Monday, June 1, 2009

Obama's Health Care Reform Policy: In Spin We Trust


Politicians speak out of at least three sides of their mouths. This is not just standard double talk, but represents the polished art form of triple talk. First, they tell us what we want to hear. Afterwards, they offer ‘clarifications and adjustments’ (never a flip-flop!) to their original remarks. Thirdly, they spin their views either to the right or left in order to repackage the policy for successful legislative butchering. All the while, they claim that their views have never changed.

President Obama, before the election, assured us that he did not advocate the federal government taking over our health care system, realizing that most Americans would not support this policy. He offered us the safer bromides of expanding health care access, reducing costs and increasing medical quality. Who could oppose these noble objectives? However, campaign slogans such as ‘we need to create the finest public schools in the world’ generate enthusiastic support, but mask the complexity of the issue. Our health care system may be the most intricate and complex quagmire that the president faces. It is a labyrinth that has trapped at least 10 past U.S. presidents. The health care maze has many tempting entrances, but no clear exit strategy. If you listen carefully outside the maze’s main gate, you can still hear faint echoes from Truman, Eisenhower, Kennedy, Nixon and all the rest.

We haven’t heard Obama’s health care reform endgame. Since his inauguration, a public health care plan (read: government single-payer system) is gaining traction in congress, the blogosphere, op-ed pages and with liberal advocacy groups. This very day, Senator Edward Kennedy is expected to offer a proposal that establishes a government plan to ‘compete’ against private insurance companies. Many of us suspect that when the political left says compete, it really means crush. Is Senator Kennedy floating Obama’s trial balloon?

How far will President Obama shift in his health care policies? Judging by his evolving views regarding closing down Guantanamo Bay in 1 year, eliminating military commissions for terrorists and pulling troops out of Iraq in 16 months, I’d say that he has a few football fields of wiggle room available. Just a few weeks ago, President Obama wisely backflipped on his prior promise to release thousands of photographs of abused detainees by U.S. servicemen.

President Obama knows what he wants our new & improved health care system to be, but he hasn’t told us yet. His bold reform strategy is likely to be reduced to incrementalism. He still maintains his hope to pass comprehensive health care reform legislation before the end of this year, but I doubt this is possible. First, like his predecessors, he underestimates the power of the special interests that will oppose and frustrate him at every turn. Every minor reform that he even suggests will generate fierce and sustained opposition from various partisans. Look what already has happened with the brief marriage of convenience between Obama and medical industry? More importantly, if the public grasps the risks of Big Government becoming Big Doctor, then they will stand up and say no. They will reject a system where the government will in effect be making medical decisions, despite the administration's assurance that physicians will be in charge. Americans want real doctors taking caring of them, not spin doctors. Once enlightened, the public will view government medicine as a poison pill and will reject it clearly and emphatically. You won’t hear any doublespeak or spin from them. Won’t it be refreshing to hear folks speaking out of just one side of their mouths? Will you be one of them?

3 comments:

Anonymous said...

I'm as skeptical as you are Michael, but maybe we should give them a chance. No one else is suggesting any significant alternative path through the woods. The modern U.S. history of healthcare as an economic business is abysmal. We're being collectively shaken by the demand for change, and that's a healthy environment for innovative thinking.

Michael Kirsch, M.D. said...

When physicians confront a sick patient who needs healing, we don't proceed with a heroic measure just to take action. The intensity of illness doesn't justify any response. For example, we don't operate on patients with degenerative chronic back pain simply because they are suffering. The treatment has to make sense. Medicare is a single-payer system that is headed toward insolvency. It has also been a magnet attracting billions of dollars of unnecessary medical care. Let's aim carefully before we pull the trigger.

Nancy Harris said...

With various health care reform bills floating around both the House and the Senate, President Barack Obama is pulling out all the stops to get the votes that the bill needs, which is good news for the public option. President Obama continues to rally behind health care reform. I am really concerned that the fiasco of this reform may make Obama a one-term president.

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