Monday, September 14, 2009

Obama's Dissolving Credibility

Obama's Dissolving Credibility
By Robert Tracinski
We had our warning during the campaign, we really did.
Remember Barack Obama's famous speech on race, back in March of 2008? Obama had spent 20 years listening to the sermons of Jeremiah Wright, full of venomous anti-Americanism and attacks on "white America." Yet when the reverend's rants were revealed to the public, Obama tried to convince us that he just happened to be missing from the pews on any well-documented Sunday, and that the Jeremiah Wright we saw and heard was not the Jeremiah Wright he knew.

It was a giant, implausible lie. Yet the speech was smoothly delivered and well-turned, perfectly balanced to seem to empathize both with the grievances of blacks and with the concerns of whites. So most people seemed to believe it.

This is what Obama's supposed gift for rhetoric amounts to: the ability to tell a smoothly polished bald-faced lie.

And that was the whole essence of Obama's big health-care speech. It was a pack of lies from beginning to end, and if we're going to finally see through this flim-flam artist once and for all-as more and more people are beginning to do-then we had better identify them one at a time.

I'll skip the lies by omission-his only mention of town hall meetings, for example, was of people who "shared their stories with us" because they are "counting on us to succeed" in passing a health-care bill. Yeah, that's what happened at town hall meetings last month!

And I'll skip the non-health-care lies, like Obama's claim that he merely inherited giant deficits-when his first big legislative campaign was for three quarters of a trillion dollars in new deficit spending. Or his claim that the economic crisis was brought back from the brink "thanks to the bold and decisive action we have taken since January." (Does anybody remember that day in February when the Dow dropped 300 points because Obama's Treasury Secretary gave a speech in which he failed to outline any details of his latest plan? Bold and decisive indeed.) Or Obama's claim that Ted Kennedy was not an advocate of big government.

For now, let's just stick to the speech's seven big lies.

1) Obama's proposal is just minor, incremental tinkering.

The key to Obama's speeches is that he counts on you not to be listening carefully and not to compare what he says from one moment to the next. So while he vows to be the "final" president to reform health-care-indicating that his approach is a sweeping, once-and-for-all overhaul, he then goes on to tell you that everyone else is a radical, but he's just in favor of cautious, incremental tinkering.

There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone. On the right, there are those who argue that we should end the employer-based system and leave individuals to buy health insurance on their own.

I have to say that there are arguments to be made for both approaches. But either one would represent a radical shift that would disrupt the health care most people currently have. Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch. And that is precisely what those of you in Congress have tried to do over the past several months.

Does it take a thousand pages of legislation to not "disrupt one-sixth of our economy"? The reality is that the proposals he advocates would create a vast new bureaucracy from scratch, with sweeping powers to regulate private health-insurance plans-eventually including employer-provided plans-and forcing individual health-insurance plans to be offered on a government-controlled "exchange." It is a plan for the comprehensive restructuring of the health-insurance industry-but Obama wants you to think that he's not really doing anything. Which makes you realize that he doesn't want to you notice or think too hard about what he is doing.

2) Obama's plan is bipartisan.

This is another attempt to deflect scrutiny by claiming that everything he is proposing is safe, bland, anodyne. Thus, his plan "incorporates ideas from many of the people in this room tonight-Democrats and Republicans." Which explains why Obama has so few Republican votes that his allies in Congress are now talking about ramming the bill through, in a dubious parliamentary maneuver, on Democratic votes alone.

Obama's one token concession to Republicans gives you a flavor for his actual "bipartisanship." Citing Republican arguments that curbing excessive medical malpractice awards would help reduce "defensive medicine," i.e., extra tests ordered to avoid a lawsuit, the president offered to authorize "demonstration projects in individual states to test these issues"-an ineffectual, symbolic measure the Bush administration tinkered with because it couldn't get Congress to pass real tort reform.

3) You can keep your existing insurance.

This is the central claim of Obama's speech: "First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have." Notice that this is already a minor change from his previous statements on this issue, in which he made the same assurance for all "private health insurance plans." The change acknowledges the fact that individual plans would be swept into the government "exchange."

But notice that, while claiming he won't change your existing coverage, Obama goes on to detail a whole set of changes to that coverage that will be mandated by government:

What this plan will do is to make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition.... They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses.... And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care.

And notice what each of these regulations would do: it would increase costs for private health-insurance companies. They would have to pay more to cover people with pre-existing conditions; more for people who go over their yearly or lifetime caps, more to make up for the limits on your out-of-pocket expenses, and more for routine checkups. Oh yes, and later on, Obama explains that his bill will be paid for by increased taxes on drug companies and insurance companies.

There is no way to increase all of these costs for the insurers without causing a corresponding increase in health-insurance premiums.

So you can keep your health-insurance-except that its cost will be driven up by all of the regulations imposed by Obama's bill. This is a well-documented phenomenon. In fact, the states in which health-insurance is most expensive-places like New York-are those which have the greatest number of "mandates" dictating benefits that insurers have to provide.

That's why most of us grasp that the "public option" is not really an option, in the long run. Obama's bill is designed to drive up the costs of private insurance, making it even more unaffordable-and thereby herding all of us into a government-managed insurance plan as the only remaining alternative.

And that brings us to the next implausibility in the speech.

4) The "public option" will not be subsidized by government.

President Obama would have us believe that a government-run insurance company would be less expensive than private insurance because it avoids "some of the overhead that gets eaten up at private companies by profits, excessive administrative costs, and executive salaries." Does anyone actually believe this? Obama himself acknowledges that the "public option" leads to less efficiency when it comes to delivering mail. Why should we believe the government is suddenly going to become a model of efficiency in the health-insurance market?

It is obvious what is actually going to happen. Since the whole purpose of the "public option" is to provide a cheaper competitor against private insurance, the government will do whatever is required to ensure that this is the case-including subsidizing the public option.

After all, weren't Fannie Mae and Freddie Mac supposed to be self-supporting enterprises, too? Why should "affordable health-care" end up any differently than "affordable housing"?

5) The health-care bill will pay for itself with cost savings.

The president continues to make a series of false claims about the "savings" that will supposedly come from all of the regulations he is imposing. Thus, for example, it is clear that requiring health-insurance companies to pay for "routine checkups and preventive care, like mammograms and colonoscopies" will increase spending-but Obama claims that this will "save money" because we'll be "catching diseases like breast cancer and colon cancer before they get worse."

This is a demonstrated falsehood. Congressional Budget Director Doug Elmendorf makes this bluntly clear: "Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness."

A related lie: "we've estimated that most of this plan can be paid for by finding savings within the existing health care system-a system that is currently full of waste and abuse," another claim that's been debunked by the CBO.

The far more plausible way to cut Medicare spending is to begin rationing or denying care. And that leads us to Obama's next big lie.

6) There are no death panels.

Obama attacks the "bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Such a charge would be laughable if it weren't so cynical and irresponsible. It is a lie, plain and simple."

But what is Obama's most plausible recommendation for cutting Medicare spending? "[A]n independent commission of doctors and medical experts charged with identifying more waste in the years ahead." How will they identify waste? By deciding which procedures are "cost effective" and should be covered by Medicare-and which procedures are "wasteful" and should not be covered.

Britain's National Health Service already has such a commission, established on precisely the same rationale. They call it the National Institute for Health and Clinical Excellence, known by the Orwellian acronym NICE. It is becoming notorious for rules that deny care to older patients because they don't have enough "quality adjusted life years" left to justify the cost of their treatment.

If you read the British newspapers-and if you're concerned about what greater government control of medicine might look like, you should-then you might have caught the latest development: a letter by a group of distinguished British doctors complaining that the Liverpool Care Pathway, a NICE-endorsed system for determining the care given to severely ill patients, is causing doctors to abandon care for patients who still have a chance of recovery.

If that's not a "death panel," I don't know what is. Yet it is precisely the system Obama advocates to cut costs under his plan.

7) Obama doesn't want a government takeover of medicine.

Here's a tip: when Barack Obama says, "So let me set the record straight," he is about to lie to you about his past. Thus, in rebutting the claim that he wants a "government takeover" of medicine, he assures us that "My guiding principle is, and always has been, that consumers do better when there is choice and competition." So how is it that he was recorded only six years ago describing himself as an advocate of a Canadian style "single payer" system-the very opposite of "choice and competition"?

Hasn't the overall theme of Obama's administration-from the auto bailouts to cap-and-trade-been the relentless expansion of government power at the expense of individual freedom?

During the Jeremiah Wright affair, the American people gave Obama the benefit of the doubt because they couldn't bring themselves to believe that such a respectable, well-spoken man could be such a brazen liar-and because they liked the inspirational, post-racial illusion he presented. They wanted to believe, and that's the kind of audience a sharp operator like him needs.

But now the spell is broken, his audiences are beginning to ask the tough questions-and Obama's credibility will continue to dissolve as his lies are exposed.

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Robert Tracinski writes daily commentary at TIADaily.com. He is the editor of The Intellectual Activist and TIADaily.com.
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