I am positive that I am not that knowledgeable about the details of the health care debate. This is a little troubling on a personal level since, tomorrow (i.e., eight hours from now), I am going to a class focusing on health policy. Yes, I too thought that I was done with classes years ago, but it is part of my program that I take this class. Although I study health, I study neither health care nor health policy, though part of the program that I am in is designed to have participants think more about health policy. Can't say that there is much better of a time to have a tutorial than now and I am really looking forward to it.
Let me start my thoughts by saying that I think that Obama's speech was great. Given my cursory knowledge of the subject, I think that his plans sounded reasonable. Of course I would like a full-fledged universal insurance program, but I don't think that it is possible or, frankly, at this point that important. If insurance is made affordable enough to make good health care attainable to all Americans, I think that reform will have succeeded. While fully universal coverage would be a better option, having the organizational structure in place to show the American public that it is possible will succeed in making it impossible to get rid of it. The perfect demonstration of this point is the number of people out protesting last month against government-sponsored health care who didn't want Medicare touched. Beyond the cognitive dissonance that makes it difficult to believe that these people make it through a regular day, the fact that Medicare and Social Security are untouchable demonstrate my point.
At the same time, it is also true (again, to my limited knowledge) that both Social Security and Medicare have remained largely the same since their creation. The fact that neither has changed significantly doesn't bode well for incremental-style changes that some in the center and the right (including Newt Gingrich) are advocating. Simply doing something isn't going to cut it in terms of creating good policy; therefore, if anything like what Obama proposed tonight is passed through Congress, then he and Kathleen Sebelius need to develop a strong agency that is relatively impervious to meddling in the future and that aggressively pursues its mandate at its inception. If the agency that is developed is strong enough to assert itself and to regulate the insurance industry to accomplish the goals laid out by Obama, then I think that a bill resembling Obama's outline tonight — with all of its significant shortcomings — can actually improve the state of health care in this country.
Finally, from a political point of view, I think that Obama's speech tonight re-cast the debate in a way that is favorable to passage. I won't say that he re-framed the debate; the Democrats' lethargy during the summer and especially in August cost them the ability to really frame or re-frame the debate. But, re-casting the debate instead of re-framing it might actually work to Obama and the reformers' advantage. With Baucus' announcement today that a bill is going to be passed whether Republicans want to be part of it or not and Obama effectively portraying Republicans as obstructionists, I think that the Democrats painted Republicans into a corner. The Republicans even helped in this regard as Rep. Joe Wilson of South Carolina's outburst calling Obama a liar (pictured at left, from TPM) only showed how correct Obama was to chastise Republicans for failing to tell the difference between civilized debate and emotional outrage.[1] I think that tonight's speech was effective enough to persuade progressives to go along, point out the obstructionist and downright rude behavior of the Republicans, and emphasize the overwhelming mandate that health care be passed as an issue of morality and American pride. Although the final bill will not end up being everything that I would have hoped for myself, I think that it will be a drastic improvement on the current situation in health care in this country and really move the country forward.
[1] TPM has also noted that this might lead to a censure of Rep. Wilson by the House for violating the rules of decorum. Following these rules, the Minorty Whip, Rep. Eric Cantor (R-VA) was also caught violating the rule to "Refrain from eating, smoking, or using electronic equipment, including cellular phones or lap top computers, on the floor." Video here.
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