Dear White House, You’re Imperfect, Now Change: Caroline Baum

Dear White House, You’re Imperfect, Now Change: Caroline Baum

Commentary by Caroline Baum

Aug. 12 (Bloomberg) -- The other day I received an e-mail from David Axelrod, President Barack Obama’s senior adviser.

OK, so millions of other people got the same e-mail, which begins “Dear Friend” and ends “Thank you, David.” Not all of them chose to respond.

Axelrod was trying to dispel rumors circulating about “health insurance reform,” to borrow the administration’s new lingo for downplaying the scary stuff -- rationing care, government bureaucrats making decisions that were once the province of doctor and patient -- and aligning itself with a public that ranks insurance companies somewhere between lawyers and lobbyists.

Adopting Axelrod’s tactics, I decided to share my response with millions of others (a few thousand, if I’m lucky). So here goes:

Dear Ax:

I know that’s what Obama calls you, and I hope you don’t mind if I call you that, too. It makes me feel as if I’m part of the inner circle.

Thanks for the e-mail. It grabbed my attention immediately -- but not for the reasons you intended. You started the note by saying, “Anyone that’s watched the news in the past few days.” It’s “anyone WHO’S watched,” not “anyone THAT’S watched.” Where are the White House grammarians and copy editors?

In case you’ve been too busy putting out brush fires at town hall meetings to follow business news, unemployed journalists are a dime a dozen. You could probably pick up some good editors on the cheap.

Women of Substance

Moving along to matters of substance, I watched the videos on the White House’s “Health Insurance Reform Reality Check” Web site. That was a great touch, using women to narrate four of the six infomercials. It’s the women in this country who minister to sick children, care for aging parents and provide emotional support for the family.

If serious women talking in that soft-soothing NPR voice tell us Obama’s plan is A-OK, who are we to disagree?

I am hoping to attend a town hall meeting in my area and do some first-hand reporting so I can “separate fact from fiction,” as you say in your e-mail. Would you mind asking your congressional liaison officer to send me a schedule of upcoming town halls in the New York metropolitan area? Better yet, just post it on the Web site so all interested Americans can attend.

Look, Americans want health-care reform. Most of us would prefer a medical insurance policy that belongs to us, not something that is conditional on employment. I bet most of us want to help the needy upgrade from emergency-room care.

‘Health-Care Wedge’

Ax, what the public doesn’t like or want is a one-sided government plan with a government option crammed down our throats.

There are plenty of alternative ideas out there for health- care reform. Check out the Cato Institute’s health-care Web site for some free-market solutions, such as allowing individuals to choose a plan that suits them and that offers the same tax treatment as employer-provided benefits.

The biggest problem with the current system -- something your plan does nothing to address -- is the incentives are bollixed up. When consumers of health care are divorced from the cost, you can’t expect to save money through competition.

It’s what economist Art Laffer calls the “health-care wedge,” or the difference between what medical care costs and what the patient pays. Unless you create an incentive for consumers to comparison shop for a health-care plan and provider the way they do when they buy a car, you’re still at square one.

Do the Math

The public isn’t as stupid as you think. Right-wing extremists are as offensive to most Americans as left-wing thugs. So stop making this about what the other side is doing to disrupt your agenda.

Start explaining how you plan to insure a big chunk of the 46 million uninsured, provide better care and cut costs.

You can’t? Then quit while you’re ahead. No one believes your math, not the average Joe, not the Congressional Budget Office, not President Obama. It feels as if you’re trying to sell us a bill of goods.

Take the issue of a public option. How can the private insurance industry survive with a not-for-profit government plan charging a pittance? You call this competition. I call this monopoly, and I’m not talking board game!

And who’s going to subsidize those low premiums? We’ve got that one figured out, too.

Please don’t insult our intelligence by claiming that, “if you like your insurance, you get to keep it.” There will be no private insurance left to keep.

Beyond Health Care

And here’s another thing: Tell the president to stop making the ridiculous assertion that your plan is essential for economic growth. As New York Times columnist David Brooksnoted on PBS’s NewsHour last week, major policy reforms tend to take place during times of fast economic growth, not during recession or times of high public anxiety.

The CBO says the various House and Senate plans don’t save money. In fact, they will cost about $1 trillion over the next 10 years. Guess where that money comes from?

Watching some clips from town hall meetings, I got the sense that health care, while the catalytic agent for public rage, is becoming a sidebar. The public is angry at the way things are done in Washington, angry at those they elected to do the people’s business and who do their own, and angry at your administration for promising to change the culture and adapting to it instead.

Ax, here’s my advice in a nutshell. Leave “fast-track” for trade bills. Put health insurance reform on slow speed.

I look forward to hearing from you soon.

Your friend,

Caroline