Obama's speech

Obama delivered his speech to the American public on healthcare last night and I just wanted to put down a few thoughts. He began by talking about the economy, which I thought was very telling. Do we really want to implement huge reforms when there are other problems looming? I was not convinced by Obama who appealed to a moral imperative to do things now. The reforms he's talking about are expensive. Expanding coverage and reforming coverage are both going to cost a lot of money. This will either be higher premiums or come from the government. The idea that it won't add to the deficit seems like some very sneaky and convenient accounting. I don't buy it for a second. That said, the expense of the these reforms and universal coverage do not change the fact that it's a worthy goal. I agree with the president that it is a moral imperative to provide greater access to healthcare.

I don't think we should be blinded by that fact. There are a lot of worthy goals in the world, poverty in the US, poverty in the world, human rights violations, etc. You can use such idealism to promote this reform, but you could use it to promote dozens of other worthy causes. In the end it comes down to cost-benefit analysis. No matter how good something is, we can't do it or buy it if it's too expensive. If the expense is reasonable then we can go ahead.

Herein lies the rub. Finding out the exact expense is almost impossible because the administration keeps combining the expansion of coverage with "cost-reductions" that will save billions. I can't speak to the veracity of these claims, because I don't know the details, and perhaps those details don't exist at this point.

Obviously if we can save billions, that's something we should do whether or not we reform health insurance or expand coverage. But that seems separate from the issue of expanding coverage. I thought it was telling that the president's anecdotes often focused on insured people who had insurance and were denied claims. This was a calculated appeal to the public to support his reforms, which in theory would improve their coverage. Again he's combining reforms on current coverage with expanding coverage to appeal to more people. These are separate things and should be treated as such. Why they are taking this approach seems obvious - expansion of coverage is very expensive.

Finally, the speech showed a rather deep divide on party lines. I don't think Republicans walked away convinced, and I didn't see any substantial concessions made by the administration. I don't necessarily fault him for that, but if these reforms make it through it's because Obama convinced people in his own party to stand with him.