Month: September 2009

Enjoy:

I’m a complicated person as readers well know. And I’m suspicious of government healthcare and also a fan of the drug companies for saving my life. But I am also a Catholic and I was brought up to know and believe that we do have an obligation to care for the sick. It is a non-negotiable demand of my faith, although, of course, how we do it is up for debate. Right now, our conscience is appeased by emergency room care. That’s obviously dumb, expensive and horribly unjust.

I don’t find Obama’s fundamentally private reform measure socialist; I find it pragmatic in an age in which technology has transformed both our ability to be healthy and the expense of it. But the moral case is what got through to me tonight, and as someone who has lived very closely with illness and medicine, I know that in real life I cannot easily walk past someone who is sick and cannot get treatment. A reader sees the Catholic angle as well:

I am so glad he spoke about abortion.  Interestingly, I just received my Florida Catholic newspaper in the mail last week.  It comes from the bishops.  It had an entire section about the importance of reform.  One article spoke about Obama’s religious leader conference call that over 140,000 signed in for.  They also mentioned that Obama said that abortion would not be federally funded.  The article not only called for reform it called for universal healthcare as a basic human right.  I think this proves people wrong who were skeptical of Obama reaching out to religious folks specifically Catholics.  He gets the social justice aspect of our religion.  He just gets it.

Yes, he does. And if the theocons would let go of their partisanship and remember the faith they are allegedly representing, they would too.

On the live-stream I didn't catch what the heckler actually said. Was it "Liar!" or "You lie!" It was an ugly moment in the Congress and I don't remember anyone heckling a president's speech before. But it is, in fact, the GOP's current position. Their position is to demonize this man. Karl Rove's op-ed on the speech went up on the WSJ website before the speech was even over, declaring it a failure and nothing new.

But there was something clarifying about a Southern good ol' boy yelling "Liar" at the president over illegal immigration. That's what the GOP now is: the worst aspects of the old Democratic party combined with a nihilism that is only eclipsed by its catastrophic governance for the past eight years. Defeating these morons and actually creating a discourse for reform is what we elected Obama to do.

But they still insist on doing it to themselves, don't they? That's the silver lining.

The readers are pretty unanimous, but this email said it best:

Allow me to sum up the President's speech as it relates to his opponents tonight:

Beep beep, motherfuckers.

9.04 pm. A masterful speech, somehow a blend of governance and also campaigning. He has Clinton's mastery of policy detail with Bush's under-rated ability to give a great speech. But above all, it is a reprise of the core reason for his candidacy and presidency: to get past the abstractions of ideology and the easy scorn of the cable circus and the cynicism that has thereby infected this country's ability to tackle pressing problems. This was why he was elected, and we should not be swayed by the old Washington and the old ideologies and the old politics. He stands at the center urging a small shift to more government because the times demand it.

And he makes sense. And this was not a cautious speech; it was a reasoned but courageous speech. He has put his presidency on the line for this. And that is a hard thing to do.

9.02 pm. This is Burke and Smith:

[Our predecessors] knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes for wisdom, and we can no longer even engage in a civil conversation with each other over the things that truly matter – that at that point we don’t merely lose our capacity to solve big challenges. We lose something essential about ourselves.

It is a defense of limited but strong government. It is not anti-conservative.

9 pm. Am I the only one to find these final themes very Catholic?

8.58 pm. The pivot to Teddy struck me as a Democratic party move. But it moved me nonetheless. And this passage brings the bipartisan peroration to a real close:

That large-heartedness – that concern and regard for the plight of others – is not a partisan feeling. It is not a Republican or a Democratic feeling. It, too, is part of the American character. Our ability to stand in other people’s shoes. A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand. A belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgement that sometimes government has to step in to help deliver on that promise.

This is a liberalism most centrists can live with.

8.53 pm. He's now offering tort reform – on the Bush lines. I've long wanted that to be in the bill. I see no reason why not. It should have been in there from the beginning.

8.47 pm. Now that's the truth:

Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for – from the Iraq War to tax breaks for the wealthy. I will not make that same mistake with health care.

8.46 pm. "I will not back down on the basic principle that if Americans can’t find affordable coverage, we will provide you with a choice." That's the commitment to some kind of public option.

8.43 pm. His description of the public option – that it can provide more efficient treatment because it doesn't need to make large profits and because it will have less overhead – is the best framing I've heard.

8.41 pm. He's framing the public option in the conservative language of competition and consumer choice. Smart move. And he isn't demonizing the insurance companies: he's saying they are merely encouraged by the system to over-price and under-deliver.

8.38 pm. Obama takes on Palin hard: "It is a lie, plain and simple." Of course it is. Palin said it.

8.37 pm. This laugh-line should have been left out:

While there remain some significant details to be ironed out …

8.35 pm. The nod to McCain and Clinton is very Obama. He's actually bragging of his capacity to change his mind and adopt others' ideas. Can you imagine Bush ever saying such a thing?

8.34 pm. And now a touch of populism:

It’s how everyone in this Congress gets affordable insurance.  And it’s time to give every American the same opportunity that we’ve given ourselves. 

8.30 pm. This is the big sell to the center:

Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there’s no reason we shouldn’t be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.

This is what appeals to me, despite my worries about fiscal expansion. After reading so many emails from so many people of terrible stories from the current system, I'm persuaded by the moral argument.

8.29 pm. He's fired up. This is the campaign Obama, appealing to the center against the old politics.

8.27 pm. Classic Obama pivot: describe the right and the left and then say he is in the middle. And the Burkean twist: "I believe it makes more sense to build on what works and fix what doesn’t, rather than try to build an entirely new system from scratch."

8.25 pm. Now the deficit question. He deflects the charge that he is spending too much money by arguing that healthcare reform, if done right, would be the most important fiscal reform we have.

8.22 pm. "It can happen to anyone." "No one should be treated that way in the United States of America." SO far a clear and moral case against the anxiety and cruelty of the current system. The pivot to the middle class is a way to deflect the Republican attack that he is an old-style tax-and-spend welfare-coddling liberal.

8.20 pm. The way he said "determined" suggested to me he meant it. He's all-in.

8.18 pm. A note on the recession just to show he has not forgotten the economy in favor of healthcare. And a nice reminder of the dreadful economy he inherited.

8.15 pm. Live-streaming is fun because the frames freeze every now and again and I just looked for a minute or so at an image of the president virtually bowing to the Speaker. The reception for Obama is pretty boisterous – a way for the Dems to vent a little after their August dust-up?

8.04 pm. Still on the Cape so no TV. I'm watching the live-stream and will have to grapple with the speech without the TV reactions. Which probably makes more sense, come to think of it.

(Photo: Mark Wilson/Getty.)

Mark Blumenthal isn't a big fan of instant polls, like the ones we are likely to see tonight after Obama's speech. The polls are skewed because those who watch such speeches are likely to be supporters of the president. Also, historically these sort of speeches don't tend to move approval ratings. His bottom line:

For all the similarity to 1993, this speech provides its own new and hard to predict "model." The speech is coming much later in the debate, and for all the evident passion of opponents, many Americans remain both interested and confused. As this week's Pew Research Center New Interest Index poll shows, virtually all Americans (93%) consider health care reform important, 73% say it affects them personally, 40% to 49% say they have been following the issue "very closely, but a huge number (67%) also says the subject is "hard to understand." That sounds like a recipe for a large audience that is potentially more attentive and persuadable than for most previous presidential addresses. But we shall see.

This is a planetary nebula 3,800 light-years away from us, from the Scorpius constellation. It looks like a kiss to me. More just-released NASA images here. A little perspective never hurts, does it?

A vent worth a read:

Which brings us to Afghanistan: Let's get the hell out! While I vociferously opposed the incursion into Iraq, I was always strongly in favor of bombing the mountains of Afghanistan to smithereens in our search for Osama bin Laden and al-Qaida training camps. But committing our land forces to a long, open-ended mission to reshape the political future of that country has been a fool's errand from the start. Every invader has been frustrated and eventually defeated by that maze-like mountain terrain, from Alexander the Great to the Soviet Union. In a larger sense, outsiders will never be able to fix the fate of the roiling peoples of the Near East and Greater Middle East, who have been disputing territorial borderlines and slaughtering each other for 5,000 years. There is too much lingering ethnic and sectarian acrimony for a tranquil solution to be possible for generations to come. The presence of Western military forces merely inflames and prolongs the process and creates new militias of patriotic young radicals who hate us and want to take the war into our own cities. The technological West is too infatuated with easy fixes. But tribally based peoples think in terms of centuries and millennia. They know how to wait us out. Our presence in Afghanistan is not worth the price of any more American lives or treasure. 

I think she's too harsh on the Obama administration. But just about right on the Republicans.

Uwe Reinhardt:

"You could pick either the German system, the Dutch system – even more so as they allow for profit-orientated insurance companies – or the Swiss system," he continued. "All these systems are fairly similar in having a structured, regulated market for private insurers, either non-profit or profit-making." 

"But I think a mixture of the Dutch and German systems would be perfect for the insurance reform in the US," he added. "It's a shame that instead of having a rational discussion on the German system or taking a plane load of senators and congressmen and flying them over there, you have this shouting match over euthanasia, and pictures of Hitler being waved about. It has descended into quite an ugly scene."

Alaska Dispatch has the goods. I was unaware that Palin "declared April 16, 2008 'Health Decisions Day' in Alaska to encourage more citizens to talk to their health care providers about 'advanced directives.'" That's almost identical to the abandoned proposal she now calls a "death panel". Then this:

In 2007, Palin said that providing adequate health care "is one of the most pressing domestic issues facing the United States as a nation." But as governor of Alaska, she did virtually nothing to ensure "real" or any other kind of health care reform.  While she and her family had access to some of the very best health insurance available (which was tax payer funded) nearly 33 percent of her constituents– about 200,000 residents — were uninsured at some point in 2008, one of the highest rates in the country.

Alaska, which has one of the least restrictive insurance markets, is dominated by two insurance companies that control over 96 percent of the market. Premera Blue Cross insures about 60 percent of the market, while Aetna insures more than 30 percent. And what they offer is some of the most expensive coverage in the U.S. Between 2000 and 2007, insurance premiums in Alaska rose more than 74 percent, while wages grew 13 percent.