Obama Rush to Overhaul Healthcare Shows a Dangerous Deficit of Understanding

Vice President Joe Biden, speaking on ABC's This Week recently, said that the administration "misread the economy." Its projections for the federal deficit were too optimistic, and slower economic growth will spell even bigger deficits for the next generation.

The administration and Democrats in Congress may also be misreading the healthcare system they are trying to overhaul. President Obama has argued that such a revamp is needed for the nearly 50 million Americans uninsured each year.

So who are these uninsured? They are not the poorest of the poor, who are eligible for Medicaid. According to 2007 figures from the Census Bureau, 17.5 million uninsured Americans have household incomes of $50,000 or more; an additional 9.1 million have incomes of $75,000 or more; 21 million of them work full time. A stunning 11 million were offered coverage by their employers and declined it, according to a report released recently by the Employment Policies Institute. (Some are healthy people who would rather spend their money elsewhere; others decline it for religious reasons—take, for example, a Christian Scientist who doesn't believe in going to the doctor.) That same report adds that 43 percent of the uninsured make more than 2½ times the poverty level and that half are under age 35 and single. So a large percentage are relatively healthy, employed young people who have made a rational economic decision to avoid healthcare premiums.

Most people agree that we have a serious obligation to provide affordable healthcare to those who need it, but most would also agree that we do not need to remake our system for millions of Americans who just don't want it. Poll after poll shows that most Americans are happy with their current healthcare—of course, we'd all like someone else to pay the bill—but the vast majority of us want to be able to keep our doctors and hospitals.

Yet the Obama administration is going full steam ahead, with the president committed to signing legislation by the end of this year. So the rush is on: The Washington Post recently diagrammed the "record-breaking influence campaign by the healthcare industry"—a web of over 350 former government officials, including ex-congressional leaders, who have been hired by the various players on all sides, spending $1.4 million a day in lobbying fees. In the suburbs of Washington where I live, the television ads are nonstop, advocating different versions of reform, many from nebulous groups with names like Healthcare Now America, Americans United for Change, Change Congress, and Democracy for America. Whether they're representing doctors, hospitals, insurers, employers, unions, or the political parties is unclear. Who are these people, and what are they really supporting? Nobody I know can tell you.

Every time the White House makes a pitch for healthcare reform, it seems to try a different argument. Some days it argues we've all got to pay for universal care for the uninsured; on others, we're told we already indirectly pay for that care, and we've got to reduce the cost of it. To some audiences, it extols the virtues of a government-run public plan; to others, it promises we can keep the coverage and the doctors we already have. It's niche marketing to various segments of the electorate and, taken as a whole, is confusing and inconsistent, if not contradictory.

It also comes across as desperate. At a recent town hall meeting in Annandale, Va., President Obama took questions that the White House said were "directly from the public." The president called on a crying woman who couldn't afford healthcare for her cancer treatment but, according to the Huffington Post, she volunteers for Organizing for America, the Democratic National Committee's political operation. Other supposedly random questions came from members of the Service Employees International Union and Healthcare America Now, a coalition supporting the White House healthcare reform plan, funded by the AFL-CIO and MoveOn.org. When the White House says it's hearing from "the public" but then calls on people from organizations it's working with to push this through, it must realize it comes across as manipulative and cynical—something many on the left accused the Bush White House of being.