Commentary by Caroline Baum
Sept. 9 (Bloomberg) -- With his job approval ratings slipping and his signature domestic undertaking in trouble, President Barack Obama will attempt to retake the initiative on health-care reform with a televised address to a joint session of Congress this evening.
Obama’s aides have put the word out that the speech will be “prescriptive.” In other words, the president will provide mundane details on how he plans to implement his grand vision of providing universal health care and cutting costs.
Don’t expect a green-eyeshade speech. The Great Chamber from which Obama will address lawmakers and, more importantly, the American people, isn’t a place for a snazzy power-point presentation on budget math.
Rather, the hallowed hall, steeped as it is in the symbols of democracy, is a place where presidents come to appear presidential and appeal to the public. It’s a venue that lends itself to big ideas, national themes and soaring oratory.
So what should the president say or do this evening in his attempt to enlist support for his health-care overhaul?
He could start by explaining the seeming inconsistency in his plan to save money by spending money.
“If I went to my board of directors with a similar proposal for ‘cost reduction,’ they would laugh me out of the conference room -- and then my job!” writes reader Michael Dunlop, vice president of operations/IT at Parts Associates Inc. in Cleveland.
Spend and Save
The Congressional Budget Office estimated the cost of various health-care plans approved by House of Representatives committees at $1 trillion over 10 years. Obama says he will pay for the bulk of the increase in spending by rooting out $500 billion in Medicare waste.
A good-faith deposit would resonate with the public after all the talk: 28 speeches on the subject of health care, or 121 if you include speeches and remarks where Obama mentioned health-care goals, according to political Web site Politico.
What’s preventing Obama from appointing, say, a waste- management czar, now that a position in “green jobs” has opened up, and setting him loose? Ridding Medicare of waste and fraud isn’t dependent on reforming the entire system.
It would be a lot easier to start with cost containment, as outlined by David Walker, former comptroller of the Government Accountability Office and longtime deficit hawk, in a Sept. 4 Wall Street Journal interview. If the U.S. creates “new obligations” before it gets its fiscal house in order, “we’ll have a Thelma and Louise moment where we go over the cliff,” Walker says.
Down Payment on Talk
If the president wants to show he’s serious about containing the costs of expanded benefits, not just expanding both, he should identify and address Medicare waste while the country explores the most effective way to provide health care to the uninsured.
On that score, the country seems to be moving away from the belief that government would do a better job of containing costs than private industry. (No doubt the government’s handling of cash-for-clunkers, with its crashing computer systems and delays in processing rebates, served as prosecution exhibit No. 1.) A special CBS news poll on health care taken Aug. 27-31 showed only 36 percent favor government over insurers -- even after routine vilification of the industry by the Democrats.
Obama has his work cut out for him if he wants to convince the public that government can create efficiencies in health care. One of capitalism’s underlying premises is that incentives -- specifically the profit motive -- encourage companies to compete with one another to produce the goods and services consumers want at prices they’re willing to pay. If not, the business is history.
Not so with government.
Craving Clarity
The CBS poll also found that 67 percent of Americans are confused about health-care reform and 60 percent think the president has failed to explain his plan clearly.
The poll numbers comport with reality on the ground. Lawmakers went home for the August recess to find constituents anxious about change and wary of signing away their current medical benefits and signing on to ObamaCare.
The president is going to have to convince those with health insurance why they will be better off under his plan.
That includes reconciling his promises to individuals with business economics. Obama has reiterated that individuals can keep their current plan. Yet employers may find it’s cheaper to pay a government-imposed penalty than provide coverage.
Substance Abuse
Obama is a gifted orator, but his empty rhetoric is finally catching up with him.
During the campaign, voters projected their fantasies onto the young, attractive and unknown candidate: a community organizer, academic (with no published scholarship to his name) and less-than-one-term senator. Lack of experience was a virtue in a world where Congress offers lifetime employment, not to mention great benefits.
When it comes to governing, form over content will only get you so far.
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