health care--Obama trapped

As he pushed through the stimulus package so quickly Congress did not have a chance to read it, Obama is now trying to push through changes in health care, which the pundits are saying makes up 1/6th of the nation's budget.  It's been pretty interesting watching the knots he's tying himself in to satisfy all his constituents.  So far, he's not succeeding very well.

In a speech to the AMA, he said he "understands" the constraints put on doctors by concerns about malpractice suits, and acknowledges that they do a lot of testing they might not otherwise do as "defensive medicine", one of the practices that makes our system so cumbersome and expensive.  As the doctors started to cheer, though, he stopped them and, without really saying so, also hinted that tort reform is off of the table.  So Obama is trapped between the doctors represented by the AMA (about 1/3 of US doctors, and arguably the more liberal 1/3) and trial lawyers.  How can he satisfy both?

At the same time, many members of his own party are digging in their heels because of the cost.  He's promising to have the CBO estimated $1T paid for with cost-savings by increasing efficiencies (i.e., less defensive medicine, among other things), but, well, see the previous paragraph for how that's working out.

Another idea he's thrown out is to pay for it by taxing health benefits above a certain minimum, i.e., targeting employer supported health insurance.  But some of the richest such plans are the ones the unions benefit from, and Sen. Dodd, for one, has pretty well scotched that idea.  

Then there are the hospitals--yet another idea he's thrown out is reduced payments to hospitals.  They are already stressed, having already faced cuts from Medicare and HMOs.

So, hospitals, doctors, unions, lawyers, other Democrats:  all pulling in different directions.

Gee, what a surprise!

CAVU