Obama campaign promises - Obama's Campaign Reversals

President Obama is so anxious to pass a health reform bill this year and so fearful that its failure may doom his domestic agenda that he is willing to reverse course and to be “open” to reversals of his campaign rhetoric.

These reversals may reflect pragmatism and flexibility. But Shika Dalmia, writing in the July 1 issue of Forbes is not so kind as I. She calls these reversals in policy “Obama’s Top Five Health Care Lies,” and TonySopranoCare.

I don’t hanker to the word “lies” in political debates. The very word “lies”strikes me as impolite. I prefer the word “reversals” – in other words, doing what needs to be done to get one’s way and to do what needs to be done to retain power. This may strike some as an abandonment of principles.

In any event, here are Obama's top five reversals.

Reversal One – No one will be compelled to buy coverage. This refers to the individual mandate, now embraced by Obama, after arguing against it during the campaign in debates with Hillary Clinton. Then, confronting Hillary, he said, “To force people to buy coverage you’ve got to have a very harsh penalty.” But now, according to the Obama people, the individual mandate has become “an affordable and fair approach to bringing everyone into our health system.” The big problem is subsidizing those who can’t pay, which is a big reason why the OMB puts a $1.6 trillion 10 year price tag on the Obama plan.

Reversal Two – No new taxes on employer benefits. Indeed, Obama promised no new taxes on 95% of people, those making less than $250,000. This is a biggie. During the campaign, Obama ridiculed McCain for even suggesting such a thing. Now, however, Obama and his team have swung around to the thought of taxing employer benefits because that’s where the honey pot of money is, some $500 billion, to support his plan. Sure, this reverses his pledge not to raise taxes, in this case, some $4000 for each employee, but now it is said this exclusion from taxes rewards the well-off, is expensive, and inefficient. Obama now leans towards a tax increase on health benefits for all. Any tax raiser who talks like a duck, walks like a duck, and quacks like a duck, is a duck, even if he promises to duck taxes for 95% of Americans.

Reversal Three – Government can control rising health costs better than the private sector. This is laughable since Medicare costs have been rising 34% faster than private sector costs. But it is said Medicare administrative costs are 3% versus 20% for private plans. For good reasons, Medicare has no marketing expense, doesn’t have to negotiate with hospitals or doctors, runs no business risks with government printing presses as backup, and delegates the administrative tasks to private plans. Still, portraying government as the Patron Saint of Compassion, Lower Costs, and Better Care at Someone Else’s Expense, namely, the “Rich,” i.e., anybody making over $250,000, is good class warfare politics and has the advantages in gaining votes from the politically disencranchised who pay no taxes. This assures political domination. But, sad to say, government will not be more “efficient; it will simply be a monopoly, dictating the terms of patient-doctor engagement.

Reversal Four – A plan won’t be a Trojan horse for a single-payer monopoly. Of course, it will. No one seriously believes a public plan with lower premiums wouldn’t undermine and destroy private plans. The Lewin Group estimates are that a public plan would drive 70% of private plans out of business. It’s simply impossible to design a public plan that competes “fairly” with private plans. Besides, President Obama has repeatedly he would favor a single payer system if he had to start over “from scratch.” Scratching out private plans would help him start from scratch. Medicare has a history of underpaying doctors and hospitals, $90 billion a year. Hospitals and doctors compensate for losses by charging private plans more. According to Obama critic, Dick Morris, Obama would like to have a Canadian-type plan in which charging patients outside of government would be illegal, assuring a total government monopoly. As the old saying goes, when you have them by a tender part of their anatomy, i.e. their wallet, their hearts and minds will follow.

Reversal Five – Patients don’t have to fear rationing. No, what they have to fear is lack of access to doctors. A looming doctor shortage is already apparent in America. In Massachusetts, the only state with near universal coverage, waiting times to see a primary care doctor have gone up in 3 years to 60 days, more than twice the average in other states. In Canada, similar average waiting times are over 4 months. There aren’t enough doctors and nurses to go around. And, on top of waiting lines, there is a veiled threat known as Comparative Effectiveness Research, meaning the government will decide what treatments are “rational” and “cost effective” based on “evidence-based medicine.” As I write, the Institute of Medicine, at the request of the Obama administration, has just issued a report “Initial National Priorities for Comparative Effectiveness Research.” The 100 priorities listed cover virtually everything in the spectrum of care. According to the IOM, “ultimate research on these and future topics will not yield real improvements unless the results are adopted by health care providers and organized and integrated into clinical practice.” Sounds like a thinly veiled threat.

What It All Means

It means the Obama administration is heeding the words of Rahm Emanuel, Obama’s chief of staff, who is widely quoted as saying “Never let a crisis go to waste.”
In this political climate, the crisis is the deep national economic recession.

The opportunities are:

One, to blame health costs are a root cause to implement a government-run and regulated care system;

Two, to introduce a European-like social welfare state as quickly as one can.
The chief weapon is the excuse that throwing government money at all problems – the credit crisis, education, energy, unemployment, and health care – is necessary to rescue the nation from economic malaise.
The chief evidence that this strategy is happening and working is revealed in these two charts.

Increase in Total Government Spending in President Obama’s First 100 Days in Office

Pre-Obama

Total U.S. GDP $14,000 billion
Total government spending $5100 billion (36.4%)

After-Obama

Stimulus package $787 billion
Supplemental appropriations $410 billion
Estimated health care spending $625 billion
Total New Obama spending $1.822 billion
New percentage of GNP from government…49.4%

Total government spending compared to other nations as percentage of GDP

Sweden 57.0%
France 54.0%
The U.S. (Post-Obama) 49.4%
Italy 48.6%
Netherlands 47.1%
Germany 47.5%
United Kingdom 43.7%
Canada 40.1%
Japan 37.5%
The U.S. (Pre-Obama) 36.4%

Source: Forbes

Watch out, Sweden and France. We’re gaining on you.