The Speech

If I say it was agood speech, will you promise not to hit me?

Seriously, the man can talk a good game, I think we all know this by now, but what was actually in there for me? Was good, bad, and ugly.

The good:

1. Ending recission (seriously, it’s so outrageous sometimes I think we forget it’s not already against the law and that ending it will be a huge fucking deal):

Under this plan, it will be against the law for insurance companies to
deny you coverage because of a pre-existing condition. As soon as I
sign this bill, it will be against the law for insurance companies to
drop your coverage when you get sick or water it down when you need it

2. Support for a public option at all:

But an additional step we can take to keep insurance companies honest
is by making a not-for-profit public option available in the insurance

3. Calling out GOP crap for what it is:

I will not waste time with those who have made the calculation that
it’s better politics to kill this plan than improve it. I will not
stand by while the special interests use the same old tactics to keep
things exactly the way they are. If you misrepresent what’s in the
plan, we will call you out. And I will not accept the status quo as a
solution. Not this time. Not now.

The bad:

1. Mandates to purchase coverage and penalty fees for going without. If you don’t have the money for insurance, and I honestly do not know any of these apparently thousands of people who don’t have insurance cuz they just don’t wanna, you will not have the money for fines. Getting everyone INSURED isn’t the goal. Getting everyone healthy is. And the auto insurance comparison is bullshit; no child has to pay for car insurance and you don’t have to have it if you don’t drive. You can choose not to drive but last I checked you can’t choose not to get cancer or get hit by a bus.

And unless everybody does their part, many of the insurance reforms
we seek – especially requiring insurance companies to cover
pre-existing conditions – just can’t be achieved.
That’s why under my plan, individuals will be required to carry
basic health insurance – just as most states require you to carry auto

2. Going soft on the insurance companies in general. Here’s a newsflash, even people who work at insurance companies think insurance companies suck. In fact, ESPECIALLY people who work at insurance companies think insurance companies suck. There’s really nothing to be lost by demonizing them outright, since that’s what they’re gonna hear anyway.

Now, I have no interest in putting insurance companies out of business.
They provide a legitimate service, and employ a lot of our friends and
neighbors. I just want to hold them accountable. The insurance reforms
that I’ve already mentioned would do just that.

3. All this revenue-neutral bullshit. Literally no one cares about deficits. Even the teabaggers don’t care, and the way I know that is that their wonderful fiscally responsible protests were nowhere during the Bush tax cuts and the two wars we started. People may say they care about the deficit but really, they care about if their lives are getting better. Right now their lives suck because if they get sick they’re screwed, and ON TOP OF IT we’re adding to the deficit. If everything else was shiny and happy, we wouldn’t be having this conversation. And by the by, I’d like the next time someone comes up with a supplemental war spending measure for it to be put on hold until it was revenue-neutral. What a load of shit.

I have insisted that like any private insurance company, the public
insurance option would have to be self-sufficient and rely on the
premiums it collects.

The ugly:

1. FOUR YEARS? Four years to enact the most paltry of reforms? Look, I get, as Sherrod Brown was pointing out on Keith’s postgame, that saying you’re gonna do it in four years doesn’t mean it has to take four years, but you’ll pardon me for not exactly trusting a damn word out of anybody’s mouth in Washington about health care reform, mmkay? “Trust us, it won’t take four years,” I mean, dude, it shouldn’t take four minutes because somebody, somewhere, is being assasinated by a spreadsheet right this very moment and “be patient while the insurance companies get comfortable with the fact that the day is no longer theirs” isn’t gonna save THAT GUY.

And all insurance companies that want access to this new marketplace
will have to abide by the consumer protections I already mentioned.
This exchange will take effect in four years, which will give us time
to do it right.

2. Remember all those Bush speeches when he was president where he slapped around his own party’s most passionate supporters for passionately supporting what they wanted? Remember how he went in front of Congress and talked about “some on the right” who were kind of kooky and out there? Remember that? WELL ME FUCKING EITHER. God almighty, I knew this concilatory crap was Obama’s kink but I just sort of assumed that like a lot of the shit he said about the rule of law he didn’t really mean it. But there he was, creating false equivalencies between people who want to give others health care, and people who want him dead.

Blah blah blah political calculation: Look, if you’re a progressive Dem and you’ve been working your ass off do you really want to be compared to Chuck Grassley? I’m sure that kind of tit-for-tat everyone-is-an-asshole talk will make Tweety wet his panties but boyfriend only has one vote and it’s already yours, so WTF?

But what we have also seen in these last months is the same partisan
spectacle that only hardens the disdain many Americans have toward
their own government. Instead of honest debate, we have seen scare
tactics. Some have dug into unyielding ideological camps that offer no
hope of compromise. Too many have used this as an opportunity to score
short-term political points, even if it robs the country of our
opportunity to solve a long-term challenge. And out of this blizzard of
charges and counter-charges, confusion has reigned.

What confusion has there been? Did Richard Cohen write this section? The only “confusion” that there has been has been the result of talk radio psychos and Republican congressmen trying to get famous, plus, you know, the wilfull ignorance of the AP and NPR when it came to the real cost of any public plan. If you’re not batshit crazy, you ain’t confused, and if you’re batshit crazy, you’re probably not listening to the president anyway. If Obama could somehow manage to talk about how batshit crazy the Republicans are without this kind of passive “mistakes were made on all sides” thing, I wouldn’t mind so much since it’s mostly a waste of his time and not mine, but I resent being slapped around just so that his hand can land on Republicans too.

3. Not going whole hog and threatening a veto without a public option. Again, blah blah blah I get it. Still, the problem now isn’t that we don’t all know we should have reform and love each other. The problem is that you have all these different camps looking to you for direction and these ain’t critical thinkers. They’re in Congress. Tell them what you want.

Following the speech a giant hybrid meatspace/Interwebs argument broke out between me, Mr. A, and a few people in the van over whether this was as good as we could get but not enough, totally shitty and half a loaf, half a moldy loaf, Obama being Obama, a total betrayal of the idea of hope and change, or just the first step in a series of steps. That argument, in this house at least, is still going on.


18 thoughts on “The Speech

  1. I watched from here in Canada (where I am visiting) and for what it’s worth I didn’t feel like hiding under a rock and apologizing for being from the US during most of it (a MAJOR improvement with this latest model of chief executive.
    Sidebar: canada is nice. kinda socialist and they have bike paths and shit. not to mention phone booths, imagine that!
    miss you guyz…hope the van was fun

  2. Sorry I missed the van. I think I’m on Mr. A’s side this time. I dvr’d the speech and liked most of it but I’m not immersed in the details of health care reform. He reminded me of the guy I voted for so that pleased me.

  3. Wish I coulda seen it–I’ll be reading the transcript in the morning. (I was, instead, rehearsing Christmas music. Good thing I love Britten.)
    I will say this, tho–if he’s not cracking heads on national teevee, he bloody well better be doing it backstage. Max Baucus needs to be explaining to his fellow Blue Dogs that he got that black eye by walking into a door. MmmKay?

  4. The final bill is going to be a class A-1 horror, I think, and nothing he said convinces me otherwise, and he’s certainly going to sign it even if it is.
    The really serious problem with doing things this way is that when the plan doesn’t contain costs (it won’t) and we’ve still got thirty or forty million uninsured, or with crappy, overpriced coverage (we will), Congress will be able to spend the next twenty or thirty years tinkering around the edges of this monstrosity. This gives them the excuse not to revisit the problem (in systemic fashion) for a long, long time.
    If it turns out, as is likely, the “reforms,” like those of Part D prescriptions and Medicare Advantage, are just ways to move money from the treasury into the offshore accounts of the health industry’s CEOs, this new system will eventually go supernova, and the conservatives will scream, “DimocRats Fail,” yet again, and demand that it all be dismantled. How likely is the sensible approach, single payer, in the years ahead, even if this all goes sour?

  5. I know this is me lacking a sense of humour (sic) at the moment, but, for the last time, Canada isnot socialist. Canada is a democracy, full stop.
    Socialized medicine and bike paths do not a socialist country make. They do make for a worry-free bike ride, though.

  6. I thought the speech was good, but, as I let be known in the Crack Van, I don’t like the plan. President Obama did show some fight and some spirit and seemed to at least take the initiative back.

  7. Thank you for opening the Crack Van (and the name you chose for the van…). It is so good to get instantaneous commentary. For that matter, if Joe Wilson wants to comment, the crack van would have been an appropriate venue. The House was not.
    Overall, I’m hoping that what the President said will back the naysayers into a corner.
    And shall I say that I am **ahem** amazed that the republican response seemed totally unaware of what was said in the speech. Yet, the webpage cited in the response already had a report up on the response before the guy had even finished his murmurings.

  8. Health reporter Jon Cohn at The New Republic said Obama made some news in the speech:
    – “a promise to provide low-cost, bare-bones policies right away–merely as a stopgap, until full reforms kick in. (This is an effort to make sure Americans see at least some benefits right away.)”
    – “malpractice reform–again, more explicitly than he has before, presenting it as an effort to reach across the aisle.”
    The low-cost bare-bones stopgap won’t take 4 years, it’s coming ASAP. And coupled with a cap on out-of-pocket costs and other reforms it’s probably will cover preventitive care, basic common maladies, then have a fair sized co-pay until you hit your payment cap. In other words, it’s probably something like lots of people would pick in 4 years.
    The tort reform stuff is a sop to the right because malpractice is only about 1% of the cost of medicine but 1% of 1 trillion dollars is 10 billion dollars. That’s not nothing. And I’m sure reforms would look more like arbitration or standardize awards, not eliminate them.
    I’m an Obama fanboy but I’d like to think I’m a fanboy because he’s freaking good at his job. He looked good at it last night.

  9. anything that isn’t single payer is inherently flawed. anything that leaves substantial numbers uninsured is inherently flawed (though I’m skeptical of montag’s 40 million number).
    but I take issue with those that say better no plan than pass this.
    No plan means two things (at minimum)- it means no end to recission, it means no public option at all. But more than that, it means a republican victory, a huge republican victory.
    Call me stupid, but I don’t want the republicans to score.
    I’m of two minds re mandating coverage. I have problems with it ethically and I think the Rs will flog it over and over to their advantage. But if there was a way to instant-enroll or instantly cover someone presenting with a massive medical emergency and no coverage at the hospital, or for the hospital to obtain compensation rather than pass on the cost, that might be good. In other words, uninsured people with huge medical bills is a problem that should be addressed, just don’t think we can mandate that people have coverage.
    I also think that any child should just be automatically covered at birth if the parents don’t have insurance or aren’t in the medicaid system or it’s future equivalent. Anything that cuts down on infant mortality and increase routine child and baby care is worth paying for. The US has Medicare for its seniors. The US should NOT have an infant mortality problem. PERIOD.

  10. virgotex – The mandate of coverage is new and a shift from what Obama campaigned for. I didn’t like Hillary Clinton proposing a mandate during the campaign so it’s even worse for Obama, who attacked Clinton for proposing a mandate, to do the same.
    A lot depends on what the enforcement mechanism is for a mandate. In Massachusetts the maximum penalty for not having health insurance is for people who make 300% more than poverty level and it works out to $17.54/week and $4.04/week for people making 200% of the poverty level or less. It’s zero for people making less than 150% of the poverty level. The penalty isn’t billed to you, it’s just added to your Mass. income taxes so for many people it looks like a reduced tax rebate or a biggger tax bill. The penalty is a separate transaction from any of your actual health care procedures so it’s not handled in a ghoulish way. I don’t like mandates but if the initial bare-bones plan is cheap and decent and the sliding scale is fair the penalties won’t be a burden to people.
    Note: More on Massachusetts mandates as an example below.

  11. Totally caved to the right wing. What a worthless chickenshit we have for preznit. “Oh, we love the insurance companies, our friends and neighbors.” What a dumbass. My contempt grows by the day for this nutless wonder.

  12. As long as corporations own Congress, we will not get what we need – single payer, universal health care. What we can get is corrections of some of the major problems with health insurance in our country. Even that is such a difficult step for the corporation owned Senate, that passage isn’t assured. With that in mind, Obama’s plan is a good one, and is probably the best that there is any chance at all of getting past the Senate.
    Obama took great pains to include Republicans in the process. He took great pains to thank them for their contributions, and to incorporate the least bad of those contributions into his plan. Still, the Republicans insult him, call him a liar before the whole Congress and on national TV, and continue their attempts to totally derail the legislation. If Obama is half as smart as we all seem to believe him to be, he will very soon write off the entire Republican Party, eliminate them from any consideration at all in writing legislation, and publicly condemn them as the unpatriotic assholes they are.

  13. i wish he didn’t want to play nice. the fuxians will not ever no how play nice til they are endangered species.
    and instead of going after tort reform HOW ABOUT GETTING RID OF BAD DOCTORS.

  14. I remain disappointed in the speech last night. I posted a comment in a thread at Corrente embedding the video of Dennis Kucinich’s response to the speech, and I stand by that.
    Thirty million new customers mandated to buy insurance. A bailout for an industry that is bleeding this country white with its care denials, a form of employment we should not be encouraging or subsidizing.

  15. “and instead of going after tort reform HOW ABOUT GETTING RID OF BAD DOCTORS.”
    The only way to get rid of bad doctors is with VALID malpractice suits. As it stands right now, except for in the state of Wisconsin, any ambulance chaser can bring a case to court and, with the judges in their pockets, proceed to bleed patients and doctors dry. A doctor’s malpractice insurance premium doesn’t go up just because they were found guilty or settled out of court, but simply because they were named.
    If Wisconsin can set up a board consisting of doctors, lawyers and judges who collectively decide the merit of a case and if this has resulted in a lot less frivolous claims, a lot more valid claims and happier doctors and patients, why is this not enacted in the rest of the country? Doctors are working people, too, and if they get piled on by the insurance companies AND the voting public who don’t understand how it works, you will see much-needed physicians quitting and, trust me, you don’t want that.
    I’ve asked all the doctors and small business owners in my circle of family and friends why they don’t organize with us against the insurance companies. They said they can try but not without the cooperation of other similar folks, who don’t want to get their hands dirty with politics and picketing.

  16. What gets me is that HEALTH CARE REFORM is TORT REFORM. The reason people sue doctors for malpractice, and sue other people for large sums of money, is to *recover enough money to get treatement* to pay for the malpractice, or for the damages they’ve suffered. If everyone had universal, comprehensive, health care we’d nearly eliminate all medical expense related law suits. The entire business of phony car crash insurance scams is based around the fact that the payout covers fake health care treatements. You’d entirely eliminate that kind of tort and fraud if ordinarily people could simply access legitimate health care and doctors had to account for their health care treatments as a government service. I’ve never seen anyone crunch the numbers but I’d really like to see a comparison between the way law suits work in countries with comprehensive single payer or other national health care and those without.

  17. Taking a lot of the profit motive out of medicine (by instituting a single-payer system so there’s effectively a limit on how much doctors can make without taking on a sideline) also does a lot to counteract malpractice, since it means a lot of the greedheads don’t go to medical school (they go into finance instead)…

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