Friday, April 10, 2009


Universal health care is one of the most important changes the Obama Administration could possibly make. The US is the only western country that does not have universal government subsidized health care. But what kind of health care reform is Obama proposing? And why is it "reform" instead of a program of universal health care?

Obama has a history in 12 years of elective office of saying one thing but doing another and never fulfilling anything he promises and healthcare could be the latest example.

In what was yet another of his town hall meetings a question was asked about healthcare and what Obama is going to do about it. He said healthcare reform was one of his top priorities ( its been a Democratic party priority for at least 15 years) but that it will be difficult to do (anyone ever notice how he is always telling us how hard everything is to do?) and that there is a system already in place, a system that, in spite of its flaws he is going to keep.

This is what he said:

"It's not the best system, it's not the system we would create if we were starting from scratch, but its the one we are used to so we are going to keep it".

The one we are used to so we are going to keep it? This is the candidate who campaigned on change? On reforming Washington? On getting rid of the old way of doing things and ushering in something new and better?

This sounds a lot more like is the candidate who told the people of Ohio he would get rid of NAFTA if he were elected but privately told the Canadian government he didn't mean a word of it. Or promised to use public financing if he were the nominee and then reneged. Or promised to vote against the FISA bill if contained retroactive immunity and then voted for it.

Although many of his supporters (or people with their fingers crossed) say give Obama a chance, his 12 year history as an elected official is he is a talker not a doer and never does what he says he is going to do.

So far , for good or ill, everything Obama has done has been Democratic Party initiatives. It's the Democrats behind the scenes setting the agenda, not Obama.Which is actually a good thing since it will be Congressional Democrats that might force Obama to keep his word.

But his statement about keeping a flawed system because its one we are used to doesn't bode well. It smacks of an approach that may be splitting the baby. It shows an unwillingness to take on the biggest obstacles to universal health care and that's the insurance companies and the drug companies.

The single biggest flaw in our system is that health care operates within our capitalist system which is market driven. Health care should not be part of a market driven concept. Republicans have long supported that system and called government subsidized healthcare socialism. But that is what has to change. That is what no other country offering universal health care does. In fact it is insanity to have a health care system that provides services that mean life or death based on the same principles that govern the marketing of Dr. Pepper.When you have a system of health care that can't differentiate between a doctor of orthopedic surgery and Dr. Pepper you have a problem.

Obama, despite his rhetoric to the contrary, has never taken on the big interest groups. Instead he has welcomed their contributions and has gotten cozy with all kinds of lobbyists including the drug and insurance company lobbyists which are some of the most well financed. So getting real health care reform from Obama could be more snake oil than anything that is really good for what ails us.

More than $600 billion is being allocated to reforming health care when what's needed it not just reform but a new system.

But all is not lost. The key to getting universal health care is through Congress not Obama. If enough pressure is put on Congress to do something meaningful, if people reject anything less than the kind of universal health care that has worked for other countries and makes healthcare a right, not a function of market driven principles, then its possible that health care reform will be something truly beneficial and not a bottle of snake oil sold from the back of truck outside a town hall meeting.


sue said...

I missed those comments at the town hall- when did he address health care?
While I agree with your point of health care being market driven- you have to remember there is a certain amount of fear that drives health care decisions- fear of being sued that is. In an industry that works w/ life and death everyday- there is a high risk of legal suit- much higher in this country than others.
And you touched on the pharmaceuticals- the insurance companies and equipment companies drive health care decisions.
Along with all of the beaurocrats that sit around making sure all regulations are followed.
So- health care is clearly too big of a fish to fry for Obama- and he clearly has no passion one way or the other.
When Hillary spoke of health care during the primary- her face lit up and you could see her passion. Obama regurgitates whatever he has just been spoon-fed.

Pumaeyes said...

You are so right yet we've know all along that Obama is a snake oil salesman. My mother has been deathly ill yet she was kicked out of a hospital when she could not even walk. She was kicked out of care center two day early and she was back in the hospital three days later. I live with a Type 1 diabetic who is also a public school teacher. We need universal health care. Obama cannot be trusted. We need Hillary.

Marc Rubin said...

"I missed those comments at the town hall- when did he address health care?"

It was during the "town hall" meeting at the White House where he also took a number of questions from the internet.

Kola said...

You are right about the need for health care and skeptism about Obama delivering just as Clinton before him failed.

The only thing I fear is that like bloggers who complain about Obama's health care proposals not going far enough you will also turn around (or already have) and complain about his 10 year projected deficit most of which is different from baseline solely due to proposed changes to health care.

Kola said...

When Obama talks about the dire situation the ecconomy is in we complain he's too negative, when the economy bleeds 600,000 jobs we ask that he speaks realistically or release bank stress results pronto so folks make a run on the banks.

When he tells us changing health care is difficult, we note and whine about how he tells us such things (even though we still remember or should) how health care reform was defeated in the 90s.

I suppose his telling us its difficulty should instead band us together to fight for it (inicluding fighting him if we have to) to get the right thing done which would actually spur growth. Now what have we done to help him thus far while he right and the insurance company has already started the fight including mailing showing that the dadta on the uninsured is inflated and bogus. What have we done to help Sebelius who is under fire or Daschle who also had the passion to see this through. No we join on two sides of our mouth compaining about this and also complaining about the potential spending or deficit this would create (not necessarily this author)

Marc Rubin said...

"I fear like bloggers who complain about Obama's health care proposals not going far enough you will also complain about his 10 year projected deficit most of which is different from baseline solely due to proposed changes to health care."

Health care trumps deficit. Those who disagree are in my opinion, as Oscar Wilde said,people who know the cost of everything and the value of nothing. But "reform" is not enough. Anything less than the kind of subsidized health care provided in countries like Norway or France is a dodge and not worth doing. Health care has to be taken out of the realm of a market driven capitalist system which is what works best for everything else but not healthcare.

Anonymous said...

Putting pressure to Congress and hoping they'll push this agenda is a wishful thinking. My party is so corrupt that....

sue said...

The health care system is so large and there are so many facets to it- this is why Obama cannot come up with a plan.

It already is partially subsidized through medicare and medicaid. Any hospital that accepts medicare is held to certain regulations. Medicaid, although administered at that state level, gets some federal funding.

The VA system is a perfect example of a government health care system- in addition, the electronic medical record that the VA has been using for years is superb- medical records are updated in a timely fashion and you can move anywhere in the country and your provider would have immediate access to all of your old records.

The big problems that Obama has to overcome are litigation, reimbursement, pharmaceuticals, etc.

We spend an awful lot every year and yield much lower results than the countries Marc mentions- partly b/c of litigation.

We also have the undocumented immigrants- it takes a toll on the dollars and it is another issue Obama is "carefully monitoring" and supposedly will have a plan sometime this summer (I am not holding my breath)

None of these entities exist in a vacuum and all are inter-related-

I think the point of this particular piece was yet another illustration of where the Hopey Changey promises pan out to nothing more than same old same old Obama. IMHO.

Marc Rubin said...

"It already is partially subsidized through medicare and medicaid. Any hospital that accepts medicare is held to certain regulations. Medicaid, although administered at that state level, gets some federal funding."

I have been in contact with someone who is being considered for a big job within the Obama Adminsitration. This person told me their plan for healthcare related to this that is so simple and logical AND would be so effective that it's hard to believe no one else has thought of it.

Im not going to preemept them by mentioning the approach here and now but if it's rejected, the only reason would be Obama buckling to the healthcare lobbyists and at that point, if this simple ( yes expensive but also doable and more effective than anything else I've heard) idea isnt adopted, I'll spill the beans and let people lobby Congress to implement it.

Anonymous said...

sue, you keep blaming "litigation" for our health care problems. It's a typical Republican talking point and not true.

The problem with our health care system is that health care is a right, but our country delivers it like it's a privilege -- a privilege only for the wealthy. The poor get none and the middle class "think" they do because they are "covered" at work, only to find when serious illness strikes that they are not covered at all.

Our emergency rooms have become dumping grounds for the uninsured (yes, including illegal immigrants) and are now among the worst in the world because they're overburdened and underfunded.