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in 2009 there is no bigger issue

Summary and Analysis of the Obama Speech on Sept 9, 2009

The Obama speech on Sept 9th was a mass of emotion, great rhetoric and a lot of contradictions.  WSJ wrote"The speech was especially notable for its use of one of Mr. Obama's favorite rhetorical devices: Noting in the first instance that his opponents have a good point, and entirely legitimate concerns, only to reject their ideas in toto when it comes to policy. Thus he endorsed the public's concern about the competence of government to manage one-sixth of the economy, only to finish with a soaring oration about the moral necessity of letting government do so."

There are many analyses of this speech that detail the facts versus the statements, a list of the ones that are most compelling is given below.   The more I reflect on this speech the more I see the arrogance and the sheer despicable politics.  He could and should have acknowledged the concerns of the American people, but choice instead to extol them to accept his policies for reform, despite the fact there still remains no written single Bill.  He is free to state his position in general, but also called for an end of the debate and action.   Action on what?  And where is the cost reduction?  All the actions will increase cost, not reduce them.  They will reduce individual choices, not increase them.  The will increase government controls, not reduce them.  I see this as a loss of freedom.  How else can one see this massive policy?  

In general there was nothing new in the speech.  Most of the points have been discussed before by him and other Democrats.  His proposal most closely follows the Baucus Bill coming from the Senate Finance Committee.   It was quite clear that the speech was a further concession to the far Left, raised the bipartisan tone of the debate, and arrogantly called for a ceasing of debate and progress, vis-a-vis, agreement to his proposals.   This was a campaign speech and not policy leadership.  It was a speech saluting his special interests while chastising the opposing special interests, which now are somewhat hard to find outside of citizen groups and think tanks.

An honest reaction:  "Government controls a lot of the spending today" in health care, said Alissa Fox, a senior vice president at the BlueCross BlueShield Association, which represents 39 independent insurers. "We don't think the solution is more government spending." 

Only about 10 percent of Americans even tuned in — and that was an incredible drop of 39 percent from the TV audience that tuned in to watch Obama's State of the Union speech just last January!

In general this set of ideas from Obama was described as status quo on steroids, with much too much government increased involvement and no cost reduction.  His ideas are nothing close to what I proposed, which could have saved his presidency.  He is spending a great deal of political capital on this reform, at a time when the people in America are worried about their jobs.  As Henninger details in WSJ, this is a time that may mark the failure of his presidency, to really listen to the American people and not just take direction from his special interests, such as Labor Unions.  

A quick summary of his positions, with my responses follow:

"A $900B plan that will be deficit neutral."  Response:  when has this ever occurred.  First of all when there is a Bill, CBO can analyze it for cost, and then we will see how low their forecast actually is, when the cost goes well over this number.

"Plan will be funded with new taxes, and reduction of waste and increased fees."  Response:  as detailed elsewhere, this statement is going to mean a hefty tax increase to the middle class, and the waste that is there today will be magnified in all likelihood with Obamacare.  

"Caps on out-of-pocket and lifetime payments."  Response:  well who is going to pay for this?  The taxpayers and policy holders.  It is a massive entitlement program, increasing costs, not reducing them.  It is another form of wage and price controls.

"Choices will be maintained and enhanced.  Government will not get between you and your care."  Response:  perhaps for the first few years, but to control costs and with the public option and care panels (see House Bill HR3200), there will be a shift to government controlled allowed care and care providers.  This will reduce greatly the doctor-patient relationship and decision making.  It also removes the patient further from being concerned about costs.  So this statement is simply not true.

"Public option will improve competition and not drive out private insurance."  Response:  again detailed elsewhere in this website, see link at left.  The bottom line is that there are 1300 insurance companies now, greatly hamstrung by government mandates from competing.  See Proposal and "A Plan that Can Work" for how to fix.

"All will be covered, just not illegal aliens, and abortions are also not covered."  Response:  not quite true, as Democrats have refused to put in this language, and there are allowances in the Bills for this to be allowed.  The effect of a mandate for all to procure insurance is far reaching, and the public does not realize how much government involvement in their lives this will require.  For instance, the IRS will now be a watchdog for the government run healthcare bureaucracy.   Think of what this means.

"Affordable insurance that cannot be canceled.  Pre-existing condition will be covered."  Response:  it is illegal for insurance to be cancelled since 1996, although there are some instances where that seems to have occurred.   Clearly with the fee constraints, total out of pocket caps, mandated coverage, and a mandate to cover all costs of a person's healthcare what is going to happen to the cost of healthcare?  And what confidence will be have in the total cost estimates of Obamacare.

"Critics want status quo and are not interested in improving these Bills."  Response:  quite untrue and quite antagonistic.  Not sure why he says he wants a bipartisan process when he uses bullying tactics like these.  All 5 Bills in Congress have excluded Republicans, and even more importantly, have not included any free market advocates in any discussions.

"Will investigate tort reform."  Response:  this is a small bone thrown to the Republicans, and is a major concern for doctors.   The AMA is delighted.   In all practicality it will never be elevated to a legislation that will pass, as the Democrats have shown continued disapproval of this notion.  There is literally no likelihood that this will ever be passed in an effective manner.  

"All must be responsible for making this happen."  Response:  in other words it is going to cost us all a lot in taxes and a reduction of care and choices. The discussion on reform began with a need to reduce waste in Medicare and cover the uninsured.  Why do we end up with such a costly policy that achieves neither of these objectives?    There are so many better ways to achieve these goals, but they do not serve the special interests.  So where is the change in DC?  

A video showing what is left out of the Bills, after all of the demonstrations over the summer:

Good reviews of this speech:

WSJ:  "Doubles Down", "Big Political Gamble"

Fortune:  Shikha on "Obama's Health Care Plan: Put Up And Shut Up"

Cato:  "Speech in Plain English"  "All Sizzle and No Substance"

Reason:  Matt Welch on the speech:  "Lies Matter"

Heritage:  "The President Learned Nothing From August"

Human   "Big Gamble"

Greg Scandlen's email: 

The more I think about Obama's speech to Congress the more mind-boggling it is. Here are a few highlights.

"There are now more than 30 million American citizens who cannot get coverage." Right at the start of his speech Obama says he will cover 30 million people. 30 million?!  What happened to the 46 million uninsured we have heard about for years and years?  What happened to the universal coverage goal?

"I am not the first president to take up this cause, but I am determined to be the last." Can he possibly mean that he will solve every problem for now and all eternity? What about the remaining 16 million uninsured? This is pathetic. The fact is, no solutions are final. New problems always arise.

"Let me repeat this: nothing in our plan requires you to change what you have." Simply not true. Later in the speech he talks about cutting Medicare Advantage.  There are more than 10 million people with a Medicare Advantage plan and in most cases they can go without Medigap coverage because of it.  The added costs to beneficiaries will be substantial.

"We will place a limit on how much you can be charged for out-of- pocket expenses, because in the United States of America, no one should go broke because they get sick." The worst offender here is Medicare. There is absolutely no limit on out-of-pocket expenses under Medicare. Will he change that?

"Businesses will be required to either offer their workers health care [but] 95 percent of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements." Wait, business will be "required," but 95 percent will be exempt? What kind of requirement is that? Is he aware that the vast majority of the uninsured work for these small businesses?

"In 34 states, 75 percent of the insurance market is controlled by five or fewer companies." Are five competitors inadequate? By what theory of economics? For many years the United States had three big automakers, three big networks, three big cereal manufacturers, three big newsmagazines. If five is inadequate, allow cross-border shopping.

"In Alabama, almost 90 percent is controlled by just one company." "All of this is in service of meeting what this former executive called 'Wall Street's relentless profit expectations.'"  Yet Blue Cross Blue Shield of Alabama, the company that has 90 percent of the market in that state, is and has always been not-for-profit. So, "profit expectations" were not a motivator.

"The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies." There goes Medicare Advantage. As noted above that means many people will indeed lose their current coverage.

"And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead." Here is where the concern about "death panels" comes from. One person's waste is another person's essential service. Is it "waste" to give anti-cancer drugs to a 90-year old?