Even on the day of the speech, we were hearing that Obama would mention
the public option, but just as something for Congress to consider if
Republicans were willing to put up with such insubordination. Mind you,
this wasn't just the usual liars and ideologues; this was coming from
the worthless, overpaid blow-dried blobs that infest American television.
I wasn't convinced of that, and in an essay I wrote last week, noted
that the voices prophesying the death of public option “is coming from
people who are more interested in persuading than they are in informing,
and who prefer to create realities rather than describe it.”
Of course, knowing that the American media is full of shit doesn't give
one the answers; it just provides a list of answers that cannot be
trusted. I didn't know what Obama was going to do.
So I was delighted and only mildly surprised when he came out
four-square for the public option. He didn't downplay it, he didn't
offer it as a “something to do if the insurance companies don't behave”
It is an integral part of his plan, and Congress is expected to move
forward on it.
He also encouraged Democrats, decent Repubicans (there are some) and
anyone for health care reform to help fight the tidal wave of lies about
health care reform by calling them out.
It didn't take long. The first official lie about his speech came two
minutes later, when Rep. Dr. Charles Boustany, a Republican from
Louisiana, tried to pass the first health care plan Congress came up
with in July as pertaining to this one, and said it “creates 53 new
government bureaucracies, adds hundreds of billions to our national
debt, and raises taxes on job-creators by $600 billion. And, it cuts
Medicare by $500 billion, while doing virtually nothing to make the
program better for our seniors.”
Obama has promised that his health plan will be revenue neutral, will
not raise taxes on small businesses, and will, if anything, greatly
In his own words, “It will provide more security and stability to those
who have health insurance. It will provide insurance to those who don't.
And it will slow the growth of health care costs for our families, our
businesses, and our government.”
Great deal, if he can make it happen.
The Republicans sat stolidly, glowering. While promising to always
having his door open to honest discussion, he made it clear that he
wasn't going to waste any time with people who wanted to kill the bill
entirely rather than negotiate on it. The same brittle cowardice of the
American right that led to such a debacle in foreign affairs under the
Bush administration is leaving them with no seat at the table. They
don't want to talk; they just want to chant “no” like a pack of two year
olds, and America is prepared to move on without them.
Obama was clear about the basic points in his plan. Nobody with an
existing health care plan need change it. The only difference for them
is that they can quit worrying that their provider will cheat them by
dropping them if they get sick, or refusing some treatment on the
pretext of an undisclosed prior condition, such as acne. Obama cited an
example of an insurance company doing just that to a woman about to
undergo a double mastectomy, and by the time the insurance company
finally backed off, the cancer had metastasized. Insurance companies
will no longer be able to impose arbitrary “caps” on the amount of
For the uninsured, an “insurance exchange” system will be set up, in
which the uninsured actually become a discrete group, eligible for group
rates and preferences. An insurance insurance policy, I suppose you
could call it. A way of assuring low(er) cost access to health care
Health insurance would be mandated, but with important waivers. As Obama
explained, “That's why under my plan, individuals will be required to
carry basic health insurance – just as most states require you to carry
auto insurance. Likewise, businesses will be required to either offer
their workers health care, or chip in to help cover the cost of their
workers. There will be a hardship waiver for those individuals who still
cannot afford coverage, and 95% of all small businesses, because of
their size and narrow profit margin, would be exempt from these
People without means to pay for health insurance would be enrolled in
the public option at government expense, which addresses the nastiest
and most cruel deficiency in the present system.
Obama estimates that only 5% of Americans will sign up under public
option, and he might be right. But I'm guessing that a lot of small
companies and low-income working individuals, plus the millions of
proprietors of micro businesses, will be joining up over the next couple
The insurance companies hate that, of course, and will fight it with
everything they've got. They feel entitled, you see. They are big, they
are rich, they are powerful, and therefore they have the RIGHT to
control access to medical care. Obama noted that “Unfortunately, in 34
states, 75% of the insurance market is controlled by five or fewer
companies. In Alabama, almost 90% is controlled by just
They aren't, and public option will be an insurance company owned by the
government that is mandated to cover its own costs, but otherwise is run
on a not-for-profit basis, with administrative costs much lower than the
private sector can manage, a characteristic of government that
Republicans hate to admit to be true.
One of the most amusing moments of the speech came when Obama lauded
Republican Senators who had worked with the late Ted Kennedy on health
care issues. “But those of us who knew Teddy and worked with him here –
people of both parties – know that what drove him was something more.
His friend, Orrin Hatch, knows that. They worked together to provide
children with health insurance. His friend John McCain knows that. They
worked together on a Patient's Bill of Rights. His friend Chuck Grassley
knows that. They worked together to provide health care to children with
The expression on John McCain's face was priceless. It said, for all to
read, “Oh, you sly asshole!” But I suspect it's going to make it just a
little bit harder for McCain to blindly oppose the bill now.
One of the most affecting moments of the speech came when Obama quoted
from an email sent by Kennedy, to be delivered on his death: “What we
face," he wrote, "is above all a moral issue; at stake are not just the
details of policy, but fundamental principles of social justice and the
character of our country."
Kennedy was right. It's a moral issue, and it reflects on the character
of the country.
Americans have developed a reputation for meanness. Meanness on the
battlefield. Meanness in the prisons. Meanness in how they treat
subjugated people. Meanness in how they treat the growing ranks of their
own impoverished. Meanness in how they treat their own children.
Meanness in how they treat their own sick and dying.
It stems, in large measure, from a desire by the far right to make life
miserable for all, so they will throw away the strengths of the American
people and replace them with the brittle ersatz values of the far right.
Should that happen, there will be little hope for Americans.
This is a point where America can address that sad trend and start to
reverse it, to move toward being the great country it was before.
Obama stood firm when it counted.
Now it's up to the rest of us.