In The Blogs

Obama's Big Speech

| Wed Sep. 9, 2009 5:41 PM PDT

A few miscellaneous comments on Obama's big healthcare speech:

The relentless attempt to appear bipartisan was kind of grating. I mean, how many Republicans did he end up namechecking by the time he was done? Sheesh. Still, he wasn't trying to please me, and I imagine this kind of stuff goes over pretty well with the average viewer.

Props for not sidestepping the whole individual mandate issue. I sort of expected him to, since requiring people to buy insurance isn't necessarily a popular position, but he met it head on. Key quote about people who choose to stay uncovered even if they can afford insurance: "Such irresponsible behavior costs all the rest of us money." I'm not sure it will work, but it was admirably direct.

He waffled at first on the public option ("These are all constructive ideas worth exploring," he said unctuously about competing proposals), but then he finished up strong: "I will not back down on the basic principle that if Americans can’t find affordable coverage, we will provide you with a choice." But was this as strong as it sounded in real time? Not really, and I think he left things pretty fuzzy about just how vigorously he's planning to push for a serious public option — which I suppose was exactly his intention.

He did a pretty good job calling out some of the ridiculous lies that have been spread about healthcare reform. This is where his (sometimes annoying!) focus on post-partisanship and "ending the ideological bickering" can pay off. It allows him to get away with strong criticism of this stuff without seeming merely partisan himself.

There was no mention of subsidy levels in his speech. This is no surprise, since that's an ultra-wonky technical detail, but it's also a pretty important one. Even if it's just in some talking points released on the website, I'd like to hear where he stands on this.

When Obama said at the end that Americans had been sharing their stories in emails and letters and that he had "received one of those letters a few days ago," I was ready to start cringing. But no! It was a letter from Ted Kennedy. That turned out to be a pretty powerful part of the speech, I thought. Too bad he then weakened the impact by going on just a wee bit too long afterward. Another minute would have been good. Three or four minutes was too much.

And the big question: will it work? Well, I've been on record for some time as believing that since healthcare reform emerged still standing even after the August hailstorm, the odds were good that it could pass this year in some reasonable form. So obviously I still think that. But I'd say the speech probably helped. It won't affect Republican votes much, but it will probably move public opinon a few notches and make it easier for centrist Dems to stick together and overcome a GOP filibuster. Basically, I'd say the odds of healthcare passing this year have gone up from 65% to about 75%. Stay tuned.

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Kevin Drum is a political blogger for Mother Jones. For more of his stories, click here.

Comments

Stick

Submitted by Quaker in a Basement (not verified) on Wed Sep. 9, 2009 5:55 PM PDT.

I can't believe you're griping over Obama's namechecking so many Republicans. What has been the biggest Republican complaint? That the plan isn't "bipartisan," that Republicans have been excluded from the process.

Obama took that stick and beat 'em with it.

Obama's speech

Submitted by Thereisnoplan (not verified) on Wed Sep. 9, 2009 5:59 PM PDT.

C'mon Kevin, don't go all Obama on us and fudge the issue.

1. Obama's "fuzzification" of a meaningful public option effectively killed it.

2. Without a solid public option for everyone meaningful HC reform isn't possible

The president had to make clear that he wouldn't sign a bill without a meaningful public option. Force the blue dogs to betray the leader of the party that put them there. The won't.

Do the people support a public plan for only 5%?

Submitted by Anonymous (not verified) on Wed Sep. 9, 2009 6:49 PM PDT.

I've heard quite a bit about popular support for a public plan. But nowhere have I heard that there's a ton of support for a public plan for only 5% of the people.

In fact, just the reverse. When people point out how few people will be affected, what I usually hear are questions about how much the plan will cost taxpayers to include so few people.

So yeah, that part of the big speech was eyebrow raising.

Scope of Public Option

Submitted by kmellis on Thu Sep. 10, 2009 3:13 AM PDT.

I've heard quite a bit about popular support for a public plan. But nowhere have I heard that there's a ton of support for a public plan for only 5% of the people.

Somewhere along the way, the popular perception of the public option and the versions of the public option being proposed by Obama and the various Congressional committees diverged greatly.

The popular perception of the public option, shared by almost everyone, is that it would be guaranteed to be much less expensive (in terms of premiums) than private-sector health insurance. A very large number of people, perhaps the majority, also believe that it will be open for enrollment to anyone.

The public option that's been promoted by the Obama administration and what has appeared in the committee bills would only be available to the relatively small number of Americans who cannot get health insurance any other way, and it is not guaranteed to be less expensive than private-sector health insurance.

This is a big difference.

The confusion originates, I think, mostly in the fact that Obama at one time campaigned on health care reform that included the creation of a publicly-run medical insurance plan that was open to all Americans. And, of course, many others have proposed this.

But once Obama was in office, and he and congressional Democrats began mapping out reform, this was quickly taken off the table because it was judged to not be politically possible. An open public plan that was also guaranteed to be less expensive (in terms of premiums) would obviously very quickly consume the entire health insurance market and, sooner or later, effectively kill private insurers.

Many of us think that is a desirable outcome, but then many other people (not just industry lobbyists) think that is a very undesirable outcome.

As a practical political matter, the difference between an open-enrollment public plan that is guaranteed to be less expensive (in terms of premiums) and one that is not is minimal. Most conservatives and the industry itself are so threatened by an open-enrollment public plan that it doesn't really matter if it's guaranteed to be less expensive. So open-enrollment was taken off the table.

In fact, just the reverse. When people point out how few people will be affected, what I usually hear are questions about how much the plan will cost taxpayers to include so few people.

This gets to the issue of cost control and affordability, and public perceptions are very confused about this, as well. Because most people, liberals and conservatives alike, wrongly believe that public plan premiums would be guaranteed by the government to be less expensive, they are implicitly assuming that the public plan would have massive government subsidies. If this were the case, then the plan would cost taxpayers a lot of money. But it's not the case.

But as part of making the public option palatable to both the insurance industry and Americans in general, in these bills it's designed to basically pay for itself and be on a level playing field with the private plans.

The combined results of these wrong perceptions have made the public option the most hotly contested aspect of reform. It is ironic and a bit sad that because both liberals and conservatives wrongly believe the public option to be extremely expansive they are both marking it out as a line in the sand that they will not cross. (Well, on the conservative side, it's been well-established by now that there's absolutely no compromise that they would accept—whatever their public rhetoric, they are absolutely opposed to any health care reform bill passing as a simple matter of a purely political calculus.)

In reality, from the progressive side as a policy matter, the very limited scope of the public option as it's actually being proposed is not at all worth losing the entire reform effort over. On the other hand, from a purely political point-of-view, it might be.

That isn't to say that it's not worth fighting for. It's foolish to preemptively bargain it away. A limited public option makes a future expansive version much more likely. As a policy matter, even the limited public option as proposed has many advantages over reform without it.

Regardless, however, the public option which is actually being proposed is far, far more limited than what most people believe. If we get a bill which includes it, a large number of people are going to be disappointed and angry that they won't be able to enroll into it.

Meanwhile, GOP congressmen

Submitted by tWB (not verified) on Wed Sep. 9, 2009 6:06 PM PDT.

Meanwhile, GOP congressmen are SCREAMING AT THE PRESIDENT. Remember when that kind of behavior would have caused fainting spells amongst the right wing?

Oh, right. That was 2001 through 2008. Different age, that.

Overcome the filibuster?

Submitted by Anonymous (not verified) on Wed Sep. 9, 2009 6:06 PM PDT.

There are only 58 Democrats counting Bernie. Getting even to 59 requires Joe Lieberman. How can Democrats "sticking together" overcome a filibuster?

Budget Reconciliation

Submitted by Anonymous (not verified) on Thu Sep. 10, 2009 5:40 AM PDT.

I think what the author was attempting to convey is that the Dems have long had the option to force this through under reconciliation but that move would still require some of the Blue Dogs on board.

Something will pass, but I

Submitted by Uncle Joe (not verified) on Wed Sep. 9, 2009 6:11 PM PDT.

Something will pass, but I doubt it'll be "reform".

two thumbs down

Submitted by Dave Brown on Wed Sep. 9, 2009 6:13 PM PDT.

It is now clear that Obama doesn't really care what kind of bill he gets, as long as he gets a bill. He's completely divorced himself from the "public option". Yet one of the few things he insists upon is compulsory insurance. Let's be clear: you can't support free market principles while at the same time call for compulsory insurance. The ability to "opt out" is the biggest weapon any consumer has.

Given that they aren't done watering down this bill, I think the real question now is, "is a bad bill better than no bill at all?"

passing something is how you move forward

Submitted by Christopher1974 on Wed Sep. 9, 2009 8:01 PM PDT.

Look. Getting out of the starting gate is the only thing that's going to work. And if you recall the chart that Kevin posted here, other countries have taken DECADES to develop the plans and coverage they have.

As for public option? I'm indifferent. I've always been indifferent to it. I don't think looking at auto insurance for instance, that having a public option is completely necessary to actually bring down costs.

Compulsory with elimination of pre-existing clauses and the ability to change plans - that will be a huge step.

Let's not let the perfect be the enemy of the good.

christopher // inaudiblenonsense.com

Oh, twaddle!

Submitted by gyrfalcon on Wed Sep. 9, 2009 9:43 PM PDT.

You would not be so sanguine about this if you were one of the people who will be forced by law to buy crappy insurance from a private company that won't cover anything but a major disaste.

Of course you're indifferent. You've got yours.r

You're Confused

Submitted by kmellis on Thu Sep. 10, 2009 3:20 AM PDT.

The public option that appears in these bills would not be guaranteed to have less expensive premiums, or offer more coverage, than the crappy insurance you're assuming you'll be forced to purchase. The public option, as formulated in these bills, would not solve the problem you're assuming it would solve.

You're a hard audience

Submitted by bleh (not verified) on Wed Sep. 9, 2009 6:13 PM PDT.

It's a problem with Democrats -- we hold our own to far too high a standard.

Yeah, he fudged the public-option issue -- except for making explicit arguments to both "progressives" and "Republicans" about it, and putting it very squarely in context. What more do you expect in a prime-time address?

Oh, and he didn't go into detail about giving taxpayers' money away to other people. Hmm, guess he loses points for not emphasizing the unattractive.

And you're complaining about a little bit of bloody-shirt waving? And oh by the way, it might less cynically be described as an extra two minutes of time about a guy who made health care a cause for his entire LIFE.

To quote someone, "sheesh."

What more do I expect?

Submitted by gyrfalcon on Wed Sep. 9, 2009 9:46 PM PDT.

From an ostensibly Democratic president, one who claims to have made health care reform a "cause of his life," something like a promise to veto any legislation that doesnt contain a strong public option.

What he's clearly happy to settle for is minor health insurance reform, not the actual health care reform that s' supposedly "the cause of his life.' Feh.

"the cause of his life.'

Submitted by Anonymous (not verified) on Thu Sep. 10, 2009 8:47 AM PDT.

Although I am not the poster bleh, I am pretty confident that said poster was referring to Ted Kennedy, not Pres. Obama.

Hi Kevin, You mention that,

Submitted by kirsten (not verified) on Wed Sep. 9, 2009 6:23 PM PDT.

Hi Kevin,

You mention that, "there was no mention of subsidy levels in his speech". But there was when Obama put his $900 billion price tag on reform. This amount is no where near sufficient to have decent subsidies. This amount is concurrent with the Baucus plan that subsidizes up to 300% of poverty level. i am quite fearful that this is a dreadful level that will come back to bite the democrats in future elections. This was my main disappoinment in the speach.

Kirsten

Huh?

Submitted by nepeta on Wed Sep. 9, 2009 6:33 PM PDT.

I was wowed by the speech. I don't see why his commitment to affordable insurance, both as a matter of cost and a matter of national character, is seen as waffling on the public option. The insurance companies sure aren't going to offer 'affordable' insurance to millions of people, so that leaves the government, who else?

What's the definition

Submitted by gyrfalcon on Wed Sep. 9, 2009 9:48 PM PDT.

of "affordable"?

Here is the AP's

Submitted by sven (not verified) on Wed Sep. 9, 2009 6:36 PM PDT.

Here is the AP's factcheck....

http://news.yahoo.com/s/ap/20090910/ap_on_go_pr_wh/us_health_care_fact_c...

Lead item:

Obama is lying when he says you can keep your existing plan because hey, who knows, your company might change the plan huh? Now Obama is going to be held responsible for things obviously beyond his control...

Compare this with:

Death Panels! Death Books! Kenya! Prison Camps! Birth Certificate! Communism! Hitler! Don't touch my Medicare!

Good thing we have fact checks huh?

This is what caught my ear

Submitted by Pauline May (not verified) on Wed Sep. 9, 2009 7:00 PM PDT.

His remark about that if you can't afford any of the above options, that the idea that McCain had on the campaign trail would be utilized. Here's the pertinent language from the .pdf of Obama's plan:

*Immediately offers new, low-cost coverage through a national "high risk"
pool to protect people with preexisting conditions from financial ruin until
the new Exchange is created. For those Americans who cannot get insurance
coverage today because of a pre-existing condition, the President’s plan will
immediately make available coverage without a mark-up due to their health
condition. This policy will offer protection against financial ruin until a wider
array of choices become available in the new exchange in 2013.

That sound like some sort of a public option to me. And to me, that takes away the scariest possibility in this whole debate, of having to declare medical bankruptcy.

Pauline

I think the president did a

Submitted by spiny (not verified) on Wed Sep. 9, 2009 7:47 PM PDT.

I think the president did a pretty good job telling us why reform is needed- but not as well describing as to how this legislation is actually "reform". He definitely lowered the bar on what "reform" is, although still probably not to the limbo contest ready levels Rahm and his blue dog buddies are going to bring it down to.

Mandates with no strong public option is a loser on so many levels- Even Obama isn't gong to be able to polish that turd and he tied himself into knots trying to- if you already have private insurance, you can't get the public option, public option is only there for 5% of the people that can't be forced to get private insurance, public option just there to help competition but he doesn't want to see private insurance companies go out of business and.... medicare is good and won't be touched. Talk about a muddled bag of excuses for preserving a corrupt system that most people will probably see right though.

Quaker: I only said that all

Submitted by Kevin Drum on Wed Sep. 9, 2009 7:58 PM PDT.

Quaker: I only said that all the Republican namechecking was annoying to me personally. My attitude at the moment is "fuck 'em." But as I said, I understand that it's a good rhetorical strategy. Kirsten: Yeah, the $900 billion figure was sort of a backdoor way of getting to the subsidy number. But I'd still like to see something direct. On the public plan, I don't think Obama threw it overboard entirely. I wouldn't be surprised if we end up with the "trigger" compromise. In any case, I think everyone knows that I don't believe the public option is a hill to die for. I'm very much in favor of it, but a plan without it would still represent historic reform if the rest of the details are decent.

Historic minor

Submitted by gyrfalcon on Wed Sep. 9, 2009 9:51 PM PDT.

health insurance reform, Kevin, not significant health care reform.

Home run

Submitted by Anonymous (not verified) on Wed Sep. 9, 2009 8:40 PM PDT.

This was easily his best speech since Iowa - that last 15 minutes was the most robust articulation of today's liberalism that my generation has ever seen. Kevin is probably right that in the matter at hand boosts the probability of getting something decent from good to even better, but I think that if health care reform does end up passing that a lot of politically active people my age will remember this speech for the rest of our lives. It was that good.

Of course the progressive left, as opposed to standard-issue liberals such as myself, is determined to hate whatever comes out of the president's mouth and a Member of Congress decided to try and recreate the full teabagger experience on national television much to his own embarrassment....but even that can't wipe the smile off my face!

Solid speech all the way

Submitted by Ripley (not verified) on Wed Sep. 9, 2009 10:36 PM PDT.

Solid speech all the way 'round. He brought the passion and the wonk, and even if some of what Obama's proposing (and deftly manipulating) doesn't live up to an ideal - mine, among others - this step is necessary. And goddamn it's nice to have an intelligent man in the lead.

As for the wheedling from people on this board and others like it (with whom I likely agree in policy terms), jesus, grow up, do something real. Progressives progress; we don't skip evolutionary stages, because nothing can.

Joe Wilson's speech was far

Submitted by Luther on Wed Sep. 9, 2009 11:28 PM PDT.

Joe Wilson's speech was far better. Imagine standing up to a corrupt, lying politician instead of one hand washing the other, Washington style.

You're talking about the

Submitted by Anonymous (not verified) on Thu Sep. 10, 2009 12:07 AM PDT.

You're talking about the wrong Joe Wilson girlfriend, but apart from your not being able to tell the two apart, I agree with what you said about Joe Wilson standing up to power.

(Aside from that, you are a douchebag sir.)

Yeah, Joe Wilson was so

Submitted by Anonymous (not verified) on Thu Sep. 10, 2009 12:13 AM PDT.

Yeah, Joe Wilson was so brave tonight, he apologized immediately. Some balls that truth teller has.

Well let's see

Submitted by SRW1 (not verified) on Thu Sep. 10, 2009 1:32 PM PDT.

There were two Joe Wilson's who thought they spoke truth to power.

One of them really did, the other one was just a lout.

He Managed

Submitted by bob h (not verified) on Thu Sep. 10, 2009 3:03 AM PDT.

to call for bipartisanship at the same time calling them liars and fiscally reckless.

We're screwed. Obama

Submitted by Josh G. (not verified) on Thu Sep. 10, 2009 5:01 AM PDT.

We're screwed.

Obama basically endorsed the Baucus plan - forcing Americans to pay up to 13 percent of income for private insurance that may cover as little as 65 percent of medical costs. This will drive millions of families into poverty while enriching corrupt insurance companies. Under the Baucus/Obama plan, if you are an individual earning $32,491 a year (just over 300% of the absurdly low federal poverty level), you can be taxed up to $4,223.83 by private, for-profit insurance companies to pay multi-million-dollar CEO bonuses. Of course, the insurance companies will still be able to deny claims whenever they want. If you refuse to pay this tax, you will be fined $950.

A year ago I would not have believed that it was possible to come up with a worse plan than the status quo, but Baucus/Obama managed it.

We need to torpedo this and start over with true single-payer: Medicare for All.

We need to torpedo this and

Submitted by kmellis on Thu Sep. 10, 2009 6:00 AM PDT.

We need to torpedo this and start over with true single-payer: Medicare for All.

Yeah, well, Medicare has premiums that are $100 a month, or more. And a 20% deductible.

$100 a month is nothing

Submitted by Josh G. (not verified) on Thu Sep. 10, 2009 6:54 AM PDT.

$100 a month is nothing compared to what insurance companies will be allowed to charge under the Obama/Baucus plan. Someone earning just $32,491 a year will be forced to pay as much as $4,223.83 annually in premiums - that's over $351 a month. And that's at the low end of the income scale. Think about what this means for young people living in large cities earning maybe $50K or $60K a year (which is barely enough to afford a studio apartment in NYC or SF). And remember that these young people are Obama's base.

Your reference to 20% Medicare co-pays is misleading. According to the official website (http://questions.medicare.gov/cgi-bin/medicare.cfg/php/enduser/std_adp.p...) this only applies to Part B: "Medicare eligible physician services, outpatient hospital services, certain home health services, [and] durable medical equipment." Part A covers "inpatient hospital, skilled nursing facility, and some home health care" - the really expensive stuff - and Medicare pays everything past the deductible.

You know some big spenders!

Submitted by Anonymous (not verified) on Thu Sep. 10, 2009 7:36 AM PDT.

As a single person who makes less than 30k per year (grad school isn't a time to get rich) in New York, I call bullshit on your claim. Actually my fellow young people are mostly sick and tired of the old ideological battles that our parents' generation insist on fighting over and over again. The single-minded obsession over the public option crystallizes that for us - the vast majority of us think that it's a great idea, makes a lot of sense and by all rights should be fought vigorously for (and for the real political junkies among us think that it can be done via reconciliation) but it's not worth killing the broader reform package over.

We younger folk basically see the debate within the Democratic Party as between the wonks on one side and the activists on the other and our sympathies are mostly with the wonks - we care about the ends, not the means.

Think about what this means

Submitted by kmellis on Thu Sep. 10, 2009 7:47 AM PDT.

Think about what this means for young people living in large cities earning maybe $50K or $60K a year (which is barely enough to afford a studio apartment in NYC or SF).

Cry me a river. $351 a month for health insurance for someone making 32K or more a year is nothing. Not to mention that it would be the same portion of a 32K income as current US medical expenditures are of the GDP. Health care is not free.

What I am hearing from people like you are the complaints of people who have basically been getting away with not paying for health insurance at all and don't want that gravy train to end.

As for Medicare co-payments...yes, it's less for hospitalization. I know this well, because I'm on Medicare. But if you're getting lots of health care that's not hospitalization, then those 20% co-payments can add up very quickly.

I live on SS Disability benefits that amount to a bit less than 12K a year. I pay $100 a month in Medicare premiums and then another $120 a month in additional insurance premiums to cover what basic Medicare doesn't. That's 22% of my income.

Not to mention that in the mid-90s I made between 30-40K as an entry level IT contractor and didn't have health insurance and couldn't have gotten any on the individual market because of my condition. I would gladly have paid $400 a month for health insurance if it were available. But, basically, because people like you would rather make monthly new car payments than pay for health insurance, the Obama plan seems "unfair" and you are therefore wiling to see that people like I was fifteen years ago remain uninsured.

Given all the people in the US who are uninsured not by choice, and given things like rescission and the other abuses and injustices that are targeted by reform, then people who oppose this reform because it would mean that someone making 32K has to pay $350 a month for insurance are simply not progressives. I suppose that's what separates out the true progressives from those who only pretend to be progressive: whether increasing social justice would negatively affect their wallet.

I earn almost exactly $32K a

Submitted by Josh G. (not verified) on Thu Sep. 10, 2009 8:50 AM PDT.

I earn almost exactly $32K a year, and $351 a month would put a massive dent in my budget. It would probably put me back into debt, after I spent the better part of a year finishing paying off my college credit card bills. Fortunately, I have health insurance already through a county-level employer. $32K a year is not even enough for me to afford a place of my own - and I do not live in a high cost of living area. Nor do I have a large car payment; I drive a 2002 Ford Focus that is fully paid for. Like the wealthy Congressmen on Capitol Hill, you don't seem to understand how difficult it is to make ends meet for regular people. And there are many others far worse off than I am, who would be hit much harder by this insanity.

This whole notion is ass-backwards. Health *care* should be a RIGHT. Instead, we are making health *insurance* into a mandated BURDEN. Insurance, as presently constituted, is the problem - not the solution. Having insurance doesn't help if they refuse to pay. And under the Baucus/Obama plan, you still won't have the right to sue if they deny coverage - you first have to exhaust your internal appeals, and then you can go to a state-level ombudsman. Of course, by that time you'll probably be bankrupt and/or dead.

As I said before, this is herding more people onto a sinking ship. We need to build a new, solid foundation, one that disposes of private insurance companies entirely.

In any case, what you say here is irrelevant; all that matters is what happens at the ballot box. And I can say that after voting the straight Democratic ticket in 2004, 2006, and 2008, Obama will not be receiving my vote in 2012 if he enslaves America to Big Insurance.

thrice as expensive

Submitted by tpx on Thu Sep. 10, 2009 7:59 AM PDT.

Since Americans approximately pay twice as much per person as the next developed nation for health care, despite still leaving 30 or so million people uncovered, one would expect reform to not only increase coverage but to reduce costs. However, the way public policy is enacted in America today one should probably expect health care costs to become thrice as expensive as the next developed nation.

...

Submitted by Crissa (not verified) on Thu Sep. 10, 2009 9:15 AM PDT.

What pissed me off was that the NPR commentator merely called the two liar statements as 'claims' with the same tone and validity, no fact-checking.

What kind of news is it which doesn't even investigate claims?

Still not coming clean

Submitted by Paul Camp (not verified) on Thu Sep. 10, 2009 6:22 PM PDT.

about his secret deals with the heath care industry. That continues to call his credibility into question. It makes it look like some players in the problem are getting special attention.

Maybe they are. Man up. Own up to it. Justify it.

Duvall from Orange County

Submitted by MAX TARDCORE (not verified) on Thu Sep. 10, 2009 6:42 PM PDT.

Duvall from Orange County isn't the only legislator getting sweet, sweet, dripping love from a lobbyist. After seeing my plans approaching fruition, you really need to see my gape.