It’s a sign of how badly things are going for Barack Obama on the make-or-break issue of his tenure that the president delivered yesterday’s prime time health care address in a forum traditionally reserved for national crises. But with public disapproval of the president’s handling of health care rising to an all-time high of 52 percent, and with even Democrats fleeing from the government insurance “public option” that had been a centerpiece of the president’s health care vision, Obama’s speech before a joint session of Congress was crisis management in all but name.
Judged on style, the speech, polished and capably delivered, was typical Obama. On many of the broad points, too, there was little that was contentious. The president called for a health care plan that would offer more security to those who already have health insurance; provide it to those who don’t; and slow the runaway costs for health care for individuals and at the government level.
Obama was also effective in discussing the problems of the current health care system. He pointed out that the United States already spends more than 1½ times more per person on health care than any other country, with dubious results; that insurance premiums have risen three times faster than wages; and that the “skyrocketing costs” for government programs like Medicare and Medicaid pose serious problems for the country down the road. So far, so unobjectionable.
And then the president faltered: He got specific.
If one aim of the president’s speech was to foster a broad consensus on health care, it failed resoundingly. What Obama offered instead was a laundry list of items favored by the partisan Left and strenuously opposed by large parts of the country. For the first time, the president made clear just what ObamaCare would entail. For those not already in the president’s ideological corner, there was little to like.
A case in point was Obama’s unqualified support for the public option. Despite dwindling support for this measure in the ranks of his own party – 23 Blue Dog Democrats in the House have said that they would oppose a bill with the public option, and others have signaled that they would follow suit – Obama came out strongly in favor of a government insurance program that would “compete” with private insurers. As he has in past speeches, Obama sought to downplay claims that a public option would force Americans into a government program. He insisted that “no one would be forced to choose it, and it would not impact those of you who already have insurance.”
But that promise runs counter to projections, including a widely cited study by the Lewin group, that the public option would cause 119 million people to lose their private coverage and force them into the government program. Because a government plan could rely on taxpayer funds, it could operate at a loss and afford itself a competitive advantage against private insurers. These insurers would have little choice but to hike premiums or go out of business. In this way, even those who already have private insurance could lose it if a public option is passed.
To his partial credit, Obama tried to speak to these concerns. He explained that, in his plan, taxpayers would not be subsidizing the public option. “I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects,” the president declared.
All well and good. Unfortunately, the long track record of government programs in sponging public funds suggests that this promise is not to be trusted. Take Medicare, a model for the public option that was devised under similar pretexts. When it was first created in 1965, premiums paid for 50 percent of the cost of physician services. That number has since fallen by half. Today, taxpayers are stuck with the bill. To pretend that there is no risk of the same result with the public option is to ignore history.
Obama was no more convincing when he attempted to debunk what he bitterly called the “bogus claims spread by those whose only agenda is to kill reform at any cost.” Especially false, according to Obama, was the claim “that we plan to set up panels of bureaucrats with the power to kill off senior citizens.” This was a “lie, plain and simple,” the president averred.
Only, it’s not so simple. Sarah Palin may have overstated the case when she recently charged that the administration would create “death panels” to decide end-of-life treatment, but suspicions that the administration could empower unelected bureaucrats to ration care for the elderly are well-founded. The Cato Institute’s Michael Tanner has pointed out that health care legislation currently before Congress would create an Independent Medicare Advisory Council to ensure that Medicare denies services that are deemed not “reasonable and necessary.” Health care expert Sally Pipes observes that this could “ultimately make it more difficult for seniors to get the care they need.” If the president really wants to find the source of concerns about “death panels,” he need look no further than the health care legislation inspired by his proposed reforms.
Nor did Obama win much sympathy from his opponents when he tried to dismiss concerns that his favored health care bill would provide coverage to illegal immigrants. That prompted South Carolina Republican Rep. Joe Wilson to interrupt the president’s speech with a shout of “You lie!” The outburst was inappropriate and disrespectful, something Wilson acknowledged in an apology, but it was not wrong on the substance. For instance, a House version of the health care legislation that Obama seeks would expand Medicaid coverage without verifying the citizenship of enrollees. As a result, a new report by the Center for Immigration Studies finds that 6.6 million uninsured illegal immigrants could receive benefits under the House health reform bill, at a cost to taxpayers of nearly $31 billion annually.
Such blatant disinformation was characteristic of a speech that flattered the president’s allies on the Left while antagonizing those Americans – and they are now in the majority – who agree with him about the problems of the current system but nurse grave doubts about the wisdom of his reforms.
Time and again, Obama accused his critics of engaging in “scare tactics,” “bogus claims,” and “making wild claims about a government takeover of health care,” even as he tried – and failed – to disprove those very claims. In his most notable feint at bipartisanship, Obama offered a gentle reproach to supporters of a Canadian-style single-payer health care system. But considering that the president also enthusiastically endorsed the public option – a program that many on the Left openly tout as a backdoor route toward the single payer model and a government takeover of health care – this could hardly be described as a Sister Souljah moment. What tattered threads of inclusiveness remained in the president’s speech were shred altogether when he invoked the late Ted Kennedy as a shining example of the kind of leadership he would like to see on health care reform. That would be the same Ted Kennedy whose own health care legislation was too radical even for most of his fellow Democrats to support.
Obama faced a tall order this week. He had to restore diminishing public confidence in his leadership and make a compelling case for his proposed health care overhaul. Instead, the president encouraged his most ideological supporters, baited his critics, and distorted the most controversial elements of his plan – not least the expected $1 trillion cost over ten years. Stop the “bickering” and pass health care reform, the president urged, but too often it sounded like, “Shut up and do as I say.” With his approval ratings so dramatically depleted, that’s a fight that Obama is unlikely to win.