This is the world that Karl Rove lives in: Obama's approval rating is in deep trouble, the public wants to kill government-run health care, and the Republicans have a shot at riding health reform like a gust of wind out of their smoldering ashes. The rest of us live in a world that looks, well, the utter and exact opposite. This is what Karl Rove being wrong looks like:
Karl Rove: "While still good, President Barack Obama's political health is deteriorating, threatened by what he thought would be balm -- his ambitious plan for a government takeover of health care"
Public Opinion (via RealClearPolitics):
Karl Rove: "Mr. Obama's trashing of American health care as "a broken system" that must be brought "into the 21st century" doesn't resonate with most Americans."
Public Opinion (via the New York Times):
Karl Rove: "To strengthen the emerging coalition of independents and Republicans, the GOP must fight Mr. Obama's agenda with reasoned arguments and attractive alternatives. Health care may actually be an issue that helps resurrect the GOP."
Public Opinion (via Gallup and The Plum Line): The public trusts health insurance companies more than Republicans.
I'm under no illusions that reforming health care will be easy, inevitable or even effective. We still have a long way to go before we work out co-op vs. public option, engineer ways to incentivize private insurance companies to take on more at-risk patients, and somehow bring down costs to make health care reform deficit-neutral (ie pays for itself) over the next ten years. As a fake president once wisely said, "we've got serious problems and we need serious people." Karl Rove is not serious people, and this shouldn't even count for trying.(Rhetorical ht @Conor Clarke)
It seems to me that there are four factors accounting for the high cost of medical care: 1) high malpractice insurance rates driven by large damage awards that have bankrupted hospitals and doctors; 2) laws that require hospitals to treat anyone, regardless of whether they have the money or health insurance to pay; 3) the millions of illegal immigrants who have neither the money nor insurance to pay for medical care and who consequently flood our hospitals not for emergency treatment but rather for pedestrian ailments, such as colds and upset stomachs, that do not require the specialized facilities and staff our hospitals are designed to provide; and 4) the government's steady reduction of Medicare/Medicaid reimbursement over the last decade or so.
The AMA has lobbied for tort reform for years, only to face the adamantine resistance of the ABA. The result? A stalemate. Only a few states, like California, have implemented tort reform so as to limit malpractice payouts, which nationwide have been increasing significantly for years. One result? The average family physician now pays almost as much in malpractice insurance as he or she makes in annual income. It's a shame that none of the reports coming out of DC indicate that there is any discussion of tort reform.
When hospitals are required to treat those without the means to pay for medical treatment, they have two options: bankruptcy or raise prices for those with the means so as to subsidize the costs associated with free medical care. Unfortunately, the huge increase in illegal immigration since the Reagan administration's amnesty program of 1987 has made it impossible for many hospitals to raise prices high enough or fast enough to cover actual costs. As a result, many hospitals are forced into bankruptcy. Twenty years ago, for example, Los Angeles County had 23 trauma care centers; by 2005 it had only 11 because of their inability to provide the required free treatment. Strangely, no one seems to have noted that the existing legal requirement to provide free treatment serves as a disincentive for acquiring health insurance. Why would indigents, the working poor, and illegal immigrants embrace the monthly cost of any insurance when they can now can get treatment free?
The reduction in reimbursement payments to doctors and hospitals is a major issue in the medical field, reducing margins to such unacceptable levels that a growing number of MDs are refusing to accept patients with Medicare/Medicaid. And yet reimbursement reduction is a fundamental component in the Obama administration's plan to reform healthcare. I anticipate that we will see a further erosion of healthcare if this plan is enacted, furthering the socioeconomic shift in this country ever closer to the Third World model--with a small elite class having access to the very best medical care while everyone else is force to make do with something less.
While I agree that free treatment for those that can't pay creates an untenable business environment, I think you may have flipped the argument.
Illegal immigrants make up an estimated 12 million people, while there are nearly 50 million American citizens without health insurance. The current population of the United States is 300 million, meaning we have about 17% of our citizens without health insurance and access to preventative medicine. Costs for these uninsured are disproportionately high because they delay treatment, especially for chronic diseases, until their illness has progressed and become more expensive to treat.
An even greater portion of health care costs comes from treating senior citizens, which will only get larger as our population ages.
http://www.ahrq.gov/research/ria19/expendria.htm
The uninsured obviously demand some health care, but the extremely difficult task is to provide cost effective access to it. The current market incentives unfortunately encourage the reduction in supply you describe instead of a scale that serves our country's overall health.
That's weird. According to you, Karl Rove said Obama's "political health is deteriorating". And you said that means Rove said "Obama's approval rating is in deep trouble." But that's not what he said, is it? Why not just quote Rove directly instead of restating his comments to fit the narrative of a blog post?
Political health deteriorating doesn't equal approval rating in trouble? What does it equal? Rove later mentions his slipping poll numbers. I'm paraphrasing, perhaps dramatically, but I don't think inaccurately.
Deteriorating support and "in trouble" are different things, even if there is a sizable overlap.
For example, if Obama had had 100% support in the past, 95% support now, and would soon have 90% support, his support would be deteriorating he wouldn't be "in deep trouble".
Haha. Not the debate I was trying to start. But I'll bite!
Tim, you are correct that "in trouble" is not synonymous with "deteriorating." But we're talking about political health, and when health is deteriorating, it's usually assumed that this is not a benign thing (ie 100% down to 95%). If a friend told you that his health was deteriorating, for example, would your first reaction be "No worries, I'm sure you were supernaturally healthy to begin with" or "I'm concerned"? I think it would be the latter.
More to the point, Rove's overall argument is precisely that Obama's political health is in trouble. In fact, the sentence after the one in question: "More troubling to Team Obama is the growing gap..." So obviously, we're talking trouble, here. Whether it is of a 'deep or imminent' or 'grave and gathering' kind, I suppose doesn't matter.
"Not a benign thing" also doesn't equal "in serious trouble" and isn't even exactly the same as "in trouble".
Deterioration usually is used in non benign situations, but not always. Also the support could be healthy for now, without the trend really being benign. Using the real stats above the "disapprove" level has gone from 20% to 35%. 35% isn't serious trouble. A further increase would be a deterioration, and probably not benign for Obama, but not necessarily a sign of serious trouble.
Another example of deterioration is http://www.rasmussenreports.com/public_content/politics/obama_administration/daily_presidential_tracking_poll
The only gap Karl Rove can cogently speak on - is the one in his hairline.
A 5 point drop in aroval numbers (from 61% -56%) doesn't mean much.Like most Independents, we are waiting on something, anyuthing to get done.
So Karl Rove's relative "expertise" is not only unwarrented, but unreliable since 2002.
Mission Accomplished
Derek,
Did you see this article about the NYT/CBS poll?
http://www.cnsnews.com/public/content/article.aspx?RsrcID=49999
It appears to call your second graph into question, although I'm not all that familiar with CNSNews.
Also, while I've seen a lot of graphs giving Obama a high approval rating in general, I've been reading a lot of articles recently regarding his dropping numbers on particular issues, especially the economy and the control of GM. These numbers would indicate deterioration in the sense that Obama may be running out of time to employ the "mandate" he has seemed to enjoy politically thus far. To continue the analogy/argument from above, his deteriorating health would be akin to aging; a 20 year olds health "deteriorates" as he ages, making the things he was once easily capable of doing at 20 increasingly difficult in his 30's, 40's etc. In other words, is Rove essentially saying what most other articles are saying, that his honeymoon is over and Americans are starting to to associate him more and more with the economy?
I'm sorry, but Karl Rove is testing a meme that Republicans want to hang on President Obama. Like him being "weak" regarding the Iran situation.
When the honeymoon is over, your polling doesn't show over 50% approval rating, and Karl Rove knows this. An excellent politician has an approval rating around 49% or below, and that still mean just under half of the polled populace approves of the job the politician is doing.
Nola, I agree that he will be heavily associated with the GM bailout. For better or for worse, that will be a major component of his administration.
But having a 50% approval rating is somehow deteriorating, really? Logic is a wonderful thing. Karl Rove and his ilk prey on spinning an issue with Pavlovian phrases repeated consistently to imprint on small and unwitting brains.
Dan,
I absolutely agree Karl Rove is trying to paint a "deteriorating" or "weak" description that is excessively hyperbolic at this point. And I would also agree the approval rating Obama enjoys right now is one nearly any President would envy at any time during his candidacy. I think my admittedly somewhat murky premise was that while Obama has a very favorable general approval rating, polls do not show that sort of support for many of his policies. I think this began with the GM bail out, which it seems most of the public views unfavorably, and has been enhanced by his clear error in the prediction of the unemployment percentage. That some have argued no one could have/did predict the severity of the recession I think is irrelevant, the point is he sold his bailout and stimulus in terms of limiting unemployment, and it didn't happen. Tied into this was the possibly skeptical nature of the NYT/CBS poll, which seems to have been picked on purpose to disprove the idea that there is disagreement concerning health care reform. Most polls do not show such rosy figures, for instance this Rasmussen poll (I need to figure out how to insert hypertext in this format)
http://www.rasmussenreports.com/public_content/business/healthcare/june_2009/41_favor_public_sector_health_care_option_41_disagree
Anyway, to go back to the deteriorating analogy, I think it depends on context. In Derek's understanding, you would obviously assume something is wrong. When my grandmother says she can't play tennis like she used to because of deteriorating health, I don't assume pneumonia.
I'm not sure why I'm trying so hard to exculpate Rove's terms, when he is clearly trying to be hyperbolic, so I guess that part is moot anyway.