The Audacity of Hope - Barack Obama [88]
With the money we save through increased preventive care and lower administrative and malpractice costs, we would provide a subsidy to low-income families who wanted to purchase the model plan through their state pool, and immediately mandate coverage for all uninsured children. If necessary, we could also help pay for these subsidies by restructuring the tax break that employers use to provide health care to their employees: They would continue to get a tax break for the plans typically offered to workers, but we could examine a tax break for fancy, gold-plated executive health-care plans that fail to provide any additional health benefits.
The point of this exercise is not to suggest that there’s an easy formula for fixing our health-care system—there isn’t. Many details would have to be addressed before we moved forward on a plan like the one outlined above; in particular, we would have to make sure that the creation of a new state pool does not cause employers to drop the health-care plans that they are already providing their employees. And, there may be other more cost-effective and elegant ways to improve the health-care system.
The point is that if we commit ourselves to making sure everybody has decent health care, there are ways to accomplish it without breaking the federal treasury or resorting to rationing.
If we want Americans to accept the rigors of globalization, then we will need to make that commitment. One night five years ago, Michelle and I were awakened by the sound of our younger daughter, Sasha, crying in her room. Sasha was only three months old at the time, so it wasn’t unusual for her to wake up in the middle of the night. But there was something about the way she was crying, and her refusal to be comforted, that concerned us. Eventually we called our pediatrician, who agreed to meet us at his office at the crack of dawn. After examining her, he told us that she might have meningitis and sent us immediately to the emergency room.
It turned out that Sasha did have meningitis, although a form that responded to intravenous antibiotics. Had she not been diagnosed in time, she could have lost her hearing or possibly even died. As it was, Michelle and I spent three days with our baby in the hospital, watching nurses hold her down while a doctor performed a spinal tap, listening to her scream, praying she didn’t take a turn for the worse.
Sasha is fine now, as healthy and happy as a five-year-old should be. But I still shudder when I think of those three days; how my world narrowed to a single point, and how I was not interested in anything or anybody outside the four walls of that hospital room—not my work, not my schedule, not my future. And I am reminded that unlike Tim Wheeler, the steelworker I met in Galesburg whose son needed a liver transplant, unlike millions of Americans who’ve gone through a similar ordeal, I had a job and insurance at the time.
Americans are willing to compete with the world. We work harder than the people of any other wealthy nation. We are willing to tolerate more economic instability and are willing to take more personal risks to get ahead. But we can only compete if our government makes the investments that give us a fighting chance—and if we know that our families have some net beneath which they cannot fall.
That’s a bargain with the American people worth making.
INVESTMENTS TO MAKE America more competitive, and a new American social compact—if pursued in concert, these broad concepts point the way to a better future for our children and grandchildren. But there’s one last piece to the puzzle, a lingering question that presents itself in every single policy debate in Washington.
How do we pay for it?
At the end of Bill Clinton’s presidency, we had an answer. For the first time in almost thirty years, we enjoyed big budget surpluses and a rapidly