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Obama, FDR, and the Politics of Health Care Reform


"I agree with you, I want to do it, now make me do it."
-- Franklin Delano Roosevelt

Facing what is likely to be the defining political struggle of his presidency -- the battle for health care reform -- President Obama emphasized in a town-hall meeting earlier this month that the "lobbyists and special interests are what is going to end up carrying the day" unless "ordinary Americans... stand up and say, 'Now is the time.'" With the deep-pocketed health care industry reportedly spending $1.4 million a day to oppose any fundamental change, the need for a countervailing popular movement could not be more urgent.

Yet shortly after this eloquent call for public pressure, President Obama then moved to undermine it, telling Congressional leaders that grass roots groups such as the Service Employees International Union, MoveOn, and Democracy for America should stop pressuring wavering Senate Democrats to support more robust reform. While continuing to express support for a public plan, President Obama has conspicuously refused to draw a line in the sand on the issue. At the same time, White House Chief of Staff Rahm Emanuel has repeatedly communicated that the Administration might be willing to support health care legislation that abandons the public option altogether.

Obama's awkward attempt to deflect grassroots pressure could not be more different from the stance taken by Franklin Delano Roosevelt, who famously said after his election in 1932 to a group of labor leaders pressing for favorable legislation, "I agree with you, I want to do it, now make me do it." What Roosevelt understood was that demands from below -- even clamorous ones -- were a resource for a president who aspired to be the architect of major social reform.

FDR's steadfastness of purpose and his ability to capitalize on grassroots pressure were nowhere more visible than in the battle over the Social Security Act -- the piece of legislation that, more than any other, defined his domestic legacy. In an eerie echo of the problems Obama is facing today, Roosevelt faced Senate opposition from within his own party . The leader of the opposition was a conservative Democrat from Missouri, Bennett "Champ" Clark, who sponsored an amendment that would have allowed employers to opt out of Social Security. The amendment enjoyed widespread support, passing in the Senate with over half the Democrats voting for it as well as all but three Republicans.

But Roosevelt and his supporters stood firm, recognizing that the Clark amendment would fatally undermine Social Security by narrowing the contribution base, limiting universality, and destroying portability (the ability to carry the pension from job to job). Promising to veto any legislation that included the amendment, the Roosevelt administration -- crucially assisted by its allies in the more liberal House of Representatives -- kept it out of the final legislation, the landmark Social Security Act of 1935. In the words of political scientist Jacob Hacker, a leading expert on the history of public and private social benefits in the United States, "Social Security passed not because Congress wanted it but because Roosevelt demanded it."

By unwaveringly insisting on a vigorous public plan and promising to veto any legislation that does not include it, President Obama could play a role similar to that of President Roosevelt in protecting the integrity of the Social Security Act. Certainly, the President is an able and articulate defender of a public plan. In a powerful critique of the logic of those who claim that a public option would drive private insurance out of business, he has pointedly asked: "If private insurers say that the marketplace provides the best quality health care; if they tell us that they're offering a good deal, then why is it that the government, which they say can't run anything, suddenly is going to drive them out of business? That's not logical." And, as he rightly notes, a public plan can keep down administrative costs, provide more options, and -- most critically -- force the insurance companies to compete.

It is precisely because a public plan is likely to bring down costs that private insurance companies oppose it so vehemently. Their fierce opposition unquestionably poses a formidable political problem for the President. But this is a battle that can be won, especially if a substantial number of members of the House of Representatives, emboldened by grass-roots pressure, make clear they will simply not vote for any legislation that lacks a robust public plan.

With opinion polls showing wide popular support for a public option, this is the time for President Obama to set aside his deep-seated instinct for compromise and to show the kind of steely resolve President Roosevelt displayed in defeating the Clark amendment. Obama's ability to rise to this challenge will do much to determine not only the fate of health care reform, but also whether he will join the ranks of that handful of presidents who have increased the security of the American people against what FDR memorably called the "hazards and vicissitudes of life."

 
 
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03:40 AM on 07/17/2009
Why is it that the Republicans are so Dead set against any type of Health care Reform? Because it's a Democratic idea. Anything that the Democrats are for, the Republicans are against. It's that simple.
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surferjay
08:52 PM on 07/16/2009
Why is our health care so expensive and poor? Could it be the billions of dollars that insurance and drug companies have given to the congress over the years?!
01:31 PM on 07/16/2009
Thanks for this great retrospective on the passage of the Social Security Act. Yes, it is similar and this is the point where Obama will rise to the pantheon of great Presidents or down to the place of wannabes. I pray everyday that Obama has the wisdom, backbone, and tenacity to draw a line in the sand at the public option. Because just like the Clark Amendment, if the public option is removed the health care reform bill will turn into a nightmare where people are forced into the hands of the profit driven insurance companies whose draconian methods do nothing but alienate people, and the taxes of many will go up. This is a recipe for political disaster. It's heatlh care reform with only the downsides remaining and the upsides stripped out.

I suspect that Obama knows this. Now it's a matter of him doing the politics that allows him to pass a good bill that will do for the American public what social security did. We're so ready for the next FDR in this country. I'm pleading with the powers of heaven that Obama ends up being that man.
01:07 PM on 07/16/2009
The only true reform in healthcare is a single-payer plan. The new bill is a concession to the insurers, who ruined our economy, and have gouged Americans for years. The bi-partisan support Obama sought was a sell-out to those representatives who pander to their benefactors (lobbyists, corporate donors, special interests), and ignore the needs of their constituents, districts, states, businesses and the nation's economic future viability.
Critics of a single-payer system scare us with "rationing" and socialized medicine run by government bureaucrats. Insurers deny coverage to those with pre-existing conditions or a propensity for any illness (based on family history). Insurers give doctors incentives to avoid or delay costly medical treatments, while gouging them for liability premiums, which forces them to order needless tests as part of their "defensive" practice, and routinely deny claims for legitimate necessary treatment. Any individual pays premiums for years, then when a major illness or injury occurs, the person's coverage is dropped or premiums soar exponentially. This is de-facto rationing for profit. As for cries of "socialized" medicine, one could look to most European nations, which offer cradle-to-grave medical care that often includes prescriptions, dental care and vision care for a fraction (less than 40%) of what we pay for limited benefits. Their businesses are more competitive and profitable than our small businesses, as they pay scarecely 25% for employee benefits what US companies do.
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Joseph A. Palermo
Author/Historian
11:58 AM on 07/16/2009
Now is the time. We cannot afford the current system. It hamstrings American enterprise and fails the test of a moral society. It's a classic market failure.

http://axisofreason.com/2009/07/13/us-private-health-insurance-classic-market-failure/
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wilsonveteran
Free America End Big Government
10:47 AM on 07/16/2009
ISN'T THIS NEW PROGRESSIVE WORLD JUST GREAT.

Thank you President Obama for taking over those evil financial institutions. Now we can get homes no matter what our income because the government will pay for it. It is our right to own a home and so what if the government tells us where to live.
Thank you President Obama for taking over those evil car companies and giving one to the Union. We all know that the Union and government will take care of us. Now we can all have a car so what if you tell us what to drive.
Thank you President Obama for taxing the rich more. Now you will have money to run our great government that gives us so many. We don't need the rich anyway because government will give us what we need. So what if they tell us what to do. Those rich can just go to other countries.
Thank you President Obama for taking over the health care industry. Now we all can have free health Care. So what if you ration it and tell us how to live it is for our own good.
Thank you President Obama for ruining business an those evil oil companies with Cap and Trade. Now we can have a greener friendlier country. We don't care if we don't have jobs and that you tell us how much energy we can use because government will take care of us. It is our right isn't it.
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Gudrun
My micro-bio is empty
11:38 AM on 07/16/2009
We were losing jobs steadily under Bush, and millions had no access to health care. Have you really been paying attention to what has been going on in this country for the last decade, or did all these problems pop up simply when a Democrat got back into the WH?
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wilsonveteran
Free America End Big Government
11:48 AM on 07/16/2009
Bush inherited a small recession when he first took office an we then had 6 years of a good robust economy with Bush and a Republican congress. In 2006 the Democrats took control of Congress an the recession started. Coincidence or what. You make the decision.
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surferjay
08:50 PM on 07/16/2009
The insurance and drug companies are ripping you and your family off- big time. Don't you care?! The congress has single payer, the military has single payer and the elderly has single payer as do most democratic countries!
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10:23 AM on 07/16/2009
Yes, Mr. President ... NOW IS THE TIME FOR SINGLE-PAYER HEALTHCARE FOR ALL. Many have been saying it and you refuse to include it now that you have been elected.

I am a MoveOn Council member and I have been dismayed at their lack of making a stand for single-payer ... true reform. As an Independent, I have been taken by the PDA (Progressive Democrats of America) and their eloquent stand for single-payer healthcare for all. Healthcare Not Warfare is a steadfast mission that includes so many facets of this very broken system we now have. Broken by the very companies who have profited off our brokenness - insurance companies, Big Pharma and hospital conglomerates. Like the banks, they are protected by many in our government and truly mandate what we will be subjected to as citizens of what has increasingly become a third world.

MoveOn ... you have been successful at getting people out to vote ... a decisive drive. Now is not the time to be on the fence and concede to policy that truly isn't in the best interest of the majority in our nation. Single-payer healthcare for all as noted in House Bill HR 676 is the decisive drive each of us should mandate at this time.
outnow
Ban the bomb
09:29 AM on 07/16/2009
Things could get very tough in America for a variety of reasons all of which would involve providing emergency medical care. For the security of the citizens in situations involving infectious dieases, do you want your neighbor turned away from treatment?

Obama needs to understand that he is compromising with the insurers and the bankers at the expense of the vast majority of citizens will futher undermine his credibility and cripple the US in many ways, not the least of which is emergency preparedness.

I have worked in medical quality issues for over thirty years. Not only is the HMO model flawed but bean-counters should not ration care. Even with private insurers that happens, so why not have the governemnt expand a single-payer system. It is much more efficient and already in place.

Obama should learn how to say "NO" to lobbyists and campaign contributions from investment bankers and insurance companies. These people do not have our interest at heart and there are good alternatives. Hang tough or we will all suffer. FDR knew this truth. Obama needs to find his spine and seek the truth. He cab still be a hero but only if he walk the talk.
10:46 AM on 07/16/2009
"...Obama needs to understand that he is compromising with the insurers and the bankers at the expense of the vast majority of citizens...."

No, he understands it full well. He doesn't care.

I no longer believe even the majority of his campaign contributions came for ordinary citizens, they came from corporate donors, his "change" from progressive to DINO is proof of it.
11:49 AM on 07/16/2009
I have been wondering the same thing. And I sure wish I had my $1600 back. He'll never get another dime from me, he has been too huge a disappointment.
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susangg
Susan in Bocas del Toro,
09:15 AM on 07/16/2009
Absolutely! The house bill is NOT satisfactory. We don't need an "exchange" of profit taking paper pushers. We need to ELIMINATE profit taking paper pushers. The only way to do that is to have a strong PUBLIC PLAN that anyone can buy into with subsidies for the very poorest Americans who can't afford to pay anything. Let the PTPP's "compete" on the open market. They can't of course (they are right about that),because 25-35 per cent of the health care dollar given to them goes to pay for things other than health care - corporate profits, dividends, advertising and marketing, fancy office buildings and private planes for the CEO, multi million dollar salaries for the head honchos, private investigators to root around and look for ways to retroactively deny you coverage, "utilization review" ("we won't cover that"), etc. etc. We can't afford it. We need that money to pay hospitals, doctors, nurses, physical therapists, etc. etc.
Any bill that does not include a public option, available immediately, to all who want it, should be rejected. We must have reform, not window dressing.
Peabodies
We are the Many. They are the Few.
12:01 PM on 07/16/2009
hear, hear, susan.
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StevieRae
Neutralize "being primaried" by voting
08:53 AM on 07/16/2009
Anyone truly interested in seeing major reform in our healthcare system should forward links to Bill Moyer's Journal show featuring Wendell Potter. This insider's story is an important lesson for Americans who need to understand what the industry, its lobbyists and "in the pocket" legislators will be doing in the upcoming weeks to defeat reform.
It also explains why a public option is so critical to providing needed competition to the "for profit" health insurance companies.

Spread the word and help educate:

http://www.pbs.org/moyers/journal/07102009/profile.html
Peabodies
We are the Many. They are the Few.
12:06 PM on 07/16/2009
Also visit Michael Moore's website --

http://www.michaelmoore.com/sicko/checkup/

His movie SiCKO is to be shown on The Movie Channel tonight, and repeated in the next few days. Details on website.

I rented the video from my local outlet (for those who don't subscribe to the premium channel).
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GrannyForObama
08:37 AM on 07/16/2009
As a frequent visitor to Canada, I can only repeat comments I have made before that Canadians are very happy with their healthcare system and would never, ever trade it for ours. As someone has commented here, it is a straightforward system, easy to implement. What people have to remember is that the media reports on EXCEPTIONS and never the rule. The problem with this is that exceptions are never presented as such. Therefore, they will find a Canadian who has had a bad healthcare experience and present that as the RULE when in fact it is an exception to what is a good universal healthcare system. Imagine never having to worry about getting healthcare coverage. Imagine if you are a business owner never having to worry about purchasing ever more expensive coverage. Imagine if you are someone who, God forbid, gets a serious illness - never having to worry you will be "laid off" and thus lose your coverage at the time you most need it. Mr. President & Congress, "Keep your eye on the prize and hold on..."
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05:04 AM on 07/16/2009
I've been a big supporter of Obama, and I still love the guy, but the warnings during the presidential campaign, that he's a compromiser, not a leader, are looking pretty acurate.
He always stops just short of absolutely demanding a strong public option. That tells me (and I'm sure Republicans and blue dog Dems,) that he'll accept a compromise.
I'm sorry, but a strong public option is all the compromise we can afford. Everyone with an ounce of sense, knows we need some form of single payer. The debate going on in Congress right now, should be about what the particulars are of a US single payer health care system.
If Obama signs a watered down health care bill, on top of the watered down credit card bill, weak stimulus package and all the other "compromises" we've gotten and should then expect in the future, he's a one term president.
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dogdiva
08:24 AM on 07/16/2009
I agree. I think his intentions are good, but I've learned that he seems to value his philosophy on compromise more than righting wrongs. It's getting pretty obvious that there is more insight in what he doesn't say (or refuses to say) than what he does say. Oddly I think all his talk on bi-partisanship during the election has turned out to be a killer. It's created a wonderful shield for Republicans. Of course many in the Congress have backed him up. The Dems have elected so many conservatives that their party numbers might be larger, but their votes aren't there and it's pulling the party to the right. Considering what has happened to the United States, especially in the past 10 years, the "incremental" approach and "centrist" are probably nails in the coffin.
11:51 AM on 07/16/2009
Why do you think his "intentions are good"? Based on what, his speeches? How about checking out his actions? From where I sit, we have another democratic president from the corporate wing of the Democratic Party. Hillary would have governed the same way. The only silver lining: At least we don't have the Clintons in the White House again.
09:14 AM on 07/16/2009
...he's a one term president.

We can only hope. That would be change America could live with. (Assuming this regime doesn't wreck the entire economy by then).
01:18 AM on 07/16/2009
I'm on lots of democrat email lists, and all the activists see this public option as the first step towards a single payer system run by the government. And they're right. That's why the public option is non-negotiable for many progressives - despite there being widespread, bipartisan support for many aspects of health care reform issues.
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12:31 AM on 07/16/2009
We need another FDR. The greatest leader we've ever had as president IMO.
09:24 AM on 07/16/2009
I agree with your opinion that FDR was definitely a leader.

The problem with the FDR administrations was that the expansive growth of the federal government included economic time bombs that are plaguing the US to this very day. Just about the time they started to subside, JFK authorized public employees to form labor unions and his successor, LBJ, unleashed the poorly crafted "war on poverty." This current socialist regime may deal the fiscal death blow to the American economic engine if saner heads do not prevail in the halls of the Senate. How many "czars" as BHO appointed so far? I lost count. National unemployment is headed to depression-era levels. Sad fate for a once great nation. And the origins of this movement began with FDR.
Peabodies
We are the Many. They are the Few.
12:11 PM on 07/16/2009
chilito -- you spout revisionist history. What has poisoned our society is the ideology started 30-40 years ago by the likes of Lewis Powell and Richard Viguerie, and continued by Roger Ailes and Rupert Murdoch and Karl Rove. They hated the New Deal, and set out to destroy it, one pillar at a time. They almost succeeded. Which is why it's so disheartening to see President Obama fall for their tricks. Bipartisanship, my foot!
09:31 AM on 07/16/2009
You might want to double check that. Ask any Japanese American person who lived in the 1940s and see if they loved it when FDR kicked them out of their homes and threw them into camps for the rest of WWII. FDR also tried to pass an amendment that said, all supreme judges had to retire at age 71. Interestingly the court had 8 judges that were 71 and older, so that would mean he would get to pick 8 new judges (the other judge was 70 years old). He also tried to increase the court to 12 so he could add more judges that would follow him. You see, the social security insurance act was seen by many, and also his top advisors, as unconstitutional and they believed the court would block its passage. Sure he did some things that were somewhat good, but I wouldn’t go as far to say he was "the greatest leader", at least not for our Republic.
10:53 AM on 07/16/2009
The sin wasn't FDR's alone. Racism ran deep in America and FDR wasn't free of it. It took his wife's insistance to create the first combat aviation training for African-Americans.

But a significant element of the racism was actually due to wealthy conservative Californians who wanted the property of those Japanese-Americans. Their property was sold pennies on the dollar at tax auctions because owners didn't have any income with which to pay property taxes.