The details of the Public Option are not new, if you've done any research on your own, but since most Americans haven't, it was nice to see the details laid out in Obama's speech-- though I think that with some of the new compromises, such as the trigger mechanisms to cut spending if cost savings aren't realized, if adopted, would pretty much doom the plan to fail. Which I think is the point. Private insurance is scared shitless right now, and they are doing everything they can to kill this thing (just like they do with 12% their customers every year).
The details of the plan, more or less, are as follows: The Public Option will be a non-profit insurance company, like the Postal Service is for mail, and will NOT be subsidized by the tax payer-- directly. If you can't afford the plan, then you will get a voucher to assist you to buy one, either from a private insurance company, or from the public option. While that sounds nice, it's a contrived way of routing government money into private insurance subsidies via the consumer. It wouldn't be so bad if the government simply subsidized people who could not afford insurance, or if they just gave anybody who wanted to sign up for Medicare, a Medicare card.
But with the mandate on the individual to purchase health insurance, (which the Republicans also support), everybody has to buy a plan, and so every citizen effectively becomes a way for the government to funnel federal money, through your forced purchase of a plan, to the insurance companies. This is supposed to drive down costs by increasing the market and spreading the risk across the whole of society, but I'm highly skeptical that it will have any effect. Afterall, the profit motive in insurance IS the problem, which thankfully Obama recognized, when he talked about the former CEO of an insurance company who talked about how insurance companies are rewarded for denying claims and denying care to the ill. But without pushing for Medicare for All, it's just a rhetorical victory on the part of progressives, not anything useful as far as policy goes.
The key reforms sought by Obama are as follows:
1) Make it illegal to deny claims based on pre-existing conditions.
2) Make it illegal to change the terms of the plan you purchase.
3) Create a health insurance exchange, through which Americans can do what Wal*Mart and Sam's Club does, which is use collective purchasing power at large volume to reduce costs to the individual.
Obama hedged on the cost, rather than saying one trillion, over the course of ten years, he said "over 900 billion" which sounds less scary, but means the same thing, which also isn't scary.
It is, as Obama was smart to point out, less than we've spent in Iraq or Afghanistan.
I thought it was sad that, even though the President dispelled the myths and disinformation that the Republicans have been spreading, the Republican response speech held afterward was to repeat the very lies and disinformation that were dispelled not ten minutes prior. Claims like "Medicare is going to be cut by $200 billion."
While it is factually true that within Medicare there will be a cut of $200 billion dollars, the cuts are coming from subsidies to insurance companies, which is wasted money. Medicare doesn't need to hire an insurance company to pay out doctor's bills. Medicare can pay doctor's bills on it's own, without losing money to an insurance company skimming corporate profits off the top on the way there.
What's more, is that this cut money is then being redistributed and then spent within the medicare program, so that the net effect is that there is no cut, and that rather than going to corporate profits, more money is going to medical expenses-- which is what Medicare is designed to do. So it's not actually a cut, but a reallocation of funds.
Republicans claim that there were many misstatements in Obama's speech. On that point I can agree. Obama said, "health insurance CEOs aren't bad people."
That is false. To run such a business, and to know that your decisions to increase your profits would kill 18,000 people every year, would require a total divorce with any human decency or sense of morality. Such a person would not be a good person by any standard I can think of. A good person would have a sense of human decency and a sense of morals, of right and wrong.
Another thing that upset me quite a bit, was when Obama mentioned that young healthy people choose not to purchase health insurance because they are willing to take the risk. FUCK THAT-- I don't have insurance because it's fucking expensive, and I'm broke as shit. I would LOVE to have health insurance. Sign me up for Medicare right now! Just don't criminalize my poverty, because I won't be able to afford to purchase one. My car just died, and I can barely afford to fix that, let alone make additional monthly payments on some private plan that is going to overcharge me, and then won't even provide any benefits when I need them. And the individual mandate, in effect, criminalizes poverty. That really sucks.
Obama said that he intends to be the last president to take up the issue of health care reform. I don't know what that is supposed to mean. These reforms are timid, the mandates are wrong-headed, and what's been put forth so far is certainly a far cry from actually fixing what's wrong with our health insurance market here in America.
I know that this isn't an important part of the speech, but it was thrilling to see the joint session erupt with protests from the Republican members of congress when Obama addressed head on the lies that have been propagated. I think the president should be required to speak at the joint session more often, like once a month, so that it would be more like the British House of parliament.
It was certainly a stark contrast between the Republicans protesting the lies being confronted head-on and dismissed tonight, versus the joint sessions that the Bush administration held after September 11th, and then leading up to the Iraq war, where everybody in Congress was silent. The Democrats sat idly by and were very quiet. No boos or disruptions. And that was when we were talking about killing people. Now we are trying to save lives, and the Republicans are hooting and hollering in protest, with one Republican from South Carolina yelling and calling the president a liar. An interesting contrast to note.
Republicans also held up pieces of paper, which I thought was a stupid form of protest, if indeed that's what it was. It made no sense whatsoever on the home TV. I'm sure THEY knew what the significance of those papers were, but nobody at home on their couches did. With the protesting and the hooting and hollering, they came across as having totally lost it, which they probably have. They were from the House, after all. There was one congressperson with a sheet of paper in his lap with the words written, "What Bill?" in large black ink letters. This one protest I thought was valid and does bring up a good point; there are currently something like six different bills, one of which is HR 676, another-- and the one that Democrats are usually talking about, is HR 3200. There are others as well, but they propose the creating of small co-opts that wouldn't have the bargaining power to lower costs like the health insurance exchange proposed in HR 3200.
Obama did a great thing with the last ten minutes of his speech, calling into question the idea that government itself is somehow un-American. It was a rebuttal to the anarcho-capitalist philosophy of Reagan and Goldwater that though meek, has been LONG overdue. There once was a time when Republicans ran on a platform increasing welfare spending, like Richard Nixon, or Dwight Eisenhower, for instance. Obama made an emotional and philosophical appeal, but I think it's one that is much needed for the sake of the public debate. If those sound-bytes are the one that end up being repeated over and over in the 24 hour news cycle, health insurance reform will be a cinch, and it will hopefully mark the turn of the tide away from that anarcho-capitalist, nonsense. Or as Evo Morales calls it, "Barbarian Capitalism."