Thursday, December 24, 2009

#186 Obamacare and Obama

The Obamacare we knew and loved last year is simply no longer the same as what its Presidential namesake seems to be embracing now. Big difference?--the PUBLIC OPTION (you saw that coming, of course), or at least what is known by that lately taboo moniker.

Now that both the House and Senate have passed the threshold of passing their respective cobbledydoos, neither passing for real Health-Care Reform--What has happened to the likes of John Q. Public Option, a plan which is only a second-rate alternative for the real thing: Mr. Single Payer? For tax-payer-funded, non-employment-based, private-insurance-free (let 'em eat Life Insurance)--that is, truly universal health care, should have been the enlightened way to go. But even its shadow-self, the Public Option, lives only precariously in the House bill, while being entirely snuffed-out of existence in Senate deliberations fairly early on. Thanks to greedy Big-Med lobbyists and grafty small-state Senators.

Obama's campaign package last year included it. He loudly promised some sort of government-run alternative to private insurance, and furthermore said that in no way could he sign a bill mandating the latter's purchase, lacking a public alternative. Well, Public Option in the Senate bill is out, while Private Health Insurance Mandatory Everybody Must Purchase Policy Or Else ... is in. Yet Obama claims some sort of victory there. Would he break his promise and sign such a bill now, if, after conference-resolution, the Senate version in principle prevails?

As late as July of this year the President was still explicitly for the Public Option. Here's the key sentence from the transcript of his radio address:

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.
Strong, unequivocal, oath-like words. Yet one month later, things had changed. He made the same speech in August at historic Broughton H.S. here in Raleigh (DM #134), with a couple of telling exceptions. In the transcript, the first part of the sentence is exactly the same as above, but notice the glaring four-word lacuna in the second half, and the deferential replacement-phrase at the end :

Any plan ... an insurance exchange ... compare the benefits ... a variety of plans [oops here] to increase competition and keep medical costs down.
The Obama shuffle. He's a canny politician who seems to want any kind of WIN here--it would really be his first of real consequence--at any cost. (He's yet to navigate through Congress his AfPak "surge" funding, which, alas, he'll get.) But the President has a chance to redeem himself vis-a-vis Health-Care Reform. The House and Senate still have to negotiate and get their separate bills together as one. Obama swears to be in the thick of things. And he's got the little lever to move the world in the House version of the Public Option. Who knows?--maybe the rather less-than-scrutable guy has been in stealth-mode all along.

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