Thursday, July 23, 2009

The LuLac Edition #885, July 23rd, 2009



The President spoke last night on Health Care and to be honest, his presentation was a mixed bag. He convinced me but he has to do more to win over members of his own party and the American people. His opening statement was strong, finally outlining the principle of WIFM (what’s in it for me) to the American people. Obama lost a major part of the message by having right wingers like Rush Limbaugh control the argument by saying that 90% of insured Americans health care will be jeopardized by trying to cover 10% of the uninsured. Americans in the abstract are a generous people. However in the concrete, they can be selfish. We are more than happy to give to a charity or provide health care to those less fortunate than we, as long as it does not impact on our own personal fortunes. The fact that Obama outlined some aspects of improving coverage was a good thing. But he has to do more.
The Clinton health care plan failed primarily because there were too many details to digest at any given time. Plus the messenger was an unknown quantity at the time. Obama seems to be shying away from giving many details and leaving it to Congress to handle the details. As a matter of fact, the President has been way to nice in handing over the bill to the Congress. Members of his own party have nickel and dimed it to death. He has to come out swinging and strong even if it means busting heads in his own party. This is his legacy this is, as his people told us in 2008, his time. To entrust it to a group of politicians worried about their next election is really naïve. Obama has said he didn’t care if he became a one term President if he accomplished his goals. If he means that, he should start acting like a President with a multi seat majority in both Legislative Chambers rather than a city alderman afraid of pissing off the Ward Chairman. Allow me to elaborate on some issues that need to be clarified in fixing the system:
1. The deficit numbers. Don’t engage in them. People don’t believe them anyway. One side who wants health care will herald them, the other will not. Leave the numbers alone. Stress how broken health care is. If you get heat on the deficit, ask the American people what’s a better way to go into debt; fixing health care or fighting a grudge war in Iraq? And ask, where were those deficit hawks in Congress when the U.S. was spending billions on military equipment that got our soldiers blown to bits because it was faulty?
2. Establish a universal health care insurance code that is nationalized. Every insurer has different sets of rules for different states. Change it. Make it uniform. A lot of money is wasted in time and energy by different plans not being able to communicate with each other about payments.
3. Tax the millionaires health benefits if you like but give tax breaks to people who have to pay deductibles. Or subsidize deductibles. Right now, Americans pay their company because less than 5% get full blown 100% covered health care. They pay the providers with deductibles. And their companies pay the insurance industry counting it as a benefit of employment. The last thing the middle class needs is a tax on health care benefits. Redefine the words “single payer” to mean that the average American won’t be shelling out three different times and ways for health care. Subsidies will make everyone happy.
4. Tell the truth. There will be taxes to pay for this. Get it over with. Say It.
5. Act like a President. Inspire. No mention of the 40th anniversary of the lunar landing. “If we can land on the moon, we can’t fix health care?” Obama needed to give Americans a call to action. His muddled attempts at trying to dissect care options as well as his analogies did not excite. And to a skeptical country, fueled by an incendiary and vicious minority, he needs to lay it on the line. He began a bit last night, but needs to get more specific.
6. Power. He has to use the power of the Presidency and his star power now. It is ebbing and a defeat will surely deflate his administration. A President, especially one who has spent the first 6 months handing out stimulus money can reward….as well as punish.
Consensus. The President seems to be so worried about getting a few Republicans to jump on board with this. For what??? He has the majority. He should use it. If this reform works, people will forget the details. Medicare recipients can’t tell you the first thing about how the bill was passed 44 years ago.
8. Make it competitive. How can big time insurers making millions of dollars every year justify rate increases? Granted they must pay claims but if the President wants to put money back in the pockets of the working class, make the business model for the health care insurance industry monopoly free.
9. The uninsured. Shut up about them. They only serve as a political lightning rod that will derail your efforts.
10. Use the three “E” philosophy in describing reform.
Efficiency: Make health care less bulky in how it’s perceived and implemented.
Effectiveness: Stress as you did Wednesday night that to do nothing will keep this issue stagnant.
Empathy: Utilize your bully pulpit to assure three interest groups involved in this; the 90% who have health care, the Health Care Industry and the Insurers. Tell them that this will increase profits in the long run.
11. Don’t scrimp. Make it either a spectacular achievement or failure. If you do a middle ground deal, you become Jimmy Carter. If you risk all of your elective capital on this, you’re Reagan and Roosevelt. A transformative President.
12. Lastly, Go Big, or Go Home. And tell your fellow Dems the same thing. Forget the politicians, you should aim for history. Martin Luther King, Junior trumps Steney Hoyer any day.


At 2:09 AM, Anonymous Anonymous said...

This seems to be a mix of political strategy and health care reform all rolled into one. I disagree with aspects of it but I like the way you presented it. Full speed ahead without wimping out which I fear Obama will do. Yonk says let it fly and bleary eyed at 2am, I have to agree with at least that part of it.

At 10:26 AM, Anonymous POPE GEORGE RINGO said...

Great point on the moon landing analogy, but the space program was for the most part embraced by the vast majority of the public and very few in congress were vocally opposed to it; in short, it was not controversial, at least in the pre-landing period. Health care is a paradox; everyone wants the costs lower but no one wants to go out on the line for it. Much like law and order citizens are the first to protest a prison being built in their neighborhood. Also, it is very easy to create a boogeyman mentality on this issue--when all else fails fear works. In a nutshell, one year from now, we will have no national healthcare program and perhaps seven or eleven or fifteen years from now a new Dem President will do the same song and dance once more. I am not knocking Obama, but the harsh reality of the blue dogs who shall always serve in the congress.

At 10:41 AM, Anonymous Anonymous said...

Yonk, take a gander at this article.

Experts Dispute Some Points in Health Talk


Published: July 22, 2009

WASHINGTON — President Obama showed great fluency in the intricate details of health policy at his news conference on Wednesday night, but experts said some of his points were debatable.
Skip to next paragraph Mr. Obama said doctors, nurses, hospitals, drug companies and AARP had supported efforts to overhaul health care.
While it is true the American Medical Association has endorsed a bill drafted by House Democratic leaders, a half-dozen state medical societies have sharply criticized provisions that would establish a new government-run health insurance plan.
Likewise, Mr. Obama said Medicare could save large amounts of money by creating “an independent group of doctors and medical experts who are empowered to eliminate waste and inefficiency” and hold down the annual increases in payments to health care providers.
Far from supporting this proposal, the American Hospital Association is urging hospital executives to lobby against it.
Of the proposed new cost-control agency, Mr. Obama said: “It’s not going to reduce Medicare benefits. What it’s going to do is to change how those benefits are delivered so that they’re more efficient.”
Hospitals say the cuts could indeed cut services in some rural areas and from teaching hospitals, which receive extra payments because of higher costs.
In seeking to portray health legislation as bipartisan, Mr. Obama said that 160 Republican amendments were adopted in a bill approved last week by the Senate health committee. Republicans said many of the amendments involved technical provisions and did not alter the fundamental features of the bill.
The president said that health insurance companies were making “record profits.” America’s Health Insurance Plans, the main lobby for insurers, contends that “for every $1 spent on health care in America, approximately one penny goes to health plans’ profits.”
Mr. Obama said he was not proposing to ration care, but just wanted to coordinate it better. For example, he said, he wants to eliminate repetitious tests ordered by different doctors for the same patient. Electronic medical records and health information technology, championed by Mr. Obama, could reduce such duplication. But, under his plan, it is not clear who would take responsibility for patients and coordinate care in traditional fee-for-service medicine. The president continued to take credit for deficit reduction by making a claim that has been challenged by many experts. “If we had done nothing, if you had the same old budget as opposed to the changes we made,” the deficit over the next 10 years would be $2.2 trillion greater, the president said. In fact, $1.5 trillion of those “savings” are mainly based on an assumption that the United States would have had as many troops in Iraq in 10 years as it did when Mr. Obama took office. But before leaving office, President George W. Bush signed an agreement with Baghdad mandating the withdrawal of all American forces within three years. So Mr. Obama is claiming credit for not spending money that, under the policy he inherited from Mr. Bush, would never have been spent in the first place.

At 11:22 AM, Anonymous Anonymous said...

Your points are well thought out and very, very political. If you weren't dealing with such an important issue, I'd commend your acumen.

At 12:16 PM, Anonymous Anonymous said...

Your point on the nuts and bolts of health care is very nimportant. tax breaks on paid deductibles is a brilliant idea. everyone who pays one will get equal breaks. it might put an end to the class warfare you so love to promote on your site.

At 1:08 PM, Anonymous Anonymous said...

Hey 1216PM, don't buy into the Yonk's class warfare rhetoric. He's just trying to impress Kucinich's wife!

At 2:19 PM, Anonymous Anonymous said...

One of the points Yonki made is right on the mark. You have 4 Blues in Pennsylvania. Then all across the country you have other Blues. Each one is its own entity and has no uniformity in the way they do business. And that's just Blue Cross. We're not even counting Cigna, Atena, Gweisinger and others. Obama has to chance being called a dictator and present standards of care, billing and processing on a national basis. Then we can talk reform.

At 3:14 PM, Anonymous Anonymous said...

I could not agree with you more in one of your points about the deficit. The GOP handed us the deficit when it sent our young men to Iraq in a war of revenge with bad equipment. Now they're talking about future generations, ironic since thyese GOP fatcats nearly maimed this current generation of young men and woman with an evil war from stupid and evil men like Vice President Cheney and Donald Rumsfeld.

At 4:03 PM, Anonymous Anonymous said...

Many people do not realize that the great legislation of our time was done by Presidents who literally had to shame Congress into action. LBJ did it with the Civil Rights act of 1964. The only thing the Congress understands is raw power and threats. Obama should use the hammer. Hard. Like LBJ. He needs to avoid becoming Carter.
Helen Fulbright

At 11:19 PM, Anonymous Anonymous said...

LOve that line, GO BIG OR GO HOME.


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