Wednesday, September 09, 2009

Dear President Obama

Your next Big Speech is tonight. How exciting for you! Everybody's back from summer vacation and ready to roll up their sleeves and work together for a better future for everyone, without the faintest whiff of partisanship or political maneuvering. It's the American Way!

I understand that the first item on tonight's agenda will have to do with Health Care. Good thinking! Permit me to mention a few ideas on the subject: think of them as Talking Points if you like (I'm told that people like Talking Points.) Feel free to refer to any or all of them in your speech if you like. You probably shouldn't feel totally free to avoid mentioning at least one or two of them...

  • Health Care is a point of National Pride.
    The World Health Organization ranks the overall quality of the U.S. health system at 37th in the world: a little better than Slovenia's, but not quite as good as Costa Rica. That isn't really good enough for a place that still runs around claming to be the Greatest Country in the World.

  • No One's Health should be compromised for the sake of Anyone's Bottom Line.
    In the face of your less-than-scrupulous adversaries' reckless talk of death panels, you may want to point out that their precious Private Insurers have been denying care to Grandmas and Grandchildren willy nilly, in the form of widespread rejection of claims, and systematic cancellation of policies, even long-standing ones, when the patient's needs become too expensive. Yes, they are accusing you of what they have been guilty of for years. And I do mean guilty: this situation would appall the people who built the insurance industry in the first place - which, after all, is supposed to, um, insure that people get health care, not withhold it from them at just the moment they need it most. The practice is wrong, cruel, and greedy. And it should be illegal.

  • The Whole Point of Insurance is to Spread Risk.
    Not to make a gajillion dollars for companies and their stockholders. You may have to tweak this one, or people will start screaming about Socialism. To do this, I'd refer to the previous point. Assure people that there is not one thing wrong with making a good living - a really good living - providing health care. It's a very important job, and it should be richly rewarded. Profit motive is not necessarily a bad thing, but when we're talking about people's lives and health, I'd think that profit could be a secondary consideration rather than an all-powerful one. And anyone who gets filthy rich by gaming the system - and in the process making the system worse, keeping quality care out of people's reach - is just that: filthy.

  • Catastrophic Care is not good enough for the Poorest of the Poor.
    I'll buy the argument that if you make a decent living and just don't believe in Insurance, for whatever reason, you shouldn't have to get too much of it - coverage for only the severest illness and injury might be enough for you (though you really do need to be covered for that, or the potential costs are too great for you and eventually for the rest of the country.) There is some debate as to whether preventative care is much of a long-term cost saver, but it is universally acknowledged that it helps maintain long-term health. Whatever plan is put into place must provide for an affordable option of ongoing heath care, not just Castastrophic coverage.

  • Core Costs must be held in check.
    Here's a point where you can completely agree with your opposition! Pretty much everybody acknowledges that overall health care costs have skyrocketed and need to be managed. (Well, except for those who will insist on disagreeing with you no matter what you say. Come to think of it, that may be a bigger group than you'd like to admit.) Article after article has been written on the subject, and some of the better ones even discuss some possible solutions. I'm talking about creative solutions, based on experience, with the actual goal of reducing costs, not kneejerk conservative calls for Tort Reform that are actually just gifts to big business (with an assault on the environment thrown in for good measure) disguised as social justice. That transparent maneuver aside, the Conservatives are right, and you probably should grant as much - any real reform MUST address overall costs head on.

  • We need to develop a Culture of Health.
    You're going to need to phrase this better - people get freaked out when you use the C word. Get Jon Favreau to help. But what I'm talking about is spreading actual patterns of healthy behavior (as opposed to lipservice about healthy behavior) across the breadth of society. Getting people to DO the healthy thing more often (nothing crazy - eat better, don't drink too much too often, get enough sleep most nights, exercise a few times a week.) Talk about your easy and obvious ways to improve health care while reducing costs. But to actually put it across? That will take your best effort. And, you'll be criticized for it, just as you were run through the wringer for (even I have a hard time believing this) telling kids to stay in school. Oy.

  • Fight back.
    This stems from the previous point, and again, you'll need smarter people than I to help you finesse it. But please, please go after these dipshits when they say stupid things, and especially when they lie. Which they have done, are doing, and will continue to do until you stop them. You will be called a Socialist when you try to improve health care. You will be compared to Hitler when you advocate education. You will be called a Harbinger of Doom when you engage in diplomacy. Most people (I hope) know that this is crap, and those that don't aren't going to change their minds no matter what you say, so GO AHEAD AND CALL IT CRAP. I know that sometimes it's hard for Democrats to call people out because they don't want to look like hypocrites when they're shown to be sitting in the same corporate pockets as Republicans. Which the Dems should, you know, stop doing. But even before that Hailstorm in Hell, you should give yourself permission to call the truth the truth and call a lie a lie. We'll respect you more for it. Really. Continue to rise above their tactics, by all means, but don't just stand there when they get together to bring you down. Be like a master martial artist and use their own momentum against them. The wackos (and the charlatans who guide them) have been nasty and don't show any signs that they will slow down. What they have shown is that they can be counted on to go to extreme, even absurd, lengths to stand in the way of policies that change some perceived social status quo (or that might cost the richest of the rich a little bit of money.) Reveal their arguments for what they are, and they'll wind up tangled in their own rope.

There we go. We did it. We solved health care! Good for us. Tomorrow maybe we can get together and figure out how to get me an agent...

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