American Elephants

Tonight President Obama gave his big health care speech to a joint session of Congress. It was very odd. Once again he started off with “the worst economic crisis since the Great Depression.” This has been debunked so often, that he must just want to emphasize how very, very hard he is working.

He said he wants to be the last President to take up the cause of health care, and many hundreds of Republicans muttered “if only!” More seriously,  most governments meddle with their government-run health care extensively every year.  They cannot keep their hands off.

I say the speech was odd, because the President seemed to want to portray passion, but came across as angry — almost shouting.  It seemed more of a rally than a speech. Although he made references to bipartisanship, the speech was entirely political and partisan.  Lots of familiar platitudes that we have heard in his 27 previous health care speeches.

“Our collective failure to meet this challenge — year after year, decade after decade — has led us to a breaking point.  Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy. These are middle-class Americans.  Some can’t get insurance on the job.  Others are self-employed, and can’t afford it, since buying insurance on you own costs you three times as much as the coverage you get from your employer. ”

We are not at a “breaking point.” Around 90 percent of Americans who have insurance are happy with their insurance and with their care.  The CBO says premiums for employment-based plans are expected to average about $5,000 a year for an individual and $13,000 for a family.  Premiums for policies purchased in the individual insurance market are on average much lower — one third lower for individuals and one-half lower for family policies. (Cato)

“There are now more than thirty million American citizens who cannot get coverage,” yet 75% of the uninsured could afford insurance.  “Those who do have insurance have never had less security and stability than they do today.” Security and stability are clearly the focus-group tested talking points, I’ve heard them constantly today, from many different Democrats.

“More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won’t pay the full cost of care.  It happens every day.” CATO’s Michael Tanner: “Actually it’s been illegal for insurers to drop people who get sick since, I believe, 1996.”

“But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government.  Instead of honest debate, we have seen scare tactics.” A bit of hypocrisy. As he tells us the scare stories about one man from Illinois who lost his coverage in the middle of chemotherapy because he had gallstones he didn’t know about, and a woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne.  I doubt these.

“Then there’s the problem of rising costs.  We spend one-and-a-half times more per person on health care than any other country, but we aren’t getting any healthier for it.” Every country is struggling with rising costs of health care. We spend more because we are a rich country and can afford it. But we also have more expensive diagnostic machines, more kidney dialysis machines in any one city than in most Canadian provinces.

I’m not sure what he means by “getting any healthier,” we have better survival rates for most cancers, better access to treatment for chronic diseases and better access to preventative screening than most other major countries.  Perhaps he refers to the WHO rating — but they rate us way down because we do not have government-provided health care.

“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.” Profits are what you may have left after overhead, administrative costs and salaries.  We have a little misunderstanding of the free market here.

“He won’t sign a bill”, he says, “if it adds one dime to the deficit, either now or in the future.” The CBO has estimated that it will add $1.1 trillion over the first decade and another trillion in the following ten years.   Nobody believes the one dime claim. They’ll pass it first and if the savings don’t work out, they”ll come back and fix it.

“Not a dollar of the Medicare trust fund will be used to pay for this plan,” well of course not, the trust fund is only an accounting gimmick, there isn’t any money in it.  “The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies”. So they’re eliminating Medicare Advantage which many seniors like, and also eliminating $500 billion by cutting payments to doctors and hospitals, and demanding pharmaceutical companies give them a 50% discount!

There was nothing new in the speech.  No plan.  Lots of  mandates with no way to pay for them.  No savings. Same lies and misstatements that have led to so much voter anger and frustration.  Insults to those who dissented.  No interest in Republican ideas.  Impossible promises. Way too long.  Didn’t clear up anything. Expectations were very low.  He fully justified expectations.