Summary
[written after the fact]. The whole infomercial was one long argument to efficiency. Obama promises to do it cheaper and better. Nifty. All the ideas he listed to make things more efficient have been tried at the state level or by HMOs. There is no compelling reason why this time it will work other than he [unlike all those other pikers] really means it. At no time were non-government solutions discussed. Zip, Zero Zilch. The only debate was about how bad our current system is versus how awesome the hypothetical government system could be in theory.Blow by Blow
Talking Point 1: The government plan will reduce costs by eliminating the 1/3rd of medical care that is unnecessary. This was the idea behind HMOs as well, but you know what the problem with HMOs was? Politics. They were sued and regulated into oblivion. Every specialist lobbied his state legislature to require that specialty to be included in all plans. Every politician went for votes by complaining about the evil HMOs.The only structural advantage the government plan would have over HMOs is that it is really hard to sue the government. Of course the government could pass a law making it really hard to sue your insurance provider, but that ain't gonna happen. All the other political problems with HMOs (lobbying by specialists, etc) apply to the government plan as well.
A question ABC did not ask about talking point #1 is: why not start with Medicare? If it is so easy to slash costs by 1/3rd then why not just do it, right now, to prove you can? Well, because that wouldn't be big and bold enough. It would leave out the "FOR EVERYBODY" from the "FREE SHIT."
Talking Point 2: Too many doctors go into specialists instead of primary care because the money is better. Obama suggests loan forgiveness for going into primary care. He also suggests that his system will provide more care by the same number of doctors by reducing the amount of paperwork and bureaucracy by having the government run it. And he said that with a straight face.
If we want more GPs the government could do things like making them harder to sue (malpractice insurance is a big bite out of their paycheck). Or we could make a medical degree more inexpensive by breaking up the AMA certification cartel; because medical schools can control the supply of docs they have an interest in charging students a lot but not quite so much that not going to med school isn't worth it.
Talking Point 3: Health Plan Exchange, a centralized market where people can compare and shop for health plans. Yeah, because that worked out so well for Massachusetts.
Which gets back to the Big Bang nature of this plan. No state plan, no government run healthcare, no nothing has accomplished what this plan promises. What was it about the MA, CA, or TN plans that didn't work for tens of millions of people that will suddenly work for 300 million?
Talking Point 4: Rationing happens anyway but the government will do it better. Your private plan is rationed after a fashion (higher premiums, etc). If you don't have a plan you are definitely rationed. Obama goes back to the argument to efficiency: the government plan will ration less because it will be so efficient it will have more money to throw around.
Talking Point 5: The Congressional Budget Office estimates the plan (as ill defined as it is) will cost $100 Billion a year and only cover 1/3rd of the uninsured. Obama's response is that you have to spend money to save money and after we spend all that money the growth of health care costs will slow down. This is an irrefutable point because like the "jobs saved" promise whatever happens Obama can just say it would have been worse without him.
Obama again repeats the idea that the government will reduce the amount of bureaucracy. They say the TV camera adds ten pounds but I never knew what they meant until just now -- the size of the balls on this guy are enormous.
Talking Point 6: More about paying for it. An audience member asks how we will "raise the revenue" [read: taxes] to pay for all this money we are saving. The propaganda format of the program is showing because Obama completely dodges the question and basically says doing this is cheaper than doing something else. Imagine how much healthcare would cost if we didn't raise taxes to pay for it!