What I Hope To Hear From President Obama on Wednesday Night

President Obama gives his health care address to Congress tomorrow.  I for one, plan to watch intently from my St. Louis hotel room and am hoping that he can finally deliver a clear message that articulates specifics about what health care reform needs to look like.

I am so glad that the Congressional vacation is over and all of the town hall hysterics that went with it.  I will give the Republicans credit for one thing – their ability as the minority party to cast serious doubts about the majority party’s plans.     But hopefully, after the president’s speech tomorrow night, both he and the Democrats will regain their footing as the party in charge.

So, what does Obama have to say to change the course of the debate and steer us toward the goal of true health care reform?   Here are the points that I believe he has to make:

1.  Private health care insurers are FOR-PROFIT companies that only benefit by not paying out claims. There is no greater example of this than an expose that appeared in the June 17th L.A. Times concerning how Blue Cross employees were praised and even given bonuses for finding ways to drop coverage on patients with expensive claims.  Blue Cross saved millions of dollars by dropping patients with serious life threatening diseases on technicalities.  In one case, a woman was dropped because she failed to disclose that she had a deviated septum – a common mis alignment of the nose that she didn’t even know she had and had nothing to do with the illness she was seeking treatment for.    As such, there several pending class action lawsuits against Blue Cross for these rescission practices.    With a system that prevents exclusion based on pre-existing conditions, millions of Americans might not have to worry about how to pay for astronomical medical bills as a result of being unwittingly dropped by their provider.  These companies are more than happy to take your monthly premiums, but don’t share the same joy in actually helping you when you need them most.  We are talking about life and death in some cases, not flat screen TV’s or fancy cars.   This type of practice is simply disgusting and President Obama needs to make the public aware that these kinds of shady dealings are rampant throughout the insurance industry and is a primary reason why health care reform is needed today.

2.  Once and for all, health care reform does not mean pulling the plug on Grandma. Again, give the Republicans credit for twisting some words around and turning it into a viscous, baseless, smear campaign.  It seems like that’s the only thing they are good at anymore.  It has been debunked time and time again, that the government is not going to mandate euthanasia for seniors or force them to consult on life ending measures.  The one House bill simply states that doctors would be reimbursed for providing such consultations, but they are totally optional by the patient.  There are no “death panels”.  Hopefully, the president can call out the far right on their deceptive smear tactics and put to rest the notion that the nation’s elderly are in jeopardy.

3.  A public health plan is the only way to force competition with private insurers and bring down costs. It pains me that there has been so much apparent waffling by the Obama administration on whether the public option is essential to reform.  One minute it is, the next minute it is negotiable.  The president needs to stop trying to get bi-partisan support on this and focus solely on getting the votes within his own party.  The Republicans have clearly demonstrated that they have no intention of supporting a public option and that’s the bottom line.  So he needs to make the case to his own party and more importantly to the American people.   A public option does not  mean that we will all become Canadian or French and  that throwing the big S-word, Socialism, around is yet another scare tactic by the far right.  I would love for Obama to stand up there and say that anyone who is afraid of Socialism should return their Social Security checks immediately and/or refuse treatment under the Medicare and VA systems – all of which are “socialist” programs.   The Republicans throw around Socialism to confuse people.  They are banking on people not making a distinction between socialism and communism.  Canada is a socialist country, but last time I checked, nobody is suggesting we bomb Toronto and Montreal.    Socialist-type programs CAN exist in a capitalist society.  Again, Social Security and Medicare are two prime examples.

The alternative to a public option that has been thrown around is the formation of regional co-ops.   I fail to see how these would provide a meaningful check on big insurance companies.  These co-ops would need to have huge numbers of members to attempt to drive down costs and what I see as a more likely scenario is the big insurance providers just swallowing up the co-ops over time and bringing us back to square one.

A government run option that is administered by medical professionals is the only way to compete and give people real choice.  Some Republicans have suggested allowing insurance companies to compete across state lines.  In theory that might be a good idea, but would require strict uniform regulations across all 50 states to ensure that these companies don’t just set up shop in the least regulated state.    But I don’t want Obama to go there.  He’s got to hammer home the need for a public option.

4.  Health care costs are the biggest drag on the economy today. Health care costs account for the largest percentage of GDP at 17.6% and costs continue to skyrocket to the point where cost increases are outpacing GDP growth.  As a result, employers are forced to demand higher premiums from their employees and Medicare and Medicaid account for nearly 50% of all health care spending.    This creates a significant drag on the economy and its recovery because a) more employers are forced to drop coverage leaving employees to fend for themselves, b) more individuals are forced to file for bankruptcy due to medical costs, and c) many businesses will be unable to grow or higher new workers, causing sustained levels of unemployment.   President Obama needs to directly correlate health care reform to economic recovery.  The American public needs to understand in plain terms that failing to fix health care will  continue to slow any recovery and job availability.

5.  We will pay for health care reform by…. This is where I am hoping the president has a thoughtful and pragmatic answer.  He has to be honest about the costs, but again, make the case that failing to act now will be far worse for the economy in the long run.  I am not an economist.  I have a hard enough time trying to budget from paycheck to paycheck, so I appreciate the heavy task of trying to figure out how to convince the public of the need to spend close to a trillion dollars of taxpayer money on top of the $787 billion already spent on the stimulus.  I certainly am aware of our indebtedness to the Chinese and their potential ability to call in their loans and  make The Olive Garden serve roast pork lo-mein instead of Fettuccine Alfredo.    But what’s the alternative?  How is doing nothing better?  I have not heard a comprehensive alternative from the Republicans that would a) provide universal or near-universal coverage, b) create true competition, and c) bring down costs.   So, again, while I wish I had the answer on how to make the cost deficit-neutral I don’t.  I suppose if I did, I would be in Washington right now instead of Holly Springs, NC.    So I am looking to the president to tell us how we can pay for this responsibly.

So, I will be in St. Louis tomorrow, working on an IT project for a major healthcare provider that among other things, will help them better track projects and costs.  Afterward, I will try a new sushi restaurant near my hotel for dinner and then go back to my room for the big speech.  Hopefully the sushi is fresh because I’m pretty sure failing to disclose a tapeworm would be considered a pre-existing condition which could get me dropped from my health plan.

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