The Monday morning column from Clark Judge:
Global Eyes on the President at West Point
By Clark S. Judge, managing director, White House Writers Group, Inc.
As everyone knows, President Obama will address the nation on Tuesday night and reveal his decision on what to do in Afghanistan. Most weekend commentary has focused on the announcement’s political implications at home and how various players in and around Afghanistan will see it. But there will be another and in the long run at least as important audience: national and diplomatic leaders of the major nations of the world.
As reported at the time, during the last several months I have attended conferences and presentations in various European capitals. All in one way or another concerned global security. On the side I spoke with additional political and journalistic players. The result has been a global snapshot of official and semi-official opinion from places as diverse as China, India, Russia, Palestine, and various parts of Europe, both in and out of the E.U.
What I sensed in total was growing doubt about the president. He speaks well, everyone acknowledged, but is there substance behind the rhetoric? He is given to sweeping pronouncements. But will he, can he follow through? He commands the most capable military force on the globe. But does he have the stomach for a fight? Does he have the strength to make and stick with hard choices, or any choice at all? As one globally prominent (and I would have thought friendly to the president) American journalist summed up global opinion at a conference in Geneva: “Machiavelli said it is better to be feared than loved. Mr. Obama is loved.”
So when the president addresses the nation tomorrow night, he will be addressing these global players as well as the rest of us. How they grade his presentation will have a profound impact on what he and his administration will be able to achieve in international circles in the next three years.
What we have heard about the speech and the substance of the announcement so far is not encouraging.
First, the speech itself: we have not yet heard it, of course. Drafting may not even have been completed. Different administrations work differently. But even in the Reagan Administration (where I was a speechwriter for the president and where we never had the kind of cliffhanger, last-minute drafting dramas that seems to have been common in, say, the Clinton White House) on major foreign policy speeches editing and even drafting by the president himself and appeals from various parts of the national security establishment could continue almost until Mr. Reagan appeared stepped to the podium. When he returned from his meeting with Mr. Gorbachev in Reykjavik, President Reagan was writing in long hand, on a yellow pad, parts of his report to the nation within an hour of going on camera.
But we do know one detail about Mr. Obama’s speech, its location. Virtually all past major presidential addresses on global security matters have been broadcast from either the White House itself-usually the Oval Office-or the House of Representatives, as the president addressed a joint session of Congress. I am talking about all presidential addresses here, going back to Franklin Roosevelt. These settings convey majesty. They convey the seriousness of the moment and weight of the Constitutional office the man occupies. When addressing Congress on such matters, they represent an appeal for the coming together of all the branches of the American government behind the common mission of ensuring the nation’s security.
On Tuesday Mr. Obama will speak from West Point. Surely the speech will be well advanced. The visuals will be impressive, perhaps even moving. But on at least on a subliminal level, the choice of setting is more likely to heighten rather than ease global doubts about the man and the administration. For Team Obama has chosen to give their man a stage set that, in the context of this moment, suggests they and he are thinking in terms of a candidate in campaign, not a president of the United States at a moment of decision. And here, too, is the essence of global doubts about the president — that he is a campaigner, not a leader.
Regarding the speech’s substance, the one detail-no one seems to know if it is true or not-is that, while announcing troop levels in the 30,000 range, he will also announce a comparatively slow deployment, more like Johnson in Vietnam than Bush for the surge in Iraq. If true, the international impression of indecision, lack of strength, dearth of seriousness in the president and his circle will become larger and more vivid.
There come moments in presidential communications when impressions coalesce and either the man in the office becomes larger-as Reagan and Roosevelt unfailingly did at such moments-or smaller in global eyes. For the nation’s sake, let’s hope Mr. Obama is seen as larger after last night.
But first signs are not encouraging.
The next month of broadcasting and blogging will be given over almost exclusively to the debate over Obamacare in the Senate. The bill will mean massive changes to the future of every American if it passes, and unless a major disaster strikes, most of media, new and old, should be focusing on it and the stakes involved. That coverage should also be specific and in-depth: What will the Senate version of Obamacare mean if passed, exactly?
I’d like to ask my readers and listeners for (1) suggestions on whom they would like to hear interviewed on this topic, both opponents and supporters and (2) what exactly you think the passage of anything like the Senate version will mean for you.
Seniors, how much more do you expect to be paying? How much longer do you expect to wait for appointments? Do you think you’ll be able to get the same level of service you are currently enjoying?
Employers: Do you expect to make changes in your group coverage?
Doctors: Do you expect your income to fall and if so, by how much?
Here’s an illustration of the sort of coverage that does more harm than good to the debate ahead.
Nicholas Kristoff has his typically very well-written column in Sunday’s Times, and it tells a heart-tugging-tale about John Brodniak. Mr. Brodniak has been living a medical nightmare, one that compellingly illustrates many of the woes of our current health care system.
But what the column doesn’t tell us is if the Senate’s version of Obamacare will do anything for Mr. Brodniak. Indeed, there is buried in the column an alarming warning about the Senate bill:
In August, [Brodniak] qualified for an Oregon Medicaid program, but he hasn’t been able to find a doctor who will accept him as a patient for surgery, apparently because the reimbursements are so low.
The Senate version of Obamacare promises a big expansion of Medicaid-like coverage for the poor and near-poor, but will it simply worsen the already large and growing problem of providers refusing to treat patients whose coverage simply doesn’t provide enough of a reimbursement to make it worth a doctor’s while to treat? This single sentence in Kristoff’s column hints at and then abandons the crucial issue of reimbursement rates, but if these are pushed too low, doctors will simply refuse to treat patients that cannot help them pay the overhead or make a living. As the Investors Business Daily poll of 10 weeks ago showed, doctors will simply leave the field rather than work for reimbursement rates that drive them towards longer and longer hours for declining income and lousy quality of life. Mr. Brodniak’s situation won’t be improved by a bill that shatters the current system and drives providers from the profession.
That’s the real question in the debate ahead, one every senator even those from the hard left have got to ask themselves: Are they making the system better or just scoring political points? Right now, as Charles Krauthammer argued on Friday, the answer is very clearly the latter. I’d like to see Nicholas Kristoff follow up with another column about Mr. Brodniak, one that tells us how the Senate bill will work to improve his life, and if so when? One that will also tell us the impact of the Senate bill on his one-time employer as well as on the doctors that will be treating him if the new system arrives, as well as on the economics of the hospitals in his area, or the medical research that ultimately allows for any sort of new cure or innovation in treatment.
I’ll be happy to interview any credentialed advocate who wants to defend the bill on the Senate floor, because that is the only question that matters right now. We know there are problems, but will the senate version of Obamacare fix them? If the answer is either “no” or “we don’t know,” or even “there’s a good chance it will help some people while hurting others,” it is not just a lousy bill, but an immoral one, a feel-good bit of posturing that won’t help Mr. Brodniak, and may in fact condemn millions more to the same scarcity that he is presently experiencing.
So, please send along your e-mails suggesting experts and predicting your own personal outcomes. The e-mail box is email@example.com.
Hank Adler is my co-author on The Fair Tax Fantasy, and he raises some very basic questions as the big denate on Obamacre opens this week:
Finals are approaching in most universities and high schools throughout the country. With a 2000 page Senate Healthcare proposal, it is unlikely that anyone could pass an examination on the specifics of the legislation. However, we should expect that the members of the United States Senate should be able to pass an examination regarding the general aspects of the current Senate proposal. Below is a series of essay questions, each of which should be answerable on two pages of a blue book, which should be presented to each member of the Untied States Senate:
Questions related to the overall economics of the Senate proposal:
1. Including the proposed tax increases, the current proposal is promised to be revenue neutral over the first decade. Are there any recently passed Senate bills or future Senate proposals which will positively or negatively impact the revenue neutrality of the current bill? If so, how do/will such bills impact the revenue neutrality of the proposal? (Please include a discussion of any current proposals to permanently improve doctor’s compensation under Medicare.) As perhaps the strongest argument supporting the current proposal is its revenue neutrality, is it appropriate for each Senator to commit to vote against any future proposals which would increase healthcare costs?
2. The current bill is not revenue neutral after year ten, what revenue increases or expenditure reductions would you propose and/or expect beginning in year eleven to pay for the healthcare proposal?
3. Over $400 billion dollars of new taxes will be collected during the first four years of the Healthcare proposal without a significant expenditure of funds. What are the underlying economic theories supporting the raising of taxes in the midst of the most severe recession in over fifty years? (Please include a discussion that contrasts the current proposal with President Hoover’s increase of taxes during the early years of the Depression.)
4. Assuming that a public option is included in the final proposal, please identify the timing and impact of employment in the private sector versus the public sector for the healthcare system. Please identify concerns and solutions with respect to geographic dislocations and system creation issues.
5. Given that several states, including California, are currently virtually bankrupt resulting from systemic budgetary issues, please explain the significant expansion of state funded Medicaid requirements in terms of the financial viability of such states.
Questions regarding the health delivery impact of the Senate proposal:
1. The Senate proposal anticipates increases in preventative care and increased access to the healthcare system outside of free clinics and hospital emergency rooms. Please explain how citizens without sufficient funds to pay the required co-pay included in virtually all insurance policies will be accessing the healthcare system under the current proposal.
2. Please explain why the exact coverage to be required and the amount of co-pays is not specified in the legislation and why that lack of specificity does not cause you to be concerned as to the cost estimates and ultimate access to the healthcare system.
3. Please explain the impacts of the current proposal on charitable contributions to hospitals and clinics in the United States and indicate whether these organizations will be viable with any decrease in contributions anticipated. What do you see as the continuing role, if any, of charitable organizations or free clinics in general after implementation of the current proposal?
1. Please explain why the current proposal is preferred over either of the following other options:
A “Marshall” type plan to train doctors and nurses wherein the government would provide loans to all individuals being trained which would therefore result in minimal costs over the ensuing decades or
The creation of government operated free clinics throughout the country providing preventive care etc., therefore avoiding all of the accompanying complications of the insurance driven strategy encased in the current healthcare proposal.
2. The President has indicated on several occasions that the current proposal is nearly identical to state requirements for auto insurance. However, in many or most states, there is a state requirement to carry insurance for uninsured drivers, which indicates that a significant percentage of the public is not carrying legally mandated auto insurance. What is the underlying data indicating that (1) with penalties for individuals not carrying insurance being drastically lower than the cost of insurance, (2) the requirement for co-pays that many poorer Americans simply will not be able to pay, and (3) the continuing requirement for hospitals to treat individuals in emergency rooms regardless of whether they have insurance, Americans will decide to purchase the insurance being offered? What data supports a result that more Americans will be covered following passage of the proposal? (In your answer, please include a discussion of the ability to get coverage regardless of current health as an incentive to individuals deciding to pay the penalty rather than carry health insurance.)
3. What is the underlying data that demonstrates that Americans who are currently uninsured because they have not completed sufficient paperwork to be insured under current governmental supported plans will complete the new forms under the proposal?
4. Please define the term “insurance” in the context of the Senate healthcare proposal. In your definition, please differentiate between automobile and homeowners’ insurance where if one is fortunate, he or she may never make a claim and the insurance expected in the Senate proposal.