Tuesday, March 23, 2010

What Obama Got: A Whirlwind

They have sown the wind, and they shall reap the whirlwind.

Hosea, 8:7

In my book, Obama, Doctors, and Health Reform (IUniverse, 2009), published in the Spring of 2009, and in an interview with Dutch TV in June, I predicted President Obama would get something, perhaps one third of what he wanted.

He got more than a third but less than a whole. Among other things he did not get a public option, he did not rid the system of employer-based care and of private health plans, and he did not institute effective cost controls.

But he likely salvaged his presidency by passing his signature domestic initiative – a massive government-directed health reform bill. And he overcame daunting political odds – a 20% plunge in political approval to below 50%, united Republican opposition, a revolt among seniors, persistence unemployment, and concerns about a government take-over and a skyrocketing national debt, and polls indicating 60% to 67% of the public disapproved of the bill, and 77% disapproving of a Congress controlled by large Democratic majorities.

Now comes the whirlwind. What form it will take no one knows.

--Will the public be satisfied when they learn of the specifics in the bill and how it effects them individually?

--Will the individual and employer mandates appall those who believe in individual freedoms?

--Will seniors gracefully accept Medicare cuts, with shifts of benefits to the young and the uninsured?

-- Will we have more raucous town meetings when Congressmen return to their districts? Will there be violence?

--Will we have Tea Party marches on Washington and state capitals?

--Will the efforts of state attorney generals succeed in efforts to declare portions of the bill unconstitutional?

--Will the unpopularity of the bill cause voters to elect a Republican majority in the House, and maybe even in the Senate?

--Will a centralized government be up to the task of administrating and implementing the particulars of the bill, and containing the costs of what it has sown?

Or, as President Obama hopes, will this new vast entitlement programs be instantly addictive to a public who he thinks yearns for more and bigger government protections with more interventions into the private sector and into their lifes?

He who rides the whirlwind cannot always direct the storm.


Michael Kirsch, M.D. said...

Hello Richard. The Dems now are the sole owners of the plan. I expect continued rise in costs, more taxes, a disgruntled medical profession and a frustrated public. When you own something, you are responsible for it. Will the Dems try to claim credit for HCR's successes and deflect blame to others for its failures? www.MDWhistleblower.blogspot.com

Richard L. Reece, MD said...

Well said. I expect the path to furthe reform to be rocky and full of rough patches. I don't think the Democrats know what they are in for.