- Guaranteed issue
- Community rating
- Portability
- Exchanges
- Mandate
- Deficit neutrality
- The public option is negotiable
At least the Republicans have a set of talking points that everyone hasn't heard already, though about all you can say about the Republican response is, well, erm . . . he's not nearly as robotic as Sebelius was!
However, I think the line he's taking is smart. Start over and do it on a bipartisan basis, which polls well. Don't add another layer of hard-to-understand bureaucracy. Don't break the budget. They're putting out a platform of modest, easy to understand reforms that can be done "without destroying jobs, exploding the deficit, rationing care, or taking away the freedoms American families cherish." Emphasizing their desire for a bipartisan package is going to make it harder for Democrats to push this through on their own. But only if they actually get that message out early, consistently, and often. Republicans have not exactly been bringing their A game recently.
In the end, I think this speech satisfied no one. There's a little information for the wonks, but not nearly enough. There's a little stirring rhetoric for the non-wonks, but again, not nearly enough. Journalists seem to have liked it. But if journalists were any reliable key to the sentiment of the American people, we'd already have national healthcare, and national second homes in Maine.
Overall, I'd expect a modest bump, but one that will be sorely tested as Republicans roll out their attacks.
"In the end, I think this speech satisfied no one."
I loved it.
wrong as usual, Megan.
Was there a speech O could have given that you wouldn't have loved - saying he didn't make nice with his opposition and/or completely cave? I suspect that you may have been in the bag before and your opinion is no bellweather for him being able to shift general opinion in his favor.
My wife and I loved it too. So that's three of us.
Great, you loved it. But unless you went from disdain/dislike of the plan two days ago, to loving/liking it now, the speech was an utter failure.
So you're ready to go forward on the non-plan that Obama laid out? You wouldn't like any more details? You think that's a workable framework for a health care system? Or does it need rather more fleshing out?
Definitely needs fleshing out, so I expect one last push to get a vote before, let us say, the end of October so that the details can come after the bill is passed.
Drudge is claiming even the House doesn't have the votes. Don't know if that's true, since he seems to just be tallying up public statements.
Does laughter count as a positive response? I certainly enjoyed the speech, though probably for very different reasons than others.
So "satisfied" means "doesn't want any more details"?
I suspect a great many people responded positively to the speech. It probably won't convert anyone with strong views about health care policy that are different from Obama's, or bring his political enemies around to his side. That's not the same as "satisfying no one".
People who already loved Obama and Democratic health care reform, still love him. I don't think this speech changed anyone's mind, which is what I think of when I think of "satisfying" them--answering their questions, soothing their fears.
So, which of the plans in Congress is this?
Sorry, this speech was to the choir. It will convince no one not already for the plan, whatever plan that actually is.
"This speech satisfied no one"? This was living history.
It must hurt - I mean physically, not just psychologically - to be so cynical.
I honestly hope that getting married and having a child will help you overcome this.
I can't even imagine what it must feel like to be so . . . damn . . . compelled to make an insanely retrograde remark. And I am not easily offended on this score.
Probably the same impulse that leads one to yell "You lie!" during the President's speech. Feels good to be so damn bad when you think you're anonymous. If it helps, playscape's remark is not gender-qualified, so if you were a man, he could have used the same words and achieved the same rhetorical effect. (Of course, I don't really know what his (assuming the pronoun) intention was.)
It was rude of representative Wilson to shout "You lie!" at the president but his remark was well aimed and, I think, struck home. I have zero faith that illegal aliens would not have access to some kind of socialized medicine. They already take advantage of any number of government programs they are not supposed to have access to.
I personally favor immigration reform but this is yet another issue where the government has no credibility.
To nObamaCare:
You know, I actually think it's a good thing that anyone who is in the united states is able to get access to health care when they need it through some means, whether ER or primary care physicians. That access means less danger to "legal" Americans (think h1n1 flu virus, for instance).
Whether "illegal" immigrants are allowed to have access to health *insurance* is another thing entirely, and one which all the xenophobes seem to say "hell yeah!" about. So you've won that one.
But access to health CARE is another matter entirely. So your options are really simple:
a) admit the faulty logic in your statement, or
b) admit that you would rather another human being DIE than have access to treatment for a medical condition, and you are a worthless scum not worthy of the moniker "human" to begin with.
I realize that's ad hominen, but it's deserving.
We don't want them to die, but we also don't want to support them with our taxes by having them join a subsidized public insurance scheme.
Honestly, you progressives need a better line than "You want people to die!"
To TallDave:
And you ignore the argument again. Health CARE is not the same as Health INSURANCE. Look at the statement referenced previously. You have no argument, so don't talk about "liberals" not having any other arguments.
Gender neutral comment. I just find you to be so hyper-analytical and unemotional as evidenced by your conclusion to this remarkable speech. As I, and many of my friends, with a similar background as you (urban, Ivy, family later in life, etc.) was changed by children, I sincerely hope you will be as well.
Let me see if I can put this gently. When you tell a woman that she needs to get married and have a baby because she's too hyper-analytical and unemotional, that is never, ever going to be perceived as gender neutral. Especially since you don't know whether I want children, or indeed, whether I can have them. This remark is just never a win for you.
Let me also suggest that whether or not you believed it was gender neutral, it is a fairly well established fact that "male" behaviors are perceived as aggressive and heartless in women, sensible and leaderly in men, even when you're just changing the name on a business school case from "John" to "Joan". So whether or not you think you would have made that remark to a man, there's a good shot that you might not have if I were saying the exact same things, but named "Michael McArdle".
Having a child doesn't require bearing a child.
I didn't say that you needed to get married - comment is more the emotional succor that comes from being with another person. Could have said the difference from living alone to being with someone, but given your recent news...
Nonetheless, I will stop.
hyper-analytical and unemotional
Yes, reason and logic have no place in deciding whether we should radically restructure 15% of the economy. Much better to focus on whether the speaker gives us warm fuzzies.
For more warm-and-fuzzies, with no analytical effort, check out ObamaCentral:
http://andrewsullivan.theatlantic.com/the_daily_dish/
See, the real problem with your questioning is having a faulty personality. Or sex. Not that there could be anything wrong with the marvelous production of Congress.
Derek (which party has the insane people again?)
You should ban that asshole.
Ah, he's just a troll. I'm only sorry that Megan took the time to respond. BTW I'm sure Megan'll be just as cold, analytical and coldly logical post marriage/kid(s) as pre.
Living history? At what point is hearing the same thing rehashed for the 12th time still living history?
A president is supposed to lead. We are at an impasse. How did this speech lead us away from an impasse?
Joe
Living history? Please tell me the name of any European leader credited with bringing in nationalized healthcare. Even if Obama succeeds no one is going to study this speech in middle school. What is going to be relevent about this speech in a year let alone to future generations? Even before the personal crack at Megan your comment was ridiculous.
'Living history'? I guess that is partially what democracy is about. Your favorite icon can say something quotidian and heh, it makes your day. Then somebody else's icon gets in, does the same; and 'all the little children of the world' get something. I'm with you in one respect though. Megan is knocking 'waste, fraud and abuse' which was one of Ronnie Reagan's favorite segue lines and it's like 'don't step on my dog's tail, please' for me.
I really wonder what goes through your mind when you make such a remark - intensely personal and hurtful. Are you so sure of you moral superiority that you feel justified in saying anything to advance a cause?
What you need to understand is that it makes you appear weak, impotent and a bit hysterical - it doesn't help you, except with other people like you.
Agree with her or not, Megan deserves a measure of civility.
Obama paid lip service to tort reform. As a practicing physician I can tell you that defensive medicine is alive, well and costs the consumer a bundle in unnecessary tests.
Second, he said nothing about how the medically underserved are going to be able to see primary care doctors when there aren't even enough of us now. The reason? Declining payments (I refuse to call them reimbursements) to primary care.
Third, he repeated the old lie about how the uninsured use ERs and drive up costs for everyone else. That is false. ER utilization is just as high in the insured population. The reason? lack of access. See #2.
I could go on, but it seems pointless. Unfortunately, the Republican response was just as poor. What does a heart surgeon know about primary care? About as much as a community activist, it turns out.
"So you're ready to go forward on the non-plan that Obama laid out? You wouldn't like any more details?"
"So, which of the plans in Congress is this?"
Are you guys serious? He laid out the broad themes - individual mandates, employer mandates, no more recission, no more denial of coverage based on pre-existing conditions - and closed with a wonderful evocation of the concept of social justice. And he did so in terms that everybody can understand. For people on my side of the fence, he showed again why we supported him and why so many of us think he's destined for greatness.
I guess what I don't understand how a plan that mimics the Massachusetts plan in many respects ( mandates, community rating, no denial of coverage) is supposed to brerak even when Massachusetts is hemorraging dollars and failing to do anything about lack of access to primary care providers. So for starters, explain that.
Crickets.
Stan,
He didn't really lay out anything significantly different than he has laid out before. I have heard or read this speech before, from the same speaker, and in the last month. The only difference was the forum. It is the details that actually matter, and it is the details that reform will rise or fall with. Obama added nothing tonight. Which plan in Congress does he want to move forward on- does he want them scrapped- new imput from moderates- Congressional leaders other than Waxman writing them up?
The details of those plans are what was sinking them. So, what is different after tonight? I am just simply stunned that the administration thought a pep speech was what was needed tonight.
And he did so in terms that everybody can understand
Here is something I can't understand: individual mandates, employer mandates, no more recission, no more denial of coverage based on pre-exisiting conditions, all wrapped up with a ribbon of social justice and no friggin way to pay for it.
If Obama wants to increase competition, why not allow private plans to market nationally? Conversely, how can the playing field be level if only the public plan can compete nationally? The Ax massively fumbled his answer to Blitzer's version of that question today.
I wouldn't fault him for omitting details from a speech to people who can't understand such complexity (that would be the Congress) as long as there was a detail-filled doc accompanying the sales pitch.
Honest question here, what are the reasons against letting insurance companies compete nationally? I've heard this mentioned as a good idea plenty of times, and on the surface it seems like a completely non-partisan idea that could help, and seems unlikely to make things worse...so what am I missing, why isn't this in any of the main plans being proposed?
"Please tell me the name of any European leader credited with bringing in nationalized healthcare."
I can think of two off the top of my head, Bismark, in the 1880's and Clement Atlee in the late 40's. And then there's Tommy Douglas in Canada, usually thought of as one of the greatest of Canadian political leaders. Of course Douglas's plan is single payer and Bismark's is essentially the same plan that Obama is proposing, but people on the far right regard them as nationalized, socialized, and all sorts of other nasty things.
The far right? How does the center right regard them?
Anyway, your awareness of political trivia is very impressive but I think most people would, indeed, think of it as trivia.
When someone calls this speech "living history" and is so emotionally enraptured that they cannot resist hurling sexist remarks at O's critics one expects words that will ring down through a few generations and/or a piece of policy that school children will learn about for years to come. I just don't think this rises to that level.
I am glad you enjoyed it and that you like the president. The far left is a hard audience to please and appease - so kudos to O for that.
For a growing number of people O's lofty rhetoric has unfortunately become banal. If you disagree with him it can be unbelievably grating especially since he does not allow much room for anyone else up on the moral high-ground.
I wouldn't mention Tommy Douglas. He wrote a thesis supporting eugenics.
Derek
That will make him a cause celeb amongst the Democrat crowd.
My last post of the evening, this time a reply to Dan Smith. Massachusetts now has 95% coverage of its population, the highest in the country. I think this is a good thing. Do you?
If you can provide evidence that the problem of finding primary care providers in Massachusetts is worse there than elsewhere in New England, I'd be interested in seeing it.
As regards the cost of the Massachusetts plan, you're right. As explained in a very good post by Alex Tabarrok in Tyler Cowen's blog, Massachusetts type plans provide a windfall for the insurance industry in the absence of a public option or rigorous regulation of the industry. Without either of these things, medical inflation is inevitable. That's why I support a public option or at least the possibility of such a plan, as called for by Senator Snowe.
A public option will force private insurance companies out of the market because the government can offer all the same benefits without being worried to make money. (You'll note that our local, state, and federal governments are quite good at deficit spending.) Moreover the government will add yet-more regulations to an already highly regulated industry. Once the private insurance companies are forced out of the market place, we'll effectively have socialized medicine. This is why we call it a Trojan horse. The line from point A to point B is clearly drawn.
A milder prescription is a mandate. Constitutional issues aside, this sounds like a swell idea, except that it will be yet another transfer of wealth from the youth of this nation to the aged in this nation. And many people will ignore the mandate, just like they don't buy driver's insurance now.
The concept of universal coverage is a variation on that old communist theme, "from each according to his means to each according to his needs." Again, it sounds swell until you try it.
The government does not have the credibility to run a program like this. Please stop supporting efforts that will make things worse for the vast majority of the public.
a) the number of uninsured motorists as a percentage of the total is quite low.
b) there's always the option of not driving, which is NOT an option with having a body.
Yes, I suppose you're in favor of getting rid of medicare and the VA, then?
We have universal coverage here, and are required to have a card and pay a sum on top of taxes, called Medical Services Plan. An informal poll done of neighbors found the majority didn't pay the fees, unless it was done by their employer. If they show up for medical care the doctors don't get reimbursed for their services.
Derek
a) the number of uninsured motorists as a percentage of the total is quite low.
Actually, no, it isn't. The insurance research council figures it is set to rise to about 1 in 6 drivers by 2010 here in California.
It is not a good thing when the primary rationale for insituting this program is to lower costs. I would take Obama much more seriously if he just said "We are expanding coverage; we will raise taxes and cutting spending to pay for it." His whole thesis that his reforms will make medical care cheaper, or decrease the demand, while subsequently giving more people coverage for medical care, is unserious and borders on lunacy.
Was there ever a speech by Obama the "journalists" didn't like? Seems like every speech he makes is the best speech ever in the history of human civilization. The MSM has pretty much expended all their credibility and that's why Obamacare is failing.
It makes you wonder what they think when his speeches criticize them.
I always get this mental image.
I only got as far as the Charmin commercial and that's pretty much the image I get of his speeches as well ;)
Interestingly, this time, the Associated Press has panned the speech.
The AP came in just short of calling out Obama as a liar (apropos Wilson) in their fact-check of the speech, when you can read here:
http://www.msnbc.msn.com/id/32767017/ns/politics-health_care_reform/page/2/
The AP said Obama used "only in Washington accounting," a "variety of oversimplifications," and outright lies of "ommission" during the speech.
Given the historically supportive nature of Obama's press coverage, this AP analysis is quite stunning. It all but says Obama's speech was filled with lies and misdirection.
A speech by Obama on his healthcare desires is completely inadequate. These are merely desires, slogans, and goals. We need good medical care, affordable for everyone, with caring doctors, served by regulated insurance companies, and a chicken in every pot. Nice wishes, if wishing would make it so.
The government demands detailed, researched Environmental Impact Statements before starting a building. We should have Official Policy Impact Statements before our representatives change our society.
We need proposed results, expected evolution, methods, justifications, comparative studies, past successes of similar policy, funding sources, expected difficulties, the works. Designed to be read and understood.
I hope people of all parties and positions could agree that this is fundamental. It is non-partisan to demand that the President and all politicians show how they have carefully researched their proposals.
No company can run without books of account. No government can write legislation without a plan in the background. The plan is there. Let's see Obama's written plan. Then, he can talk about it.
Where is the policy paper, Obama's research on healthcare reform?
Andrew, you make me think of one of my favorite science fiction novels, Donald M. Kingsbury's "Courtship Rite." In the political system of the outer space colony he portrays, any representative who introduces a proposed new law is required to submit a prediction of the measurable consequences of that law. Score is kept, and if his predictions prove inaccurate, his future votes count for less, and the votes of legislators whose predictions were more accurate count for more. I could wish that our politicians were required to submit such predictions. For one thing, we'd have more debate on the actual consequences of their proposals, and less on the emotional appeal of their rhetoric.
I like Kingsbury's idea. Alas, we have no chance of such a reasonable government structure at the present. But, we can at least ask the right questions. I hope that the simple cry can find some resonance "Where is the policy paper?".
Politicians have found that can't be held responsible if they don't write it down. We have to demand this. As many of "us" as we can find.
There are people who think having a pimple on their butt
is a major health care crisis and they must go and SEE THE DOCTOR. Most of such people are women.
It will serve them all right if we do get a single payer system--pimple on the butt and irritations of the plumbing will put them on a list that will take years for them to come to the head of the line.
As the saying goes ladies, be careful for what you wish for, because you just might get it.
Well, 47 million uninsured has now become 30 million. So he's getting closer to intellectual honesty. One is tempted to ask where those 17 million disappeared to (FEMA camps? lol) but one also wishes to encourage such movement towards virtue, feeble as it is.
It's still very hypocritical, though. First he scares us with what a terrible crisis this is, then he complains about scare tactics. Then we get the tired false analogy of "auto insurance" mandates. You are not required to buy "auto insurance," you are required to buy liability insurance due to the fact you are operating a couple tons of machine at speeds of up to 70 mph or more which could cause severe harm to others.
Let it be said there are some things Obama got right here. Exchanges are a good idea. Insurance companies should be able to compete across state lines. Malpractice reform is a nice talking point, at least, though we'll see if it actually happens.
Overall, though, this is nothing new, just Magical Pony Sales Pitch #4,237. He claims we can do more with less by adding his patented new formula called Government!. Government! will cut costs, Government! will cover everyone, Government! will give you security. Government! will makes your whites brighter, your skin clearer, and rainbows and kittens will appear everywhere. Unfortunately, the American people have seen Government! in action and aren't impressed.
Honestly, I am starting to think the rumors of his brilliance are vastly overstated. I don't think he even realizes the things he are promising are impossible. He seems to honestly believe statements like "Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan."
This was a nice moment, too:
It's not a question of coverage, it's a question of enforcement, and an enforcement mechanism was proposed and voted down. Illegals aren't supposed to vote either, but for some reason voting is easier than buying cigarettes, and we hear mutters of "voter suppression" and "poll taxes" even when the enforcement plans include giving people free photo IDs.
This was not the forum for shouts from the gallery but I really wish there was such a forum. I am in admiration of one aspect of the Brittish system where leaders have to go in front of parliament and they take serious swipes at each other and have to answer pointed questions. I think it makes for more able politicians and would allow a set time and place for the politicains to hassle each other over the more onerous obfustications of the other side.
There is something wrong with a system that keeps opposing views from actually engaging with each other in a productive manner. Furthermor, it might serve as a model for citizens if they see an aggressive yet controlled debate by the political leadership.
Our system of proxies and spokesmen throwing punches via the media could be improved. All the stuff about Obama's teleprompter or Bush's supposed stupidity would have harder time thriving (or be proven). Unless a journalist gets aggressive with the President there is really no public venue where he will be challenged. That seems wrong somehow.
I don't think O wants to allow competition across statelines (except for the public option.) Axelrod was quite clear about that on CNN today (albeit fuzzy about the reasons for it.) I wonder if it's that states and insco's don't want it, or because it would allow people to escape the unaffordable coverages that places like New Jersey mandate.
"FEMA camps."
Heh.
I came away from this feeling about the same as I did before. My immune system is beginning to reject the 'faux professorial' speaking style. Taken as a whole, it didn't compute - 'its going to do all this, and not increase the deficit one dime'. It may not, but not much mention of necessary tax increases. It just didn't ring true.
I was also amused that he was finally dragged into mentioning malpractice reform. His trial projects are probably just a way to stall and kill this, though. This was a touchstone for me to see just how bipartisan he really is. My sense is still that if he were to offer serious tort reform as part of a package deal, he would get some votes from the GOP.
I give it a B-/C+
Obama would do himself a big favor if he'd stop looking down his nose at people and pointing his finger at him. It's quite condescending and doesn't make him any points.
Somebody should buy him a copy of "How To Win Friends and Influence People."
Megan, I wouldn't even expect a bump. There was nothing in here to convince anyone either way; no new information, no new plans, nothing. Where's the bump going to come from? Was there a substantial chunk of independents thinking, "You know, I might support this health care plan if the President said the same think everyone else has been saying, but slightly more eloquently?"
And to the liberal ninnies: This was not living history. This didn't even have the level of oratory in Bush's second inaugural, let alone something comparable to the greatest Presidential speeches of the 20th century (e.g. Reagan's Berlin Wall and Challenger speeches, JFK's inaugural, Berlin, and New Frontier speeches, or FDR's Four Freedoms speech.)
Please don't call them ninnies.
Also, you and I are not the target audience. Independents who haven't been paying attention are.
Sorry, one does tend to get intemperate with the sort of person who has so fallen into the cult of Obama to consider last night's rambling "great oratory".
Independents who haven't been paying attention at this point didn't watch the speech, or likely switched to another channel 10 minutes in when it sounded like a State of the Union address. Watch the ratings come in - I'd bet money that the aggregate viewership for the speech was significantly less than that for the "So You Think You Can Dance" premiere. The only people who were watching were we wonks who had already made up our minds, and there was nothing in that speech to change them.
The only bump would then come from people convinced by media coverage of the speech, but again, the media coverage isn't going to be substantially different from what it's been the last few months.
Geraghty has it right.
I get frustrated hearing the commentariat talk about whether Obama convinced the Blue Dogs, or this or that other faction in congress last night. The real crowd he had to convince was the voting public.
If insurance is a legitimate business but we need a public option to keep them "honest" why don't other industries also need a government competitor to keep them "honest"? I hesitate to make this point because Obama may take such projects up.
So wait, did he announce a method to obviate the laws of supply and demand for health care? If he did, we better apply it to Medicare quick.
If he didn't, then who gives a shit what he said?
yours/
peter.
and national second homes in Maine. -- Megan
I think you've just hit on the measure that will bring Olympia Snowe definitively on board.
Obviously you have never talked to a Maine native about tourists . . .
Second homes in Maine are expensive. Journalists can't afford them. And take it from a Mainer - the coast is over-run by tourists in the summer. Too many CT license plates and yankees caps. Ugh.
How come the Federal Government doesn't force everyone to purchase burial insurance?
The practical problem with the Republican response is that it is late and not serious. The time for them to have made serious, bi-partisan proposals was months ago. That time, they wasted pandering. Now that the soup is almost done, for them to jump up and say, "no, we're serious now, let's start over," means they're not really serious, but wish they had been previous.
What a disappointment. Walmart must have had a two-for-one Labor Day special on vacuous policy pronouncements. So there has been no health care reform for 100 years? Was he saying incremental-ism is some kind of inherently evil approach to governance? Not a word on how Medicare is going to be saved. Even if you manage one day to get around to tackling all the fraud, waste, and abuse, you still have one massively underfunded program. The buffoons in DC will never get it right. If we have make one huge dramatic change, we'd be better off disestablishing the US and letting the states go their merry ways.
The con arguments I've heard are national competition would:
- produce a race to the bottom by inscos
- eliminate the protections that "advanced" states like NJ have introduced
- allow inscos to compete better with the public option
- reduce states' rights
All except the last one seem like positives to me.
I'm generally in favor of reducing states' rights. That's more often a code phrase for "states depriving individuals of rights" than it is a defense of anything legitimate.
But I certainly agree that having insurance companies compete to get my business by offering me the least expensive coverage possible would be desirable. What we have now is a massive system of shelters from market pressures for big health insurance corporations; and what the Democratic Party proposes would give them even bigger shelters. Big businesses rarely lose from government regulation in the long run. Note that most of the major interest groups in the medical industry have expressed support for the Democratic proposals; what's going on now is "we've already found out what you are, now we're haggling over the price."
Obama will get a bill. And it will be substantial. More than any president since Roosevelt. This is what drives republicans and Megan crazy. Success drives them crazy. The speech was Roosveltian(?) Precise, passionate and direct. If any second guesser wants to know what Obama wants, I'll point them to this speech.
@ Matt C no friggin way to pay for it
Heard that.
Also applies to needapithyunname
admit that you would rather another human being DIE
than have access to treatment for a medical condition,
and you are a worthless scum not worthy of the moniker
"human" to begin with.
If forced to ration limited health care resources,
the order is citizen, legal resident, illegal alien.
Charity begins at home. Or, as The English Patient said:
"My action did not change how many died, just which ones."
"The practical problem with the Republican response is that it is late and not serious." Russell, the Republicans have made a number of proposals from the very beginning. No one Democrat in Congress has paid the least bit of attention. If you need Republican votes, your proposals have to have something to do with what conservatives want. If you don't need them, and build proposals which are acceptable only to the left side of the aisle, then don't claim that you are trying to be bipartisan. It's dishonest.