Our Vulcan-in-Chief on Health Care

Dear reader, know that I tried my best not to take the bait on President Obama's press conference today, which included a spirited discussion of the public health insurance option.  I realize I've been writing a little too much on this one topic just because it's so constantly in the news, as the central fault-line in Congress.  But look - I'm only human.  When the President of the United States starts talking about Mr. Spock from Star Trek while answering a question on health care, I'm going to write about it.  It's that simple.

Ezra Klein, Jon Cohn, and Matt Yglesias have already written about Obama's initial answer on whether a well-designed public health insurance option would drive private insurance out of business, which culminates in the refutation, "But just conceptually, the notion that all these insurance companies who say they're giving consumers the best possible deal, if they can't compete against a public plan as one option, with consumers making the decision what's the best deal, that defies logic, which is why I think you've seen in the polling data overwhelming support for a public plan."  But that was just the cornerstone of a five minute stretch where, true to his most recent form, the President didn't back down from challenges to the public health insurance option. This part of the transcript is worth reading in full.

There was plenty of good:

• On whether private insurance could possible compete with private insurance or, as AHIP and Blue Cross Blue Shield claim in a letter to Sen. Kennedy today, it's impossible:  "If, on the other hand, the public plan is structured in such a way where they've got to collect premiums and they've got to provide good services, then if what the insurance companies are saying is true, that they're doing their best to serve their customers, that they're in the business of keeping people well and giving them security when they get sick, they should be able to compete."
• On the need for tougher regulation, particularly for private insurance in a National Health Exchange:  "I think the American people understand that, too often, insurance companies have been spending more time thinking about how to take premiums and then avoid providing people coverage than they have been thinking about how can we make sure that insurance is there, health care is there when families need it."
• On the oft-cited conservative refrain that a public plan means that the mantra of "If you like what you have, you can keep it" won't be true, as employers drop their benefits to let their employees buy cheaper plans in the Exchange, Obama pushed back in a way I haven't heard before - that people are already losing what they like and have each year, and health care reform is necessary to curb that.  "Let's assume that nothing happened.  I can guarantee you that there's a possibility for a whole lot of Americans out there that they're not going to end up having the same health care they have, because what's going to happen is, as costs keep on going up, employers are going to start making decisions:  We've got to raise premiums on our employees; in some cases, we can't provide health insurance at all. And so there are going to be a whole set of changes out there.  That's exactly why health reform is so important."
• On being told his "logical" answer was "Spock-like language": "First of all, was the reference to Spock -- is that a crack on my ears? (Laughter.)  All right, I just want to make sure.  No?"

But for all the good, Obama was also befuddling and exasperating.  Yes, he never backed down from his support for the public plan.  Yes, he continued to swat away the most superficial arguments against public coverage with the greatest of ease.  Yes, he is the best Communicator-in-Chief on the issue we've seen in some time.  But he pointedly refused to say it's public plan or bust:  "we have not drawn lines in the sand other than that reform has to control costs and that it has to provide relief to people who don't have health insurance or are underinsured."  House Speaker Nancy Pelosi has not had a problem drawing a line in the sand.  Nor has the Congressional Progressive Caucus.  Nor has the Tri-Caucus.  Nor have Sen. Kennedy or Dodd.    And this quote from Sen. Chuck Schumer from the Senate floor today makes the senior Senator from New York very much the Dr. McCoy to Obama's Spock:

We can only bend so much to try to win over opponents of health care reform. We cannot bend so far that we break... It is time to move passed the partisan bickering and make sure that the health care reform passed by Congress includes a public option.  It is the right thing. It is the smart thing. And it is what the American people want and what they deserve.

Those are impassioned words... but they wouldn't be appropriate coming from Mr. Spock nor, much to the regret of those of us who insist health reform must somehow expand public coverage in order to be real reform, from Mr. Obama.

(Photo credit:  Nancee_art on Flickr.)