Well. It’s been another tough few weeks for Obama – to say nothing of his increasingly frazzled cheer squad, watching from the sidelines, thermos untouched by their side, hand-made banner wilting from lack of use. Mired in a struggle to get a fairly modest set of health-care reforms through, the Prez was sidetracked by the messy arrest of black academic Henry Louis Gates, and a subsequent intervention therein. As a third whammy, the new front in the Afghan war is already starting to bog down — as it inevitably would — the stimulus package has not kicked in yet, and may well be vastly less than is required, and, well isn’t that enough?
Health care is the big one, the fight that Republicans think will break Obama if they can win it — just as it broke Bill Clinton’s first presidency, as the GOP took control of Congress, and launched a full-scale war against the executive branch. Hillary Clinton’s health care plan at that time was a complex system, which edged towards a dominant public option — and more importantly imposed a vast series of standard pricings and conditions on private insurance.
The aim was to stop average Americans being cheated and gouged by Big Health, but if it ever had a chance of getting through Congress (when it was still controlled by Democrats) that was killed by the Clintons’ high-handed “take it or leave it” approach — brave, and the sort of thing that sections of the left are demanding of Obama, but suicidal in the face of a Congress of members permanently running for re-election, and drip fed by Health system donations.
Obama’s model is more modest than that — but still a big ask for the American system. At the core of it he wants a “health care exchange” — a fancy-pants way of saying that a public health insurance plan would always be available to any American who wanted to purchase it (together with the Medicare system for low income earners), and that people on crap existing plans could jump out of them into the public system. Unlike Oz Medicare, the public plan is just one plan among many, paid for out of general tax revenue, rather than a universal specific levy.
The fact that Obama has got centrist “Blue Dog” Democrats even talking and negotiating about this means that he has got genuine universal health care provision closer to fruition than any President since the attempt was first made under Harry Truman. But almost jumping over a crevasse ain’t much of an achievement, and failing to get the system up would be a big blow to his Presidency. The safer option would have been to leave the US system in private hands, subsidise plans for low income earners, and mandate it in the same manner as car insurance.
But the result would be to put even more power in the hands of Big Health, with concomitant increase in service costs etc — making the most expensive, least effective major health care system in the advanced world even worse. A public option would help introduce actual competition into the system, which is why Big Health hates it so much.
Obama wanted a vote on the proposal before Congress ends its summer session in August — but that relied on getting an assent from centrist Democrats, and a couple of friendly Republicans. It’s a measure of the difficulties of getting the thing up, that even the House of Reps — where the Dems have a 70+ seat majority — is looking tough to get. The “Blue Dog” Democrats — Senators and Reps mostly in districts or states who voted for McCain in the presidential race — want a far more limited programme, using “health care co-operatives” to provide plans for those who can’t afford anything other than the most basic care.
This would be provided by private companies offering a pooled system, shouldering the burden of customers likely to cost more than they can pay over time — but still leaving provision in the hands of a private company (worse, a monopoly of private companies). They’re also baulking at the trillion dollar cost over ten years, and a host of other, smaller, concerns.
The Republicans hope — and have said, foolishly, publicly — that the health care thing will break Obama. That’s unlikely — the Democrats will come to some deal by the vote (now pushed back to December) and the White House will make whatever compromise necessary to get something passed, that they can call a major health care reform. The issue is currently the subject of a phenomenal proxy war between groups opposed to the bill at all, and those supporting it, with TV ads, mailouts, door-knocks etc covering the nation.
The GOP’s fear campaign — that overnight the US will become a health care North Korea — is undoubtedly having an effect, but so too is a no-nonsense campaign directed at the Blue Dogs, to let them know that they will be unseated in party primaries, if they simply try and kill the bill.
There’s a lot of kvetching about Obama’s leadership on the issue — an underwhelming press conference that failed to deliver the inspiring whoosh people wanted — but which was designed to not up the pressure on the Blue Dogs, such that they would feel no choice but to vote health reform down under any circumstances. But coming on top of the angst created by his comments on the false arrest of black Harvard professor Henry Louis Gates — calling the undoubtedly stupid and possibly racist white cop who arrested the man in his own home, uh stupid — which were uh, uh stupid, there was concern that Obama was not performing as well as he could under the slow shit-rain of a continuing Presidency.
He recovered as well as he could — calling the cop, asking him down to the White House for a beer — which showed a touch of the old Obama, and the NUBO rule (Never Underestimate Barack Obama) holds, but it is tough times, with the smell of blood in the water.
Worth considering as the Rudd government extends the federal system to all hospitals, that Americans are shrieking about a system that would minimise the number of their fellow citizens who are sent home to die, of easily curable conditions (about 15,000 last year). God bless America, because someone needs to.
yes he can
If you are rich in America or employed and insured you should be able to get the very good but very expensive health care available in America without going broke. Presumably the chances of getting really good medical or hospital care if you are old or poor and covered by Medicaid or Medicare (? terminology) is much chancier. The trouble is that such an expensive system in a country where there are such huge ethnic, religious and socio-economic divisions is going to elicit great unwillingness to pay extra taxes to pay for people you see as idle, wilfully obese and stupidly neglectful of their own welfare and have little in common with you when you can think of a hundred things you would rather have your money spent on. Of course your hypothetical prosperous middle class or richer taxpayer (probably white) who sees little reason to spend his marginal dollar on Mexican immigrants or African-Americans fresh out of gaol could be torn by the reality (if I am right) that the really hard cases are families gainfully employed but without adequate health insurance who can’t rely on free treatment under Medicaid etc. One of the many reasons for Australians to feel blessed is that our ethnic composition is not such as to produce a large underclass of non-and-never taxpayers who are resented and/or despised by the productive.
As noted elsewhere West Wing tv series episode re feisty fictional character Roberto Mendoza, arrested for being Hispanic by white bread coppers. Later endorsed as lefty US Supreme Court judge.
Methinks the White House press folks, the real Matt Santos being Obama, and the good academic and police of Cambridge, ought to have that beer and recall real life is not a tv show, and write their own script. Indeed not follow mass media prescriptions and lazy templates as fate.
This life is not read through …. Red Hot Chilli Peppers said that.
And don’t you love the fact there is a president in the USA who can use the word “calibrate” and also make a timely admission of an error. What was that he said before ‘we are just keep on telling the truth until it stops working’.
Well some folks stopped telling the truth a long time ago – New York real estate fraudsters and kidney salesman and where did the profits go from that I wonder this last 10 years. Could it be that Israeli ‘fascist’ foreign minister via the Diaspora. Mmm. I wonder.
On the Gates affair, let us start with a less usual cliché than the racism, obstinate or dumb cops or… ones. Try Town & Gown with its very long history. Consider especially that America is not at all egalitarian like Australia (or at least not in the Australian style except v. superficially: you call people Mr. and Sir as part of that courtesy which minimises the danger from concealed carry in the US) and that Harvard profs are widely seen as, in our terms, up themselves (and certainly used to deference), not least if they have fame outside Boston and Cambridge. It seems that the arresting sergeant has an impeccable record in race relations and there was another, black, sergeant with him who (of course) backs him. So, let us assume that Gates was arrogant and highly offensive, presuming, as no proper Yankee or other gentleman would, on his status and position’s privileges, as indeed seems to have been the case . So…..
Why are you so certain that “stupid” is the right word? Would it have been stupid to treat a white man exactly the same way in exactly the same circumstances? That surely depends a good deal on local police and law enforcement practice as well as the actual law applicable in Cambridge Massachusetts, as to which I expect you are no more expert than I.
Have you never come across a policeman (or even a police woman) in Australia reacting badly to your or a friend’s irritable response to, e.g. being refused the right to drive directly to your own home because of a football crowd, and have you not, on reflection had some sympathy for the police reaction to your egotistic assertion of your individuality rather than calling it “stupid”.
It would be really good to hear Gates make a charming little self-deprecatory speech to Cambridge police joking about having had a bad breakfast on the plane, having to break in and then treating the police like students who had presumed to be able to put his assignment in late. What do you think the chances are?