The First Year of the Obama Administration: Facts, Opinions and Discussions

His problem is that he allowed the debate to shift to the public option, which gave the GOP ammunition on the following fronts:

1) People would be forced into the public option as their employers decided it was cheaper, and that it would be rationed care.

2) Their taxes would go to cover non-citizens

3) The debt would spiral out of control, as well as individual taxes.

Those are serious concerns, but what the president should have done is focus on insurance reform, which would have been far more easy to swallow. I am a physician who strongly opposes government-run, universal health care, but I do support the insurance reforms Obama proposes, such as

a) no denial for pre-existing conditions

b) yearly caps on out-of-pocket maximums

c) no loss of coverage for illness, or downgrading of benefits

d) no droppage of coverage as long as premiums have always been paid.


That would have shut off a lot of the fear-mongering, both on the legitimate points and nonsense points (such as that the plan provides funding for abortions); what remains to be seen is whether or not Obama can reframe the debate.

Either there will be a compromise bill, or a democrat-rammed-through-bill, but there won't be no bill. It will be interesting to see how this plays out, but I suspect some sort of compromise will be in the works which delays or denies a public option but allows for insurance reform.


I am deeply disappointed that medical malpractice reform and protection against defensive medicine is absent from this bill. If one wants to cut waste in spending, there are few better places to start.

Peace,

V-03

 

I have to agree with you here. IMO he should have focused more on medical malpractice reform and insurance reform and nothing else. He would have enjoyed a majority of support from both the Dems and Repubs IMO. I would certainly have supported it but as it stands now, I won't support the kind of reform he and the Dems are proposing. There are some very legitimate concerns that are keeping him from getting the support that he needs and thank goodness people with common sense are standing up and letting their voices be heard rather than letting this kind of reform just pass blindly (much like how the last stimulus package was passed).

 

People aren't rebelling for the most part because of legitimate concerns, when people are informed of exactly what President Obama wants he has a 53% approval of it, and 46% disapproval. The underlying problem IMO is he is not getting his message across, which is mostly his fault and a little bit of the rights fault.

 

ShaneP

The more I think about it, I agree, especially with the economy the way it is. I think an argument could be made that reforming health care would be better for the economy, but that's certainly debatable.

V03

Once again, well said. Few questions...

Isn't health care already 'rationed', now instead by insurance companies? Just curious.

That would have shut off a lot of the fear-mongering, both on the legitimate points and nonsense points

Not sure about that. I think from the get go they did do a lousy job of explaining what a public option is. More importantly, I think President Obama overestimated (or was naive) about how much Republican support he could expect. Either way, I think he's realized this and is engaging accordingly.

I read an interesting article how the people most engaged are older people, who by their very nature are more involved in the health care system. This is the one age group Obama lost to McCain and thus is having his difficulties with. Younger people, Obama's biggest supporters, overwhelmingly support reform, but are more focused on the economy as an issue.

Anyway, I agree that some sort of bill will pass. But I 100% agree with your insurance reforms, and if they had been presented that way, the debate would be at a different point.

 

Not really, since its dependent on what plan you have with what company. Sure, you may have a company that's really trying to prevent people from getting treatment, but you're not STUCK with that system, per se. Which is where the concern of a single system is, is that you're forced into the system that then restricts treatment.

 

You are certainly stuck if you can't afford anything better. The fact is that health care is currently rationed by wealth: those who pay more can get more care, faster access, and better quality.

 

So why not have the government subsidize smaller insurance companies to help drive down costs?

 

Lowbacca

I get your point, but I'd say we kinda are.

An insurance company has limited resources, and as a business their goal is to maximize profits. They do this by taking as many healthy people as they can and denying as many claims that they can.

 

Disclaimer: I have nothing to do with health insurance other than as a consumer. I am a licensed insurance agent (customer service) in property and casualty. I have worked (over 20 years ago) for an insurance company.

With that said, the goal of insurance is to provide sustainable, affordable, and equitable coverage. The law of large numbers govern insurance.

In health insurance, pre-existing conditions serve as a deductible. Just as you are not allowed to purchase fire insurance as the wildfire bears down on your home, collect the cost to rebuild the home, then cancel the coverage, you are not "allowed" to be healthy for years and then purchase coverage once treatment is required.

I don't know if portability is built into any proposals, but I think it should be. If you've been covered, you should remain covered.

I think one goal of health reform, however implemented, is to increase the size of the pool (hopefully we'll increase the number of healthy folks not needing coverage NOW) to help lower the costs for those who do need coverage (now). And healthy or not, preventive care should be strongly emphasized.

Reduce unnecessary paperwork, reduce unncessary tests - all those things should be goals as well.

I'm on limited time (have just a few minutes during my break) so I can't add much more at this time. Sorry.

 

I have read and heard you could cut costs by over 10% just by doing those things.

 

No, there's no rationed care in America in that sense.

If you are denied a service and you need help, you go to the emergency room, where universal health care is then provided at spiraling cost to everybody else .

I would still like to see something passed; IMHO, Obama needs to make the bill a centrist one. That will likely mean abandoning the public option and focusing on insurance reform. With the new deficit report, he has the ammunition to demand that the liberals in the party back off on a public plan and instead allow him to focus on insurance reform and improving access to primary care.

The GOP arguments on cost are legitimate, given the deficit projections. Now is not the time for another entitlement. Fix insurance, malpractice, defensive medicine, and access to preventative medicine, and we'll save billions a year. If he doesn't focus there, the efforts will be sunk.

Peace,

V-03

 

Fix insurance, malpractice, defensive medicine, and access to preventative medicine, and we'll save billions a year. If he doesn't focus there, the efforts will be sunk.

Not going to happen. The managed care providers, the pharma companies, the trial lawyers all got in on the act early to protect their vested interests to the detriment of real reform. Putting the kind of regulatory caps on malpractice damage awards that are in place in many if not all European countries is just one critical aspect of reform that simply cannot happen under a Democrat-run Congressional regime.

 

Or any kind of Congressional regime in which the interests you listed are funding campaigns for our representatives and senators, or any kind of Presidential administration in which the President doesn't have the balls or the willpower to tell these interests to go climb Mount Redoubt. (And that, in a nutshell, is my biggest disappointment with Obama. He said that the lobbyists would not run his White House and lo and behold, they haven't gone anywhere.)

I agree with your list and Vaderize's list. That is where real reform needs to happen. I'm not hopeful.

 

Question: what is Hillary Clinton up to?

Here is an interesting take

Inside Clinton's foreign policy revolution, originally from the Washington Post

The secretary has quietly begun rethinking the very nature of diplomacy and translating that vision into a revitalised State Department, one that approaches US allies and rivals in ways that challenge long-held traditions. And despite the pessimists who invoked the 'team of rivals' cliche to predict that US President Barack Obama and Clinton would not get along, she has defined a role for herself in the Obamaverse: often bad cop to his good cop, spine stiffener when it comes to tough adversaries and nurturer of new strategies. Recognising that the 3am phone calls are going to the White House, she is instead tackling the tough questions that, since the end of the Cold War, have kept America's leaders awake all night.

Hillary Clinton as low profile bad cop.

 

That is an interesting take...I'll read it more carefully later.

 

Hey, whatever works.

 

The next question I have is:

If the republicans try and simply kill reform altogether, will the dems and Obama move to budget reconciliation and ram through a bill?

If they do take that path, what will the consequences be politically? The GOP will scream bloody hell from every soapbox that they can climb up on, and it will probably stick more than the dems counter-pointing-out that they did the same thing with post-9/11 legislation (ie, the Patriot Act), but how will things change?

Will a uni-partisan bill guarantee a democratic massacre in the midterm elections, especially if the economy is improving? The GOP has pointed out the administration's flaws, but so far, I haven't heard any ideas from them.

Anybody else feel that way?

Peace,

V-03

 

I said this in the Future of the Republican Party thread, and I'll say it again here.

It benefits the Republicans nothing to start throwing out new ideas this long before the elections. If they propose new ideas that gain a lot of popular support, it only gives Obama and the Democrats the opportunity to co-opt them and take credit for them when the elections come around. The ideal strategy for the Republicans is to spend their time between now and the elections actively opposing Obama and the Democrats' policies, and preparing their own ideas to reveal during the elections.

For example, they did that effectively in 1994. They spent pretty much all of 1993-4 attacking Clinton, and then only presented their ideas (in the form of the "Contract with America") six weeks before the election. That gave enough time to push a cohesive message as a party, but little time for the Democrats to co-opt any of the positions or effectively respond to them.

Kimball Kinnison

 

That might be a great idea if this were still 1994. But it doesn't do much for them right now as the perception of the party is rather low. Not to mention that they're acting like they're in an insane asylum. They have no message and the 'ideas' that they have proposed have been rather pathetic and mocked. So, if they're looking to come back to power then secrecy isn't their best option.

Where I think Obama has went wrong is on the torture issue and his foreign policy decisions. He's basically keeping the stuff that GWB put in place.

 

Does it benefit the Republicans at all to participate in lawmaking during the worst economic crisis since the Great Depression? They want to wait until unemployment hits 12% before they weigh in?

You'd think someone in the Republican party would put aside politics for a few months. But here we are talking about the future of the Republican party in the Obama thread if only because the future of the Republican party thread is reserved for talking about Obama.

 

The two are entwined now thanks to Republican chicanery. If Obama succeeds then it means they're failing and if he fails then they take it as a sign they've 'won'. Granted winning is relative when it leaves your country (metaphorically) in smoking ruins.

 

I think Kimball has explained adequately why Republicans are content to fiddle while Rome burns. To try to help their fellow Americans in a time of crisis would be bad gamesmanship.

 

Firstly, the irony of topic-swapping in this thread and the Future of the Republican Party thread does not escape me. Secondly, if you don't believe that the direction in which things are headed is the proper one, why should you go along with it out of 'good gamesmanship'? I don't begrudge Nancy Pelosi and her ilk for opposing the growing majority of folks that don't give a rip about second amendment rights--they think it's wrong, and they stick to that. It's an ideal with which I strongly disagree, but I grudgingly respect those that stick to it even though it's a total dead end. It's consistent. If the conservatives in Congress disagree with the president and the Democratic majority, why should we encourage them to compromise their principles instead of sticking to their guns?

 

It's not just for political gain, though. That's merely your interpretation of it.

Let me put it this way. Let's say that you have an idea that could win wide-ranging support as a moderate solution for the economy. However, if your opponents are able to co-opt it (and score the political benefits from it, including cementing their power base), they will be able to use the political capital that comes from it to push through other programs that you believe would be disastrous for the nation.

In such a case, it can become a question of contrasting immediate harm (withholding your good solution) vs. long-term harm (allowing your opponents to implement other policies that would be disastrous). Similarly, you might get a short-term benefit, but in the long run not gain as much.

The problem is that you are trying to treat each issue as though it exists in a vacuum when they don't. The political capital that Obama gets from passing health care reform spills over to help him push cap-and-trade (or some other policy). Similarly, when his approval goes down on health care, it also tends to decline on other areas, too. You can't say "They should just fix health care and focus on the other stuff later", because later they will have a much harder time pushing their proposals through.

For the most part, it's not going to be the end of the world if the Republicans wait a year before they put forward their own comprehensive plans (just before the elections). Might things be worse off then? Sure, but in the long run, it would allow for the overall implementation of better policies (at least according to the Republican viewpoint) and would provide a way to limit the ability of the Democrats to undermine those future policies.

Kimball Kinnison