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Bridging climate science, citizens, and policy

Health Care – What Did Obama Say?

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Did Sen. Obama campaign on a public option or not?  It’s a question that is taking up a lot of pixels online and airtime on radio and TV.  As a motivation to go looking for some answers, I have pondered something for a while about President Obama and other elected officials: How much does every American read into a candidates’ generic statement?  Are we really listening to what they’re saying or are we hearing what we want to hear?  All too often, I fear it is the latter.   That’s one reason why campaigns are so frustrating to many people.  Candidates are purposefully generic because they know everybody will read into their statements what they want to some degree.  Getting elected is all about convincing enough people that you support everybody’s position.  You can’t, of course, but that’s the task.

To begin with, I think I remember then-Sen. Obama campaigning on a public option.  While I knew he wasn’t the most progressive Democratic candidate, he was all I had once Nov. 2008 rolled around.  But did he campaign on something close to what I wanted or didn’t he?  Here is some of what I found:

The presidential debates provide some answers.  Below, (O-) stands for comments Sen. Obama made and (M-) stand for McCain’s.

O – Just one last point I want to make, since Senator McCain talked about providing a $5,000 health credit. Now, what he doesn’t tell you is that he intends to, for the first time in history, tax health benefits. – 1st Presidential Debate

So here’s what I would do. If you’ve got health care already, and probably the majority of you do, then you can keep your plan if you are satisfied with it. You can keep your choice of doctor. We’re going to work with your employer to lower the cost of your premiums by up to $2,500 a year.

And we’re going to do it by investing in prevention. We’re going to do it by making sure that we use information technology so that medical records are actually on computers instead of you filling forms out in triplicate when you go to the hospital. That will reduce medical errors and reduce costs.

If you don’t have health insurance, you’re going to be able to buy the same kind of insurance that Sen. McCain and I enjoy as federal employees. Because there’s a huge pool, we can drop the costs. And nobody will be excluded for pre-existing conditions, which is a huge problem. – 2nd Presidential Debate

M – If you’re a small business person and you don’t insure your employees, Sen. Obama will fine you. Will fine you. That’s remarkable. If you’re a parent and you’re struggling to get health insurance for your children, Sen. Obama will fine you. – 2nd Presidential Debate

O – Well, I think it should be a right for every American. – 2nd Presidential Debate

O – Number one, let me just repeat, if you’ve got a health care plan that you like, you can keep it. All I’m going to do is help you to lower the premiums on it. You’ll still have choice of doctor. There’s no mandate involved.

Small businesses are not going to have a mandate. What we’re going to give you is a 50 percent tax credit to help provide health care for those that you need. – 2nd Presidential Debate

O – And some of the cuts, just to give you an example, we spend $15 billion a year on subsidies to insurance companies. It doesn’t — under the Medicare plan — it doesn’t help seniors get any better. It’s not improving our health care system. It’s just a giveaway. – 3rd Presidential Debate

M – Now, Senator Obama, I’d like — still like to know what that fine is going to be, and I don’t think that Joe right now wants to pay a fine when he is seeing such difficult times in America’s economy. – 3rd Presidential Debate

O – Here’s your fine — zero. You won’t pay a fine, because… […] Zero, because as I said in our last debate and I’ll repeat, John, I exempt small businesses from the requirement for large businesses that can afford to provide health care to their employees, but are not doing it. – 3rd Presidential Debate

O – And once you’re out on your own with this $5,000 credit, Senator McCain, for the first time, is going to be taxing the health care benefits that you have from your employer.

And this is your plan, John. For the first time in history, you will be taxing people’s health care benefits. – 3rd Presidential Debate

O – But we’re going to have to invest in the American people again, in tax cuts for the middle class, in health care for all Americans – 3rd Presidential Debate

It now appears that Sen. McCain was more correct than Sen. Obama was: fines will be imposed on those who refuse to pay for corporate insurance.  Lately, I read that the fines will be high enough to dissuade most people from choosing them over the mandated insurance.  During the debates, the discussion was all about what fines small businesses would be impacted.  It now looks like (according to the Senate legislation) ordinary Americans will be the ones fined.  As then-Sen. Obama pointed out – for the first time in history.  I’m not sure how much sense it makes to fulfill Sen. McCain’s warnings.

Next, here is the Obama/Biden  “HealthCareFullPlan.pdf”.  It includes items such as:

  • In markets where the insurance business is not competitive, their plan will force insurers to pay out a reasonable share of their premiums for patient care insted of keeping exorbitant amounts for profits and administration.
  • Allow consumers to import safe drugs from other countries.

The former looks like it made its way into the Senate bill.  The latter was a casualty.

  • New Affordable, Accessible Health Insurance Options – any American will have the opportunity to enroll in the new public plan or an approved private plan.

There won’t be a public plan or a public option.

  • Expansion of Medicaid and SCHIP.

Is Medicaid expanded?  I don’t remember details on SCHIP actions taken earlier this year.

How about the Organizing for America, BarackObama.com website?  Any mention of a public plan or public option?

  • Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice.

I’ve read that this proposal came out after John Edwards and Hillary Clinton campaigned harder on their health care plans.  Interestingly, it could be argued that Sen. Obama triangulated then to grab as many progressives as he could.  Once elected, of course he had no intention of following through on such a proposal.  What happened instead is his staff worked out a deal with the pharmaceutical industry so that they wouldn’t run the kind of ads against potential legislation that they did during President Clinton’s 1st term.  So it wasn’t just my imagination.  Sen. Obama campaigned on one thing and then worked to achieve something quite different once he was elected.  No wonder many (most?) Democrats feel betrayed and disillusioned with the Great Speaker.  That was one thing I was worried about with this man – would be be a better speaker than President or would he be as good a President as he is a speaker?  It’s starting to look like his speaking skills are superior.

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