Wednesday, September 9, 2009

Obama Health Care Speech, Meat and Meaning

We know we must reform the system. The question is, 'How?'
- President Obama, Health Care Speech, September 9, 2009

Tonight at 8pm Eastern President Obama made his appeal for passing health care reform. Prescriptions columnist David Herszenhorn had a timely piece in the New York Times this morning, "How to Watch the Obama Speech." Where was Herszenhorn right? Where did he go wrong? This is my attempt at establishing whether, as my journalism professor put it, "it was worth the effort."

  1. Did Obama express support for a government-run insurance plan or a compromise? Obama clearly proposed an "exchange" (i.e. cooperative?) rather than a public option. The exchange will provide competition and bargaining power between individuals/small businesses and insurance companies. To increase competition we will "make a not-for-profit option available through the insurance exchange; it would only be an option for those who do not have insurance."
  2. Did Obama praise influential conservatives (e.g. Senator Grassley, Rep. IA) or present a tough stance against opponnents? Obama mentioned McCain, does that count?
  3. Did the centrists in the crowd applaud or restrain? Good question...maybe talking heads will provide the answer later tonight...
  4. Did Obama reassure elderly voters of the security of their Medicaid benefits? "I will protect Medicare." He suggested Medicare/Medicaid are unnecessarily burdened by the rising cost of health care and that health care reform will "provide security for those that have health insurance and coverage for those that don't."
  5. Did Obama explain how to financially subsidize health insurance coverage for the 40+ million insured? He began his speech by attempting to dispell the myth that those uninsured are on welfare; lack of employer sponsored coverage and high costs affect many middle-class uninsured. He also suggested that those with insurance "have never had less security than they do today" due to insurance companies' ability to drop or deny coverage. Additionally, Obama said he will not allow any bill to pass that adds a dollar to our nation's deficit. The money is out there, he indicated, "it is just not being used efficiently."
  6. Did Obama present "any sign that he is now willing to let Democrats go it alone?" He talked about the need to bring Democrats and Republicans to the table to discuss legitimate options.
  7. Did Obama establish clear boundaries or be conciliatory? "Agreement on 80% of reforms" in the House and Senate Bills."The time for games has past...Now is the time to deliver on health care." 
  8. Which influential (moderate?) Republicans, if any, did Obama direct positive attention? McCain was mentioned, he seemed caught a bit off guard. McCain had suggested immediate coverage of those facing catastrophic health costs due to being denied or dropped from health insurance coverage during his Presidential campaign.
  9. Did Obama set new deadlines? Kathleen Sebelius will be charged with moving forward on fixing the problem of defensive medicine...TODAY!
  10. Who applauded? Which Republicans? Democrats? I need a Congressmen photo cheat sheet for this one. Couldn't find one in time...there has to be one out there. Again, maybe the talking heads will provide this information later tonight.
Finally, and most importantly (as Herszenhorn points out): Were you convinced?
    Details of Plan "Every American Needs To Know"
    • If you have health insurance, nothing in plan will require employer to change the plan or doctor that you currently have.
    • Health care insurance companies will not be able to deny coverage based on a preexisting condition. This and dropping coverage when you get sick and "need it the most" will be illegal.
    • No caps "on amount of coverage you can receive in a year, or in a lifetime."
    • There will be a limit on what you should be charged for out-of-pocket expenses.
    • Preventive care will be an integral part of health insurance coverage (colonoscopy and mammograms were cited).
    • Those without health insurance will be offered quality, affordable choices. 
    • Creation of a new insurance exchange for individuals and small-business; insurance companies will have an incentive to participate; individuals will have greater bargaining power.
    • Tax credits for those who make too little to afford insurance on their own.
    • Exchange will take in effect in 4 years; immediate coverage for currently dropped that will go bankrupt without help. -- shout-out to McCain who proposed this while running for President.
    • Affordable coverage means that all Americans should be insured (i.e. mandatory insurance). Everyone must do their part in order for other health reform elements to be achieved (citing coverage for pre-existing conditions). Hardship waiver for those who cannot afford coverage. 95% of small businesses exempt from requirements.

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