Thursday, 25 June 2009

Obama Pushes Healthcare Plan on ABC

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ObamaOn June 24, ABC TV gave President Barack Obama interview time with Diane Sawyer on Good Morning America, a prime-time special with both Sawyer and Charles Gibson at the White House called Questions for the President: Prescription for America, and the whole Nightline program after the local news.

While it could be said that Sawyer and Gibson did not let the president off easy, the ABC network itself ended up giving the president more than an hour and a half of airtime to push his version of healthcare reform without any serious rebuttal from the opposition. By its choice in programming, ABC repeatedly gave the president the last word rather than include all sides of the debate.

The one-hour special Questions for the President: Prescription for America ran so long that it continued during the Nightline segment, adding an extra half hour to the earlier show. It was designed as a faux town-hall, question-and-answer session, faux because the 164-member audience was chosen and invited by ABC rather than open to the public. Sawyer handled the microphone for the audience questions and Gibson served as the moderator/interviewer on center stage with the president.

Sawyer and Gibson did not shy away from tough questions, and the audience supplied some pointed questions of their own, but the format always gave Obama the last word. Although Gibson sometimes followed up on questions, the audience was never allowed to ask for further clarification after the president gave his answer. A debate or panel format would have led to more sides of the issue being explored in greater depth.

President Obama repeatedly declared that if America does nothing, we are all doomed to higher and higher healthcare costs. But the specifics of how his plan is going to prevent this were few and far between. The lack of details and the vagueness of his answers ought to give the viewer pause.

For instance, audience member John Sheils, senior vice president for The Lewin Group, brought up his organization’s analysis of the public-insurance option so favored by the president. Sheils pointed out that using the Medicare reimbursement model as a basis, which pays less to doctors and hospitals, a family might save as much as $2,500 in annual premiums under the public insurance option. If that were the case, up to 70 percent of those with private insurance would probably switch to the public plan. This includes businesses switching to the public option, meaning that, as Gibson rightly pointed out, employees who like their plans could be forced to give up their preferred private plan for the public one. Obama’s non-answer boiled down to him getting the following last words right before a commercial break: “What we think is, is that we can set up a system in which you are expanding choices for individuals as opposed to constricting them.”

If the president had a system in mind that he thought the public would accept, wouldn’t it have been easier to list the details than just asking people to trust that it will all work out in the end? He said only that he “thinks” a system can be set up. That’s not exactly the best way to inspire confidence. In his response to the Lewin Group’s analysis, he actually outlined ways that individual choice would be limited, not expanded. He said that an individual with employer-based coverage wouldn’t be allowed to just dump his plan for the public option. He never explained how this limitation expanded the “choices for individuals as opposed to constricting them.” Obama said employers would be penalized if they don’t provide coverage. The employer, then, doesn’t really have a choice either. How does this system end up “expanding choices”?

Left out of the discussion by ABC’s “the president takes center stage” format was what happens to the 30 percent who initially stay with private insurance. Private carriers would be left with these fewer customers. These customers would be forced to pay higher premiums not only due to their smaller numbers but also to make up for what the public option won’t pay for. President Obama did imply that the public option could fairly reimburse healthcare providers, but, again he didn’t say specifically where the money would come from, and thus provided nothing substantial to refute the Lewin Group’s analysis.

The president himself said that uncompensated care, such as an emergency room visit by someone with no insurance coverage, “adds to all of our premiums collectively about a thousand bucks a year.” This is an admission that when doctors and hospitals aren’t reimbursed for their full costs, whether through lack of insurance or poor reimbursement by Medicare, they pass the cost along to those who do have insurance.

If the public option pays more than the Medicare reimbursement model, the money must come from someone. If that someone is the person who is paying the premium — and it would be unfair for it to be anyone else — the plan is no longer cheaper than private coverage and has no reason to exist. If public insurance does, in fact, use the Medicare reimbursement model, the few who are privately insured would soon be unable to afford private-plan premiums and would be forced to switch to the public option.

Private insurance companies would cease to exist except possibly for the very wealthy. Everyone would end up in the government plan that doesn’t pay enough to doctors and hospitals. Healthcare rationing or raising public premiums would be the only options. The less expensive public plan would eventually cost Americans dearly.

While ABC failed in this instance to provide an in-depth look at opposing viewpoints to President Obama’s healthcare reform plan, they have aired alternative views on other occasions. The video archive for John Stossel’s 20/20 programs includes his “Sick in America” series. Click here for a link and then scroll down to “Sick in America.” Those who want to see what else ABC has broadcast on healthcare will find that Stossel offers quite a different “prescription for America.”

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