Health Care Reform: Debating the Public Option

After months of debate in the House and Senate over health reform, what is left to debate? The public options, of course.

The Public Option
The public option seems to be finally out of the bill. The House passed the Democrat-backed option. The Senate seems likely to drop it to get some bill to the floor for a vote.

I like the idea of a public option as competition between the private and public sectors. Many Republicans and some Democrats say it’s a bad idea. But what about the examples of the “public option” that are offered today:

• Medicare for elders
• Health care for members of the House and Senate
• Health care for our armed forces

The irony of the Opposition
How many Representatives and Senators who are firmly opposed to you and me having a public option would voluntarily opt out of their public option and buy private insurance on the open market? When they put their personal health care on the line, maybe I’ll listen to their whining and talking points about the evils of public health care.

If it’s good enough for our Troops, isn’t it good enough for you and me?
Our brave men and women fighting overseas and supporting the effort worldwide get their health care from this same federal government. They have federally operated hospitals with doctors and nurses on the federal payroll. So, if it’s good enough for our brave troops, why is it bad for us?

But what will the reality be like?
The only problems with any health care program, be it private or public, are the complexity, the confusion, the paperwork, and the bureaucracy. I have to deal with Medicare and Medicaid as my mother is in a nursing home. It’s baffling and there’s no one to lead you through the maze of bureaucracy. So, my only fear with a public option is the same level of complexity that will make even its most ardent supporters cry for something easier.

So, would a public option be what we need to counter the money-making insurance companies? Is it inherently flawed? Or, is a good idea in theory, but once it makes it through the House and Senate. would it be so complex and full of red tape as to be not worth it?

Obama’s Nobel Prize Speech Pleases No One

Few were happy with President Obama’s speech after receiving the Nobel Prize for Peace in Olso this week. It was the Peace Prize he won, but his speech certainly did not ring of “Let’s give peace a chance.” Rather, at times, it sounded more like a war speech and not a peace speech.

He reminded the audience in City Hall in Oslo that the United States is still in two wars. Just days before he announced his intentions to send 30,000 more troops to Afghanistan. He even touched on echoes of the Bush/Cheney doctrine of a “special role” for the US along with its justifications for the US to take pre-emptive acts. At times, it sounded like he was formulating an Obama Just War Theory. He argued that evil exist in the world and that, at times, nations must take up arms to defeat this evil.

View from the Left
Those are the left were not so pleased with this position. Protesters in Oslo carried banners saying “You’ve won it, now earn it.” Many had hope that Obama would have started bringing troops home from both Iraq and Afghanistan by now. Others, including myself (see blog post), questioned giving Obama the Peace Prize without a track record to earn it.

Some commentators on the left (like Daniel Schorr on NPR and the New York Times editorial) thought his more balanced evaluation of the realities of international relations and even that his speech was elegant.

But is it just me, or does this thought pass your mind: it's like a minor "slap in the face" to your hosts to accept a peace prize while expounding theories of just wars?

View from the Right
I am sure this speech gained no traction with the right. Those who admire Sarah Palin or listen to Rush Limbaugh or agree with the ideas espoused by the “tea party” activists – most of these every day folks who are conservative thinking simply don’t trust Obama. From the right, Obama does not respect our country; he does not love America. And nothing he may say is likely to ever change their view.

Why Alienate Everyone?
Obama is an intellectual, a nerd if you will. As a fellow nerd, I can understand how he wants to intellectually balance all the input he has received on matters of war and peace. Having balanced all these conflicting viewpoints, he as formulated his own middle path that meanders through the issues, sometimes leaning right and sometimes leaning left. And often departing from previously stated positions, as I suspect he (like I) get a certain intellectual pleasure of coming down on a position that would have been unexpected before hand.

In short, before Obama was a liberal, he was a nerd. And this is what you’ll get from a president who is a nerd: a policy that, while intellectually sound, can baffle most of the people and please almost no one.

Slow Closure for Prisons That Detain Suspected Terrorists

Despite President Obama’s commitment to close prisons holding detainees suspected to be terrorists, the closure of such facilities is coming along quite slowly. Under the Bush Administration, detaining suspected terrorists without charges was par for the course. The hope was that under an Obama Administration, these facilities would be expeditiously closed. But, closures have been slow coming.

The closures were hoped to end the practices that violated the international standards of human rights and much of what the US stands for as a land of freedom and due process of law. The torture and abuse of prisons in Abu Ghraib prison in Iraq was well documented. Also infamous was the practice of “outsourcing” detention and torture known as extraordinary rendition. But lesser known cases of abuse and torture occurred in other military detention facilities such as Camp Bucca in Iraq, which finally closed in September 2009.

Still, other detention facilities remain open. One of the unresolved issues involves where to move the most dangerous of the suspects.

Granted, individuals suspected of being terrorists or plotting acts of terrorism, or supporting known terrorists, should be detained. It’s the practice of rounding up anyone who might be a terrorist that violates the spirit of law and due process.

As long as America still operates these facilities, we are not the nation founded on basic human rights that we proclaim to be.

Health Care Reform?

Well, the House of Representatives has passed a health reform bill (HR 3962) by a slim vote of 220-215. At this point, I don't know whether it's real reform, or just the culmination of political grandstanding by both parties and President Obama.

The Vote

The Democrats voted 219-39 while the Republicans were 1-176, with Rep. Joe Cao of Louisiana casting the lone “yeah” vote. Not exactly a resounding vote. Nearly 1/5 of Democrats voted against the bill. And it seems a lot of the moderate "pro-life" Democrat votes were "bought" by allowing them to vote "yeah" on an amendment prohibiting paying for abortions in the public option or in the insurance exchange pools. In all, it seems to me that everyone was voting with one eye on the 2010 midterm elections.

The Democrats want to report they gave the people health care reform. The moderate to conservative Democrats get a favorable "pro-life" check mark on their scorecard so the remain elegible for the litmus-test voters.

And the Republicans can say they did all they can to oppose socialist healthcare.

What's Still Baffling about the Republican Position

I'm still baffled about Republican mantra that this is a "government take-over" of health care. There is a public option, but that remains an option.

Clearly, the words "government take-over" are fighting words for conservatives. Clearly, politicians favor slogans and getting the base energized by charged slogans over a fare discussion of the pros and cons.

Between this tactic and the screaming opponents at the town hall meetings, it seems to me the Republicans don't like the essence of democracy: a fair and open discussion of the issues!

We also need to call out the Republicans on this: if government-run healthcare is so bad, why do the Republican representatives and senators accept it?

I don't think any bill the Democrats have proposed has been anything near perfect. Still, I think we have to call out the Republicans as being obstructionists in the public debate.

Republican Proposals

The Republican proposals, to counter the Democrat's bill, have read like the pile of scrap wood from the RNC party planks. Start with tort reform (limit those rare, but big settlements), throw in some enhanced competition among insurance companies, but leave the reality of many remaining uninsured. (After all, being uninsured is something you should be free to be.)

A Couple of Good Things to Say

It does appear that the new proposal will increase the number of people insured. And it does address the issue of denial of coverage to those with "pre-existing conditions." As someone with a "pre-existing condition" that precludes me from getting certain insurance coverage, I feel strongly about this aspect of reform.

The Mess We're In

The more I look at it, the best we can expect is to tack on a few modifications to the existing healthcare system. Perhaps, system is too kind a word. Some people have employee-provided insurance, some have government-provided insurance (Medicare, Medicaid), a few buy it, and many are uninsured.

Just as the "system" is so complex, the solutions only add to the complexity. There is no clear vission of a simpler, more understandable system. Instead, we're adding some additions to a structure built on a shaky foundation and with a questionable structural integrity. As an engineer, it doesn't appear to be a sound proposal.

Competent Person Appointed FEMA Deputy Administrator

Why is this news? Shouldn’t that be the norm?

Well, remember “Heck of a job Brownie” and the failed levees flooding most of New Orleans? (See photo at right to refresh your memory.) FEMA (Federal Emergency Management Agency) Administrator Michael D. Brown’s “qualifications” included judging Arabian horses. No real understanding of the work of first responders or what emergency preparedness means. FEMA’s response was slow as thousands were left homeless.

Contrast that with Richard Serino, now the Deputy Administrator of FEMA whose background includes 36 years with Boston Emergency Medical Services (EMS), much of the time as the EMS chief. Here’s someone who has an intimate knowledge of the work of first responders. Someone who knows what it takes to be prepared for any type of emergency, even when one least expects it.

So, what about that Pres. Obama, appointing competent professionals to important government posts!

I’m an engineer, and in my profession, you can’t make if you’re incompetent. Engineers can quickly tell who knows what they’re doing and who doesn’t. Unlike politics and business, where a smile, a strong personality and always having something to say can make up for competence, in engineering, you can’t fool the laws of nature! So, I have a problem with any politician who appoints incompetent cronies.

So, I’m delighted to see competent individuals, like Richard Serino, appointed to important posts.

Obama Wins Nobel Peace Award! (But Why?)

So President Barack Obama has won the Nobel Peace Prize. But the first reaction of many is to ask “Why?”

While I appreciate their consideration of our new president, I think the popular response in America is “He hasn’t done anything yet!”

Supporters and opponents of the president alike are equally surprised and a bid dumfounded.

But this award shows the dichotomy of perception of Obama here in America vs. abroad. In Europe and elsewhere, Obama’s election as president was seen as a welcome change, a new dawn, a sea change in America’s attitude and policy on the international stage. Thus, it is no surprise that in Europe this award is highly lauded.

Still, in the US, even those who support Obama think it’s premature. Others note that the war is ongoing in Iraq and there is not troupe reduction there. And in Afghanistan, many point to the irony of a peace award given to a leader pondering a troupe build-up. In addition, Guantanamo still holds unindicted prisoners and Obama supports renewing key provisions of the Patriot Act.

An interesting sidebar: Republicans and the Taliban are equally critical of awarding the prize to Obama.

So why did Obama win? To me, the award is based on a perception abroad that Obama’s election represents a major sea change in American attitude and policy on international affairs. And, in some circles, international diplomacy being one, perception is reality. For many, it’s not the facts, it’s the attitude or the words.

But still, wouldn’t you feel better if it was someone or a group, maybe not well known to the rest of the world, working for years to bring justice and peace in their land?

The Shout in the House

On Tuesday, U.S. Rep. Joe Wilson was formally rebuked on Tuesday by a vote in the US House of Representatives. No matter what else he does in life, Rep. Wilson will always be know for shouting "You lie!" during Obama's speech to Congress on September 9th.

While I don't agree with Rep. Wilson's views on health care reform, I don't think a Congressional rebuke was necessary.

I think of his shout as an analog "micro-tweet." It was more an interjection than an interruption. Unlike the protesters at some of the recent town hall meetings, the representative did not prevent the President from finishing his speech. He merely interjected a two-word tweet.

And it doesn’t stand up to fact checking.

So, I’d leave it at that.

Sure, it was rude. Sure, a grade school kid would know better. And I and most rational folks wouldn’t want to set a precedent of encouraging anyone to interrupt a speech because of a difference of opinion.

But he knows what he did. He apologized to the President. His actions have been judged in the court of public opinion (not to mention the late night comedy circuit).

Most think he was out of line. A minority applaud him. These are folks who don’t like the Obama Administration and like the idea of someone “putting to him." I say the rebuke only makes him more a martyr for their cause. The rebuke may be counterproductive and energize the opposition to reform.

Most importantly, the whole issue of the shout and rebuke is a major distraction from the debate over the important details of reform.

So, let’s put the Shout in the House in the past and let's get on with a civil discourse where all opinions are heard on this important topic of reforming health care!