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Obama and the Congress: Televised Health Care Summit – what’s POSSIBLE?

Thursday, 25 Feb 2010

Let’s be clear: President Obama never included the gold standard of a single-payer on his list of things he said were attainable goals. He said prior to election that if starting with a blank canvas then a single-payer system was the ideal. But we aren’t starting at a blank slate, there are huge systems in place. Many people took his hypothetical “start from scratch” comment to mean he’d work around the clock for both that and a public option. The fact that many still think it’s the best way to go, and the reality that Joseph Stiglitz has no more confidence in big insurance than he does in the U.S. banks and sees single-payer as the only viable solution, doesn’t mean people will suddenly get rational about what they want from legislators in Washington.

The President’s familiarity with Congress, as many have commented, dictated a pragmatic agenda. His support for reform is abundantly clear, and today’s televised summit is part of that process. He’s on record as favoring a public option, and single payer, but every signal he’s given suggests he can’t see a path from here to there in any timely manner; the genuine political risk associated with accomplishing no reform can’t be denied.

Most of us can only guess at what transpires behind the scenes. Given what happened on camera at the retreat in Baltimore it stands to reason the GOP doesn’t want to have this process televised, but they were busily complaining for the record about the “lack of transparency” and the administration has called their bluff. Managing appearances means the GOPers will stick to talking points, as will most of the Democrats. Few are able to carry their side in a real debate the way we’ve seen the President do.

The GOP will be talking for their base. Period. This is about politics, not progress, from their perspective.

The President has backed reform opponents into a public relations corner (admittedly with their help) and they are mostly focused on not losing face. I wish I could offer a kinder assessment, but the evidence isn’t there to suggest that Republicans in Congress are after a deal: they’re posturing, not negotiating in good faith.

“…what we’ve seen is that the private healthcare insurers do not know how to deliver an efficient way.”

World Bank Chief Economist, Joseph Stiglitz

So today’s televised forum offers the potential, merely the potential, that the public appearance will provide the pressure necessary to get most of the Senate Democrats to sign on, coupled to the extreme likelihood that we’ll hear bluster from the other side about the consequences of the “nuclear option” of reconciliation — and whatever comes of this process will fall short of most of our ideals – yet it will be the first substantive progress in decades addressing a system that is, frankly, already government subsidized even if you ignore Medicare (I don’t know any other way to classify the tax-exemptions for insurance premiums: insurance is, frankly, part of a person’s compensation/benefit package through their employer.)

So before the day’s event is even done I’m encouraging you to look at the eventual outcome as a “glass half full” when it’s been empty. I’m assuming the Democrats will get something passed and on Obama’s desk before the fall elections if they want to avoid “throw the bums out” being aimed solely at their party.

The health insurance system is flawed. It’s arguably the most wasteful part of medical expenses: by the very nature of business and capitalism, the incentives for “improvements” by insurers are confined to their own profit margins, while premiums pay over $1 million/day to high-dollar lobbyists to steer legislative outcomes instead of medical and/or cost-control improvements.

Politics is, and has always been, the art of the possible. It’s messy, but it’s better for our avid participation even when we don’t all agree.

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