The Sermon on Health Care: My Thoughts

President Obama delivered a speech last evening to Congress concerning health care and health insurance reform.  I was impressed at how sermon-like his speech was.  In effect, he came down from the White House to preach a message.  And he’s good at it.  He is obviously far more comfortable at the podium than his predecessor and it shows.  If you haven’t seen it yet, you can read it here and you can watch it here.

Here are a few thoughts after watching the speech.

• This is not about health care reform, but health insurance reform.  We have the best health care in the world, though we still need actual health care reform as well, see this, and so we are fighting about how to pay for it and who should pay for it.
• The President is correct, health insurance needs major reform.  The abuses are rampant, the absurdities are abundant, and one only needs to do a bit of reading and research to find a few tragic stories.  Individuals who have paid for years into a plan should not be dropped when they face a major illness.  Individuals should be able to seek insurance on their own and join together in groups, other than employee-based programs, for bargaining with insurance companies.
• The President is naive to say that a government public option could be properly managed, keep within a budget, or not be taken advantage of to expand government control over the lives of its citizens.  He needs to understand that this is where fears of “death panels,” and big government come from.  In spite of what he says, this is a Pandora’s Box of trouble that would be nearly impossible to shut once opened.
• The President is naive to say that he actually knows the cost of the public option.  The government has rarely, if ever, accurately predicted the cost of a government program.  Just look at Medicare and Social Security.
• The President is naive to say that the public option could be paid for without raising taxes or without increasing the deficit or that they would find enough spending cuts to provide the cash.  If the costs are estimated inaccurately, then there can be no guarantees here either.  Furthermore, he simply cannot control what later Congresses and administrations will do!
• The President is correct that malpractice litigation needs addressed in order to better protect doctors.  I hope he really follows through on this in a meaningful, lasting way.
• After all of this talking, the American people still do have a plan for this bill that we can actually put our hands on, read, and think about. During the video of the speech, for a few brief seconds you can see a person in the audience holding a sign that says, “What Plan?”  Exactly.  We don’t want to know just the big picture here, we need a plan with details, for it’s the devil in the details that we are worried about.
• This episode was not the defining moment of the night, but an unguarded moment that will now be exploited by a media that loves reality TV.  For what it’s worth it seems to me that, on the whole, Republicans tend to be a bit more kind than Democrats.  Last night they made for a mostly kind audience in spite of Joe Wilson’s outburst and this contrasts rather sharply with Democrat responses during a number of President George W. Bush’s speeches.
• The Democrats need to drop the public plan option, and Congress needs to very specifically target health insurance reform, and provide a plan with real teeth, a plan that is shorter than War & Peace (preferably no more than a few hundred pages), that takes on the abuses in the health insurance industry, levels the playing field for all Americans, and has no hidden surprises.

By the way, you can read the Republican response here.

I’m no expert, these are just the thoughts of an American citizen and taxpayer.  The question is, what do you think?