Sorry, but for me, Obama has not closed the deal on health care.
Real health care reform means both universal coverage and cost control. More people being covered is going to put more pressure on costs. And health care costs in the US are already way out of whack with the rest of the world.
When Obama talks about reducing costs, I feel like I am on a used car lot. As my colleague Jeff Lawrence says, "There's no such thing as a dysfunctional system because every system is perfectly aligned to produce the result it is currently getting." And the current reality is working well enough for medical malpractice lawyers, for people with private coverage (like me), for drug companies, for insurance companies, and for folks on Medicare and Medicaid. None of us well-situated folks want to take any real losses.
There's no real cost reform Obamacare.
Where is the requirement for service consolidation and elimination of overlap, where are the generic substitutes, where is the cap on malpractice suits, where is the middle class tax increase, where is the employer mandate, where is the ban on unnecessary procedures, where is the effort to shift services more toward younger people and prevention and, yes, away from people my age well into their AARP years?
Obama has not distributed enough pain to have any meaningful reform on the cost side. The evidence? There aren't enough of the right people people whining.
The protesters are middle class folks who are scared that either their coverage will go down, their costs will go up, or their taxes will rise. They have good reason to be fearful. The drug companies are all for Obamacare. That's a very bad sign.
If we are going to have universal coverage, with or without a public option, someone has to pay for it. Obama's feelgood administration is falling into the leadership failure traps of, gulp, his predecessor, failing to deliver bad news, failing to take the heat from his own constituencies, failing to try inspiring all of us to take a short-term hit for some larger, longer term goal.
Pain-free health care cost reform is an oxymoron.
Do you agree?