Honesty Option for Health Care

The debate is heading for rock bottom.

"If you like your plan," Barack Obama promises for the umpteenth time in the Rose Garden yesterday, "you'll be able to keep it. And each bill provides for a public option that will keep insurance companies honest, ensuring the competition necessary to make coverage affordable."

At tonight's press conference, will someone please ask the President why, half a century after handing over health care to profit-making private insurers, it should be necessary now to keep them "honest"?

Meanwhile, the industry that gave Americans one of the worst medical systems in the world at the highest cost is busy lobbying for more of the same with the legislative watchdogs like Sen. Max Baucus, who are negotiating the details of how to reform their ways.

In the House, we are in Joe the Plumber territory, as Democrats propose to pay premiums for the poor by taxing the very wealthy, couples making $500,000 a year or, as Nancy Pelosi is now hinting, perhaps $1 million.

This would affect only a tiny fraction of the richest Americans but, in their Joe-the-Plumber fantasies, the working class can empathize with Republican outcries. "Tax is a four-letter word" with voters, says conservative Democratic Sen. Ben Nelson, pointing out that even families not in the top 1 percent "hope they're going to be there someday."

In the Wall Street Journal, one of the last rising Republican stars still standing, Bobby Jindal accuses Obama of a "fundamentally dishonest approach to reform," contending that "Democrats disingenuously argue their reforms will not diminish the quality of our health care even as government involvement in the delivery of that health care increases massively.

"For all of us who have seen the Federal Emergency Management Agency’s response to hurricanes, this contention is laughable on its face. When government bureaucracies drive the delivery of services--in this case inserting themselves between health-care providers and their patients--quality degradation will surely come."

When the GOP sinks to using Bush's Heckuva-Job Brownie to beat up on Democratic health care plans, the debate must be nearing low tide.

The Politics of Attention Deficit Disorder

Six months of scrambling on all fronts--bank bailouts, economic stimulus, climate change--have brought the President lower approval ratings from a public suffering from crisis overload and left him needing a Hail Mary pass to score on his key issue.

"With skepticism about the president's health-care reform effort mounting on Capitol Hill--even within his own party," the Washington Post reports, "the White House has launched a new phase of its strategy designed to dramatically increase public pressure on Congress: all Obama, all the time.

"Senior White House aides promise 'an aggressive public and private schedule' for Obama as he presses his case for reform, including a prime-time news conference on Wednesday, a trip to Cleveland, and heavy use of Internet video to broadcast his message beyond the reach of the traditional media."

This test of presidential clout, coming up on a complex issue against the background of other trillion-dollar commitments that have still to bear fruit, leaves him exposed not only to Republicans with their simple-minded message of tax phobia and deficit fear but increasing anxiety among 2010-vulnerable Democrats who now sense a potential lack of visible progress on all fronts by next fall to keep them in office.

In this kind of ADD political climate, health care legislation lends itself to demagogues' cover on all sides, with providers "promising" non-binding new efforts to cut costs as Republicans line up with Senate Finance Chairman Max Baucus to "back" a future public option for health insurance with trigger mechanisms that will never be pulled off.

This leaves the President having to resist the temptation to settle for small gains that can be claimed as victory but will leave the failed health-care system fundamentally unchanged.

As he embarks on this week's campaign, to get him into "Win one for the Gipper" mode, he may want to take to heart Ted Kennedy's valedictory in Newsweek, "The Cause of My Life," which retells the medical consequences from generations of the "Kennedy curse" and makes a passionate plea for universal health care now.