Obama Has a Grown-Up Talk With America (Gulp)
Late in tonight's press conference, President Obama got a question that just begged for an easy, evasive answer. The question was whether he was prepared to promise Americans that, under his reform plan, "the government will never deny any services, that that's going to be decided by the doctor and the patient, and the government will not deny any coverage."
The easy, evasive answer would have been to agree: "Of course we'll cover whatever your doctor recommends." Or Obama could have sidestepped the question, by offering some bland statement of support for the medical community: "We revere physicians and want them at the center of our health care system."
But Obama didn't give those answers.
Instead, he answered truthfully. Can I guarantee that there are going to be no changes in the health-care delivery system? No. The whole point of this is to try to encourage changes that work for the American people and make them healthier. And the government already is making some of these decisions. More importantly, insurance companies right now are making those decisions. And part of what we want to do is to make sure that those decisions are being made by doctors and medical experts based on evidence, based on what works. Because that's not how it's working right now. That's not--that's not how it's working right now.
Tomorrow's headline will probably focus on the length of Obama's professorial answers, the small bits of news in his press conference*, and the fact that he seemed genuinely pissed off about what happened to his friend, Henry Louis Gates, in Cambridge the other day. But the most striking thing to me was Obama's willingness--in that question about doctors and a few others--to speak candidly about his health plan, even if that meant giving openings to some of his critics.Consider that Obama's mission tonight was actually very straightforward: to build support for health reform at a time when it is moving through Congress but, for the first time, running into serious obstacles. To accomplish this, Obama basically had two options at his disposal. He could reassure the public by minimizing the scope of change he was promoting or he could persuade the public by convincing them change, even extensive change, was actually necessary.
In the past, Obama has frequently emphasized the former approach. And at times tonight, he did it again--most clearly when he repeated his promise that people could keep their insurance if they liked it.
But Obama spent most of his time this evening explaining why things had to be different. He did this, first, by talking about the problems of the status quo. He talked about rising premiums, dwindling benefits, and growing costs that are strangling employers and government alike. Invoking a line of reasoning that first emerged in a Steven Pearlstein Washington Post column, Obama said
If somebody told you that there is a plan out there that is guaranteed to double your health-care costs over the next 10 years, that's guaranteed to result in more Americans losing their health care, and that is by far the biggest contributor to our federal deficit, I think most people would be opposed to that. Well, that's the status quo. That's what we have right now. So if we don't change, we can't expect a different result.
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http://blogs.tnr.com/tnr/blogs/the_treatment/archive/2009/07/22/obama-has-a-grown-up-talk-with-america-gulp.aspx