Let's look a bit closer at the five paragraphs of fantasy public policy pablum President Bush threw into his State of the Union message on health care reform. (After all in addvance publicity, health care was touted to be one of his main policy initiatives in the speech.) It's easy to see that it's no reform at all but a giant federal subsidy of the private insurance corporations which are the inefficient and wasteful source of the current crisis in health care in the first place. (See my previous diary on single payer health reform.)
Basically the President spoke only about changes in health care financing. With only passing mention of medical malpractice, information technology, and price transparency he expressed no concern, sensitivity, nor compassion about the sick and suffering, or, for that matter, the poor and uninsured. His message spoke only of health care financing issues. He totally endorsed "private health insurance." He proposed to create a new tax subsidy to offset increasingly expensive insurance premiums so that "100 million" citizens who already have insurance will benefit from lower tax bills. Finally he offered Federal funds to all "States that make basic private health insurance available to all their citizens."
It is important to note that the monopsonistic health insurance industry where 10 insurance companies cover more than 50% of all "commercial" (i.e. not medicare, medicaid, imprisioned, VA, or military) lives, is the main source of inefficiency and waste in the health care system. Insurance companies skim about 20% of the insurance premium dollar off the top for their administration and profit and at least another 10% of the premium dollar is used by health care providers to cope with the complex and confusing bureauratic rules and systems required by the multiple insurance companies. In sum, annually over $400 billion in premium dollars is diverted away from patient care each year in the United States. Bush's major reform proposals would only endorse, expand and subsidize this outrage.
His proposals show neither leadership nor concrete proposals for expanding coverage for the working poor (who do not benefit from tax relief incentives) or for those excluded from insurance because of prior illness, except for bucking the issue to the states.
It should also be noted that President Bush in his most recent radio address let it be known that he would propose a new tax on all individuals who had "excessive" health insurance coverage. It is obvious that in the few intervening days that this concept became so laughable that it was omitted from the speech all together.
In sum it is easy to see there is nothing of practical substance, no conception of social equity or justice, and no compassion nor understanding of the real world in this part of The State of The Union speech. In this area as in others, the President is lacking in leadership.