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Mystery Health Care Speech Theater

By Steve Rhodes

In which I talk back to the president.

This text has been edited for length, clarity and comedy.

OBAMA: There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone. On the right, there are those who argue that we should end the employer-based system and leave individuals to buy health insurance on their own.

RHODES: And there are those who believe those aren't mutually exclusive.

OBAMA: I have to say that there are arguments to be made for both approaches.

RHODES: And I should know, because I've made them!

OBAMA: But either one would represent a radical shift that would disrupt the health care most people currently have.

RHODES: And the last thing the American people sent me here to do was change the system.

OBAMA: Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch.

RHODES: Like Medicare.

OBAMA: But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government.

RHODES: So I'm replacing Rahm Emanuel as my chief of staff.

OBAMA: Instead of honest debate, we have seen scare tactics.

RHODES: So I'm replacing Rahm Emanuel as my chief of staff.

OBAMA: Some have dug into unyielding ideological camps that offer no hope of compromise.

RHODES: And that's just among Democrats.


OBAMA: The plan I'm announcing tonight would meet three basic goals.

RHODES: One, help me get re-elected. Two, strategically place the onus on Congress so I won't have to put my ass on the line. And three, never take a clear stand on the public option while making both sides think I have.

OBAMA: It will provide more security and stability to those who have health insurance.

RHODES: Oh, and four, say "security and stability" as much as I can because it tested well in focus groups.


OBAMA: Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange - a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices . . . This exchange will take effect in four years, which will give us time to do it right.

RHODES: Now, I know what you're thinking: If it takes the government four years to set up an insurance exchange when many new businesses start in four months . . . But this way I don't have to defend the inevitable early rough edges before my 2012 re-election campaign, during which I can argue that you need to put me back in office to see it through. This is what I meant about long-term political points.

OBAMA: That's why under my plan, individuals will be required to carry basic health insurance - just as most states require you to carry auto insurance.

RHODES: Even though I excoriated Hillary Clinton during the campaign when she made the same argument. I had to differentiate myself somehow, and I thought mandates was a good wedge issue.

And here is where I invite my friends and readers who argued so vociferously against mandates once Obama took that position - like they suddenly argued against public financing of campaigns when Obama bailed on that - to now restate their position just as loudly in opposition to the president's new plan. See, the beauty of thinking for yourself is that you don't have to do contortions every time you have to adapt to someone else's cynical new stance.


OBAMA: Given all the misinformation that's been spread over the past few months, I realize that many Americans have grown nervous about reform. So tonight I'd like to address some of the key controversies that are still out there.

RHODES: First, the death panels. They're really not as bad as some folks are making them out to be . . . we call them security and stability panels.

OBAMA: My guiding principle is, and always has been, that consumers do better when there is choice and competition. Unfortunately, in 34 states, 75% of the insurance market is controlled by five or fewer companies.

RHODES: How is that not competition? The major media in this country is controlled by five or fewer companies . . .


OBAMA: Insurance executives don't do this because they are bad people. They do it because it's profitable.

RHODES: Um, doesn't that make them bad people?

OBAMA: As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill; they are rewarded for it. All of this is in service of meeting what this former executive called "Wall Street's relentless profit expectations." Now, I have no interest in putting insurance companies out of business.

RHODES: I don't have the guts to argue that health care shouldn't be a for-profit business.

OBAMA: An additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear - it would only be an option for those who don't have insurance.

RHODES: So those with insurance won't be allowed to choose the public option?

OBAMA: In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.

RHODES: Then how will that keep insurance companies honest? Those are the 5 percent of customers they want least!

OBAMA: I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.

RHODES: So it could go out of business if it doesn't make enough money?

OBAMA: It's worth noting that a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight.

RHODES: A majority of American don't understand a public insurance option of the sort you've proposed tonight.

OBAMA: But its impact shouldn't be exaggerated - by the left, the right, or the media.

RHODES: Because that isn't to my political advantage, even though I've just argued that a public option is the key to driving down costs in the private insurance market and making affordable insurance available to all who need it.

OBAMA: To my progressive friends, I would remind you that . . .

RHODES: . . . I've never kept my promises to you because you're a bunch of chumps.

OBAMA: And to my Republican friends . . .

RHODES: I'm ready to cave if I can just pass something.

OBAMA: For example, some have suggested that that the public option go into effect only in those markets where insurance companies are not providing affordable policies. Others propose a co-op or another non-profit entity to administer the plan. These are all constructive ideas worth exploring.

RHODES: In the next week?


OBAMA: We've estimated that most of this plan can be paid for by finding savings within the existing health care system - a system that is currently full of waste and abuse.

RHODES: Oh wait, somebody slipped an old Reagan speech into the TelePrompter.

OBAMA: I want to speak directly to America's seniors for a moment, because Medicare is another issue that's been subjected to demagoguery and distortion during the course of this debate.

RHODES: Contrary to what you've heard, your death will be swift and painless.


OBAMA: Add it all up, and the plan I'm proposing will cost around $900 billion over ten years.

RHODES: Oops, somebody slipped the Republican response into my TelePrompter.


OBAMA: I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open.

RHODES: I'll even put health care negotiations on C-SPAN. Oh wait, somebody slipped one of my campaign speeches into the TelePrompter.


OBAMA: I received one of those letters a few days ago. It was from our beloved friend and colleague, Ted Kennedy. He had written it back in May, shortly after he was told that his illness was terminal. He asked that it be delivered upon his death.

RHODES: Too soon?


Look back on how we were right about everything in the Mystery Debate Theater files.


Posted on September 10, 2009

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