Robert Reich's Final Appeal

Here's a good video of Robert Reich trying to mobilize people to the last ditch fight to save health care reform in the US. He is focused on the "public option". He's right to say that is the key. And he's right to say the only way to stop the opponents is to kick up a ruckus...



Here is a bit from Obama's speech on health care to the joint session of Congress. I've bolded the key bits that look worrisome:

Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. I just want to hold them accountable. The insurance reforms that I've already mentioned would do just that. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.

Despite all this, the insurance companies and their allies don't like this idea. They argue that these private companies can't fairly compete with the government. And they'd be right if taxpayers were subsidizing this public insurance option. But they won't be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects. But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers. It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities.

It's worth noting that a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight. But its impact shouldn't be exaggerated – by the left, the right, or the media. It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles. To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it. The public option is only a means to that end – and we should remain open to other ideas that accomplish our ultimate goal. And to my Republican friends, I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have.

For example, some have suggested that that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others propose a co-op or another non-profit entity to administer the plan. These are all constructive ideas worth exploring. But I will not back down on the basic principle that if Americans can't find affordable coverage, we will provide you with a choice. And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need.

What does he mean?

• Only for those who don't have insurance? -- Does that mean that if the public option was cheaper but you already had some private insurance you couldn't switch to the public option? What if your employer has "insurance" with a huge deductible, one which means you don't seek medical help until it is life-or-death? Why can't you get onto the public option which will focus on preventing disease instead of the plan that only lets you see doctors as a last ditch, save-my-life option?


• Less than 5%? -- Where does that number come from? There are tens of millions without insurance. Is Obama saying that they will, under health care reform, suddenly going to find the money and decide that they want the gold-plated private insurance which heretofore they've ignored in favour of going uncovered? This is ridiculous!


• The public option has to be unfunded from the public purse -- That is bizarre. Obama says he wants to extend health care to those who can't afford it and somehow these poor folk are going to find the money within their current expenditures? That magically "savings" in health care expenses will make it affordable? That is ridiculous. Real public health care will cost money. Just like a real public education system costs money. Just like public roads cost money. Just like a public heath service costs money. Obama is whitewashing the truth. The reality is that it will cost money. Over the long run it health care reform will lower costs because Americans spend anywhere from 50% to 80% more on health care than other developed nations. But in the short run, setting up a real public option will cost money. Obama is treating the public like fools to think they will swallow this "not one penny will be spent on this reform, all costs will be covered by 'savings' in the reformed system". Crazy!


• The 'public option is only one path' and others are possible claim -- This is ridiculous. The key to a successful health system is one in which everybody is covered and the insurance companies can't cherry pick and leave all the expensive cases to the government. Obama thinks he can 'reform' private insurers by mandating that they no longer cherry pick, but that just means the private companies will work harder to come up with techniques to allow them to get rid of expensive clients while keeping the cheap, healthy clients. That is how the profit motive works. You constantly try to find ways to cut costs while garnering the biggest customer base possible. If you know there is a default government system which will take the 'expensive' insurance cases, you are going to find a way to 'encourage' your clients to move off your plan and into the government's.

If Obama is going to successfully "sell" health care reform he has to be honest with the American people. He has to say "this will require some sacrifice to get set up" but in the long run it will be better for us. To sugar coat it is to lie.

Here's an analogy. Education is something that is good for you. You don't lie and tell the kiddies "oh, school is so much fun, it is better than going out in the parks to play". No, you say, "I know you don't like sitting through classes, I know there's lots of homework, I know it takes a lot of work. But if you put the effort in, you get rewarded in the end with a better job, but even more important, you have the ability to understand so much more of the world and where you can go. So many more doors will be open to you." You sell education as a sacrifice which pays off in the long run. You don't pretend that in the short run it is just jolly good times 24x7.