Thursday, September 10, 2009

Obamacare You Can Live With

In an attempt to regain control of the health care debate if not his presidency, President Barack Obama crafted a speech a fifth grader could grasp and Congress could follow allowing all Americans to receive affordable medical services.

What struck me was all the goals and specifics outlined by the president seem reasonable enough for Congress to adopt with all sides of the equation giving up some of their hallowed turf. That's what sausage-making legislation is all about. I think if Obama had his druthers, he would prefer extending Medicare to all and raise taxes to fill the deficit holes. But, no, the man is a political pragmatist and has a feel for what flies and what sinks.

To win this battle, the emotionally-charged debate needs to be unplugged after a summer of discontent. That became evident when snickers rolled across the chamber floor after the president said "there remain some significant details to be ironed out." That wasn't unusual.

What was a violation of decorum was Rep. Joe Wilson (R-South Carolina) who yelled "you lie" when Obama debunked charges that the proposed legislation would pay for medical coverage for illegal immigrants. Wilson later apologized to the White House, claiming "emotions" got the better of him.

The only areas of the speech Wednesday night that left me uncomfortable was Obama's argument that any plan approved by Congress be deficit neutral. I do agree with this statement:"Put simply, our health care problem is our deficit problem. Nothing else even comes close." It's the numbers game how we get there is what is troubling.

The encouraging aspects of Obamacare -- and I use the term approvingly and not mockingly as opponents have coined -- is legislation that would force the insurance carriers to be more accountable.

What this plan will do is to make the insurance you have work better for you. 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 most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. 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. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies - because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.

I have no problem with Obama doing an end run around the liberal Democrats demand for a public option. Instead, he dipped into his bag of campaign proposals and suggested a new government insurance exchange to cover the uninsured.

If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange - a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers.

Obama laid down a few markers. His proposals translate to the premise that health care is a right for every American. It also would require all Americans to buy health insurance as they do automobile insurance.He seemed willing to allow consumers to buy out-of-state health insurance, a practice now under the exclusive domain of individual states. And, he supports a Bush administration proposal to test by region ways to cap malpractice lawsuits.

Frankly, the speech comes too late in the legislative process, I fear. No one seems to recall a presidential speech that tipped the scales in favor of landmark legislation. I doubt the president changed any minds in Congress. We won't know for several days if it stirred the grass roots to demand reform as outlined by the president.

One thing is clear. There's 80% agreement in Congress over what so far has been introduced in draft bills and that's the closest we've been since President Teddy Roosevelt argued for it almost a century ago.

We may not get a whole loaf from health reform, but a couple of slices short is not all that bad.

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