Tag Archives: ObamaCare

Obamacare but who cares?

This week I saw two interesting things that have driven me back to the blog: 1). Healthcare.gov did not spiral down into a political story. It somehow stayed relatively factual and 2). Everyone missed/is missing the point.

To me, this isn’t about public healthcare, President Obama’s leadership or the government being able to handle a major website.  Though all those things are true especially in the short term, these outcomes – ineffective launches, partial solutions/partial failures, and discord in addressing problems – are symptoms of a larger problem.  We, the royal we, all of us, do not want to have to put in the work required to solve problems, to get things right, to actually implement positive change (and not just change for change sake).

Our expectations about work, timing and sacrifice have so drastically changed as a result of technology that our perception of public policy is now totally unrealistic.  We want complete and beneficial solutions and we want them immediately.  We elected President Obama in the midst of a financial crisis and two wars but then pretended like that wasn’t a big deal and he should have us out of trouble in less than a year. Two or three years tops.  I’m as guilty as the next voter of unrealistic expectations 6 years ago.  The difference, I think, is that somewhere along the line I realized it.

Let me use Healthcare.gov as an example.  Throughout the last week or so, we’ve heard a series of complaints (larger issues than just a crashing website) – Obamacare was a bad idea, government cannot do “big things,” this is going to continue to fail now that the launch failed.  What we’ve forgotten is that the private marketplace wasn’t doing a great job prior to this attempt.  Healthcare was expensive, limited in its coverage and exclusive to certain types (or classes) of people.  So, in this era of quick fixes and high expectations, we’ve conveniently forgotten that one reason we had to resort to Obamacare was the private market failed.  Furthermore, we don’t know the government is going to do it well or even right.  Public policy is, by nature, trial and error.  But is that a reason not to try or to give up on Obamacare?  If so, what’s your idea? What’s a better idea?  Returning it to employer-based private healthcare returns us to a system of inflated costs, ballooning treatment, no prevention to speak of, and many of the most sensitive (the poor, kids, poor families with kids) left without help.  We’ve seen the private market fail, in some cases spectacularly so, in recent years.  The mortgage/financial crisis comes to mind. The point is not which is better because these are not mutually exclusive.  The point is where do we turn when we have a problem? How do we approach solving society’s big problems? I’ll try to stick to the issue de jure.

For those who complain the uninsured or underinsured is a made up problem and the private market can handle it, I have a quick example to the contrary.  A young woman who wants to start a family requires special medication in order to have a healthy pregnancy. Fair enough.  Other than the pregnancy, there are no major health concerns and the medication is temporary just until the pregnancy is considered out of the danger zone (in other words, you can start telling your friends).  As a result of temporary medicine, this woman is uninsurable in the private market.  Yup, preexisting condition.  But she’s not taking the medicine anymore? Get this – she might get or choose to get pregnant again, and if that happens, she may need the medicine again, and the medicine is kinda expensive, but will be required by the doctor should a pregnancy occur, and therefore the private health insurance does not want to risk the cost and will not cover the woman.  Forget that chain of “ifs,” and just look at the decision itself.  An otherwise healthy woman who has a family, provides for them and creates stability both in the community and in the insurance pool is rejected because of the helpful (temporary) medicine used in the early stages of conception.  Makes sense from a business sense, right? Obamacare says this person must receive healthcare and cannot be turned down.  Am I saying that this hypothetical alone is sufficiently evidence that Obamacare was the right decision or policy choice? No. Not at all.  What I am saying is – challenge! If you argue that Obamacare is a bad idea, fine. What’s your idea?

My guess is that someone out there, some health insurance executive or some other experienced veteran of the healthcare industry already knows what the solution is (Obamacare or otherwise) but for a variety of issues – cost, political climate, feasibility, etc. – the solution is not possible right now.  Ok. Then, we’re back to square one.  Which brings me to my original point, this is serious business.  We cannot just expect that we can create an “exchange,” pressure insurance companies into it, throw together a website, and get the right balance of people in order to lower costs and achieve broad healthcare offerings.  It takes time and commitment.

Nothing in life worth doing is easy.

I always use this example when talking about religion, but it fits for public policy too.  Why should being religious or being devout be easy? Working out and staying in shape isn’t easy.  It’s tough. It requires discipline and dedication.  Education isn’t easy.  It’s long, expensive and challenging.  A college degree, graduate degree or professional school degree is an accomplishment and educated workers are compensated accordingly because it’s valuable.  If medical school were easy, how much would you trust your doctor?  Ok, ok, you get the point.  For some reason, we don’t hold politics in the same esteem.  We just assume that the President, Congress and others should just “get it done.”

We, the royal we, all of us, need to roll up our sleeves and get to work.  Similarly we need allow our politicians the same freedom.  When they don’t, we have to be paying enough attention to hold them accountable.  But that’s not gonna happen, is it?

Not only do we not hold them accountable when they shut down the government and spout useless rhetoric (see the Tea Party, Rep. John Boehner, Sen. Mitch McConnell), but we also do not understand when politicians do not take us (the voters) seriously.  They know that we’re not paying attention. There’s no incentive to work hard or get things right.  The only incentives are soundbytes and re-elections.  We don’t like when it requires hard work, when the solution is complex and when it will take years (a generation?) of discipline to correct systemic problems.  If we don’t have the discipline to pay attention and hold public leaders accountable, why should we expect they’d stay disciplined to address these problems?

My take is this is part of a larger cultural issue, of which I’m just as guilty, that we talk a good talk but we can’t walk the walk.  I’m doing it right now. I’ve written this blog post and that’s as far as my observation or passion will take me.  I’ve got a job, family and limited time (just like everyone else) so I cannot take on the Washington establishment. I cannot try to change people’s minds about what government can do and what leaders should be or could be.  Why? I’m having trouble figuring out how to get paid to do it.  Until I can, I’ve got a regular job to go to and try to make enough money to pay for the mortgage, health insurance and student loans.  There is no incentive for me to take this on.  I’m busy.  Is Obamacare working? Is it not working? Who cares? Nothing is gonna change anyway…right?

Look. I’m not trying to be a Debbie Downer here.  All I’m saying is that we have no one to blame (see Obama, see Congress) except ourselves.  We maintain a double standard for public policy choices. These unrealistic expectations make it seem that things which are true in our own lives (valuable achievements are difficult and take time/discipline) somehow are not true in Washington. Yet at the same time, we do not have time or resources to get involved.  Where does that leave us on Obamacare? on public policy generally? What does it mean for “big” problems facing our generation?

I don’t know.  I’m still working on that.  But if I figure it out, I’ll let you know.  Hopefully you’ll be able to spare a minute.


I’m a cliche, but that doesn’t make it untrue

When I started thinking about this post, I was trying to find a way to talk about President Obama’s two distinct personas.  Campaign Obama was fiery, quick and eloquent regarding both our country’s biggest problems and his role in solving them.  President Obama has taken a much more cerebral approach and his inner wonk took over.  His politics have been measured and deliberate.  Even his speeches surrounding ObamaCare were more specific and policy-driven than flowery and idealistic.  What’s interesting to me is how Presidents attempt to strike a balance between rhetoric and governing.

The funny thing is I couldn’t really figure out what else to say because there’s no right answer.  If Obama is heavily focused on policy, legislating and governing, there is often a disconnect because the American people (and the media) are waiting for a classic Obama-style speech.  I mean, how else will we know how to feel? If Obama is scheduling and delivering powerful speeches and “selling” his vision, there is likely going to be questions about what he actually working on and who is organizing the White House while he’s stumping.  It’s probably one of those lose-lose moments where the media will find a story regardless of which side a president favors.

On the other hand, I was surprised that it took till this morning on Today for President Obama to begin showing signs of anger.  I’ll be thrilled when we reach full-on rage.  Over the past few weeks, one of the things I’ve found frustrating about President Obama was his inability to embody our collective feelings.  One of the best things a President can do is reflect or mirror the public sentiment.  I don’t know about you but my feelings regarding the BP oil spill in the Gulf of Mexico are a mix of nausea, disappointment and anger.  It seems and feels hopeless.  If Obama cannot bring us hope, he should at least show the American people that he understands our anger.

I understand, intellectually, that there is probably nothing he can do at this point to make any type of significant change to the situation.  But, emotionally, I want him on my side.  I want him telling me that he’s just as angry as I am and this isn’t politics, it’s personal.

While I think he was about 2-4 weeks late with his comments, it is nice to see that he’s now getting fired up publicly and showing some of the emotion that I’m certain existed privately before today.  Ironically, I feel like a cliche because the media has begun writing this exact story and now I’m just one of the uninteresting mass media stories.  On the other hand, some journalists, like this story on CNN.com, are starting to try to guess the greater meaning.  It’s amazing to me that there might be a racial component even in our reaction to this disaster but anytime there are high powered emotions are involved so is our latent subconscious.

More broadly, I’m also interested in the fact that the types of stories written about Obama and his administration are changing.  There are stories about his deliberate reaction to the Deep Horizon disaster, about the angry voters of the Tea Party and far Left, and about his role as campaigner in the Democratic Party (to be published in this week’s New York Times Magazine).

I know we’re in an instant gratification culture where we want to have our cake and eat it too.  Meaning, we want Obama to be everything to everyone – campaigner, rhetorician (is that a word?), speechmaker, governor, Leader of the Free World, and expert policy maker.  I trust him.  But I would still like him to take control of this story, offer some perspective and become the mouthpiece of the American people.

More Questions Than Answers

I haven’t posted in a few days and was struggling to find a topic this week.  Even as tax day came and went, the general response wasn’t particularly extreme or surprising.  It did, however, get me thinking.  What if the divide in American politics doesn’t turn around and doesn’t begin to close? I started “The Pickle” for many reasons, one of which was to support the idea that our government, our democracy requires that opposing groups find a way to work together. Opposing groups in Washington do not appear to be attempting to work together. Instead, political parties and interest groups seem to be encouraging divisiveness and distrust.

This may be a cynical view but it sure seems like a complicated problem.

While I think there has always been competitiveness between parties and almost everyone “plays politics,” there also is a bitterness and tension that I still haven’t figured out how to explain (or deal with).  Instead of calling for the two groups to become more reasonable in their dealings with each other, I want to imagine a scenario that includes both groups becoming more solidified in their positions.  Assuming we haven’t seen the tipping point in partisan politics, what’s next?

Let’s say the Tea Partiers and loyal GOPers combine into a force on the political right and Obama’s celebrity coupled with a fear of the aforementioned anti-government alliance fuels solidification on the political left. How would the American voter and, more importantly, our system handle an evenly divided gridlock? Are we entering a transitional period where we should expect fewer bills and smaller victories?

This doesn’t seem to make much sense in the shadow of an almost trillion dollar, healthcare reform bill.  “ObamaCare,” as it is now being called, might end up being the prototype for future legislation.  If one party has a majority in Congress (both houses) and controls the White House, that party can pass highly partisan legislation.  If there is a split between the Congressional majority and the White House, expect to get next to nothing done.  That is a more likely (though cynical) view of the future.

Let’s assume the Republicans regain both the House and Senate in November.  As a sidenote, I actually think this is unlikely. But I digress.  If the GOP takes over a majority, what can we expect between January 2011 and November 2012?  There are probably a few small areas of common ground between Republicans and the Obama administration.  That’s about it.

This is where Moderates could become valuable.  (Is it weird that I always find a way to get back to writing about Moderates?)

Like Sens. Olympia Snowe or Joe Lieberman in the past, a group of moderate Senators and members of Congress could band together and become a small but powerful “party.”  The two political poles feel strongly about what’s best for the future of this country and, as a result, are highly vulnerable to gridlock.  Should the Republicans take over a majority or even close the gap in the 2010 elections, moderates will be the deciding vote(s) on each bill.  In this hypothetical, if the Obama administration or a Republican majority attempts to pass any substantial legislation, they will court this moderate minority (assuming it is large enough) to create a majority or super-majority in the respective chambers.  As men and women in the business world would say, there is a void or need in the “market” that my so-called moderate minority could fill.

While I have no idea who would lead or organize such a group, I think it could work and could bring serious power and legitimacy to moderate voices in this country.