "hidden tax" of $1000 dollars a year to subsidize charity and emergency care for the uninsured.
It was an impressive performance, but as John Nichols of the Nation observes, it was hardly a rousing, "to-the-barricades" oration:
Obama still talked about "options" and "choices." But he suggested that they would be offered mainly by insurance companies that would be enjoy "incentives"--i.e., new streams of taxpayer dollars--if they agree to abide by consumer-friendly regulations and come up with strategies for covering more of the uninsured.
The president expressed support for a very limited public option, a kind of welfare program that only about 5% of Americans would choose to join. This is not the public option his liberal supporters had in mind. It's non-threatening to the insurance companies, though. Private insurers love the idea of the government low-grading the insurance pool and taking on the sickest people who can't get coverage anywhere else. That means private insurers can make even more money off the remaining healthy, paying customers.
James Ridgeway of Mother Jones is even less optimistic, "As for the public option, that's pretty clearly gone down the drain."
One GOP legislator decided that a joint session of Congress was basically a town hall with the president. Rep. Joe Wilson (SC) screamed "You lie!" when the president explained, for the umpteenth time that undocumented immigrants will not be covered. As with the town halls, Wilson's performance had a whiff astroturf about it. Sure enough, Sue Sturgis of Raw Story found that Wilson pocketed over $2 million in campaign contributions from the health care industry.
The president also reminded America that health care reform will not pay for abortions. (For more on myth-making around women's health, see Laurie Rubiner's excellent post at RH Reality.)
Instead of presenting a vision and asking Congress to line up behind him, the president stressed that he was synthesizing a compromise position incorporating ideas from the left and the right. Instead of a coherent vision, the president's scheme sounds more like a last-ditch compromise plan to enable him to declare victory. Like many Democrats, the president seems to be confusing the strategic with the expedient. If "reform" means saddling ordinary Americans with expensive mandatory insurance without a meaningful public option to keep costs in check he could doom the electoral fortunes of the Democrats for years to come.
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