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Sunday, June 28, 2009

President Obama Dangerous and Dogmatic Commitment to Health Care Reform

Presidential advisor said something fairly startling regarding health care this morning. In response to a question about whether or not taxing employer provided health insurance benefit would be off the table, here's how Axelrod responded.

One of the problems we’ve had in this town is that people draw lines in the sand and they stop talking to each other. And you don’t get anything done. That’s not the way the president approaches us. He is very cognizant of protecting people — middle class people, hard-working people who are trying to get along in a very difficult economy. And he will continue to represent them in these talks,”

The president has been similarly coy about whether or not he would institute the value added tax to pay for health care reform.

With budget deficits soaring and President Obama pushing a trillion-dollar-plus expansion of health coverage, some Washington policymakers are taking a fresh look at a money-making idea long considered politically taboo: a national sales tax.

Now, if I had a chance to ask Axelrod a question, I would ask him if a marginal tax increase was off the table in order to pass health care reform. It appears that the president is convinced that massive health care reform is in and of itself the best policy no matter how we get there.

In medicine, there is a very important principle, first do no harm. Politicians would be wise to follow the same rule. The world is littered with laws that wound up doing much more harm than good. It appears the president believes that the key to his legacy and to future American prosperity is Euro socialist style health care reform. Furthermore, it appears that he is willing to do whatever it takes to get there.

For a clue to Obama's belief system, we really only need to look at Obama's own words.

Obama praises Bill Clinton more highly than any other contemporary Democrat, because Clinton recognized the staleness of the old political debate between Left and Right and came close to moving beyond it with his politics of the Third Way, which "tapped into the pragmatic, nonideological attitude of the majority of Americans." But Clinton blew it, and the author gradually lets you know it. First, he regrets Clinton's "clumsy and transparent" gestures to the Reagan Democrats, and his "frighteningly coldhearted" use of other people (e.g., "the execution of a mentally retarded death row inmate" before a crucial primary). Then Obama notes sadly that Clinton's policies--"recognizably progressive if modest in their goals"--had commanded broad public support, but that the president had never been able, "despite a booming economy," to turn that support into a governing coalition. Finally, he gently accuses Clinton of the worst offense of all: strengthening the forces of conservatism. Due to his "personal lapses" and careless triangulations that ceded more and more ground to the Right, Clinton prepared the way for George W. Bush's victory in 2000.

President Obama is looking to be a transformative president on the scale of FDR and Lincoln. He believes that sweeping health care reform is his ticket to presidential immortality. President Obama should heed both the presidencies of FDR and Clinton. FDR wouldn't have much of a legacy had it not been for his victory in WWII. If President Obama thinks that Social Security, Fannie Mae, and other big government policies secured FDR's legacy, then President Obama had better re read history. As for President Clinton, the former president was very adept at reacting to events. When health care reform failed and the Congress transferred over, the president pivoted to the middle and passed a balanced budget and a capital gains tax cut.

The current president doesn't seem to have any of those instincts yet. So far at least, he will move toward passing health care reform at all costs. (except maybe including a conservative idea like health savings accounts) It appears that he believes that sweeping health care reform will be a transformative victory that will resolve everything no matter what he sacrifices in the process. He'd better rethink that approach. First of all, it's unlikely health care reform will pass if it includes massive tax increases like taxing employer's health insurance and the value added tax. Second, the voters will punish anyone that supports such an idea. It will mean breaking his very clear promise not to tax anyone but the top 5%. Sweeping health care reform will be a political, economic, and electoral failure if its first result is to raise everyone's taxes. Raising everyone's taxes isn't much of a legacy, and the president should realize that soon.

If the president continues to be blinded by the laser light focus that sweeping health care reform is itself a means to an end, it will ultimately bring himself, his party, and our economy down.


Anonymous said...

How can you say Obama wants European-style healthcare reform when its the only thing he refuses to back?

mike volpe said...

What does he refuse to back? He backs universal health care. What do you think European stlye health care is?

Anonymous said...

I advise on several health insurance boards such as , , and I often quote the Switzerland health care system as an example of tough questions that we as a nation will have to answer someday, if we go down the path of nationalized government health care plan. We’ll have to at some point draw the line in the sand and refuse further care for patients receiving critical illness treatments, intensive care unit, trauma care, acute management services, disease management, neonatal intensive-care unit for newborns and seniors in extended care treatment nearing hospice stage . Did you know that premature babies are not resuscitated upon birth if they cannot draw breath in Switzerland? Did you also know that holds true with “senior care” experiencing system failure or multiple organ failures requiring support? Another example, they don't extend the life of a senior via medical equipment such as intubation or respiration for multiple organ failures. Not to be morbid….they are unplugged and allowed to pass. Anyone in the business of paying claims knows that the single most expensive bill in what carriers call “shock loss” is within NICU for newborns and seniors in acute / intensive care / hospital in the last three months of life.
The Swiss apparently made decisions made based upon cost vs. quality outcome. Are we as a nation prepared to make that type of decision or to define when to incubate, resuscitate a newborn or a senior? Are we ready to define the conditions and rules of medical procedures with organ failure? With a litigious society I think not. This is why we need TORT REFORM. Without TORT REFORM medical provider costs will never drop. Liability costs with medical providers are nearly half of operating expenses. Humana health plans state that their costs of medical liability and defensive medicine accounts for nearly 10 cents out of every premium dollar collected. Compare that to Humana’s reported pharmaceutical claims of 15 cents out of every premium dollar collected. Or better yet, 21 cents out of every premium dollar collected is paid back to physicians for physician treatments. The cost of litigation is only obvious with Humana health plans. I sit on the board with several other health insurance carriers. Their books all show similar costs. They basically insure a shrinking populace that is mostly made up of people that only buy insurance because they need it. So is mandatory participation such a bad idea?
I don't think we are hearing about TORT REFORM because most of the house and senate on the federal level are lawyers and have practicing law firm interest’s. In the healthcare system there is no total innocence. We hear about insurance executives with bonuses, doctors overbilling, hospitals overbilling because the street gang thug got dropped at their ER door with no insurance. The lawyers are there to stir the pot and promise lavish fortune at the end of the PERCEIVED misery chain. Am I saying we don’t need them? No, but I am saying there is clear and documented abuse of the legal system that awards outlandish claims in the millions for a questionable mistake. Are ambulance chasers not sociably recognized as being the most abusive? What about those that educate their clients on defraud and then use the legal system to pirate insurers?
I sure wouldn’t want to be on the receiving end of these serious decisions that we will have to make. My senator claims that the government would be held blameless but what about the medical provider that has to make the call? What about the insurance payer that has to deny continued care for an infant that will not survive? Without serious TORT REFORM we aren’t going to get costs down or have good people make headway.

Anonymous said...

He backs a "public option" but a government run nationalized "single-payer" plan, which is what Canada and Western Europe have, is most definitely NOT what he's willing to support.

mike volpe said...

There's 1300 health insurance companies in the country. Why have another one unless that one has an unfair advantage. The reason he doesn't come out for single payer is that wouldn't go. Instead, he is for the "public option". Why would we need a public health insurance company? We don't have a public grocery story. We don't have a public realtor. Why would we need a public health insurance company?

the fact is that a public health insurance company would always have an unfair advantage. It doesn't have to make any money because shortfalls can be made up with new taxes. As such, a public health insurance ocmpany would only have one of two outcomes. Either it functions like any other health insurance company in which case it would be useless. Or it would have an unfair advantage and soon enough become the only one still standing. Now, either you believe he wants to create a useless public insurance company, or you understand that the public insurance company is nothing more than a marketable way to create single payer.

berkshire said...

I m agree with him and that is the universal health care.