Well I listened to President Obama’s speech on NPR last night whilst playing with my daughter and Curious George. Suffice to say, I didn’t catch the entire thing, though what I did catch sounded pretty good. A few thoughts:
CNN says it boosted support for Obamacare. We’ll see if it lasts. Speeches, especially those of masterful orators like Obama, can certainly sway us – but is it sustainable?
If reforms to the health care industry do not cover illegal immigrants (I hate the term “alien”) then who will cover the costs of their medical care? It’s beyond wishful thinking to believe the immigration problem will simply fade away regardless of which side of the debate you fall on. And until then, illegal immigrants will need medical care, as will their children. Either the brunt of that expense will fall on local community emergency rooms or we can talk about spreading out those costs. This is the same problem we have with legal, low-income uninsured. Ignoring it will not make it go away.
If we’re going to adopt British norms of political behavior, we should also adopt British norms of governance. It’s fine to have a polarized system when the majority can wield power. You just can’t have it when you need a supermajority — which is to say, a high level of consensus — to get anything done. So if we’re going to move toward British-style heckling, lets also move toward British-style majority rule. Deal?
Yes, then we could have Britain’s lovely health care system, high taxes, high unemployment, high cost of living, and endless rain.
Also from Yglesias:
Would Obama seriously veto an otherwise good health plan on the grounds that it adds literally one dime to the deficit?
Right? I have a hard time believing this.
I also wonder why Obama hasn’t moved more seriously to pull out of Iraq and Afghanistan in conjunction with his health care push. Not that I’m entirely sold on rushing out of either conflict, but it certainly would add fuel to this debate. Save money by ending the war! Bring health care to citizens and veterans alike through the cost-saving measure of peace!
I wonder if half-baked reform plus an individual mandate won’t be too much of a burden on the young and on lower-middle-income people? How much will insurance cost on the private market after reforms? How much cost-assistance will people be eligible for? How will this effect consumer spending in other areas?
I hate the heartstrings stories. Every anecdotal story of woe is just another version of Joe the Plumber. Little Suzy in Maine whose school is made from cardboard boxes. Bob, the carpenter from Tuscaloosa who lost both legs in a fight with his BCBS billing rep. My eyes fog over, the sound of the sea fills my ears. I drift….. I’m glad we didn’t have to suffer much of this in last night’s address. The Ted Kennedy reference was appropriate.
The bone thrown to Republicans – tort reform – is probably the least appealing bone from where I stand. I would prefer some more robust market reforms, insurance across state lines, and so forth. I would be fine and happy with a public option if these reforms were included, especially if vouchers were a part of the mix. Tort reform is small potatoes.
I do like the idea of providing catastrophic coverage right away. Why didn’t we do this decades ago? McCain seemed pleased with the shout-out.
Did Obama say that the public option would have to be self-sufficient based on premiums and not public tax dollars? Really? Or am I mistaken?
How will this work exactly? Wouldn’t it just make more sense to expand Medicaid to say – 200% of the poverty line and institute some cost-saving reforms? I wonder, for instance, if letting each state implement Medicaid is the right approach…. Perhaps a national Medicaid, easily accessible in one online location as well as at Medicaid offices (not state-run offices) might make more administrative sense. Maybe even make Medicaid cost something on a sliding scale as you rise above the poverty line. This just seems like a simpler idea than adding a non-profit public option that is somehow totally self-sufficient to the mix.
Indeed, the one thing that I thought lacking from what was a fairly decent speech, was any semblance of simplicity. What is your plan Mr. President? Which of the many circulating plans is it? Can I tick the reforms off on my fingers? I do like some of what I hear, but I come away with cobwebs – shaky on details but also on the broader vision.
Keith Hennessey lays out his predictions for health care reform:
- Cut a bipartisan deal on a comprehensive bill with 3 Senate Republicans, leading to a law this year; (5% chance)
- Pass a partisan comprehensive bill through the regular Senate process with 59 Senate Democrats + one Republican, leading to a law this year; (25% chance)
- Pass a partisan comprehensive bill through the reconciliation process with 50 of 59 Senate Democrats, leading to a law this year; (25% chance)
- Fall back to a much more limited bill that becomes law this year; (40% chance)
- No bill becomes law this year. (5% chance)