OP-ED

Obama & Company

Millenson_122k_3 The late great newspaper columnist Mike Royko suggested that Chicago’s motto be changed from “Urbs in Horto” (“City in a Garden”) to “Ubi Est Mea” (“Where’s Mine?”). Unfortunately, Barack Obama and his Chicago political brain trust remembered this basic lesson when it came to cutting deals with Congress, but completely forgot it when communicating with actual members of the public on health care reform.

As a result, the fragile flower of reform may not have been completely plucked, but the manure dumped on it in Massachusetts was not meant as fertilizer.

Throughout this process, Obama and his Chicago-bred advisers have been intent on avoiding the mistakes that sunk reform during the Clinton administration. But their diagnosis was flawed. Yes, Bill and Hillary stiff-armed both the special interests and their Republican opponents, falsely believing that public opinion polls showing widespread support immunized them from the insidious need for compromise. But while the Obama administration cut early deals with doctors, hospitals, insurers and the pharmaceutical companies, attempts to bring moderate Republicans into the fold conspicuously failed.

When the inevitable counter-attack on reform emerged, it made the infamous “Harry and Louise” ads of the early 1990s look like a C-SPAN broadcast of a CPA convention.

It shouldn’t have a surprise: within just a few weeks of Obama taking office last year, opponents of provisions in the stimulus bill funding government research comparing the effectiveness of various medical interventions compared the effort to Nazi euthanasia policies What was surprising is that the Obama administration failed to realize that the campaign of deliberate distortions that successfully alienated the American public from the Clinton plan needed to be countered with plain-talking to the American public — as White House press secretary Robert Gibbs belatedly acknowledged only after the Massachusetts senate debacle was clear.

Put aside for a moment the analysis about widespread voter anger and look specifically at health care. Americans don’t hate big government; they hate big government when it’s not bestowing benefits on them. Asked by the Kaiser Family Foundation Tracking Poll whether they thought Congress passing health care reform would make them or their own family better off, worse off or have no effect, the number saying “Better off” stayed relatively stable, rising slightly from 38 percent in February, 2009 to 42 percent in November. But the percentage saying “worse off” soared from only 11 percent in February to 31 percent by last summer, declining slightly to 24 percent by November. Most of those who started off saying “no difference” defected to the “worse off” side.

Moreover, when you break down the numbers by party affiliation, the number of Republicans saying “worse off” started at only 22 percent — a surprisingly bipartisan beginning – before jumping to 61 percent by summer and nudging down to 54 percent by November. Just 11 percent of the critical independents, meanwhile, began by thinking that health care reform would make them worse off, but that percentage more than tripled by summer to 36 percent, before dropping to 29 percent in November. Even Democratic discontent, while modest, still went from a mere 3 percent to 11 percent in summer, before dropping to 7 percent.

Those numbers track my personal experience talking with many friends and neighbors in Chicago about the reform bill. They are confused and scared about warnings on cost, cost and more cost , yet seem ignorant of reform provisions that would actually save them money. So, for example, a well-read lawyer friend ranted about the way the health insurance benefits at his small family firm would be taxed as a “Cadillac plan” because illness by a few members had driven up the premiums. When I pointed out that the ban on pre-existing conditions could actually drive down his premiums so that he wouldn’t be paying so much money for a little bit of bad luck, he was completely dumbfounded; the thought had never occurred to him.

The poll results are even more disconcerting when you realize that they come at a time when one-seventh of the nation has no health insurance, many more have inadequate policies and unemployment remains high. In Massachusetts, however, with its universal coverage, even that thin veneer of “Where’s mine?” support for Obama’s plan disappears. Massachusetts voters are already paying taxes for universal coverage at home. Why subsidize “big government” that’s not giving anything to me?

In the movie, “The Untouchables,” federal agent Jim Malone famously explains how you bring down Al Capone and his gang: “They pull a knife, you pull a gun. He sends one of yours to the hospital, you send one of his to the morgue. That’s the Chicago way!”

The Republican right-wing pulled out the knives, guns and the lead pipe connected to the kitchen sink. The Democrats retaliated with Martha Coakley. Obama and the Democrats can either love their enemies like, say, one-term president Jimmy Carter, or they can practice the Chicago Way.

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PeterGary LampmanjdrbarNate Recent comment authors
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Nate
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Nate

with no penalty and lasted no more then a couple years

Nate
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Nate

not all time must be spent effectivly. Liberal dogma is like a first person shooter video game, come here blow up some lefty whack jobs for an hour then back to reality. Social inteligence and grace are highly overrated, I prefer my praticle inteligence any day. My outburst are very well targeted I might add, only people making inaccurate assumptions or passing propoganda as fact get nailed. For example, not knowing what I do for a living you shouldn’t have assumed I was an insurance broker and then proceed to disparage me based on your assumptions of insurance brokers. Then… Read more »

rbar
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rbar

Nate, If you want to advertise for your business that “blows up the status quo” – whatever it actually is – it would help if you described what you are actually offering. The only conclusion that is reasonable based on the 30+ of your posts that I have read is that you are a person with knowledge of the insurance industry spending quite a bit of time commenting on this blog, but unfortunately lacking sufficient social intelligence and grace to avoid outbursts like the one you just hastily typed, which unfortunately ends up nullifying your entire commenting effort … you… Read more »

Nate
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Nate

“and you seem to be more interested in preserving the status quo than fight for possible alternatives.”
Being unpopular I now know no one cares, but in light of my profession this is a supremly ironic statement. My career and business is built on blowing up the status quo. My entire sales pitch is individuals and companies breaking the mold and exiting the status quo.
Apparently I have been so successful, where’s the payoff, that I am now the status quo? The insurection has become the establishment, I would have expected to notice when it happened.

Nate
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Nate

rbar, seeing as how I am not a broker I don’t feel I can answer your question in the way you had hoped. Nor can I imagine what healthcare experience you have that would begin to compare to mine. Maybe if you would pay more attention to what I do you could frame these request properly???? Prior to a number of them being made illegal a sizeable reduction in premium for living a healthy life is the most obvious. This applies to both group and individual plans. Now that “underwriting” is illegal other methods must be found. Charitable contributions to… Read more »

rbar
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rbar

Nate, Your comments seems much more idealistic than mine, and mine, by the way, are supported by actual health care experience, not insurance brokering (you overestimate your popularity when you assume that everyone knows or is even interested what exactly you do for a living). Tell me exactly 1) how do you/the companies you represent can offer financial incentives to persons with a healthy lifestyle – I am truly interested in financial incentives for healthy living. 2) financial incentives for healthy living was NOT your argument – you talked about guaranteed access to subsidized insurance “breaking the bank”. If you… Read more »

Peter
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Peter

“Americans don’t hate big government; they hate big government when it’s not bestowing benefits on them.”
Another fact, Americans actually like taxes, just other peoples.

Nate
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Nate

Gary does that include all those enrolled in Medicare and Medicaid? only 25% of the population, maybe less is insured by insurance companies. Not sure what you would accomplish i that minority all dropped coverage

Gary Lampman
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Gary Lampman

What would Happen if the majority of Americans told Insurance Companies to get screwed.Everyone drop Insurance and stop the entitlement payments. I don’t know this to be true ,but I bet, some large scaling back would appear in the Industry.
It is an illusion of Insurance,that they are in control of our Health.They are permitted this hold on us only because their members fear the consequences. I think that fear is a much greater motivator than money. Money has always been insurance Crutch.

jd
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jd

Oh, and I fully agree with the main thrust of this post. It is remarkable how much bipartisanship-seeking still emanates from Democratic party moderates, when their opponents essentially want to eliminate them and undermine any efforts to govern. As the recent example in Alabama shows, even conversion to being a Republican isn’t enough.
I can’t tell yet whether I like Alan Grayson (D FL) or whether he is ultimately a good tactician, but one thing is clear: the man knows how to take the fight to the enemy.

Nate
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Nate

oh….and Matt started it

Nate
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Nate

this jd is where us evil free marketers can save the day if left alone to do our job.
Individuals are willing to change their behavior today for a polutry sum of $x.
The long term savings of those changes are significant, say $y.
If only there was some way to fund x wih the promised return of y….

jd
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jd

It’s OK, Nate. We lost hope with you and the right a while ago. That said, when you don’t stray from the mechanics of insurance and launch into the blame game, as I’ve said before, you often have good insights. You are certainly right that a few bucks now is better able to trigger action for many people than the prospect of even a few years of life in the distant future. Sad, but true. It doesn’t have anything to do with being specifically “money motivated,” though. To use decision theory jargon, it has to do with time discounting of… Read more »

Nate
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Nate

wow rbar expected better of you, I’m really losing hope with the entire left this year. For starters before you start arguments with what I do you might want to actually get a clue what I do. Lessons the chance you end up looking like an idiot. In my “profession” I actually target the sickest of the sick. Healthy groups that have low insurance premiums aren’t usually interested in my services. Sick groups paying an arm and leg on the other hand are much more receptive to my solutions. The rest of your argument was just as inteligent and factual… Read more »

rbar
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rbar

Nate, That’s exactly the problem with your profession: you want to sell insurance to healthy people and avoid any losses … and then you seriously complain about medicare costs, a third party payor that covers people who are actually sick and need health care services big time. “The other is with guaranteed access to subsidized insurance why take care of yourself, they have removed any financial reward for healthy living.” I don’t think you seriously believe that. Show me the Americans who live healthy for financial reasons. The healthy lifestyle people tend to be educated and affluent, while the sedentary… Read more »