Health Care: The Speech, The Sequel (2009)

 Originally posted as a Facebook note September 10, 2009.

I watched Pres. Obama's speech last night in homey Armstrong/Douglas lobby with about two dozen Political Science Club members and friends. We enjoyed sub sandwiches from Milio's, and there was plenty of pop though few people seemed to be imbibing. Thanks to Kevin, Liz and Eliot for procuring the feast.

The speech itself was pretty good, though we are far from knowing whether health care reform will be addressed this year, or even this decade. Obama hit most of the notes I thought he needed to: he reminded us of the problems with health care delivery currently, spelled out the key points of the reform measure brewing in Congress, stressed some broad points of agreement across party lines, and made some conciliatory gestures while promising not to let innuendo overwhelm the debate as it appeared to do in August (good luck with that...).

The atmosphere in the House chamber was occasionally raucous, but not so circus-like as to drown out the message. It's interesting that Rep. Joe Wilson (R-SC) and others chose their most boisterous protest to be on the issue of benefits for illegal immigrants, which to my mind is a red herring.

The weak point in my view was Obama's promise to limit the budget impact of health care reform to, well, zero. His promise not to add "one dime" to the deficit was not quite as hoaky as Pres. Clinton's veto pen, because thank heavens he didn't wave an actual dime, but it's the sort of promise that seems certain to come back and bite him down the road. It relies too heavily on savings from eliminating waste, fraud and abuse, and not to say there isn't some of that, but I've heard this song before... it's never as easy, unambiguous, or as much as it seems when you promise it. Moreover, budget estimates are extremely sensitive to the method used to get them. Even if Obama is able to limit the deficit impact to zero without finagling, someone else is bound to have an estimate that shows it won't be zero.

The Republican response, by Rep. Charles W. Boustany of Louisiana, was ineffective, but as Jane points out, it's a nearly impossible rhetorical situation. He was strongest where Obama was weakest, boring in on the shaky budget claims. But by listing the points of agreement, and adding very little to that, it made it seem like mostly they agreed with Obama, which raises the question of why they're not working with him on crafting a bill. His presentation was marred by partisan jibes like "government-run health care," which is probably a cut above "socialism," but is a wildly inaccurate description of the current proposals. He also made the strange assertion that Republicans were anticipating that Obama would announce he was scrapping the health care efforts to date and starting over.