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Dr. Obama's Health Care Prescription: Change Will Make You Feel Better

6 years ago
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Can you lull a nation into trying something new by being detailed, dull and earnest? It worked in debates when candidate Barack Obama was trying to get Americans used to the idea of a young black president with an African name. His East Room news conference Wednesday night was an exercise in applying the same technique to health care.
An all-nighter atmosphere prevails on Capitol Hill, where crashing lawmakers say they doubt they can meet Obama's deadline of House and Senate bills passed before the chambers break for the summer on July 31 and Aug 7, respectively. (Update: Senate Majority Leader Harry Reid said Thursday that the Senate won't vote on its bill until the fall).
The news conference, by contrast, had the air of a decorous ritual. There were 10 questioners, and seven asked about health care, giving Obama a large, leisurely, prime-time canvas on which to paint his vision of reform.
The studious mood was interrupted twice, once when the wrong reporter shot up to ask Obama a question and once when Politics Daily's Lynn Sweet asked Obama about the arrest of his friend, Harvard professor Henry Louis Gates, at his own house. The Cambridge police "acted stupidly," Obama said, a sound bite bound in the short term to overshadow anything he said about health care.
For the record, he said a lot. We had Dr. Obama talking about blue pills and red pills, mammograms, tonsils, allergies and advanced diabetes. We had Professor Obama explaining how the U.S. health care system works versus how he thinks it should work. Obama The Economist discussed the role of health care in driving up deficits, and Obama The Peacemaker praised Republicans who are contributing good ideas and negotiating in good faith.
But there was also Obama The Avoider. People can keep their health plans if they like them, he said, as he often does. But it's likely any overhaul will change the types and numbers of plans offered. Even he said at one point, "Can I guarantee that there are going to be no changes in the health care delivery system? No."
What about experts who say Americans would have to give up tests, referrals, choices and end-of-life care in order to stop costs from spiraling upward? "They're going to have to give up paying for things that don't make them healthier," Obama said. It was a reference to the better medical coordination and best practices research he hopes health reform will deliver.
And there were moments of Obama The Partisan. "I've heard that one Republican strategist told his party that even though they may want to compromise, it's better politics to go for the kill. Another Republican senator, that defeating health care reform is about breaking me," he said. He added that "this debate is not a game" to people and businesses who are counting on their leaders for help.
Why the rush, someone asked. Will support for health reform collapse if there's a delay? "Number one, I'm rushed because I get letters every day from families that are being clobbered by health care costs. And they ask me: Can you help?" Obama said. "The second thing is the fact that if you don't set deadlines in this town, things don't happen. The default position is inertia, because doing something always creates some people who are unhappy."
The president didn't answer the second part of the question, but it's the key to why he's appeared every day this week to talk about health care and why the Democratic National Committee is running ads gently pressing fellow Democrats to get with their president's agenda. It's also the reason Obama spent the first few minutes of the news conference making a naked appeal to self-interest.
"I realize that with all the charges and criticisms that are being thrown around in Washington, a lot of Americans may be wondering: What's in this for me? How does my family stand to benefit from health-insurance reform?" he said.
For the second time in two days he laid out areas of "rough agreement" in all the bills moving through Congress. People will have coverage even if they get sick, lose a job, change jobs, move, or have a pre-existing condition. There will be limits on out-of-pocket costs and coverage of preventive care. Individuals and small businesses will be able to choose plans through a health insurance exchange or marketplace. And none of this will add to the federal deficit, which Obama said makes Americans "queasy" with good reason.
In a moment notable for its edge, Obama held himself up as an exemplar of fiscal discipline in comparison to his predecessor. "In the past eight years, we saw the enactment of two tax cuts, primarily for the wealthiest Americans, and a Medicare prescription program, none of which were paid for. And that's partly why I inherited a $1.3 trillion deficit," he said. "That will not happen with health insurance reform. It will be paid for."
Two-thirds of the cost would come from dollars being spent more effectively than they are now, Obama said. Congress is looking at tax increases, mostly on the wealthy, to finance the rest. "I don't want that final one-third of the cost of health care to be completely shouldered on the backs of middle-class families who are already struggling in a difficult economy," Obama said.
It's hard to think of an argument that Obama did not make in his one-hour tutorial, including the risks of doing nothing. "If somebody told you that there is a plan out there that is guaranteed to double your health care costs over the next 10 years, that's guaranteed to result in more Americans losing their health care, and that is by far the biggest contributor to our federal deficit, I think most people would be opposed to that," he said. "Well, that's the status quo. That's what we have right now."
Most people do think the system needs to change. But any change is frightening. Obama is now -- some might say belatedly -- distilling the many chaotic strands of congressional activity into a narrative that's easier to follow – and maybe to trust.
Government making you cynical? The prospect of change making you anxious? All legitimate, Obama said, but suck it up. "We've made big changes before that end up resulting in a better life for the American people," he said.
At this point, it looks like he's staking his legacy on this big change.
Filed Under: Health Care

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