Well, we now know what super-awesome-fun-time the Obama ladies had with their patriarch during their Martha’s Vineyard vacation. Limited to nil. Because its obvious in the second address to the full Congressional body that President Obama went to school and studied how to re-frame the debate in his favor. Simply put, Obama delivered an impressive moderate speech on Wednesday evening, using his pulpit to battle against both extremes. In this speech he didn’t give a damn what the Limbaugh’s and Hannity’s will say (Side Note: Hannity has said tonight that Obama’s speech was straight partisan, which I disagree) – and he went out of his way to tell liberals that they are going too far with their support of Single Payer or the Public Option as a means to the end. It was an address to the moderates of each party and independents. But there are still a ton of questions to be answered. Lets breakdown the speech and what still remains outstanding.
The strongest part of tonight’s address happened in the beginning and the end. Obama, like usual, was very effective in framing his debate with strong personal anecdotes and effectively questioning the moral fabric of the nation to spin into his debate. But right from when he started discussing HIS plan, he was quick to distance himself from the far left and right plans. He disregarded the Single Payer option and leaving it up solely to individuals. Obama said, “Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn’t, rather than try to build an entirely new system from scratch.”
The most interesting part to me about the Obama Plan is how much it mirrored the Patients Choice Act introduced by Republican Paul Ryan. I’d say they are nearly 75% similar, with the differences being the public option, giving people tax credits to help pay for insurances, and serious tort reform. Otherwise the emphasis on preventative care, Market Exchanges, making all Americans eligible, and mandatory coverage are all similar. Here are links to each summarized plan: Obama Plan – Find PDF Link and Paul Ryan Plan – Short or Long Summary
Obama’s plan was based on three parts:
1) If you like your plan you keep it – no exceptions. In addition, the coverage you have can not be dropped for pre-existing conditions, no cap on services over a given year, limit the amount of out-of-pocket expenses per individual, and focus strongly on preventative care. In essence offering more stability and security to your current plan. There are still questions though; Obama used the buzzwords “required to change”. While you may not be required, what if your employer decides that the tax penalty for not providing care is less than the $15K-$20K cost to provide services to an employee? Then, you will lose coverage and need to go on the public plan – although you weren’t required to change. The tax penalty will need to be higher than the coverage itself for this to work or it is just another instrument to drum up funds for the public option.
2) Offer quality, affordable choices to citizens that do not have Health Care. To achieve this the government would set up new Market Exchanges, or essentially a co-op to lower costs. There still needs to be a far better explanation how they plan on making this work. First off, Im guessing they will be State-run Exchanges based on how Obama described current coverages. This may limit the insurance companies involved and lower the pool of potential customers which in turn limits potential savings. Then, he said that 95% of small businesses would be given tax credits if revenues or margins did not hit a minimum that allowed them to access the Exchange. These margins still must be defined and what is considered “small business”.
Involved in the Exchange would be a Public Option. It is still to be determined how influential a public option would be. Some on the left think this was a throw-in by Obama to appease his electorate. Others have already spun it as a mandate to pass a comprehensive public option. Whichever way it goes, it was undoubtedly buried in Obama’s speech. He also acted sheepishly when discussing its merits – as if he was ashamed of it. He was quick to mention a public option would only effect 5% of the public. What he didn’t say was whether he meant 5% would be eligible or only 5% would want to sign up. Obama also didn’t want the perception to be that the public option was the only option. He made sure to explicitly say that the government plan was there as competition to keep insurance companies honest and not to run them out of business. One point I liked was that Obama says his public option will be funded solely by the premiums it accumulates from its customers and not from additional taxes. If this is true, I think it will be a much better barometer to premiums and can fairly compete in the Exchange.
Also, Obama mentioned it would be 4 years before any Exchange would be started up. In the interim Obama proposed the McCain strategy of high risk pools to cover long-term illnesses at a lower cost. I’m not sure how willing Progressives would be to holding off reform plans into the 2nd term (*ahem*…or 1st of a new President). In the hours following the address, progressive talk hosts were already not thrilled with the timeline.
3) His final key, is to make it a requirement of all individuals to buy Health Care. The individual mandate was promoted by Hillary Clinton and John Edwards in the primary, and Obama was against it at the time. I see the benefit of an individual mandate, if properly created. Companies that do not provide a Health Care plan will have to pay a piece of their employees care. This will need to be carefully structured to not knock small companies out of business. Some may also find making people buy insurance, unconstitutional…a claim Obama will likely have to fight.
There were two areas that Obama was very weak in the Congressional address. I felt like Obama almost made a mockery of the tort reform that this country so desperately needs. He did nothing to deflect the common belief that the reason Democrats ignore medical malpractice suit regulation is because they are in the tank for trial lawyers. Rather than making it a part of the Health Care reform, he is using it as a carrot for the Republicans to reach – essentially taking a key issue for the Republicans and politicizing it, exactly what he spent an hour lambasting them for doing. He said he will have Kathleen Sebelius move forward on looking into the viability of tort reform, but I am skeptical. Obama spent a grand total of 5 sentences on helping doctors reduce defensive medicine and worrying more about covering their asses instead of diagnosing illnesses.
The other weak point was discussing funding of the plan. I appreciate that he is determined to not sign a plan that adds “one dime to the deficit” and will add a provision that cuts in spending will be made if the savings promised don’t materialize. However rather than explain more aggressively how the plan will be paid for he used his to time to poke at the past Bush administration and distract from addressing his plan. From what I was able to gather, not one dollar of the Medicare trust fund will go to pay for this plan. However the majority of the $900 Billion cost over the next 10 years (Note: This is an Obama/Baucus estimate, nothing from the CBO yet) will be raised from stopping the waste in Medicare claims and fraud, a government run program. How confident should we be in a public option when we are looking to pay for it with the wasted $100 Billion in Medicare fraud? If it hasn’t been done already, how confident should we be that they can eliminate this fraud that has brought Medicare on the brink of bankruptcy? Also, since he was quick to bring up that the plan costs less than the Bush tax costs, a dubious claim in the least, the remainder will likely be paid for by raising taxes on a large number of Americans.
I definitely agree with the President when he says, “the status quo is not an answer”. We need reform, just the right reform. Did tonight’s speech lead us in that direction? I have my doubts. In the hours after the speech, brain-dead members from each party were already on the talk shows claiming the same talking points. I have less confidence in our Congress working together than Obama as our President. Let’s keep in mind the Obama plan in this address, is a far cry from the 1000 page House bill being debated the past month. But we will see…Obama’s speech should have helped gain back some of the dropping support among independents and that will help his position if he can inarguably state Americans support him. As President Obama said, drawing laughter from the Congressmen, “there remain some significant details to be ironed out.” But for at least one evening, you got the feeling what a bi-partisan District of Columbia could achieve.
UPDATE: If you have spent 5 minutes listening to any political radio or TV show this morning, you will be disheartened to see politicians from both sides doing nothing more than spin Obama’s speech to their liking. Almost as if they heard a different speech completely. And the A.D.D. Media is focusing more on Rep. Wilson than any Health Care topics. Same old, same old.
UPDATE #2: The CNN poll among speech watchers echos my initial impression that Pres. Obama was impressive in his delivery of the outlined plan. 67% favored the plan he outlined in the address and 77% had a positive reaction to the speech. However, it should be noted that people identifying themselves as Democrats watched the speech in greater and numbers than are represented in the American public as a whole. Also, these polls are very similar to the ratings Pres. Clinton received in 1993 and nothing was passed back then.