http://prospect.org/cs/articles?article=health_care_reform_gets_a_booster_shotHealth Care Reform Gets a Booster Shot
Obama's speech had some important news: his plan now includes some immediate relief on insurance costs.
Paul Starr | September 11, 2009 | web only
President Obama's speech to Congress on health care Wednesday evening succeeded at several levels. Beforehand, observers said that he needed to explain to a confused public what he is proposing and why it makes sense, and the speech did that. Analysts also said that the president needed to shift the momentum from August, to confront the ugly distortions of the opposition, and to mobilize support in his own party. In those respects as well, the speech did all that might have been expected of it.
But Obama also undertook several things that were unexpected -- at least, I didn't expect him to do them. He introduced an important new element into the policy discussion. He signaled his support for what is now the likely resolution of the most contentious issue--the public option. And after paying respect to Republicans for their ideas, he used the coda of his speech to make the larger case for liberalism more eloquently than any president has in decades.
The new element in the policy discussion has to do with a little-discussed but serious political vulnerability of the proposals being considered in Congress--the timetable of reform. Under the current proposals, most of the uninsured wouldn't get coverage until the new insurance exchanges are set up in 2013. The law would move more quickly in improving prescription-drug coverage for the elderly and curbing some of the worst insurance abuses. But before the non-elderly would see results firsthand from the new system for buying, subsidizing, and regulating insurance, Republicans would have two elections to arouse public anxiety and overturn reform.
Obama said that it would indeed take four years to set up the exchanges in order to "do it right." But
then he added, "In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill."
Making catastrophic health insurance "immediately" available would provide a bridge to more substantial reforms in 2013. Some may worry about the measure's potential effects. Given the overall budgetary expenditure that Obama endorsed ($900 billion over 10 years), will the cost of short-term catastrophic coverage force Congress to adopt lower subsidies for the more comprehensive coverage beginning in 2013? And because temporary programs often have a way of becoming permanent, might catastrophic insurance become entrenched by 2013 as the level supported by the federal government?snip//
As he finished, Obama seemed to strike the posture of a general leading his troops into battle. He would hear nothing of those who counsel retreat. Shrinking from the fight, he said, was not what he and others came to Washington to do. "We did not come to fear the future. We came here to shape it." He appealed not just to our sense of justice but to a liberal vision of our national character. There have been elements of this appeal in his earlier speeches, but they were pitch perfect Wednesday night.
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