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How Obama miscalculated on health care

A point by point response to the article “How Obama miscalculated on health care”  by: Nina Easton , Fortune, Aug 20, 2009

Your article is on point in its conclusion that the Health Care Reform (HCR) activity has gotten stuck in the mud and Driver Obama is having one hell of a time in getting his auto moving. However the causal reasons described in the article warrant a little examination.

The reasons provided by you have mostly to do with problems with the HCR proposal as synthesized by the various Hill Bills and President’s Speeches. I will try answering the various issues raised by you one by one. These answers are based on a clean & simple vision of HCR as gleaned from President’s original vision statements. Your initial observations are, in most cases, a compilation of objections raised by GOP, some Blue Dogs and Industry Lobbies overtly and covertly engaged in influencing the legislation to protect their profits.

Many of the objections fall into the myth category. The real problem with Team Obama is that they have failed to provide the answers enumerated below as standard response. Of late, as reflected in Axelrod’s e-mail they have started busting some of the myths. However on substantive issues they have been evasive.

President has taken “inclusion” to an absurd extreme. In the process he has made many promises, implicit or explicit, and made deals with Health Inc. lobbies. Like the unnecessary pact made with Pharma to contribute 8B per year in exchange for giving up the negotiation power. Then there is the Insurance Industry who are too clever by half. First is the demand for none to token competition from Govt/Semi-Govt Insurance. To this end Finance Committee has  been crafting the CoOp plan – lame and harmless to please the Insurance Lobby.

Then there is the compromise with GOP, to achieve the illusory Bipartisanship. GOP is more or less synonymous with Big Biz. GOP in the name of free market does not mind supporting the Oligarchy the Insurance Industry really is. Additionally there is the political objective to “Break Obama”. Accommodating GOP has been like a pact with the devil, where the devil bedevils you more and more as you try meeting his demands.

The main reason for drop in HCR & Obama poll numbers is a muddled conviction-less message resulting from accommodating too many compromises even when they cloud the primary focus. Thus the assurances like the Public Plan is not going to change your insurance or it will only insure the poor, so there is no impact on Employer Based Coverage. So while the finance committee is doing the CoOp ritual, the Prez shows his willingness to lobotomize or even kill the Public Plan if it wins him the GOP vote.

Obama forgets that the Devil will never be satisfied. While the Dems bend backwards, Grassley the little devil, is badmouthing the bill he is co-authoring and boasting he stalled the Bill by sticking his finger into the dike.

…underestimating the power of this simple number: More than 80% of Americans are satisfied with their health care, polls indicate. That number stays stable even as strong majorities tell pollsters they want “reform” and support “universal health care” — even as a plurality cites “health care costs” as their top financial concern, ahead of retirement, mortgage/rent, and losing their jobs.

“Most people love their current Employer paid plans” is a real canard. People do like/love their Doctor or even the Hospital. No body really loves  the Insurance Comapny. What they do like is the Employer payment of premiums. This insulates them from the financial aspects of health insurance. If the pollsters clearly advise the subject about their fate when they lose their job or change jobs and have a preexisting conditions , the respondents will be much more enthusiastic about reform. Moreover the insulation is illusory. The high premiums today are passed on to the employees in the form of lower salaries or makes the Companies uncompetitive on the world stage. Not only the employees be happier if their portion of the premium $ got reduced. The employers should be a lot happier by subscribing to a PO or another competitive Private Plan, allowing them to compete more effectively in a global market.

…fears that they’ll lose their private plans and be dumped into a new Medicare-style government plan. They’re fearful, too, that the government will have a hand in their end-of-life decisions.

The language is indicative of stoking anxieties of public. “Dumped” into a Medicare style gov plan. Firstly no body is going to be forced to do anything. Even today the Employers change the Insurance Providers and the Plans, including reduction of benefits and raising the co-pay and deductibles in order to control the costs. This point is never explained to the subject by the pollsters and most reporters. Surprisingly the President also sings the tune — most of you are happy with your Dr and your plan and nothing will change. In fact the only people who are happy are the Insurance Companies for their chattels in congress for serving them well and snaring even the POTUS.

Second egregious error is calling Medicare a dump. Are we ignoring the fact that MC takes care of 45M Senior Americans. Almost all of them are happy with MC and scared, thanks to the fear vultures, that their insurance will be impacted or taken away by HCR. Those Americans who call Medicare a Dump should introspect. For it is a morally bankrupt people who will consign their elderly to a Dump which is not good enough for them. In fact I have challenged many a free marketeers to transfer their parents from this evil socialized medicine to a wonderful free market system. Once again the problem is in not countering the GOP or Media inspired myth with a strong message.

As for EOL decisions the Obama Bull Horn is not strong enough to counter the din of fear-mongering Rush/Beck/Hannity/Newt/Palin combine.

In the new NBC polls, 54% are more worried about government control of health care than they are worried about reform not going far enough.

Another suspect poll. Rather than a faceless Govt Plan do they provide some information about Medicare as a Govt Plan. Another weakness not in the plan but in the messaging machine.

According to a statistical model by the nonpartisan health-care consulting firm The Lewin Group, more than 88 million employees would lose their private employer plans and be shifted into the public plan. (The study estimates that 103 million people would be covered under a public option.)

First off, Lewin Group’s pedigree gives a lie to its claim of non-partisanship. Surprisingly every single GOPster I have seen speak about HCR quotes the Lewin group. It seems an integral part of the GOP playbook. Let us debunk this most pernicious falsehood used to strike fear in simple minds.No body is being asked to move into the Public Plan. Nor does the govt want them to lose their private employer plans. As I said before Employers provide the health benefit  to compete in the job market. As we said some of them do change the providers and benefits to control their costs. Now the fallacy, that employers will drop their plans and ask the employees to go join the Public Plan. Public Plan is not free. It is not exactly a soup kitchen. Unlike Medicare it is based on a full premium model. If they run efficiently the premiums might be 10-20% (some estimate) lower, over time. The employees will have to shell out the premiums from their pocket that too without the govt contribution in the form of tax free dollars. So the employer has to now provide the premium + 15-30%tax. This also as the public plan builds up.

Obama is trying to walk a tightrope on this question, but the rope is really too thin to walk. If he includes a public option — raising the very real prospect that more Americans will be on a government-controlled insurance plan — his plan is a nonstarter with Republicans and many conservative Democrats. But if he signs a bill that doesn’t include a Medicare-style plan for non-seniors, he will lose support from his own liberal base, and possibly the votes of 100 Democratic lawmakers in the House.

As debunked before, there is no prospect at least no real prospect, of a forced shift to govt controlled plan. In fact the good GOP friendly free market companies would not want to subscribe to a poorly managed Medicare style dump. Would they?

So why should it bother the GOP and Blue Dogs (By the way GOP shames them by coddling them as one of their own) that there is a Govt Dump. Their beloved Ins Co should be able to out compete the dump based on their level of service, patient friendliness (compared to a Gov bureaucrat) and competitive premiums.

Now let us get to the Insurance Company Free Market myth.
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Even leaving aside the controversial public option, there remains enough government control in any legislation the Democrats produce to anger free-market minded voters — regardless of party affiliation.

The GOPsters and a few Dogs claim that the Public Option hurts Free Market. There is nothing Free Market about the Insurance Oligarchy sanctioned by Govt to freely fleece captive customers. Current state of Insurance does not provide meaningful choice. It is a myth that one can choose from the so called 1300 companies. In fact it is wasted effort to try finding a difference between rates for comparable plans between the few choices available in a particular area. If the Govt run option is inefficient & less patient friendly, it should be easy to compete with it. The reason the Oligarchs are trying to scare the public is to preserve their current Govt protected status.

In his press conferences the Prez powerfully debunked the myth that a PO is tantamount to a Govt Takeover of Insurance Industry. He pointed out that  the goal is to provide Lower Cost Universally Accessible Quality Health Care. And that an Ins Co delivering differentiated value, in quality, cost and patient friendliness, should be able to out compete the PO easily. He further maintained that the PO was the only reliable way to keep the insurance companies honest in adhering to the requirements laid out in the HCR bill.

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