Obama's Decision To Let Congress Tackle Health Care Questioned

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First Posted: 06-18-09 01:37 PM   |   Updated: 06-18-09 01:52 PM

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News on the health care reform front this past week has not been good, with two potential Senate bills receiving bad-to-atrocious cost and impact estimates and rising concern that a public option for insurance coverage will fall by the wayside.

In light of these bad developments, a growing number of health care advocates are beginning to revisit a legislative strategy that was once considered unquestionable. Should the White House have introduced a bill itself rather than let the product originate in Congress?

Months, even weeks ago, such a question would have been dismissed with a mix of ridicule and laughter. If one lesson was to be learned from Bill Clinton's failed effort at health care reform 15 years ago, it was that secrecy was a death sentence. The White House certainly preached such a philosophy in public, with chief strategist David Axelrod declaring in early June that it was never the president's "intent to come to Congress with stone tablets."

Several weeks later, however, health care advocates are wondering whether the White House deference to the legislative branch was ultimately misguided. One Democratic operative compared the current climate to a "three-ring circus," with no distinct voice bringing lawmakers together.

Another health care reform advocate, meanwhile, emailed the following note of concern:

"President Obama certainly learned from President Clinton's mistakes. He didn't drop a book on Congress' desk and say, 'Pass this.' There's an obvious downside to that approach, as we're seeing this week. The President has been out saying all the right things in public, standing up strongly for a public option. But I'm worried about the inside game. I just hope all those former Congressional staffers who are now top White House political aides are pressuring their former bosses hard to stick with a strong public option. I fear this isn't happening, given the way Congress is wandering off on their own looking for 'compromises.'"

Certainly, there is panic in the air. Two prominent health care reporters -- Ezra Klein of the Washington Post and Jonathan Cohn of The New Republic -- both published pieces on Thursday lamenting the past week of developments. At the heart of their concerns were the inglorious reviews received by two preliminary pieces of legislation that emerged from the Senate this past week. A partial bill put out by the Senate Health, Education, Labor, and Pensions (HELP) Committee was estimated by the Congressional Budget Office to cost $1 trillion dollars while only covering 16 million additional people. The Senate Finance Committee's effort was hardly better: estimated to run a $1.6 trillion tab while lowering the number of uninsured by two-thirds. The Finance Committee's Chairman, Max Baucus is now looking at ways to lower costs.

At the same time, a group of bipartisan former Majority Leaders released a study on Wednesday that did not include a national public option for insurance coverage -- a key component to Obama's vision reform and a proposal favored by three-fourths of the public.

Added together, the events have created somewhat of a dreadful if not chaotic environment for health care reform advocates. Operatives say they are now working around the clock, including full days on Sundays, just to limit the political fallout. "The sky is falling," offered a particularly pessimistic aide.

All of which is not to say that legislation won't pass. White House aides have publicly remained calm, arguing that the legislation process is inherently ugly. In private, some have grumbled at the Senate's work -- wondering, in particular, why incomplete legislation was allowed to be scored by the CBO. Still, said one high-ranking administration official, "we'll pass a bill."

Along those lines, there do not appear to be huge regrets in the White House over the decision to allow legislation to originate in Congress. For all the lament from outside government, the truth remains that the Obama administration has played a very active role in the process. High-ranking aides to the president are engaged with the bosses they used to work with on Capitol Hill. The President and his campaign arm, Organizing for America, have begun ramping up a public campaign designed create an environment ripe for a bill's passage. Poll numbers show that the public still very much favors comprehensive reform along Obama's wishes.

And then there are those who argue that, when it comes to health care, it doesn't matter where the product originates. Republicans would have been skeptical regardless of whether the bill was crafted by Obama, Sen. Ted Kennedy, or Baucus. The fault lines, in short, were already largely drawn.

"I still believe that it would have run into this kind of trouble either way," said Mike Lux, a progressive activist who worked in the Clinton Health Care War Room. "So I don't think where it starts matters that much."

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News on the health care reform front this past week has not been good, with two potential Senate bills receiving bad-to-atrocious cost and impact estimates and rising concern that a public option for ...
News on the health care reform front this past week has not been good, with two potential Senate bills receiving bad-to-atrocious cost and impact estimates and rising concern that a public option for ...
 
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I am wondering about the co-op plan. Does anyone have any facts or grounded, evidence-based arguments for or against them? On first glance, it appears they would provide an option to citizens that is similar to credit unions. The CU model provides financial and service benefits to its members because the profit mandate is not a factor, and, being locally- or regionally-managed allows these nonprofit institutions to be more directly accountable to their members (as opposed to federal programs). I do worry about the accountability factor and the potential for politicization of a federal health insurance program. But I don't know how Medicare or Medicaid have fared with respect to political changes over time. So my instinct would be to vote for membership-based health care co-ops, but I would like to read more about existing models for this approach.

    Favorite    Flag as abusive Posted 07:20 AM on 06/21/2009
- Acidic I'm a Fan of Acidic 6 fans permalink

Anything is better than what we have now.

    Favorite    Flag as abusive Posted 09:09 AM on 06/21/2009
- stell I'm a Fan of stell 20 fans permalink

So what's new? O outsourced the porkulus to Pelosi and Reid. He's just the one who is supposed to "sell" their policies to the American public. The trouble is, he isn't selling single payer. Didn't he promise C-SPAN townhalls? In the end the Dems will pass something for the sake of passing something. It will probably be the co-operative deal, but O will go on TV and call it "historic" like he calls everything else he does.

    Favorite    Flag as abusive Posted 07:30 PM on 06/20/2009
- Acidic I'm a Fan of Acidic 6 fans permalink

Wow your right he does say historic a lot, but your diggin pal. If that's all you got than he is doing phenomenal.

    Favorite    Flag as abusive Posted 09:11 AM on 06/21/2009
- ThomH I'm a Fan of ThomH 21 fans permalink

Obama 's "healthcare reform" is sinking not because it lacks a champion, but because it is too expensive. Seeing the true cost of making health insurance more "universal" (by forcing its purchase via government mandates) and "affordable" (via subsidies paid by taxpayers.) has produced sticker shock.

Obama's plan perforce increases total national healthcare cost because it keeps the health insurance companies in the act. They impose a 50% markup beyond the cost of the healthcare they cover. No wonder the healthcos like his plan: their revenues and profits increase. But no amount of jawboning by Obama will eliminate charging the cost increase to taxpayers.

The much debated "public option" is a snare and delusion, distracting us from what's truly needed: universal Medicare For All, funded mostly by a slightly higher payroll tax. Paying for healthcare this way eliminates completely any need for purchase of health insurance by employers and individuals. It eliminates wasting over $1 billion per day on overhead imposed by healthcos, more than enough to cover everyone now lacking insurance or with nadequate coverage. Everybody in, nobody out. All this, at a reduced overall national bill for healthcare.

Time to move to the proper debate: how best tackle moving $1 trillion per year of private health insurance purchases to publicly financed Medicare For All.

Let's enact single-payer HR 676, then move on to lowering the cost of healthcare itself by replacing fee-for-service with annal stipends to large competitive group practices delivering true health maintenance.

    Favorite    Flag as abusive Posted 06:09 PM on 06/20/2009
- S1m0n I'm a Fan of S1m0n 93 fans permalink
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Recent AMA studies confirm: Canada's 'universal' system costs half as much as the American status quo.

I repeat: what you now have costs you double what it should. Fifty cents of every dollar spent on health in the United States goes to non-medical expenses. Wasted, in other words.

    Favorite    Flag as abusive Posted 03:38 AM on 06/21/2009

If you really believe that insurance companies have a 50% markup, Thom, you really don't know much about insurance.

Look it up.....most insurance companies make between 5-7% profit margin. United Healthcare, the largest company makes 7.78% - this is much less than oil companies (13.56% for Exxon) software & development companies (Google has an operating margin of 31.5% and Apple makes 19.67%) and banks (19.98% for BOA) - even with billions pumped into the banking system, "to prevent collapse", they are running 20% operating margins! But I guess you feel these companies aren't as "evil" as insurance companies, so they are allowed to escape your wrath.

Insurance companies help control costs but most uniformed people screaming for a government run single payer system don't know that. Take two people going to see a doctor, one with insurance and the other without. Who do you think pays less? The person with insurance. That's because the insurance companies keep tight control of their networks and negotiate vigorously with physicians, hospitals and other providers in order to keep costs down. Not to go to their bottom lines - again most make only 5-7% margin - but to upgrade systems, start new health care initiatives, wellness programs and the like.

The person without insurance - - they have to pay whatever the provider's fees are, because they don't get the discounts the insurance company negotiates, nor will they receive the wellness care benefits, the nursing consulting services and other services insurance companies offer.

    Favorite    Flag as abusive Posted 03:58 AM on 06/21/2009


One more thing, who do you think the government turns to when they need a network??.­.........d­rumroll...­........th­e insurance companies! They are the ones with the expertise in network management, disease management, wellness programs, etc., etc., etc. What most people don't know is that Medicaid and Medicare have their healthcare programs administered by insurance companies - not the Feds - and if you throw in Part D, you have a government trifecta run by insurance!

Try cutting the insurance companies out of the mix and see what a mess you'll end up with. You think government is bloated now.....if the Feds had to fully administer all of their own healthcare programs you would see the size of Sebelius' HHS agency double or triple in size. So go ahead and vote for a single payer system and watch your taxes rise - they will have to do so to pay all the new government salaries to staff a beefier HHS and to cover the medical fees that increase without full network management, risk assessment, disease managment and the like.

A bloated HHS agency is Obama's, Kennedy's, Waxman's and Sebelius' dream come true and our worst nightmare!

    Favorite    Flag as abusive Posted 04:00 AM on 06/21/2009
- Acidic I'm a Fan of Acidic 6 fans permalink

Bought and paid for by your friendly insurance industry lobbyist.

    Favorite    Flag as abusive Posted 09:14 AM on 06/21/2009
- maxfax I'm a Fan of maxfax 17 fans permalink

Now is not the time to back down.

    Favorite    Flag as abusive Posted 06:06 PM on 06/20/2009
- lastams I'm a Fan of lastams 50 fans permalink

While the Senate trys to kill an idea popular with three quarters of the American Public, House Democrats have but put a serious proposal on the table which would:

Establish a health care exchange where consumers can select from a menu of
health care options,
ensure that Americans have portable, secure health care plans ,
end increases in premiums or denials of care based on pre-existing conditions, age, race or gender,
eliminate co-pays for preventative care,
cap out-of-pocket expenses and
guarantee catastrophic coverage that would protect every American from bankruptcy.

One wonders what it will take for Baucus and the other Health Insurance stooges to put this genie back in the bottle,
But God knows, I’m sure they will try.

    Favorite    Flag as abusive Posted 12:40 PM on 06/20/2009
- fedupinfla I'm a Fan of fedupinfla 48 fans permalink
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Please sign these petitions!!

http://ga3.org/campaign/healthpetition?source=healthpetition

http://standwithdrdean.com/

http://www.americansunitedforchange.org/page/s/AMA

Let those in Washington know we DEMAND a public option!!!!!

    Favorite    Flag as abusive Posted 11:47 PM on 06/19/2009
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Wow, they really need some pro-single payer bloggers over at CNN!

http://politicalticker.blogs.cnn.com/2009/06/19/democrats-fear-obama-health-plan-on-the-rocks/

    Favorite    Flag as abusive Posted 05:29 PM on 06/19/2009
- power1 I'm a Fan of power1 4 fans permalink

Boy, Obama is really doing a good job of attacking those deficits.

    Favorite    Flag as abusive Posted 04:50 PM on 06/19/2009
- jwredd I'm a Fan of jwredd 50 fans permalink

See, this is the problem. At some point the public has to stop blaming the politicians for being spineless and wishywashy and realize that we are a finicky and easily manipulated body that loses it's nerve. We all came out and voted for change and big, bold initiatives yet when it starts rolling the opposition starts in with deficits and "how are we going to pay for it?". People like power1 spread the seeds of fear and we as a collective get freaked out, things get watered down or outright derailed and we end up with nothing new. If this doesn't work out it will be because we don't have the stomach for making the initial down payment and commitment and don't demand what we want and need. Unfortunately there are way too many power1s among us.

    Favorite    Flag as abusive Posted 12:20 PM on 06/20/2009
- Acidic I'm a Fan of Acidic 6 fans permalink

Your my hero! Well said

    Favorite    Flag as abusive Posted 09:18 AM on 06/21/2009
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Please someone tell me - how can President Obama expect CORPORATE OWNED POLITICIANS to vote for a HEALTH CARE BILL that would be "against" the interests & PROFITS of the HEALTH CARE INDUSTRY - that will NEVER HAPPEN!!

Is Obama naive OR a CORPORATIST hiding behind a YES WE CAN, CHANGE WE CAN BELIEVE IN facade??

    Favorite    Flag as abusive Posted 04:18 PM on 06/19/2009
- escribacat I'm a Fan of escribacat 298 fans permalink
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What is your suggestion? Dictatorship?

    Favorite    Flag as abusive Posted 01:44 AM on 06/20/2009
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"PUBLIC" FINANCING of political campaigns - TAKE THE MONEY OUT OF POLITICS! CORPORATIONS would no longer be allowed to BUY "our" government!

ALSO - TERM LIMITS! The President can only have two terms! Congressman max 5 - 2 year terms & Senators max 2 - 6 year terms!

Does that sound like a dictatorship?

PLUS - term limits would bring in new blood & new ideas, BUT most importantly "our" congressional "servants" would NOT be owned by the greedy, soulless, democratic devouring CORPORATIONS!

What do you think?

    Favorite    Flag as abusive Posted 08:12 AM on 06/20/2009
- greatscot I'm a Fan of greatscot 31 fans permalink

No Bill is better than a bill w/o the Gov't Option. A single-payer bill is best - everyone under Medicare!
A Huffposter wrote today - "Gov't Option Or A Third Party" That's a real do-able thing. There are about 50 million of us without health insurance; another 20 million whose insurance costs are rising beyond theitr ability to pay, and some 20 million workers who are 1 paycheck away from losing their coverage. That's 90 million people folks! We don't have to BEG the parasites for coverage; we can DEMAND it, and if they kill the public option we need to take notes and TURF THEM OUT at the next election. And don't let them start up about God, Gays, and Guns as a serial distraction. Keep focussed on Health care as the #1 issue and WE CAN GET THIS DONE! Congress needs to understand, we've been down this road before and been cheated, so we're somewhat experienced at that. We're done asking politely for a national health care system. Single-payer or a third party! Pass it on!

    Favorite    Flag as abusive Posted 03:56 PM on 06/19/2009
- Actionmac I'm a Fan of Actionmac 10 fans permalink
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PETITION TO SUPPORT HEALTH CARE REFORM:

Citizens for Real Health Care Reform
And a PUBLIC OPTION

http://ga3.org/campaign/healthpetition

    Favorite    Flag as abusive Posted 03:50 PM on 06/19/2009
- Acidic I'm a Fan of Acidic 6 fans permalink

Petitions are nice, but protests are better!

    Favorite    Flag as abusive Posted 09:24 AM on 06/21/2009

This is what happened the last time Ted Kennedy tinkered with Healthcare.

Richard Nixon's explanation of HMOs. "… the less care they give them, the more money they make."
Transcript of taped conversation between President Richard Nixon and John D. Ehrlichman (1971) that led to the HMO act of 1973:
Ehrlichman: "Edgar Kaiser is running his Permanente deal for profit. And the reason that he can - the reason he can do it - I had Edgar Kaiser come in - talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because -"
President Nixon: [Unclear.]
Ehrlichman: " the less care they give them, the more money they make."
President Nixon: "Fine." [Unclear.]

This is how it was foisted on the American people.
In the Senate, (Ted) Kennedy, author of the HMO Act, also encouraged its passage: ``I have strongly advocated passage of legislation to assist the development of health maintenance organizations as a viable and competitive alternative to fee-for-service practice. This bill represents the first initiative by the Federal Government which attempts to come to grips directly with the problems of fragmentation and disorganization in the health care industry. I believe that the HMO is the best idea put forth so far for containing costs and improving the organization and the delivery of health-care services.''

    Favorite    Flag as abusive Posted 03:00 PM on 06/19/2009

Perhaps now Kennedy sees the error of his ways?

    Favorite    Flag as abusive Posted 03:30 PM on 06/19/2009
- Lyr I'm a Fan of Lyr 35 fans permalink

If Kennedy sees the error of his ways he could have started with an immediate repeal of the HMO act, which he authored. I have a very hard time taking someone seriously who promises to protect me from the monster he created. First do no harm. Whatever made Kennedy, a man who is not a doctor think he could improve healthcare is beyond arrogance and into hubris.

    Favorite    Flag as abusive Posted 04:33 PM on 06/19/2009
- Acidic I'm a Fan of Acidic 6 fans permalink

Didn't Mr. Moore have that in " Sicko "?

    Favorite    Flag as abusive Posted 09:25 AM on 06/21/2009
- cvwilson I'm a Fan of cvwilson 11 fans permalink

This country's health care system is unsustainable and I think that the health insurance companies know it. Without a strong public option I think reform would be nothing more than a federal bailout in the form of us being handed over to them as captive customers via mandates subsidized by federal tax money. I think President Obama needs to do two things. He needs to let the Congress know that he will veto any health reform bill that does not include a public option. The second thing he needs to do is let every Democratic senator know that they will make a personal enemy out of the President of the United States if they do not vote for cloture. They do not have to vote for the final bill, but they will not participate in Republican efforts to keep it from a vote on the floor.

    Favorite    Flag as abusive Posted 02:37 PM on 06/19/2009
- Tulka2 I'm a Fan of Tulka2 250 fans permalink
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Right on!

    Favorite    Flag as abusive Posted 02:44 PM on 06/19/2009
- jwredd I'm a Fan of jwredd 50 fans permalink

Making enemies within his own party would lead to nothing but gridlock but the veto of anything not containing a public option is right on.

    Favorite    Flag as abusive Posted 12:41 PM on 06/20/2009
- olderdem I'm a Fan of olderdem 10 fans permalink

Public option or just forget about any reform. Time for Obama to go out can campaign again.

    Favorite    Flag as abusive Posted 12:35 PM on 06/19/2009

That's all he does is campaign...

    Favorite    Flag as abusive Posted 02:25 PM on 06/19/2009
- Tulka2 I'm a Fan of Tulka2 250 fans permalink
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Hello? This is what having the presidency is good for. It's the "bully pulpit". The office is for educating and leading. It's what we elected him to do!

    Favorite    Flag as abusive Posted 02:34 PM on 06/19/2009

Did you like it better when Bush and Cheney went to their undisclosed locations, made decisions, and then lied to us after the fact to justify those actions?

How soon we forget...

    Favorite    Flag as abusive Posted 03:31 PM on 06/19/2009
- 1dogs2 I'm a Fan of 1dogs2 122 fans permalink

I've come to the conclusion that Harry Reid has to be removed as Majority Leader -- NOW. It's time for Dick Durbin to take that position and replace incompetence with competence and timidity with courage. How could a competent leader allow an incomplete bill to be assessed by the CBO? How could he let a bill that has not dealt sufficiently with cost issues be assessed by the CBO? No doubt the drafting process has suffered from Sen. Kennedy's illness and consequent inability to attend to the details of drafting and to the political atmospherics -- but somebody had better pick up the reins and GET THIS DONE! The difference between Speaker Pelosi's leadership and Reid's is night and day.

    Favorite    Flag as abusive Posted 12:09 PM on 06/19/2009
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