Dr. Obama's Miracle Cure

"Snake oil" has been defined as "a derogatory term for compounds offered as medicines which implies that they are fake, fraudulent, quackish, or ineffective. The expression is also applied metaphorically to any product with exaggerated marketing, but questionable or unverifiable quality or benefit." This is a concept to keep in mind when considering the current furor over "health care reform" now gripping the country.

I don't usually watch speeches by politicians--even Presidential ones--on TV. But I felt that the health care debate was grave enough a matter that I should watch President Obama's speech before Congress Wednesday night to find out just what he is trying to sell, and to see if he could somehow dispel the confusion and suspicion that surround the legislation now before our representatives. Click here to read the full text of his remarks.

As contemporary political speeches go, it was a pretty good one--direct, breezy, and kinda friendly-like (except toward insurance companies and critics of his ideas). We all know that Mr. Obama is a good speaker. His outline of the health care reform plan he proposes was presented with appealing, and probably deceptive, simplicity. As he sees it, nobody loses, everybody gains, and it won't cost anybody an extra cent. Given the breathtaking complexity of medical science and the health care business, and the fierce battles that have raged over the issue for so many months and years--does that smell just a little like snake oil to you?

For one thing, if this plan is so clear and self-evidently ideal for everyone, where was this speech when the health care debate started last spring? Why not lay out your plans at the outset and thereby avoid all that public confusion, anxiety, and anger? Why, instead, were 1000+ -page bills hurled onto the table with a dare that anyone try to read them, and a demand that they be passed in a matter of days, essentially without opposition? Why, having so put people on the defensive and insulted their intelligence and integrity, did Democrats find it necessary to castigate them as liars, racists, and Nazis when they expressed reservations or objections to what they believed, without the benefit of the President's guidance, this legislation provided? Was it just a try to get away with whatever they could and, if determined opposition developed, have a basis for demonizing it? Don't blame people if, after being treated this way, they are suspicious of the Administration's new-found candor.

Another thing that left me skeptical was the President's explanation of how his plan will be paid for--all $900 billion of it over 10 years. Is it really possible that "reducing . . . [fraud,] waste and inefficiency in Medicare and Medicaid will pay for most of this plan"? If all that fraud and waste were so easy to identify and eliminate, why hasn't it already been done? Can government agencies that have squandered that much money for so many years be trusted to suddenly become honest, efficient, and financially responsible, merely because this President wills it? Can the rest of this reform really be paid for by adding premiums paid by or for 30 million new insureds--less than 10 percent of the population--when insurance companies are also being forced to cover all of their preexisting conditions, all of their routine checkups and preventive care, and all of their annual, lifetime, and out-of-pocket expenses? And what's this about "charg[ing] insurance companies a fee for their most expensive policies"? Aren't those usually their highest-quality policies? That's probably one choice you won't have under the new plan.

Nor was I impressed by the President's reference to tort reform, such as limits on specious lawsuits and on jury awards for noneconomic damages. All the President promised to do was "move forward on a range of ideas" in this area. No specific ideas or proposals, and no promises--"We'll look into it." Given that organizations of plaintiffs' lawyers are always among the Democratic Party's most slavish and financially generous supporters, you can rest assured that meaningful tort reform won't be part of any health care bill that gets through Congress.

Remember that, as the President stressed, the financial viability of his plan depends on everyone being forced--under threat of fines--to participate in the health insurance system at their own cost (or at the taxpayers'). It matters not that an individual may have sufficient means to pay his or her own medical expenses if and when they arise. And for larger businesses, providing health insurance benefits to employees is no longer simply a supplemental form of compensation or a means to attract and retain the best talent available; it's now a moral and legal obligation to employees and to society in general.

What most affronted me about the President's speech was contemptuous way he characterized those (including me) who have raised serious and legitimate issues about what the current health care reform legislation does and doesn't provide for, and what its effects may be. His response to concerns about rationing care to senior citizens and coverage for illegal aliens and abortions consisted almost entirely of epithets: "misinformation", "bogus claims," "demagoguery and distortion", and "lies." Aside from vituperation, here is all he had to say about these things:

It is a lie, plain and simple [as to rationing of care]. . . .

The reforms I’m proposing would not apply to those who are here illegally. . . .

[U]nder our plan, no federal dollars will be used to fund abortions.

As to care rationing, the President gave no explanation as to how government-run or -certified boards and panels would be restrained from taking into account the age and "quality-of-life" prospects of senior citizens and critically ill patients in determining how to contain costs and allocate scarce resources--as Rahm Emmanuel's own physician brother has advocated.

The President's assurances that his health care plan will not cover illegal immigrants or abortion don't seem credible, either. An article today from the Associated Press observes that while the House version of the health care bill prohibits spending any federal money to help illegal immigrants get health care coverage, and health care legislation in the Senate is also being crafted to exclude illegal immigrants from coverage, illegal immigrants could use their own money to buy into a new government-run insurance plan if Congress creates one; worse, there is no provision in any of the bills for enforcement of the prohibition on federal health care subsidies for illegal immigrants, nor is there any requirement for people to prove that they are citizens or legal residents before getting health care benefits.

As to coverage of abortions, the nonpartisan FactCheck.org reports that while the bills now before Congress don’t require federal money to be used for supporting abortion coverage, the legislation would allow a new "public" insurance plan to cover abortions, despite language added to the House bill that technically forbids using public funds to pay for them; low- and moderate-income persons who would choose the "public plan" would qualify for federal subsidies to purchase it, and private plans that cover abortion also could be purchased with the help of federal subsidies.

Of course, one runs a risk in pointing these things out. As the President said, "If you misrepresent what's in this plan, we will call you out." As in, take you behind the woodshed? Whup you upside the head?

The bottom line: we must all be most vigilant about what issues from Congress in the way of "health care reform." Will it really do, or avoid, all the things the President promised? Will it carefully adhere to the guidelines that he set forth Wednesday night? Or was the President just talking through his hat like the snake oil salesmen of the 19th century, using his personal charm and glibness to sell us a magic elixir that contains (in its dense and endless verbiage) who knows what, and will affect the body politic in ways we can't foresee and wouldn't want? This is one instance in which we can't "try before we buy," so we'd better be absolutely sure that this cure is not going to be worse than the disease.