After all the histrionics of town hall meetings, this fact remains: Health care costs are on track to virtually bankrupt our nation over the long term. But if President Barack Obama doesn't inject more leadership and clarity into the muddied debate, he is in danger of losing this opportunity for change.
Opponents of health care reform paint it as a battle between those who like their health insurance or Medicare — a majority of Americans — and those who are uninsured or underinsured. Irresponsible actors such as former Alaska Gov. Sarah Palin have embarked on a campaign of half-truths and disinformation to frighten people worried that they won't be able to keep what they have.
In fact, every American should be in favor of reforming the system, not just because universal coverage would be rational and humane, but because the status quo leaves everyone vulnerable.
Most Americans who are not on Medicare are one job loss away from losing health insurance for themselves and their families. Due primarily to unemployment, 14,000 Americans lose their insurance daily. For the newly jobless who have exhausted COBRA options, being cast into the private market is like swimming in a storm-tossed sea without a life preserver. Insurers want to cover only the healthy. And to employ the tactics of opponents, so-called death panels already exist: private insurers who refuse to cover people with pre-existing conditions, cap lifetime coverage and retract coverage once a customer is ill.
Even employed Americans are at risk, as employers increasingly reduce or eliminate health benefits because of skyrocketing costs. Nearly 1.3 million full-time workers lost their health insurance in 2006, a time when the economy was better. Others have seen benefits steadily erode.
Those who lose insurance join 47 million others, many of whom struggle to find care. Last week, thousands waited for free medical, vision and dental services outside an arena where the Los Angeles Lakers once played basketball. The care was provided by Remote Area Medical, a group founded to serve Amazonian Indians but which now responds to the avalanche of unmet needs here.
This is the system that Obama seeks to reform. So far his approach, looking to avoid the sins of a previous push by the Clinton administration, has been to put forward a set of principles — universal coverage, cost controls and no deficit spending. He has let Congress grapple with the details. That has worked to a point, but now Obama needs to put his stamp on a plan, one that lays out what he will support, what he won't and how to pay for it.
The debate over a government option and whether it is integral to Obama's reform agenda is a good example of the confusion being sowed. Conservative Blue Dog Democrats, who are crucial to the Senate passing any reform, shouldn't have to guess Obama's bottom line. Neither should the public.
The plans being considered in Congress don't yet do enough to control costs or clearly designate how universal coverage will be paid for without adding to the nation's deficit. Obama needs to endorse a specific initiative and sell the details. Americans are confused and easily misled about what Obamacare means because it appears that the president hasn't decided himself. That needs to change, otherwise the momentum toward reform will stall; health care costs will continue to outpace inflation; and more and more Americans won't have coverage.