the Heritage Foundation

The Morning Bell


THURSDAY, SEP 10, 2009


The President Learned Nothing From August





“There remain some significant details to iron out.” Thus spoke the President of the United States last night, in an address in which, with a straight face, he told an awaiting nation that he was finally delivering not lofty rhetoric, but his grand plan on health care.
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On that score President Obama was right. It may have been, however, a bit of an understatement. Absent, of course, was how exactly all the savings he confidently predicted would materialize, how exactly the government would prevent employers from dumping all their employees into a government plan and how czars and boards would operate without bureaucrats coming between Americans and their doctors. Ah, details, details.

In fact, while he kept referring to “our plan” he never explained whose plan he meant. One of the two House plans? The one Senate plan that exists or the Finance one that’s under construction? What’s he actually for? What’s the President against?

To the question that all of America wanted an answer, to wit, is the President abandoning his stubborn attachment to a public plan, the President had no clear response. Or maybe he did. He appeared to draw a line on the sand at one point by saying, “I will not back down from the idea that, if Americans cannot find affordable coverage, we will provide you with a choice.” Maybe that was the clearest indication of the night that Barack Obama is still sticking to the public plan, to be introduced by whatever means. But a minute later he said he was open to other ideas!

As for the rest on this subject in a 45-minute speech, his 29th devoted to health care in nine months in office, Mr. Obama ducked behind the English language—or, more charitable observers would say, used it to its fullest extent. There was his promise, for example that “nothing in this plan will require you or your employer to change the coverage or the doctor you have.” [italics added] This is a change, even an improvement on past exertions.

Previously, the President had insisted that nobody would be forced to abandon the insurance plan they have. Last night he said nobody will be required. See the change? Of course, all he seems to mean is that the government won’t require you – he said nothing about what the consequences of the plan may prod your employer to do.

To critics, including analysts at The Heritage Foundation, who charge that many employers would gladly dump all their employees into his proposed exchange, leaving millions of American with no real choice but the public plan, President Obama mysteriously said that the government plan “would only be available to those who don’t have insurance.” But the congressional plans are open to smaller firms with insured workers. So what proposal is he referring to?

One could praise the President for showing moxie, as when he evoked America’s “self-reliance, our rugged individualism and our fierce defense of freedom” as he tried, yet again, to sell sweeping controls over one sixth of our economy. Less of a surprise was the decision to close the speech with an ode to the late Sen. Ted Kennedy. Just about everyone was waiting for the Camelot Moment.

And the President did stump for civility. Yes, the man who weeks ago told his opponents “I don’t want the folks who created the mess doing a lot of talking. I want them to just get out of the way,” said with hope in his eyes “I still believe we can replace acrimony with civility.”

He also threw Republicans a bone, or at least hoped that the nation would see it that way. He offered to look at a proposal near and dear to conservatives’ heart—tort reform. That is, reforming the legal system so that bad people will not game the medical malpractice system. Or, rather, Mr. Obama offered to send the proposal to the states and let them experiment with a few demonstrations of ideas — approved by his Health Secretary, of course.

But why not get serious with state experiment, not just for tort reform but for a range of reforms? In fact, that has been proposed in true bipartisan legislation the President seems to have overlooked. The 50 states are the proper laboratories to try out different proposals. But the states need Washington to give them the power to do so.

What we did not see, alas, was a willingness to start over and set aside those issues where the American people can’t agree – most importantly the public plan, the individual and employer mandates, a maze of new federal regulations that pre-empt existing laws, and a massive Medicaid expansion. There are ideas that really do have broad support. The key ones:

Empower the states to explore ways of achieving the goals of affordable and accessible coverage for their citizens. Bi-partisan proposals to do this have been introduced in both the House and Senate. As welfare reform showed us, states are laboratories for change and can learn what works and what doesn’t.

Extend tax relief for those who need help. Offering tax credit to middle class families in need by reforming the way the tax code treats health insurance. And instead of expanding Medicaid, providing lower-income families will assistance offset by other spending.



At the very least, Mr. Obama and the Democrats should stop trying to ignore reality; they should stop pretending that August didn’t happen, that there hasn’t been a national revolt against a government takeover of health care. They keep telling themselves—and thus keep hearing—that the Town Hall meetings of summer were concocted by FOX News and abetted by the Internet. Reality may need to set in before we can get real reform.