Why Does Obama Keep Pushing Health Care?

I wrote the following comment on March 27, 2009, to a Wall Street Journal opinion piece, "National Health Preview." It seems as true today as it did 5 months ago and I thought it was worth repeating it and publishing it on this blog.

What is motivating President Obama to persist in seeking universal health care? If his main constituent groups did not benefit in some way, he would not propose universal care. Unions gain because it removes health care coverage from the bargaining table and allows unions to negotiate for other items. Minorities make up a majority of the group without health insurance and a rationed, restricted coverage is probably better than no coverage, especially when Obama's plan is to have the wealthy, as opposed to the users, bear the costs for the coverage. In addition, minorities make up a large share of the Medicaid government health program for the poor and universal health care would probably increase the health coverage benefits to this group.

It would push senior Medicare coverage into universal coverage and stealthily allow for a future decrease in senior benefits by limiting all beneficiaries' health costs and not just seniors. The savings from the reduced expenditures on seniors will subsidize the other groups' costs.

Congress and the President will most likely continue to have their existing separate health coverage with exceptional benefits fully paid by the taxpayers.

Therefore, while many would see over time a noticeable decrease in the quality of their health care through delays, rationing, denials and spending caps, Obama's main constituency groups will see an improvement and President Obama and Congress will continue to have their existing health coverage.

In rereading it, I notice I did not mention any benefit for the broad swath of Americans who have health insurance, mostly paid for by their employers. The failure of Obama to articulate a benefit for most of America who do not see the cost of their medical care and who are overwhelmingly satisfied with their medical care and medical insurance is probably the single biggest reason for the President's failure, at this point, to have broader support for his health care plan.

If most people do not understand what is in it for them, why would they support the President's plan? If some parts of the plan annoy, frighten and scare them, why would they not react vociferously against the plan?

If Obama were an attorney handling a jury trial, the equivalent would be that he did everything except convince the jury, which in this case is most of the American people. At this juncture, the failures and obstacles appear to be the result of strategic decisions, or lack of decisions, made by the President.

In the end, the results will be solely the President's doing, whether it is success or failure. I do not think there is any more that the President could ask for when introducing a major initiative. If he cannot make a case that convinces Americans, then the proposal should not be passed. After all, it is for their benefit and if they do not want a different health delivery and insurance structure then they should not have to have it.