On Obama’s health care reform speech

September 10, 2009 on 9:40 am | In culture, ethics, health, politics | 6 Comments

Last night, President Barack Obama delivered a speech to a joint session of Congress with a boldness and clarity that I think has been lacking since the end of his campaign.  His address laid out his proposals for health care reform in clear, concise language. He clobbered the atrocious lies and distortions that have been spread in the media lately as well as the anti-reform ideologues that started them. He also achieved the important goal of framing health care reform as a moral issue, and as a fundamental economic security issue:

“Put simply, our health care problem is our deficit problem. Nothing else even comes close.”
                                            -President Barack Obama

The address was also masterful political theater, clearly crafted to assert the President’s authority before the assembled chambers of Congress on the issue which may define his presidency.  Even reform opponents played their part in the spectacle: at a moment in his speech when Obama clearly asserted that his health care proposals would explicitly exclude coverage for undocumented immigrants, the traditionally quiet decorum of the event was punctuated by South Carolina Republican Rep. Joe Wilson, who loudly shouted “You lie!” at the president. President Obama could not have illustrated the vapid thoughtlessness of health care reform’s enemies any better than that.

Now, while I certainly found much to commend in the president’s speech, it wasn’t all rainbows and whiskey.  As a progressive who favors a single-payer health care system, I can’t say that I agree with all of President Obama’s proposals.  In particular, I feel that private, for-profit health insurance companies represent a fundamental conflict of interest between investors’ expectation of profit and patients’ need for medical care.  Obama is pushing for new laws that will limit insurance companies’ strategies to maximize their profit, which appears to be a nuanced, measured compromise — but in practice, it will be the federal government that bears the burden of enforcing these laws, and that means it will take time for insurance companies to comply with the new laws. We can nearly rest assured that their compliance will be grudging and constantly in search of loopholes. Put simply, the new laws Obama proposed would not fully resolve that fundamental conflict of interest.  I realize that Obama’s proposals are a political and practical solution rather than an ideal one, and I encourage everyone to support any legislation that accomplishes the goals he set.  My criticism is only meant to serve as a reminder that the fight for equity, fairness, compassion, and justice in the U.S. health system will not end with the passage of health care reform. I think that Bad Astronomer Phil Plait expressed a similar point regarding Obama’s education speech on Tuesday very well, and with all due tribute, I will repost the image here that he used to do so: