I love politics. I read the political news regularly. Yet I have no idea what the basics are of the Obama health plan. I have no idea what problem it is supposed to solve. I don’t know how it works. I know it keeps changing. But I don’t know how it benefits or hurts me. I do know it will cost a lot of money, and I know it will expand the government. I think lots of conservatives and moderates and even Democrats are in this same boat of bemusement and skepticism.
This is the first moderately complex policy Obama has pursued. Everything else as been ready “off the shelf,” such as the “grab bag” stimulus or has been no policy at all such as his “Hate America” speech in Cairo. Pushing policy is where skills besides speechifying come into place: he must have the ability to translate complexity, the ability to compromise, and the ability to separate needs and wants in major legislation. He’s shown none of those skills. He’s descended into policy wonk abstractions talking about “the government option” or whatever it is this week. He’s gotten side-tracked by abortion and other concerns. He’s seen revolts from the Democratic Party’s left and right. He’s been called out on his lies and exaggerations by the CBO Director. In short, he’s failing before our eyes, just as Clinton failed, with an overly ambitious and scary policy that may radically change and ruin the quality of health care we receive.
The truth is most people want something impossible on health care: the same level of care and benefits, while paying less, with minimal out of pocket expense, no penalties for preexisting conditions, and without regard to whether you’re employed. This is impossible. Either costs must continue to rise, benefits must be cut, or both. That is called reality. Obama is avoiding reality in his plan by suggesting the richest Americans can foot the entire bill. But some of his critics are living in fantasy land too if they think the distorted market we have is an efficient one. It’s probably overly generous in terms of quality of care, patient choice, and investment in R&D. But that can all be easily fixed by giving people more pain from high medical costs and by giving people “good enough for government work” options of lower quality (but cheap) clinics and insurance.