The man Barack Obama consulted on medical matters for over two decades said on Tuesday that the president's vision for health care reform is bound for failure.
Dr. David Scheiner, a 70-year Chicago-based physician who treated Obama for more than 20 years, said he was disheartened by the health care legislation his former patient is championing, calling it piecemeal and ineffectual.
"I look at his program and I can't see how it's going to work," Scheiner told the Huffington Post. "He has no cost control. There would be no effective cost control in his program. The [Congressional Budget Office] said it's going be incredibly expensive ... and the thing that I really am worried about is, if it is the failure that I think it would be, then health reform will be set back a long, long time."
Scheiner, who prefers a more progressive approach to reform, was hesitant about trying to divine the president's motives, although he said he believed that "in his heart of hearts" Obama "may well like a single-payer program."
"His pragmatism is what is overwhelming him." Scheiner added: "I think he's afraid that he can't get anything through if he doesn't go through this incredibly compromised program."
Admitting that he was not a political practitioner, Scheiner said he felt compelled to speak out because of his unique relationship with the president and this critical moment in the health care debate. A champion of a single-payer health care system, Scheiner noted repeatedly that he came to the debate from the perspective of having dealt with the hassles and pitfalls of the current system. His speaking out is part of a larger effort, launched by Physicians for a National Health Program, to push Congress to consider single-payer as an alternative to current reform proposals.
As Scheiner sees it, all alternatives simply fall short. Keeping private insurers in the market, he warns, would simply maintain burdensome administrative costs. He argued further that the pharmaceutical industry is not being asked to make "any kind of significant sacrifices" in the current round of reform negotiations. As for a public health care option, Scheiner insists that the proposal remains vague and inadequate.
"First of all, they haven't really gone into great detail about the public option," he said. "How much is it going to cost, are they going to really undercut private health insurance by a considerable amount? Will there be any restriction that you can get for public option?"
Despite his policy critiques, Scheiner's affection for his long-time patient is quite obvious. He recalled the president as being "gracious" and "never pulling rank" when he came to his office. "Part of my shtick, is I sing songs and I love humor," Scheiner said. "I remember last time I saw him I told him a joke, he said, 'Doc, you told me that joke before.' I was so impressed he can remember my bad jokes -- this guy has to be really bright."
During the course of the campaign, Scheiner became one of the many mini-celebrities in Obama's orbit. When the then-Senator released a one-page summary documenting his health, criticism for its brevity was laid on the doc's doorstep.
"The guy was healthy, you know," Scheiner recalled. "What can you say? His only problem was that he smoked ... But there wasn't that much to say. If I had added anything it would have been pure drivel. There wasn't anything serious in his record. He'd never had anything. The guy is built like a rock, he could probably bench-press me...
"I think my most impressive time was when Jon Stewart actually mocked my report," he added. "I thought that was wonderful."
All of which makes his current criticism of Obama's health care policies all the more difficult. While Scheiner raved about the president's intellectual curiosity, he was at loss for words as to why Obama had consulted with private industry executives more than primary care physicians. And while he spoke glowingly about the president's oratorical talents, he expressed disappointment that Obama had not done more to explain the benefits of single-payer coverage to the American public.
The White House has said that the president moved away from a single-payer approach both because of philosophical objections (consumers should be allowed to keep their coverage) as well as political realities (limited support for the proposal in Congress). The administration's position increasingly resembles the maxim, Don't let the perfect be the enemy of the good.
"It's a good question," Scheiner said, when asked if having watered-down reform become law was better than getting a single-payer system stalled in Congress. "Is something better than nothing? That is a hard one for me. That is a difficult one, because, in the end, I think [Obama's] program is going to fail."