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Right now, Barack Obama is in a world of hurt stemming from self-inflicted wounds as well as circumstances. His base has turned against him due to the watered-down, compromised-away health care legislation -- that now might become a bill that goes down to defeat. Meanwhile, it looks like the Copenhagen world summit on climate change has had a breakdown in negotiations, and that there will be no deal or treaty issued from there. Obama was looking for two big wins in these issues; instead, the record of 2009 may record these two big failures.
Also, the handling of H1N1 flu has been a debacle and a comedy of errors. Who is wearing the pants at the federal government? Well, on H1N1, incompetence wears the pants. On health care, the insurance industry wears the pants. On drug importation, the pharmaceutical industry wears the pants. And TIME magazine just named Ben Bernanke its Man of the Year. Obama's 2009 will be remembered by two phrases, "cash for clunkers" and "cash for caulkers," and for rising joblessness.
For escalating the Afghanistan conflict, I'm ready to nickname him "President Quagmire." International Human Rights Day came and went. Obama did not remove land mines, cluster bombs, and depleted uranium weapons from the U.S. arsenal. Instead, he defended the status quo with a neoconservative speech in Oslo, Norway, where he received the oddly-named Nobel Peace Prize.
Enough about his failures. Right now, health care reform is on the ropes. Does he have a plausible pathway to achieve success -- to snatch victory from the jaws of defeat? Well, yes, but the reason why Obama fails is because he has never yet heeded advice that comes from my quarter. Yes, I will discuss how to turn things around, but Obama will continue to fail as long as he continues to discount my advice.
Obama could (and in my view, should) immediately pledge to veto all corporate welfare bills. Period. This would reunite him with his base against the health care bill in its current form. The bill has become unpalatable because it is corporate welfare, and it include the noxious individual mandate which is a demerit to lay at the feet of Nancy Pelosi. To rescue the bill, remove the Pelosi mandate and insert the Kusumi health plan.
The Kusumi health plan is simple: No new bureaucracies. Just add $100 billion annually into Medicaid, permitting that system to raise the threshold amount of income that a household can earn while still being eligible for Medicaid. Consider: What is the whole purpose of Medicaid? It's there for poor people. Instead of making a new system of new bureaucracies, what if we simply fixed the existing one and allowed Medicaid to serve the purpose for which it is ostensibly there? Let's tell Medicaid to "do its job." And the prescription drug plan that exists in Medicare can and should be ported over to also serve those on Medicaid.
Along with the above, a health reform bill should include the insurance reform that's already been discussed this year. If the bill basically says, "No price - nor coverage - discrimination for sick people and those with pre-existing medical conditions," that simple rule would stop insurers from denying coverage and/or jacking up rates for people with pre-existing conditions and for those with coverage when illness strikes.
If the above does not sufficiently bend the cost curve for national outlays on health care, then proceed with more insurance reform that caps gouging. The bill could basically say, "Co-pays may not exceed $200 per month ($2,400 per year) per person, and deductibles may not exceed 10% of the patient's actual household income in the year prior to buying the policy. For whatever reason, patients may not be burdened beyond the basic premium and the amounts implied above."
That latter piece of the puzzle is likely to be resisted by the industry, because it seems to cap their revenue or expense offsets. But it's actually not a premium cap, it's just a dirty tricks cap. The above paragraph does not limit what premiums they can charge. My proposal is actually not a price cap. The invisible hand of free market forces will limit premiums to those which the market will bear.
In four paragraphs, I have explained the Kusumi health plan. Yes, it is real reform. No, it does not include the noxious Pelosi mandate. And no, it is not single payer universal health care. Therefore, the private sector insurance industry will continue to exist in a free market system. This is reform, but it is not an existential threat to the insurance industry.
Q.E.D.. A good reform is still possible, but right now is the eleventh hour for Barack Obama, who never takes any of my advice. ;)
