I don't really think he does understand the issues OR he thinks the overriding issue is his conceit that HE will usher in a new era of "bi-partisan" cooperation and singleness of purpose.

I think this is a large part of his psychology (as far as I'm willing to try and understand it, which is not very far - I've had it with psychoanalyzing presidents.)

There are a (relatively small) number of themes that Obama was very consistent on during the campaigns, and at least some of them are in his books as I understand it - and on these he is almost chillingly consistent. (I'm not talking about things on which he was vague or on which he's expressed different opinions at different times. I talking about a few things on which he was almost scripted every time he brought them up, even when not giving a speech.)

To name a few: getting over partisanship (as you said), the medical e-records thing, getting people to do volunteer work, the errors of the 1960s protesters, ...

The people he listens to on this particular issue are convinced that controlling health care expenditures is the key thing that needs to be done now (I don't disagree), and that the main ways to do that are by discouraging patients from "excessive use" (by deductables, copays, etc) and by outcomes research (hence the e-records). Neither of these is necessarily a bad thing - well, maybe the first one is a little demented - but he's gotten focused on them, and that seems to make him feel that everything else is expendable commentary.

At least, that's my take.

This bit from nyceve's post:

There's also the spectacle of what I would call a medical-industrial congressional employment office. While the rest of us go to work every day wondering whether today will be the day we get the pink slip, CQ Politics reports that the medical-industrial complex seems to be an employer of choice for congressional spouses.

Nearly four dozen members of Congress have spouses employed in the health care industry — ties that lawmakers acknowledge are influencing their thinking about how the health system should be overhauled.

Financial disclosure forms made public in mid-June showed that at least 39 members were tied to the industry by their spouses in 2008. In addition, 13 full-voting House members are medical doctors.

And do not forget that Obama's wife made big bucks for the family working for a part of BHIP (Big Health Industry Players).

The money is astonishing. We make phone calls; BHIP hires wives, family, staffers, etc.

No...public option/single-payer/Medicare for All way, way too scary...so when you hear about the 3% Medicare admin cost v. 30% private insurance admin cost, just remember that 3-20% of Medicare spending is fraudulent, about $70 billion/yr.

They argue that yes, Medicare has lower administrative costs as a percentage, but that's because

1) The base (the total amount spent on health care costs) in Medicare is artificially high because of these fraudulent charges (which makes the administrative costs a smaller percentage of the whole)

2) They don't spend money chasing down fraud, like the private insurers do.

Much depends on exactly how much fraud there is and how much (more) could reasonably be expended tracking it down, but the argument's kind of a crock anyway. (20% of spending being fraudulent would turn that 3% into just a bit less than 4% of the non-fraudulent spending costs.)

I actually saw this argument spelled out on a blog today, but I forgot immediately which one. I'll see if I can track it down in my browsing history...

Here you go! I actually found it on an anti-Medicare blog, but that link I just gave is to PNHP.

[BTW I'm trying out a new (to me) research tool called Scrivener. I haven't totally got the hang of it yet, but so far it pretty much rocks. It was a great help in tracking that information down, for example.]