Re: YouTube Wars…

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That “Shock Uncovered” video is from the very same health care forum that I posted about yesterday. And as I noted then, there was indeed a shock — to Obama, who showed up unprepared, and (I am convinced) without any real idea what, specifically, he wanted to do about health care reform.

As I also noted yesterday, that was not the case for long, and within weeks, candidate Obama did have a fully developed plan. But it is worth putting those early responses in a bit of context. I had raised a number of potential reform scenarios, and Obama (unwisely) tried to wing it. Here’s part of the transcript:

KAREN TUMULTY: Senator, on the question that is really the lynchpin of all these other questions, which is coverage, there are only a few ways of getting there. Could you at least give us a sense of where your thinking is on this? Have you accepted or rejected any of the concepts like an employer mandate or require that employers provide coverage? An individual mandate where people would have to buy into the system the way they do with auto insurance?

Are you wedded, for instance, to this idea, as the first two candidates were, that we basically should stick with this system in which most people get their coverage from their employers or have you found any positives to the idea that’s being offered by your colleague, Ron Wyden, to essentially break that system and come up with a new one? Could you at least give us a sense of, you know, which possibilities here intrigue you and which ones that maybe you’re dismissing at this point?

BARACK OBAMA: Well, we have a plan that we are in the process of unveiling. What we want to do is try to set up a series of round table discussions before we actually announce it. Not just with experts, which we’ve already done, but rather with frontline workers, with nurses, with doctors, with consumers, which we’re going to be scheduling over the next couple of months in terms of rolling it out. But let me just address a couple of points.

As I indicated before, I think that we’re going to have to have some system where people can buy into a larger pool. Right now their pool typically is the employer, but there are other ways of doing it. I would like to — I would hope that we could set up a system that allows those who can go through their employer to access a federal system or a state pool of some sort. But I don’t think we’re going to be able to eliminate employer coverage immediately. There’s going to be potentially some transition process. I can envision a decade out or 15 years out or 20 years out where we’ve got a much more portable system. Employers still have the option of providing coverage, but many people may find that they get better coverage, or at least coverage that gives them more for health care dollars than they spend outside of their employer. And I think we’ve got to facilitate that and let individuals make that choice to transition out of employer coverage.

I do believe that employers are going to have to pay or play. I think that employers either have to provide health care coverage for their employees or they’ve got to make a decision that they’re going to help pay for those who don’t have coverage outside the employer system. So I think that’s one important principle. And as I said, the second important principle is that we’re going to have to put more money into prevention, more money into chronic care management, more money into medical technology, because that is how we’re going to accrue the savings that help us provide subsidies to those who don’t already have it.

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