9
   

What I need from President Obama

 
 
snood
 
Reply Sun 6 Sep, 2009 09:57 am
I think I understand at least a part of why Obama hasn’t really let loose and gotten fired up about this gigantic healthcare fight. I think it’s because the right would pounce on any opportunity to call him some version of “an angry black man”. But I so do not give a **** about that right now. They will pounce on anything, anyway.

I am really in a funk about the state of this fight for healthcare reform, and about the tactics of the right " not to counter-propose anything about healthcare " but just to do any and everything they can to kill Obama’s presidency.

So, looking toward the speech on Healthcare he is going to make on Wednesday, I’ve thought of a few things I need President Obama to do when he gets behind the mike and between the Teleprompters. I need him to do these things or I am going to lose a lot of respect for his courage " point blank. I think I will always admire the man for some of what he has done, and the effect his elevation to prominence has had on so many things.

But if he caves on public option and doesn’t stand up and make the kind of fight that healthcare reform needs and deserves " it will mean to me that he doesn’t have the kind of spine I thought he did when I voted for him.
This is what I need President Obama to do…

1) I need him to explain simply and clearly what the public option is and is not " that it is not a government takeover of health care or even a government-run health care program, but rather a government-run insurance option that would provide an alternative to the private sector, solely and specifically for those individuals and small businesses that either don’t have any viable health insurance, or who want a better deal.

2) If he decides to throw the public option under the bus, I need him to explain in detail how in the hell we’re supposed to get any accountability from the insurance industry.

3) I need him to explain " also clearly and directly - how we're going to pay for all this. If he still wants to “limit itemized tax deductions” like he’s been saying - he needs to go on and make an aggressive argument for it, and speak directly to the jello-spined Democrats in Congress to back him up on it.

4) I need him to explain the deals he has made with Big Pharma and other health industry bigtimers. I need him to tell us what exactly he gave up as his part of the deal. I need him to tell me if he really thinks he can somehow compromise between the health needs of the Americans who voted him in office, and the desires of the multi-billion dollar health insurance industry " I think we all know he can’t, but I need him to stand there and try to explain his buddying up to them.

5) I need Obama to remind people once and for all about what is really at stake here. It isn’t the risk of any goddamn “death panels”, or “socialized medicine”. It’s a real-live America where people go bankrupt and lose their homes to pay their medical bills, and can't get insurance because they've been sick in the past, and get their coverage revoked just when they need it, and lose insurance because they lost their jobs, and die because they either can’t afford the treatment they need, or their insurance carriers won't pay for it.

Like I said , I’m feeling down " and part of it is because from what I’ve seen, I think he is going to try again to “reach out” to those same slimebags who have been calling him everything but a child of God, instead of grabbing his cojones and trying to push through a healthcare bill with some teeth. I guess we’ll see…
 
edgarblythe
 
  2  
Reply Sun 6 Sep, 2009 10:12 am
I agree with you completely, snood. It's a fight too many of our people don't seem to have a stomach for. If not now, it will be another 16 or 20 years before another opportunity presents itself.
0 Replies
 
Robert Gentel
 
  2  
Reply Sun 6 Sep, 2009 10:23 am
@snood,
I think he might just need to wait for his second term, I think it was a bad decision to fight for health care reform right on the heels of huge stimulus spending and with the whole nation so concerned about finances. Not because it's actually a bad economic time to think about these things, but a bad political time. He spent a lot of his political capital on the stimulus and then waded right into a much more controversial issue with a lot of money behind his opposition.

I fear he has seriously undermined health care reform by miscalculating his political capital, and I'm very worried that he's seemingly willing to compromise instead of swing for the fences. A compromise in health care reform could be a very very bad thing (especially if you take the public option off the table).

P.S. I don't think the "angry black man" stereotype is playing into it at all, if he went balls to the wall he wouldn't be doing it angrily anyway, that's not his style. What he's doing is conserving political capital while he's rapidly losing it, which is a lot more scary to me.
DontTreadOnMe
 
  2  
Reply Sun 6 Sep, 2009 03:23 pm
@Robert Gentel,
Robert Gentel wrote:

...I think he might just need to wait for his second term....


could be. clinton faced a similar problem after making one of his first topics gays in the military. conservatives were incensed and the gates rapidly closed.

that some kind of stimulus was vital to avoid a further melt down doesn't seem to matter to the hard right. it's had a similar effect as the gay thing.

tell ya this much. if he doesn't grab the reins, dig in the spurs and start riding herd to compel the dems into a cohesive unit, i don't see how he will get a second term. he could even get pushed aside by another dem, like hilary or whoever.
0 Replies
 
mysteryman
 
  1  
Reply Sun 6 Sep, 2009 06:39 pm
@snood,
And if he doesnt do any of the things you say you "need", what then?
0 Replies
 
georgeob1
 
  1  
Reply Sun 6 Sep, 2009 08:05 pm
The essence of democratic politics is finding a way that is possible, given the usually conflicting interests and opinions of those involved. That is wisdom, not spinelessness.

My opinion is that the "reform" of our health care system is simply too complex and gigantic a task, presenting too many pitfalls and unexpected side effects for any government, however well-indended to do well. Moreover, doing it at all will inevitably bring the hand of government into the lives of American citizens far more than most of them want.

This country is about freedom and democracy - not some attempt to create an authoritarian paradise ruled by philosopher kings - congressmen, or even benign brueaucracies.

If president Obama is wise he will adjust his course and listen to the will of the people, instead of the voices of zealots who wish, at all costs, to see this or that program for the supposed perfection of our lives enacted for us.

I believe the evidence is that most people are more worried about the state of our economy and a fast growing national debt than they are about drastically reformed health care services or even a so-called "green economy". These are at least valid concerns and President Obama would be - in my judgement at least - a fool to ignore them. It is certainly true that he didn't create our national debt , and that our economy was in its current turmoil when he took office. However these are the facts he must deal with and he will be judged by how well he does so - and not on the degree to which he enacts some preconceived program of social development.Moreover, by his administrations own recent admission the planned Democrat programs will double our total national debt (not just annual deficits) in the next ten years -- even with some hard-to-believe promised "savings" (which from government never seem to materialize).
DontTreadOnMe
 
  1  
Reply Sun 6 Sep, 2009 08:23 pm
@georgeob1,
georgeob1 wrote:
...
My opinion is that the "reform" of our health care system is simply too complex and gigantic a task, presenting too many pitfalls and unexpected side effects for any government, however well-indended to do well....


i can't remember if it was here or someplace else; but it was pointed out that it's not the healthcare system, but the health insurance system that needs reform. we have a lot of really good doctors (we could always use more good ones), the facilities are generally pretty good and most of the drugs seem to actually do something.

it's just getting access to those elements streamlined in the case of us who have it, and just plain access to those that don't.

that is where any support i have for national health comes from. no individual person, individual corporation, union , etc. has the juice to make that happen. it just seems to me that the only body that can facilitate health insurance reform is the feds.

access, affordability and the elimination of pre-existing turn downs are major aspects that need to be fixed. and i'm not a big stickler how that happens, just that it happens.

snood
 
  2  
Reply Mon 7 Sep, 2009 11:48 am
It would be funny - this notion that Obama is "rushing headlong" into something with healthcare - if it wasn't so damn sad and ridiculous.

We in this country have been wringing our hands about how to fix healthcare for 60 years. The Republicans had 8 years with control of all three branches of government for much of the time, and did nothing.

The main reason a major part of the right opposes any potent change from Obama is to hurt Obama's presidency. I wonder if any of the rightwingers on A2K have the integrity to even acknowledge that?
ehBeth
 
  1  
Reply Mon 7 Sep, 2009 11:55 am
@georgeob1,
georgeob1 wrote:
My opinion is that the "reform" of our health care system is simply too complex and gigantic a task, presenting too many pitfalls and unexpected side effects for any government, however well-indended to do well.


who can fix the health care insurance morass the U.S. finds itself in? do you think the insurers/big pharmas/other vendors/suppliers will make efforts to make the system work more effectively for the consumers? who should/can take the lead in this?
georgeob1
 
  1  
Reply Mon 7 Sep, 2009 11:59 am
@snood,
snood wrote:

The main reason a major part of the right opposes any potent change from Obama is to hurt Obama's presidency. I wonder if any of the rightwingers on A2K have the integrity to even acknowledge that?


You evidently believe that, however you can neither prove it nor even demonstrate convincingly that it is a major factor in many cases. You are prejudging the motives of others and accusing them of duplicity and, perhaps, racism -- all without any evidence for it.

My strong impression from what I observe opponents have said and done is that they are concerned about our fast growing national debt; don't believe the vague assurances the president has offered them about protecting their privacy and control of their relations with insurers and medical providers; don't believe the vague promises that government will really control costs and entitlements, given its failure to do so on previous programs; do not trust the good intentions of the Congress to which the president has handed this ambitious program; and don't want that much government intervention in their lives.

These are all real and understandable reactions, and they are more than sufficient to account for the political impasse we see before us. It all happened once before during the Clinton Administration.

Despite all this you cling to your shopworn paranoid delusions.
0 Replies
 
georgeob1
 
  1  
Reply Mon 7 Sep, 2009 12:10 pm
@ehBeth,
ehBeth wrote:

georgeob1 wrote:
My opinion is that the "reform" of our health care system is simply too complex and gigantic a task, presenting too many pitfalls and unexpected side effects for any government, however well-indended to do well.


who can fix the health care insurance morass the U.S. finds itself in? do you think the insurers/big pharmas/other vendors/suppliers will make efforts to make the system work more effectively for the consumers? who should/can take the lead in this?


That isn't too complex a task. Today Health Insurance providers are regulated by the 50 states, each doing its own thing with very little coordination among them - and very little standardazation required by the Federal government. The result is a multiplicity of corporate entities, each constrained to offer servises only in individual states. No surprise that the insurers take advantage of this situation to limit portability and deny coverage to potential high cost consumers to protect their rate bases. The Federal government could regulate and charter insurance companies, just as it does banks, and do so in a way that promotes portability and prevents dropping coverage when claims rise. If desired the government could subsidize the cost of basic policies that provide coverage for injuries, maternity and childhood & infectuous diseases, etc.

The government could also act more vigorously to eliminate some of the fraud that occurs in Medicare and Medicaid. To be fair this is likely a part of the President's plan.

None of this would require a complete overhaul of our health care system; forcibly insert government into the health care decisions and relationships of our citizens; or add hundreds of billions to our national debt..
ehBeth
 
  3  
Reply Mon 7 Sep, 2009 12:41 pm
@georgeob1,
Using the U.S. banking system as an example isn't exactly brilliant, since it's a bit of a laughing-stock internationally these days.

~~~

Seems to me most of the discussion has been around changing access (aka funding/insurance) to healthcare, not U.S. healthcare itself. Suggesting the discussion is primarily around the healthcare system is a trifle misleading. Where the idea of the government being involved in healthcare decisions comes from is beyond me.
georgeob1
 
  1  
Reply Mon 7 Sep, 2009 12:48 pm
@ehBeth,
ehBeth wrote:

Using the U.S. banking system as an example isn't exactly brilliant, since it's a bit of a laughing-stock internationally these days.

Cheap shot on a point not relevant to the conversation. My point about the chartering and regulation of nationwide health care insurers still stands. Many nation's banks are under more or least equal trauma today - The USA, Spain, the UK, Germany and many others. Canada and France emerged very well as a result of prior prudence. However, thank you for pointing out the difference in such a self-serving way.


ehBeth wrote:

Seems to me most of the discussion has been around changing access (aka funding/insurance) to healthcare, not U.S. healthcare itself. Suggesting the discussion is primarily around the healthcare system is a trifle misleading. Where the idea of the government being involved in healthcare decisions comes from is beyond me.


Perhaps you haven't been paying attention to the details of the debate or those of the draft legislation in the House of Representatives.
0 Replies
 
Robert Gentel
 
  2  
Reply Mon 7 Sep, 2009 12:49 pm
@DontTreadOnMe,
DontTreadOnMe wrote:
i can't remember if it was here or someplace else; but it was pointed out that it's not the healthcare system, but the health insurance system that needs reform. we have a lot of really good doctors (we could always use more good ones), the facilities are generally pretty good and most of the drugs seem to actually do something.


That has been argued here (Thomas made that case and I argued against it).

I disagree and think that the problem in the US is in the health care, not the insurance, and that the insurance problems are a symptom of that fundamental problem.

There is a trend toward specialization that is leaving basic medical care as the job no doctors want, and that is driving up health care costs. And quite frankly the costs are ridiculous, I live in a country that has comparable life expectancy to America and I don't even bother with insurance (though I will, just to be safe) and pay out of pocket. My girlfriend just got back from the doctor, the visit cost less than $50 and the blood work in the lab will cost about $50. This is with no insurance at all, just paying out of pocket. In the US, I'd be broke right now.

Here is an article about the specialization problem in America:

Family doctors: An endangered breed
As more medical students shun primary care for higher-paid specialties, experts warn of a severe imbalance that could cripple the nation's health care system.


Quote:
"As a primary care doctor, you are a gatekeeper of the medical system," said Manriquez, 26, who with Glass is a first-year student at the University of Washington School of Medicine. "Primary care is where you can have the most immediate impact in affecting patients' lives by managing their health."

Still, Manriquez realizes that he's setting himself for considerable challenges.

For one thing, as a family doctor, Manriquez will probably make one-fourth the salary of a specialist while trying to pay down $140,000 on average in medical school debt.


And there is a rising commercialization of medical services, with industry pushing new expensive solutions and hospitals racing to start charging their patients for them. See this article:

Quote:
Of course, there has always been a profit motive in medicine. Doctors who own their own imaging machines order more imaging tests; to take an example from my moonlighting work, a doctor who owns a scanner is seven times as likely as other doctors to refer a patient for a scan. In regions where there are more doctors, there is more per capita use of doctors’ services and testing. Supply often dictates demand.


I, for one, do not want universal insurance paying for this ridiculous medical service that inflates costs so dramatically. I want public health care, not public insurance. That way doctors don't have personal motivation to inflate the costs to make more money in the public system.

The way I'd structure it is similar to how it is in many countries I've lived. The public health care is simple and not "nice". If you have any money at all you want to avoid it. It just does it's job and is for people who can't afford anything else. It keeps people alive, and the keeps the costs of the private sector in check. I think we can do this for far less than we can insure everyone while letting the medical industry keep trying to squeeze blood out of a rock.
DontTreadOnMe
 
  1  
Reply Mon 7 Sep, 2009 01:35 pm
@Robert Gentel,
Robert Gentel wrote:


...I disagree and think that the problem in the US is in the health care, not the insurance, and that the insurance problems are a symptom of that fundamental problem...

i see what you mean, but what i was talking about is the quality of our doctors, facilities, machines and drugs. not so much about behavior.

...There is a trend toward specialization that is leaving basic medical care as the job no doctors want.....

i agree with you here.

..." Doctors who own their own imaging machines order more imaging tests; ".....

ohh, indeed they do. it makes very good business sense. and in terms of ease, i.e., walking from one room to another for a ct scan, it is good for the patient to have a ones stop shop.
but again i agree that there is the tendency to order more tests than are really needed to pay the thing off and get it into the profit column. which could also be accomplished by getting a very good lease on the machine and a favorable rate on the capital loan. one of those "for payments received and one dollar" deals. sounds bizarre, but we did it that way on big ticket equipment and managed to make money without ripping people off.

in real world action though, how would you go about telling the doctors that they can't buy the machines? how do you tell them that they can only order a test for this, or for that? because, at that point, you do then have a bureaucrat making decisions and a doctor saying, "hey! who's the doctor? me or you?"

that will go over like a leak in a space suit.



I, for one, do not want universal insurance paying for this ridiculous medical service that inflates costs so dramatically. I want public health care, not public insurance. That way doctors don't have personal motivation to inflate the costs to make more money in the public system.

i don't want to pay for extraneous stuff either.

The way I'd structure it is similar to how it is in many countries I've lived. The public health care is simple and not "nice". If you have any money at all you want to avoid it. It just does it's job and is for people who can't afford anything else. It keeps people alive, and the keeps the costs of the private sector in check. I think we can do this for far less than we can insure everyone while letting the medical industry keep trying to squeeze blood out of a rock.


well, as i said in the previous post; "access, affordability and the elimination of pre-existing turn downs are major aspects that need to be fixed. and i'm not a big stickler how that happens, just that it happens. "

good description of the public health. i don't believe it is meant to, or should be the only thing available. just one piece of the pie. and the piece that will nourish you even if it doesn't taste as good. that's what it's for. baseline care for those who have absolutely nothing. it sounds trite, but it's bad enough when people, especially a parent has to make a choice between good food or sort of "ehhh" food to make rent. to then need to make a choice between "ehhhh" food and taking the kid to the doctor is not something i feel good not caring about. and i don't have all the answers by any means, so i'm open to ideas that do more than simply give out more tax credits for zero results, etc.
mysteryman
 
  1  
Reply Mon 7 Sep, 2009 01:41 pm
@snood,
Quote:
The Republicans had 8 years with control of all three branches of government for much of the time, and did nothing.


Except for the disaster called Hillarycare, exactly what have the dems done, before Obama, to fix healthcare when they controlled all 3 branches?

For you to blame the repubs solely is refusing to admit the truth.
BOTH parties have refused to try and fix healthcare.
Why is that?
Rockhead
 
  3  
Reply Mon 7 Sep, 2009 01:44 pm
@mysteryman,
because nobody wants to get blamed for fecking it up...

image is their job security.
0 Replies
 
JPB
 
  2  
Reply Mon 7 Sep, 2009 02:00 pm
@mysteryman,
Quote:
BOTH parties have refused to try and fix healthcare.
Why is that?


Perhaps because they're all worried about the next election cycle and refuse to make hard choices. We don't seem to "govern" any longer. Everything is political and we aren't electing leaders but career politicians.
mysteryman
 
  1  
Reply Mon 7 Sep, 2009 02:03 pm
@JPB,
I agree with both you and Rockhead.

However, it was snood that solely blamed the repubs and I was wondering why he has blinders on.
Since both parties have failed to do anything, to blame only the repubs is the height of partisan blindness.
0 Replies
 
ehBeth
 
  2  
Reply Mon 7 Sep, 2009 02:32 pm
@snood,
snood wrote:
We in this country have been wringing our hands about how to fix healthcare for 60 years.


MM, try re-reading this. Looks like all Americans are included here. True, the next sentence references Republicans, but Snood didn't give anyone a pass.
0 Replies
 
 

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