What I wanted to yell at the President

I watched the address to the joint session of Congress a couple
of weeks ago with a friend. In general, I really like watching
Obama speak, because it’s such a relief to have a President who
isn’t embarrassing me with every sentence out of his mouth.

But there was one point when I was talking back to the TV
screen. It was after he’d talked about how he and everybody else
in the country could design a system from scratch that would work
better than the one we have, but he believed that we could get
more done by building on the system we have.

So then he said, “We will place a limit on how much you can be
charged for out-of-pocket expenses, because in the United States
of America, no one should go broke because they get sick.” I
remarked to my friend, “So how is that incremental?” At the time,
and until I just looked at the text of the speech, I believed he
actually had used the word incremental.

The reason I’ve continued to think about this off and on for
the last two weeks is that I think that really is the reason
health care reform has been so hard to get. There really isn’t a
consensus in this country that no one should go broke because they
get sick.

This is why, although it was a well-delivered speech, the polls
all found that it didn’t convince anyone. People who believe that
they won’t go broke when they get sick because they’ve done the
right things all their lives, and that the people who will go
broke are lazy and improvident, want to hear why this new system
isn’t going to cause them to go broke because other people get
sick. And the President did say that, but not in a way that anyone
really believes.

The reason I understand this better than President Obama does
isn’t because I’m a better politician than he is. It’s because
he’s spent his life doing what the system says he should do and I
haven’t. I know people who really believe that I should go broke
when I get sick because I retired at the age of 50. They don’t
say it in such crude language, but their disapproval of someone
making that choice says it for them.

So the right way to pitch the reform shouldn’t be telling sad
stories about the people who go broke because of the present
system. It should be making the point that the present system
is in fact making you go broke because other people get sick,
and spending money differently will make you go less broke as
well as making them get less sick. I don’t say I know how to do
that, but I can see that that isn’t what the President is trying
to do.