Saturday, May 1, 2010

Obama 2009 and health care

I've obviously been away from this blog for a while. As such, this post is mostly hindsight. Yay, hindsight!

Question: Why did Obama do so poorly with health care over the past year?

Answer: Because by and large, he didn't deal with health care over the past year.

Background: Way back in 1993, Bill Clinton decided to deal with health care. So he appointed a working group to put together a plan that would be introduced to Congress, appointing his wife Hillary to lead it. They submitted their completed proposal to Congress, involving all aspect of the plan. As a result, not only did this proposal fail, but it also ushered in a catastrophic extremist Republican takeover of Congress that lasted for the next 13 years.

With this in mind, it was clear that Obama's plan for health care amounted to "hey Congress, come up with your own health care plan and I'll sign whatever you want." This would solve the problem that the Clinton/Clinton plan ran into, which is that egomaniacal Congresspersons were insulted by being handed a plan to rubber-stamp.

Obama was obviously well aware of this problem. Thus, he decided to go way too far in the other direction.

Back in August 2009, the idea of having a public option for health care was polling at 77%. By the time the health care bill finally passed, the popularity of the bill was down to 50.2%. So what happened in between?

What happened is that Obama didn't use his oratorical abilities to support what he wanted in the first place. He tried too hard to stay out of "the fray" and as a result, abdicated any control or influence over the final product.

While Congress was discussing what provisions should be in the final plan, Obama was giving speeches saying that he was for some kind of (vague) health care reform whether or not it included any specific provisions. That is to say, he spend all of 2009 declining to say what specific provisions he wanted in the bill.

While this shifted the burden of the discussion off of the White House and on to Congress, it also abdicated the power of the "bully pulpit." That is, it completely failed to leverage his popularity as President to push for any specific proposals in the bill.

The result? Joe Lieberman pretty much got to define the bill himself. As a result, the final bill that ended up being passed was considered unpopular by the general electorate. Not because it was a national health care bill, but rather because it was a bad one, at least compared to what had been floated previously. The critical point being a Public Option. The Public Option was popular. Then Lieberman got it removed from consideration. After that, the bill polled as unpopular.

It wasn't until Obama's 2010 State Of The Union speech, and his following Republican Caucus Q&A session that he actually started punching back. My guess on the entire thing in retrospect is that Pelosi and Reid had said "you stay out of it, we'll handle everything," and so he tried that. Essentially, the Democrats had shelved their most powerful weapon in one of the most important debates, and as a result struggled through the latter half of 2009 without the support of one of the most eloquent and charismatic Presidents to come along in many decades.

However coming into the SOTU 2010, they had failed to deliver. Things were coming down to the wire. Thus, Obama took over. And the results are like night and day.

All of a sudden, the (weakened) bill passed the Senate. The House passed the Senate version. Obama signed the law. Done deal, dance in the end zone, Democrats win. The only problem is, in all of this they forgot about the original provisions they were trying to pass.

What we have as a health care bill amounts to pretty much nothing that affects the average citizen. Sure, if you were denied for a pre-existing condition, you get to receive health care now, and that's awesome. Bue that doesn't involve the rest of us. The rest of us are being told that our employer-based coverage is going to increase. The rest of us are basically being told that the health insurance industry is going to rape us for everything they can, while they still can.

What they fail to realize is that we, the working poor and middle class, gave up on them a long time ago, even as we have continue to faithfully pay their premiums.

To this day in 2010, I can't afford to visit a doctor. That's just how it is. Nothing has changed for me, or anybody who isn't either incredibly poor or incredibly rich. My employer-provided plan is a joke. I pay through the nose every month, and yet the deductible still hovers over my head like a sword of Damoclese: no reasonable health care expense is worth admitting the problem.

And so I go, my family and I, every month paying for something we can't afford to take advantage of.

That's what America has come to mean to me.


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