Advice to President Obama: Look Left, Right and Then Stick to the Center

I happen to be a liberal Democrat. And I think I'd probably prefer a single-payer system similar to Canada's -- in which the government guarantees all adequate health care but private medicine is still available.

But I also understand there are grave and legitimate concerns in this country about a socialized medical system. And since we live in a democracy, we Democrats should try to avoid running over people, even though we have a majority in both houses of Congress, just because we can -- not on an issue representing nearly one-fifth of the nation's economy.

So I am shocked at the strident attacks on President Obama in recent weeks from his base, his hard-core supporters on the left, because he and his White House colleagues have suggested that they could ultimately support legislation this year that will take a substantial step toward reforming America's health care system -- but may not include a "public option", i.e., a government-provided insurance program to compete with private insurance policies.

For example, I have heard some members of the House Democratic progressive caucus and liberal cable TV talk-show hosts and guests actually state that they would rather have no health care reform legislation this year at all if there is no "public option." And in recent weeks at least some liberals on TV and the blogosphere are actually already talking about running someone in a Democratic primary against Mr. Obama in 2012. With such friends....

Therefore, at the outset of his speech to Congress, Mr. Obama might want to turn to the Democratic side of the House and ask his fellow Democrats:

"If we can guarantee access to quality health care for almost all Americans, would you really prefer no bill at all because we can't pass a public option this year?"

Then he should ask: "Is there anyone among my Democratic friends who take that position who do not have any insurance? I doubt it."

Then he should turn to the Republican side of the aisle, and ask:

"How many of you believe that there are death panels favored by Democrats? How many of you believe that we want a socialized system when you know what we have proposed preserves everyone's current private insurance policy options? How many of you agree that it's okay to lie and distort and shout other people down who may support health care reform rather than engage in honest and respectful debate?"

Then he should say:

"I respect all of you who disagree with me on this. And I assume you are just as disgusted by these voices of hate and distortion on your side of the aisle as I am -- and that you want to work together with me and your Democratic colleagues to come up with a solution that most of us can support."

And then, it would be time for the pivot to propose a health care plan based on principles that the Great Center of American politics can support -- one that (1) mandates that all employers provide insurance; (2) mandates all insurance companies to provide adequate coverage regardless of pre-existing conditions or other loopholes; (3) institutes cost-cutting and structural reforms to reduce overall health care costs that, if left unchecked, will bankrupt us; and (4) subsidizes premiums for the poor and the lower middle class and as many people as possible within the limits of today's soaring deficits and continued recession.

That may mean that, for this year at least, public subsidies might not cover 100 percent of all uninsured Americans, depending on how well the rest of the program demonstrates reduced health care costs.

"There's always next year," he could say. "Let's see how we do in our first year or so with the new system -- including whether public exchanges and possibly co-ops can provide competitive pressures on insurance companies absent a public option."

One little-noticed proposal has attracted an ideologically breathtaking span of senators and seems to have been unjustly overlooked in the debate: the Healthy Americans Act, sponsored by liberal Democratic Sen. Ron Wyden of Oregon and conservative Republican Sen. Robert F. Bennett of Utah. The amazing list of 15 co-sponsors includes eight Democrats, such as progressives Bill Nelson of Florida, Debbie Stebenow of Michigan, and Maria Cantwell of Washington, and seven Republicans, such as conservatives Bob Corker of Tennessee, Mike Crapo of Idaho and Charles E. Grassley of Iowa.

I had heard about this bill but never took the time to look it up and research it. How is it possible we know so little about it? And why hasn't Mr. Obama invited these 15 senators to the White House to have them explain it better? Maybe he should before his speech Wednesday.

The basic idea of the proposal is, in effect, to "liquefy" everyone's current employer-provided health insurance policies -- i.e., require all employers to pay in cash to each employee the actual cost of that individual's insurance policy, and that extra compensation would have to be used by each employee to purchase health insurance policies. All those receiving this boost in pay would receive a tax deduction, varying in amount according to their income -- i.e., you get some or all of the tax deduction the employer currently gets for paying your insurance.

Those employers who do not insure their employees would have to make an "employer shared-responsibility payment," the amount depending on their revenues and size of their work force, as would all self-employed individuals and all those who do not have insurance and can afford to make this payment.

These new sources of revenue for the federal government, plus higher revenues owing to elimination of various currently applicable tax deductions and credits, would finance the cost of subsidizing the premiums of those who cannot afford to pay for private health insurance -- 100 percent for those at or below poverty level and a sliding scale of subsidies on up into the middle and upper-middle class.

And here's the most remarkable fact:

The Congressional Budget Office and the Joint Tax Committee have determined that the plan would be deficit neutral during its first two years (spending would be offset by these increased tax revenues), after which time, the plan would generate net revenue. Meaning, it would help reduce the deficit, rather than increase it ... amazing!

I understand that there are offsetting concerns to this Wyden-Bennett proposal -- the most serious being it may be risky to put too much faith in the ability of individuals to make the right choices when it comes to the complex world of health insurance options. (Remember Grandma not being able to figure out all those complicated prescription-drug insurance policy options?)

But the bill sets up state "Health Help Agencies" to explain, coordinate, and make all private insurance options available -- plus private-market insurance brokers are still going to be around to offer advice and assist in making the right choice for each individual or family.

In short: With such a broad, bipartisan group of senators to work with, the Wyden-Bennett plan may be a better place to start than what we have seen to date.

So, good luck Wednesday night, Mr. President. If this were a basketball game, you would fake left, then right, and then drive hard into the bipartisan center lane to sink the winning basket -- the lane where most voters are and where the country sorely needs you to be.

Lanny J. Davis, a Washington lawyer and former special counsel to President Clinton, served as a member of President George W. Bush's Privacy and Civil Liberties Oversight Board. He is the author of Scandal: How 'Gotcha' Politics is Destroying America. This piece is also published at http://pundits.thehill.com and appeared on Monday, September 7, 2009 in Mr. Davis's regular Monday column in the Washington Times called, "Purple Nation."

Comments

[freelyb]

This fine and friendly point of view does nothing to address the source of the biggest costs in medical spending and in human lives--the for-profit motive behind our current care. All those rosy outcomes that Davis mentions have no basis in reality. He fails to take into account the voracious hold that greed and power have over those in charge. This is a whistling-in-the-wind fantasy from someone who doesn't usually dig too deep.

[Doofus]

I never agree with Lanny Davis, but this
time I do, so now I am worried about that.

[Doofus]

All things being equal, I'd still prefer that we end up
with the same arrangements that Congress members
& the President have, and the other way around.

[Json]

I haven't bothered to read anything from Lanny since his horrific "should we prosecute Cheney?" articles. (For those of you that missed it, first he argued that we shouldn't because it would be a big hassle, then in the next article he said we should, but only because Cheney was really being a jerk.)

And while the subject has changed, his views clearly have not. Political expediency still seems to be the highest aspiration in his mind. Ignore the fact the the republicans have no interest in reform and have said so publicly...strive for the "center".
Obama stated a while back that a public option is a vital part of the reform package. So given that, I hope he ignores Lanny, and listens to the voices saying "Do what you believe...even if it is difficult...even if it will cost you political capital."
He ran on a platform of "change"...is it really that outrageous to expect some?

[splinky]

An interesting proposal.

Hey, I have a new idea: let's do that with Social Security, too--instead of withholding money from pay for a government run boondoggle like Social Security, we could let everyone invest their own money in their own 401(k) plans.

Oh, wait, maybe I've heard that somewhere before.

[raechel]

Advice to the President: Tell us what you think the best solution is to the health care crisis. Tell us why you think it's the best solution.

Advice to the rest of us: Listen.

[max hp]

Nop, You got it all wrong.

The correct answer is:

Look Left, Look Right and LOOK LEFT AGAIN.

A Public Option is the right answer - it's what's LEFT, when you remove the Insurance companies.

[Helzapoppin]

"If we can guarantee access to quality health care for almost all Americans, would you really prefer no bill at all because we can't pass a public option this year?"

Yes.

Access is not affordability. And unaffordable access is not access at all.

[LeLoup]

Agreed!
Furthermore, let's define "almost", shall we?

[Moose49]

The public option IS the centrist position. It is the compromise between those on the left who want single-payer and those on the right who don't want any government involvement. The mid-point.

[Doofus]

This is what happens when you compromise too soon, I think.
If single-payer is sheer fantasy, is public-option 'plausible' fantasy?

'Would you really prefer no bill at all, if there's no public option?'

To insist on a public option, if not single-payer, is to go 'all in'.
If there's no bill at all, then what will happen in next year's
election? Will irate Demos seize the moment and toss out
most Repos? Or if 'too liberal healthcare' is enacted (which
would be practically anything at this point), will Repos prevail?

What to do? WHAT to do?

[Moose49]

I think you hit the nail on the head when you talk about compromising too soon.

You fight like hell for what you believe in, but if the votes aren't there, you compromise but you bargain hard to get something solid in return. I still believe it's possible to get the votes for public option, but I could live with a bill without IF in return, we get 1) sufficient subsidies to ensure that every American really can afford to buy health insurance; 2) tougher regulations in insurance companies not only to ban the use of preexisting conditions and rescissions but also routine denials of claims, interference in treatment options and refusal to cover care that your doctor believes is necessary; and 3) a REAL trigger that would kick in if people's needs aren't being met.

[BBackSoon]

I only managed the headline and about three sentences of this bullshite appeasement tripe.

No I will not settle. This topic is only available for discussion or actual legislation once a generation and this is our chance. If we settle for some, next time or Triggers or any other smoke and mirrors we might just as well start planning on spending more on our insurance than on our houses. And I for one am already there.

[Ariadne]

Single payer is the answer.

[kathyNAM]

Lanny- you lost any credibillity you may have had when you signed on to work at Fixed news. Luckily I don't think the President will ever look to you for advice- but I have some for you- go away and be quiet.

[mcmchugh99]

I am a progressive who donated $4,600 to Obama, and I am shocked that they would even think of passing a "reform" that would require everyone to buy private health insurance with no public alternative at all.

If I know anything about American capitalists, it is that they will milk a mandate like that and rip off the consumers without mercy. They do that every day in every way, and I don't believe they will be regulated at all.

[freelyb]

Exactly.

[brt929]

Mr. Davis:

You consider yourself to be a "liberal" Democrat? Your record, especially your recent stand on the Employee Free Choice Act contradicts that completely.

Since you make your living as an attorney for corporations and government contractors, excuse me if I doubt the veracity of your statement.

You are a sell out, and that is clear if you would champion the Healthy Americans Act, which would only benefit the Insurance Companies. Not only would the Employer lose the tax benefit of paying for the employees' coverage, but the employees would lose their group rate, and you would probably end up with even more uninsured.

Ask anyone that has been in the insurance business, they will tell you that is the most bone-headed idea. I'm surprised at Senator Wyden, I thought he was smarter than that.

Let's take the onus off of the employers, since they have clearly lost the battle with the insurers.

Universal Health Care would shore up Medicare and Medicaid, and it would end the manipulation of Health Care costs by the Insurers.

The Insurers will continue to sell supplements, and they will still continue to make great profits.

[altohone]

A right-wing corporatist coup supporter and financial beneficiary doesn't seem like quite the right person President Obama should be listening to for anything.

The Clintonian DLC'ers are the ones defying the will of 70% of our citizens who know the public option is the only way to fix the failures of the current system that puts profits first.

[swansong50]

I agree whole heartily with you altohone. We're done with the DLC crowd. He's difinitely NOT a liberal. That's his first lie...

[bichn]

Forcing taxpayers to buy private health insurance is just a bail out to the industry. That is offensive beyond the pale. Insurance companies will not cut premiums if they don't have too and without a public option they won't have to. People could wind up paying more (yet again) for less. Sorry but the fact that the health insurance industry would gladly support reform - but only if no public option is included - speaks volumes. The public option could have an immediate impact on premium costs. And, quite frankly, the government is too out of touch with main street to understand what a person can really afford. In one of the several bills being considered they talked about up to 400% of poverty or $43,000, which puts the poverty level at around $8,500....SERIOUSLY? If you are making $43,000 in Detroit that might be alot of money but where I live I could not even afford my house payment, car payment, utilities and food much less health insurance and yet $43,000 is 400% of poverty level? And if I don't BUY it, I will be penalized? In a couple of the bills floating around the insurers are responsible for paying less of that premium to actual health care leaving the insured to pick up the tab. Sorry, but with no public option taxpayers should not be forced to buy from the private insurance industry who have consistently screwed them for YEARS. No deal.