Obama Misses the Point on Health Care Debate
My wife is an economist -- and I study politics. But on President Obama, she has been right all along. From the start she understood that he was speaking to the nation in a way that resonated uniquely with voters; I was skeptical.
Now, she understands that his lofty rhetoric is missing the point on the health care debate. And again she is right.
In one amazing presidential campaign and six short months in office, President Obama has established himself as one of the greatest public orators in American history. That makes it even more perplexing how he has missed opportunity after opportunity to stir the nation to support major health care reform.
Wednesday night's press conference might have been the low point. We witnessed Professor Obama explaining the intricacies of the policy options in sonorous tones; he made the economic argument in a way that made every listener understand why economics is "the dismal science." I was screaming at the television set every time he launched into the litany of cost savings from effective use of technology, saving two-thirds of the cost by efficiencies within the system, not allowing the health care reform to add to the deficit, the excessive cost of U.S. health care, and the undeniable problem of 46 million uninsured Americans. We get that. He did not need to pound it into our heads.
What was missing was the very simple concept that health care is a public good.
If an uninsured family does not take a child with symptoms of swine flu to the doctor because of the cost of health care, swine flu will spread. Other children and adults will be infected. And we will all lose. We need to fix the system so this does not happen--not just for that uninsured family's sake but for all of our sakes.
The debate has been framed in terms of winners and losers. The Obama strategy has been to pick off interest group after interest group--the doctors, the nurses, the pharmaceutical industry, the AARP--in order to get a majority behind the bill. The opposition has taken the opposite tack. Poke holes in the specific proposals, raise fears, play to the claims of those who might not benefit from a specific part of the whole.
That is old school, interest group politics, the kind of politics that is flooding our airwaves on this issue
What is needed is the Obama of the campaign. Raise the aspirations of a great nation. Let the nation know that we, the American people, we, the nation to whose standards every other nation in the world aspires, can do better. And in doing better, we do so not just for the less privileged among us, but for all of us.
The public good argument is clear. A reformed health care policy will make us a stronger nation and--and this is the key--will benefit everyone. That argument can be made in economic terms. When an uninsured person does not get treated early on for a wound because of fears of the cost, the wound may become infected. Eventually he goes to a hospital emergency room and is treated. When the bill is unpaid, the hospital writes it off. But that write-off goes into other fees; and insured people end up paying higher fees for services and consequently insurance premiums. Those costs are real; they are just less apparent than others. But people are treated--and those costs are paid.
The President came close to making the public good argument only once during his press
conference, when he outlined the cost of the current system. "If somebody told you that there is a plan out there that is guaranteed to double your health care costs over the next 10 years, that's guaranteed to result in more Americans losing their health care, and that is by far the biggest contributor to our federal deficit, I think most people would be opposed to that."
Then he left that argument. I cannot believe I am saying this, but Ronald Reagan would have made the point, in simple homespun language, probably with a couple of human examples as props. The health care debate is a human debate, not an economic one. And it is a debate about what is best for all Americans, not just the underserved.
This President, every bit the Great Communicator that Reagan was, must make this argument in terms of what is best for every American, not financially, but in terms of our health. His plan--even with lots of compromises--recognizes that health care is an American problem, not a special interest problem. His plan--even with lots of compromises--improves markedly on the current system, in a way that should be reassuring, not frightening.
He has to sell it in that way.
L. Sandy Maisel is director of the Goldfarb Center for Public Affairs and Civic Engagement at Colby College.
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An informed public would know that America does not have the world's best healthcare. The World Health Organization reports the United States falls behind 36 other developed nations in providing our human right to universal healthcare. There are 36 countries that provide superior healthcare for their citizens. The United States pays several times more for inferior healthcare. Finally, every one of the superior countries utilize a form of Single Payer healthcare. Not one of them utilizes a system that even remotely approaches what our healthcare looks like.
Over 30% of every insurance premium is put in someone's pocket, as profit. Subsidizing a few profiteers for providing inferior healthcare makes no sense, especially as it locks out tens of millions of citizens from receiving any healthcare.
The CBO is right. Without shifting to a Single Payer healthcare system, there's no way to lower costs. An informed public is necessary in a democracy.
Maisel: Nope. You and the Mrs. are both wrong.
Obama clearly understands that health is a public good. Listen to any of his Senate speeches on public health.
Wednesday night was a sales pitch. He was framing his argument for reform from the perspective of those critical of the plan - using economic and other fiscal-like terms.
Think about it. Using the 'public good' argument would have only estranged any conservative democrats, or mild republicans that are on the fence. Pitching the reform as fiscally responsible, cost savings, and increasing our competitiveness in the global marketplace speaks directly to any dissonant lawmakers concerned with the fiscal implications of the plan.
Do you remember Hurricane Katrina??? Do you want the same people controlling your healthcare? The U.S. Government (Republicans & Democrats) has never managed a successful or efficient program. Reform –Yes!, Government controlled –NO!
No FEMA under Bush sucked. Under Clinton it was quite successful. As was the VA and many other agencies. Its a matter of leadership and hiring the right personnel. Most seniors like Medicare by the way but its cost problems (which Obama is seeking to defray) have gone up because of general increases in health care costs over the last few decades.
It's not just Obama who has missed the point in the health care debates. It's everyone. Anyone who believes that this debate is about health care is sadly and tragically mistaken. This debate is, and always has been about the economy and finances. Not medicine and technology. If we really truly wanted to have a debate about health care, we would be debating who and how to fund sex ed programs, contraception, abortion, disease prevention and management, and advances in technology to help us manage the issues of health. Only talking about who pays for it, and how much, makes about as much sense to me as discussing the warrantee when buying a used car, and only focusing on the warrantee, without even aknowledging that the car itself is a lemon. Who in their right minds would pay $800 for 2 aspirin, as some hospitals charge, especially when we know that aspirin causes kidney and liver damage that only requires more medication. Who in their right minds would pay a dime for chemo and radiation for cancer treatment, knowing that the chemo/radiation is going to obliterate someone's immune system to the point where they are likely to keel over from the flu virus?
When THESE issues are discussed, we will be discussing Health Care. Until then, we will only be discussing and debating the economy.
You are correct. Health care is something we will all use at some point, and it helps everyone for everyone else to be well.
Health care ideally should be not-for-profit, so there is no incentive to keep people sick or make people sick. There would also be incentives to actually cure diseases instead of just treating the symptoms forever and ever.
Trained doctors want to practice in the fields and urban areas where they are paid the most.
So how is this going to be overcome except by humane concern for fellow Americans, which they are incapable of until they are out on the streets?
Unfortunately an electorate that "elected" Bush and Cheney twice is not going to be receptive to lofty debate.
As bad as things are getting everyday - and yes Obama should emphasize the crisis even more - the public is still susceptible to the same old Conservative shibboleths and distractions.
I hope I am wrong, but I see a psychological Depression spreading in this country among The Middle Class.
That has already translated into poll numbers, but unfortunately not to the elected officials.
Yes! Obama needs to use his inherent ability to inspire us and uplift us to better our society.
Thank You! You said what needed to be said.
Couldn't agree more. I think the president did make two key points:
1. The current system is bad and getting worse
2. He is determined to press for a new system
Both of these were appropriate for the format (a press conference), but nothing new nor inspirational for the "five-minu
It seemed as if the WHite House felt obliged to stay within this format. An opportunity missed.
I read through the notes on Obama's press conference last night, but what I saw was what a lot of the talking head pundits and others on Capitol Hill wanted; rhetoric that explains how we will pay for this and how we will get it done.
Up until this point, Obama has been promising wonderful "health care" but never gave any specifics. I know that most people's eyes glaze over at the numbers part, but then those same people scream "We havent' heard any DETAILS!!" Sorry folks, the devil is in the numbers, but so are the details. People are holding everything this man says to a double standard, and it's ridiculous. It honestly doesn't take a speech to tell America the health care is good, just ask the person dying of cancer b/c they can't afford treatment.
Properly framed or not, there are too many structural problems within our current system of health care delivery that are in need of major reform before any major change can have a chance to work without bankrupting the nation.
If we want affordable and accessable healthcare in our country, then we need a couple of things poiticians don't like to talk about: 1) tort reform - frivilous lawsuits have driven up insurance cost and forced doctors to conduct a myriad of unnecessary tests because they fear a lawsuit if they don't. 2) The AMA controls med school enrollment (quotas) so that there are not enough doctors to meet our healthcare needs currently - if we cover the uninsured where are all the doctors and nurses going to come from? Costs will skyrocket- simple supply and demand. We need to fix these 2 items first and fast as part of the structural foundation for workable healthcare reform.
And then spread the cost to all... I'm tired of our President's class war mentality.
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