So no matter how good of a presentation he gives, no matter how passionate or charismatic his final pleas to the jury, it has already made up its mind. In my evidence class in law school, I was taught that 90% of people make up their minds about cases during the opening arguments. From the beginning of this debate, the American people have viewed Democrats’ proposals for what they really are — a means of injecting the federal government into the health care system. So long as the President stays the course and continues to support government intervention in health care, he won’t change the jury’s mind.

Adding to the weakness of his case, the President’s colleagues, his co-counsel if you will, continuously hurt his case by making it clear that 1) they aren’t listening to the American people, and 2) they are avoiding the tough work of creating new policies and instead playing word games.

Case in point, Speaker Pelosi. Reuters reported today that:

“Pelosi said she remained committed to the idea of a public insurance option to compete with private insurers. which has scared off Republicans and some centrist Democrats. But she said that overall House Democrats were 85 percent in agreement on the way forward and that these differences would narrow.”We make a distinction between those who want to obstruct the debate and those who have legitimate concerns,” Pelosi said.”

That’s Pelosi code for: bipartisanship has long been dead. Those people that have concerns about the legislation we’ve drafted in the House, they are Astroturfing, un-American obstructionists we can’t be bothered with. So much for civic participation or bipartisanship. She’s too busy working on backroom deals with Democrats she might be able to appease than to worry about what the American people have to say.

Then, Former Senate Majority Leader Tom Daschle said this:

“I find it interesting that many of the conservative and Republican opponents to a public option oppose it in large measure because it would be so popular. I mean, that’s their argument. Everybody is going to go to this public plan, even though we guarantee that it’s going to have a level playing field. But their opposition is because it’s going to be so popular, they oppose it.”

When you’re done laughing, maybe you can direct me to a link where a conservative has indicated that their problem with the public option is that it’s going to drive private insurance out of business because of its immense popularity. Is that what Mr. Daschle thinks The Lewin Group concluded when it released its study predicting that 83.4 million people would lose their insurance and be forced into the public option thanks to expensive mandates on businesses and increasing costs of private insurance due to government regulations included in this bill? Clearly, Mr. Daschle is just as confused about that study and about the choices Americans want to preserve for themselves as he was about including his car and driver as a gift on his tax returns.

Finally, President Obama himself said this yesterday at an AFL-CIO picnic.

“We have never been this close. We’ve never had such broad agreement on what needs to be done. And because we’re so close to real reform, suddenly the special interests are doing what they always do, which is just try to scare the heck out of people.”

Why is it that dissent from the left is a ‘legitimate concern’, but when the right dissents, it’s trying to scare the heck out of people? According to a Rasmussen poll, 53% of Americans oppose health care reform, and 68% believe liberals’ reforms will increase the deficit. And, it’s not because they’ve had the heck scared out of them or because they’re afraid of the bill’s popularity. It’s because they’re concerned about the road this is taking us on, about our country’s financial future and about their own health care. Despite how difficult Congress has made it for Americans to read these bills, with the House bill reaching over 1,000 pages and the Senate bill not far behind at a little over 600 pages, Americans did their homework this summer.

The left is losing the case, and it’s not due to a lack of speeches by the President.

“Since the start of June, Obama has given 25 speeches and statements alone on his health care plan, according to Mark Knoller of CBS News, who keeps a detailed log of presidential activities. And that doesn’t include a battery of interviews on the topic.”

As Jonah Goldberg points out,

“His July 22 press conference was billed as perhaps Obama’s last chance to save health-care reform. It tanked…Afterward, public support for Obamacare dropped significantly. A Pew poll taken that week found that more people opposed the proposals being considered by Congress than supported them, and that Obama’s overall approval had dropped 7 points from the previous month. Other polls showed similar declines.”

America doesn’t need another speech. Unless President Obama gives us something new tomorrow evening, he will lose even more supporters. Americans don’t want a rebranding of the issues. They want narrowly tailored solutions to specific problems – tax benefits for individual insurance, opening up insurance markets across state lines, addressing pre-existing conditions and tort reform. President Obama’s only chance to turn around the jury’s opinion is to change course and address these topics. In law, closing arguments cannot contain new information. Luckily for President Obama, he is not bound by any rules tomorrow night. If he truly cares about health care, he will tear up his old closing argument and start over with a new plan that addresses Americans’ concerns and brings Republicans into the fold. If not, his closing statement will be nothing more than another rhetorical exercise on a jury that made up its mind months ago.

*Originally published September 8, 2009 on The American Issues Project Blog, here.

“Someone once said to me, “This is a Trojan horse for single payer,” and I said, “Well, it’s not a Trojan horse, right? It’s just right there…I’m telling you, we’re going to get there, over time, slowly.’”

Sure enough, that is the approach peddled by Democrats this summer. But, Americans never bought it. Did Democrats lose people because Americans didn’t want the government involved in their health affairs? Because their general anti-government fears were awakened? Or because liberal politicians weren’t successful at selling their second choice?

The answer as to why Democrats failed so enormously on their signature policy after an overwhelmingly successful election cycle: all of the above. It’s clear that the facts weren’t on their side; we’ve seen ObamaCare fail to stand up to substantive analyses time and time again. In short, you cannot provide more coverage at a lesser cost. And, you cannot create competition through government involvement because the government will always have an unfair advantage.

But, from a more superficial, strategic point of view, Democrats not only lost, but were knocked out of the park because they lacked a clear vision of what they wanted. We still don’t know what their single, overarching priority was – to increase coverage? To control costs? To stick it to the evil insurance companies? To bring socialized medicine to America? Democrats thought they could rely on the trusty campaign slogans and idealistic rhetoric that won them the election to pass their agenda through. Ironically, Democrats and specifically the Obama administration, generally held in high esteem as being master communicators, failed to articulate their vision.

And now, the Democrats’ Operation Health Care version 2.0 calls for:

“Convinc[ing] members that nothing is set in stone and that they are more than open to negotiations. And they’re engaging in a softer sell, prioritizing health insurance reforms while pitching the public option as something that’s way, way down the road…Whatever course the negotiations take, Democrats say the key is convincing heartburn-ridden members that they are flexible.”

Flexible? What does this mean? Does it meant they’re prepared to lay the public option to rest? Putting a public option in place now that kicks in in 2013 is bad for everyone – health care opponents and supporters alike. Opponents want no part in a public option, and supporters want it now. What’s the bottom line here? There can be no middle ground between government-run health care and a private system. What are Democrats willing to concede? What aren’t they willing to concede? With Democrats having pursued universal health care for half a century, you’d think they’d have solidified a plan of action by now.

One possibility is that this new strategy is baloney, that Democrats have not learned anything from this summer and that they’re just playing word games. Another is that they have determined that this is the only way for them to save face – to pass some kind of health care reform even if it means putting the public option off while they regroup.

House leaders, realizing the situation is volatile and could be the decisive factor in the 2010 election cycle, are reportedly going to wait until a Senate bill is on its way to the floor before voting on their own health care bill.

“We’re not going to make our guys walk off the cliff without seeing what the hell the Senate does,” said one House Democratic leadership aide.”

Indeed. If ‘walking off a cliff’ is code for ‘voting for a public option’, that is exactly what they’d be doing.

*Originally published September 1, 2009 on the American Issues Project Blog, here.

“Even if Obama is forced to abandon the public option temporarily, it will probably be mere semantic abandonment. The CATO Institutes’s Michael Tanner argues that the compromise plan being considered by six members of the Senate Finance Committee would eliminate the public option in name only. A health insurance co-op plan, he says, is just another name for government-run health insurance.

But Howard Dean revealed a more cynical Democratic strategy, which would obviate the co-op charade. Dean told MSNBC’s Joe Scarborough that the Senate’s removal of the public option is a ploy to get the bill through the Senate and then have the public option reinserted at the reconciliation stage, where it would only require 50 votes, not a supermajority. Dean admitted that “the president knows very well that you aren’t really going to have health care reform without a public option. But he also knows he has to get this out of the Senate.”

I’d be interested in hearing what our AIP readers think about this suggestion. I still believe, as I said on Rick’s show, that strategy is flawed, and if that is the path that Democrats want to take, they’re going to anger a lot of people. This isn’t the first time Howard Dean has mentioned pushing the bill through without a majority vote in the Senate. He has also appeared on This Week with George Stephanopoulos where he made clear that he believed the public option should be pushed through no matter what, through reconciliation if necessary.

If the debate over health care reform hadn’t become so heated and so personal, then perhaps Democrats could get away with pushing the bill through the way Dean suggests. But, anyone who thinks that they can unilaterally shove this down Americans throats with the American people paying such close attention is completely out of touch. Polls show that 49% now disapprove of Obama’s handling of health care reform, and 54% think that passing no reform is better than passing current proposals. Former Speaker Newt Gingrich put it best when he responded to Dean’s assertion that reconciliation is a viable option for getting this passed.

“But if you want to see why the — why a substantial number of Americans are very frightened, that’s a good example. The Senate rules on passing reconciliation were clearly designed for budget items.If we’re now going to try to rewrite 17 percent of the economy, life and death for every American, by pretending that massive health reform is a reconciliation item and ramming it through with 51 votes, first of all, I don’t think — I think a lot of Senate Democrats (inaudible) I think the idea of stripping the Senate of its ability as a Senate to operate with some sense of discretion andramming through something on this size will go down very badly with many senators, will go down very badly with much of the country.”

For this reason, while I agree with Limbaugh that President Obama is committed to a public option, despite hints to the contrary at his town hall this weekend and from HHS Secretary Kathleen Sebelius, I cannot believe that this stepping back, at least on the surface, from the public option was planned all along just to sneak it back into the bill at the last minute.

Instead, I believe that the White House will continue to push for the public option, even given its slim chances of getting passed in the Senate. I think it will continue to regroup and try to refocus its message to focus on the evil insurance companies, in an effort to reframe the debate. And, if the House and Senate pass very different-looking bills, I’m not sure what will happen during a conference committee – or rather, if anything meaningful would actually get passed in such a committee, although something labelled as ‘health care reform’ would surely get passed to save face. Perhaps these public cooperatives are just another means toward the same end as Rick Moran explores in his new AIP column. As Rahm Emanuel has said, “The goal is non-negotiable; the path is negotiable.” Health care opponents shouldn’t get their hopes up until the public option is completely off the table.

*Originally published August 18, 2009 on the American Issues Project Blog, here.

I set out to do some research to see if there were any hard numbers floating around on the internet because, as Liz guessed, there certainly aren’t any in the bill. While there haven’t been any premiums set by Congress, analysts have been able to make some predictions as to how premiums will be impacted. Here’s what we do know.

This WSJ article offers great insight into the trajectory premiums would surely take under ObamaCare.

Because the tax code subsidizes private insurance only when it is sponsored by an employer, the individual market is relatively small and its turnover rate is very high. Most policyholders are enrolled for fewer than 24 months as they move between jobs, making it difficult for insurers to maintain large risk pools to spread costs.Mr. Obama wants to wave away this reality with new regulations that prohibit “discrimination against the sick”—specifically, by forcing insurers to cover anyone at any time and at nearly uniform rates. But if insurers are forced to sell coverage to everyone at any time, many people will buy insurance only when they need medical care. This raises the cost of insurance for everyone else, in particular those who are responsible enough to buy insurance before they need it; they end up paying even higher premiums. And the more expensive the insurance, the less likely people will buy it before they need it.

Another proposed reform known as “community rating” imposes uniform premiums regardless of health condition. This also blows up the individual insurance market, by making it far more expensive for young, healthy or low-risk consumers to join pools—if they join at all. And if the healthy don’t join risk pools, then premiums go up for everyone and insurers have little choice but to reduce their risk by refusing to cover those who have a high chance of getting sick, such as people with a history of cancer. This is why 35 states today impose no limits whatsoever on how much insurers can vary premiums and six states allow wide variation among consumers.

New York, New Jersey and Massachusetts have both community rating and guaranteed issue. And, no surprise, they have the three most expensive individual insurance markets among all 50 states, with premiums roughly two to three times higher than the rest of the country. In 2007, the average annual premium in New Jersey was $5,326 for singles and in New York $12,254 for a family, versus the national average of $2,613 and $5,799, respectively. ObamaCare would impose New York-type rates nationwide.

Of course, it’s no surprise that these additional regulations on insurance come at a price. If people can purchase insurance at any time and have every medical problem covered, assuming the premiums are more expensive than the penalty fees one would pay for not having insurance under ObamaCare, which is most likely a safe assumption to make, it is inevitable that many would only opt in when facing a medical issue. And everyone else who is responsible and maintains coverage in both good and bad times would foot the bill.

In addition, if doctors are under-reimbursed under ObamaCare, as they are under Medicare and Medicaid, they would try to recoup those losses somewhere else, namely by shifting the costs onto private insurers. This would, in turn, drive up insurance premiums for private insurance. One study suggests that premiums would increase between 75 and 95% under ObamaCare. And of course, as the cost of private insurance increases, more individuals and employers will be forced to switch to the public option. This is why private insurance cannot endure in a system with a public option.

In addition to the higher premiums individuals like Liz would face, there is also the penalty that small business would incur if they cannot afford to insure their employees. Jimmie Bise crunched the numbers for us here at AIP last month. He assumed a 4 or 6% penalty on small business with payrolls (not profits, payrolls – an important distinction) of $250,000 or more. The current floor for the penalty begins at 2% for payrolls of $500,000 or more and increases to 8% as payrolls increase. These penal costs will have serious consequences. Businesses will be forced to let employees go, adding more people to the unemployment lines. Or, they might try to recoup costs by raising prices, which in this economic climate, is not good for private businesses or consumers.

And finally, there is also the matter of the tax hikes that will have to be implemented to pay for this huge government program. Taxes will surely be raised on the top income brackets, which include small business owners and investors who will not have that capital to invest and will not create new businesses, opportunities and jobs they otherwise could have. However, with health care costs adding to the deficit above and beyond the $239 billion figure originally estimated by the Congressional Budget Office, it might not just be the so-called rich facing tax increases.

ObamaCare’s deficit hole will eventually have to be filled one way or another—along with Medicare’s unfunded liability of some $37 trillion. That means either reaching ever-deeper into middle-class pockets with taxes, probably with a European-style value-added tax that will depress economic growth. Or with the very restrictions on care and reimbursement that have been imposed on Medicare itself as costs exploded.

Going back to Liz’s original question, Liz and others like her, including as many as 88 million Americans that could be forced into the public option (according to a study by the Lewin Group), can expect to pay premiums that are increased by as much as 75 to 95% under ObamaCare. Add in the penalties for small business owners and tax hikes, along with the collateral damage to the economy, and the cost of this program is astronomical.

*Originally published August 16, 2009 on The American Issues Project Blog, here.