I'm much happier with this speech than I'd expected. I think the President made a strong case for the public option, which was in itself good. And he also referred to a plan that includes the public option "my plan". That's good, too.
But, even better, I think the President drew a line in the sand on the public option. A fine line, and a line that is open to some interpretation, but a line nonetheless. I haven't gone back to the video to confirm my notes, but I am pretty confident that I got at least the gist: he's open to any alternative to the public option that achieves its goals, that is, anything that insures that all Americans have access to affordable insurance. Short of a single-payer system--which is certainly not in the cards today and I doubt will be in my lifetime--I don't see how you achieve that goal without a government-backed insurance plan that introduces real competition into the market.
Both substantively and tactically, I think that the President made a smart move by mentioning medical malpractice reform. Republicans have a valid point about fear of lawsuits and the cost of medical malpractice insurance being a contributor to the rising cost of health care. It is far from the biggest cause, but it is a cause and we should be looking at ways to address everything that's contributing to the spiraling cost of health care in the US. I'm genuinely interested in what happens with this. Tactically, of course, it makes it just a little bit harder for the Republicans to use malpractice reform as their default alternative to broader health care reform.
Update: Josh Marshall also notes the President's drawing a sort of faint line in the sand on the public option, though he is a bit more skeptical than I am. I agree with Josh's contention that there is a lot of wiggle room in the President's position, but, I think it gives those of us who support the public option rather more leverage than I'd expected from the speech.
Wednesday, September 9, 2009
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Two thoughts, one substantive the other tactical.
ReplyDeleteSubstantive - it was very hopey changey. He promised the moon and clearly still believes he has credibility. I particularly liked the suggestion that government could wring waste out of medicare. I also liked the non-sequitor that the now vastly limited public option would only have 5% sign ups yet would deliver "competition" in state markets dominated by one insurer. He is now on record with his clear promises and the downfall will be not stipulating such in a final bill - eg not including language prohibiting end of life counseling or attempting to play dumb fungibility games around abortion. Middle America's reaction to the promises without details will be a measure of his remaining credibility, which I think has slipped dramatically. He will be the last person who realizes this though when the snake oil stops selling.
Tactical - the downsized, limited, nonsubsidized public option was interesting. It leaves him two paths - one call it innocuous but beef it up in legislation or with a czar or two, ditch it because it wasn't a big deal anyway. I am sure lefties are hoping for the first but should be aware the second, ditching it, is also very possible. I took the downplayed public option as a firm indication of its peril, depending on how the political winds blow.