Over the coming weeks, Americans will find out whether the man they elected their president is just a great orator and politician or whether he is also a great leader.
Of the central features of candidate Barack Obama's health care proposal, he said one thing was essential -- a public insurance option to compete with the private insurance industry that is now dominated by a cartel of Wall Street-driven, for-profit behemoths. Another thing Obama said he would not support -- a requirement that all of us be forced by law to buy overpriced health coverage from private insurance companies.
Many of the people who voted for Obama did so because they believed his health care proposal was the best among the field of Democratic candidates and -- no contest here -- far better than the insurance industry-backed plans advocated by the Republicans.
Obama was not alone in calling for a public insurance option. So did Hillary Clinton, among others. About the only thing that distinguished Obama's plan from Clinton's, in fact, was his opposition to forcing all of us to buy health insurance. "Why should we force people to buy something they can't afford?" he asked repeatedly on the campaign trail.
After listening to the speeches he made in Montana and Arizona and to comments made by Health and Human Services Secretary Kathleen Sebelius and Obama's press secretary, Robert Gibbs, on the Sunday morning talk shows, I'm wondering what happened to the guy Americans elected.
Having worked in the health insurance industry for nearly 20 years, I know Obama and Clinton were right in insisting that a public health insurance plan is vital to reform. A public plan not only will serve to "keep the private insurers honest," as Obama used to say before he started waffling, but it will also provide millions of people who now have no insurance at all with good coverage at a more affordable price. That's because the big for-profit insurers waste increasingly big chunks of your premium dollars on nonessential things like exorbitant CEO salaries and profits for the big institutional investors who own them. A public plan would not waste your precious dollars that way.
But unless I missed it -- and I even read the transcript of his comments to make sure I didn't -- Obama never even mentioned the public insurance option in his opening remarks in Montana, where he stood just a few feet away from one of the insurance industry's biggest friends in Congress, Senator Max Baucus.
The president finally seemed obligated to mention it in the Q&A session. In response to a question from a man who lost his insurance when he lost his job, Obama said this of the public insurance option, using language that would make you think some well-meaning but naïve freshman congressman just recently came up with the idea:
And one of the options that's being debated is, should there be a public option, all right? (Applause.) And I want to -- I want to just explain this briefly, because this is where the whole myth of a government takeover of health care comes from. And not everybody -- not even every Democrat -- agrees on the public option, but I just want at least people to be informed about what the debate is about.
The idea is, if you go to that marketplace and you're choosing from a bunch of different options, should one of the options be a government-run plan that still charges you premiums? You still have to pay for it just like private insurance, but government would not -- this government option would not have the same profit motive. It would be obviously like a non-for-profit. It would have potentially lower overhead, so it might be able to give you a better deal, should you be able to choose from that option among many others. That's what the debate is about. (Applause.)
Now, what the opponents of a public option will argue is, you can't have a level playing field; if government gets into the business of providing health insurance, they will drive private insurers out of the health insurance market. That's the argument that's made. (Applause.) And I -- that is a legitimate, it's a fair concern, especially if the public option was being subsidized by taxpayers, right? I mean, if they didn't -- if they could just keep on losing money and still stay in business, after a while they would run everybody else out. And that's why any discussion of a public option has said that it's got to pay for itself, it's not subsidized by private insurers.
I don't know about you, but to me that sounds an awful lot like a guy who is trying to talk himself -- and us -- out of the best idea he and many others in the Democratic party have come up with to reform our badly broken, profit-driven health care system.
Less than 48 hours after setting us up for his soon-to-be-even-more-obvious capitulation to the demands of the insurance industry, the New York Times reported in its online edition that the Obama administration had begun sending signals "that it has backed away from its once-firm vision of a government organization to provide for the nation's 50 million uninsured and is now open to using nonprofit cooperatives instead."
Secretary Kathleen Sebelius said on Sunday morning that an additional government insurer is "not the essential element" of the administration's plan to overhaul the country's health care system. "I think there will be a competitor to private insurers," she said on CNN's State of the Union. "That's really the essential part, is you don't turn over the whole new marketplace to private insurance companies and trust them to do the right thing. We need some choices, we need some competition."
Her less-than-forceful insistence on a government insurance organization was paralleled by Robert Gibbs, the president's press secretary. "What I am saying is the bottom line for this for the president is, what we have to have is choice and competition in the insurance market," he said on CBS's Face the Nation.
Not only is Obama clearly ready to throw the public option overboard, he is embracing the requirement that we all be forced to buy insurance from private insurers. That means your tax dollars and mine will be used to pay subsidies to the big insurers to provide coverage to people who can't afford to buy their policies, because the big insurers charge far more than they should because Wall Street investors demand that they do.
One of the people who undoubtedly talked Obama away from the public option and into supporting this mandate is his new BFF, Aetna CEO Ron Williams. Williams, who made $65 million off of Aetna's policyholders' premiums over the past two years and who was the mastermind behind Aetna's shedding of eight million members a few years ago to meet Wall Street's demands, is the insurance industry's leading champion of requiring us all to buy insurance. And, of course, without a public option, we'll all be forced to buy coverage from Aetna or one of the other private insurers.
According to a recent article in Forbes, Williams has been to the White House a half a dozen times recently to advise the president and his staff on health care reform. That same article quoted a Wall Street analyst as saying that Aetna likely will dump about 600,000 policyholders during the coming months to satisfy its investors' unrelenting profit demands.
During his speech in Montana, Obama talked a lot of trash about the insurance industry. Don't be fooled by that tough talk. It's all part of a strategy to try get us to believe we'll get the reform he promised during the campaign. Industry leaders are in fact delighted he's denouncing their behavior, because they believe most of his supporters -- who were hopeful the stars might finally have aligned for real reform -- will be fooled into thinking the reform bill that reaches his desk will benefit them more than the special interests with their armies of lobbyists. And they know the nonprofit cooperatives Sebelius and Gibbs are now trying to sell us on don't have a prayer of succeeding. The big for-profits will never let them get off the ground in any meaningful way.
Sadly, I believe the fat cats are winning and that the bill Congress sends the president will be one that gives an industry with an unsustainable business model a new lease on life and a guarantee of unprecedented future profits.
So I hope the president's aides are buying lots of lipstick. He'll need all he can get to put on that pig of a bill.