Wednesday's presidential address to Congress is the moment for President Obama to prove he is a real outsider, and the fate of genuine health care reform depends upon it.
The President promised the public during the campaign he would be a Washington whistleblower. Obama said he would haul drug company executives before him on C-SPAN and demand greater savings. He said he opposed mandatory health insurance because Americans would buy insurance if they could afford it. He campaigned as a populist, not a beholden politician.
The White House's recent retreat on health reform, before the debate even began on the House or Senate floor, shows its time for Obama to renew his vows to the American people and find his inner whistleblower.
President Obama can insist on a health care solution that helps middle-class families, not insurance companies' bottom lines, but he will have to be the outsider president he promised, not the insider chief executive official Washington is demanding.
It's not easy being a whistleblower, an individual who puts the public's interest above those of your closest associates, but it's necessary now for real reform.
The President can learn a lot from Wendell Potter. Potter gave up his high-paying job as CIGNA's top public affairs spokesman at 55 because he saw how the insurance company's stalling tactics left a teen-age transplant patient to die and their pricing stranded a permanent underclass without health care. He abandoned his big salary and his ability to work in the industry ever again to speak out across the country against the industry that employed him, on behalf of the type of reform the President promised.
Potter believed Obama when the new president fervently insisted that health insurance reform provide a public alternative to the private insurance market, rein in health insurers' worst patient abuses and challenge the insurance industry's price gouging.
This summer Potter gave up the industry's secrets to Congress. He spoke across the nation and hit full whistleblower stride this past week, gracing Good Morning America, CNN and All Things Considered just as the president himself started talking tougher about insurance company abuses. Then, the White House pulled the rug out from real reform. The President and Health and Human Services Secretary Kathleen Sebelius suddenly claimed that a public option to the private market, a sort of voluntary Medicare that would compete with insurers, was not essential to a health care overhaul. In Washington that's the equivalent of flying the white flag in the Rose Garden and handing over the Oval Office pens.
Without a public option to private health insurers, Congressional health care reform will be worth very little to the vast majority of the American people, and could cost them quite a lot. Every American will have to show proof of having health insurance and, unless they've got Medicare, Medicaid or Veterans' Administration health care, they'll have to get it from the private insurance industry--the same industry whose skyrocketing premiums and shrinking coverage created the problem in the first place. The employers' lobby, which hands out campaign checks, is going to make sure employers pay as little tribute to insurers as possible and regular folks, who don't give campaign cash, get stuck with more of the bill.
Taxes will go up to subsidize the uninsured, yet there's no reason to believe the new "basic" private health insurance policies will be any better than the current bare-bones plans that leave families underinsured and vulnerable to financial meltdown.
The purported rationale behind Obama's capitulation - the votes aren't there - just isn't good enough. You never know if the votes are there until you take them, and the votes haven't been taken. When the President himself is watching a vote closely and pointing out the campaign cash trail, a lot of votes will suddenly materialize.
Obama has yet to play hardball though. He sacrificed one of the biggest potential pots of health care cost savings in the name of political expediency. According to detailed news reports, Obama cut a profitable deal for the drug companies in exchange for political money from drug makers to fight the insurance companies with television advertising. The pharmaceutical industry got a promise that the government won't purchase prescription drugs in bulk, which could have saved more than 60% on the nation's prescription drug bill. Now insurers have little to quarrel with in Obama's revised approach.
The President needs to take a page from Wendell Potter and remember some principles require you to go against those in your own club. Instead of capitulating to politicians, and the tens of millions in insurance company money that influenced them, the president needs to challenge Democrats who oppose his plan and shine a spotlight on their funding. He needs to insist on public hearings and public votes rather than backroom policy making that has created the status-quo.
If the stick of the presidency isn't enough to rally the votes Obama needs, then the President needs to embarrass those laggards in the media and threaten to replace them. He promised a better fight on the campaign trial and that's what Americans deserve now.