Friday, August 14, 2009

Does Obama Really Want Health Care Reform?

I am reluctant to wade into the US debate on health care for several reasons. First, as a Canadian it does not affect me directly, (although only a fool would believe that what happens south of the 49th parallel is irrelevant to Canadians). Second, the issue is horrendously complex. Third, Christians can be found on both sides of the current debate depending on the exact issue being discussed. While a modern society should have affordable basic health care for all people, the exact mechanism and details are surely debatable.

But I just want to point out that, if my highest priority was getting the 48 million uninsured Americans covered, I wouldn’t go about it that way Obama is going about it. And that constitutes a genuine mystery: why is he doing what he is doing?

But let’s back up; I just assumed that coverage for the uninsured is the primary motivation driving Obama’s plan. Is that true? I’m actually not sure. There are so many tangled threads weaved together here and so many different agendas at work that it is hard to know who wants what anymore. The issue of the uninsured is certainly the main concern of the Catholic bishops and it would be my highest priority as well. But there are many other concerns that various people have:

1. The rising costs of existing health care programs like Medicare and Medicaid.

2. Ensuring abortion access to more women by having a plan that covers abortion available to every American

3. Preserving the profit motive that drives innovation in drug research and development and new treatment techniques

4. Reducing the costly expenditures at the end of life by some form of rationing

5. Perceived government incompetence to run large programs: will toilets cost $1,000 like they do in the Defense budget?

6. Lack of trust in an administration top heavy with pro-euthanasia, pro-abortion and pro-eugenics officials

7. Resistance to big government taking over more and more of life and the soft tyranny that that implies

8. The Democrats don’t seem to want to talk about the details; they prefer to attack the credibility of their opponents who have gone, in recent days, from merely being unfeeling and stupid to being racist Nazi thugs

Depending on which of these issues you care about, the debate is skewed in a certain direction. The problem seems to be that Americans are having about six different debates simultaneously with individuals floating back and forth between various issues without really ever engaging one another.

Where has Obama gone wrong?

1. He has given the impression, rightly or wrongly, that he just wants people to shut up and let the “experts” figure this out. His argument is that reform is so urgent that we should all just agree to what is on the table now and then let congress work out the details. Americans have spoken pretty clearly on that idea and the consensus is “No way.” Obama is painting his opponents as being unwilling to engage with the issue but people get the impression he really means that they are unwilling to capitulate and sign a blank check. Hence the anger.

2. He has said that he has a plan to ensure 48 million uninsured Americans right away and it is revenue neutral. It won’t cost a dime. If that were possible why was it not done in the Clinton administration? Can you believe that an administration that tosses trillions around like candy is really going to be fiscally responsible? Is there any wonder that people actually laugh out loud when politicians say it will be revenue neutral?

3. Obama says he can save the money by making Medicare more efficient. His opponents don’t actually doubt that he can; they are just worried about how he will do it. To suggest that there is that much fat to be trimmed is ludicrous and to suggest that the Democrats, who are not exactly famous for reducing public sector job levels, would do it is even more ludicrous. So what does that leave? This is the opening though which all the “death panel” and “euthanasia” scare tactics come in. This gives them credibility. Ordinary people just can’t see how you can save that much money and still give the elderly and disabled the same level of care as before. And guess what? That is a good question. If Obama admitted that insuring an extra 48 million people would cost x million dollars per year, but we need to do it because it is the right thing to do, he would at least eliminate the fear of tossing Grandma out of the lifeboat.

4. Obama has needlessly made abortion an issue in this debate. All he needed to do was to sit down with the Conference of Catholic Bishops and say: “OK, you tell me what I need to do in order to make this thing abortion-neutral in your eyes. What amendments would satisfy your concerns?” And then he should have done it. His pro-abortion supporters would have been furious but he could have said to them: “Look, we can fight the battle to make all health care insurance include abortion another day. Right now, we have a crisis and getting insurance for 48 million uninsured people is a higher priority than public funding for abortion.” He would have had to take a lot of criticism. But what would NARAL and Emily’s List and Planned Parenthood done about it in the end: vote Republican? If Obama had done what I’ve suggested, he would have brought the Catholic bishops onside and I believe ensured the passage of the legislation. They actually want to support him on this one. But his unwillingness to do so suggests that he is such a fanatic on abortion that he is willing to let health care reform (and probably his second term) fade into the mist to preserve his ideological purity.

5. The decision to paint all opponents to the current legislation (i.e. the famous 1,000 page largely unread document) as stooges of the Insurance companies, racist Nazi thugs and anti-democratic may well go down as the most disastrous political decision of Obama’s career. The American people don’t believe him and the tactic is just not working. If heath care reform is sunk, it will be in large part because of the decision of the White House to condescend to ordinary Americans and tell them to shut up and be respectful of their Washington masters. This is a public relations train wreck.

Obama can blame conservatives, drug companies, insurance companies, or whomever he wants, but the truth is that most of his wounds are self-inflicted. You don’t pass health care reform by stacking your administration with pro-abortion and pro-euthanasia appointees, asking people to give you a blank check, telling them it won’t cost anything, refusing to take abortion off the table, and then painting all those who object as stupid, racist, un-American Nazis. Obama is giving the nation a tutorial on how not to get health care reform passed.

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