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Wednesday, September 9, 2009
Politics in the Q and A

The President's speech to students yesterday was not much politicized. His answers to their questions afterward were quite political.

As an extension of a previous discussion here of President Obama's speech to the nation's schoolchildren yesterday -- except in Los Angeles (oops!), where school starts today -- here are some notes on what the President said in the question-and-answer session with students after the speech. This could also be a useful introduction to tonight's speech, come to think of it.

The school speech itself is here at the official White House Web site; yesterday I called it excellent and inoffensive, and I stand by that evaluation, despite the disquiet of people who counted and found that there were too many first-person singular pronouns or some such thing.

A transcript of the questions and answers after the speech reveals that some of that discussion was politicized. You may want to have an instructive discussion with your children about it, but you might reasonably wait until after tonight's speech on health care, since the politicking here is on that theme.

About two-thirds of the way through an otherwise innocuous session, President Obama talks about some of the letters he received from Americans:

And you read these letters and some of them are really inspiring. People talk about how they're the first in their family to go to college, and they're having to work full-time but they're sure that they are going to get a better job and a better career, and so they're sticking with it even though that it's hard.

Some of the stories are really depressing. You hear about people who are sick but don't have health care, and suddenly they get a bill for $100,000, and there's no way they can pay for it, and they're about to lose their house.

And you're just reminded that the country is full of really good people who sometimes are going through a hard time. They just need a break. They need a little bit of help. Maybe the way things are set up right now isn't always fair for people, and that motivates you, because you say, well, I can't make everything perfect, I can't prevent somebody from getting sick, but maybe I can make sure that they've got insurance so that when they do get sick, they're going to get some help.

Here our Chief Executive is peddling an illusion. First of all, if these sick people "don't have health care," then they didn't get a $100,000 medical bill, did they? If they got the bill, assuming there wasn't some sort of processing error, they must have received the care -- and quite a bit of it, at that price.

If they really cannot afford to pay for health care, they still cannot be turned away; it's the law. If they really can't pay the bill, some combination of arrangements with the providers will substantially reduce it or make it go away altogether. (To compensate, my medical bills and my insurance premiums will increase.)

If they can otherwise afford a house, are we quite certain they couldn't afford health insurance in the first place? And if they can't afford a house, hasn't President Obama had already made certain that people who can't afford their houses won't lose them (thus increasing my tax burden)? Someone here must have missed at least one memo; perhaps it was I?

I'd love to know which adult helped this student with this next question. Was it a teacher, a parent, or a helpful soul from Washington?

STUDENT: Hi, my name is Sean. And my question is, currently 36 countries have universal health coverage, including Iraq and Afghanistan, which have it paid for by the United States. Why can't the United States have universal health coverage?

THE PRESIDENT: Well, I think that's the question I've been asking Congress, because I think we need it. I think we can do it. And I'm going to be making a speech tomorrow night talking about my plan to make sure that everybody has access to affordable health care.

Part of what happened is that back in the 1940s and '50s a lot of -- most of the wealthy countries around the world decided to set up health care systems that covered everybody. The United States -- for a number of different reasons -- organized their health care around employer-based health insurance. So what happened was, is that you basically got your health insurance through your job. And you can see some problems with that. Number one is if you lose your job, then you don't have health insurance. The other thing is some employers may not want to do right by their employees by giving them health insurance, and then they're kind of out of luck.

And so what happened was, is that the majority of Americans still have health insurance through their job and most of them are happy with it, but a lot of people fall through the cracks. If you're self-employed, if you start your own business, if you are working in a job that doesn't offer health insurance, then you're -- you have real problems.

So what we're trying to do is set up a system where people who have health insurance on the job, they can keep it, but if you don't have health insurance for the job, if you're self-employed, if you're unemployed, that you're able to get health insurance through another way. And we can afford to do it and it will actually, I think, over time save us money if we set that up. All right?

First of all, the answers to Sean's questions are:

  • We could have nationalized our health care system decades ago, but, historically, Americans love freedom and prosperity more than those other countries. (You know, the ones we keep saving from tyrants?) And we are evidently less fond than other peoples of trading in both for substandard, rationed, hideously expensive, government-managed care.
  • We're quite attached to the quality of our health care and of our medical and pharmaceutical research, not just its availability -- which makes comparing our medical care to that in Iraq and Afghanistan just that much more absurd.

My brief response to President Obama's answer is:

  • Republicans have been proposing portability of health insurance for a long time, so that people don't lose their coverage when they change jobs. These are the same Republicans, by the way, that the President has been saying (not here) aren't proposing any solutions of their own, just rejecting his. Some of these solutions already exist in some form, in at least some states. I recently changed employers twice without losing my coverage, even though the one in the middle was incompetent to provide the promised coverage. In Utah, the mechanism I used is called a "conversion plan." State law requires it. It's not perfect, but it averted disaster -- and there was still at least one unused safety net beyond the conversion plan.
  • Maybe if employers weren't taxed half to death, they could spare a few dollars to help employees with health benefits -- but that's a larger topic for another day.
  • It simply is not true that the only way to get health insurance is to be given it by your employer. If you're self-employed or employed by a small business that doesn't offer it (many do), there are numerous opportunities to obtain group coverage through small business associations and other organizations -- if for some odd reason you can't find a provider who will directly serve a small business or individual. If you're in college, you can get it there.
  • If the problem really is "people falling through the cracks," then the answer is to close the cracks judiciously, not nationalize a huge chunk of the nation's economy.

In short, the problem is not what the President says it is, and, even if it were, the solution would not be what he says it is. If this makes you wonder whether the real goal or motive here might not be what he says it is, either, welcome to the fast-growing club.

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