Health Care Theology

Come, you who are blessed by my Father, inherit the kingdom prepared for you from the foundation of the world. For I was hungry and you gave me food, I was thirsty and you gave me drink, I was a stranger and you welcomed me, I was naked and you clothed me, I was sick and you visited me, I was in prison and you came to me…. Truly, I say to you, as you did it to one of the least of these my brothers, you did it to me.
-Jesus talking to his followers

The tragedy isn’t that American health care provision is going to be reformed by government mandate, it’s that we needed another mandate.

My bad.

Better Late Than Never

I would like to think President Obama read my reactions to his State of the Union Address, but I won’t delude myself. And yet, it seems almost possible.1

I finally got around to watching his Q&A session with House Republicans. I hadn’t given it primacy because from my pundit reading I had gotten only four things:

  1. There really was no reason for things like this to be televised.
  2. The President “won” the event.
  3. The President’s only gaffe was using the wrong name for the congressman from Texas.
  4. The Republicans made a tactical error by giving the President the primary microphone, allowing him to outyell them, in effect, and still look good. And, as always, they were stupid.

In other words, nothing to see here.2

I’m glad I disregarded their gloss.

The event was a primer on American politics. The President has frequently spoken over the last two years–with little or no effect on Republicans, Democrats, his administration or, indeed, himself–about the need to move beyond political posturing. In this event, he gave that argument a test case.

First, he tried to have an honest debate. He refused to be cajoled into spewing partisan talking points and, instead, used fact, truth and open conversation as more than campaign slogans. He restated his desire not to “relitigate the past” and acted accordingly. He pointed out factual inaccuracies, but left room for policy differences.

Second, he wouldn’t let the conversation be squeezed into pre-defined molds. He mashed together taxes, health care, jobs and deficits so much they almost seemed inter-related. Apparently he forgot politicians only change topics to avoid difficult questions, not to worry about some bigger picture.

Third, he dropped the ‘if clause’. Two nights earlier, he’d told Republicans if they demand a supermajority vote on all action, “then the responsibility to govern is now yours as well” (emphasis mine). At the Q&A, he treated them as if they had a responsibility to govern because they had been elected, and he attempted to engage them accordingly.

Perhaps my favorite moment of the night was the President’s response to the final question. A former Illinois state senate colleague had engaged the President relatively congenially, providing too accommodating a finish for what Republicans hoped would be a clash of prepared talking points, so the congressman from Texas stepped up with his list of misleading grievances and fired off a closing missive. The President smilingly but clearly questioned the rant’s divisive intent, corrected the false claims, and provided a concrete example of how it could have been done. Diplomacy made politics looked stupid.

All this is not to say political problems are over. One freshman congressman notably pointed out that for all the President’s talk of engagement, the congressional Democrats were extending a hand only to stiff-arm Republicans. The rest of the Republican speakers spent their time posturing, posing and generally ignoring his calls for honest conversation (after all, they’d invited him there to make their points, not to get their questions answered). And, honestly, the President was breaking new ground by making his bipartisan rhetoric seem realistic. Change I can believe in? I’m not sure. But it at least gave me hope.

I finished my SOTU notes pointing out, “We’d be a lot better off if he could inspire himself to act in a way that might accomplish his vision [of politics that are generous and participatory].” We’re a lot better off after this Q&A.

  1. He even referred to the health insurance reform bill. I mean, really.
  2. I found it interesting that President Obama had predicted the relative silence of the media, in effect daring them to report his engagement of political adversaries. I should not have had to watch this to find out that President Obama likes Paul Ryan and his family–unless it’s politically detrimental to the congressman, of course.

His Take on SOTU

If you liked (and understood) my take on the State of the Union Address, you might be interested in James Fallows’s take. He has a similar take on some issues, though he comes from a different perspective.

If you didn’t like my thoughts, you might like his. Though he has a similar take on some issues, he comes from a different perspective. He more elegantly notes some of the things I pointed out, but his evaluations differ from mine in some respects.

If you like the idea of individual responses to particular statements or actions, you’ll like his article.

If you didn’t like my brief, hurried composition, you’ll like his long, detailed form.

If I haven’t addressed your feelings yet, you might want to go read someone who does.

In other words, I’d recommend Fallows’s annotated SOTU to any interested parties.

My Take on SOTU

After seven hours of downloading, I finally got to watch the State of the Union Address. After that much effort, I felt obliged to record my comments as they happened, thinking I might live-blog it three days late. Considering that a chronology would require you to either re-watch the speech or vaguely surmise context, though, I decided instead to present them topically and add a few notes.


Until last weeks ago, I assumed I was about the only American who found Barack Obama’s speaking style simply annoying. Then I had a chat about him with a Chinese student. It turns out I’m the only person in the world who finds Barack Obama’s speaking style annoying.Watching this speech reminded me why. Each phrase—of his speeches—is spoken—as if it is—it’s—own—sentence—worthy of—Bartlett’s. Each phrase also gets a falling tone, a vapid gesture (most often the left-handed pinch-point) reverting to folded hands, and a smug nod. Clunky. Pretentious. Annoying.

But something miraculous happened during this speech. Occasionally, he started talking in full sentences and with standard tones and rhythms. It turns out he’s conversant in normal English. I actually liked his style in parts.

Distractions other than the President

I’ve had my share of time onstage behind a speaker, so I know it’s hard. Pelosi did too. She was so self-concious that people were going to see her at the beginning she went out of her way to look engaged and engaging. She actually looked friendly—almost human. But that gradually gave way to making faces at the audience and then a glazed stare. Biden was tall enough to keep his face out of the picture most of the time, but he did randomly rub his chest for a few minutes.

Michelle Obama scares me.

I know audience response is the only way to express feelings, so I don’t blame Boehner for raising his hand or Alito for mouthing words any more than everyone else for obviously talking and making faces to could get camera time and making a point.

That said, where did the cheering come from? I thought I was watching a Presidential address, but at times it sounded more like a high school football game. I even got a distinct “U-S-A, U-S-A”.

I wonder if the recorder was trying to record the cheers, because he was definitely punching keys during an extended ovation.

Notable ovations

Happy with himself“The true engine of job creation in this country will always be America’s businesses.” Standing O. Seriously? That’s what we call a truism, people. It doesn’t really deserve an ovation.

“All this [activity that caused the economic collapse and subsequent deficit] was before I walked in the door.” Applause. They seriously applauded the budget deficit, since Barack said it wasn’t his fault. And just to make sure, the President paused and made faces until he got sufficient response. That, my friends, was disgraceful all the way around.

We’ll get rid of Don’t Ask Don’t Tell. Huge, drawn-out ovation. We’ll get equal pay for women. Moderate applause.

Things he said that I liked:

He broached the bailout early and effectively in argument, rhetoric, and demeanor.

A focus on jobs is a good call. A really good call. I especially like one that pays attention to infrastructure needs. Sounds a little Rooseveltian, but it’s worthy.

“I know the Senate will [pass a jobs bill]. They will. They will.” I found this particularly effective. He was applying some pressure, while displaying support for the Senate he had already referred to as “gridlocked”. (Sadly, it was the last positive gesture toward political opponents.)

He was pretty heavy-handed with the lobbyists. While they are Washington’s most bipartisan whipping boys, I hope he actually does something about them.

Things he said that I didn’t like:

About those letter-writing children. Do kids really write letters asking the President why they have to move and how to afford homes and education and health care (and if they do, does he really read them every night)? ‘Cause those were either fabricated Obama talking points or some freakishly informed kids.

“[T]he best anti-poverty program around is a world-class education.” Not really sure I agree, but coming from Columbia and Harvard, he obviously values world-class education. “So we’re going to improve community colleges and offer $10,000 to families trying to send kids to college.” (my paraphrase) Yup, world-class.

Anyone else pick up on the countless distinctions between himself and the American people? It started early as he told about how Americans faced a tough year, but “they” were resilient and “they” were staying busy and “they” were working hard.

“We won’t quit. I won’t quit.” Quite a way to finish a speech when you’re a President who already feels the need to deny a Messiah complex.

Things he didn’t say, but said:

If you really want to play a dominant part in the world, China, you have to join it. (Future trading partners have to “play by the rules”.)

Republican Senators, you’re the minority. Go away. (“If the Republican leadership is going to insist that sixty votes in the Senate are required to do any business at all in this town—a supermajority [thanks, Mr. Webster]—then the responsibility to govern is now yours as well.”)

Democratic Senators, let’s ignore everyone else and do whatever we want. (“Democrats, I would remind you that we still have the largest majority in decades[.]”)

Things he said, but didn’t say:

America will double its exports over the next five years. (How, you ask? By finding new, developing markets.)

My exports plan will create two million jobs. (That exports plan he doesn’t really have. Ironically, that’s the same wildly unreliable number of jobs he claims to have created with his stimulus package.)

Things he said that didn’t make sense:

I’m not sure, but it certainly sounded as if he repeated the numbers from his famously inaccurate website to track job creation. I’d call that both deceitful and stupid. But that’s just me.

“We can’t afford another so-called economic expansion like the one from the last decade—what some call ‘the lost decade’.” Who, exactly? I’ve read a lot about the economy lately, and I’ve never heard that. Even from the most depressing pundits.

The CBO says the health [insurance] reform bill will reduce the deficit by one trillion dollars in two decades? Say it with me, Joe: “You lie!”

The Republicans’ response to deficits would be to make “fewer investments in people”—by giving tax cuts. To people.

Health care reform has been in progress for the last “century”?

Ways he contradicted himself:

He’s all about transparency. But the Supreme Court ruling that lets corporations make political advertisements with their names on them instead of doing it through a PAC is a problem.

“We could argue about who’s to blame for [lack of unity], but I’m not interested in re-litigating the past.” Other than when he just spent the last half hour blaming Republicans and Bush for all our problems.

“I will not give up on trying to change the tone of our politics.” “Democrats, let’s rock. Republicans, go home and die. [paraphrase—see ‘Things He Didn’t Say, But Said’ for the direct quotes])”


His agenda is worthwhile. His speaking style was lighter—almost relaxed and engaging at times. His rhetorical vision was grand, generous and participatory. His message was spiteful, dismissive and partisan. Despite my personal distaste for his delivery, I recognize that he has inspired millions to act in a way that might realize his vision. We’d be a lot better off if he could inspire himself to act in a way that might accomplish his vision.

Digest: Why the Health Care Reform Bill Should Be Scrapped

Thus I inaugurate what may become a staple of the blog—the Digest. The basic theory is that a real post should be well-reasoned and explanatory, probably with a lot of links. I have ideas for these kinds of posts. Generally, they grow more and more consuming and the related Google Reader tag gets longer and longer until the post would require countless hours of writing, several editors and a publishing agreement. The Digest is where I rattle off some of those ideas with minimal explanation, perhaps returning later to further explain a point. In other words, I just dump my thoughts out and let you run with them. Go ahead. Run.

  1. It’s not health care reform. It’s health insurance reform. While this may seem a minor complaint, it’s actually the key source of the problem. And it’s being ignored.
  2. No one has ever died for lack of health insurance. Despite all the claims of death-by-lack-of-insurance, it’s a bogus notion. Ask yourself when was the last time you saw an EMT carrying a briefcase full of insurance contracts or an obituary lamenting the lack of a signature on the appropriate form. People die from lack of health care. (cf #1)
  3. Forcing participation in a broken system doesn’t fix it. The current health care system doesn’t work. Insurance companies, rather than spreading costs and leveraging their size to lower prices, have become middlemen that complicate processes and raise costs. Throwing money at those companies (or forcing the citizenry to do so) doesn’t solve the problem. It’s simple, really: expensive faulty system + tons of money = really expensive faulty system.
  4. Socialized health care has the potential to work. Ask Europe.
  5. Socialized health care has the potential to fail. Resurrect and ask the USSR or just ask a real, live Cuban. Or rate the quality of care in China.
  6. But this isn’t socialized health care. It’s socialized health insurance. (cf #1)
  7. Insurance |inˈ sh oŏrəns| noun; a thing providing protection against a possible eventuality. (The New Oxford American Dictionary, 2nd Edition)
  8. It’s impossible to force a company to provide insurance for pre-existing conditions. That’s not providing insurance; it’s paying for health care. (cf #1 and #7, noting especially the term possible)
  9. If you think health care costs are too high and insurance companies are crooked now, imagine the state of affairs when everyone has coverage. Insurance involves risk. Insured people are gambling they will require expensive medical care; insurers are gambling they won’t. When it’s mandatory, it’s not gambling.
  10. Insurance is inherently wasteful. Think about this: insurance companies make money. They’re like casinos. Sure, some people win and the company pays out, but they’re still in business. That means lots and lots of people are losing. So let’s make the party bigger. And require yearly trips to Vegas while we’re at it.
  11. Taxing of cadillac health care plans is backwards. We have special taxes on cigarettes and alcohol not because they are privileges, but because they are dangerous. This is the opposite. People who pay out the nose to have every possible medical need and wish attended by young, handsome/beautiful doctors and pseudo-medical personnel are actually taking care of themselves. Now they need punished?
  12. I oppose robbing the rich to pay the poor. While I’m all in favor of those with means helping those in need, it should be a choice.
  13. Remember the American dream? People use to think America was the land of opportunity. Now they think it’s the land of ease and plenty. Everyone’s a socialist until they pull in an above-average income.
  14. It’s worth losing a year of legislative work to protect centuries of history and whatever future we have.
  15. (Oh, and I believe deficits actually matter.)