Sunday, October 4, 2009

Ten Obama Health Reform Tigers

Under the surface, it promises only an extended version of the old system--or at least the less effective parts of it. The Baucus plan would pay for this extension by taxing top-end insurance plans. Since many of these plans were won by hard union bargaining, the tax will hit Joe Lunchpail as hard as Gordon Gekko. You cannot expect the public to be terribly impressed.That is the tiger Democrats have by the tail.

“The Democrats’ Phantom Fix on Health Care,” Time Magazine, October 12, 2009

President Obama, in his weekly address on Saturday, noted Friday’s dismal unemployment numbers and said the health care overhaul would bolster small businesses and create jobs.

Mr. Obama called the overhaul “a critical step in rebuilding our economy” and said he was working with his economic advisers “to explore additional options to promote job creation.”

“Health Overhaul is Drawing Close to Floor Debate,” New York Times, October 3, 2009

Here I will argue President Obama has ten tigers by the tail, not one. A group of tigers is called a “streak” or an “ambush.” Either term is appropriate because this thing called health reform is moving like a blue streak, or at least the Democrats say it is, but ambushes are waiting in the bushes.

One, the first ambush lurks in the malaise surrounding the general economy and the associated continuing unemployment rates and rising national debt. Simply put, the $787 billion stimulus package doesn’t seem to be working. Unemployment trumps health reform as a priority.

Two, the second ambush resides in Obama’s language. He stresses “moral imperatives,” “economic imperatives,” and “mandates, “ both individual and corporate. Americans don’t like to be lectured to, nor do they like to be reminded of theur supposed moral deficiencies.

Three, the third ambush is President Obama’s premise that health reform is “a critical step in rebuilding our economy” and” promoting job creation.” Americans with eyes to see and ears to hear know health care is the only growing sector of the U.S. economy. More often than not, health care is the largest employer in their communities.

Four, the fourth ambush, surprisingly, is occurring in AARP. Its 40 million + members are split between those over 65 and those between 50 and 65. The two groups see things differently, with the over 65 crowd favoring the status quo and the younger group favoring reform. AARP has lost 600,000 members in recent months.

Five, the fifth ambush hides among young adults, 18 and over, who, generally in good health will be mandated to buy individual insurance, which they may feel, will be to pay for older and sicker people. The young voted for Obama, but do not often vote in midterm elections.

Six, the sixth, and most vocal and deadly ambush, lies among the old. Despite reassurances the $500 billion ten-year Medicare cut will not affect their care, only 1 of 3 support health reform and most think reform will reduce quality.

Seven, the seventh, ambush may be in how the Democrats plan to collect the penalties for those who choose not to pay insurance, and instead pay the penalties. If the penalties for violations are taxes collected by the Internal Revenue Service, the public is likely to be furious.

Eight, the eighth ambush, is passive resistance and even animus among the business community, because of Obama’s tilt towards socialism, proposed mandates on employers to cover employees, increased taxes of those making $250,00o or more, his surtax on millionaires, and his penalties on insurance policies with premiums of $21,000 or more.

Nine, the ninth ambush, is a reaction to vagueness of how to pay for the $900 billion cost of reform over 10 years, though Democrats insist that it will not add to the deficit. Given past cost overruns of Medicare and Medicaid, the public is leery stamping out fraud and abuse, preventing disease among the elderly, and punishing doctors will do the trick.

Ten, the last ambush, is Democrat division over whether to create a government insurance company to compete with private insurers. The more liberal House will not pass a health care bill without such a public insurance option, while the Senate appears unlikely to pass one with it.

Maybe the upcoming debate of how to reconcile the two Senate and the three House versions of health reform will boil down to this version of the old nursery rhyme.

Any, many, minor, more.

Catch which tiger by the tail,

If they holler, let them roar,

Any, many, minor, more

Dr. Richard Reece is author, blogger, speaker, and reform expert. Dr. Reece’s latest book, Obama, Doctors, and Health Reform ( is available at,, and for $31.95 (hardcover), $21.95 (softcover), and $6.95 (electronic). For information on speaking fees and arrangements, call 860-395-1501.

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