The administration’s revised approach to the health care question is clear: ignore Republican criticism and pass a bill with Democratic support alone. After 30 minutes of liberal policy proposals and Bush-bashing, Obama did extend a minor and meaningless olive branch: a command to begin exploring tort reform. The offer was too little, too late — if Obama is going to get a bill by the end of the year, it’s going to be without any Republican support.
Major reform is now off the table. Obama made that fact clear when, referring to major reform proposals (the liberal “single-payer system of Canada” and conservative “end the employer-based system”), he said:
Either one would represent a radical shift that would disrupt the health care most people currently have.
Obama instead advocated for “[building] on what works and [fixing] what doesn’t,” which translates practically to: let’s take a structurally flawed system and make minor reforms rather than overhauling it (I recommend David Goldhill’s recent piece in The Atlantic for an excellent take on the flawed incentive structure of our current system — HT to David Brooks).
- Saving money is not the main goal. Obama made that fact clear with this statement:
I will not sign a plan that adds one dime to our deficits – either now or in the future. Period.
In other words, the intended end of any bill would be to make it deficit-neutral rather than reduce costs over the long run. Obama has chosen to make the main focus be expanding coverage — the problem is that the coverage that we already have is not sustainable.
I must give kudos to the president for finally taking some control of the issue instead of allowing Pelosi et al to dictate policy-making. Unfortunately, Obama’s actual proposal left much to be desired.