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June 8, 2009
Misdirecting Health Care
In a letter to Congress tossed over the transom as he left the country for Cairo last week, President Obama threw down the gauntlet on health care, stating unequivocally for the first time as President that he wants a government option for health insurance. The letter is a classic in Obama-speak, beginning with a full page of scare tactics and exaggerations, hurry-ups and platitudes:
urgent...current course unsustainable...a necessity we can not defer...threatening our economic future...staus quo is broken...can not afford to postpone...historic juncture...affordable health care... best practices...highest quality care
On the second page Obama finally gets to the point:
I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive and keep insurance companies honest.
Republicans in Congress have said for months that a public option is a non-starter and would be a deal-breaker for a bi-partisan health care bill. The President's letter has roiled the waters, reflected in the growing frustration among republican senators. Several were quoted in Politico following the President's letter:
For Obama, passing socialized medicine would be the crowning achievement of his liberal presidency, marking him a success in the collective mind of the left no matter what else happens under his watch. For Americans, it will mean government control over another one-sixth of the economy, and the cold hand of government directing our most critical and private medical decisions.
Every other ill-advised measure put in place by Obama and company can be reversed by future administrations and Congresses, albeit at a cost. The health care public option, however, will be an irreversible step toward government rationing of health care. A much-quoted study by the Lewin Group indicates that a Medicare-like public plan would result in 119 million of 172 million privately insured people switching to the government plan, as employers drop their insurance and private insurers are priced out of business. Our medical care system would be run down until we are left with a government-run system of mediocrity in medicine, with costs controlled by rationing the availability and timeliness of care, as experienced in Great Britain and Canada.
While Obama jumping in with both feet for the public option gives cover to Congressional Democrats, it is not without risk for the President. A report in Sunday's New York Times recaps the risks for Obama:
But as Mr. Obama wades into the details of the legislative debate ... he will face increasingly difficult choices and risks. If he embraces a tax on employee benefits, an idea he attacked when he was running for president, he may infuriate labor and the middle class. If he insists on a big-government plan in the image of Medicare, he could lose any hope of Republican support and ignite an insurance industry backlash. If he does not come up with credible ways to pay for his plan, which by some estimates could cost more than $1 trillion over 10 years, moderate Democrats could balk.
Obama knows his Presidential spending binge is a volatile issue with the electorate, and he has to some extent painted himself into a corner by saying he wants a bill that pays for itself. As a result he has floated all manner of trial balloons, and lead balloons, on tax-raising measures, including taxing benefits, limiting charitable deductions for high-earners, and a new value-added-tax that would have the government skim their cut off the top of every transaction in the economy. Obama has also trotted out a dog and pony show of health industry executives eager to show they can trim $2 trillion in health care costs over the next decade.
The Republicans for their part introduced their own health care plan a few weeks ago, called the Patients' Choice Act, that is based on replacing the $300 billion tax benefit for employment-based health insurance with refundable, advanceable tax credits to individuals, and also includes supplemental help for low-income Americans, state and regional health care exchanges, health savings accounts and programs to end excessive malpractice costs. The Republican plan has of course been ignored by the mainstream media, but will inform the negotiations for a bipartisan bill if there is one.
The Times report indicates that the President will be putting on the full court press for his health care plan in the coming weeks, returning to campaign mode with speeches and staged town-hall meetings. We can look forward to the usual Obama rhetoric, pressure on recalcitrant members of Congress and much trumpeting for Obama's plan in the main-stream media echo chamber. Senate Democrats have reserved the use of budget reconciliation, meaning minimal debate and a simple majority could be invoked if the democrats feel the need to override republican objections. Democrats in both the House and the Senate are currently drafting bills with public options included, with the expectation of passing a bill by October.
Obama, Emanuel and company have proven they can move their agenda through Congress, and when it comes down to it, the Republicans are powerless to stop them, as long as the Democrats are willing to take the political risk of owning a government health care program. That kind of political risk did not stop them on the stimulus bill, or on the nationalization of banks and autos, and it is unlikely to stop them on achieving the long sought liberal goal of national health insurance.
The wild card is Obama's narcissism, as described in a recent American Thinker column. Obama likes to be liked, and he will not be too popular when everyday Americans wake up and realize they will soon be shuttled to a government health insurance plan not of their choosing. Not to mention that he covets reelection.
In the face of the Obama media barrage, Republicans will be attempting to get the message out to Americans that the Democrats' plan to take medical care decisions out of the hands of doctors and patients and put them in the hands of politicians and bureaucrats. Once the details of the Democrats' bill are revealed to the public and to the stakeholders in the medical business -- doctors, insurers, hospitals, corporations and the network of supporting health professionals -- it is only a matter of time before people realize the consequence of what is in store. Mitch McConnell, Senate Majority leader has said that while there is no question on the need for health care reform,
Some are openly calling for this government takeover of health care. Others disguise their intentions by arguing for a government ‘option’ that we all know will really lead to government-run health care being the one and only option.
It is that disguised intention that will no doubt be sugar-coated in Obama's sermons to the public, and which Republicans hope to expose.
The Sotomayor nomination, cap and tax, the dollar and the deficits, the Middle East and North Korea, and GM and Chrysler will make this a very interesting summer in the fever swamp of Washington. But in the liberal mind, all of those issues pale in comparison to the realization that this may be their best chance at reaching their utopian dream of across the board health entitlements.
Obama has been described by Fred Barnes in The Weekly Standard as the "master of misdirection," adept at the head fake, getting you looking one way while he tacks the other way, saying one thing and doing another. The President has insisted all along that he wants a bi-partisan bill, which for republicans means not including a public option. Now Obama has come out strongly in favor of the public option. It remains to be seen which is the misdirection.