Obama Speaks

I noticed that Obama was talking about “insurance reform” at first, he used that term repeatedly, and I thought he was finally giving us a measure of honesty. I can get on board with insurance reform, if that’s the best we can do. I’d rather see a reform of the health care system, but if we can’t do that let’s at least make the insurance system better. It wasn’t long into the Q&A session, however, before he was talking about “health care reform” again.

I actually got kind of excited when he said the following, thinking that we were finally going to talk about the 500# gorilla in the living room. Other nations do it a lot cheaper, so maybe we ought to look at how they do it.

“…on average we, here in the United States, are spending about $6,000 more than other advanced countries where they're just as healthy. And I've said this before, if you found out that your neighbor had gotten the same car for $6,000 less, you'd want to figure out how to get that deal.”

Nope, because he followed that with absolute gibberish, which involved something about paying for the increased cost of the reformed system. The first sentence isn’t even a sentence, notwithstanding the punctuation in the transcript, which I left in place. Emphasis is my addition, and note that he’s back to referring to “health care reform.”

Now, what we did very early on was say two-thirds of the costs of health care reform, which includes providing coverage for people who don't have it, making it more affordable for folks who do, and making sure that we're, over the long term, creating the kinds of systems where prevention and wellness and information technologies make the system more efficient.

That the entire cost of that has to be paid for and it has got to be deficit-neutral. And we identified two-thirds of those costs to be paid for by tax dollars that are already being spent right now.

So taxpayers are already putting this money into the kitty. The problem is, they're not getting a good deal for the money they're spending. That takes care of about two-thirds of the cost.

The statement about some sort of generalized making the system more efficient “takes care of about two-thirds of the cost” is magical thinking if I ever heard it. We take care of paying for the higher cost of the reformed way of doing what we pay too much more for by reducing the cost of what we’re doing while reforming it so that we are doing it at a higher cost. It makes my head hurt. He babbles some gibberish at us, figuratively wipes his hands in satisfaction and announces proudly with a big smile, “That takes care of about two-thirds of the cost.”

It’s like that $6000 cheaper car. We get that $6000 discount by giving the dealer $4000 and asking him to raise the price of the car by another $4000 so that... Wait.

And that part about “creating the kinds of systems where prevention and wellness and information technologies…” supposedly in the bill? That’s the first time anyone has mentioned any of that, other than the $19 billion that has been donated to the computer industry to create a computer system that will be delivered about the time we have our next Republican president and will almost certainly be unusable.

Anyone who believes that today’s computer industry is going to suck up $19 billion and deliver a working, useable, nationwide computer system needs their head examined. The industry may or may not be capable of it, probably is, but it will certainly not deliver.

Nobody is going to have to give up anything, except maybe some millionaires will have to pay just a tiny smidge more in taxes. And when one reporter pins him down on a specific example then, yes maybe perhaps that very eldery woman might not get that procedure. The system will cover 98% of Americans because we don't want to cover 100% like some despicable "single payer system, where everyone is automatically enrolled" would do.

Finally, Obama repeatedly said that the goal of his plan is to “reduce the rate of health care inflation.” To the degree that he did attempt to discuss reducing present costs, he tried to make the medical profession the “goat” by saying that they order too many tests, don’t talk to each other, and prescribe treatments that do not really add to quality of life. Doctors, apparently, do things merely because they can, or because the “fee schedule” makes it to their advantage to do so.

He didn’t mention the role that the legal system plays in the cost of health care, nor the role that is played by the administrative costs and profits of the insurance industry, nor the corporate culture of the medical and pharmaceutical industries.

Those things, of course, have nothing to do with the cost of health care.