Weariness and Desperation in Health Care Debate

|  By Roger Aronoff  |  August 19, 2009

Welcome to Waterloo. Not enough votes for a public option, not enough votes without a public option.

The health care debate has descended into a fiasco, draining President Obama of his high approval ratings, angering his base, polarizing the country, damaging his credibility, along with that of the Democratic-led Congress. South Carolina Senator Jim DeMint's characterization of this turning out to be Obama's Waterloo is looking more and more prescient. Obama's push for health care reform is on life support, along with a cap-and-trade bill unlikely to pass in the Senate, and a deal between Israel and the Palestinians that seems farther away from reality than even in recent years. And despite Obama's attempt to change their behavior by treating them differently, there is no indication that Iran or N. Korea has any intentions of giving up their nuclear weapons programs, nor Iran's support for terrorist organizations to recede.
President Obama and his pals in the media are growing ever more desperate. The MSNBC line-up is doing its best to discredit the opposition to the Democrats' ideas for health care reform, but even they may have their limits to their obsequiousness to Obama. Clearly congressional members of his own party are tiring of playing along with the idea that Obama has delivered a consistent message. They have grown weary of trying to keep up with Obama's shifting policy standards, while claiming they haven't shifted at all.
On June 15 he told the American Medical Association (AMA) that "This gives you some new options. And I believe one of these options needs to be the public option." Then in July he said: "That's why any plan I sign must include an insurance exchange-a one-stop shopping marketplace where you can compare the benefits, costs and track records of a variety of plans, including a public option to increase competition and keep insurance companies honest, and choose what's best for your family."
This past weekend: "The public option, whether we have or we don't have it is not the entirety of health care reform. This is just one sliver of it. One aspect of it."
Speaking on CNN's "State of the Union," Health and Human Services Secretary Kathleen Sebelius said that Mr. Obama still believes there should be choice and competition in the health insurance market-but that a public option is "not the essential element."
In an article in Tuesday's Washington Post, it was clear that this had crossed a line one too many times:
"In the Senate, where negotiations are now focused, John D. Rockefeller IV (D-W.Va.) said that a public option, as the plan has become known, is 'a must.' Sen. Russell Feingold (D-Wis.) said that 'without a public option, I don't see how we will bring real change to a system that has made good health care a privilege for those who can afford it.'
"House Speaker Nancy Pelosi (D-Calif.) said that the plan will be included in whatever bill is voted on in the House. 'There is strong support in the House for a public option,' she said, though she did not demand that the administration express support for the idea.
"One Democrat predicted that without the provision, the bill could lose as many as 100 votes in the chamber."
Obama was possibly floating a trial balloon. Sen. Kent Conrad (D-ND) said on Fox News Sunday: "Look, the fact of the matter is there are not the votes in the U.S. Senate for the public option, there never have been."
Welcome to Waterloo. Not enough votes for a public option, not enough votes without a public option.
Obama goes around acting as if his past comments were not on tape, and being shown across the country. He continues to assure us that he hasn't changed his position when clearly he has. He has done that often, but during the campaign, he was given a pass by the media. Now, it is so obvious, they are unable to ignore it.
Here was White House Press Secretary Robert Gibbs at Tuesday's White House briefing: "Well, as I've said, now, yesterday and earlier today, the President-his position, the administration's position is unchanged; that we have a goal of fostering choice and competition in a private health insurance market. The President prefers the public option as a way of doing that. If others have ideas, we're open to those ideas and willing to listen to those details. That's what the President has said for months."
The dirty little secret is that Obama doesn't care what is in the bill. He just wants to pass anything that will allow him to claim a victory on health care reform, or as it's currently being called, health insurance reform. He'll take it from there. The nose will be under the tent, and vast new bureaucracies and regulation will be created by the executive branch that will have no bearing, nor be remotely influenced by the words in the legislation. The more blank pages in the legislation the better.
The fact is, most of Obama's base really prefers an overt government takeover of the system, through the so-called single payer system. Obama clearly stated in 2003 that that is his preference while speaking to the Illinois AFL-CIO.
"I happen to be a proponent of a single payer universal health care program."...But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House."
And some of them don't care what it costs. That is certainly the sentiment of MSNBC's Ed Schultz. He said so back in April. "I want to tell you one thing about health care when it comes to money. Personally, this is where I stand: I don't care how much it costs."
Camille Paglia had an article in Salon last week. She opened by expressing her past and continuing support for Obama, and her disdain for former President Bush. She then took Obama to task for his and the Democrats' handling of the health care issue:
"Having said that, I must confess my dismay bordering on horror at the amateurism of the White House apparatus for domestic policy. When will heads start to roll? I was glad to see the White House counsel booted, as well as Michelle Obama's chief of staff, and hope it's a harbinger of things to come. Except for that wily fox, David Axelrod, who could charm gold threads out of moonbeams, Obama seems to be surrounded by juvenile tinhorns, bumbling mediocrities and crass bully boys.
"Case in point: the administration's grotesque mishandling of healthcare reform, one of the most vital issues facing the nation. Ever since Hillary Clinton's megalomaniacal annihilation of our last best chance at reform in 1993 (all of which was suppressed by the mainstream media when she was running for president), Democrats have been longing for that happy day when this issue would once again be front and center.
"But who would have thought that the sober, deliberative Barack Obama would have nothing to propose but vague and slippery promises-or that he would so easily cede the leadership clout of the executive branch to a chaotic, rapacious, solipsistic Congress? House Speaker Nancy Pelosi, whom I used to admire for her smooth aplomb under pressure, has clearly gone off the deep end with her bizarre rants about legitimate town-hall protests by American citizens. She is doing grievous damage to the party and should immediately step down.
"There is plenty of blame to go around. Obama's aggressive endorsement of a healthcare plan that does not even exist yet, except in five competing, fluctuating drafts, makes Washington seem like Cloud Cuckoo Land. The president is promoting the most colossal, brazen bait-and-switch operation since the Bush administration snookered the country into invading Iraq with apocalyptic visions of mushroom clouds over American cities.
"You can keep your doctor; you can keep your insurance, if you're happy with it, Obama keeps assuring us in soothing, lullaby tones. Oh, really? And what if my doctor is not the one appointed by the new government medical boards for ruling on my access to tests and specialists? And what if my insurance company goes belly up because of undercutting by its government-bankrolled competitor? Face it: Virtually all nationalized health systems, neither nourished nor updated by profit-driven private investment, eventually lead to rationing."
With friends like Camille, who needs enemies?
And just to touch on a few other points. There is much consternation on the left about groups like Freedom Works spending money and organizing people to oppose this so-called health care reform. But according to this New York Times article, "The drug industry has authorized its lobbyists to spend as much as $150 million on television commercials supporting President Obama's health care overhaul, beginning over the August Congressional recess, people briefed on the plans said Saturday." This was basically a deal cut between the Obama administration and the drug industry that has upset some on the left, and on which Obama again may be ready to flip flop.
Obama claimed an endorsement by the AARP, which they distanced themselves from. Yes, they support reform, but want to first see the bill.
Last week The American College of Surgeons stated that they are "deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States.
"When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight."
They gave several examples, including these:
"Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service."Three weeks ago, the President suggested that a surgeon's decision to remove a child's tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what's right for the patient."
And finally, there is the constant claim that Republicans offer no ideas of their own to fix the health care system. In fact, there have been a number of plans put forth by Republicans. Besides tort reform, which is part of almost all Republican plans but which is a non-starter for the Democrats, who are beholden to the trial lawyers lobby, the editors at Family Security Matters have documented the Empowering Patients First Act, a proposal by Georgia Representative Tom Price, a medical doctor.
The key points, as they describe it, include: 1) Access to coverage for all Americans; 2) Coverage truly owned by the patient; 3) Improving the health care delivery structure; and 4) reining in out-of-control costs.
Health care reform is on life support, and not very likely to succeed. The question is how much time, effort and political capital Obama is prepared to spend, and how much longer his allies in the media will be with him.